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A second issue that was discussed was organ donation. The meeting raised the concern that Australia has one of the lowest rates of organ donation in the developed world. The meeting agreed that a national approach to community education and encouragement of organ donation is required. The fact that it is time for a coordinated national approach on this issue was signalled by the agreement reached that a national education program for health professionals and transplant coordinators would be initiated. A single national organ donation system will be developed and implemented, with South Australia conducting a pilot on how the system might operate.

The third issue of interest was Medicare funding. It was agreed that Medicare funding needs to be addressed in a way that would bring the focus of health services back to where it should be - on the needs of the patients and the clients that we serve. The meeting agreed that new agreements need to be drafted and that they should aim at overcoming the barriers that now prevent services from being provided in the most effective manner. A decision on where a patient receives treatment should not depend on which level of government picks up the bill. It was pleasing that the Commonwealth agreed that it should provide some additional funds to States to compensate, albeit to a very minor extent, for the cost shifts resulting from the decline in the proportion of the population taking out private hospital insurance. Of course, this trend continues and it seems to be actually accelerating. The fourth issue of interest was non-coronial autopsies. Ministers agreed to actively encourage an increase in the non-coronial autopsy rate to at least 25 per cent of those people dying in hospitals. The ACT supported this resolution. ACT pathologists have shared international and national concern at the declining rate of non-coronial autopsies. Autopsies provide more accurate statistics on causes of death and are a vital part of the clinical assurance process.

The fifth issue was the supply of Factor VIII. Factor VIII is an essential component of blood and when it is deficient is associated with spontaneous uncontrolled bleeding. Patients with haemophilia A, an inherited disorder, have a congenital and lifelong deficiency of this factor and almost exclusively make up the patient population requiring treatment with Factor VIII. Based on the findings of the report of the Working Party on the Supply of Factor VIII, Health Ministers agreed on measures that ensure Australia will provide sufficient Factor VIII through a combination of locally produced and imported products to enable effective treatment of patients. The ACT currently harvests sufficient plasma from single donor units to meet routine demands for Factor VIII concentrates. However, there is no surplus and the ACT is also dependent on supplies from other States to meet intermittent and unpredictable emergencies such as major trauma or emergency surgery. The ACT will not hesitate to purchase the synthetic product to overcome any shortfalls in Factor VIII should the situation require it.

I suppose the most interesting issue that came out of the conference for the ACT was the debate about the Clinical School. Members of the Assembly may recall my concern when I returned from the AHMC to find that my recollection of the meeting differed from that of Dr Carmen Lawrence. The issue was and is important. The Commonwealth has unilaterally decided to control the supply of doctors by restricting the number of medical school students. This is patently absurd. No other profession expects that every student trained will automatically be able to be employed. For example, there is no restriction or quota on the number of teachers or nurses being trained, apart from the sheer ability of universities to fit the students into their facilities.

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