The President's Blog

Dear fellow Members, it is my pleasure to write the President's Blog. A way of communicating with you, as your elected President of MDA National.
October 2021

 

Dear fellow Members

The COVID-19 pandemic continues to dominate the conversation, whether we are talking about serious evaluation of public policy, or the chat (at a 1.5m distance) over the neighbours’ fence. Its impact on healthcare will be long lasting. Both New South Wales and the ACT have reached 80 per cent double dose vaccination rates and are on the cusp of greater freedoms of movement. At the other extreme, in places like my home state of Western Australia, many individuals have noticed minimal disruptions to their day-to-day lives beyond being effectively locked out from the rest of the world, and often close family and friends.

COVID-19 infections have had a significant impact on our Emergency Departments, hospital wards and Intensive Care Units. With the slow but steady move towards a highly vaccinated population, the focus of managing COVID-19 will move from our hospitals to general practice.

In both general practice and other specialties we have seen the massive expansion of telehealth services. This long overdue Medicare reform has been one of the few benefits of the emergence of SARS-CoV-2. Cancellations of elective surgery in the public and private systems will have an impact in the months and years ahead.

All of these disruptions represent areas of risk for your MDA National. Through our Board and Management Committees we consider these issues carefully in keeping to our mission of supporting, promoting and protecting our members. For example, we have had to consider the legal and ethical issues around doctors resident overseas providing care to patients in Australia. Our claims teams have been fielding calls as diverse as patients complaining about refusal of mask or vaccine exemptions, accusations of overly enthusiastic promotion of vaccination, and refusal to prescribe non-evidence-based treatments.

As I have stated previously, much of this occurred against the background of our staff being kept away from the office and often needing to work while ‘home schooling’ their children.

The increasingly successful vaccine roll-out provides a source of increasing optimism. We await evidence on vaccine effectiveness and safety in 5 to 11 year olds, a greater understanding of ventilation and other workplace safety controls, and the emergence of possible antiviral treatments with anticipation.

It has been a testing time for our Members and our staff. It will continue to provide challenges for MDA National. The pandemic has led to a hardening of international markets, making our ability to purchase reinsurance on competitive terms more difficult. The pandemic has put huge pressure on the ability of many of our Members to earn a living from seeing patients. The generosity of the courts and increased plaintiff lawyer activity will not go away any time soon. Be reassured that we are ready for all the challenges ahead.

Sincerely
Dr Micheal Gannon


 
September 2021

 

Dear fellow Members

I hope that many of you took the opportunity of RUOK Day to reach out to your colleagues in these difficult times. While the impact of the COVID-19 pandemic has affected people in different parts of Australia to widely varying extents, it has universally been a time of great fear and uncertainty.

Members working in Intensive Care Units and general medical wards in Sydney hospitals have been at the coalface of managing the disease and death that the infection can bring. For others there have been other less tangible disruptions to practice.

Restrictions on certain procedures have caused problems in areas like ENT surgery and Gastroenterology. Other members have had their practices disrupted by sometimes perfectly reasonable and other times heavy-handed determinations on the urgency of surgery, e.g. our colleagues in Plastic and Reconstructive surgery.

In other areas, our practices have been curtailed by the unavailability of nursing staff. The pandemic has brutally exposed our overreliance as a nation on nursing staff who come from overseas. Many of our nursing colleagues have availed themselves of the opportunity to escape the stress of our poorly resourced public hospital system, for often much more relaxed and pleasant jobs in COVID-19 testing facilities or SARS-CoV-2 vaccination programs.

The pandemic also represents something of a risk to the viability of the private medical sector. Private hospitals are an efficient, capable, and very important part of heath care delivery in Australia. They are not simply a fallback option to be used by state and territory health departments when their bed capacity is revealed to be inadequate. The levels of uncertainty and anxiety in the community also represent greater risk to medical indemnity organisations.

GPs are bearing the brunt of the ever-increasing number of requests for vaccination exemptions. It is exhausting explaining the benefit/risk equation to the sensible and inquiring ‘vaccine hesitant’, let alone handling those happy to swallow the latest fantastic theory on social media. Many have been doing a power of additional work in delivering the massive vaccine roll-out.

At MDA National, our staff understand the uncertain times in which medical practitioners live. At the same time, we are very fortunate in that the majority of us have the opportunity to go to work, to socialise to the extent we can, and to talk about the shared experience of this ongoing disruptor.

Our staff, especially those in Victoria enduring one of the planet’s longest lockdowns, and those in New South Wales who have now been at home for nearly three months, have found it difficult to engage with their teams and talk to their mates. I thank them on behalf of the Board, the Executive team and all of our members.

As we push towards 50 per cent of the Australian population being fully vaccinated, there is light at the end of the tunnel. A return to freedom of movement between the states and territories, and indeed internationally, is an important part of our ability to rest and recuperate by enjoying a holiday. Separation from loved ones is harmful. In my own practice, nearly a quarter of new mothers are kept apart from their parents in that period of equally great joy and need.

It is also important to re-establish our health care supply chains which have been impaired by the restrictions on movement of people and capital. We can only hope the arrival of spring heralds better times for our members and staff in the weeks ahead.

Sincerely
Dr Michael Gannon


 
July 2021

 

Dear fellow Members

Thank you for the loyalty you have shown the organisation and the confidence you have shown in your board members in the recent renewal. It was in the context of a number of years of adverse claims experience, and a hardening international reinsurance market, that we came to you seeking an increase in premiums for year 2021/22.

We are keenly conscious of the intercurrent disruptions to private medical practice around Australia. I have a special place in my heart for what seems like the near constant disruptions suffered by our Members in Victoria.

The Mutual and Insurance Board’s of MDA National do not take this vote of confidence for granted. We have a proud history of meticulously careful management of Members’ funds to give you the confidence to take care of your patients, knowing that you will enjoy protection and support (should you ever need it) in a civil matter or, as is increasingly the case, with a complaint to a hospital or the regulator. The whole MDAN team is thinking of our staff and our colleagues suffering through the extended lock-down in New South Wales and Victoria. We will do everything we can to support you in these difficult times.

With 10 million vaccine doses administered and more than a million doses being delivered each week, we can only hope that we are slowly but surely moving towards something like a ‘new normal’. We have not seen the last of the challenges of year 2021 or for that matter the COVID-19 Pandemic. In a world of uncertainty and disruption, the stability provided by your MDA National will continue to be a source of comfort and confidence.

Sincerely
Dr Michael Gannon


 
June 2021

 

Dear fellow Members

It has been a difficult and occasionally bruising month for many of our office staff, discussing and explaining premium increases for our Members across Australia. Management have worked hard on cost control over the past couple of years. We have communicated to Members facing a significant increase in the cost of their premium that the major driver is the cost of claims.

The truth is that insurance is becoming more expensive across the board. In the last 24 hours alone, I have had a conversation with a fellow Board member about the huge increase in the cost of Directors and Officers (D&O) Insurance in his other business. Listening to the radio this morning, I heard that the peak body for those who run carnivals and sideshows is finding it virtually impossible to obtain insurance.

This is a consequence of ‘social inflation’, where courts are becoming more and more generous in their payouts. This could be interpreted as a change in the way the judiciary thinks. It could reflect a wider societal change where people who have been injured are more likely to seek compensation. It could reflect growth in plaintiff lawyer activity. My opinion is that it is a combination of the three.

An examination of the international experience makes for very sober reading. The American publication Inside Medical Liability talks about the escalation of ‘nuclear verdicts’, some over $100 million. This adds to the costs borne by our patients. It is important that the medical indemnity providers continue to work in their own patch, helping to improve patient safety and supporting continuing education of doctors to reduce the risk of claims. It is also a reason why we need to engage with Government at industry level on sets of rules that mean that we can continue to provide cost effective health care to our patients.

These are testing times for general insurers and re-insurers. We are not immune from these changes. The increase in premiums again shows the leadership of MDA National as a medical indemnity provider in Australia. We have never subjected our Members to a call. Members should be satisfied that their organisation is always staying ahead of the game in making sure that we always have sufficient capital reserves, and doing everything we can to stay abreast of, and where possible ahead of, changes in the insurance industry, both nationally and internationally.

Sincerely
Dr Micheal Gannon


 
April 2021

 

Dear fellow Members

Recently, the doctor owned Medical Indemnity Insurers, united in our approach, wrote to Health Minister Hon. Greg Hunt MP asking for indemnity for GP members, other doctors and practice entities for their participation in the COVID-19 Vaccination Program. MDA National and our sister organisations made similar representations through our industry body, the Insurance Council of Australia earlier in the year. Those initial approaches were rebuffed by Minister Hunt.

The Government has shown no appetite to introduce a statutory no-fault compensation scheme. If that cannot be delivered swiftly, bearing in mind the urgency of the timelines, then a guarantee of indemnity is essential.

MDA National continues its advocacy through our close relationship with the AMA, discussing the importance of doctors being confident that if they administer vaccine in good faith, they will enjoy indemnity from the inevitable adverse events that will accompany the massive and unprecedented exercise that is vaccinating the entire Australian population against a novel pathogen.

The vaccine manufacturers sought and were granted immunity by the Federal Government. We sought then, and continue to seek now, similar arrangements for doctors administering vaccine in the private sector and beyond.

The ATAGI advice on the Astra Zeneca vaccine and the emergence of a seemingly idiosyncratic Thrombosis and Thrombocytopenia Syndrome (TTS) have only made the case more urgent. The community’s faith in an unprecedented whole of population vaccine roll-out will be tested if there is any reticence on behalf of trusted health professionals to administer the vaccine. Study after study has shown the high regard in which Australians hold their GPs. It is entirely reasonable that GPs would seek this protection while contributing to this hugely important public health measure.

In the event of a claim, the treating doctor might be the first point of contact. Even if there is a legal process in which the doctor and the manufacturer are both addressed in a claim, this becomes a complex and therefore expensive legal process.

Elsewhere in the world, governments are indemnifying healthcare professionals for the risks associated with administering COVID-19 vaccinations. Therefore, it will become difficult for Australian organisations like ours to purchase reinsurance in that competitive international market.

MDA National will continue to make the strongest possible representations on behalf of our Members.

Sincerely
Dr Micheal Gannon


 
March 2021

 

Dear fellow Members

Probably only the keenest observers of the medical indemnity industry are aware of the recent largely unheralded, but major, shift in the way we do business. In 2020 the regulations changed to remove the concept of Insurer of Last Resort, e.g. where MDA National was required to write a policy for a medical practitioner in Western Australia, Avant in New South Wales, irrespective of the level of risk. The new Universal Cover regulations require all insurers to make an offer to an applicant wherever in Australia they practise.

This and other impacts on the industry make it both easier and necessary for medical indemnity insurers to charge a higher premium to Members we judge to be of greater risk. This alignment of risk and premium might mean a higher premium for individuals with a history of large claims.

Some high-risk Members will search for ‘a better deal’ elsewhere. It is sad to lose Members who have been loyal to the organisation. Equally, we strive to remove cross-subsidies wherever feasible, so that the medical indemnity premium paid by an individual doctor reflects their risk and cost to the organisation.

It is all about finding the right balance between respecting our heritage and history as one that cherishes our Mutual obligations to each other, while setting competitive and fair prices for individual doctors.

There are numerous challenges for MDA National as we seek to manage our investments. While Australia has been close to world-leading in its resilience against the impact of the COVID-19 Pandemic, there is still great uncertainty with gradual withdrawal of Government support, and deteriorating conditions in markets and the insurance industry internationally.

Nonetheless, we are thoroughly committed to using this opportunity to enhance our Responsible Investment policies. We are carefully considering environmental, social and corporate governance (ESG) factors in how we manage our investments and the funds we hold on your behalf.

As Chair of the AMA Ethics Committee a few years ago, I assisted in developing an ethical investment policy which made sure that the AMA did not invest in companies involved in the production of tobacco, pornography, or weapons of mass destruction.

MDA National seeks to be more expansive in our decisions, ensuring that we do not invest in companies that use child labour or modern slavery. Further, we seek to involve ourselves in enterprises that emphasise the importance of positive climate change policies and sustainable development.

We obtain professional advice in delivering financial value to members, while having a set of values that are entirely keeping with the ethical way we treat our patients.

An organisation which represents doctors must acknowledge the relationship between human health and issues like energy efficiency, waste and pollution, and the health and safety of workers in supply chains. I can assure you all that this is core business for MDA National.

Sincerely
Dr Michael Gannon


 
February 2021

 

Dear fellow Members,

It is my pleasure to introduce a new regular way of communicating with you, as your newly elected President of MDA National. It is a matter of great honour and pride that I was elected late last year, having first joined MDA National as a medical student in 1989 and being closely involved with the organisation as far back as 1993, when I was President of the Australian Medical Students Association (AMSA).

MDA National’s ethos of supporting, promoting and protecting starts when we are medical students and continues with us through our journey as junior doctors, doctors in specialist training, and then doctors in practice.

On a number of occasions, I have personally been in a position to seek the support of the organisation. I have not forgotten the support given to me during a coronial investigation as a junior registrar.

I am proud to lead a Mutual Board of diverse talents with backgrounds across many different areas of medical practice and from across Australia. You can read about our fellow elected Board Members here.

MDA National has consistently been recognised as a medical defence organisation that maintains a close relationship with its Members, supporting them in their work week by week and protecting them in their hour of need. Having been a member of our Cases Committee since 2011, I can assure you that collectively we pride ourselves on the way we manage inquiries and complaints involving our Members.

It is also our job to promote high quality medical practice. It is my intention to continue to support our outstanding education programs and to advocate on your behalf to help deliver to our patients and fellow citizens health care of the highest levels of safety and quality.

Your MDA National is strong and well capitalised, having overcome the difficulties and challenges of the one in a one hundred year whole-of-society disruptor that is the COVID-19 pandemic. I look forward to communicating with you all regularly in the months ahead.

Sincerely
Dr Micheal Gannon