This week in Canberra, the Government introduced the Higher Education and Research Reform Amendment Bill 2014. The bill seeks to, among other changes, deregulate university fees. In recent months, AMSA has opposed this proposed deregulation, and highlighted the public health concerns associated with skyrocketing medical school fees in particular.
The Government addressed the issue of medical school fees in the legislation’s Regulation Impact Statement. Excerpts from the statement are included below:
4.4 Additional options identified through the consultation process
During consultations with sector stakeholders (see section 5), additional options were identified and subsequently considered by the working groups.
4.4.5 Medical places
Set a net price cap. Given the number of Commonwealth supported medical places will continue to be designated by the Government, the Government would set a new maximum student contribution level for courses in medicine. This would account for the proposed reduction in Commonwealth contribution and provide some scope for price differentiation
The introduction of the demand driven system for bachelor level Commonwealth supported places in 2012 did not include an uncapping of medical places, primarily due to the shortage of clinical training places for medical students and the high cost of providing medical training. The reforms announced in the 2014/15 Budget proposed that medical places continue to be capped but that fees for medical places be deregulated. Given that demand for medical places is likely to remain high and supply capped, it is unlikely that universities will compete on price in offering medical degrees following fee deregulation. This is an issues considered further in section 6.4.
6.4.6 Medical places (Set a net price cap)
Under this option, the Australian Government would set a new maximum student contribution level for courses in medicine, both to account for the proposed reduction in Commonwealth contribution and to provide some scope for price differentiation.
The impacts of this option will be dependent on the price cap elected by the Australian Government. A price cap that is too low will likely become the effective price for undertaking a medical degree in Australia, and will prevent the market from realising the benefits associated with price differentiation. A price that is too high will likely be no different than having no price cap at all.
Choosing an effective price cap – one that prevents excessive price increase (given that enrolments in medical places will remain capped), but also allows for price differentiation – will likely require considerable analysis and experimentation on behalf of the Australian Government.
It is unclear whether this option represents a net benefit or a net cost relative to the Government’s proposed reforms – given that the value of the net price cap has yet to be determined. This option is likely to be more regulatory, but it is unclear whether the costs associated with this additional burden would be significant and/or greater than the possible benefits arising from the option. If the Government choose to pursue this option, greater analysis and ongoing monitoring would be required
7.4 Additional options identified through the consultation process – not preferred
Set a net price cap.
Applying a cap is a more regulatory option compared to the proposed deregulation of fees. Regulating in this way, in the context of a high paying profession, makes little sense. While the application of a price cap on student fees could potentially constrain cost for students at more desirable institutions, it would also reduce the capacity of providers to compete fully on price and quality. Any cap would need to be set high enough to allow adequate provider revenue to be generated, and still provide scope for price differentiation.
The cost-benefit analysis showed it is unclear as to whether this option represents a net benefit or a net cost relative to the Government’s proposed reforms. If chosen well, a net price cap should allow for price differentiation, while also tempering excessive price increases driven by caps on the number of medical places. Choosing an effective price cap would require considerable analysis and experimentation on behalf of the Australian Government. This option was not recommended by the Legislation and Financing Working Group. This recommendation was supported by Government.
The Australian Medical Students’ Association is calling on the Federal Government to achieve the greatest feasible Renewable Energy Contribution by 2020 to protect the health of Australians.
Yesterday, the Renewable Energy Target review was released, finding the current scheme was effective and could achieve a 26% share of electricity from renewable sources by 2020, yet recommending ending support for new renewable energy power stations.
Despite a submission from AMSA, it was disappointing to note that the review failed to adequately address the health benefits of the RET, including the economic savings.
For the full media release, please see here: AMSA RET Press Release
Applications are now open for delegate positions to the East Asian Medical Student Conference (EAMSC) 2015 to be held in Jakarta, Indonesia.
This 6-day conference (January 10 – 15) allows medical students from over 27 countries from the Asian, Pacific, Oceanic and European regions come together to discuss a pertinent topic in medicine. It is a brilliant way to undertake and present research on the international stage, get involved in a unique public health campaign on the global level, sightsee around a foreign country, and make lasting friendships with our international counterparts. An immersive social program, cultural performances and cultural exchange lead to a truly memorable and heart-warming experience. You then have the opportunity to get published, present your research or distribute your public health poster or film clip nationally back here in Australia.
The post-conference tour (January 15 – 18) is to be held in beautiful beached Bali!
The theme for this year focuses on a subspecialty of infectious diseases: Sexually Transmitted Infections.
For further queries, contact the Regional Chairperson of AMSA International Australia, Michael Keem: email@example.com or the AMSA GHO, Timothy Martin: firstname.lastname@example.org
Medical students launch national youth mental health campaign
Media Release. August 21 2014.
The Australian Medical Students’ Association (AMSA) is this morning launching a national campaign to tackle the burden of mental health afflicting Australia’s youth. The campaign, supported by the Australian Medical Association, Headspace, beyondblue, and Orygen Youth Health, will be launched at an event in Melbourne this morning.
AMSA President, Jessica Dean, said today that Australia’s youth are disproportionally affected by the burden of mental health and AMSA is acting to both raise awareness as well as lobby for improved access to mental health services in tertiary education centres.
“The Australian Institute of Health and Welfare found that young Australians are at a greater risk of developing a mental health disorder, with more than a quarter of those aged between 16 and 24 years experiencing a mental health disorder in the previous 12 months,” Ms Dean said.
“Despite the increased burden of disease, youth are less likely to access services for mental health concerns. This denotes both a lack of awareness and opportunity.
“AMSA will be working with the universities to improve both access to mental health services as well as raising awareness with the community and young Australians.”
The campaign has support from multiple providers of mental health services, including Headspace. Headspace CEO, Chris Tanti, said today that for decades mental health has been the poor cousin and not kept pace with funding attracted by other specialities in medicine.
“This initiative by AMSA is critically important and signals that the future doctors of this country are up to date and well aware of the impact mental health problems have on the future wellbeing and health of all Australian,” Mr Tanti said.
The launch event is being held at 10:30 this morning, Thursday 21st August, at BOQ Specialist Bank, Level 49,120 Collins Street, Melbourne.
Speakers at the event include Professor Patrick McGorry, Jeff Kennett from beyondblue, Headspace, and Dr Sally Cockburn. Media is invited to attend.
For further information about the launch, or to arrange interviews with the AMSA President, speakers or delegates, please contact Mr Ben O’Sullivan on 0437 195 272 or email@example.com
0437 195 272
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We are incredibly excited to release the first edition of AMSA’s official magazine, Panacea, for 2014: The Hx Edition.
Full of useful, insightful and fascinating articles from medical students around Australia, it’s a great read. Download Panacea here: Panacea: the Hx Edition
Please share Panacea with your friends and colleagues!
Thursday 21st August, 10:30am
BOQ Specialist Bank
Level 49, 120 Collins Street, Melbourne
Media invited to attend
The Australian Medical Students’ Association (AMSA) is hosting the launch of its Mental Health Campaign. Speakers include:
- Professor Patrick McGorry AO, 2010 Australian of the year and executive director of Orygen Youth Health
- Chris Tanti, CEO of Headspace
- Professor Jayashri Kulkarni, Director of the Monash-Alfred Psychiatry Research Centre and professor of psychiatry
- Jeff Kennett, Chairman of Beyondblue
Why: With over a quarter of people aged 16-24 years experiencing a mental health disorder annually, the Australian Medical Students’ Association is launching a campaign to address the mental health burden of young Australians. The campaign, the largest in the organisation’s history, will partner with national mental health organisations to raise awareness as well as educate and inform students and the wider public about mental health and wellbeing. Destigmatisation of mental health as well as a reduction in the national youth burden are crucial steps in providing future prosperity of both the individual and the nation.
0437 195 272
Medical student representatives from the Australian Medical Students’ Association (AMSA) will be hosting an event on the 15th August at Parliament House, South Australia, to discuss the mental health impacts of Australia’s immigration policies.
Co-hosted by a multi-partisan panel of parliamentarians including Tammy Franks MLC (Greens), Katrine Hildyard MP (ALP) and Stephen Wade (The Liberal Party), the event seeks to inform politicians regarding the health impacts of indefinite detention and offshore processing.
AMSA President, Ms Jessica Dean, said today that there is considerable evidence that links deterrence policies with mental illnesses including depression, anxiety, self-harm, post-traumatic stress disorder and suicidal ideation.
“Refugees are an already victimised and vulnerable group. Systematic oppression, torture and trauma are commonplace experiences prior to migration; amplifying mental trauma through mandatory detention and offshore processing is reprehensible,” Ms Dean said.
Research has found that between 60-80% of asylum seekers in Australian detention centres suffer some form of mental illness and this is exacerbated by prolonged mandatory detention.
“The health profession must then pick up the pieces when vulnerable refugees are eventually settled in Australia,” Ms Dean said.
Last week a group of prominent and respected doctors, lawyers and academics signed the J’Accuse statement outlining their concerns that successive Federal Governments had been pursuing inhumane policies despite clear evidence that detention causes mental illness.
“The future doctors of Australia see the impacts of our policies first hand, and they are calling for a fresh approach.”
“AMSA calls for an end to the politicking of people’s health and for parliamentarians to consider this issue from a health perspective.”
The event launch will be occurring at 10:30am, Friday 15th August in the Old Chamber, South Australian Parliament House.
For further information about the event, or to arrange interviews with the AMSA President, speakers or delegates, please contact Mr Ben O’Sullivan on 0437 195 272 or firstname.lastname@example.org
Speakers and guests in attendance include:
Claire O’Connor, Barrister, Anthony Mason Chambers
Dr Patricia Montanaro, President, Australian Medical Association SA
Louise Vidal, Operations Manager, Life Without Barriers
Cindy Turner, National Manager, Support for Refugees and Asylum Seekers
Manal Younus Assistant National Director, Welcome to Australia
Khodadad Mikhch and Liz McArdle, Mental Illness Fellowship Australia (MIFA)
James Lisik, Vampire Cup Coordinator
Blood drips into his arm, sliding in through his cannula to the insistent beeping of ECG warnings. The imaginary tune of Staying Alive accompanies one paramedic who is on his chest performing compressions, and another who keeps him supplied with oxygen.
30 compressions. 2 breaths. Repeat.
Joe, a 30-year-old car accident victim arrived at the state’s premiere trauma hospital just an hour ago. Regardless of state of the art facilities, efforts of a team of over 10 emergency physicians, anaesthetists and surgeons, every hand on deck is required to save a patient like Joe.
And there’s one more key ingredient which can’t be bought from a pharmacy: blood.
As part of the efforts to save him, Joe was transfused 10 units of blood. Efforts that are streamlined to afford victims every chance at life. Efforts you or I would expect for each of us, or for our loved ones, were we in the same awful situation.
Massive transfusions are only one small part of modern medicine’s need for human blood. Any number of indications – from leukaemia to childbirth – can require blood products such as red cells or fresh frozen plasma, as can minor emergencies and surgical cases.
It is estimated that 1 in 3 Australians will need blood, or blood products at some point in their life, yet only 1 in 30 donate. Each week Australia needs over 25,000 donations to meet our demand for blood.
The Vampire Cup (AMSA Blood Challenge) is a challenge to you – Australia’s medical students – to meet our need for blood during the time of year we need it most: winter. Many regular donors fall ill and are unable to donate – but you can step in to fill their place. From the 11th of July 2013 to 26th August 2013 over 1000 medical students rolled up their sleeves and donated blood – 1 in 16 medical students around the country. MeDUSA (Deakin University), won Vampire Cup for the third year in a row in 2013 with more than a quarter of students donating!
This year, Vampire Cup runs from July 12th until August 25th – so you have 6 weeks to quit the excuses, make an appointment and donate a pint of your finest red.
One day someone you know will need it.
And let’s face it – If Deakin can do it, so can you.
Join the Facebook event for more information
How to make sure your donation counts towards the Vampire Cup:
Share your blood donation photos on Instagram and Twitter: #VampireCup #BloodSaves
James Lisik, Vampire Cup Coordinator, launched the 2014 Cup in Adelaide on July 11th. Have a question? Contact James.
AMSA has a myriad of exciting programs and projects to get involved with! Applications are now open for positions for:
- AMSA Global Health
- AMSA Academy (Global Health, Recreational Drugs and Intro to Research short courses)
- AMSA National Exchanges Program
- The Asian Medical Students Association
- The AMSA Mentoring Program
There’s sure to be something that floats your boat so check it out here!
AMSA has been sending letters to each of the cross-bench senators, including Senators Lambie, Lazarus, Wang, Muir, Madigan, Day and Xenophon. AMSA has also been engaging with Members of Parliament and Senators on this issue through meetings both in Canberra and at local electorate offices.
Mr Clive Palmer MP
17 Southern Drive
Maroochydore, QLD, 4558
Via email: Clive.Palmer.MP@aph.gov.au
31 July 2014
Dear Mr Palmer,
The impact of fee deregulation on medical education and workforce planning
We are writing on behalf of the Australian Medical Students’ Association (AMSA) to express our apprehension with the Budget announcement that Australian universities will soon be granted the discretion to set their own fees for students. AMSA represents the over 17,000 medical students in Australia, and many of these students are alarmed over the impact of this change on access to medical education and medical workforce planning.
Our specific concerns are outlined in further detail below. In summary, it is our view that:
1) Skyrocketing fees, particularly in areas like medicine, will have an impact on equity to access of medical education, and detract many excellent future doctors and health leaders. It will be a turn away from the meritocratic selection of Australia’s future medical workforce.
2) In particular, fee deregulation will increase barriers to access to medical education among those from low socioeconomic groups and rural and remote backgrounds. These students have also been shown to be more likely to return to these areas of health need in their future career.
3) International examples have shown high levels of graduate debt deter doctors from pursuing careers in general practice. This would also have an impact on the health of communities.
Fee deregulation as a deterrent to studying medicine
Andrew Norton from the Grattan Institute predicted, following the budget, that students could be charged over $37.000 per year to study medicine . This is unsurprising, given the quite significant demand for medical school places, and the fact that Medical Deans of Australia and New Zealand estimate that there is a shortfall in funding of over $20,000 per medical student per year . It is reasonable to expect that even despite the ability to let this expense accumulate as a HECS debt, some students will be dissuaded from medical school by the prospect of a debt which could (for a six-year course) exceed $200,000.
Medical courses are long and challenging. Entering medical school is in itself is a significant decision. For undergraduate courses, these decisions are often being made by seventeen- or eighteen-year-old school-leavers. For postgraduate courses, these decisions are being made by graduates of other degrees who have likely already accumulated some amount of HECS debt and have the option of entering the workforce. The prospect of taking on a debt in excess of $200,000 from a six-year-course would be sufficient to disincentivise pursuit of a medical career for many of these potential good future doctors – this is not a positive outcome. With a cap on student contribution to fees, access to a medical education at many of Australia’s best tertiary institutions is not a matter of wealth, but of merit. We must ensure it remains this way.
Impact on access to care among rural communities and low socioeconomic groups
Australia is currently suffering from a doctor maldistribution. Access to medical practitioners in outer metropolitan communities, Aboriginal and Torres Strait Islander communities, low socioeconomic status communities and, in particular, rural and remote communities, is lacking. There is evidence, reiterated in the Mason Review, that recruiting medical students from these backgrounds will assist in resolving this maldistribution . Medical students from rural communities, in particular, are more likely to practice rurally. Unfortunately, the Bradley Review also demonstrated that these groups of students also have poor access to tertiary education  and evidence from the UK suggests that the fear of debt is sufficient to deter lower SES students from higher education .
Limiting access to medical education, therefore, is an issue of both equity and health. Medical degrees often attract an array of high achievers. For some of these high achievers, particularly those from the aforementioned backgrounds, to turn their back to medicine due to exorbitant fees, would be a travesty. Instead of erecting further barriers for such capable students to access the medical profession, the government should be seeking ways to demolish these barriers.
Impact on career decision-making
The development of the medical workforce, which is crucial to ensuring the health of Australians, is a culmination of numerous interplaying factors. Medical education is a key element, and changes to medical education often do impact upon the workforce.
It is now accepted that Australia’s healthcare needs would be best served by a strong emphasis on preventive medicine and primary care. This need for additional general practitioners has been reaffirmed in reports produced by Health Workforce Australia. Attracting graduates to such pathways is essential. Evidence from the United States, New Zealand and limited evidence from Australia suggests excessive graduate debt is associated with a reduced intent to work in primary care [6-8]. As such, increased fees would appear to be a backwards step in addressing Australia’s health needs by diverting doctors away from where the community needs them – as rural, remote or outer metropolitan GPs.
AMSA acknowledges that the tertiary education sector requires increased funding. We are very much in support of an increase in Commonwealth base funding to overcome the shortfalls, and are dismayed at the passage of the onus away from the Commonwealth and towards private contributions.
It is our view that even if student contributions are to increase, some regulation is required in the tertiary education sector to ensure that education remains accessible to students from all walks of life. As such, AMSA would recommend that a cap is reinstated to the amount of student contribution universities may ask for, especially for courses where fees are expected to increase significantly, like medicine.
The higher education reforms proposed by the Government, as such, should be rejected in the Senate.
It is impossible to predict with complete certainty what medical school fees will rise to following fee deregulation. However, it is reasonable to expect that the incredibly high demand for medical courses will lead to a steep increase in the cost of a medical degree. This is concerning firstly for reasons of equity to access to medical education. It is also concerning because high levels of graduate debt are likely to be a step in the wrong direction when it comes to resolving medical workforce issues. AMSA strongly encourages the government to consider these ramifications, and, short of re-introducing a cap to the private contribution to tertiary education, to introduce mechanisms by which the impact could be minimised.
We would be very interested to hear your thoughts on this very important issue, and to convey those thoughts to the 17,000 future doctors that make up our membership base.
Australian Medical Students’ Association
Vice President (External)
Australian Medical Students’ Association
- Dodd T. Degrees could cost up to $20,000 a year. Australian Financial Review. [Internet]. 2014 May 15. Available from: http://www.afr.com/p/national/degrees_could_cost_up_to_year_r9mwupvnLgE8lpMhErtpJI
- Medical Deans of Australia and New Zealand. 2011. Submission to the Australian Government’s Base Funding Review of Higher Education.
- Mason, Jennifer 2013, Review of Australian Government Health Workforce Programs (“Mason Review”), Department of Health and Ageing, April, Available from: https://www.health.gov.au/internet/main/publishing.nsf/Content/work-health-workforce-program-review
- Bradley D, Noonan P, Nugent H, Scales B. Review of Australian higher education. Final report. Canberra: Commonwealth of Australia; 2008. Available from: http://www.innovation.gov.au/HigherEducation/Documents/Review/PDF/Higher%20Education%20Review_one%20document_02.pdf
- Callender C, Jackson J. Does the fear of debt deter students from higher education? J Social Policy. 2005;34(4):509-40.
- Grayson MS, Newton DA, Thompson LF. Payback time: The associations of debt and income with medical student career choice. Med Educ. 2012;46(10):983-91.
- Moore J, Gale J, Dew K, Simmers D. Student debt amongst junior doctors in new zealand; part 2: Effects on intentions and workforce. N Z Med J. 2006;119(1229):21-8.
- Sivey P, Scott A, Witt J, Joyce C, Humphreys J. Junior doctors’ preferences for specialty choice. J Health Econ. 2012;31(6):813-23.