[Articles] Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial

Our findings show that, at 12 months, almost half of participants achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care.

AMA shines in Australia Day Honours

Former Australian Medical Association President Dr Mukesh Haikerwal has been awarded the highest honour in this year’s Australia Day awards by being named a Companion of the Order of Australia (AC).

He is accompanied by the current Editor-in-Chief of the Medical Journal of Australia, Laureate Professor Nick Talley, as well as longstanding member Professor Jeffrey Rosenfeld – who both also received the AC.

The trio top a long and impressive list of AMA members to receive Australia Day Honours this year.

AMA Federal Councillor, Associate Professor Julian Rait, received the Medal of the Order (OAM).

A host of other members honoured in the awards are listed below.

AMA President Dr Michael Gannon said the accolades were all well-deserved and made he made special mention of those receiving the highest Australia Day Honours.

“They have dedicated their lives and careers to helping others through their various roles as clinicians, researchers, teachers, authors, administrators, or government advisers – and importantly as leaders in their local communities,” Dr Gannon said.

“On behalf of the AMA, I pay tribute to all the doctors and other health professionals who were honoured today for their passion for their profession and their dedication to their patients and their communities.

“The great thing about the Honours is that they acknowledge achievement at the international, national, and local level, and they recognise excellence across all avenues of human endeavour.

“Doctors from many diverse backgrounds have been recognised and honoured again this year.

“There are pioneering surgeons and researchers, legends across many specialties, public health advocates, researchers, administrators, teachers, and GPs and family doctors who have devoted their lives to serving their local communities.

“The AMA congratulates all the doctors and other health advocates whose work has been acknowledged.

“We are, of course, especially proud of AMA members who are among the 75 people honoured in the medicine category.”

Dr Haikerwal, who was awarded the Officer in the Order of Australia (AO) in 2011, said this further honour was “truly mind-blowing” and another life-changing moment.

“To be honoured on Australia Day at the highest level in the Order of Australia is beyond imagination, beyond my wildest dreams and extremely humbling,” Dr Haikerwal said.

“For me to be in a position in my life and career to receive such an honour has only been made possible due to the unflinching support and unremitting encouragement of my closest circle, the people who have been with me through every step of endeavour, adversity, achievement, and success.”

CHRIS JOHNSON

AMA MEMBERS IN RECEIPT OF HONOURS

COMPANION (AC) IN THE GENERAL DIVISION

Dr Mukesh Chandra HAIKERWAL AO
Altona North Vic 3025
For eminent service to medical governance, administration, and technology, and to medicine, through leadership roles with a range of organisations, to education and the not-for-profit sector, and to the community of western Melbourne.

Professor Jeffrey Victor ROSENFELD AM
Caulfield North, Vic
For eminent service to medicine, particularly to the discipline of neurosurgery, as an academic and clinician, to medical research and professional organisations, and to the health and welfare of current and former defence force members.

Professor Nicholas Joseph TALLEY
Black Hill, NSW
For eminent service to medical research, and to education in the field of gastroenterology and epidemiology, as an academic, author and administrator at the national and international level, and to health and scientific associations.

OFFICER (AO) IN THE GENERAL DIVISION

Emeritus Professor David John AMES
East Kew, Vic
For distinguished service to psychiatry, particularly in the area of dementia and the mental health of older persons, as an academic, author and practitioner, and as an adviser to professional bodies.

Dr Peggy BROWN
Sanctuary Cove, Qld
For distinguished service to medical administration in the area of mental health through leadership roles at the state and national level, to the discipline of psychiatry, to education, and to health care standards.

Professor Creswell John EASTMAN AM
St Leonards, NSW
For distinguished service to medicine, particularly to the discipline of pathology, through leadership roles, to medical education, and as a contributor to international public health projects.

Professor Suzanne Marie GARLAND
Docklands, Vic
For distinguished service to medicine in the field of clinical microbiology, particularly to infectious diseases in reproductive and neonatal health as a physician, administrator, researcher and author, and to professional medical organisations.

Dr Paul John HEMMING
Queenscliff, Vic
For distinguished service to higher education administration, to medicine through contributions to a range of professional medical associations, and to the community of central Victoria, particularly as a general practitioner.

Professor Anthony David HOLMES
Melbourne, Vic
For distinguished service to medicine, particularly to reconstructive and craniofacial surgery, as a leader, clinician and educator, and to professional medical associations.

Dr Diana Elaine O’HALLORAN
Glenorie, NSW
For distinguished service to medicine in the field of general practice through policy development, health system reform and the establishment of new models of service and care.

MEMBER (AM) IN THE GENERAL DIVISION

Dr Michael Charles BELLEMORE
Croydon, NSW
For significant service to medicine in the field of paediatric orthopaedics as a surgeon, to medical education, and to professional medical societies.

Dr Colin Ross CHILVERS
Launceston, Tas
For significant service to medicine in the field of anaesthesia as a clinician, to medical education in Tasmania, and to professional societies.

Associate Professor Peter HAERTSCH OAM
Breakfast Point, NSW
For significant service to medicine in the field of plastic and reconstructive surgery as a clinician and administrator, and to medical education.

Professor Ian Godfrey HAMMOND
Subiaco, WA
For significant service to medicine in the field of gynaecological oncology as a clinician, to cancer support and palliative care, and to professional groups.

Dr Philip Haywood HOUSE
WA
For significant service to medicine as an ophthalmologist, to eye surgery foundations, and to the international community of Timor Leste.

Adjunct Professor John William KELLY
Vic
For significant service to medicine through the management and treatment of melanoma, as a clinician and administrator, and to education.

Dr Marcus Welby SKINNER
West Hobart, Tas
For significant service to medicine in the field of anaesthesiology and perioperative medicine as a clinician, and to professional societies.

Professor Mark Peter UMSTAD
South Yarra, Vic
For significant service to medicine in the field of obstetrics, particularly complex pregnancies, as a clinician, consultant and academic.

Professor Barbara S WORKMAN
East Hawthorn, Vic
For significant service to geriatric and rehabilitation medicine, as a clinician and academic, and to the provision of aged care services.

MEDAL (OAM) IN THE GENERAL DIVISION

Professor William Robert ADAM PSM
Vic
For service to medical education, particularly to rural health.

Dr Marjorie Winifred CROSS
Bungendore, NSW
For service to medicine, particularly to doctors in rural areas.

Associate Professor Mark Andrew DAVIES
Maroubra, NSW
For service to medicine, particularly to neurosurgery.

Dr David William GREEN
Coombabah, Qld
For service to emergency medicine, and to professional organisations.

Dr Barry Peter HICKEY
Ascot, Qld
For service to thoracic medicine.

Dr Fred Nickolas NASSER
Strathfield, NSW
For service to medicine in the field of cardiology, and to the community.

Dr Ralph Leslie PETERS
New Norfolk, Tas
For service to medicine, and to the community of the Derwent Valley.

Associate Professor Julian Lockhart RAIT
Camberwell, Vic
For service to ophthalmology, and to the development of overseas aid.

Mr James Mohan SAVUNDRA
South Perth, WA
For service to medicine in the fields of plastic and reconstructive surgery.

Dr Chin Huat TAN
Glendalough, WA
For service to the Chinese community of Western Australia.

Dr Karen Susan WAYNE
Toorak, Vic
For service to the community of Victoria through a range of organisations.

Dr Anthony Paul WELDON
Melbourne, Vic
For service to the community, and to paediatric medicine.

PUBLIC SERVICE MEDAL (PSM)

Dr Sharon KELLY
Yeronga, Qld
For outstanding public service to the health sector in Queensland.

Professor Maria CROTTY
Kent Town, SA
For outstanding public service in the rehabilitation sector in South Australia.

GPs highly efficient – Productivity Commission

Medical patients across Australia are highly satisfied with their GPs, according to the latest Productivity Commission report, which also found general practice to be the most efficient component of the health system.

The Productivity Commission Report on Government Services 2018 has found Australia’s general practice sector to be both cost effective and highly efficient.

But the report also shows that Australian Government total expenditure on GP services per person only grew by 80 cents between 2015-16 and 2016-17 – from $370.60 to $371.40

AMA President Dr Michael Gannon said the report highlights the funding pressure that general practice continues to operate under, and the pressing need for the Government to deliver new real investment in general practice in this year’s Budget.

“A well-resourced general practice sector can help keep patients out of hospital and save the health system money,” Dr Gannon said.

“GPs are providing more services for patients as the population gets older and, despite this pressure, satisfaction with these services remains high.

“The next Budget is a genuine opportunity to recognise and reward quality general practice.”

Dr Gannon said the Productivity Commission confirmed that the quality and productivity of Australia’s GPs is up with the best in the world.

Its report, he said, offered compelling evidence that the Government must provide greater support for general practice.

The number of GP services in 2016-17 was 6.5 per annum per head of population, which is up from 5.9 services per head of population in 2011-12.

“This reflects growing demand for GP services in the community due to the impact of complex and chronic disease, as well as an increase in GP numbers,” Dr Gannon said.

“There were 105.9 full service equivalent GPs per 100,000 population in 2016-17, compared to 82.9 per 100,000 population in 2011-12.

“Around 75 per cent of patients could get a GP appointment within 24 hours in 2016-17, which is consistent with previous years.

“Significantly, cost does not appear to be a significant barrier for patients who need to see a GP, with only 4.1 per cent of patients saying that they deferred accessing GP services due to cost.”

The Productivity Commission found that patients were highly satisfied with their GPs on a number of measures, including:

91.6 per cent said the GP always or often listened carefully to them;
94.1 per cent said the GP always or often showed respect; and
90.6 per cent said the GP always or often spent enough time with them.

CHRIS JOHNSON

Your AMA Federal Council at work

Dr Tony Bartone	AMA Vice President	Aged Care Workforce Strategy Taskforce Summit	04/12/17	Hannah
Dr Richard Kidd, Dr Chris Moy, Dr Tony Bartone	Chair – Council of General Practice, Federal Councillor, AMA Vice President	My Aged Care Referrals and Health Integration Workshop	29/11/17	Hannah
Dr Richard Kidd	Chair – Council of General Practice	United General Practice Australia (UGPA)	15/12/17	Moe
Dr Richard Kidd	Chair – Council of General Practice	DVA Health Consultative Forum	1/11/17	Michelle
Dr Richard Kidd	Chair – Council of General Practice	TGA Nationally Coordinated Codeine Implementation Working Group (NCCIWG)	29/11/2017	Georgia M
Dr Tony Bartone	AMA Vice President	National Medical Training Advisory Network	08/12/2017	Warwick/Richard
Dr John Zorbas	Chair – AMA Council of Doctors in Training	National Medical Training Advisory Network	08/12/2017	Warwick/Richard
Dr Richard Kidd	Chair – Council of General Practice	TGA Nationally Coordinated Codeine Implementation Working Group (NCCIWG)	24/1/2018	Georgia M
Dr Richard Kidd	Chair – Council of General Practice	Health Sector Group meeting	13/2/2018	Michelle
Dr Tony Bartone / Dr Simon Torvaldsen	AMA Vice President / AMA Council of General Practice Councillor	TGA Medicine Shortages Working Group	24/11/17	Georgia M
Dr Tony Bartone	AMA Vice President	TGA Advisory Committee on Medicines Scheduling	21/11/17

How good are you at basic suturing?

Are you a junior medical officer looking for a refresher in basic suturing? Are you up to date with your basic surgical skills? Suturing is an essential skill in the everyday practice of medicine. Although suturing technique is important, as a junior doctor you’re also expected to have a thorough understanding of wound management in general to effectively care for a patient with a laceration.

Whether in primary health or in an emergency environment, junior doctors will encounter many types of wounds requiring closure. The decision to close a wound and the technique used are influenced by many factors, including location, depth and contamination of wound, age of patient and resources or time available.

Designed in response to feedback from junior doctors and accredited for CPD by ACRRM, ACEM, CICM and ANZCA, the Basic Suturing learning module will help doctors bolster their competence in the basic techniques of minor surgery. Doctorportal Learning, in partnership with Osler, have created an easy to understand, well-structured module with step-by-step instructions and streaming video demonstrations of basic knot tying and suturing techniques for beginners. The module covers:

Wound assessment
Wound cleaning
Suturing technique
Post suturing wound care
Knowledge and assessment.

Click here for more information and add basic suturing to your skills.

Proposed incentive missing the mark on quality

BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE

With the proposed start date of 1 March 2018 for the new Quality Improvement Incentive (QII) under the Practice Incentives Program (PIP) fast approaching, the AMA is becoming increasingly concerned that the proposed incentive arrangements are still not settled to the satisfaction of the profession.

Ideally, the QII should be taking us a step closer to rewarding quality care. However, the incentive has been short-changed of its key ingredient for supporting continuous quality improvement in general practices – funding.

The Government is not investing in this incentive, which means it is not investing in better data, quality improvement, or general practice. What it has done instead is pull $21.2 million out of PIP and sought to move existing PIP payments around. Abolishing the Quality Prescribing, Cervical Screening, Asthma, Diabetes, and Aged Care Access incentives to pay for the QII is a zero sum game and means that many practices will be financially worse off under the new incentive. In fact, for all intents and purposes, it would seem that the Government has lost its grasp of English in that an incentive is supposed to motivate or encourage someone to do something.

Practices are unlikely to implement the internal changes required to take up this incentive if the value of the incentive does not support the effort involved.

What is the Government thinking?

Through this incentive it wants data to better inform its policies and, while that is sensible, many practices are initially going to have to undertake a significant amount of work to improve the quality of their data. In addition, they will have to get up to speed on data governance to ensure that patients’ privacy is safeguarded. Patients will need to understand what data will be collected, how the data will be de-identified, what the data will be used for, and who it will be shared with.

If this work is not adequately funded, if the incentive does not provide a return on investment, practices will not take it on.

With this incentive supposedly only a few weeks away, we have no clarity on what the requirements are that practices will be asked to sign up for. We do not know what data will be extracted, whether quality improvement activities are to have a set focus, or how the quality improvement over time will be measured. We don’t even know what the dollar value of the incentive will be!

While the AMA is strong advocate for rewarding quality care, the proposed new QII is not fit for purpose. It is underfunded and critical detail is still missing. Practices should not be asked to sign up to a vague program that is likely to leave them worse off.

As the Government’s budgetary process rolls on the AMA will be continuing to make it clear to the Minister that the QII is under-funded and under-done. The solution is more time, thought and investment – something current policy settings sadly lack.

National architecture needed for mental health

Almost one in two Australian adults will experience a mental health condition in their lifetime, yet mental health and psychiatric care are grossly underfunded when compared to physical health.

Those statistics were the stark reality AMA President Dr Michael Gannon laid out when releasing the AMA Position Statement on Mental Health 2018.

In doing so, he called for strategic leadership to integrate all components of mental health prevention and care.

The AMA is calling for a national, overarching mental health “architecture”, and proper investment in both prevention and treatment of mental illnesses.

“Many Australians will experience a mental illness at some time in their lives, and almost every Australian will experience the effects of mental illness in a family member, friend, or work colleague,” Dr Gannon said.

“For mental health consumers and their families, navigating the system and finding the right care at the right time can be difficult and frustrating.

“Australia lacks an overarching mental health architecture. There is no vision of what the mental health system will look like in the future, nor is there any agreed national design or structure that will facilitate prevention and proper care for people with mental illness.”

The AMA has called for the balance between funding acute care in public hospitals, primary care, and community-managed mental health to be correctly weighted.

Funding should be on the basis of need, demand, and disease burden, Dr Gannon said, not a competition between sectors and specific conditions.

“Policies that try to strip resources from one area of mental health to pay for another are disastrous,” he said.

“Poor access to acute beds for major illness leads to extended delays in emergency departments, poor access to community care leads to delayed or failed discharges from hospitals, and poor funding of community services makes it harder to access and coordinate prevention, support services, and early intervention.

“Significant investment is urgently needed to reduce the deficits in care, fragmentation, poor coordination, and access to effective care.

“As with physical health, prevention is just as important in mental health, and evidence-based prevention can be socially and economically superior to treatment.”

Dr Gannon said community-managed mental health services had not been appropriately structured or funded since the movement towards de-institutionalisation in the 1970s and 1980s, which shifted much of the care and treatment of people with a mental illness out of institutions and into the community.

The AMA Position Statement supports coordinated and properly funded community-managed mental health services for people with psychosocial disability, as this will reduce the need for costly hospital admissions.

The Position Statement calls for Governments to address underfunding in mental health services and programs for adolescents, refugees and migrants, Aboriginal and Torres Strait Islander people, and people in regional and remote areas.

It also calls for Government recognition and support for carers of people with mental illness.

“Caring for people with a mental illness is often the result of necessity, not choice, and can involve very intense demands on carers,” Dr Gannon said.

“Access to respite care is vital for many people with mental illness and their families, who bear the largest burden of care.”

The AMA Position Statement on Mental Health 2018 is available at position-statement/mental-health-2018

CHRIS JOHNSON

[Comment] The Lancet–CAMS Health Summit 2018: a call for abstracts

The Lancet and the Chinese Academy of Medical Sciences (CAMS) have held three successful health summits in 2015–17 in Beijing, China. We continue to support China’s health science research communities and invite abstract submissions from China for the 2018 The Lancet–CAMS Health Summit, to be held on Oct 27–28 in Beijing. Submissions are invited from all aspects of health science, including, but not limited to: translational medicine; clinical medicine; public health; global health; health policy; the environment and ecological systems; primary care; maternal, newborn, child, and adolescent health, health professionalism; and medical education.

Christmas message from AMA President

It has been a very busy and very successful year for the Federal AMA. Your elected representatives and the hardworking staff in the Secretariat in Canberra have delivered significant achievements in policy, advocacy, political influence, professional standards, doctors’ health, media profile, and public relations.

We have worked tirelessly to ensure that health policy and bureaucratic processes are shaped to provide the best possible professional working environments for Australian doctors and the highest quality care for our patients.

Our priority at all times is to provide value for your membership of the AMA.

As 2017 draws to a close, I would like to provide you with a summary of the work we have undertaken on behalf of you, our valued members.

General Practice and Workplace Policy

Our strong advocacy led to a decision to lift the freeze on Medicare patient rebates.
AMA coordination of Doctors’ Health Services around the country, with funding support from the Medical Board of Australia.
Launched the AMA Safe Hours Audit Report, giving added focus to the issue of doctors’ health and wellbeing.
Maintained a strong focus on medical workforce and training places, with the National Medical Training Network significantly increasing its workforce modelling and projection work following sustained advocacy by the AMA.
Secured a number of concessions in the proposed redesign of the Practice Incentive Program (PIP), as well as a delay in the introduction of changes.
Lobbied at the highest level for a more durable solution to concerns over Pathology collection centre rents, focusing on effective compliance, and achieving a fair balance between the interests of GP members and pathologist members.
Led the Reforms to After-hours GP services provided through Medical Deputising Services (MDSs) to ensure that these services are better targeted and there is stronger communication between the MDS and a patient’s usual GP.
Successfully lobbied the ACCC to renew the AMA’s existing authorisation that permits GPs to engage in intra-practice price setting, potentially saving GPs thousands of dollars annually in legal and other compliance costs.
Ensured a proportionate response from the Government in response to concerns over the security of Medicare card numbers, avoiding more draconian proposals that would have added to the compliance burden on practices, and added a barrier to care for patients.

Medical Practice

Fundamentally altered the direction of the Medical Indemnity Insurance Review, discussing its importance to medical practice at the highest level, helping to ensure the review is not used as a blunt savings exercise, and saving doctors and their patients millions of dollars in increased premiums.
Led a nationally co-ordinated campaign with the State AMAs and other peak bodies to uphold the TGA’s decision to up-schedule Codeine.
Campaigned against an inadequate, poorly conceived, and ideological National Maternity Services Framework, which has now been scrapped.
Campaigned on the issue of Doctors’ Health and the need for COAG to change mandatory reporting laws, promoting the WA model.
Launched the AMA Public Hospital Report Card.
Pressed the case for vastly improved Private Health Insurance products through membership of the Private Health Ministerial Advisory Committee (PHMAC), my annual National Press Club Address, an appearance before a Senate Select Committee, and regular and ongoing media and advocacy.
Launched the AMA Private Health Insurance Report Card.
Successfully convinced the Government to address concerns with the MBS Skin items, and will continue to do so with the MBS Review more broadly.
Successfully lobbied for changes to the direction of the Anaesthesia Clinical Committee of the MBS Review.
Launched a new AMA Fees List with all the associated benefits of mobility and regular updates.
Saw a number of our Aged Care policy recommendations included in a number of Government reviews.
Lobbied against the ill-thought-out Revalidation proposal, which resulted in a vastly improved Professional Performance Framework based around enhanced continuing professional development.
Successfully held off the latest attempt to have a non-Medical Chair of the Medical Board of Australia appointed.

Public Health

Launched the AMA Indigenous Health Report Card, which this year focused on ear health, and specifically chronic otitis media, in conjunction with the Minister for Indigenous Health, The Hon Ken Wyatt AM.
Led the medical community by being the first to release a Position Statement on Marriage Equality, and advocated for the legislative change that eventuated in late 2017.
Released the updated AMA Position Statement on Obesity, following a policy session at the AMA National Conference, which brought together representatives from the medical profession, sports sector, food industry, and health economists.
Launched the AMA Position Statement on an Australian Centre for Disease Control (CDC), which was welcomed by experts in communicable diseases.
Released the AMA Position Statement on Female Genital Mutilation, which provided a platform for the AMA to engage in advocacy on preventing this practice.
Released the AMA Position Statement on Infant Feeding and Maternal Health.
Released the progressive and widely-supported AMA Position Statement on Harmful substance use, dependence, and behavioural addiction (Addiction).
Successfully lobbied against the proposal to drug test welfare recipients, including a strongly worded submission to a Parliamentary Inquiry on the proposal, which resulted in defeat of the proposed measure in the Parliament.
Released the AMA Position Statement on Firearms, generating considerable media coverage and interest, in Australia and overseas. Most importantly, it is a factor in Australia maintaining its tough approach to gun control.
Released the AMA Position Statement on Blood Borne Viruses (BBVs), which called for needle and syringe programs (NSPs) to be introduced in prisons and other custodial settings to reduce the spread of BBVs. This policy has been promoted by other health organisations and saw the AMA create strong ties within the sector.
Ongoing and prominent advocacy for the health and wellbeing of Asylum Seekers and Refugees, including a meeting with the Minister for Immigration and Border Protection, The Hon Peter Dutton MP, and lobbying on behalf of individual patients behind the scenes.
AMA lobbying of manufacturers saw a change to the sale of sugar-sweetened beverages in some remote Aboriginal communities, which will improve health outcomes.
Promoted the benefits of Immunisation to individuals and the broader community. Our advocacy has contributed to an increase in child and adult vaccination rates.
Provided strong advocacy on climate change and health.
Consistently advocated for better women’s health services.
Lobbied for the establishment of a No-Fault Compensation Scheme for people adversely affected by vaccines.

We promoted our carefully-constructed Position Statement on Euthanasia and Physician Assisted Suicide during consideration of legislation in Tasmania, Victoria, NSW, and WA.

I would like to thank Dr David Gillespie for his contribution to the Rural Health portfolio, and hope that his legacy will be seen in the success of the new Rural Health Commissioner, a position the AMA lobbied for and supports.

In the New Year, we will release new Position Statements on Mental Health, Road Safety, Nutrition, Organ Donation and Transplantation, and Rural Workforce.

As your President, I have had face-to-face meetings with Prime Minister Malcolm Turnbull, Opposition Leader Bill Shorten, Health Minister Greg Hunt, Shadow Health Minister Catherine King, Greens Leader Dr Richard Di Natale, and a host of Ministers and Shadow Ministers.

We also organised lunch briefings with backbenchers from all Parties to promote AMA policies.

In July, our advocacy was publicly recognised when the Governance Institute rated the AMA as the most ethical and successful lobby group in Australia.

I have met regularly with stakeholders across the health sector, including the Colleges, Associations, and Societies, other health professional groups, and consumer groups.

As your President, I have been active on the international stage, representing Australia’s doctors at meetings in Zambia, Britain, Japan, and the United States.

The highlight of the international calendar was the annual General Assembly of the World Medical Association. Outcomes from that meeting included high level discussions on End-of-life care, numerous ethical issues, Doctors’ health, and an editorial revision of the Declaration of Geneva.

But our focus remains at home, and your AMA has been very active in promoting our Mission: Leading Australia’s Doctors – Promoting Australia’s Health.

We have had great successes. We have earned and maintained the respect of our politicians, the bureaucracy, and the health sector. We have won the support of the public as we have fought for a better health system for all Australians.

We have worked hard to add even greater value to your AMA membership.

May I take this opportunity to wish you, your families, and loved ones a safe, happy, and joyous Christmas, and a relaxing and rewarding holiday season. I hope you all get some quality private and leisure time – you deserve it.

Dr Michael Gannon
Federal AMA President

Long-term investment for serious reform

The AMA has delivered its Pre-Budget Submission 2018-19 to the Government and released it publicly while calling for a new era of big picture health reform.

In releasing the submission, AMA President Dr Michael Gannon said the Government had a rare opportunity for initiate serious health reform, due the culmination of a number of key health policy reviews.

But, he said, any reform will need significant long-term investment.

“The conditions are ripe for a new round of significant and meaningful health reform, underpinned by secure, stable, and sufficient long-term funding to ensure the best possible health outcomes for the Australian population,” Dr Gannon said.

“The next Budget provides the Government with the perfect opportunity to reveal its health reform vision, and articulate clearly how it will be funded.

“We have seen years of major reviews of some of the pillars of our world class health system.

“The review of the Medicare Benefits Schedule (MBS) is an ambitious project.

“Its methods and outcomes are becoming clearer. Its best chance of success is if the changes are evidence-based and clinician-led and approved.

“A new direction for private health insurance (PHI) has been determined following the PHI Review.

“We must maintain flexibility and put patients at the centre of the system, but recognise the fundamental importance of the private system to universal health care.

“The Medicare freeze will be lifted gradually over the next few years.”

Dr Gannon said the Government needed to now look at all health policies as investments in a healthier and more productive population.

He said there was now a greater focus on the core health issues that will form the health policy battleground at the next election.

“There is no doubt, as shown at the last Federal election, that health policy is a guaranteed vote winner – or vote loser,” Dr Gannon said.

“Our submission sets out a range of policies and recommendations that are practical, achievable, and affordable.

“They will make a difference. We urge the Government to adopt them in the Budget process.

“Health should never be considered an expensive line item in the Budget.

“It is an investment in the welfare, wellbeing, and productivity of the Australian people.

“Health is the best investment that governments can make.”

The AMA Pre-Budget Submission 2018-19 covers:

General Practice and Primary Care;
Public Hospitals;
Private Health Insurance;
Medicare Benefits Schedule (MBS) Review;
Preventive Health;
Diagnostic Imaging;
Pathology;
Mental Health and the NDIS;
Medical Care for Older Australians;
My Health Record;
Rural Health;
Indigenous Health;
Medical Workforce;
Climate Change and Health; and
Veterans’ Health.

The submission can be found at ama-pre-budget-submission

It was lodged with Treasury ahead of the Friday, 15 December 2017 deadline.

CHRIS JOHNSON