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Communiqué from Federal Council meeting 17-18 August 2017

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Welcome to the inaugural communiqué from Federal Council highlighting the debates had, and decisions taken, at its meeting in Canberra in the depths of winter on 17-18 August.

In giving his report, AMA President Dr Michael Gannon made mention of the many recent advocacy wins of the AMA. He reported that the working relationship with the Federal Government has evolved following the compact agreed at the time of the Federal Budget in March, enabling frank and effective engagement with Health Minister Greg Hunt.

Dr Gannon reported that benefits of this engagement can be seen in recent successes with the Minister moving to scrap the draft national maternity services framework which was opposed by the AMA for lack of obstetrician and GP involvement; and support by Minister Hunt to work with State and Territory colleagues to remove mandatory reporting from the National Law. Advocacy on this latter issue has been strongly supported by Federal, State and Territory AMAs, which uniformly endorse the WA approach to mandatory reporting.

The Secretary General’s report provided a comprehensive overview of the AMA’s medico-political advocacy. The Secretary General Anne Trimmer noted that the Governance Institute’s 2016 Ethics Index, with research undertaken by IPSOS, ranked the AMA as the most ethical of the national membership and industry associations.

She reported that the secretariat is working with the Minister’s advisers and the Department of Health to shape appropriately targeted after hours GP services, arising from the draft MBS Review report into these services. The secretariat is working with the NBN to finalise criteria for improved access to broadband in rural areas with a proposal to grant Public Interest Premises status to medical practices under the satellite footprint.

Two of Federal Council’s committees are working with the secretariat to develop a new advocacy strategy for aged care with funding and technology identified as priority areas. Federal Council also agreed to campaign for additional funding for the incoming Practice Incentive Program Quality Incentive and strongly opposed recently flagged proposals to increase the return of service periods for future bonded medical places program participants.

The Federal Council noted updates on the two major government reviews currently underway, the MBS Review and the Private Health Ministerial Advisory Committee review of private health insurance arrangements. An informal grouping of approximately 30 members is working with the AMA to inform its response to the draft reports. Work on the PHMAC review has slowed over the winter period although a new working group on risk equalisation has been established. The AMA will be advocating for changes to the risk equalisation pool to facilitate coverage OF pregnancy under all levels of PHI cover.

Federal Council discussed the Government’s review of the medical indemnity schemes. The AMA has worked closely with the Department of Health to shape the terms of reference and remains strongly committed to the schemes as an effective mechanism to moderate the cost impact on practices and patients. The AMA has been communicating to the profession the need for active engagement in the review by Colleges, Associations and Societies.

The AMA is represented on a small working group to review the Health Professional Online Services (HPOS) system, which emerged as vulnerable to fraud. The Minister for Human Services, Alan Tudge, kept the President informed of the steps taken to ensure integrity of the system prior to the establishment of the review of health provider access to Medicare numbers.

With a Senate inquiry underway into the value of private health insurance and medical out of pocket costs, the Federal Council set aside a policy session to consider the issues in depth. The AMA lodged its submission at the end of July (the submission can be read at submission/submissions-out-pocket-costs-australian-he…).

The submission included data on billing practices collected from a poll of members.

Federal Council, noting the growing public commentary calling on limits on out of pocket medical expenses, agreed that the priority was to correct misleading statements about the role of doctors’ fees in the debate about affordability of health care. An animated debate ensued with Councillors contributing a range of views based on their personal experience.

The issue has been largely driven by private health insurance and the growth in gaps in coverage and exclusions. Federal Council noted that there had been limited complaints to the Private Health Insurance Ombudsman about out of pocket expenses. Federal Council also noted that many medical services had always had an element of out of pocket contribution, not to be confused with the charging of an excessive fee which the AMA strongly opposes. Federal Council agreed that there needs to be greater clarity on what constitutes an excessive fee and that this needs to be clearly communicated to the public.

The President acknowledged the comments of Federal Council and noted that he had an opportunity to address these issues in his upcoming address to the National Press Club (the transcript of the President’s address can be read at media/dr-gannon-national-press-club-address-0).

The AMA’s work on public health initiatives continues, ranging from road safety to obesity and physical activity. Federal Council heard progress reports from working groups led by Councillors and debated draft position statements on road safety, obesity and physical inactivity. Other working groups are considering nutrition, mental health and the social determinants of health. A revised position statement on mental health is in development in conjunction with the AMA psychiatrists’ group.

Federal Council received reports from each of its practice group councils, and from its committees. The State and Territory AMAs and Australian Medical Students’ Association provided reports on current areas of advocacy.