MUDGE: Well, not yet quite as serious as it became in certain parts of America 15 years ago, when services collapsed in areas such as obstetrics. It was only after that, that the government stepped in. We are very hopeful that the Prime Minister's initiative here, in calling a summit, will enable Australia to escape that fate - that he will act before hand.
FULLWOOD: Sorry, this is the worry, I assume, litigation becoming more and more common?
MUDGE: We certainly are a very litigious society, and the quantum of damages awarded in medical cases is going up all the time. I mean, now the quantum is as high as $15 million for a case of cerebral palsy. There are only 800 obstetricians in Australia, $15 million means fifteen thousand for every single individual of us.
FULLWOOD: Yes, and some premiums for doctors are more than $100 thousand a year, so where do you spread that cost in the end?
MUDGE: Well, that sort of cost is either got to be past on to the patient, or doctors go out of business. I mean, those are the only two alternatives. Really, we need to spread it across a bigger pool of people. It's not fair to ask only the sick to pay for indemnity costs.
FULLWOOD: The Prime Minister has announced a summit on medical indemnity insurance. What are you expecting from that? Do you want the Government to do more, perhaps?
MUDGE: Well, unfortunately there is no solution without government involvement, I wouldn't want to pre-empt what the outcome of this is, but I think the initiative in calling a summit really is going to raise expectations, certainly amongst doctors, that a solution will come out of it, and not yet another government committee. We have had committees for the last five years - it's time we really had a conscious about what the solution is.
FULLWOOD: Yes. I suppose when you're a patient, and you go along to a doctor, should you be mindful that things can go wrong in surgery?
MUDGE: It's a paradigm really, isn't it? We've never had lower complication rates. It's never, for example, been safer to have a baby, than it is in Australia now, and yet when things go wrong, I think, such as our expectation of perfection, that if we don't get a perfect outcome, I think, we're forced to the courts, is all to quick.
FULLWOOD: Yes. Dr Mudge, are more people coming, more students, medical students entering the profession?
MUDGE: There are certain areas of the profession that are almost becoming 'no go zones', including my particular branch, which is obstetrics. In obstetrics and gynaecology, we've surveyed our trainees, and some 50 percent of them have no intention to practice obstetrics, they're going to do gynaecology, only.
FULLWOOD: Gee, so this is the area, it seems where it is most critical, by the sounds of things.
MUDGE: It is critical, and with an insurance cost of a $100 thousand for obstetrics, the average specialist delivers about 100 patients a year, it's a $1000 per patient just to cover indemnity costs, before you even start to look at covering your other costs, or heaven forbid, trying to make an income for your family.
FULLWOOD: Yes, I assume that patients… is there some way that their health insurance, that can be looked at perhaps as help in the cover?
MUDGE: Yes it can, but how do you keep up with it? Premiums have risen 20 percent a year, every year, for the last five, and now they have doubled. I delivered a baby last night, and suppose that baby gets cerebral palsy, and sues me in 25 years time, because that's the leading, by the time you reach the age of majority plus seven, now in 25 years, what is a case of cerebral palsy going to be worth? Is it going to be worth $15 billion?
FULLWOOD: Unbelievable, yes it's quite, yes, a critical time for you, and Dr Mudge thank you so much for joining us here, a lot of issues to be resolved for you.
MUDGE: You're welcome Anne.
FULLWOOD: Thank you very much.