Governing termination of pregnancy - submission to Tasmanian Government April 2013

The Australian Medical Association Tasmania would welcome legal certainty on abortion. Termination of pregnancy is a health issue and as a medical procedure should not form part of the criminal law. AMA Tasmania supports the right of every woman to make her own health decisions, but at the same time it is important to respect the right of a doctor to determine the services they provide.

Doctors’ views regarding abortion are as diverse as views among the rest of the community. What is important to all doctors and their ability to provide quality care to their patients is the independence of the doctor patient relationship. Any legislative change must ensure doctors have the independence that is crucial for them to be able to provide the best possible care for their patients without fear of criminal proceedings. AMA Tasmania has grave concerns that the draft legislation has the potential to criminalise members of the profession with conscientious objection to termination of pregnancy.

For a copy of the complete submission click here.


AMA Euthanasia Submission March 2013

AMA position on euthanasia and physician-assisted suicide

Medical practitioners should not be involved in interventions that have as their primary intention the ending of a person’s life (this does not include the discontinuation of futile treatment). Some patients may fear that when they lose decision-making capacity, their goals and values in relation to their end of life care will be unknown or even disregarded by their families and/or the health care team since the patient can no longer actively participate in their own health care decisions. As such, this fear may lead some patients to request assisted dying before they lose decision-making capacity. For most patients in the terminal stage of illness, pain and suffering can be alleviated by therapeutic and comfort care; however, we fully acknowledge that there are still currently instances where the satisfactory relief of suffering cannot be achieved.

We must, therefore, ensure that all patients have access to appropriate palliative care and advocate that greater research must go into palliative care so that no patient endures such suffering. No one should feel that their only option for satisfactory relief of pain and suffering is to end their own life.

In consultation with the patient (or their advocate), doctors apply the most appropriate therapeutic means to treat their patients. Where death is inevitable and when treatment that might prolong life will not offer reasonable hope of benefit or will impose an unacceptable burden on the patient, death should be allowed to occur with dignity and comfort. For doctors, this means using their skills to care for the patient by making them as comfortable as possible, free from unnecessary suffering. It does not mean deliberately taking the life of the patient.

 
 

Doctors in Training

8th September2012 : The Tasmanian Government must recognize and commit to the funding to support and train our future medical workforce.  This requires the strategic funding of the THOs, departments and specialists to supervise the training and ensure that excellent quality care is give to the right patients at the right time and right place.  Departments relying on locum and short term contract specialists to meet clinical care and DiT supervision requirements must be adequately funded to meet the regional workforce demand to employ full time specialists or equivalent.

DiT positions must be funded for both junior doctors and specialists in training (known as “registrars”), which can be 4-12 years in the hospital system, not just funding increased intern positions.

The Training of Tasmanian DiT’s should encompass ”rotation Tasmanian Training programs”- whenever practical to facilitate each region having the benefit of Tasmanian trained DiT’s, DiT’s are exposed to our excellent clinicians and teaching opportunities and can complete training within Tasmania, and each region has opportunity to attract these doctors as specialist in the future. 

If the Tasmanian Government does not have the capacity to support the necessary increases medical workforce, it must advise the Federal Government of this so that the necessary funding of specialists to train the DiT’s and the expansion of hospital training positions can be established.

[ AMA TAS Calls on the Tasmanian Government to clarify the funding capacity and plans to fund DiT’s 2013-2018 ]

Click here for the full policy


AMA Tasmania's Budget Submission to the State Government for 2011

budgetsymbol

19th November 2010: The AMA has pleasure in lodging this Budget Submission covering capital and recurrent expenditure in the heath sectors. These issues have been raised by a wide cross section of members from across the state and in many different clinical areas.   Click here for a full copy. In summary:

Capital expenditure

 1. Prioritise Capital Works expenditure over purchases.

 2. Secure dementia unit at the RHH

 3. RHH - Conversion of the current administration into additional wards for 60 beds and relocating administration offices.

 4. Build an additional 400 car parking spaces on site - RHH

 5. 100% increase in anesthetic area - RHH

 6. Information Technology including a flexible live electronic discharge access

Recurrent Expenditure

 1. 150 extra beds in public hospitals across the state in order that the 85% occupancy rates recommended by the AMA can be achieved.

 2. Cancer Services for Tasmania.

 3. Exclusive on Call Arrangements for Visiting Surgeons.

 4. Provide additional training for General Physicians and General Surgeons.

 5. Allow movement of hospital based staff physicians into the private hospitals.

 6. Accrual based Capital Replacement Budgets.

 7. Launceston General Hospital


Improving care for patients with chronic and complex care needs.

The AMA recognises the need for more efficient arrangements to support the provision of well-coordinated multidisciplinary care to patients with chronic and complex disease. If access to coordinated multidisciplinary care is improved then patients will benefit, the number of avoidable hospital admissions can be reduced, and long-term savings to the health system will be generated. In considering this issue, it is important to recognise that current MBS arrangements are meeting the needs of most patients. The Government's own draft Primary Care Strategy said in this regard that supported by the Medicare Benefits Schedule (MBS), most Australians have good access to affordable services provided through general practice, have a choice of provider, and have been supported in their access to many specialist and diagnostic services. See the attached plan for all details.

Chronic Disease Plan (April 2010) - pdf file


Waiting times for Elective Surgery

The AMA calls for better waiting time for elective surgery. Tasmania continues to lag the rest of the country in waiting times for elective surgery. The number of category 2 patients seen within the recommended time of 90 days for elective surgery has continued to decline. Only 49 per cent of category 2 patients on elective surgery waiting lists were seen within the recommended time of 90 days.

Statement click here. 17th March 2010 (State Election)


Dying with Dignity

August 2009: AMA Tasmania does not support physician assisted suicide or voluntary euthanasia. AMA Tasmania contends that "dying with dignity" is not synonymous with euthanasia although this phrase has now almost become a euphemism for premature death intentionally brought about by medical means.

Click here for the AMA Tasmania submission to the Enquiry into the Dying with Dignity Bill 2009

Letter of addemdum Click here


Public Hospital Reform

Tasmanian patients do not necessarily get best value for the money spent on the State hospital systemand have poorer access to hospital and medical services than other Australians. There is clearly a need for better planning with more medical input and less bureaucracy. Every dollar spent on unnecessary bureaucracy is a dollar that is not available for patient care. In other words, more beds not desks.

Submission (October 2008) - pdf file


Royal Hobart Hospital - Funding and Performance

Royal Hobart Hospital - Funding and Performance (November 2005)


Substitution for Doctors Hobart

Substitution for Doctors (November 2005)


Proposed pulp mill

Pulp Mill and Health


Submission

Submission from the Tasmanian Branch of the Australian Medical Association

Re: Draft Guidelines for Integrated Impact Statement (IIS) for Proposed Kraft Pulp Mill in Northern Tasmania (pdf file)


Health Workforce Impact Statements

The Tasmanian Government introduced 'Better Hospitals Program one and two' address significant deficiencies in the Hospital system in Tasmania. deficiencies are in the number and location of specialist doctors as well as the the hospital infrastructure. Previous Government policy decisions were taken for the wrong reasons and without sufficient regard to the health needs of Tasmania.

Read more about Health Workforce Impact Statements and AMA Tasmania's position on this issue.


Pulp Mill Assessment Bill 2007

'AMA Tasmania is an organisation representing 500 medical practitioners in Tasmania. We are concerned about improving the health of Tasmanians and have a track record of influencing legislation to achieve that end. For example; seat belt legislation, air pollution in the Tamar Valley, agricultural chemical pollution in drinking water, banning of smoking in pubs and clubs and most recently the banning of smoking in cars where children are present.'

Read Dr Michael Aizen's full brief to the members of the Upper House (pdf file)


Position Statement – Proposed Tamar Valley Pulp Mill

The Tasmanian Branch of the AMA has examined the (draft) Gunns' Integrated Impact Statement and in summary concludes: AMA Tasmania has significant concerns about the potential for adverse health effects resulting from the proposed Pulp Mill.

Read full statement here


Health Workforce Impact Statements

The AMA notes that it is common practice for Government decisions to require an environmental impact statement. The AMA calls for all Government decisions on health to require a health workforce impact statement.

Health Workforce Impact Statements


Policy's and Position Statements

AMA Tasmania is the State's peak health lobby group advocating on a number of health issues on behalf of our members and Tasmanian patients. At a State and Federal level, the AMA provides information and commentary to the media and formulates policy, and position statements on a number of key public health issues. 

AMA Position statements (available at the AMA website http://www.ama.com.au/policy/positionstatements):

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