The Year Ahead in Health

AMA President Dr Steve Hambleton says expectations for 2012 should be based on an assessment of last year’s achievements and challenges, but predicts battles will continue.

So, here we are in 2012.  We have a new year and we have a new Health Minister.  To get an idea of what to expect in the year ahead, we must first assess the year just gone.

Compared to recent years, 2011 was slow and steady in regards to health policy and health reform.

Other than the COAG Health Agreement in February, the Government’s flawed mental health package in May, and the Government’s triumphant tobacco plain packaging legislation at the end of the year, we did not see new policies or programs that would bring about major structural change or new directions for the health system.

The economic times were no doubt a contributing factor, and will continue to be.  The fact that health took a back seat to the major political battles of the carbon price, the mining tax, and asylum seekers is another.

In this environment, the Government and the Health Minister were content to put to bed the policies and programs that survived the sudden end of Kevin Rudd’s health ‘revolution’.

While the AMA was an outspoken critic of elements of the Government’s agenda, we were also highly supportive in other areas, particularly around public health issues.

We strongly supported the tobacco plain packaging legislation.  We supported the Government’s moves to increase the immunisation rate, and we welcomed the Government’s increases in medical training places and the increased funding for Indigenous health.

We wanted more from the COAG Agreement but we acknowledged the final outcome was a relatively good result given the change of government in several States.  The single funding pool was a step in the right direction and there is now greater transparency in the system with the States now unable to pass the blame for the performance or non-performance of their hospitals.

It is in the primary care area, however, where we sought more consultation and cooperation from the Government, and still do.

We accept that the Medicare Locals are now here to stay, and we understand that the Coalition would not scrap them if elected.  But we do not accept that the model has to stay the same.

The AMA is encouraging ‘bottom up’ activism from local doctors to ensure strong GP leadership and management of Medicare Locals.  I visited every State and Territory last year and met with local doctors and Medicare Locals management and there were signs that our message was getting through at the local level and making a difference.

We will work with the new Minister to get some changes from the top, too.  In fact, Medicare Locals was the main topic of discussion when I had my first meeting with the new Minister, Tanya Plibersek, in January.

The Minister heard our concerns and we will have further discussions soon.

I explained that the AMA would also keep working to inject some common sense into the GP Super Clinics program.  We want them stopped where they are not needed, not working, or where they compete with existing GPs.  The money would be better spent on existing general practices.

I believe that Medicare Locals – and all the issues associated with them – and the introduction of the Personally Controlled Electronic Health Record (PCEHR) will be the headline stories in health in 2012, at least for the first half of the year.  There may also be a couple of surprises in the May Budget.

Pressure will be building on the Government for decisive action or direction on aged care, mental health and dental care.

Minister Plibersek has already publicly expressed her wish to see improvements in the provision of dental services for the poor and disadvantaged.

Meanwhile, the AMA will continue to battle for a reversal of cuts to the Better Access program for GP mental health services and better access to medical services for older Australians, including those in residential care.  I will be discussing these matters soon with recently promoted Minister for Mental Health and Ageing, Mark Butler.

Looking ahead, I see a positive working relationship with the Government.  We share many common objectives with the new Health Minister, and we will have robust debate with her on the matters on which we do not totally agree.  That’s advocacy.  That’s politics.