Mr LATHAM (1:37 PM) —I move:

That the House urges the Australian Competition and Consumer Commission to conduct a full-scale inquiry into the medical profession, focussing on:

(1) anti-competitive practices, particularly among surgeons and specialists;

(2) reform of medical training practices, particularly within the College of Surgeons; and

(3) areas where the medical profession does not comply with trade practices law.

When the parliament passed its national competition policy in 1995, there were high hopes that this would clean out anticompetitive practices in the professions. This was particularly the case for the medical profession and the notorious practices of the College of Surgeons. In some areas the ACCC has made good progress, especially in its scrutiny of contracting arrangements in hospitals. For instance, in December last year it won an important case to prevent price fixing by the Society of Anaesthetists. However, a key area of public concern is still unresolved: the anticompetitive practices of the College of Surgeons.

We hear a lot of concern in this parliament about the costs of health care, the length of waiting lists and the paucity of health funding. These problems have been made much worse in Australia by restrictions on the supply of specialist doctors. These restrictions massively inflate the income of specialists within the College of Surgeons club. In nearly every specialty area Australia has many fewer surgeons than the recommended specialist to population ratio. Most people think that the New South Wales Police Commissioner, Peter Ryan, is Australia's highest paid person on the public payroll. In fact, they should have a look at some of the money earned by surgeons in our public hospitals. Medical specialists have formed a club, which keeps their numbers down and their prices up, and incomes of more than $800,000 per annum are not uncommon. To adapt a Paul Keatingism, `Never get between a surgeon and a pile of public money.'

This decade we have heard a lot of noise about competition policy but too little action when it comes to the College of Surgeons. These practices are a deliberate anticompetitive strategy by the college. It is organised along the lines of a club: those inside the club protect their interests at the expense of those outside the club. They have adopted feudal training practices, virtually torturing prospective specialists such is the degree of difficulty in gaining entry, making it as hard as possible for anyone to join their club and thereby the public money benefits that come from it. Australia does not have medical academics, an unusual state of affairs. At huge public expense, the club is allowed to run our university medical programs. We have medical doctors running our university programs, not medical academics. This is not a standard of public accountability and competition policy that applies to any other profession in the country.

The ACCC has made noises about this issue for long enough. It needs to establish a full inquiry into the College of Surgeons to effectively bust up the club. Australia needs an independent system for the training of medical specialists. This would produce a higher number of surgeons, more competition, more reasonable prices, smaller waiting lists and, of course, better service for the public. We need to make the medical profession as a whole much more accountable and transparent. For instance, the recent report by the independent pricing tribunal on the New South Wales health system showed that there is virtually no data relating to the salaries, costs or efficiency of service of visiting medical officers. As in any other area information is power, and the medical elite has all the information, thus, in this sector, they have all the power.

The public interest can only be advantaged by greater transparency. Quality decision making in the public sector relies on quality information. Con Costa, the President of the Doctor's Reform Society was quoted in the Bulletin on 2 March 1999. He said:

I've had specialists come to me complaining about the colleges that make the decisions about who gets the treating hospital positions. It's not an open and transparent system. It's still an old boys' network. Getting them to speak out is very hard because it's a small and closed circle. That works to disadvantage specialists and patients.

I point out the hypocrisy on the part of the Howard government. If this government showed anywhere near the interest in the closed shop of the medical profession in this country as they did in the crane rates on the waterfront, then, by now, Australian medical consumers would have been far more advantaged. They might have seen this club busted up, some injection of competition and some benefits across the health sector. Most of all, action needs to be taken by the ACCC, and the purpose of this motion is to urge that action as soon as possible.

Mr DEPUTY SPEAKER —Is the motion seconded?

Mr Kelvin Thomson —I second the motion and reserve my right to speak.