By Margaret Perrott
NSW — State-wide meetings of registrars, resident medical officers (RMOs) and interns were held on February 11 to decide on future campaigns and strike action to fight the Health Insurance Amendment Bill (No. 2, 1996). The bill, passed by both houses of federal parliament in December, with the connivance of the Democrats in the Senate, denies Medicare provider numbers to qualified new doctors not in "recognised" training programs.
More than 1000 doctors took part in the meetings and voted to strike indefinitely from March 10 unless the government repeals the legislation. Motions calling for the support of the Australian Medical Association and condemning the Australian Democrats were also passed overwhelmingly.
Dr Lucy Chapman, president of the Illawarra RMOs Association, outlined the campaign so far, the reasons for militant action and the need for unity against the legislation. The government had "spotted the most powerless group in the whole medical community to use as slaves", she said.
The 400-500 doctors registered each year, but denied provider numbers, would be "forced into dead-end positions in the hospital system", or placed on the Register of Medical Opportunity — an amendment brought in by the Democrats which would force doctors into government-created, 10-year long rural training positions. If doctors refuse such a position three times they will be forced onto the dole.
Chapman pointed out that the changes penalise those who do not chose the "normal career path" of specialist training or GP vocational training through the College of General Practitioners (RACGP). These include doctors in the "small" areas such as sports medicine, occupational health and women's health centres. Women doctors are more likely to be found in these areas, or do not complete vocational training due to family pressures.
The effects on the community will include less choice of type of service, longer waiting times in GPs' surgeries and casualty departments, up-front fees and even worse service provision to country areas. "This is the thin edge of the wedge of the destruction of Medicare and eventually government control of clinical decisions", Dr Meg Sams from the Illawarra RMOs Association said.
Doctors are traditionally conservative, and hospital doctors are very reluctant to take strike action. RMOs withdrew services in 1974, winning improved pay rates, working hours and overtime provisions. Strike action in the '80s helped reduce maximum shift lengths from 72 to 34 hours.
Although expressing fears for the welfare of patients, the Wollongong meeting unanimously endorsed strike action by all junior medical staff. Illawarra RMOs plan to supply only minimum emergency teams to deal with cardiac arrests during the strike. They are relying on the support of casual medical officers and visiting medical officers to supply other emergency services to patients.
The RMOs agreed that they want the federal government to seriously address the inequity of services in rural areas and the spiralling cost of medical care, but not by scapegoating 400 graduates annually at the whim of the RACGP, which has the ear of minister for health Michael Wooldridge.
Plans for a month-long campaign of industrial action, media publicity, community support building and solidarity with other workers' organisations were discussed. It is hoped that strike action will be taken nationally, but NSW RMOs are prepared to lead the way. As one participant put it, "Unhappy doctors have unhappy patients. This is just plain wrong, and we must do something about it."