Doctors strike against Medicare cut


By Kamala Emanuel

More than 1000 doctors across NSW have been on strike since March 10 in a bid to reverse legislation restricting new doctors' access to Medicare provider numbers.

Mass meetings on March 14 resolved to broaden the campaign, called on junior doctors in other states to escalate their actions and agreed to a conference to further coordinate the campaign.

Legislation passed with the support of the Democrats in November limits provider numbers to doctors who undertake specialist or further general practice training. Patients attended by doctors without provider numbers (outside of the hospital system) are ineligible for Medicare benefits and will have to pay the full fee for service.

The aim of federal health minister Michael Wooldridge is to reduce Medicare spending by $250-500 million. The government justifies the cuts in terms of improving doctor training, minimising over-servicing and containing the health budget.

However, according to Dr Peter Saul, senior staff specialist at John Hunter Hospital and chairperson of the committee in charge of training for junior doctors in the Hunter region, the legislation is "overtly not about training. If it was, there would have been consultation with the bodies in charge of postgraduate medical training, but there wasn't."

Saul told Green Left Weekly: "Wooldridge has bandied around that there are 4000 too many doctors in Australia. Having been on committees looking at these issues, I know there is just not enough evidence to support that figure."

Saul is also critical of the legislation's moratorium on provider numbers for overseas-trained doctors, pointing out that the "attempt to turn into fortress Australia" will create immediate vacancies, particularly in rural areas.

"We rely on overseas-trained doctors, and I'm sure Australian doctors go overseas in droves. We all benefit from this freedom of movement, from the cross-fertilisation of medical ideas, which is now at risk of drying up.

"The impact of this legislation on education and the work force has not even remotely been considered ... It's a budgetary measure. Wooldridge was told to deliver a 4% cut to Medicare expenditure and admitted in the Senate that he thought this was the quickest way to do it.

"The direction is clear: the replacement of widespread access to Medicare with an American-style, means-tested access to Medicare, supplemented by private health insurance", he said.

In 1996, rolling stoppages and single-day strikes took place in several states and territories to lobby politicians to oppose the legislation. When the legislation was passed, junior doctors from the Hospital Medical Officers' (HMO) branch of the Public Service Association in NSW decided to intensify their campaign.

This industrial campaign has been successful because it has involved the rank and file members and delegates. Before stop-work meetings in February, all union members, particularly the new intake of interns, were educated about the issues.

More than 2000 doctors, medical students and supporters rallied in Sydney and a further 200 rallied in Newcastle on the first day of the strike. Since then, daily rallies have been held at the major teaching hospitals in Newcastle, with one march to the local shopping mall to explain the implications of the Medicare cut, and another to the university to call on the dean of medicine to condemn the legislation.

A South Coast Labour Council picket line has been established at Wollongong Hospital. On March 14, a rally was held in the ACT, where doctors have been threatened with fines of up to $2000 per day if they join the strike. Doctors in the Northern Territory are set to strike from March 17, and meetings in other states are being planned to consider further action.

The NSW Health Department has moved to take NSW hospital doctors to the Industrial Relations Tribunal. Although tribunal decisions are not binding on the federal government, the HMOs are hoping it will recommend that Wooldridge negotiate with the union.

People wishing to support the doctors' campaign are urged to move motions of support at their union and other meetings and send copies of these to the NSW PSA (HMO branch), GPO Box 3365, Sydney 2001, fax (02) 9290 1555, and to Michael Wooldridge, Minister for Health and Family Services, fax (06) 273 4146. Copies of a petition can also be obtained from the PSA.