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2015: a year of action on many fronts

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It has certainly been a year of pressing issues for the Council of Salaried Doctors. Some we’ve been directly involved in, others we’ve observed with interest. There are too many issues to cover in detail, but here are the highlights:

Bullying and harassment in the medical workplace

You can’t be precious when you work in a medical workplace. People say things in the heat of what is frequently a tense health care moment that may shock those from other environments. At other times, staff need firm direction, even performance management. Australian workplace law recognises that “reasonable management action” is not harassment.

The key thing for us is to recognise when things can go too far, or when there is deliberate sexual or other harassment of a staff member. That is not acceptable, and we must speak out about it. The AMA, along with its associated body, the Australian Salaried Medical Officers Federation, is developing a Position Statement on sexual harassment in the medical workplace to give doctors a framework for appropriate behaviour and responses to harassment.

End of Life/ palliative care

Demand for palliative care is increasing as our population ages. Patients and their families are seeking access to services to provide relevant care to people who are actually dying from their chronic and complex conditions. 

Gaps remain, as our health system is not always able to offer the care that is sought. In an ideal world, governments would work together to provide the necessary funding, as well as a strong legal framework within which patient-centred palliative care can be conducted with dignity and certainty. We intend to keep this important issue in our sights.

Employment issues

Once again, the medical workforce has faced challenges to its structures and ability to cope, particularly related to teaching, research and substitution.

The China-Australia Free Trade Agreement may allow Australian health care providers to set up private clinics in China, but its effect on pharmaceuticals and other areas of health care in Australia are, as yet, undetermined.

Activity-based funding has created a situation where funding models may not adequately compensate hospitals in certain areas, leaving salaried doctors to do more work with fewer resources.

The appearance of hospitalists has been considered by the Committee and the Industrial Coordination Meeting (ICM). There aren’t many yet, but numbers are likely to increase, so we are monitoring the situation, and there will be an update of our Position Statement. We don’t want the hospitalist role to usurp that of either Visiting Medical Officers or Doctors in Training.

Safety of doctors in the workplace

The AMA has highlighted evidence that doctors are at greater risk of stress-related problems than the general population. This is why doctors’ health services are vital to both the profession and the public good.

Doctors need physically safe workplaces. They need to be sure that they are safe from hostile patients. Sound policy and proper funding are vital to this. The AMA is reviewing its Position Statement on Personal Safety and Privacy for Doctors, and the Committee is providing valuable input.

The Australian Border Force Act (ABF Act)

The ABF Act threatens two years’ jail for health workers who speak out against conditions in immigration detention centres. Despite this, more than 400 Royal Children’s Hospital Melbourne staff have refused to discharge patients who face being returned to detention, and have demanded that all children be released from detention. The ABF Act is an outrage to medical independence, clinical judgment and the industrial wellbeing of those involved in treating asylum seekers. We will continue to make representations to the Government on this issue. 

Alterations to salary packaging arrangements

The Government announced in its 2015-16 Budget that it would introduce a cap of $5000 for salary sacrificed meal entertainment allowances from April 2016. A consultation process saw more than 64 submissions received, AMA included. This change affects salaried doctors more than any other group of doctors. We are greatly concerned about its potential effect on the ability of hospitals to attract and retain staff, especially struggling rural hospitals. Let’s hope the Government recognises the value to hospitals of this small incentive, though to date senators appear unmoved on the issue. 

Medicare Benefits Schedule Review

On 22 April, the Government announced a review of the more than 5500 items on the MBS. What this will mean for rights of private practice (RoPP) in public hospitals is not clear yet, but various governments have in the past targeted RoPP with outrageous and unsubstantiated claims of impropriety. Let’s hope we’re not facing another witch hunt, and that the benefits of RoPP will not be overlooked.

This is the final report from the Committee for the year, so I bid you farewell until next year. Enjoy a well-earned break as we prepare for another, doubtless hectic, year ahead. Best wishes for the Festive Season.