Voting for a healthy future:

The Australian health system needs a “seismic shift” according to the Australian Medical Association (AMA).

Addressing the National Press Club on Wednesday, AMA President Dr Steve Hambleton said Australia’s health system gets the results it was designed for - but it was designed for a different set of health issues.

“If you are going to get seriously unwell, Australia is a great place to do it,” he said. “You will get world class care.”

Dr Hambleton said that because of the health system’s expertise in acute care, people were much more likely to survive heart attacks today than they did 10 years ago.

“As a result, more Australians are now living with coronary heart disease and the disability that follows an attack,” he said.

But he warned that “real health reform” means redesigning the health system to meet new challenges.

“Let’s not wait for the heart attack and the ambulance,” he said. “Let’s not rely on the emergency department, the catheter lab with the latest stent, the coronary care unit and the cardiac rehabilitation.

“Let’s fix the lifestyle and prevent the heart attack instead.”

Dr Hambleton went on to say that Australia faces many of the same issues as other developed nations such as ageing of the population with chronic and complex health problems, the need to boost primary health care and a lack of coordination in health promotion activities.

He was critical of the focus on containing costs by “getting people in and out of hospital” as fast as possible and said there should be more focus on preventing them from going to hospital in the first place. He said that while Australia spends close to the average on health compared with other OECD nations, we are not spending it in the right areas.

Dr Hambleton cited Australia’s successes in immunisation rates, plain packaging for tobacco products and the National Disability Insurance Scheme as evidence of all sides of politics working together on new solutions for modern day problems.

Dr Hambleton said he hoped the focus during the election campaign would be “a battle of ideas and policies” in areas such as health, education and economic security and called for policies for a healthier and smarter nation. He was critical of politicians and talkback hosts who are fixated on issues such as immigration, asylum seekers, the emissions trading scheme (ETS) and personal attacks.

He said that health policies should “be tested against the reasons we need health reform – our increasing burden of chronic disease and our ageing population.”

If proposals did not work towards addressing these two policy drivers through a coordinated and strengthened primary health care system, they should not be supported

The AMA’s list of key health issues for the election were released by Dr Hambleton. He described them as “common sense, practical and affordable”. The publication is available here.

In summary, the issues are:

• Healthier Australian families – with a focus on wellness, not illness.

• Affordable medical services– focussed on five measures which the AMA would like to see reversed, the key one of which is the cap on tax deductions for work-relation self-education expenses known as Scrap the Cap. This measure particularly hits doctors who are required to undergo a minimum level of self-education each year merely to maintain their professional registration.

• Public hospitals– the AMA wants the ‘blame game’ to stop and for funding to be better targeted, patient-focussed and clinician-led.

• Medical workforce and training – the AMA wants a five-year medical workforce training plan.

• Indigenous health– Dr Hambleton called on all states to sign up to the Closing the Gap funding levels and targets.

• Care for aged patients– the AMA is concerned about inadequate funding for dementia, palliative and acute care for aged patients.

• Tackling chronic disease– a coordinated care program is needed to tackle the growth in patients with chronic and complex diseases due to the ageing of the population.

• General Practice infrastructure– the AMA wants to see the end of GP Super Clinics and an expansion of the Primary Care Infrastructure Grants program.

• Medicare Locals– while the AMA supports the concept of Medicare Locals, they are concerned about their engagement with GPs.

• e-Health system– the AMA supports a national e-health system for better quality patient care but is critical of its implementation across the country which it describes as “slow and patchy”.

• Appropriate care for asylum seekers– the AMA believes that asylum seekers should have access to health care, regardless of the detention arrangements. The organisation is concerned about the lifelong health impact of detention on children, and on the mental and emotional health of detainees. They have called for an independent medical panel to report on health services for asylum seekers as a “true sign of a compassionate country”.