Wrong Diagnosis Dr Fels – 7 February 2003

The proposal by the ACCC that Government appointed bureaucrats and consumer representatives should have a say in who should be performing complex surgical procedures should be rejected if patient safety and quality are important, said Mr Stephen Milgate, Executive Director of the Australian Doctors’ Fund.

Mr Milgate said “The ACCC has spent years and countless thousands of taxpayers dollars demanding that the Royal Australasian College of Surgeons (RACS) justify why it has such high standards and why Australian surgical graduates have high international standing. The RACS costs in meeting the ACCC demands have been passed onto its Fellows and must eventually be passed onto patients.”

“Dr Fels would have us believe that there is a conspiracy among 4000 surgeons to put training programs beyond the reach of those who want to be surgeons.”

“Governments, not Medical Colleges, have always had the power to licence doctors – governments can pass a law tomorrow giving all motor mechanics a licence to perform brain surgery, but for good reason they have required that those who want to be surgeons meet the requirements of a recognised medical college.”

“The reality is that to maintain standards and to work within a training budget that taxpayers can afford not everyone who wants to be a surgeon can be. This is the same for every professional occupation where entry is limited by the number of available opportunities.”

“Most importantly the training of a doctor in complex manual and procedural skills is intensive. It requires one on one supervision and many hours of co-working whilst at the same time ensuring that patient safety is maximised. It is an apprenticeship system that has proved highly successful.”

“In Australia doctors give advanced training to their colleagues at considerable personal cost but at no charge to the community. (Medical Colleges do charge course fees to cover the costs of materials).”

“There is no current barrier to supplying surgical education and training other than having to be accredited by the appropriate government authorities. Again governments have been reluctant to have a variety of organisations offering different forms of training at different standards.”

“Government funding, not intervention, will increase the number of surgical training posts and stop the rationing of operating theatre time which sees many highly qualified surgeons idly drinking coffee whilst waiting to get into an operating theatre.”

“The effect of Professor Fels’ recommendations will be massive increases in government bureaucracy, doctors abandoning the honorary training of their colleagues, taxpayers forced to fund all surgical training, and surgical standards determined by government controlled committees. That is, the destruction of one of our most important professional institutions and a very uncertain future for every patient needing surgery.”

“By this time Professor Fels will be well into retirement but all Australians will be left with the consequences,” said Mr Milgate.