WADA needs new clarity of purpose

When one thinks of a union, the Australian Medical Association does not immediately come to mind. The
august institution, formed in 1962 from what were state branches of British Medical
Association, represents a traditionally well-paid and highly respected professional sector. The
The AMA has also evolved into a powerful force in policy-making; health ministers on all sides have
repeatedly hesitated to put himself on the wrong side of the association. Few blue collar unions could
be seen as analogous in their access to and influence over government.

But the AMA is a union and, like unions in general, finds itself afflicted by a drop in membership
and diminishing influence. As the Herald reported over the weekend, AMA members in all
medical disciplines has been steadily falling since its peak in the 1960s, when it spoke for 95 percent
100 of doctors in the country, and even from 1987, when it represented 50%. Today the
the association represents less than 30% of the country’s 104,000 doctors. And in a development
reminiscent of the association’s antecedents, the Victorian branch has created a new membership
structure that does not send half of the members’ dues to the federal body. The breakup, according to
Victorian AMA President Roderick McRae reflects the wishes of Victorian doctors who are
“dissatisfied, for whatever reason, with the national approach” and finding the costs increasingly
unaffordable. Outgoing association chairman Omar Khorshid opposed the Victorian government
branch relocation.

Indeed, if there was one theme that explained the misfortunes of the AMA, it was fragmentation. As for the larger
workforce, the medical profession has changed significantly since the 1960s, before the era of medicare.
Today, the profession is broader and more specialized. Physicians work in a more diverse practice
groups. There is a greater reliance on overseas-trained doctors, particularly in parts of Australia where the burden of chronic disease is high, but the supply of GPs is not. In his
farewell interview with HeraldKhorshid dismissed claims that the association’s declining membership was a sign that it did not represent all doctors, but it was nonetheless telling that such claims existed.

Perhaps even more disturbing is the claim that the AMA has trouble reading the temperature of the
public and its trusted institutions. Victorian branch push for tough restrictions during COVID
often harassed a weary populace, not to mention former Deputy Chief Medical Officer Nick
Coatsworth, who accuses the branch of mocking and fearmongering. McRae’s sarcastic outburst that
anti-vaxxers and COVID deniers shouldn’t seek hospital treatment for a disease they denied existed, which stemmed from understandable exasperation, but she had the Twitter ring rather than a plea responsible and compassionate for public health.

Along the same lines, the Victorian branch motion at the weekend AMA conference demanding a
royal commission on the medical regulatory body, the Australian Health Practitioner Regulation
Authority, no doubt has its merits. The motion arises out of a dispute about the Authority putting
registration conditions for Broome GP David Berger, who raised his eyebrows for his
combative advocacy against zero COVID. (Khorshid says the wording of the decision has members
alarmed that it could be applied more broadly.) But the motion also raises legitimate questions about WADA’s priorities and policy stance more broadly. Again, we could argue that unions have also diminished their standing with Australian workers when they have been seen as pursuing niche agendas and deviating from their main purpose.

We hardly need to stress the importance of the AMA’s primary purpose – to fight for the interests of physicians – amid the chaos that COVID continues to inflict on a healthcare system that was strained and inefficient to begin with. . It is true that the interests of physicians have rarely, if ever, been perfectly aligned with those of the public.
interest. Nevertheless, the debate on the future of health care in Australia stands to benefit from
coherent and unified advocacy on behalf of the medical profession. WADA still has policy
influence, but it takes renewed clarity of purpose to make a more convincing claim that the doctor knows best.



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