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Salaried doctors an essential voice in the AMA

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This is my final article as Chair of the Council of Salaried Doctors. I have served on the Council for five years, including three as Chair, and believe now is the appropriate time for me to relinquish this role.

The necessary reorganization of membership records to reflect salaried doctor membership is now taking place, which delays the election of my successor. In the interim, Dr Barbara Bauert – the Northern Territory Representative on AMACSD – has kindly agreed to Chair AMACSD and represent Salaried Doctors on Federal Council.

My time with AMACSD has been thoroughly satisfying – and turbulent. In my years on the Council, we have contended with many challenging issues affecting the Australian health system.

I have written about many of these issues in Australian Medicine in recent years.

Of course, these articles have only touched the surface of the myriad number of issues that affect salaried doctors and their patients. To varying degrees, these issues have had a direct impact on clinical standards, working conditions, training opportunities and patient access to medical care.

 In recent times, these articles have focussed on:

  • palliative care and the need to better address end-of-life decisions;
  • revalidation as a discussion initiated by the Medical Board, but no real details yet to be considered;
  • funding cuts at both State and Federal levels, with inevitable implications for access;
  • medical registration and the problems experienced with AHPRA and the 2010 national system;
  • generalism as a necessary medical skill set, given the complexity of contemporary patient presentations;
  • rights of private practice – a complex, long-standing, and invaluable part of public hospital work;
  • clinical governance as a mechanism for improved standards of care;
  • workforce issues and the challenges of training today’s junior doctors through to independent practice;
  • safety in the medical workplace;
  • supervision of trainees as an essential part of medical education; and
  • the Queensland contracts dispute – the harm that has been caused, the remedies that are being applied, and the lessons to be learned.

There is nothing minor about any of these issues.

What is clear is that, while we have a system of health care that is among the best in the world, its future is far from guaranteed.

Providing insufficient resources will inevitably harm our ability to provide the care we expect to give, and that Australians rightly expect to receive.

One of the principal roles of the AMA is to support, represent and defend doctors and others who work to maintain our health system in the face of harsh criticism, dramatic funding cuts, personal risk, mounting workloads and responsibility, and an increasingly complex and difficult industrial landscape.

The current situation in Queensland merits special mention. We have consistently called for a less belligerent approach from the Newman Government, and an acknowledgment that the vilification of the medical profession in Queensland was utterly misguided. The resolution achieved in recent weeks is not perfect, but it is a much better outcome compared with what could have occurred.

I remain concerned about a broad trend away from collective bargaining, largely based on ideological motives. This is something we must monitor carefully in coming years.

We must also recognise that the issues played out in Queensland have the potential to resonate through all health systems around the country.

The dispute also demonstrated that the combined advocacy of the AMA and Australian Salaried Medical Officers Federation – working closely together, as we absolutely must – can genuinely protect the interests of doctors and the health system in which they work. 

Within the AMA, the Council of Salaried Doctors has been determined to deal with the question of salaried doctor representative numbers in the AMA. This issue been on our agenda for some years, and we consider the current constitutional reform process as the ideal time to obtain clarity around the salaried doctor membership category.

If the Queensland contracts dispute has demonstrated anything, it is that the interests and impact of salaried doctors are an essential part of the collective voice of the AMA.

As I hand over the reins to Dr Bauert, I take this opportunity to thank everyone who has been involved in the Council of Salaried Doctors for their help, support and good judgment. The importance of what we do should never be underestimated.