By Frances Gilham
Budget debate and discussion continues to dominate the health news, with many commentators suggesting the proposals have ignored the evidence and don’t address structural system deficiencies.
In an article for Medical Observer, UNSW academics have called for a trial period of the co-payment system so a comprehensive evaluation can ensure best health outcomes.
Alison Verhoeven, Chief Executive Officer of the Australian Healthcare and Hospitals Association, lamented in a Croakey post that we are seeing a continuation of the ‘blame game’ and cost-shifting between the Commonwealth and States and Territories, which will result in compromised public hospital services.
And Croakey’s Marie McInerney wondered about the missing details in the Budget paper, saying the Government has shown a lack of understanding of the real determinants of human health.
Rather than just fighting the proposal, rural GP Dr Paul Mara suggested GPs should use the debate as a catalyst to reform primary healthcare.
Health Minister Peter Dutton defended the measures at the Press Club. Croakey Co-ordinator Melissa Sweet gives her take on the speech here.
The Australian newspaper has defended the Budget measures. In this editorial it argues in support of the co-payment, saying: “The introduction of price signals will, on balance, contribute to sustainable healthcare”.
Protecting the vulnerable
Croakey published a great deal of commentary about how the co-payment might impact the health of Australians – particularly our most vulnerable groups.
The website reported on a campaign by a group of researchers calling for #noGPtax, followed by a story about a petition from the Victorian Aboriginal Community Controlled Health Organisation asking Senators to block the co-payment measure.
Concerned bloggers wrote on Croakey about the Budget’s potential impact on women, young Australians, our public health workforce, our systems for controlling communicable disease and – in a particularly scathing piece from St Vincent de Paul Society CEO Dr John Falzon – the excluded, the poor, the homeless and the mentally ill.
The Australian Medical Association (AMA) has also responded strongly to the Budget announcement, with new President Associate Professor Brian Owler warning the co-payment would hit the “working poor” particularly hard in this article on The Conversation. Previous President Dr Steve Hambleton writes for Medical Observer that although the AMA isn’t opposed to co-payments, the proposed version is a poor, unworkable, inequitable model.
Professor Lesley Barclay painted a poignant picture in The Conversation of how rural health would suffer, while a study in the NT underscores the importance of access to primary care for people with diabetes.
Croakey also republished a Conversation article by Flinders University’s Associate Professor David Hunter who considered the ethical implications of creating a medical research fund based on GP co-payments.
The Consumers Health Forum has concerns about the “farce” of establishing the fund from healthcare cuts, while the Opposition Labor spokesperson Catherine King has raised questions about the implications for the future of the NHMRC.
Concerns culminated in the #MarchinMay protests; thousands of people marching against the Budget in cities across Australia. Croakey covered the protests and the Twitter responses.
Implications for Indigenous health
Much Budget commentary has focused on implications for the health of Aboriginal and Torres Strait Islander peoples, although there has been some lack of clarity around the extent of the cuts and where they will hit hardest.
Croakey bloggers said the Budget would negatively impact on Indigenous cancer outcomes, and slow progress in reducing Indigenous smoking rates; issues of concern given the most recent Closing the Gap report, covered by The Guardian.
Mick Gooda, Aboriginal and Torres Strait Islander Social Justice Commissioner at the Australian Human Rights Commission, wrote an impassioned article on The Drum saying the Budget could devastate Indigenous Australians – in particular the proposed withdrawal of Commonwealth investment in education and hospitals.
And Professorial Fellow at the University of Wollongong, Ian Ring, wrote a similarly strong article in The Canberra Times saying the cuts to Aboriginal health programs seem to be the biggest to any program – and coupled with the impact of co-payments, could be a significant backward step for Aboriginal health.
In an article for The Conversation, University of Queensland lecturer Elizabeth Strakosch said that on balance, it appeared Tony Abbott was failing on his promise to be the PM for Aboriginal Affairs – a sentiment echoed in a Croakey article from an anonymous health policy analyst demonstrating the health funding cuts in this area.
At least one Aboriginal Health Service has decided not to charge the co-payment if it goes ahead, according to a Fairfax article, which says the Winnunga Nimmityjah Aboriginal Health Service has accepted a potential yearly loss of $350,000 because of its decision to protect its clients from the co-payment.
The importance of culture
Meanwhile, this report from a recent Indigenous women’s health conference highlights the importance of cultural and spiritual healing.
And in this opinion piece, Dr Paul Dawson wrote about the importance of providing culturally appropriate care for mothers and infants in this demographic to improve generational health outcomes.
The CEO of Hunter New England Health Michael Di Rienzo is doing his best to address this issue in the Hunter, with his organisation leading every NSW health district in the employment of Indigenous Australians, ABC News reported.
Further reports by the ABC indicate Newcastle is experiencing some success in raising Indigenous baby weights, and on making hospitals culturally safe places for Aboriginal people.
And in the NT, there have been criticisms of mandatory sentencing, including claims that it doesn’t work as a deterrent and that it’s resulting in high levels of imprisonment amongst Aboriginal and Torres Strait Islander peoples.
Mental health campaigns in the spotlight
Beyondblue is letting people know that mental health initiatives in the workplace can save billions in productivity, compensation and other costs, The Age reported.
But it is important that programs are evidence-based, with a major new study finding that counselling and other psychological therapies can do more harm than good if they are of poor quality or the wrong type, according to an article in The Guardian.
International laws need work in this area, with concerning news emerging that a UK woman had a job offer rescinded when Emirates airline discovered she had a past history of depression.
A new database from the World Health Organization (WHO) may help; its newest venture is called MiNDbank, and aims to end human rights violations against people with mental health conditions by facilitating debate, dialogue, advocacy and research into mental health.
There are concerns in Australia that mental health is becoming fragmented. In Victoria, mental health organisations face an uncertain future after losing funding, according to this article. And writing for The Conversation, the University of Melbourne’s Anthony Jorm says there is a lack of a coherent vision behind the Government’s actions in mental health.
The Guardian has released a series on the mental health care woes in the US: this long but interesting article summarises the issue and is worth a read. But experts are keen to point out that improving mental health care is not the answer to preventing gun-related violence.
Innovation in digital health
On the eHealth front, the independent report into the Personally Controlled Electronic Health Record (PCEHR) has finally been released, the Australian Financial Review reported.
The report calls for a rename – to the My Health Record – and a change from opt-in to opt-out, a move supported by Health Minister Peter Dutton.
The issues of privacy and ownership of electronic health records were discussed at a recent eHealth conference in Sydney this week, reported on in detail in this Fairfax article.
And Australian researchers are at the forefront of technology research, with a new real-time Twitter analysis project under way that will map the world’s emotions, Amy Corderoy wrote for the Sydney Morning Herald.
Alcohol policies and programs
A number of alcohol-related policies and programs featured in the news this fortnight.
A trial of ‘non-mandatory sobering-up centres’ in Sydney is to be dismantled, following an evaluation that showed they were not operating cost-effectively, news.com.au said. Family and Community Services Minister Gabrielle Upton said the centres were still a worthwhile exercise.
The Australian published a story on fetal alcohol spectrum disorder (FASD). Experts are calling for the Government to recognise the condition as a disability – in line with the World Health Organization’s categorisation – to allow sufferers to receive more support, the article says.
This article on The Conversation described new research findings which highlight how the rise of ‘native content advertising’ is making regulating alcohol advertising on social media difficult.
And in a response to a parliamentary inquiry, Marcia Langton and colleagues have suggested that controlled ‘safer drinking areas’ should be established in Indigenous communities, in a bid to stop deaths in informal drinking camps in the Northern Territory, an article in The Australian says.
New measures to be introduced in Sydney in mid-July, will include a ban on shots, doubles and pre-mixed drinks after midnight in pubs, clubs and bars, the Sydney Morning Herald said.
Finally, Professor Mike Daub has a “win-win” suggestion for the Government – use alcohol and tobacco taxes to fund medical research, he suggested.
Obesity and nutrition concerns grow
Unhealthy food taxes are ‘vital’ to fight obesity, a United Nations investigator has said at the annual summit of the World Health Organization. Unhealthy diets pose a greater risk to global health than tobacco, he said, and governments need to move to tax harmful food products.
But in Australia, researchers are concerned we’re moving in the opposite direction. Deakin University’s Gary Sacks wrote an article for The Conversation, explaining why extending the GST to fresh food would be disastrous for public health.
Two worrying reports have come out recently, one showing that Australia’s obesity levels are growing faster than any country in the world, and another showing our children are among the least active in the world.
Given the low level of activity among Aussie children, it is becoming more important than ever that we let kids have enough time to play, Dr Melissa Stoneham wrote for Croakey in this article.
Data, evidence and primary health
New data from the BEACH (Bettering the Evaluation and Care of Health) study has shown doctors are prescribing antibiotics for acute bronchitis in adults 90.6% of the time, despite guidelines and campaigns to reduce the use of antibiotics in such situations, MJA Insight reported.
And doctors are not using best approach for assessing cardiovascular event risk, resulting in potential over-treatment, this article in Medical Observer said.
New evidence has also shown financial incentives for improving healthcare quality and safety are not sufficient on their own to impact on care provision, according to the latest policy review from the Primary Health Care Research and Information Service (PHCRIS) published on Croakey.
And HIV notifications are up in Queensland, alarming experts quoted in this article on the ABC website, who hope it’s due to increased testing, but are worried that the ‘stay safe’ message is no longer effective. There has also been a jump in early detection of HIV in NSW, according to the Sydney Morning Herald, which experts put down to a system of rapid testing, resulting in earlier diagnosis.
Other reading at Croakey this past fortnight
• Drawing some links between opera, history and public health
Stay in touch
Don’t forget to contact Croakey with any suggestions you may have for the new column, Wonky Health, by Tim Senior. Read more about the initiative here.
If you have something you’d like to see highlighted in the Health Wrap please get in touch with me on Twitter via @FrancesGilham or my colleague Kellie Bisset on @medicalmedia.
You can find previous editions of the Health Wrap here.
Frances Gilham is the Digital Communications Manager at the Sax Institute, a non-profit organisation that drives the use of research evidence in health policy and planning. Frances has qualifications in health science and communications, and has previously worked in nutrition and the public sector. She enjoys playing online, and using digital media technologies for conversations about health, health policy, and the importance of evidence.
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