Doorstop Transcript - AMA Budget Submission

DR BILL GLASSON: The Prime Minister said yesterday that he looked forward to the day when Indigenous people could share in the full enjoyment of the bounty Australia brings.

We look forward to that day too. The AMA budget submission is calling for an extra $400 million to improve the health of our Indigenous Australians. Good health is a bounty that other Australians take for granted. I urge the government to make Indigenous health a priority.

I also extend an invitation to the Prime Minister and government officials to personally come with me on a tour of Indigenous communities, to see what we can do with that $400 million. Simple things like clean water, sanitation, housing, education, things that you and I take for granted.

Australians have shown an unprecedented spirit of goodwill to the victims of the Asian tsunami and the Eyre Peninsula bushfires. Let's extend that spirit of goodwill to fix Indigenous health. The AMA is also calling for more money for mental health services and for the long-term care for the severely disabled.

The Prime Minister has spoken of the bounty Australia brings. Let us have unity on the bounty, not mutiny on the bounty.

I'd also like to say congratulations to the Australian of the Year, Dr Fiona Wood. She is a wonderful doctor, a wonderful person, and we're proud of her. Very happy to take questions.

QUESTION: Dr Glasson, how much - ballpark figure - how much do you think would be needed from the government to put into Indigenous health?

DR GLASSON: Well look we are calling for $400 million into Indigenous health. Approximately $200 million into mental health, and that's an area that has been forgotten for too long. And finally funding for the long-term care scheme, which is in the order of $120 million. And so it's these three areas that we're asking the government to consider in its 2005-2006 budget.

QUESTION: Over what period of time is that?

DR GLASSON: Initially obviously the $400 million - we could spend it tomorrow in Indigenous health…probably not…we need to commit them to the $400 million first and foremost and then we need to build on programs such as educating our own Indigenous health workers, Indigenous doctors to actually work within the system; build up the primary care aspect of the - such that indigenous places can access doctors and access the Pharmaceutical Benefits Scheme. So it's a whole range of initiatives that, as I said, we'll build over four to five years.

But we actually need $400 million really in the system today but we probably don't have the resources to deliver it.

QUESTION: Doctor, during your lifetime the health standards of non-Indigenous Australians would have increased considerably. Do you think that in that same period the health conditions of people in Indigenous communities have gone forward, backward or stayed the same?

DR GLASSON: Sadly, we've gone backwards. And I think that's a terrible admission to make. I think that essentially over the last three or four decades, if you look at any health statistic, we in fact are going backwards.

And when you compare us to the rest of the Indigenous communities around the world, whether it be American Indian or the New Zealand Maori, in fact our statistics are atrocious; they're frightening; they're unacceptable and they're un-Australian.

QUESTION: Third world conditions, are they?

DR GLASSON: Third world conditions, absolutely. You go into some of these communities, they are worse than third world conditions. And that's why I'd like the politicians and the public to actually go and have a look for themselves. Go and ask why are we asking for $400 million. I can tell you why. Go and walk around those communities and the answer stares you in the face.

QUESTION: How embarrassing is it when we've just come out of a federal election where this was not an issue at all? Did you not ask for putting indigenous health at the top of your submission last year?

DR GLASSON: Look, we did. Obviously we've been targeting Indigenous health since I've been President and the Presidents before me have been echoing the same message. I think it's time. I think time now, and I think the Prime Minister is starting to speak out. I think that's a good signal. I think government ministers are starting to speak out across the board, and I also noticed the bureaucrats are speaking out.

I think all of them are saying, shame, shame, shame; it's time we did something. And I believe that we will get this commitment in the budget and, if we don't, I'll be severely disappointed.

QUESTION: You spoke of the generosity of people regarding overseas tragedies. Do you think that, if the average Australian went to some of these places in North Queensland and Northern Territory, that would elicit the same level of compassion on their part to improve the situation? Is it just that we don't see it?

DR GLASSON: I believe you're right. I believe that the average person out there does not understand the predicament that we find a lot of Indigenous patients find themselves in, or Indigenous people find themselves in. Things we take for granted, as I said, clean water, clean housing, a proper diet, education.

Look if you wake up in the morning and you haven't got clean water; you haven't got something to fill your tummy and you're supposed to go to school and try and learn, then it will not happen.

Essentially you'll wake up with low self-esteem. So the only way of actually rebuilding, I suppose, the Indigenous population or health of the population is actually building around clean water, better housing, better health, better education. Then most people wake up like you and I in the morning feeling good about themselves, feeling positive, feel as though they want to go out and help other people.

And that's what we've got to engender in Indigenous people. So there's no point in just targeting health on its own, we must target education, housing, the whole elements or pillars of society, of community that we take for granted.

QUESTION: Doctor, do you believe that, if more money was spent on the mental health and long-term care, that would take pressure off other areas in the health system?

DR GLASSON: Look I do. Can I just make a point about mental health? Now each and every one of you standing before me here will have some form of mental illness during your life. It may be minor but for 3 to 5% of you it will be major. It'll be something that you'll live with for the rest of your life.

Because we can't see it, like a physical disability, we tend to ignore it. And governments, both state and federal, have ignored this over the last few decades. And what we've done, we have de-institutionalised people with mental disorders which has been good, put them in the community. But we have not had the funds to go with it, to provide the services in the community. And as I talk to my psychiatrists and my GPs, they are continually crying out that they cannot find acute beds for acute psychiatrically disturbed patients and this is unacceptable.

And where most of these patients lie, they lie in prisons and they lie in the homeless. Go and visit the homeless parts of major cities and they are the people that, in fact, suffer from a lot of the major mental disturbances.

So putting funds into mental health actually saves money in the long term. Putting money into long-term care, to answer the second part of your question, also is about compassion.

It's about making sure that if you or I have a child who's somehow disabled at birth that we can access the services that child deserves. We don't go through some complex legal process trying to get someone to blame to get the care that we require.

So we do need funds in that system so we have equity. And it's really a moral and social issue to look after those who are most disadvantaged in society.

QUESTION: Tony Abbott has promised that he won't change the parameters of the Medicare safety net, which has blown out extravagantly. Do you expect that he'll keep that promise?

DR BILL GLASSON: Look as we speak we're actually looking at that safety net, looking at what pressures are coming upon it. And obviously if that's not viable, if it financially blows out then some constraints will have to be put upon it.

I think it's a great initiative. I think it's a great initiative for patients out there and I'd hate to see it sort of drastically I suppose reformed as a consequence of blowing out, because I think that the combination of the Medicare system at one end, the safety net at the other makes you, gives you a degree of security and safety from the point of view of having a major ailment.

But we will look at it closely, we'll look at what the statistics are showing…

QUESTION: Who's we and what are you looking at?

DR GLASSON: Well, it'll be the medical profession - the AMA obviously will look at the statistics that the Government is obviously developing and if there are particular areas that need to be addressed we'll have to address them, there's no two ways about it.

But obviously Tony Abbott believes in the safety net, we believe in the safety net, and I believe the community believes in the safety net. So we have to preserve it, but if it needs some rejigging then we're happy to rejig it.

QUESTION: What kind of rejigging?

DR GLASSON: The rejigging really comes to the, from the financial sense, in other words if it's blowing out in one particular sector or one particular element then we may have to put some constraints on it. But at this stage the data that we have seen, it does not suggest that. The data is that doctors and patients are being very responsible.

But as I said if data further down the line would suggest it is blowing out then we may have to, as I said, either restrict - I don't want to really put a threshold on this but obviously depending on what's happening in the system we may have to adjust it.

QUESTION: But is the blowout that's there now, is that because there are too many patients in there or that the charges from the patients that are in there are too high on the list?

DR GLASSON No I think what's happened at the moment, the only bits that are blowing out are charges already in the system that weren't being accessed by the safety net. And so for the mainstream sort of item numbers that doctors use there has been very, very little shift across the board.

There's certain areas, as I said, that where patients were actually paying a gap, they were not accessing the safety net but now they are, has shown some spike or some increase. But I don't think that necessarily will continue. I think that what will happen now is that the graph will in fact level out and I think you'll see very little increase over the next 12 months, apart from…

QUESTION: Surely if the charges were already in the system, shouldn't that have been included in the original model? The fact it's blown out means they're unforeseen.

DR GLASSON: Yeah to an extent you're right. Obviously when you're trying to model this initially it's very difficult to work out exactly what costs are in the system. And I think the modelling that has been done for the majority of the profession has been in fact pretty well spot on.

But there's a couple of areas as I said there is a certain amount of pressure on, but I think the important thing for the public to understand is that you believe in it as the public, we believe in it as the medical profession because we believe it addresses a whole range of issues around affordability and security.

QUESTION: Can you ever foresee a day where people will be buying private health cover for gap fees? The safety net will effectively be privatised?

DR GLASSON: I mean I think what happens with the private system in the long term will obviously depend on obviously the costs within the system, and we want to make sure that the gaps that patients pay are affordable, and that's the idea of the safety net.

At the end of the day the patient pays it one way or the other, okay? So we've got to make sure that those patients across the board have equity of access to the system and that it's affordable. Now if those gaps get too large and that we say we the taxpayer can't afford the 80% safety net at the moment, then that may need to be adjusted.

But I'd like to think that that doesn't occur, because the figures that I'm seeing at the moment is there is not a huge shift at all and that for most cases patients and doctors are being very responsible.

QUESTION: Will the safety net eventually have to be means tested if it keeps blowing out to this degree?

DR GLASSON: I hope, you know I hope not because if I have a child that has a major catastrophic event tomorrow and I have got significant financial impost on me and psychological ones, it's trauma to my child, I'd like to think there's a system there to protect me as much as anybody else. And I think that's the good thing about the system. I think that you, I, or anybody can access it.

And so I don't think that we should try and means test it because what happens with means testing, you often end up hurting a lot of people you don't want to hurt. And that's often the single income person with two or three kids, they've got a mortgage and all the rest of it, but they don't quite reach the threshold. And I think wherever you draw the line, a threshold, somebody gets hurt.

So I'd like to see us preserve the system. I think it's a great system. As I say if it does need some modification so be it, but let's look at the statistics first, let's look and see if it is really blowing out and I'm sure if it's sustainable I'd like to preserve it in its current form.

QUESTION: Do the statistics show that it's helping the people that it's meant to help? Or is it helping perhaps other patients who might not be so close to the line?

DR GLASSON: I think it's probably both, is the answer to your question. I think that as long as it's helping the people that really need to be helped I believe in the system.

If on, if as well it helps some other people that might you can argue can afford an extra dollar well so be it. But the reality is that the whole idea of the system is to make sure that those people who need to be helped get helped.

Please don't destroy the system because there's five percent of the people in it that you feel shouldn't be in it, because the 95% of people that are accessing it really appreciate it. These are young mums having babies. These are young mums who are trying to pay a house off. These are young mums who are trying to buy clothes for their kids and feed their kids. These are the people we're trying to help.

So I think we've got to make sure and make a clear point about what we're trying to deliver here, and that's affordability on one hand and security on the other. That you lying in your bed at night know that you have some major catastrophic event in your life, the system will come and pick you up and support you. And I think that's what it's all about.

QUESTION: Just back on your, the comments about the indigenous matters, what's your view of the current progress of the grog bans in Queensland in Indigenous communities? Is it working?

DR GLASSON: Yeah I mean I must say, I do a lot of work amongst Indigenous communities. When I go to the dry communities where alcohol is banned there is a different philosophy. There is a much more positive philosophy, we don't have the issues around people being bashed and you know, the family breakdowns etcetera. So alcohol is a real issue and I think we've just got to get up and say that. And I think the Indigenous leaders like Noel Pearson have been saying that. We have to do something about the alcohol.

Now it's for the Indigenous communities to really make those decisions and drive them and for us to support the Indigenous leaders. So we have to get responsible Indigenous leaders to actually come out publicly, which they have been saying, and saying listen, we do not support open access to alcohol across the board. We're going to restrict it or we're going to ban it, whatever the community wants.

But the community must be listened to, not just one or two individuals that may be in their interests to keep the alcohol going. So we do have to do something about that and I believe if we do that it makes a big difference.

And I must say that Peter Beattie has been on this issue and I commend him on it for getting behind it and getting behind the indigenous community to try and get an outcome, because 90% of indigenous people don't drink, are not tied up with abuse directly but they get caught up in it because they live in communities where there is an element or a percentage that actually cannot control their alcohol consumption and the violence, the violence against women, the violence against children is unacceptable.

And so we have to stand up and say enough's enough. We're going to put money in the system, but we've got to make sure that money's spent properly and if that means actually restricting alcohol then so be it.

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