Transcript of Radio Interview: AMA Vice President, Dr Mukesh Haikerwal, With Jon Faine, ABC 774 Melbourne, 31 March 2005

JON FAINE: Let's talk about it from the GPs' point of view as well. We've put in calls to the Health Insurance Commission and they've given us a statement that says: The Government's monitoring the situation. The Health Insurance Commission has granted an approved pathology authority licence to the co-op and has also granted a small number of its members approved pathology practitioner status. But as they don't yet hold accredited pathology laboratory approvals, they are unable to access Medicare benefits. In other words, it hasn't gone all the way through yet.

Dr Mukesh Haikerwal is the AMA's Vice-President for Victoria.

Dr Haikerwal, good morning.

HAIKERWAL: Good morning, Jon. How are you?

FAINE: It's hard to see how this has made it as far as it has. But what's the AMA's position? It's your GP members who are going to be in the hot seat.

HAIKERWAL: That's right. As an AMA, we look after all the professions, including the pathologists too, so there are concerns expressed from both sides.

FAINE: But there's more GPs than there are pathologists.

HAIKERWAL: That would…

FAINE: What advice do you give them?

HAIKERWAL: The pathologists have a very important part to play in the medical scene.

What we say to our GP members is you've really got to have it in writing from the HIC to know that this is a practice that is actually … is approved and that you actually are safe to do this. Because otherwise they can end up having problems later on down the track.

Also, if you're going to be in this model of ownership of … part ownership of a lab, you've actually got to be upfront with your patients and say that you do have this interest and give them a choice in terms of what else … other labs they wish to use. And then they might of course…

FAINE: Sorry, just on that point, I'm sitting down with the doctor, the doctor has just said, 'look, I'm worried about that lump and we're going to do some tests'. I'm hardly in a position to sit and argue the toss with the doctor about where those tests are to be conducted.

HAIKERWAL: If I look behind me here in my room, I've got three sets of lab request slips here, so people can choose which one they want to go to, which is more convenient for them.

FAINE: Well, the taxpayer picks up the bill. I don't care as long as the tests get done.

HAIKERWAL: I understand that, but some people do actually pay out of pocket.

But the other important thing as far as I'm concerned is that the ethics of the whole situation have to be taken into account…

FAINE: Ah yes, the ethics.

HAIKERWAL: …and people really need to have an ethical framework where they do do tests. The tests have to be necessary, we don't want people having tests unnecessarily. And that they have to be able to justify what tests are being done.

And I think patients have a very important part to play in this, to say, you know, do I really need this test, what's it for and how am I going to get the results and all those sorts of things are a very important part of making sure that the quality is maintained.

FAINE: Why aren't they concerned about the ethics at the Health Insurance Commission end of it? How can they have not seen this before it hits them?

HAIKERWAL: Yeah. Well, I mean, that's discussions we'll be having with them and with the government. They've got a new portfolio minister, of course, so it is probably early days for them to get to grips with this issue. It's one of those very complicated issues, that it's not simply a payment agency, the HIC … and they have got these other considerations around ethics and around administering complicated services like pathology.

FAINE: But it's not complicated ethically, it's incredibly simply ethically. You can't have someone commissioning taxpayer-funded tests for which they get part of the fee.

HAIKERWAL: Well, that's certainly one point of view and I think what's important is that there be…

FAINE: Well, can there be any other?

HAIKERWAL: Well, you know, the ownership of labs currently isn't that clear cut and certainly it's important that labs … people who have an interest in the labs declare at the time that they…

FAINE: But if you were getting a private laboratory kick-back, that would be a major scandal. What difference does it make if it's coming from a co-op?

HAIKERWAL: I think that if there are kick-backs, that's certainly a problem. I think that most people do work in an ethical framework and it's important that they do continue to do that. I think that people have the right to expect a quality service and that the tests they have to be approved … the results to be proved by quality approved pathology providers, those that have come through the College exams and have got experience in pathology interpretation.

FAINE: So will you be suggesting to your members who are GPs that they not engage in this practice?

HAIKERWAL: I think that they have to look very carefully at what is being suggested for them. They need to make sure that they have covered their bases safely and that they are backed up by fully trained pathologists in the way in which their services are provided for them.

FAINE: I'm grateful to you for your time.

HAIKERWAL: Thank you.

FAINE: And I haven't asked you about Nathan Buckley's hamstring.

HAIKERWAL: I can't answer that one either.

FAINE: Dr Mukesh Haikerwal, Vice-President of the AMA.

And to those text-message correspondents who say we're being mean to Nathan, no, we're not, we're being mean to the media who seem to think it's a more important story than anything else. Of course we're sorry for Nathan, but for goodness sake, put it in its proper context.

Ends