Date published: 
5 July 2019
Media type: 
Transcript
Audience: 
General public

SHARRI MARKSON:

And welcome back to The Kenny Report. I’m joined now by the Federal Health Minister Greg Hunt. Thanks for joining me.

GREG HUNT:

Oh, pleasure.

SHARRI MARKSON:

Look, I want to start with this big issue that’s really erupted in the past month or so, about surgeons charging really high fees, particularly for life saving surgery.

Now this all came to the attention of the media when a professor of surgery at, I think it was, University of Sydney, Henry Woo.

He criticised the disturbing number of online fundraising campaigns that have been set up to get access to the high profile controversial surgery. Do you think this is appropriate?

GREG HUNT:

So the first thing is, I won’t comment on individual doctors, particularly those with very, very strong reputations.

But the second thing is the biggest cost that somebody will face if they have cancer is likely to be the cost of medicines. And very recently, we’ve listed new medicines such as Keytruda, Opdivo.

SHARRI MARKSON:

But that’s a completely separate topic.

GREG HUNT:

Well, no, it’s about saving, in some cases, hundreds of thousands of dollars a year. And these medicines make a massive difference to the lives of patients.

In terms of exorbitant fees, we are focused on that. The option is there for people to have public hospital treatment, and it’s high quality.

And in the case of people who have life-threatening conditions, it’s done in a very, very timely manner. For those that choose to go through the private system, we are taking very strong steps about exorbitant fees.

I announced last night that we would have the transparency system up in place, so as everybody will know what are the fees that a particular doctor has been charging and they can compare that. Because as the Chief Medical Officer said, who has developed this system.

SHARRI MARKSON:

So this will be on a website?

GREG HUNT:

It’ll be on a website.

SHARRI MARKSON:

Transparency website?

GREG HUNT:

Correct. And so it’ll be a transparency website and it will be available from 1 January 2020. What I can announce today is that the first two areas will be oncology, or cancer treatment, and obstetrics and gynaecology.

And so, that’s a very important step forward. It’s never happened before, and we’re doing it on our watch so as people can see and choose.

And those that are outliers will clearly be exposed. There’s a second big thing that we’re doing in conjunction with the AMA – or the Australian Medical Association.

They are having their members agree to participate in a process where if you’re starting a process of treatment an informed financial consent agreement. So you will actually know from the doctor what your total cost is likely to be, if anything.

SHARRI MARKSON:        

And so in terms of the transparency website, if it’s with cancer treatment and obstetrics, so all medical practitioners or surgeons operating in this field; how does it work, they’ll have to disclose how much they’re charging each patient.

GREG HUNT:

Well, we would expect them to.

SHARRI MARKSON:

But each patient, or how does it actually.

GREG HUNT:

It would be by a particular class of activity, because obviously the private details of a procedure for yourself, or myself, or somebody else should remain confidential.

But what they will show is the average fees for a particular class that will be comparing like with like. And then secondly, we will be very clear that if doctors are not participating- these are the doctors that are in, and these are the doctors that are not.

SHARRI MARKSON:

So if there is a neurosurgeon like Charlie Teo whose fees are significantly higher or double, then this (inaudible) that would be obvious for anyone.

GREG HUNT:

Obviously, in two ways. One is through the website. Secondly, also through the informed financial consent agreement.

So if you enter into other relationships – and this is the most important one in terms of people's health – you will know how much particular services, such as if you're doing work on your house or other things, you'll get a quote in advance; that's not happened before, and that's changing.

And we expect that to be in place within the next month off the back of a discussion I had with the president of the AMA Tony Bartone only yesterday.

SHARRI MARKSON:

Just back to Charlie Teo; the reason this controversy erupted is because he was charging some people who are dying up to $120,000 for lifesaving treatments, and they were needing to fundraise to get that surgery. Do you think that is appropriate?

GREG HUNT:

Well I take a very cautious view about what I call exorbitant fees. Chief Medical Officer has been absolutely clear, without referring to particular individuals, that fees do not necessarily equate to quality.

They do not necessarily produce better outcomes. And we will make sure that for the first time, the public will have genuine choice and the ability to compare, but also the informed financial consent agreements for their particular treatment with their particular doctor, so as they can see what if, any fees, that they will face.

SHARRI MARKSON:

If someone has to re-mortgage their house or even sell their house to afford surgery to treat a brain tumour, that other surgeons have said might not even be the best form of treatment, is this something that concerns you? Do you think these sort of practices should be investigated?

GREG HUNT:

Well we do have very, very strong processes through the Medical Board of Australia and the (inaudible). They do look at individual cases where they've been being referred, and they have investigative powers. And so

SHARRI MARKSON:

(inaudible) Have you got the outcome of any of these investigations?

GREG HUNT:

Well we do see that, from time-to-time, doctors are sanctioned, suspended, disbarred depending on their particular circumstances or conduct, and so they operate as independent, fearless agencies to prosecute in the public interest but they deal, effectively, with what are, of course, the outliers and the cases of malpractice or bad practice.

They have strong powers and they have a fearless approach and we have empowered them to be absolutely right.

SHARRI MARKSON:

Is Charlie Teo facing being disbarred?

GREG HUNT:

I'm not aware of circumstances. It wouldn't be appropriate for me to talk about any circumstances.

SHARRI MARKSON:

Yip.

GREG HUNT:

But I do not have any specific information on that.

SHARRI MARKSON:

Has Charlie Teo indicated to you whether he would participate in the transparency website?

GREG HUNT:

Yes, he has. So he has indicated that he would and I welcome that. I think that would be a very strong sign to other doctors, other surgeons. We would like to see all of the medical practitioners in Australia become a part of this system.

SHARRI MARKSON:

Did you urge him to or what was the nature of the conversation?

GREG HUNT:

Look, I have spoken with him and I said: a very strong sign would be if you were to do this; and he said: no, I would very happily do that. So, I welcome that from him.

SHARRI MARKSON:

Yeah. And that will be up and running from January next year.

GREG HUNT:

Correct.

SHARRI MARKSON:

Yip. Great. Oh, and of course, he would qualify for it because he does cancer treatment.

GREG HUNT:

Yes.

SHARRI MARKSON:

So it would only be his treatment on cancer patients that would go up on this website initially?

GREG HUNT:

Well, it will start- we worked with the AMA and the College of Surgeons and other medical bodies to identify the priorities and then we'll just progressively work right across all of the specialities.

SHARRI MARKSON:

Yeah. Now look, I just want to ask you about the flu season. It is particularly brutal this year and I just want to run you through some of the figures.

GREG HUNT:

Yes.

SHARRI MARKSON:

There have already been 40 people die of the flu (inaudible). In New South Wales, there have been 30,000 cases of the flu this year – 30,000 – and just to put that in some context – by this time last year, there’d only been 4600 flu cases.

GREG HUNT:

That’s correct.

SHARRI MARKSON:

And you can check my figures, there you go. And the year before at this time, there were 5700 cases of the flu and that was seen as a very bad year. So if 5700 cases in 2017 is seen as a bad year for the flu, if you have 30,000 in New South Wales this year, I mean that's just a disaster, isn't it?

GREG HUNT:

Well, it's related to international circumstances and the type of flu which is occurring, not just in Australia but around the world in any one year. Last year, we saw a dramatic drop in the number of cases. We saw a dramatic increase in vaccinations.

Two years ago, eight million Australians were vaccinated. Now, it's likely to reach 13 million this year. I met with one of the flu vaccine (inaudible) this morning to look at further effectiveness.

They said this had been a particularly tough year around the world. But in the older age groups, their advice, which I do want to check, but their advice to me is that Australia has now become the country with the highest rate of flu vaccination in the senior age groups and one of the highest rates across the general population.

So, we've gone from eight million vaccinations two years ago to 13 million this year. We've been able to secure the supplies.

Our job is to make sure that those vaccines are there to get the best quality vaccines and to keep driving forwards. But this is one of the challenges that not just Australia but the world faces –that it's a highly contagious disease; it travels across borders; and so, we have to work both on the safety and the hygiene as well as working towards universal voluntary vaccination in (inaudible).

SHARRI MARKSON:

What were you discussing with the flu manufacturers this morning? I mean, were you looking at having compulsory flu vaccinations for school students?

GREG HUNT:

No, we're not. That isn't one that we're looking at ourselves. We follow the full advice of the- there's a cross jurisdictional or a broad-based immunisation advisory group, and we will implement their advice if they recommend new vaccines or broader-ranges of coverage, then we follow that.

SHARRI MARKSON:

Because that’s one of the issues, isn’t it, that you might get the flu vaccine but it might not cover the strain that's going around this year?

GREG HUNT:

Well, no. The vaccine is done every year, and so the World Health Organisation works with the national jurisdictions and with the manufacturers to ensure that we have the most up-to-date vaccines.

So that process is going on right now to develop the vaccine for next year and it's about ensuring that we have the most effective vaccine.

Also, one of the things that can happen (inaudible) targeted vaccine for older age groups because they have differing needs and in particular, that was what we were focusing on today.

SHARRI MARKSON:

And so you're going to implement that. Is it too late for this year?

GREG HUNT:

No, no. The vaccine is developed rapidly and then- unlike other vaccines. So for example, what we've done with cervical cancer and Gardasil 9, which takes many years to develop, but then becomes a permanent vaccine which continues each year until there's a new evolution of that.

The flu vaccine is redeveloped each year to address the emerging strains around the world.

SHARRI MARKSON:

Just lastly, you said today that you would accept all the recommendations of the stillbirth report.

One of the recommendations is to improve the decision-making around the timing of birth for women with risk factors.

There's a debate going on at the moment about whether, you know, if a woman does have risk factors (inaudible) bang on the 39 weeks. Is that something that you think you would endorse and that that would bring down the stillbirth rate?

GREG HUNT:

So the medical advice is something that will be developed through this process, and I'm very cautious about giving direct medical advice.

I think my job and our job is to make sure that we have a national roundtable with the experts that comes to a consensus.

And again, not all doctors will agree but using evidence-based research to provide the best advice to mums and to their families on what is the optimal time for birth. But of course, by definition, the vast majority of pregnancies seek to run full-term.

SHARRI MARKSON:

40 weeks, yeah.

GREG HUNT:

There has been some change away from practices which were inducing early, and I think that's a positive thing.

SHARRI MARKSON:

Thank you very much for your time, Minister. Appreciate it.

GREG HUNT:

It's a pleasure.

Ministers: