Doctors must have health say
Caption: AMA President Dr Michael Gannon meets with Helath Minister Sussan Ley at Parliament House, 21 July 2016
Doctors must have a central and active role in Government decisions on health funding and the allocation of resources within the health system, AMA President Dr Michael Gannon has said.
Just days after Prime Minister Malcolm Turnbull highlighted the need for a “better working relationship with the AMA and its GP membership”, the AMA has sharpened its pitch for a greater say in the financing of health care and the deployment of resources.
Dr Gannon said recent policy failures and poor decisions such as the Abbott Government’s hamfisted GP co-payments, the extended Medicare rebate indexation freeze and cuts to public hospital funding showed the need for much greater involvement of doctors in the formulation of policy.
“When major health decisions are taken without clinical involvement, the results are often sub-optimal and unsustainable,” Dr Gannon said. “Doctors bring a practical and informed perspective from the real world of their clinical practice to health financing and funding decisions [and] must have an active role in the operation of healthcare financing and funding processes, and be involved in decisions on the allocation of resources at the health system level.”
As the Federal Government digests the lessons of its narrow victory in an election where health was a leading issue, there are signs it will seek out the counsel of the AMA more attentively and frequently.
Mr Turnbull and reappointed Health Minster Sussan Ley have both met with Dr Gannon since the election, and at the announcement of his new Ministry on 18 July the Prime Minster said he was “confident we will have a better working relationship with the AMA and its general practitioner membership”.
Dr Gannon said doctors, individually and as a profession, had a direct interest in the overall resourcing, performance and sustainability of health care, and their role as stewards of healthcare financing and funding must be explicitly recognised by governments.
The specific role to be played by doctors and the medical profession in the stewardship of health care resources was detailed in two Position Statements released on 21 July.
The first, AMA Position Statement on the Doctor’s Role in Stewardship of Health Care Resources 2016, set out the obligation on individual practitioners to eliminate wasteful practices, minimise diagnostic errors and ensure patients receive the most appropriate treatment.
“Individual doctors affect health care expenditure through their clinical recommendations and decisions regarding patient treatment,” Dr Gannon said.
“Doctors can reduce wasteful expenditure by applying responsible stewardship to their everyday practices through, for example, appropriate clinical decision-making, minimising diagnostic error, and eliminating tests, treatments or procedures that are unnecessary, inappropriate, or unwanted by the patient.”
The AMA President said this should not be confused with rationing, which limits the amount of care a patient receives because of financial constraints.
“Doctors must retain their clinical independence and professional autonomy so they can make health care decisions based on the best interests of the patient, and not the interests of third parties such as insurers, governments or employers,” he said.
The second Position Statement, The Role of Doctors in Stewardship of Healthcare Financing and Funding Arrangements 2016, details how the stewardship obligation on individual doctors extends to encompass of the medical profession as a whole.
“The primary ethical duty of the doctor is to care for, and protect the healthcare interests of, the individual patient,” the Position Statement said, adding that there was a secondary ethical duty on doctors “to protect the interests of other patients and the wider community”.
“This secondary duty involves ensuring healthcare financing, funding and expenditure are managed to ensure resources are available for health needs currently and into the future,” the Statement said. “Doctors must have an active role in the operation of healthcare financing and funding processes and be involved in decisions on the allocation of resources at the health system level.”
To achieve this, doctors and their representatives “should seek opportunities to formally engage in healthcare financing and funding processes”.
Together, the Position Statements make the case for doctors and the AMA to be at the centre of decisions affecting health financing and the allocation of resources, for the sake of patients – something that so far the Government seems to be open to.