Starting today, Croakey will publish a weekly summary of health-related reports, announcements and media releases from Commonwealth government agencies, Health and Aged Care Ministers and other politicians, national health sector organisations, and some international bodies.
It will focus on issues with health policy implications, so will avoid one-off funding announcements (or re-announcements) and other trivia, such as releases from professional associations welcoming the appointment of a new health minister. The column is compiled by health policy analyst Charles Maskell-Knight.
Charles Maskell-Knight writes:
This week’s edition covers the period since 16 December – a week of getting stuff out before Christmas, followed by three weeks of inertia.
Health Ministers
Before Christmas Minister Mark Butler wrote an op-ed piece in The Australian (available on the Health website here) puffing the benefits of the deal on hospital funding reached at National Cabinet. Like all government statements so far, it is light on detail about how the new funding arrangements will operate.
Butler had a busy Christmas break, doing a doorstop on Christmas Eve to talk about complaints from GPs about shortages of the new shingles vaccine Shingrix. He had announced on 8 October that the “cutting-edge” vaccine would be available free to over 65s from 1 November, but supplies of the vaccine to GPs have not been keeping up with demand.
He also announced on 28 December – with three days to go – that all 58 Medicare Urgent Care Clinics had been opened and were operating as promised by the end of 2023. In a press conference and media release on 9 January and radio interview on 11 January he talked up the early achievements of the clinics. Now we need to wait for a proper evaluation to see if they are really taking pressure off emergency departments.
Butler also used the 9 January press conference to discuss the Cleanbill bulkbilling data, which showed a decline of 11 percentage points during 2023 in the proportion of GP clinics that bulkbill every patient. He said that the Government’s preferred measure of bulkbilling showed that 73 percent of GP services were bulkbilled.
On 19 December Aged Care Minister Anika Wells released the latest aged care star ratings, claiming they showed continuing improvement in the quality of care. The Aged and Community Care Providers Association issued a self-congratulatory media release welcoming the report. As I have previously written in Croakey, the star rating system is deeply flawed, and receiving three stars does not necessarily indicate an acceptable level of care. Dr Rodney Jilek from the University of Canberra released research in early January highlighting aged care homes with compliance action against them and yet still receiving three-, four- or five-star ratings.
Wells announced the appointment of nine new members to the National Aged Care Advisory Council, including three health union officials. While the Minister asserted that “Council members are not organisational representatives but are selected because of their strong connections to sector organisations and relevant expertise”, it is hard to imagine that appointees such as union officials or the CEO of the main aged care provider organisation will not approach issues with their members’ interests in mind.
Assistant Minister Ged Kearney announced on 21 December a grant of $2.5 million to the Federation of Ethnic Communities Councils of Australia (FECCA) over four years to engage CALD communities so they can have a direct say in the strengthening Medicare reforms.
Department of Health and Aged Care
The Department announced on 21 December the release of a Digital Health Blueprint and action plan for the next decade, intended to ensure comprehensive health information about patients is available to healthcare providers in real time. It may not be too little, but it is awfully late.
The Department also announced before Christmas the release of the exposure draft of the bill for a new Aged Care Act. Shortly after taking up the job in 2022, Aged Care Minister Anika Wells said that the new Act would be in place by 1 July 2023. The new target appears to be 1 July 2024. Responses to the draft are due by 16 February. The draft diverges from the recommendations of the Aged Care Royal Commission in many ways. Perhaps the most significant is that the duty to provide high quality care proposed by the Royal Commission (recommendation 14) has been watered down to a duty not to cause adverse effects to the health and safety of individuals (clause 120).
On 4 January the Department announced the release of the report of the review (completed in August last year) of the Australian Brain Cancer Mission. The Mission was announced in 2017 by then Minister Greg Hunt as a “captain’s pick” with $50 million in funding from the Medical Research Future Fund (MRFF). The review identifies a number of opportunities for improvement. It notes that the report “may reflect response bias, as findings are limited to only the views put forward by those that were consulted. For instance, it is possible that researchers made positive comments about the Mission because of concerns that future funding might otherwise not be available”.
Other government bodies
On 21 December the Aged Care Taskforce released the communique from its final meeting. In news that will not surprise anybody, members concluded that the recommendations in its final report “would create an aged care system that is simpler, more flexible and transparent for older people.
It would also enable the aged care sector to meet current and future funding challenges and support service quality and innovation”. It probably also includes a recipe for apple pie – but we will need to wait for the report to be released (at some indeterminate future time, but likely the Thursday afternoon before Australia Day) to be sure.
COVID-19 response inquiry
A number of organisation released their submissions to the COVID-19 response inquiry.
The Grattan Institute pointed out that “disadvantaged Australians fell behind at every stage: they had lower vaccination rates, fewer antiviral treatments, and higher risk of death. Sadly, this didn’t come as a surprise. These health gaps existed before the pandemic and remain today”. It called for urgent action to close those gaps.
The Royal Australian College of General Practitioners (RACGP) in its submission stated that “GPs must be formally recognised as frontline healthcare providers in pandemic preparation, response, and recovery… GPs are not sufficiently embedded in the planning process, and are, to some extent, treated as an afterthought”.
The Australian Medical Association (AMA) argued that governments should “evaluate and learn from Australia’s pandemic response, with a focus on listening to experts and ensuring consistency in policies and communication across jurisdictions.” It also highlighted “the importance of an adequately resourced Australian Centre for Disease Control, which can undertake several pandemic response functions including rapid risk assessment, scientific briefings, public education and disease prevention”.
First Nations health
The Stroke Foundation announced that it was adding a new category to the 2024 Stroke Foundation Stroke Awards to “recognise excellence in stroke prevention, treatment, recovery or research in First Nations communities”.
An article in The Medical Journal of Australia highlighted the University of Queensland Poche Centre Indigenous urban heath research agenda, and called on “governments and research funding bodies to reimagine understandings of First Nations health research in Australia and to provide greater policy focus and funding allocation to urban First Nations health research”.
Consumer and public health groups
COTA issued a pre-Christmas release calling for “all Australians to help combat loneliness by connecting with their older neighbours, friends, and family in their communities” during the holiday season.
National Seniors Australia published an article on 11 January on the Aged Care Taskforce saying it was “anticipating the release late this month of final recommendations from the Aged Care Taskforce”. Assuming its intelligence is reliable, the odds on a 25 January release are firming.
Trade unions
The Australian Dental Association launched a pre-Christmas festive oral health survival kit full of good advice such as “avoid thoughtless eating and drinking” and “limit sugary drinks and alcohol”. I’m sure their hearts are in the right place, but I am also sure they will be largely ignored. Who can really believe that “dentists love a party too”?
In response to the flooding following Cyclone Jasper, the RACGP called on the Government to expand access to Medicare-funded mental health services in affected areas.
On 8 January the RACGP issued a media release responding to the Cleanbill GP bulkbilling data, calling for additional funding to address rising practice costs, and for GPs’ remuneration to continue to be exempt from payroll tax.
The RACGP combined with the Royal College of Pathologists of Australasia in opposing the government’s proposal to remove the seven-day delay in adding pathology test results to My Health Record. This change was foreshadowed by the Department on 8 November, following a public consultation process.
Industry groups
The Pharmacy Guild Queensland “urged the Government to expand continued dispensing arrangements for community pharmacies to supply all PBS subsidised medicines to patients impacted by floods in Far North Queensland”.
The Guild also issued a media release on the results of the first four months of allowing pharmacies to diagnose and prescribe for simple urinary tract infections in Western Australia.
The Medical Technology Association of Australia issued a media release welcoming the release of Pain Australia’s report on consumer experience with spinal cord stimulator (SCS) implants. Within a few hours Private Healthcare Australia (PHA, the private health insurers’ lobby group) countered with a release claiming the devices “often do more harm than good”, and arguing the survey “should be interpreted with extreme caution because it was commissioned and fully funded by the Neuromodulation Society of Australia – a group representing the providers of spinal cord stimulators”.
PHA also rushed to issue a release following Minister Mark Butler’s reported (but not announced) decision just before Christmas to reject private health insurers’ applications to increase premiums. The group claimed the increases “reflected inflation, record claims over the past year, and essential costs such as IT upgrades to combat the ever-growing threat of cyber-attacks”. The release didn’t mention the 20 percent increase in insurer reserves since before the pandemic, nor the 32 percent increase in management expenses at a time when benefits paid increased by just over 7 percent.
PHA joined the anti-vape campaign, releasing data on New Year’s Eve showing 178 people had used their private health insurance for a vaping-related hospital admission since 2020. Nine patients were aged under 15. As CEO Dr Rachel David said, these data are only the “tip of the iceberg” as it only includes people using private health insurance for their hospital stay.
Other politicians and parliamentary committees
Shadow Health Minister Senator Anne Ruston seized on the news that the St Vincent’s group had undergone a cyber-attack and accused the Government of being “missing in action” in not responding publicly to the events. Following the release of the Cleanbill data, she leapt on the bandwagon, assailing the Government for declining bulkbilling numbers. She did not proffer any alternative policy solutions to the problem.
International
A report by the (US-based) Commonwealth Fund with an international price comparison of the first group of drugs to undergo (US) Medicare price negotiations demonstrates yet again how successful the PBS has been in providing access to affordable medicine. The average price of the basket of ten drugs in Australia was only 12 percent of the US price, and the lowest of the eight countries included in the study.
• Have we missed anything? Let Charles Maskell-Knight know using ‘The Zap’ in the subject line: info@croakey.org
Charles Maskell-Knight PSM was a senior public servant in the Commonwealth Department of Health for over 25 years before retiring in 2021. He worked as a senior adviser to the Aged Care Royal Commission in 2019-20. He is a member of Croakey Health Media; we thank and acknowledge him for providing this column as a probono service to our readers. Follow on X/Twitter at @CharlesAndrewMK.
Thumbs up to ‘The Zap’ , thank you✊🏽