Transcript: Dr Steve Hambleton, with Marius Benson

ABC News Radio, Monday 16 January 2012

Medicare, energy drinks and prescription drugs

COMPERE:     Medicare has been slammed by one of Australia's most senior health experts with a warning that misuse is costing up to $3 billion a year. And that warning comes from Dr Tony Webber, the former director of the Professional Services Review Panel, which investigates allegations of abuse by doctors. He says Medicare is dysfunctional and open to rorts by unethical doctors.

Well for a doctor's perspective on that assessment, Marius Benson is speaking to the national President of the AMA, Dr Steve Hambleton.

[Beginning of interview excerpt]

Medicare

MARIUS BENSON: Steve Hambleton, Dr Tony Webber is a figure of some authority in medical circles. He says Medicare is dysfunctional - it's time for a complete review. Is he right?

STEVE HAMBLETON:  Well no, I don't think so. I think Dr Webber certainly was director of the PSR and was - presided over an area where a number of individuals who I guess were doing the wrong thing came to his attention. And it looks like he's extrapolated that to the rest of the profession. So I think it's probably fair to say that not too many of his colleagues would actually agree with his comments today.

MARIUS BENSON: Is it accurate to characterise Medicare as basically based on an honour system - that it is essentially defenceless against unethical doctors?

STEVE HAMBLETON:  Well it really is an honour system, but you are working one to one with an auditor, and that is your patient who's in front of you. And so - look, the great majority of individuals are doing the right thing, looking after their patients and care for their patients.

Some of the estimates that we've seen, you know, between two and three billion just seem outrageous. And really, there's no - there's not even any calculations that could back up such a claim. We don't want to extrapolate a few bad eggs to the whole rest of the profession.

MARIUS BENSON:   What about a specific criticism, for example, that optional cosmetic surgery is being paid for with Medicare safety net funds?

STEVE HAMBLETON: Look, I think if there are a few safety net areas where they do need to be tweaked. I think we need to look at that. I think the safety net was built by John Howard and Tony Abbott to actually work as catastrophe insurance for those families that had high expenses in one year. It was never intended to pay for high out-of-pocket expenses for cosmetic surgery. And certainly, the government has done some changes to the safety net to - in the obstetric area. In fact, they saved a whole lot more than they were expecting to, even in the first year.

But for those families where the safety net protects them for those excess, out-of-pocket expenses when they've got sick children, it's working really well, so we do support it.

MARIUS BENSON:   But maybe some tweaking to look at issues like cosmetic surgery being paid for in that way?

STEVE HAMBLETON: Look, some of the issues that he's raised I think are not the intention of the safety net. And we have no issue with calling to account individuals who are abusing that privilege. And I guess that's why we have Medicare, or at least that's why we have a PSR process. And if people are doing the wrong thing then they should be called to account.

Energy drinks

MARIUS BENSON:   Now the criticism of Medicare appeared in an article in the Medical Journal of Australia. There's a couple of other issues been raised in the latest issue of that magazine. One is that young people are overdosing on caffeine energy drinks. You believe tighter regulation is needed in that area?

STEVE HAMBLETON: Yes we certainly do. And now we've got actually hard evidence that caffinated energy drinks are actually causing problems right here in this country. You know, we got 297 calls to the New South Wales Poisons Information Centre, some of those kids, even ending up in emergency with heart palpitations, agitation, tremor, and gastro-intestinal upset. Now AMA has been raising this issue for a little while. We do need the legislator [indistinct] government's forum on food regulation to have a full review of these policy guidelines.

MARIUS BENSON:   Do you want the sales restricted?

STEVE HAMBLETON: Well we certainly do, and certainly to children. Some of these energy drinks have got as much as three strong cups of coffee in 60 mills. You know, not more - much more than a mouthful. They were never intended to be drunk in that way, and certainly not by children. So there should be warnings about children; should be restrictions on selling it to children. We have to look at the advertising; they're clearly targeting young people with their flashy advertising.

Prescription drugs

MARIUS BENSON:   Okay, can to - take you to another article in the medical journal? This reports a huge increase in the use of prescription drugs; half of people aged 50 and over in Australia taking five drugs or supplements simultaneously. It sounds worrying. Is that a cause of concern or not?

STEVE HAMBLETON: It is worrying. But we are seeing that - our ageing population and increasing numbers of chronic disease, and people are taking more and more drugs to keep themselves well. I guess the main one people are starting to take are statins to keep their cholesterol down. There are interactions though, and the more medications a person takes the more opportunity there is for medication misadventure.

So every time a doctor prescribes a new drug, we need to go through that list to make sure that it's compatible. It's not just he prescription drugs as well we see, it's actually over the counter medications like arthritis pills like fish oil, and all of these things can have interactions and we need to make very certain that we're actually doing more benefit than harm.

MARIUS BENSON:   Dr Steve Hambleton, thank you very much

STEVE HAMBLETON:  Thank you very much.

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