AMA President: Health policy and "desperate needs"
Andrew Jackson The Australian Medical Association (AMA) has traditionally been an enemy of bulk-billing and Medicare but the health scene is changing quickly and the AMA has now fallen out with the Federal Government's agenda which is to promote the corporate take-over of the health system and medical services. The AMA is resisting the Government supported push by big corporations and private health funds to introduce the American type "managed care" health system which would remove from doctors control of medical treatment and fees. The impact of this situation can be seen in the address by the ANA President, Kerryn Phelps to the National Press Club on July 18. Below are extracts from her speech. The fact of the matter is that Medicare — the heart of our health system - - is in strife. An efficient Medicare sets the Australian health system apart from those, say, of the United Kingdom or the United States. If you tune in to watch Chicago Hope or any of the other popular American hospital dramas, you will get a glimpse — a frightening glimpse - - of the patients' and the doctors' point of view in the managed care style of medicine. This is the system where administrators and clerks — removed from direct contact with patients — make decisions about what treatment doctors may offer to patients, based on cost. What is more frightening is that health officials in this country have been examining elements of both the US and UK systems to trial here. We must not let that happen. Funding Some of the problems can be solved by addressing funding shortfalls. Earlier this year, the AMA presented our Health Budget Submission to the Government. It talked about public hospital funding. It talked about the need to properly fund and manage health programs for Indigenous Australians. It talked about anti-smoking programs, and programs to combat alcohol and drug abuse — some of the biggest killers in our community today. Needless to say, at the time, the AMA Budget Submission was totally ignored. Aged care While the public hospital system is in a constant state of crisis, the aged care sector is in a state of despair and disrepair. The number of residential aged care places has risen by less than 10,000 in the past six years ... in an ageing population. Old people are still waiting in hospitals for beds in residential facilities to become available — so there is still a high level of unmet need. There also needs to be improved access to aged care services for people with special needs, and older Australians in rural and remote communities. The staff in Residential Aged Care facilities play an essential role in the delivery of quality care to older people. However, nurses in private aged care facilities receive lower wages than nurses working in hospitals. The work is demanding and often demoralising. Little wonder that there is a drought of nurses prepared to work in aged care. We need to see increased wages for nurses which reflects their real worth, and a national training strategy for all workers in the aged care industry. Rural Australia One of the most glaring inequities is the difference in access for people living in rural and remote parts of Australia. It is impossible to take an economic rationalist view of health provision in rural Australia. The tyranny of distance and the small populations mean you are working with a completely different set of fundamentals. We need to develop national standards to ensure equity for all Australians and to ensure that governments are held accountable for the delivery of quality health services to every Australian community. It is time that significant elements of health policy in this country were treated as a national treasure ... to be elevated as much as is practical above party politics. Health will be the Number One issue for the next election and beyond. You cannot be a Clever Country or a Knowledge Nation or an Ideas Island or a Learning Landmass or a Tax Territory unless you first take care of the health of your people. The next government must put in place a long-term plan for Australia's health system, for Medicare. Indigenous Health Indigenous health is another area of desperate need. It is a national tragedy that needs a more dignified response than the argy-bargy of party politics. Indigenous Australians have the worst health of any group in Australia, with lower life expectancy at birth. Indigenous parents can expect to lose their babies at a rate two to four times higher than the national average, and indigenous men and women can expect to live 20 years less than non- indigenous Australians. Chronic diseases are the leading cause of premature death. Other countries have bitten the bullet and significantly improved the health of their indigenous populations. Australia has not. The message received by the AMA Taskforce in Indigenous Health is that there needs to be a quantum leap in funding for Indigenous Health if progress is to be achieved and the cycle of ill health broken. At least an extra $245 million per year is necessary to fund Indigenous health services. Such an increase was not forthcoming in the recent Federal budget. It is also essential that the basic infrastructure such as clean water, sanitation, appropriate housing and transport — taken for granted by other Australians — is available to all Aboriginal and Torres Strait Islander communities irrespective of where the communities live. Underlying all these matters, however, is the fundamental matter of the relationship between Indigenous and non-Indigenous Australians. The issue of a treaty is being taken forward by ATSIC and by Aboriginal Land Councils. Today I announce the AMA's support of their efforts. Until there is an unassailable commitment in the form of a contract to overcome the poverty and desperation of our most disadvantaged citizens, we are not taking the issue seriously enough.