Taking stock and lessons learned
As my term as President of the AMA comes to an end, so does my three-year stint as Chair of the AMA’s Economics and Workforce Committee.
This is an ideal opportunity to review EWC’s work, and point to what lies ahead.
Personally, I have greatly enjoyed this period working with AMA members on EWC. This is a role I have undertaken since July 2011, and one that I leave with a mix of feelings, including accomplishment, collegiality and professionalism. I also have a little regret at its passing – this has been a great job.
Since 2011, EWC has had a broad and demanding agenda of work.
In 2011 we were engaged in commentary on the design and roll-out of the Labor Government’s health reform proposals, and the new organisations set up to implement the changes.
These included new hospital financing arrangements using activity-based funding, and the operation and impact of new bodies such as the National Health Performance Authority (NPHA) and the Independent Hospital Pricing Authority (IHPA). A lot of the talk then was about a new era in transparency, certainty of funding, responsiveness to local needs, and a strong focus on performance with greatly improved approaches to performance reporting.
While the Federal Government was introducing its new era, the AMA continued to produce the AMA Public Hospital Report Card, the only publication to give year-on-year information on the key performance areas for our public hospitals. The Report Card continues to draw on the ‘on the ground’ experiences of EWC members.
EWC has also provided a medical perspective and critical input on e-health and the Personally Controlled Electronic Health Record (PCEHR), and on major new initiatives such as the National Disability Insurance Scheme.
Underpinning these high profile and one-off issues, EWC has also focused on a range of ongoing ‘bread and butter’ issues. These include medical profession issues such as national registration arrangements, the scope of practice of non-medical practitioners and public reporting of industry payments to health practitioners.
Workforce and training issues, policy matters around the AMA Fees and Items List, MBS and MSAC issues, and a long line of AMA Position Statements, have been consistent agenda items for policy development and advice at most EWC meetings.
EWC has made strong contributions across all of these areas.
A few issues stand out for me, either where EWC had primary responsibility or its comments were particularly influential. These include EWC’s consistent engagement on hospital pricing and monitoring, and highlighting shortfalls in Budget estimates through the AMA Report Card.
EWC also provided strong and sustained advocacy for improved e-health and PCEHR arrangements.
EWC played a key role in the AMA’s success in lobbying against the Labor Government’s proposed cap on self-education expenses, and in changing and substantially moderating proposals in areas such as pharmaceutical payments to doctors.
Addressing this wide-ranging agenda gives EWC the capacity and the context to respond effectively to new issues as they arise, with the interests of our members and organisation ‘front of mind’.
What are some of the lessons learnt from EWC’s work?
· We need to take a very clear and dispassionate view of government changes and reform measures – the spin is almost always greater than the reality.
· Our comments are strongest when they clearly reflect the medical perspective – a challenge is to ensure this is the primary consideration in health financing decisions.
· New funding and financing arrangements are not a replacement for ensuring there is actual capacity to meet health care needs.
· More activity on reporting performance does not equal more information or more performance.
Taking stock of the last three years, I am confident EWC will continue to build on its strengths and lessons learnt, and serve the AMA well.