In the latest edition of The Zap, health policy analyst Charles Maskell-Knight underscores the importance of the New Centre for Disease Control being independent and adequately funded, and urges a “chill pill” for those trying to beat up a storm over the review of national dietary guidelines.
He notes that the Senate select committee inquiry into dental services report was tabled on 30 November last year, meaning the Government response is due on 29 February.
Meanwhile, why is the Government so shy about releasing a report making recommendations for new aged care funding arrangements?
The quotable?
The Department of Health and Aged Care is running an awareness campaign about the Medical Costs Finder website. As far as I can see, it would be better off spending the money allocated to the campaign on improving the site.”
Charles Maskell-Knight writes:
The column below covers announcements from Ministers and government, consumer and public health groups, trade unions, and politicians and parliamentary committees, and brings news on First Nations peoples’ health, and international developments.
Ministers and government
Minister Mark Butler announced the “Stronger Medicare Awards, to honour those who have made a significant contribution to Australia’s primary care sector”.
Nominations for the awards “will be open to individual health professionals, practices or health centres and multi-disciplinary teams working across the full range of primary care services [and can] extend to the many hard-working people who do not have professional qualifications in healthcare, but work for primary care services to help patients access the care they need, when and where they need it”.
The conflation of Medicare and primary care is a little odd: those people toiling away to deliver on the core Medicare promise of free public hospital treatment might feel a little miffed that they aren’t also eligible for recognition.
Butler also announced a $50 million grant from the Medical Research Future Fund (MRFF) to support further development of an artificial heart.
Assistant Minister Ged Kearney visited Lung Foundation Australia’s new offices to launch new silicosis services including a social work program and a support nurse service, “free confidential telephone-based support networks for people living with silicosis, their family and carers”.
The Department of Health and Aged Care is running an awareness campaign about the Medical Costs Finder website. As far as I can see, it would be better off spending the money allocated to the campaign on improving the site. I am scheduled for a common (1.2 million services last year) cardiac diagnostic procedure with a schedule fee of just under $250. The procedure does not appear on the website, meaning I have no idea whether the out-of-pocket cost I have been quoted is outrageous or merely the (extortionate) average.
I asked the Department how many specialists are providing data to populate the site, but it was unable to respond within three days.
Croakey’s managing editor Alison Barrett published an article here drawing together reactions to the Government’s response to the House of Representatives committee inquiry into Long COVID. I won’t repeat material included in her report, beyond a shout-out to public health consultant and researcher Glen Ramos, who said:
It’s a literal nothing-burger that does little more than nod to the recommendations with promises of some action in the future. It is a sad reflection of the overall response to COVID-19 that the current Federal Government has had since its election.”
If residential aged care is often terrible for old people, imagine how bad it must be for younger people coping with social isolation as well as poor quality care. The Government set targets a number of years ago of no people under the age of 65 entering residential aged care by 2022; no people under the age of 45 living in residential aged care by 2022; and no people under the age of 65 living in residential aged care by 2025.
The Australian Institute of Health and Welfare (AIHW) released the latest report on progress towards the targets. While younger people are still being admitted to aged care, the number has trended down steadily from over 500 per quarter in 2016-17 to just over 80 per quarter last year. At the end of 2022-23, over 2,000 younger people were still living in aged care. It will require a concerted effort to find them all more suitable accommodation by 2025.
The Australian Digital Health Agency announced the launch of Australia’s National Digital Health Strategy 2023-2028 to “provide a clear path to an inclusive, sustainable and healthier future for all Australians”.
The strategy aims to achieve four clear outcomes for digital health in Australia:
- Digitally enabled: Health services are connected, safe, secure and sustainable.
- Person-centred: Australians are empowered to look after their health and wellbeing, with the right information and tools.
- Inclusive: Equitable access to health services, when and where they are needed.
- Data-driven: Readily available data informs decision making at the individual, community and national level, contributing to a sustainable health system.
The Australian Health Practitioner Registration Agency (AHPRA) reported on a round table of regulators to discuss the (legal) use of unregistered cannabis products. According to the report, the use of these products “has spiralled in recent years, from around 18,000 Australian patients using products in 2019 to more than one million patients using medicinal cannabis up to January 2024”.
The number of prescribers has also risen sharply to more than 5,700 medical and nurse practitioners. The regulators agreed to continue to work together “to monitor issues and identify any gaps in the regulatory and wider health response to this rapidly growing industry”.
The NHMRC called for expressions of interest from people to serve on a Sustainability Working Group to contribute to the review of the 2013 Australian Dietary Guidelines. This prompted an outburst of ire from the meat industry, and a statement from Nationals leader David Littleproud that “Labor’s ideology doesn’t match the practical reality that people need to eat. Dietary guidelines should be about food, not elitist agendas trying to control people”. [Read more on related matters in this Croakey report, Community group urges health sector to stop promoting farmed salmon.]
The fact that the current guidelines include an appendix on food, nutrition and environmental sustainability has been lost in the hysteria, as has the fact that the process of guideline development by the NHMRC is entirely independent of the Government. I don’t know if chill pills are included in the dietary guidelines, but a few people need to take some.
The Australian Bureau of Statistics (ABS) released the latest earnings data, showing that in the year to November 2023 average ordinary time earnings in the healthcare and social assistance sector increased by 6.3 percent, faster than the economy average of 4.5 percent. Pre-pandemic (November 2019) average health care and social assistance wages were 95.9 percent of the economy average, but they have now increased to 99.3 percent.
Consumer and public health groups
The National Rural Health Alliance issued a media release on the links between climate change and health. CEO Susi Tegen said “as a member of the Climate and Health Alliance, we join the call for funding the implementation of Australia’s first National [Health and] Climate Strategy and we call for a National Rural Health Strategy which would incorporate policies and activities to mitigate and address the impacts of climate change on health and wellbeing in rural Australia”.
The director of the health program at the Grattan Institute, Peter Breadon, wrote an article for Croakey arguing that the next National Health Reform Agreement should include “reform schedules [with] specific, ambitious actions linked to performance measures and funding. They should also paint a picture of the future that can mobilise clinicians, patients, and the community”.
Breadon also wrote an article for Pearls and Irritations on the proposed Centre for Disease Control, arguing that the new Centre should pass three tests: it should be independent; it should provide public advice; and it should be adequately funded. The Department told Croakey that “the Government is considering the scope, structure and governance arrangements for the Australian CDC”. Let’s hope that they are reading Pearls and Irritations for inspiration.
Trade unions
The Australian Medical Association (AMA) put out a media release on the vexed issue of access to healthcare by prisoners in state and territory jails, calling for Medicare and PBS eligibility to be extended to them.
The problem is section 19 of the Health Insurance Act 1973, which provides that (unless the Minister directs otherwise) a Medicare benefit is not payable for a service which has been provided “under an arrangement” with a state government. As prisoners cannot access services unless the state arranges to let doctors into the prison, Medicare benefit is not payable.
There are two obvious solutions: the Minister directs that benefits are payable for prisoners; or state governments start funding prison health systems properly. Everybody except the Commonwealth prefers the first option.
The AMA called on the Government to replace the Veterans’ MATES program with a similar program to support quality use of medicines by veterans. (The program was terminated following revelations that some veterans’ data had been shared without their consent.)
The Royal Australian College of General Practitioners (RACGP) made a submission last year to a Senate inquiry into the Climate Change Amendment (Duty of Care and Intergenerational Climate Equity) Bill 2023 introduced by Senator David Pocock. Last week the College’s Specific Interests Climate and Environmental Medicine Chair Dr Catherine Pendrey gave evidence to the inquiry, saying:
The health impacts of climate change on our population, and particularly our children and future generations, should be considered in all government decisions that could substantially contribute to climate change… Climate change is a public health emergency, and our leaders need to act urgently.”
[On related matters, the latest ICYMI column covers a new policy statement from the American College of Pediatrics on climate change and children’s health, making recommendations to paediatricians, the health sector and government].
The RACGP also issued a media release asking the Government “to invest in growing Australia’s general practice workforce to meet the growing needs of patients today, and into the future”. It called for funding for additional places in the Fellowship Support Program and the PEP – Specialist Program, and funding to ensure GP registrars receive the same pay and conditions as registrars working in hospitals.
The College announced the results of a poll of GPs which asked “What kind of embedded allied health professional would most benefit your practice and patients?” The most popular responses were a psychologist (57 percent), a pharmacist (11 percent), a credentialled diabetes educator (also 11 percent), and an occupational therapist (four percent). The College is seeking funding in the next Budget to allow practices to employ other health professionals.
Finally, the College and the Tasmanian branch of the AMA both welcomed a commitment from the Tasmanian ALP to exempt GPs from payroll tax if it wins the 23 March state election.
The Royal Australian and New Zealand College of Radiologists (RANZCR) issued a media release asking the Government to provide $4.1 million to support the Regional and Rural Training Pathway (RRTP), which was created by RANZCR to train more radiologists and radiation oncologists in non-urban areas.
The government funding would pay for the continued training of five doctors already treating patients in regional Australia and two new positions for Indigenous trainees, and help address “a severe maldistribution of medical imaging and radiation oncology specialities in non-metropolitan locations”.
The RANZCR also asked the Government for “further support for brachytherapy services and the removal of restrictions on all MRI machine licences”.
The Pharmaceutical Society of Australia and the Guild welcomed the next phase of the Victorian Community Pharmacist Statewide Pilot to begin in March 2024, under which suitably trained pharmacists will be able to treat herpes zoster (shingles) and a flare-up of mild plaque psoriasis.
The Australian Dental Association issued a release foreshadowing World Oral Health Day on 20 March, and encouraging people to #BrushandBoogie – brush your teeth while listening to your favourite music and boogie-ing… and film the event for Instagram. I’m sure I’m washing my hair that day.
First Nations peoples’ health
A recent review published in The Medical Journal of Australia found that First Nations people are very poorly represented in trials of parenting programs, and the specific needs of Aboriginal and Torres Strait Islander families have not generally been considered in Australian trials.
Only nine of 109 studies identified in the paper reported on the cultural background of participants, and only 0.6 percent of participants identified as First Nations. The review concluded that “Indigenous … parenting methods are neither adequately understood nor incorporated into policy and practice”.
Politicians and parliamentary committees
The House of Representatives standing committee on health inquiry into diabetes held its ninth public hearing in Canberra on 16 February, taking evidence from witnesses including Private Healthcare Australia, the Juvenile Diabetes Research Foundation, and the Australian Health Promotion Association. Its final hearing will be on 1 March, but a date has not yet been set for the report to be finalised.
Senate estimates heard evidence from the Department of Health and Aged Care on 15 February.
The Senate select committee inquiry into dental services report was tabled on 30 November last year, meaning the Government response is due on 29 February.
The last major parliamentary inquiry into dental services, Bridging the Dental Gap, was tabled in June 2013, and went un-responded to by the Abbott/Turnbull/Morrison Governments until December 2020, when the relevant committee resolved that a Government response was not required. Let’s hope this Government is a little more diligent in meeting its obligations.
International
The Royal Society of Canada released a report on aged care (“long-term care” or LTC in Canadian), in the context of the federal government preparing a new Safe Long-Term Care Act.
Its first recommendation was that the government should “move immediately to ensure sufficient funds are available to raise the minimum level of direct care hours to 4.5 hours per day [270 minutes] for each LTC resident”.
In Australia the standard is now 200 minutes per day, increasing to 215 minutes from 1 October this year.
Finally
To end this week’s column, a story about an announcement that hasn’t been made.
In December last year the Aged Care Taskforce chaired by Minister Anika Wells to “review funding arrangements for aged care and develop options for a system that is fair and equitable for everyone in Australia” held its final meeting, and endorsed the recommendations to be included in the final report.
Members patted themselves on the back, noting that “the proposed recommendations 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”.
This week, for the tenth week in a row, Wells did not release the report.
A cynic might assume it has been held back until after the Dunkley by-election – that is certainly the view of shadow minister Senator Anne Ruston, who said “Labor’s continued refusal to be transparent with the report has reaffirmed suspicions that it is concealing plans for financing the aged care sector until after the Dunkley by-election”.
If the report’s recommendations are really as good as its members believe, why hold it back?
But if it just proposes a cash-grab from supposedly wealthy baby-boomers, maybe the Government doesn’t want it colouring the views of Dunkley electors.
• 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.
