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Tuesday, 25 November 2003
Page: 22756

Mr LINDSAY (5:35 PM) —I thank the member for Lowe for his kind words. I was surprised to hear the member for Lowe say in his speech on the Medical Indemnity Amendment Bill 2003 and the Medical Indemnity (IBNR Indemnity) Contribution Amendment Bill 2003 that this insurance crisis is all the government's problem and that we have allowed it to happen. Let us do a quick reality check on that. UMP was run by the doctors. If anyone was to know what the likely liabilities were going to be, it would have been the doctors themselves. I think there is a view out there that they did not charge the right premiums. To blame that on the government is spectacular.

I make the point that in medical procedures difficulties are always going to happen. That can be expressed in more colloquial language, which I do not wish to use in this parliament, but it is true. Doctors do not consciously make mistakes. In some cases it does not matter how good a doctor is; things happen that are beyond everybody's control. As much as you explain it to the patient, I guess sometimes the patient does not want to hear that. Sometimes it is not expected that something will happen, but it happens—and it is always going to happen. I guess it is pretty hard for patients and doctors to know who is going to pick up the pieces after some tragic event occurs, and that has been exacerbated by the propensity these days for people to sue.

Another element in all of this debate leading up to these bills coming into the parliament has been the politics of medicine. The politics of medicine are often said to be more political than the politics of politics, and I think a number of people in all fields of endeavour who are associated with this would nod their heads and agree that the politics of medicine can be quite complicated, quite fierce, quite unreasonable, quite emotive, and so it goes on. I guess all members of parliament would have started to receive representations earlier in the year, and I was no exception. As it unfolded locally in my electorate, I was certainly very close to it and was feeding information continually to the government on behalf of the medical profession.

A whole series of things occurred leading up to this legislation. Back in about the middle of the year, doctors started writing to me. At that stage, they were asking for reform of state laws to assist in resolving the medical indemnity crisis. It was rather unfortunate that the Beattie state Labor government took so long to action a matter that the New South Wales Labor government actioned quite quickly. It was quite distressing for the doctors because they were asking for things—like a statute of limitations, constraints on compensation payments, the streamlined processing of claims, the requirement for structured settlements, improved reporting and risk management of MDOs, the removal of discretionary cover coverage in Queensland and compulsory medical indemnity coverage for health professionals. So doctors at that stage were seeking quite a range of things.

The whole issue was pretty well summed up by a notice that I saw in the Aitkenvale Family Health Centre on Ross River Road in Townsville, which said:

The insurance crisis facing us as general practitioners is unfortunately deepening. The recent legislation enacted by the Beattie government has unfortunately done little to change the litigious climate that currently exists. The Beattie government despite their protestations to the contrary and unlike their colleagues in NSW, took the soft option. They have failed to address statute of limitation issues, damages thresholds, capping of damages or mandatory structured settlements adequately. It appears that they were more intent on protecting lawyers and their civil liability practices than providing sustainable affordable medical practice in Queensland.

It was a very tough charge and one that was publicly there for all to see. The notice continued:

The upshot of this is that in addition to the already serious position of insurance there is not likely to be any improvement in medical liability cases and awards in the near future. This means that premiums will continue to rise. UMP have issued their renewal notices for this year with an average 58% increase in premiums, this comes when we are already paying a 50% “call” which UMP required to prevent liquidation, and the prospect of a further government levy, still being negotiated, to cover the so-called tail insurance. All of the medical insurance organisations ... are predicting compounding annualised increases for the foreseeable future. Our survival in general practice is now seriously threatened.

It was quite a bleak notice for patients to see. A number of things have unravelled. I attended a rally of about 70 doctors. I do not think they expected me to attend, but I would not have missed it. It was a very sobering meeting, but the doctors expressed their appreciation that I did go and listen to what was being said. They indicated that they were preparing to strike—and perhaps a number of other colleagues would have also had doctors in their electorates threatening to strike for a day—and the AMA in Queensland was certainly promoting that option. The key thing that came through at the rally, which was interesting, was that the doctors had formed a view that they just wanted the lawyers out of their surgeries. I can understand that. I can understand the distress and the threat they were feeling from the litigation they were continuing to face, even though they had done nothing wrong whatsoever.

It reached a bit of a peak when, finally, one of the GPs, Dr Geoff Broadbent, went into print in the Townsville Bulletin and said that all doctors should refuse to treat lawyers and politicians until the medical indemnity crisis was solved. Goodness me! Didn't that light up the Townsville and Thuringowa community. At the end of the day, after I had spoken to Dr Broadbent, I think he regretted what he had said because he then understood that the government were trying to find a way through this that would help doctors, as we ultimately have.

Dr Broadbent's call came with a stinging rebuttal from a Townsville barrister, Laurie Middleton. He simply called for a calm and sensible debate over the medical indemnity crisis, rather than pointing the finger of blame at lawyers and politicians. Laurie Middleton said that the law was not solely to blame for the medical indemnity crisis, with greedy and incompetent insurance companies and doctors who did not want to pay their insurance premiums contributing to the mess. That also lit up the Townsville Bulletin,as you might imagine, with his claims that insurance companies were incompetent and that doctors did not want to pay their insurance premiums. I made no comment on that, but the public in Townsville and Thuringowa certainly noted those comments.

I was distressed, however—and I told the president of the AMA in Queensland this—by the continual referral to the IBNR levy as a tax. That was just mischievous and wrong. I pointed out to her that the IBNR levy was in fact tax deductible—so if it was tax deductible how the hell could it be a tax, as taxes are not tax deductible? She saw the logic of that argument and probably took that back to Brisbane, and I saw the AMA then back off Australia wide from using the word `tax'. That was not through my efforts, but it certainly was heard within the medical profession because it just simply was not a tax.

At the same time other sectors of the economy were starting to get uneasy about the government making efforts to try to solve this medical indemnity problem for doctors. The other sectors of the economy were saying: `Look, why don't you solve it for us? Why don't you pay our levies?' They had a fair point, and I think that was well made and well heard. Senator Patterson, the then minister for health, did a sterling job on this particular issue, which was finalised by the current minister for health, the member for Warringah. I think that at the end of the day Bill Glasson, in his leadership role with the AMA—Bill was a fierce advocate and I had not known him previously to be a fierce advocate, even though I have known him for a long time; I had considered him to be a fairly gentle sort of person—was not gentle on this issue but he made his points and certainly he, hand in hand with the government, thrashed the issue out, resulting in the legislation before the parliament today.

I am very pleased that the legislation that we are considering today has in fact made the doctors happy. It has given them certainty and it has strengthened their confidence so that they can get on with doing what they are really there to do, and that of course is to provide medical services to the Australian community. I congratulate the former and current health ministers on their efforts in finding a way through this very difficult problem. Life is not always easy. It certainly has not been easy in this case but now we have a great outcome that allows us to move on to other health issues, as the government has done. I certainly support the legislation.