Martyn Goddard  - Australian Consumers Association Health Spokesperson

[EMAIL PROTECTED]

Ph: (02) 9577 3399


> Dear Andrea
> Sounds also like Martyn Goddard and the Australian Consumers Association
> needs educating any one know his contact details so we can write to hime
> about midwifery options and their record of saftey and efficacy ??
> Denise Hynd
> ----- Original Message -----
> From: "Andrea Robertson" <[EMAIL PROTECTED]>
> To: <[EMAIL PROTECTED]>
> Sent: Thursday, August 14, 2003 7:38 PM
> Subject: [ozmidwifery] Another article on the doctor's crisis
> 
> 
>> Hi,
>> 
>> Yet another article: Sydney Morning Herald, Aug 12, 2003 - Page 1 with big
>> pic. The doctors bleating again about their insurance. I note that the
>> doctor in Moree (featured in the huge pic, with a baby) says she still
>> works at the hospital, so women aren't really missing out on obstetric
>> care, just private medicine.
>> 
>> ----------------------
>> 
>> Doctors at a premium in the litigation era
>> Ruth Pollard and Ben Wyld report.
>> August 12, 2003
>> 
>> 
>>   Sixteen months after Australia's largest medical defence organisation
>> collapsed, the true cost is
>>   only now emerging.
>> 
>>   At Westmead Hospital, obstetrician Andrew Pesce is worried. "Ten years
>> ago," he says, "there were 15 of us providing obstetrics and gynecological
>> services at Westmead to people in the area. There are now seven.
>> 
>> "I now turn away more patients . . . than I look after. Our specialty is
>> dying - the way that we practise has been corrupted by the expense of the
>> litigation and the psychological impact that it has on the practitioners."
>> 
>> General surgeons, neurosurgeons and others paint the same bleak picture.
>> Doctors will keep quitting the
>> profession because their insurance way too high - despite Federal
>> Government subsidies, significant state law reform and Canberra's action
> to
>> prop up United Medical Protection since the insurer went into provisional
>> liquidation last year.
>> 
>> W ithout Government subsidies, obstetricians face annual premiums of up to
>> $140,000. Dr Pesce, spokesman for the National Association of Specialist
>> Obstetricians and Gynecologists, says 45 of the nation's 700 practising
>> obstetricians left obstetric practice in 2001.
>> 
>> "That is about six to seven per cent of the workforce. Last year it was
>> even higher than that, and  there is no indication it is going to get any
>> better."
>> 
>> One casualty of the crisis is Moree obstetrician and general practitioner
>> Maxine Percival, who stopped doing private procedural obstetrics in May
>> last year. Dr Percival, who would have faced a premium of $20,000 this
> year
>> if she had maintained her procedural insurance, now only practises
>> obstetrics for the local public hospital. She said a loss of confidence in
>> UMP forced her to give up her procedural work.
>> 
>> "In obstetrics, litigation can be launched 25 years after the procedure,"
>> Dr Percival said. "I don't know if UMP or their subsidiary will be around
>> next year, let alone in 25 years' time."
>> 
>> The Government stepped into the indemnity crisis after UMP went into
>> provisional liquidation with unfunded liabilities of $460 million. UMP had
>> about 30,000 members, or two-thirds of the country's doctors. The
>> Government rescue package is estimated to be worth $260 million over four
>> years.
>> 
>> Dr Percival says that for women in Moree, who don't want to be admitted to
>> the district hospital as a public patient, the alternative is a three-hour
>> trip to the nearest obstetrician in Tamworth.
>> 
>> "For towns that are relatively isolated, you can't put pregnant women in
>> the back of an ambulance and transfer them three hours away, hoping they
>> get there without having their baby."
>> 
>> Dr Pesce said Federal Government subsidies had helped to make medical
>> indemnity more affordable for obstetricians but the pressures, both
>> financial and legal, continued to bite.
>> 
>> The president of the NSW Neurosurgical Association, Dr Warwick Stening,
> had
>> warned last year that 10 of the state's 30 neurosurgeons would resign if
>> the medical indemnity crisis continued. In a move to reduce medical
>> misadventure, cut premiums and thereby halt the exodus, neurosurgeons
>> launched a project to identify and measure risk in the hospital system and
>> to manage better the risk of neurosurgical procedures. Working with NSW
>> Health, the risk-management model will be rolled out in the next year.
>> 
>> "We are still a long way from solving the problem, but this is a positive
>> step that we have taken which will allow us to identify problems before an
>> unfavourable outcome occurs," Dr Stening said. "All we can do is to start
>> to reduce the number of claims by reducing the number of adverse
> incidents."
>> 
>> Dr Stening said the NSW Government's Health Care Liability Act of 2001 and
>> the Civil Liability Act of 2002, along with Federal Government subsidies,
>> had helped ease the financial pressure on neurosurgeons.
>> 
>> But that was not to say, he said, that a special new levy - imposed on
>> doctors in case of a claim against them - would not hurt the rest of the
>> medical profession. A recent survey of 750 general surgeons aged over 55
>> has found that one in five intends to retire in the near future. Nearly
> 100
>> per cent of them nominate medical indemnity as the reason.
>> 
>> Many experts are placing their hopes on the establishment of a federally
>> administered fund for the catastrophically injured. This would help cut
>> medical indemnity premiums. Yet after 10 months of meetings, progress on
>> achieving such a fund is no closer.
>> 
>> Dr Pesce said: "The Government has made great effort to improve the
>> situation . . . we now need substantial reform of the remaining uncapped
>> liabilities that doctors face, and that is for the long-term care costs
> for
>> the catastrophically injured."
>> 
>> The Assistant Treasurer, Helen Coonan, said the long-term scheme was
>> definitely on the national agenda. "You cannot contemplate a proper system
>> of professional standards for doctors . . . without having regard for the
>> long-term care needs of those catastrophically injured by medical
> negligence."
>> 
>> It was November 2001 when a court handed down a decision that would send
>> shockwaves through the medical fraternity. Sydney woman Calandre Simpson,
>> who suffers from cerebral palsy, was awarded $14.2 million after she
>> successfully sued the doctor who botched her delivery.
>> 
>> It was almost twice the previous highest award, and it highlighted the
>> vulnerability of both the country's medical insurance industry, and
>> individual doctors. The payout has since been reduced to just under $11
>> million on appeal.
>> 
>> The tort law reforms put in place by the federal and state governments
>> since the collapse of UMP, six months after the Simpson decision, have hit
>> consumers hard, according to the senior health policy officer for the
>> Australian Consumers Association, Martyn Goddard.
>> 
>> They would simply deliver increasing wealth to insurance companies and do
>> nothing to lower the cost of premiums, Mr Goddard said. "The real cause of
>> the bulk of indemnity rises wasn't a sudden increase in litigation - there
>> has been no such increase - it was changes to the structure of the
>> global  reinsurance market."
>> 
>> The Federal Government clearly needed to intervene in the medical
>> reinsurance market, he said. "They are doing the opposite, which is trying
>> to reduce premiums by subsidies and by limiting patients' rights."
>> 
>> ---------------------------------
>> 
>> -----
>> Andrea Robertson
>> Birth International * ACE Graphics * Associates in Childbirth Education
>> 
>> e-mail: [EMAIL PROTECTED]
>> web: www.birthinternational.com
>> 
>> 
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