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The Zap: a comprehensive account of all the latest health and aged care news

Pill testing programs, health workforce reform, Close the Gap Day, oral health, vaping and the new national lung cancer screening program are among issues highlighted in the latest edition of The Zap.

This week there are a few quotables because we were spoilt for choice:

I understand the Department’s new slogan is ‘More Reviews than Rotten Tomatoes’.

AND

Operating under weak and poorly enforced regulations with financially insignificant penalties, the for-profit sector fosters an environment where corners are frequently cut, compromising the quality of care and endangering patient health.”


Charles Maskell-Knight writes:

Thursday 21 March was National Close the Gap Day. As reported by Croakey, the Lowitja Institute marked the day by publishing the Close the Gap Campaign Report 2024, with a set of recommendations intended to “provide a pathway towards achieving the National Agreement’s goals”.

In relation to health, the report called for full implementation of the 2021–2031 National Aboriginal and Torres Strait Islander Health Plan and other supporting plans, including:

  • a commitment to long term (10+ years) needs-based and coordinated cross-sectional funding by the Australian, state and territory governments
  • a review of current government governance models and partnerships over the Health Plan and other supporting plans to assess whether they represent genuine decision-making opportunities. This review should aim to create efficiencies and maximise decision-making power for members
  • investment in the urgent establishment of suitable governance mechanisms over the Health Plan to ensure Aboriginal and Torres Strait Islander leadership is fully imbedded in its implementation.

On 22 March the Government and the Lowitja Institute hosted the National Aboriginal and Torres Strait Islander Health Ministers Roundtable, bringing together all Health Ministers and CEOs, Aboriginal and Torres Strait Islander Collaboration members, and First Nations health leaders.

According to Health and Aged Care Minister Mark Butler, the meeting focussed on topics identified by the First Nations health sector: Closing the Gap; building a health system which is culturally safe and free of racism; and the National Health Reform Agreement.

Ministers agreed to develop a First Nations Schedule to the National Health Reform Agreement, co-designed with First Nations people so that it “includes the right actions and reforms that best suit the needs of Aboriginal and Torres Strait Islander people”.

Many health sector organisations marked Close the Gap Day and supported the report and its recommendations, including the Royal Australian College of General Practitioners (RACGP), the Royal Australian and New Zealand College of Ophthalmologists, Australian College of Rural and Remote Medicine (ACRRM), the Society of Hospital Pharmacists of Australia,  the Pharmaceutical Society of Australia, the National Rural Health Alliance, and the Public Health Association of Australia (PHAA).

PHAA vice-president Dr Alana Gall, a Palawa woman and researcher, said “there’s overwhelming evidence that proves that health and other initiatives which are led by Aboriginal and Torres Strait Islander communities get the best results”.

It appears that governments are slowly getting the message.


Ministers and government

World Oral Health Day was Wednesday 20 March – an obvious day for the Government to release its response to the Senate dental services inquiry. It failed to do so, meaning the response is now three weeks late.

(To help fill the dental policy gap, Croakey will be holding a webinar on tackling oral health inequities on 8 April – sign up here to join the discussion.)

Assistant Minister Ged Kearney introduced the niftily titled Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) Bill into Parliament. The Bill removes the requirement for nurse practitioners and endorsed midwives to work under the supervision of a medical practitioner, and will allow them to provide services under Medicare and prescribe under the PBS on an autonomous basis.

The Bill was welcomed by the Australian Nursing and Midwifery Federation (ANMF), the Australian College of Nurse Practitioners, and the Australian College of Midwives. In a slightly alarming trope, the Australian College of Nursing claimed that the new arrangements would “unleash” endorsed midwives and nurse practitioners.

Minister Mark Butler introduced the Therapeutic Goods and Other Legislation Amendment (Vaping Reforms) Bill 2024 into Parliament. The Bill bans the “importation, manufacture, supply, and commercial possession of disposable single use and non-therapeutic vapes”. After the legislation comes into force, vapes will only be available on prescription.

Butler said that “vapes were sold to the Australian community as therapeutic goods, to aid those seeking to quit cigarette smoking and so, it is entirely appropriate to regulate them as therapeutic goods – through controls that simultaneously ensure legitimate access and provide sound public protection”.

He held a media conference on the subject as well as giving a number of TV and radio interviews, addressing a range of issues including the “tax and regulate” option proposed by the National Party – the only political party to still accept donations from the tobacco industry.

The legislation was welcomed by many health groups, including the Australian Medical Association (AMA), Quit, the Cancer Council Victoria, VicHealth, and the RACGP.

College President Dr Nicole Higgins said: “We must do everything we can to stop a new generation of nicotine users emerging because once young people start vaping, they will have a lot of trouble stopping… our role [as GPs] is crucial, and although we do have a big job ahead of us prescribing nicotine vapes for patients who need them, I’m confident that with the right kind of support we can continue helping patients from all walks of life wean themselves off nicotine.”

Butler also introduced legislation to add lung cancer to the National Cancer Screening Register, following the decision in the 2023 Budget to introduce a new National Lung Cancer Screening Program from July 2025. The screening program will target asymptomatic individuals aged 50 to 70 years with a history of cigarette smoking of at least 30 pack-years, including ex-smokers who have quit within the past 10 years.

The Minister also announced measures to increase the number and diversity of bone marrow donors, improve chronic wound care, and expand Royal Flying Doctor services.

The Department of Health and Ageing announced it was carrying out an aged care worker survey, open until 30 April. The survey is open to anyone providing one-on-one care, regardless of their workforce status (employed, contracted, labour hire, independent professional), and can be found here.

I’m not sure how the Department will overcome the obvious difficulties in drawing conclusions from a self-selected sample, but it must have a cunning plan.

The Department also launched a consultation on after hour primary care policies and programs, due to close on 20 April. The Department notes that “the Review builds on a range of previous reviews undertaken between 2016 and 2020 and is taking place in parallel to and in close association with a separate review of general practice incentive programs and in awareness of other contemporary reviews and reform activities. It is separate and complementary to the Department’s Review of General Practice Incentives, which is taking place concurrently”.

I understand the Department’s new slogan is ‘More Reviews than Rotten Tomatoes’.

The Australian Institute of Health and Welfare (AIHW) released a number of publications, web reports, and updates, including:

  • the eighth national report on the 21 Better Cardiac Care measures for Aboriginal and Torres Strait Islander people
  • a report on acute rheumatic fever and rheumatic heart disease (which predominantly affect First Nations people) for 2022
  • an update of the Aboriginal and Torres Strait Islander Health Performance Framework
  • a report on treatment pathways for people hospitalised for acute coronary syndrome.

In relation to the cardiac care measures, there is some good news, tempered with bad news.

Between 2006 and 2021 the age-standardised mortality rate from cardiac disease for First Nations people fell 35 percent from 205 per 100,000 to 134 – but it is still 1.5 times the rate for non-Indigenous people.

The proportion of First Nations people receiving percutaneous cardiac intervention (a stent or stents) following a severe heart attack increased from 28 percent in 2006-07 to 70 percent in 2020-21 – but First Nations people are still 14 percent less likely to receive such an intervention compared with non-Indigenous people.

The Independent Hospital and Aged Care Pricing Authority (IHACPA) released its determinations of the National Efficient Price and National Efficient Cost to be used in calculating public hospital funding for 2024-25.

While IHACPA had earlier “signalled the intent” to adopt activity based funding for community mental health care from 2024-25, it has decided to defer this change to 2025-26. It has now foreshadowed reviewing the ICU eligibility criteria and adjustments for the 2025-26 pricing model, as well as the paediatric adjustment.

Ahpra announced a collaboration with the Weethunga Health Network