Dr Kerryn Phelps, AMA President, with Philip Satchell and David Bevan, ABC Radio, Adelaide

7 Feb 2002

SATCHELL: Well, David, I think you would agree that the most passionate and, for us, the most difficult to control of our debates before the election has been the one on health. It was a corker.

BEVAN: It was.

SATCHELL: And one of the difficulties was that both the Minister and the Shadow Minister agreed that health is not simply by…you don't measure it simply by counting the number of beds; that health is such a huge issue that it comes down, almost invariably, to how many beds we're going to open here or close there and it's hard to get any real fix on it.

BEVAN: Well, that day we got a call from the AMA, who said to us, "Look, we heard this debate between Dean Brown and Lea Stevens, between the Labor Party and the Liberal Party, and we weren't impressed. Not impressed at all".

And the next day we spoke to Michael Rice, from the AMA here in South Australia. And Michael said, "Look, we're not impressed, but we will continue to monitor all of the parties and, as we get close to election day, the AMA will actually bring out some sort of health report card on the state of the State and the state of the election campaign".

Now, Kerryn Phelps is the Federal President of the AMA, and she's in Adelaide today to discuss various issues affecting the health sector and speaking to doctors.

Kerryn, I'm hoping…I'm not sure you can do this, but I'm hoping that you'll be able to give us that health report card, this morning. Or do we have to wait another day for the AMA to tell us?

PHELPS: No, I can certainly let you know a fair bit about our impressions of the upcoming election and the health promises that have been by both sides.

BEVAN: And that is?

PHELPS: Well, it's not a one-line answer I have to tell you. I think we need to really look issue by issue at what's being offered. But, if we look perhaps first at public hospital funding. Because there's no question that, over the last couple of years, the issues of beds being closed, ambulances on bypass, emergency departments overflowing, shortages of nurses have certainly been in the headlines and certainly have required some sort of response from government.

When we look at the response that we have seen in the lead-up to this State Election, we've heard from the Liberal Party that they're willing to work with doctors and nurses to ensure staffing is in line with awards. They, of course, are saying the Federal Government needs to do more, which is something that we hear no matter what state we're visiting. They're looking at more capital works over the next two and a half years, more money for Accident and Emergency to employ more doctors and nurses. But, of course, it's not just about money; it's about conditions as well. Labor, on the other hand, is also offering to fund 76 additional acute hospital beds, an extra

24 emergency care extended care beds, $6 million dollars over four years to employ cleaners, which is very reassuring.

And so, in terms of public hospital funding, I think that the importance of health has certainly caught the ear of the respective candidates for the State Election this year.

BEVAN: Well, on that issue of funding hospitals - and we can quickly rattle through the different sectors - but, on the issue of funding public hospitals, does the AMA see any significant difference between Labor and Liberal?

PHELPS: I think that it's difficult to analyse between the two, and I think that we might just have to wait another day or so before we make any kind of particular analysis of the different offers. Because, a lot of the time, what happens is that the incumbent government re-announces its Forward Estimates, which means that they've already announced the money, it's already planned for, and they're saying, "We're still going to pay it".

BEVAN: Well, later on today, Labor will be releasing its costings. So, we find out what it's prepared to cut in order to redirect money into other, what it calls 'priority areas', so we'll have a better idea from Labor, I think, early afternoon. But we're still waiting, as you say, to get a clear picture from the government.


BEVAN: What about mental health?

PHELPS: Well, mental health is an absolutely essential area to look at, particularly in this upcoming election, because mental health services have emerged as a really serious problem in South Australia. We're seeing that mental health services have been inadequate for many years, here. And a reform process has started to address the issue, but the system's really at crisis point at the moment. Once again, both Liberal and Labor have indicated that they're going to be spending more money on mental health. But they need to make sure that they engage the medical profession in any future planning, because it's the medical and nursing professions who actually see the deficiencies first-hand. And the politicians, I think, can very much benefit by consulting with the medical profession and saying, "Well, where do you see these areas of inadequacy, and what should we do to make sure that it's okay?".

I mean, it's got to the point where the treatment is so inadequate that people are being held sometimes under restraint and with armed guards. And, of course, there are issues there for the safety of the staff as well. Now, this is really not - it's not appropriate. And so we need an ongoing commitment to training hospital staff, providing appropriate facilities in all public hospitals, and of course, more residential beds for people who require that kind of intensive care.

BEVAN: Can you see any difference between the two major parties on the issue of teaching and research?

PHELPS: Teaching and research has long been ignored because it's easy to ignore it. It's not visible to the public. It's not until some years down the track that you see the deficiencies there. And quite often, when hospital budgets have been tightened up, the thing that they think that they can cut back is the amount of time and effort put into teaching and research. But it ultimately will have to be paid, in terms of less in the way of teaching and, less in the way of medical advancement in the future. And we cannot tolerate inadequate teaching and research.

And a healthy state relies on a good research base, and we're losing well-trained professional staff to other states due to the uncertainty of research funding in South Australia. So, what the AMA has been calling for is a strong commitment by government to ongoing hospital research funding. And that is needed to really turn the tide. And the specialists that I speak to are saying that, over the years, they really have noticed that the time that they have available to teach the junior staff and the undergraduates coming through has been diminished and diminished.

There have been not particularly firm commitments made by the the prospective governments on either side, over this. They've both said that they recognise South Australia's reputation for leadership in the area, that they need to develop the agenda to maximise the state's capacity, but, you know, not a lot in…from the Labor side in terms of commitment. The Government plans to establish a $40 million dollar innovation fund and provide $67 million dollars for teaching and $5.9 million dollars for research. We, obviously, need to see the details of how that money is going to be spent.

BEVAN: Kerryn, I'm not walking away from this conversation with a clear idea who I should vote for.

PHELPS: I'm not here to tell you who to vote for. I'm here to say that health must be at the top of the agenda. I think that the voters need to listen to what both parties are saying, to look, perhaps tomorrow, at the summary of the health promises of both sides, and to say, "Health is important to us", and particularly, at a local level, to press their local Members for what they're going to do about the health sector.

BEVAN: But, I think, essentially we trust doctors and we look to the AMA, representing doctors, to help us work through this issue of the-- health. Because a lot of people are going to vote according to who they think will give them the best health system.

By tomorrow, will the AMA be able to give us a health report card and say, "This is what the two parties are going to say on this issue, are going to do on this issue, and we think this is a good idea and that's not"?

PHELPS: Well, I'll be talking to AMA South Australia today and I'll be going to the AMA South Australia Board meeting tonight and that matter will be discussed. Today would be, I believe, too early to do so. But by tomorrow, I believe, you'll see a release of the report card more broadly and then I think that voters will be able to make up their minds.

But it is such an important thing for not only the health system within a state to be working well, but for the Federal and State Governments to be coordinated and communicating well, too. We see a lot of tangling of wires between one level of government and the other, and I believe that there is more that can be done at both levels to ensure better communication.

BEVAN: Before we let you go, Kerryn, the issue of private health insurance has reared its ugly head again this week. The Federal Health Minister, Kay Patterson is saying this morning that the cost of private health insurance will rise. What's the AMA's position on that?

PHELPS: I think with the cost of medical services increasing - the cost of providing improved technology, the cost of paying for award wages for staff, the cost of sort of generally running hospitals and providing services is going to go up - we have to expect that.

And I think that the main thing is that there is transparency in the process. That we, as consumers and, you know, I might be the President of the AMA, but I'm also the member of a health fund, and I want to know that if I'm paying an increased premium that I know why it's being paid, why it's being increased, and that there is some transparency in the process.

Now, it's gotten beyond the point where the health funds can really just talk to government about why their costs are going up. I think there are so many taxpayers' dollars, now, going in to prop up private health insurance. And I think that that was needed because we were placing such a great pressure on the private hospitals on the public hospitals with the fallout from private hospital insurance. I think the taxpayers, now, need to know why that money is being increased, why they're being asked to pay more, when quite often families are on very tight budgets. They need to know they're getting full value for their money.

SATCHELL: Dr Phelps, is it possible, and I take your point that it's difficult to say, at this point, who's got the better policy in health. But I think the one thing we have picked up is that there is goodwill perhaps on both sides, on all sides of politics to get health right, and it's one thing that people desperately want to have right. Yeah, and it's such a changing scene. It's changing all the time.

PHELPS: Mm. Well, I think it's important from the point the AMA is a representative group for the medical profession and an advocacy group for public health, and if the AMA has been able to - as it has - to raise awareness of the issues for both sides of politics to the point where it is, if not the major then one of the major health election issues for the South Australian State Election, then the AMA's done its job. Because whoever is in power knows that the electors are watching, the electors care, and that the AMA will continue to raise these issues with the public.

And I think accountability is the thing that is so important in government. That whichever side is elected this weekend, that there is accountability for what they do with the health system, which we know in South Australia is under serious stress.

SATCHELL: Dr Phelps, thank you.


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