*** Aboriginal and Torres Strait Islander people are advised that this column contains the name of a deceased person ***
The Federal Government is rolling out health announcements faster than you can say, ‘when is the election date’?
Today, the Government announced a raft of health-related initiatives under the Closing the Gap 2025 Implementation Plan, including a pledge to reduce the costs of 30 essential products in more than 76 remote stores and to build a nutrition workforce in remote communities by upskilling up to 120 local First Nations staff in remote stores.
This followed the announcement yesterday of a five-year $573.3 million package of women’s health initiatives, including improved access to contraceptives, menopause support and treatment for endometriosis, pelvic pain and uncomplicated urinary tract infections.
And, as Charles Maskell-Knight reports below, there is some news at last on the national public hospital funding agreement.
His column also covers global health impacts of the Trump Administration, recommended reforms to improve aged care for First Nations people, the alcohol industry dragging the chain on pregnancy warnings, and pre-budget submissions from a range of health groups.
The quotable?
Every day, [the Consumers Health Forum] hears from consumers who are forced to ration medication, skip medical appointments, or delay essential care because they simply can’t afford it.”
Charles Maskell-Knight writes:
Health Minister Mark Butler joined Prime Minister Anthony Albanese as the Government announced a one-year extension to the public hospital funding agreement due to expire at the end of June, and a “one-off funding boost” of $1.7 billion on top of existing growth.
Total Commonwealth public hospital funding will now grow by 12 percent in 2025-26.
The statement said that the extra funding will “help cut waiting lists, reducing waiting times in emergency rooms and managing ramping”.
At the time of writing, I could not find any details of how the $1.7 billion would flow to the states.
Shadow Health Minister Senator Anne Ruston criticised the Government for breaking a promise to reach a five-year agreement, creating uncertainty and “also creating a possible multi-billion-dollar black hole in the process”.
She said this “puts the Prime Minister in stark contrast to the former Coalition Government, who provided certainty and increased hospital funding by 86 percent”.
The record shows that in the 2014 Budget the Coalition sought to tear up the public hospital funding agreement reached by the Gillard Government 18 months previously, and achieve savings of $55 billion over a decade in the Commonwealth contribution to public hospitals (see page 39 in the 2014 health Budget Senate estimates transcript).
It also unilaterally terminated the National Partnership Agreement on Improving Public Hospital Services.
So much for “certainty”.
And I can only think Ruston’s reference to a “possible multi-billion-dollar black hole” is an example of projection.
Albanese also announced that the Commonwealth and NT Governments, together with the Aboriginal Peak Organisations Northern Territory (APO NT), had signed a Partnership Agreement to strengthen service delivery in remote First Nations communities in the Northern Territory. The Commonwealth will commit $842.6 million over six years.
Existing hearing and oral health services will continue to be funded under the agreement.
Aboriginal Peak Organisations Northern Territory Convenor, Dr John Paterson, said the organisation welcomed the commitment. He said “investing in Aboriginal self-determination to Close the Gap in the Northern Territory will deliver vital services and programs for our mob in the bush”.
Ministers and government
Minister Butler released Cancer Australia’s National Framework for Genomics in Cancer Control, saying it “marked a significant step toward improved cancer outcomes through personalised cancer care”.
The Department of Health and Aged Care said that interim First Nations Aged Care Commissioner Andrea Kelly had released a report to Government, recommending a series of critical reforms to improve aged care for First Nations people.
Kelly found that the aged care system does not currently meet the needs of First Nations people and needs urgent reform. Her report identified 27 “urgent and time sensitive recommendations” for action by Government.
The Department said that Aged Care Minister Anika Wells had extended Kelly’s role as Interim First Nations Aged Care Commissioner until June 2026, and that Kelly would use the next 18 months to establish an office for a permanent Commissioner and continue to advocate for older Aboriginal and Torres Strait Islander people.
No word on what the Government would do to address the urgent and time sensitive recommendations.
The Therapeutic Goods Administration registered pegcetacoplan (Syfovre®) for “the treatment of adult patients with geographic atrophy (GA) secondary to age-related macular degeneration with an intact fovea and when central vision is threatened by GA lesion growth”.
UNSW researcher Dr Lisa Nivison-Smith from the UNSW School of Optometry described the TGA action as “a historic decision [which] gives hopes to thousands of Australians who until now have been told there is little they can do to save their vision and they face the possibility of losing their ability to read, drive and see the faces of their loved ones”.
The Australian Institute of Health and Welfare (AIHW) released updated suicide and self-harm monitoring data, including the latest data drawn from state and territory suicide registers.
It also released residential aged care quality indicator data for the September 2024 quarter.
Trend analysis (over 13 quarters for some indicators, and six for others) shows a statistically significant decrease in the proportion of residents experiencing polypharmacy, antipsychotic medication use, falls that resulted in major injury, one or more pressure injuries, use of physical restraint, physical restraint exclusively through the use of a secure area, significant unplanned weight loss and consecutive unplanned weight loss; and a statistically significant increase in the proportions of residents reporting ‘good’ or ‘excellent’ consumer experience and quality of life.
So far, so good – although the absolute level of some indicators of poor-quality care is still high. For example, 17.3 percent of residents are still receiving antipsychotics, and the rate of decrease has slowed over the last 18 months.
However, there has also been a statistically significant increase in emergency department presentations and hospital admissions. Perhaps increasing care minutes per resident increases the likelihood of significant health issues being noticed?
The National Health and Medical Research Council (NHMRC) sprang into action following Minister Butler’s request that it review the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents in Australia and develop new guidelines.
The NHMRC website has a section on the review, including a timetable suggesting targeted consultation will begin mid-year.
Consumer and public health groups
Consumers Health Forum (CHF) Dr Elizabeth Deveny joined ACOSS CEO Cassandra Goldie AO and others at Parliament House to call for a permanent, adequate increase to income support payments.
Deveny said that “every day, CHF hears from consumers who are forced to ration medication, skip medical appointments, or delay essential care because they simply can’t afford it”.
“The rising cost of living has made these choices every day for millions of Australians,” she said. “Raising the rate isn’t just about fairness and dignity – it’s a smart investment in the health of the nation.”
The National Rural Health Alliance (NHRA) joined with the Climate and Health Alliance in “advocating for funding of the National Health and Climate Strategy to mitigate climate impacts on health professionals, rural communities and their livelihoods”.
While the Strategy was released by the Government in late 2023, not a lot of progress has been made in implementing the key actions.
NHRA CEO Susi Tegen called for “immediate and ongoing support for rural communities and urge both state and federal governments to collaborate in bolstering resources for medical and health services, ensuring that rural populations are better prepared during extreme weather events”. (Read more in this recent Croakey article, Australian Government urged to invest in climate health action, as communities suffer and new research sounds alarm.)
In related news, the Australian Conservation Foundation released research it had commissioned from YouGov on the impact of the warming climate and increasingly frequent heatwaves. It found that 85 percent of parents were worried about their children’s health and safety in extreme heat, and 70 percent had responded by reducing the time their children spend outside.
At the same time, 45 percent reported limiting the use of air conditioners or fans during heatwaves because of the cost of power bills.
Palliative Care Australia (PCA) reported that: “In the last eight weeks, 13,000 people have signed PCA’s petition calling on government to deliver better access to palliative care”.
PCA released its federal election platform last November, calling for funding to support palliative care delivered by primary care, removal of PBS copayments for palliative care medications, better access to palliative care in aged care, and a program of home palliative care for people aged under 65.
The Public Health Association of Australia drew attention to research carried out by the George Institute and published in the Australian and New Zealand Journal of Public Health on pregnancy warnings on retail alcohol products.
The pregnancy warning label was introduced by the Government in 2020, with a three-year lead-in period before mandatory labelling on all products packaged after 1 August 2023.
Data collection for the research took place during June-November 2023. The research found that just over a third of products did not include the mandatory warning, and concluded that:
“The outcomes suggest a substantial number of producers (i) may have decided to either delay using the mandatory pregnancy warning until very late in the transition period (despite producers being permitted, but not required, to introduce the mandatory pregnancy warning at any time during the three-year transition period from 1 August 2020 to 31 July 2023) or (ii) may not be compliant with the legal requirement for the mandatory pregnancy warning to be applied to products labelled from 1 August 2023.”
The research essentially confirms that human nature is such that people are unlikely to comply with a requirement that they do not believe is in their interests until it is mandatory to do so.
First Nations health
The Lowitja Institute marked the first anniversary of the death of Dr Lowitja O’Donoghue AC CBE DSG by announcing an “exhibition portraying her most iconic, triumphant, and heartbreaking moments from childhood, a career in health, Indigenous activism, high-profile leadership, and stellar career in Australian Aboriginal Affairs”.
The exhibition will open on 4 June at the Kerry Packer Civic Gallery managed by The Bob Hawke Prime Ministerial Centre, University of South Australia, and will feature “vision of a selection of Dr O’Donoghue’s landmark speeches and media interviews, historic items of personal clothing and awards, items of cultural and political significance, newspaper clippings and quotes, and never seen before photographs, letters, and reports”.
Trade unions
Advanced Pharmacy Australia (AdPha, previously the Society of Hospital Pharmacists) released its pre-budget submission, with “nine targeted recommendations covering scope of practice, workforce development and sustainability, and medicine access”.
These include:
- expanding the Partnered Pharmacist Medication Prescribing (PPMP) collaborative care model from hospitals into aged care and general practice, and allowing pharmacists to prescribe medicines on the Pharmaceutical Benefits Scheme (PBS) under the PPMP and similar models
- Government funding for pharmacy technician sector-specific training and resources
- a nationally consistent approach to access to the PBS for public hospital day-admitted patients, outpatients, and patients upon discharge by including NSW and the ACT in the Pharmaceutical Reform Agreements initiated in 2001.
AdPha also commented on the Government’s public hospital funding announcement, “urging states and territories to direct a portion of the funding to bolster the essential hospital pharmacy workforce”.
Representatives from the Australian College of Midwives were in Canberra, meeting parliamentarians and advocating for proposals in its pre-budget submission, including:
- funding for a Midwifery Transition to Practice Program
- appointment of a Commonwealth Chief Midwife
- access to various MBS items; and expansion of primary maternity units including Birthing on Country.
The Australian College of Rural and Remote Medicine (ACRRM) released its pre-budget submission, arguing for:
- funding to expand the rural generalist training pathway
- action to prevent rural maternity service closures
- rural generalist specific MBS items
- incentives for rural generalists such as funded accommodation and better remuneration for senior doctors.
The Australian Medical Association released its Plan to modernise Medicare – or, more accurately, its plan for extra funding for general practice.
It is proposing a seven-tier “standard consultation item structure that will support patients to spend more time with their doctor by significantly increasing funding for the longer consults that today’s patients need”.
It is also calling for the Government to provide an extra 500 training rotations in general practice for early career doctors, an additional 500 GP training places, and “fix the inequality in pay and leave entitlements for GP trainees compared to their hospital counterparts”.
Finally, it asked the Government to provide more funding to support the employment of more nurses and allied health professionals in general practice.
Most health policy analysts would agree that, 40 years after its establishment, Medicare needs to be updated.
However, many of them would also agree that one of the key issues to be addressed is the over-reliance on fee-for-service as a funding mechanism (see for example here, here and here). Enshrining fee-for-service remuneration for GPs is not modernisation.
The Australian Primary Health Care Nurses Association (APNA) issued a statement marking Primary Health Care Nurses Day (5 February), claiming that “new data reveals half of the nation’s 98,000+ highly trained primary health care nurses are emptying bins and vacuuming rather than focussing on patient care”.
The APNA Workforce Survey of over 3,000 nurses working outside hospitals found they had an average 21 years’ experience, and 43 percent held postgraduate qualifications.
However, 30 percent said they “rarely or never” work to their full scope of practice.
APNA called for “commonsense policy changes”, including adopting the Scope of Practice review reforms, and ensuring that practices only claim the Workforce Incentive Payment for clinical care provided by nurses and allied health professionals.
APNA also called the second Primary Health Care Nurses Day held on 5 February a huge success, with almost 170 organisations joining in to celebrate the day.
The Australian Psychological Society (APS) issued a statement drawing on its pre-budget submission “highlighting key reforms needed to ensure psychologists can continue delivering critical, lifesaving services to the community”.
It set out ten priorities:
- free online training for health professionals to support women and children facing violence
- direct access to psychology services for victim-survivors of DFV
- an APS-led DFV Professional Support Network
- extending Commonwealth Prac Payments to postgraduate psychology students
- developing an evidence-based National Psychology Workforce Strategy
- improving access to psychology services
- Bulk billing Incentives for psychologists
- psychologist-determined support in Better Access
- streamlining GP Mental Health Reviews
- improving youth access to psychology services.
The Pharmaceutical Society of Australia (PSA) commended the NT Government for further expanding the range of vaccination that could be provided by pharmacists. PSA National President Associate Professor Fei Sim “encouraged other Australian states and territories to follow the Northern Territory’s leadership in this area”.
The PSA also praised the SA Government for allowing pharmacist immunisers to “authorise and administer any vaccine within their individual scope of practice, including for the first time travel health vaccines for cholera, rabies and typhoid”.
The PSA released its pre-budget submission, with proposals including:
- fully funding measures designed to enhance the professional practice of pharmacists
- embedding annual indexation, rural loadings and after-hours loadings to payments for pharmacist-led services
- aligning payments for pharmacists to administer National Immunisation Program vaccines to reflect complexity and payments to other immunisers
- funding integrated pharmacists within Aboriginal and Torres Strait Islander Primary Health Services
- doubling the Workforce Incentive Payment (WIP) to general practices who employ an on-site pharmacist
- funding pharmacist participation in multidisciplinary case conferences.
The Royal Australian College of GPs (RACGP) issued a statement on training places in WA, noting that growth was not keeping up with population growth, and calling on the state Government to consider offering incentives for GP training.
The RACGP also said that it would be meeting parliamentarians in Canberra in the week beginning 10 February “to urge all political parties to take doctors’ advice on how to ensure affordable access to care for all Australia”.
The Rural Doctors Association of Australia (RDAA) reiterated its call for a “boost to childcare services in rural and remote towns for local doctors, health and other professionals, to support them to stay in those towns and help encourage more of their peers to ‘go rural’ too”.
It released a position paper and urged “the major parties to commit to drive change in this critical area if elected to Government”.
Industry groups
Australian Private Hospitals Association CEO Brett Heffernan posted on LinkedIn addressing the Department of Health and Aged Care’s consultation on a framework for financial reporting by private hospitals.
Heffernan wrote that “after two years of briefings, multiple independent research papers, the unprecedented opening of hospital books to prove the case and data updates, the Federal Government has done nothing” to address the financial viability of the private hospital sector.
“Now the Health Dept wants more. More!? How about No,” he wrote.
The Private Hospital Sector Financial Health Check carried out by the Department last year received data from only 40 percent of private hospitals.
As I wrote at the time, when the Department approached the sector for data, there is every reason to believe that hospitals that were doing well would not respond to a voluntary survey.
Before the Department of Finance or the Expenditure Review Committee of Cabinet will support any new policy proposal to provide support for private hospitals, they will want evidence of the financial situation of the sector as a whole, not just those entities that chose to respond to a polite request for data.
APHA need to understand the Finance Department line (which I confess I may have used myself at one stage in my career) that if producing the evidence to justify expenditure is too much trouble, then the expenditure clearly isn’t needed.
Politicians and parliamentary committees
The Senate Community Affairs Committee opened an inquiry into the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025.
The bill contains a potpourri of amendments, including to:
- the Dental Benefits Act 2008 and Health Insurance Act 1973 to change the timeframe for making claims relating to bulk-billed Medicare and dental services from two years to one year
- the Human Services (Medicare) Act 1973 to update investigative powers in relation to Medicare fraud offences
- the National Health Act 1953 to streamline pharmacy approval processes
- the Therapeutic Goods Act 1989 to enable the department to manage and alleviate the consequences of therapeutic goods shortages. and support compliance and enforcement activities undertaken in relation to unlawful therapeutic and vaping goods
- the Public Health (Tobacco and Other Products) Act 2023 to clarify the intended operation of certain provisions.
Submissions are due by 28 February, with a reporting date of 3 April.
The House of Representatives inquiry into the health impacts of alcohol and other drugs in Australia held a hearing in Canberra on 7 February, including witnesses from the Department of Health and Aged Care, the Department of Education, and the Australian Federal Police.
International
Croakey colleague Dr Lesly Russell has written that “keeping up with what is happening [under the Trump Administration] is like drinking from a firehose”.
If anyone is still thirsty, here are some more US health news items.
In late January the Ugandan Ministry of Health confirmed a case of the Sudan strain of the Ebola virus in the capital Kampala.
Within four days, the World Health Organization (WHO) launched a first-ever clinical efficacy trial for a vaccine against the strain.
WHO said “the candidate vaccine was donated by IAVI, with financial support from WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), Canada’s International Development Research Centre (IDRC), and the European Commission’s Health Emergency Preparedness and Response Authority (HERA) and support from the Africa Centres for Disease Control and Prevention (Africa CDC)”.
The US Centers for Disease Control (CDC) was not credited with any involvement.
However, the CDC was permitted by the Trump Administration to issue a health advisory about the outbreak, albeit a week after it had been announced.
Past editions of this column have reported on the non-publication for two weeks of the CDC Morbidity and Mortality Weekly Report (MMWR). The report did appear this week, focussing on the impact of the Los Angeles bushfires on emergency department use,
The edition does not include three papers on H5NI avian influenza which were originally scheduled for the vanished 23 January edition.
However, The New York Times reported that the online version of the MMWR originally posted this week included a report on the transmission of H5N1 from a cat to a human in one household, and vice versa in a second household. The report was removed from the website after a short time.
Professor Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health, said that “if there is new evidence about H5N1 that is been held up for political purposes, that is just completely at odds with what government’s responsibility is, which is to protect the American people”.
In other international news, the effective closure of the US Agency for International Aid (USAID) has received much media attention for the impact it will have on some of the poorest countries in the world. The impact on health includes the suspension of funding for PEPFAR HIV antiviral therapy received by about 20 million people across the world.
It will also have potentially dreadful consequences for people participating in clinical trials carried out through the agency, funding for which has also been frozen.
According to The New York Times, “thousands of people [have been left] with experimental drugs and devices in their bodies, with no access to monitoring or care”.
When women taking part in a trial in South Africa of a ring inserted into the vagina intended to prevent pregnancy and HIV infection attended a clinic for a check-up, they were told that the ring needed to be removed immediately.
The stop work order was so sweeping in its terms that the research staff would be violating it if they helped the women remove the rings. However, staff ignored the order and proceeded anyway.
Other affected trials include:
- malaria treatment in children under age five in Mozambique
- treatment for cholera in Bangladesh
- a screen-and-treat method for cervical cancer in Malawi
- tuberculosis treatment for children and teenagers in Peru and South Africa
- nutritional support for children in Ethiopia
- early-childhood-development interventions in Cambodia
- ways to support pregnant and breastfeeding women to reduce malnutrition in Jordan
- an mRNA vaccine technology for HIV in South Africa.
The NYT reported that in England, “about 100 people… inoculated with an experimental malaria vaccine in two clinical trials… no longer have access to the clinical trial staff if that vaccine were to cause an adverse reaction in their bodies”.
Finally
More news from the US of the dismantling of the network of health advisory bodies that help keep the US – and the rest of the world – healthy.
US health care news site Fiercehealthcare.com reported that the Trump Administration had “indefinitely cancelled meetings of the Health Information Technology Advisory Committee (HITAC), an advisory panel that helps the federal government establish rules and standards for the use of healthcare data and technologies”.
Perhaps now chief tech bro Elon Musk is running the US Government, external advice on technology is no longer required.
The committee was established under the 21st Century Cures Act, signed into law in the last few weeks of the Obama Administration.
Consultations and inquiries
Here is our weekly list of requests by government bodies and parliamentary committees for responses to consultations or submissions to inquiries, arranged in order of submission deadlines.
Please let us know if there are any to add for next week’s column.
Department of Health and Aged Care
Medical Research Future Fund Traumatic Brain Injury Mission – refreshed Roadmap and Implementation Plan
10 February
Department of Health and Aged Care
Private Hospital Financial Data Collection Framework
14 February
National Health and Medical Research Council
Investigator Grants peer review process
14 February
Therapeutic Goods Administration
Draft guidance documents – audit framework for medical devices
17 February
Therapeutic Goods Administration
Proposed amendments to the Poisons Standard
17 February
Attorney General’s Department
Draft National Plan to End the Abuse and Mistreatment of Older People 2024-2034.
17 February
Australian Medical Association
Rural Health Issues Survey
19 February
Department of Health and Aged Care
National Health and Medical Research Strategy – Webinar Survey
28 February
Senate Community Affairs Committee
Inquiry into the Health Legislation Amendment (Improved Medicare Integrity and Other Measures) Bill 2025
28 February
Department of Health and Aged Care
Draft National Allied Health Workforce Strategy
3 March
Department of Health and Aged Care
Consultation on PHI Rules sunsetting in October 2025
31 March
Department of Health and Aged Care
Updating clinical guidelines for dementia care
31 December
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, and on Bluesky at: @charlesmk.bsky.social.
