Political message in National Press Club speech
AMA President Dr Michael Gannon has called on all sides of politics to take some of the politicking out of health, for the good of the nation.
Addressing the National Press Club of Australia, Dr Gannon said some health issues needed bipartisan support and all politicians should acknowledge that.
“Some of the structural pillars of our health system – public hospitals, private health, the balance between the two systems, primary care, the need to invest in health prevention – Let’s make these bipartisan,” he said.
“Let’s take the point scoring out of them. Both sides should publicly commit to supporting and funding these foundations. The public – our patients – expect no less.”
During the nationally televised address, broadcast live as he delivered it on August 23, Dr Gannon warned political leaders that the next election was anyone’s to win and so they should pay close attention to health policy.
“Last year we had a very close election, and health policy was a major factor in the closeness of the result,” he said.
“The Coalition very nearly ended up in Opposition because of its poor health policies. Labor ran a very effective Mediscare campaign.
“As I have noted, the Government appears to have learnt its lesson on health, and is now more engaged and consultative – with the AMA and other health groups.
“The next election is due in two years. There could possibly be one earlier. A lot earlier.
“As we head to the next election, I ask that we try to take some of the ideology and hard-nosed politicking out of health.”
In a wide-ranging speech, the AMA President outlined the organisation’s priorities, while also explaining the ground it has covered in helping to deliver good outcomes for both patients and doctors.
The AMA’s priorities extend to Indigenous health, medical training and workforce, the Pharmaceutical Benefits Scheme, and the many public health issues facing the Australian community – most notably tobacco, immunisation, obesity, and alcohol abuse.
“I have called for the establishment of a no-fault compensation scheme for the very small number of individuals injured by vaccines,” Dr Gannon said.
“I have called on the other States and Territories to mirror the Western Australian law, which exempts treating doctors from mandatory reporting and stops them getting help.
“We also need to deal with ongoing problems in aged care, palliative care, mental health, euthanasia, and the scope of practice of other health professions.
“In the past 12 months, the AMA has released statements on infant nutrition, female genital mutilation, and addiction.
“In coming months, we will have more to say on cost of living, homelessness, elder abuse, and road safety, to name but a few.
“Then there are the prominent highly political and social issues that have a health dimension, and require an AMA position and AMA comment.
“All these things have health impacts. As the peak health and medical advocacy group in the country, the community expects us to have a view and to make public comment. And we do.
“Not everybody agrees with us. But our positions are based on evidence, in medical science, and our unique knowledge and experience of medicine and human health.
“Health policy is ever-evolving. Health reform never sleeps.”
The address covered, among other things, health economics: “Health should never be considered just an expensive line item in a budget – it is an investment in the welfare, wellbeing, and productivity of the Australian people.”
Public hospital funding: “The idea that a financial disincentive, applied against the hospital, will somehow ‘encourage’ doctors to take better care of patients than they already do is ludicrous.”
Private health: “If we do not get reforms to private health insurance right – and soon – we may see essential parts of health care disappear from the private sector.
The medical workforce: “We do not need more medical school places. The focus needs to be further downstream.
“Unfortunately, we are seeing universities continuing to ignore community need and lobbying for new medical schools or extra places.
“This is a totally arrogant and irresponsible approach, fuelled by a desire for the prestige of a medical school and their bottom line.
“Macquarie University is just the latest case in point.”
And general practice: “General practice is under pressure, yet it continues to deliver great outcomes for patients.
“GPs are delivering high quality care, and remain the most cost effective part of our health system. But they still work long and hard, often under enormous pressure.
“The decision to progressively lift the Medicare freeze on GP services is a step in the right direction.”
On even more controversial topics, Dr Gannon stressed that the AMA is completely independent of governments.
While sometimes it gets accused of being too conservative, he said, it was not surprising to see the reaction to the AMA’s position on some issues – like marriage equality.
“Our Position Statement outlines the health implications of excluding LGBTIQ individuals from the institution of marriage,” he said.
“Things like bullying, harassment, victimisation, depression, fear, exclusion, and discrimination, all impact on physical and mental health.
“I received correspondence from AMA members and the general public. The overwhelming majority applauded the AMA position.
“Those who opposed the AMA stance said that we were being too progressive, and wading into areas of social policy.
“The AMA will from time to time weigh in on social issues. We should call out discrimination and inequity in all forms, especially when their consequences affect people’s health and wellbeing.”
Last year, the AMA released an updated Position Statement on Euthanasia and Physician Assisted Suicide.
It came at a time when a number of States, most notably South Australia and Victoria, were considering voluntary euthanasia legislation.
There was an expectation in some quarters that the AMA would come out with a radical new direction. But it didn’t.
“The AMA maintains its position that doctors should not be involved in interventions that have as their primary intention the ending of a person’s life,” Dr Gannon said.
“This does not include the discontinuation of treatments that are of no medical benefit to a dying patient. This is not euthanasia.
“Doctors have an ethical duty to care for dying patients so that they can die in comfort and with dignity.”
The AMA also takes Indigenous health very seriously.
Dr Gannon travelled to Darwin last year to launch the AMA’s annual Indigenous Health Report Card, which focused on Rheumatic Heart Disease.
“In simple terms, RHD is a bacterial infection from the throat or the skin that damages heart valves and ultimately causes heart failure,” he said.
“It is a disease that has virtually been expunged from the non-Indigenous community. It is a disease of poverty.
“RHD is perhaps the classic example of a Social Determinant of Health. It proves why investment in clean water, adequate housing, and sanitation is just as important as echocardiography and open heart surgery.
“The significance of challenging social issues like Indigenous health, marriage equality, and euthanasia is that they highlight the unique position and strengths of the AMA.
“The AMA was recently ranked the most ethical organisation in the country in the Ethics Index produced by the Governance Institute of Australia.
“People want and expect us to have a view – an opinion. Sometimes a second opinion.”
A transcript of the full address can be found here: