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Will the real AMA please stand up! - Howe

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Brian Howe Deputy Prime Minister

Minister for Health, Housing and Community Services

16 September 1992


The Federal Government has requested an urgent meeting with senior representatives of the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) to clarify the attitude of the medical profession to general practice reform.

Health Minister Brian Howe said today the request was conveyed in a letter to AMA President, Dr Bruce Shepherd, from the Secretary of the Department of Health, Housing and Community Services, Mr Stuart Hamilton (attached).

Mr Howe said: "This step is necessary because recent statements by some AMA representatives are not consistent with the views conveyed by Senior AMA figures."

Mr Howe noted today's statement by the chair of the AMA Council of General Practice, Dr Roly Bott, who urged all doctors to support the reforms and said:

"The stance of the NSW branch, which represents only 27% of GP's in that state, is not reflective of the broad view of the profession." (Australian 16/9/92)

Mr Howe said he believed that elements of the medical profession were attempting to force a political confrontation with the Federal Government to serve their own political agendas.

"It is bewildering that after 12 months of consultation and negotiation, we now find that the narrow self interest of some elements of the profession are trying to scuttle those reforms negotiated by the federal bodies of the AMA and the RACGP and widely supported by doctors around the country," he said.

Mr Howe said that following a General Practice Summit convened by the AMA in Canberra four months ago, the Federal AMA issued a news release on 10 May - quoting Dr Brendan Nelson - which stated:

"The summit endorsed a wide ranging package of measures which will improve the quality of care that GP's are able to provide to their patients. These decisions include:

* the requirement for formal general practice training before a new doctor can enter unsupervised general practice;

* increased emphasis to be placed on general practice training for all medical students and doctors."

Minister Assisting the Prime Minister for Social Justice Minister Assisting the Prime Minister for Commonwealth-State Relations

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Mr Howe said that on 27 August, following the release of the Federal Budget, the Federal Vice President of the AMA, Dr Brendan Nelson, issued a news release which stated:

"The GP initiatives announced are as discussed between the Government, the AMA and the RACGP."

The Chairman of the AMA's Council of General Practice, Dr Roly Bott, said in a news statement issued 11/9/92:

"The AMA's Council of General Practice... recognised the need for junior doctors to have appropriate training prior to going into unsupervised general practice.

"This is not provided by either the medical course or hospital residency alone."

In the final line of his statement, Dr Bott made this comment:

"It is obvious that some groups have other agendas and would cynically use the concerns of trainee doctors for their own ends.”

That sentiment has been echoed by the President of the RACGP, Dr Tony Buhagiar, in a media statement as:

"mischievous forces at work raising concerns among hospital medical officers."

Mr Howe said the challenge now for the medical profession was to demonstrate its commitment to improving the quality of general practice.

CONTACT: Ross Gardiner, Mr Howe's Office, 2777680

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Dr B Shepherd Federal President Australian Medical Association PO Box Elis

Queen Victoria Terrace PARXES ACT 2600

Dear Dr Shepherd

I am writing concerning public comments made by AMA representatives within the last few days regarding the general practice initiatives recommended by the General Practice Consultative Council (GPCC). My concern is that these comments are not consistent with the views being conveyed by Dr Nelson at meetings of the GPCC.

Earlier this year the Government, the AMA and the RACGP entered into a genuine consultative process with the aim of developing a package of general practice initiatives which would be broadly acceptable to each of the parties. Although

a difficult task, the process was successful in bringing the parties to a point where the GPCC was able to agree on a set of recommendations which has been the basis of the recent Budget announcements. As the senior AMA representative on the GPCC, Dr Nelson has played an important role in this consultative process.

At the last meeting of the GPCC (27 August 1992) there was a lengthy discussion about the Budget announcements resulting from the extensive consultation between our organisations. Whilst it is acknowledged that AMA representatives did

indicate that the AMA was concerned about certain aspects (eg access to other training programs and a comment contained in one of the Budget papers about practice budgets), the clear message that was conveyed was that the AMA was in general

agreement with the outcome and the way in which it reflected the proposals put in “The Future of General Practices A Strategy for the Nineties and Beyond".

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I am therefore disappointed by the comments made over the weekend concerning the recommendations of theGPCC. Given the consultative process to-date I cannot believe that the comments made represent the opinions of the AMA. General

Practice Council or the views of most of the general practitioner members of the a m a .

Such comments also raise questions about whether the AHA. representatives who take part in the consultations have any real authority to speak on behalf of the AMA. Their participation and agreement does not seem to result in any commitment to the outcome of the process at the organisational level. This lack of commitment casts serious doubt on the value of this type of consultative arrangement.

I am also bemused by the range of public comments each supposedly representing the AMA's position, which makes it very difficult to know when a final position has been reached or indeed how we will be able to recognise it as such.

While we will continue to develop the proposals in consultation with the profession, including the RACGP and the AMA, we see little point in continuing to further develop the

GP initiatives at the GPWG or its various working parties until such time as the AMA Federal Council's position is clarified.

I suggest that a meeting of the GPCC should be convened urgently to see whether we are in a position to progress the initiatives through the co-operative process we have jointly established with the RACGP.


Yours sincerely

Stuart Hamilton

/^September 1992