Australian Medical Association

Genetic testing will increasingly play a vital role in mainstream health care in terms of preventive health and diagnosing and treating illness. This position statement addresses various aspects of genetic testing including access, consent and genetic counselling, privacy, genetic discrimination, direct to consumer genetic tests, public and professional education, workforce and infrastructure, research, gene patents, and genetic selection. 

Genetic testing will increasingly play a vital role in mainstream health care in terms of preventive health and diagnosing and treating illness. This position statement addresses various aspects of genetic testing including access, consent and genetic counselling, privacy, genetic discrimination, direct to consumer genetic tests, public and professional education, workforce and infrastructure, research, gene patents, and genetic selection.

The costs associated with lifestyle related disease are increasing, evidence suggests that using financial incentives and disincentives with patients can encourage preventive health behaviours.

The costs associated with lifestyle related disease are increasing. Evidence suggests that using financial incentives and disincentives with patients can encourage preventive health behaviours. This AMA background paper outlines the currently available research on when financial incentives and disincentives are likely to be effective, and when they are not.

The idea of a chaperone may seem old fashioned. But patients differ in their preception of what is required during a medical examination,  particularly if the patient comes from a different background. The presence of a chaperone is one way to minimise complaints being made against doctors.

Whenever you are conducting an examination, whether it is in a suburban surgery or in a busy hospital, consider whether you should have a chaperone present.

The AMA submission on the exposure draft of the Personally Controlled Electronic Health Records Bill 2011 highlights that the safety objects of the legislation will be undermined by the opt-in design of the system and the ability of patients to to effectively remove clinical documents from their PCEHR. The submission also makes several suggestions to improve the transparency of the governance arrangements for the PCEHR and to clarify the operation of the civil penalty provisions.

The Australian Taxation Office (ATO) recently released draft addenda to GST Rulings 2006-9 and 2006-10 for comment.  These draft addenda will effect the GST status of some medical services and the AMA is seeking legislative changes to ensure that medical practitioners do not face additional compliance costs.

The AMA's submission to the Senate Finance and Public Administration Committee on the National Health Reform Amendment (Independent Hospital Pricing Authority) Bill 2011 highlights the importance of the Pricing Authority, the Australian Commission on Safety and Quality in Health Care, and the National Health Performance Authority collaborating on their roles and responsibilities, for example, on data collection requirements.

It also points out that the Pricing Authority should consider the standards set by the Performance Authority when calculating the national 'efficient' price, that is, it must take into account the performance that must be achieved. In addition, the National Health Reform Agreement allows states to pay hospitals less than the determined efficient price, therefore, we recommend that the actual payments made to hospitals are reported to Parliament so that it is clear when poor performance is linked to insufficient funding.

Overall the Bill before Parliament responds to the AMA's lobbying last year to ensure the Pricing Authority considers the range of variables affecting the actual costs of providing health care services when calculating the national efficient price. However we recommend that the Authority is explicitly required to ensure hospitals can fulfil their teaching and research obligations.

The AMA submission to the Department of Health and Ageing on the Personally Controlled Electronic Health Record System: Legislation Issues Paper should be read in conjunction with the concerns expressed in our submission on the PCEHR Draft Concept of Operations.

The AMA made a submission in response to the National Health Reform Amendment (National Health Performance Authority) Bill that was referred to the Senate Community Affairs Legislation Committee for inquiry in May 2011. The AMA has argued for amendments to empower the new Authority to report on, and impose penalties for, data manipulation and to address other issues of concern including adequate consultation with medical practitioners. The Authority will report on the performance of: local hospital networks; public hospitals; private hospitals; primary healthcare organisations; and other bodies or organisations that provide health care services.

The AMA's submission highlights how important it is to inform registered medical practitioners (doctors), patients, their family and carers, and the wider public of the standard of behaviour expected of doctors in relation to sexual boundaries within the doctor-patient relationship. It’s imperative that doctors understand and respect their ethical and legal duties in relation to sexual boundaries. It’s also important that patients, their family members and carers understand and respect these boundaries as well. As such, the AMA believes that the guidelines need to be clear, comprehensive and avoid ambiguity.

It has become increasingly common for health practitioners not holding a medical degree or professional doctorate qualifications, to adopt the title ‘Doctor’ (Dr). The AMA opposes the use of the title ‘Dr’  by health practitioners in a way that misleads people into believing they are consulting or receiving treatment from a medical practitioner.

The AMA has made a submission to the Productivity Commission supporting the introduction of a government funded system of comprehensive care and support for people with long-term, significant disabilities. The AMA also supports the introduction of a no-fault national injury insurance scheme.

Within the health care team, each professional brings a particular combination of training and experience which defines their role and responsibilities. This AMA Positition Statement outlines the core knowledge, skills and unique qualities of medical practice that make medical practitioners a pivotal part of Australia’s health system.  In this position statement the term ‘doctor’, which is the term in common community use, refers to a medical practitioner and the terms are used interchangeably.

The purpose of this Guideline is to clarify the responsibilities of medical practitioners, patients, and relevant third parties regarding certificates certifying illness ("sickness certificates") within the context of the doctor-patient relationship.

The AMA made a submission in response to the National Health Reform Amendment (National Health Performance Authority) Bill that was tabled in Parliament on 3rd March 2011 and referred to the House of Reps Standing Committee on Health and Ageing for inquiry. Amendments were sought to empower the new Authority to report on, and impose penalties for, data manipulation and to address other issues of concern including adequate consultation with medical practitioners. The Authority will report on the performance of: local hospital networks; public hospitals; private hospitals; primary healthcare organisations; and other bodies or organisations that provide health care services.

The AMA supports the establishment of a national disability insurance scheme which is "no fault" and comprehensive in the care and support it provides to cover the cost of long-term care for people with serious disabilities. The AMA's submission to the Productivity Commission's Inquiry brings to bear the expertise and collective experiences of the medical profession on what might contribute to the success of an optimally operating national disability support scheme from a health and medical point of view.

The AMA has developed a Privacy Resource handbook to help doctors comply with the Privacy Act 1988.

The Resource handbook is based on the Privacy Act 1988 in force as at 1 July 2010.

The AMA intends to update this Resource Book if the proposed changes become law.

Doctors, particularly General Practitioners, provide preventative care to their patients on a regular basis. Doctors also coordinate the preventative care that patients need from other health care professionals, and promote health and prevention in the broader community. The AMA position statement "Doctors and Preventative Care 2010" describe these important aspects of a doctor's role.

The AMA's Position Statement on Doctors' Relationships with Industry 2010 provides guidance for doctors on maintaining ethical relationships with the pharmaceutical industry, medical device and technology industry, and health care product and service suppliers in general ('industry'). While collaboration between doctors and industry contributes beneficially to the quality of health care that Australians receive, doctors have a responsibility to ensure that their relationships with industry are consistent with their duties to their patients and towards society at large.

The AMA's Position Statement on Medical Professionalism 2010 serves to identify the major values of the profession and highlight the profession's commitment, and indeed responsibility, to put patients first, regardless of the challenges posed by a dynamic health care and broader social environment.

AMA Submission to the Community Affairs Legislation Committee on the Healthcare Identifiers Bill 2010 and Healthcare Identifiers (Consequential Amendments) Bill 2010

The AMA considers healthcare identifiers are an essential building block towards the implementation of electronic health records, and we are therefore a strong supporter of their introduction. Healthcare identifiers will facilitate the secure access to, and appropriate sharing of, electronic patient information by healthcare providers.

We support the passage of the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010.

Establishment of the Healthcare Identifier Service was agreed to by the Council of Australian Governments in 2006 as part of the national approach towards accelerating work on electronic health records to improve the safety of patients and improve efficiency for healthcare providers.

In July 2009, the Department of Health and Ageing released a discussion paper on legislative proposals to support the establishment and implementation of unique identifiers for healthcare purposes and the privacy of health information.

The AMA submission on the discussion paper is supported by the AMA Position Statement on Unique Healthcare Identifiers in 2008.

AMA response to nurse practitioner and midwife legislation that the Government announced in the 2009/10 Federal Budget.

In the 2009/10 Federal Budget, the Government announced that it would move to allow some nurse practitioners and midwives to provide services funded under the Commonwealth Medicare Benefits Schedule (MBS) and to prescribe medications that are subsidised under the Pharmaceutical Benefits Scheme (PBS).  It also announced that the Commonwealth would subsidise indemnity insurance for midwives, although it decided not to extend this cover to home births.

The Government recently introduced three Bills into the Parliament to implement its Budget announcements. These are the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009, the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 and the Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009.

These Bills have been referred to a Senate Community Affairs Legislation Committee Inquiry and the AMA has provided a detailed submission to this Inquiry. The AMA submission highlights that, if implemented carefully, the legislation may help address unmet community health needs - provided it is done in a coordinated way and medical practitioners are still involved in the overall care of the patient. The AMA has warned the Committee that if the legislation is not implemented carefully, it will fragment care, increase the risks of inadvertent patient outcomes, cause duplication and increase costs.

The AMA submission outlines detailed recommendations designed to ensure that the ultimate arrangements work in practice and patient safety is safeguarded.

The Federal Parliament's Senate Community Affairs Committee is conducting an Inquiry into the Health Workforce Australia Bill 2009 (the "Bill"). The Commonwealth agreed to establish a new health workforce agency at the November 2008 Council of Australian Governments (COAG) meeting and this Bill seeks to implement that commitment.

The AMA has provided a submission to the Senate Inquiry.

The Australian Medical Council (AMC) is developing a national code of professional conduct for doctors entitled Good Medical Practice: A Code of Conduct for Doctors in Australia (previously entitled Good Medical Practice: A Draft Code of Professional Conduct). The Code is intended to supersede existing State and Territory medical board professional conduct codes. The AMC intends to recommend that it be adopted by the new national medical board. The AMC's Final Consultation Draft of April 2009 reflects the feedback they received in response to the previous public consultation draft of August 2008.

The AMA's submission is attached.

Whilst the AMA considers the Final Consultation Draft to be a major improvement on the earlier version, the AMA has highlighted a few sections that require further amendment, including the sections on conscientious objection and on conflicts of interest. The AMA has also emphasised the need for the release of the Code to be accompanied by relevant public and profession based education campaigns and to be subject to a regular 3-5 year review cycle.

Because the type of work involved in preparing medico-legal, third party or other reports, eg for employers or insurance companies, varies so much and is influenced by a range of factors, such as the State or Territory in which the work is undertaken, the AMA does not recommend a level or range of fees for these services. Individual practitioners set their fees for this type of work based on the time and extent of the work involved.

The AMA Joint Submission highlights concerns that the proposed arrangements will impose additional requirements on registrants to provide information, including workforce data, to the relevant board as a condition of registration, and extend existing arrangements for information sharing about registered medical practitioners between various government agencies.

AMA Joint Submission on Good Medical Practice: A Draft Code of Professional Conduct (August 2008)

AMA Position Statement: Ethical Considerations for Medical Practitioners in Public Health Emergencies in Australia - 2008