The New South Wales doctors' dispute 1984–85: An interpretation

The NSW doctors’ dispute 1984–85 has had a lasting effect on the Australian health care system. Militant surgeons were effective in securing some modifications to regulations and administrative arrangements governing the role and remuneration of certain groups of doctors in NSW public hospitals and some changes to the federal government's Medicare scheme.

This paper examines the causes, actors, issues and outcome of the dispute. The key to understanding the dispute is a knowledge of both the specific issues debated by militant doctors and the federal and NSW Labor governments and the broader historical forces that have shaped the politics of national health insurance throughout the twentieth century. In contrast to media reports, the outcome of the dispute is interpreted as a compromise rather than a victory for the doctors. It is further argued that a theoretical generalisation formulated by two American political scientists, Marmor and Thomas, about disputes between doctors and governments over payment methods is only partially useful in explaining the outcome.

Two prominent and well‐documented historical themes from the politics of national health insurance in Australia — namely, the resistance of sections of the medical profession to any contraction of the private market for medicine and the fragmentation of the organised medical profession during periods of disputation with governments at the state and federal level — are discussed. These themes, and some generalisations about the capacity of the medical profession to influence public policy outcomes, are illuminated by the study.