Yet more condemnation of the aged care star ratings system, women’s health matters, the Coalition’s commitment to establish a $20 billion Regional Australia Future Fund, and the Trump Administration’s war on global health and health research – these are among the topics covered in The Zap this week.
Our columnist also brings more updates on the sector’s election priorities, as well as oral healthcare news, and calls to grow the mental health workforce.
The quotable?
By embracing these principles, candidates, political parties and public commentators can contribute to a more respectful and constructive election campaign, promoting the social and emotional wellbeing of First Nations peoples and social cohesion of the nation.”
Charles Maskell-Knight writes:
World Health Day, on 7 April, marked the 77th anniversary of the founding of the World Health Organization in 1948.
The theme for this year was Healthy beginnings, hopeful futures, “urging governments and the health community to ramp up efforts to end preventable maternal and newborn deaths, and to prioritise women’s longer-term health and well-being”.
The National Rural Health Alliance (NRHA) marked the day by calling on all parties to “commit to ending the significant health gaps faced by rural women, especially when it comes to maternity services and postnatal health”.
Chief Executive Susi Tegen reiterated the NRHA’s calls for a National Rural Health Strategy including “access to equitable funding and a commitment to separating rural health funding out of urban health funding”, together with “infrastructure funding… to cover clinician accommodation, health student housing, childcare and outreach clinics infrastructure to meet population health and workforce needs”.
The Australian College of Rural and Remote Medicine (ACCRM) also acknowledged the day, urging “all political parties to prioritise maternity care in their election commitments, ensuring women in rural and remote communities can access safe, high-quality care close to home”.
ACCRM President Dr Rod Martin said “we’ve seen growing political recognition of women’s health, but there is still no clear plan to reverse the decline of rural maternity services”.
The Pharmacy Guild said that “this year’s World Health Day, celebrating maternal and child health, is an opportunity to recognise community pharmacy’s role in ensuring mothers and babies thrive”.
Pharmacy Guild National President Professor Trent Twomey said “we’re lucky in Australia to have so many pharmacists offering more services than ever before. Common issues like uncomplicated UTIs [urinary tract infections] and swimmer’s ear are now just a pharmacy trip away from treatment, saving time and money for busy families”.
There is more to maternal and infant health than quick access to scripts for antibiotics.
As the election campaign carried on, the Government announced if re-elected it would spend a billion dollars to “roll out even more places Australians can go for free, public mental healthcare backed by Medicare”.
This included funding for 31 new and upgraded Medicare Mental Health Centres; 58 new, upgraded or expanded headspace services; 20 Youth Specialist Care Centres for young people with complex needs; and more than 1,200 training places for mental health professionals and peer workers.
Croakey published an article on the announcement from Associate Professor Sebastian Rosenberg, together with reaction from a number of health groups.
Other groups to comment included Mental Health Australia, which welcomed the announcement, and the Rural Doctors Association of Australia (RDAA), which emphasised the importance of building the rural mental health workforce to allow access to rural mental health services to be boosted.
In other election news, Butler announced that a re-elected Labor Government would contribute $27.5 million to CQUniversity for the construction of a Health and Engineering Wing at the university’s Cairns campus.
Opening in 2028, the new building would double nursing student capacity from 630 to 1,260, expand facilities to accommodate growth in physiotherapy, occupational therapy, and clinical exercise physiology, and accelerate delivery of the Bachelor of Medical Imaging.
Butler also announced funding for a health and aged care plan for the Northern Territory, including $60 million for a new aged care home in Darwin, an area with a chronic undersupply of aged care services.
Catholic Health Australia (CHA) welcomed the announcement, but also called on the next government “to increase the Aged Care Capital Assistance Program by at least $297.63 million per year to $540 million per year to support a sustainable aged care sector in regional, rural and remote areas”.
Leader of the Opposition Peter Dutton joined Shadow Minister Anne Ruston to promise that the Coalition would “restore funding for the Suicide Prevention Research Fund”.
This followed a media release from Suicide Prevention Australia bemoaning the absence of a clear commitment from either major party to suicide prevention funding.
The Coalition also promised $10 million to support CareFlight to acquire an additional King Air B250 fixed wing aircraft to better service the Top End, matching a Labor undertaking.
The Coalition’s major health-related announcement was a commitment to establish a $20 billion Regional Australia Future Fund, with the earnings to be allocated to regional healthcare, child care and infrastructure.
The commitment was welcomed by the NHRA, which said “it is about time in this election campaign that regional, rural and remote Australia received some focus”.
Chief Executive Susi Tegen said “rural healthcare doesn’t function in isolation”.
“Funding needs to be provided for infrastructure to accommodate the health workforce and those who are training, to come and stay in rural areas,” she said.
“Medical students need to be supported to study in rural areas and rural clinics need to be expanded. Accessing childcare is an enormous issue for health professionals working in rural Australia.”
Government
The Therapeutic Goods Administration (TGA) announced it had accepted a court-enforceable undertaking from Your Solution Compounding Pharmacy Pty Ltd (YSCP) to cease advertising of prescription-only compounded medicines for weight-loss.
The TGA said that YSCP had “acknowledged that its website likely unlawfully promoted the use or supply of prescription-only medicines”.
The TGA also noted that from 1 October last year Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) products, such as semaglutide, can no longer be compounded by pharmacists and supplied to patients.
The Australian Institute of Health and Welfare released the latest Deaths in Australia report, including the GRIM (General Record of Incidence of Mortality) and MORT (Mortality Over Regions and Time) data files.
Who said demographers don’t have a (dark) sense of humour?
First Nations
Indigenous groups, together with the Black Dog Institute, have developed the Respectful Election Guidelines to ensure election debate is respectful and inclusive. This follows the harmful impact of much public debate during the Voice referendum campaign.
The guidelines were co-developed by the Australian Indigenous Psychologists Association (AIPA), Indigenous Allied Health Australia (IAHA), Gayaa Dhuwi (Proud Spirit) Australia, Thirrili, and the Black Dog Institute.
They are based upon five principles:
- Set the standard for respectful debate
- Promote truth and honesty
- Prioritise wellbeing
- Foster unity
- Lead by example.
“By embracing these principles, candidates, political parties and public commentators can contribute to a more respectful and constructive election campaign, promoting the social and emotional wellbeing of First Nations peoples and social cohesion of the nation,” say the guidelines.
Alison Barrett summarised comments on election priorities from a wide range of First Nations health groups in this Croakey article.
Consumer and public health groups
The Digital Health Cooperative Research Centre (DHCRC) put forward its election priorities. These include:
- a roadmap for the adoption of standardised aged care data across the aged care sector
- a national entity to accelerate the growth and translation of the evidence-base for the role of AI in healthcare
- investment in training and education to develop a digitally enabled healthcare workforce
- development of National Digital Health Procurement Guidelines
- increased R&D funding for digital health research.
Croakey published an article by Peter Breadon from the Grattan Institute highlighting large inequities in access to shingles vaccination, and suggesting action to address poor access to vaccines more generally.
Hepatitis Australia said that a quarter of the over 220,000 people in Australia living with hepatitis B were unaware they had the disease, yet about a quarter of affected people were likely to die from liver cirrhosis or liver cancer.
It called for a nationwide rollout of universal offer of hepatitis B testing for people aged over 25, saying “diagnosis unlocks access to simple, effective treatment that protects the liver and prevents cancer”.
“But people can’t get care if they don’t know they’re living with this virus,” Hepatitis Australia said.
LGBTIQ+ Health Australia (LHA) launched its election policy priorities, saying the highest priority was implementation of the National Action Plan for the Health and Wellbeing of LGBTIQA+ People 2025–2035.
LHA Chair Carolyn Gillespie said “we are seeking commitment to delivering on the Plan’s promise with specific targets, dedicated funding and clear timelines”.
She added that LHA “seeks urgent action to address well-known health and wellbeing disparities, with recommended projects that include improving access to gender-affirming healthcare, medical care for people with innate variations of sex characteristics, mental health services, aged care, domestic and family violence responses, and disability inclusion”.
The NRHA attended the Remote Food Security Roundtable in Alice Springs, and then issued a statement saying it was concerned that the newly announced Government scheme on food security in rural Australia would subsidise only 30 products in 76 remote stores, including nutritionally poor options such as instant noodles and processed canned meats.
Chief Executive Susie Tegen said “this leaves out a huge section of rural communities who struggle every day with the rising cost of living, environmental impacts and worse health outcomes than urban areas”.
“Recent figures show grocery prices in remote areas cost twice those in metropolitan areas,” she said. “Rural Australians should be able to access healthy fresh food at accessible prices, similar to those who live in urban settings”.
Palliative Care Australia announced it was leading two education projects to target community based palliative care and earlier referral for cancer patients.
The first project is intended to “make sure medicines on the Core Community Palliative Care List are more available from local pharmacies, and that pharmacists can better support patients and carers in their use of these critical medicines at home”; while the second is intended to encourage specialists treating cancer to have more timely palliative care referral conversations with their patients.
Trade unions
The Australian Dental Association (ADA) announced that its annual survey of 25,000 people had found that over half of people aged over 65 were delaying dental treatment, largely due to cost, while almost half of the same cohort reported debilitating oral health issues.
(None of this would come as a surprise to anybody who has been reading AIHW reports on dental care for the last two or three decades.)
The ADA used the findings as further evidence of the need for the Government to implement its proposed Seniors Dental Benefits Schedule, a proposal backed by COTA.
The Australian Psychology Society and the Royal Australian and New Zealand College of Psychiatrists issued a joint media release trauma and serious mental health conditions, “calling on the Coalition and Australian Greens to match [the Government’s] investment in growing Australia’s mental health workforce”.
They said that the mental health workforce was burning out under unrelenting demand and rising stress. While they welcomed the Coalition’s commitment to increased spending on mental health services, they said action was needed to grow the psychiatry and psychology workforces.
The Pharmaceutical Society of Australia (PSA) convened a roundtable bringing together over 20 pharmacy and other groups to shape an agreement on pharmacy programs that no longer sit within the Community Pharmacy Agreement.
These include “medication management programs (including Home Medicines Reviews and Residential Medication Management Reviews), Aboriginal and Torres Strait Islander specific programs, and rural support programs that encompass pharmacists in a range of practice areas”.
The PSA also said Queensland was the first jurisdiction to introduce “Collaborative Pharmacist Medication Prescribing, allowing pharmacists to prescribe certain medicines in collaboration with a medical practitioner or nurse practitioner in both public and private hospitals [including] charting medicines for administration in inpatient settings and prescribing medicines for supply to patients on discharge or in an outpatient setting”.
Advanced Pharmacy Australia also welcomed the Queensland move.
The Royal Australian College of GPs (RACGP) announced a successful RACGP Hackathon, featuring more than 100 attendees coming together for a weekend of intense problem-solving, collaborative teamwork and creative thinking.
Six teams comprising three or four GPs, a tech expert, and an entrepreneur worked to “finding cohesive solutions that effectively bridge the gaps between clinical excellence, practice efficiency and business sustainability”.
The winning team developed an app for real-time tracking of appointment times to improve communication with patients and ease the pressure on clinic staff.
The RACGP urged the Tasmanian Government to act to ensure ongoing funding for the Perinatal and Infant Mental Health Service in North and North West Tasmania, which is apparently due to close on 20 June.
The RACGP was one of 40 health organisations to sign a call on all political parties and candidates to commit to ensuring affordable, accessible abortion care in Australia.
The group said that data from 2021 shows:
- one in three Australian women, and 50 percent of women in remote areas, had no local GP providing medication abortion;
- only 11 percent of GPs in Australia prescribe medication abortion;
- many publicly funded hospitals that provide maternity and women’s health services do not provide abortion care, or care is very limited.
It urged parties to affirm abortion as essential healthcare, and said the next Government should:
- ensure appropriate remuneration under the Medicare Benefits Schedule
- support workforce capacity by working with medical and professional colleges providing sexual, reproductive and maternal healthcare training
- ensure public hospitals provide abortion care as part of standard, comprehensive reproductive health services
- work with state governments to implement all 36 recommendations from the Senate Inquiry into universal access to reproductive healthcare.
The Royal Australasian College of Physicians (RACP) said it was pleased to see that many of the NSW Drug Summit Report’s 56 recommendations aligned with the RACP’s long-standing advocacy, and urged the NSW Government to implement them to move NSW further towards adopting a health-focused approach to drugs.
The RACP also used the doctors’ strike in NSW to argue for a greater investment in growing and supporting the medical workforce. RACP President Professor Jennifer Martin said “Australia does not have enough physicians, and the ones we have are not always able to practise in the communities where they are needed”.
The Rural Doctors Association of Australia (RDAA) won the prize for quirkiest media release title of the week with Do unicorns exist? Of course they do!, marking National Unicorn Day.
According to RDAA President Dr RT Lewandowski, Rural Generalists (RGs) are “uniquely adaptable, highly skilled and… rare. True unicorns”.
Lewandowski said “let’s not horse around and get right to the point… Rural Australia needs these unicorns, who can be treating a case of warts in the morning, a heart attack at lunch time, a broken arm in the afternoon, and maybe running a mental health clinic on another day”.
He called for more Commonwealth funding committed to training RGs, more training places allocated to rural, greater support for rural medical supervisors, and targeted funding and initiatives that support rural general practices to keep employing their RG unicorns.
Industry groups
The Australian Healthcare and Hospitals Association called on political parties to “to prioritise health system reform by committing to measuring and reporting what matters”.
It said that “despite the well-known importance of health information and reporting, Australia has yet to implement a comprehensive National Health Information Strategy to support coordination and action on system-wide and structural reforms for the Australian health system”.
Last week I reported that the Australian Private Hospital Association (APHA) had “circulated a media release with yet another diatribe at the rapacious insurers and the uncaring Government”.
This week the APHA circulated a media release with yet another diatribe at the rapacious insurers, but not the Government.
According to the APHA, Minister Butler when speaking at the Australian Financial Review Health Summit on 7 April reiterated earlier comments that private health insurers needed to lift the proportion of premiums they paid out in benefits. (The text of the Minister’s remarks is not available outside the AFR paywall.)
However, Shadow Minister Ruston did not match this “commitment”, thus earning the wrath of the APHA which issued another media release, accusing her of repeating the insurers’ talking points and acting as Minister for Health Insurance rather than Minister for Health.
The APHA is reaching new heights of invective in its attacks on insurers: “[their] crocodile tears cannot be taken seriously… Australians’ bulldust barometers are well-tuned to see through the lame charade… This is the latest in a litany of falsehoods promulgated by insurers to protect their unbridled profiteering at the expense of patients, hospitals and their employees, and the entire healthcare system”.
Last week Medicines Australia issued an optimistic statement about the future of the Pharmaceutical Benefits Scheme (PBS) under the new US tariff regime. At that time all pharmaceutical imports to the US were tariff-exempt under President Trump’s “Liberation Day” executive order.
As they say, a week is a long time in politics.
This week Trump announced that “major tariffs” on pharmaceutical import were imminent.
Given the US pharmaceutical prices are already nearly three times as high as prices in other OECD countries, raising the prices of imported pharmaceuticals does not seem particularly sensible.
However, given the wild gyrations of US tariff policy, who knows whether tariffs on pharmaceuticals will eventuate – or how long they will last.
International
There is enough news about the Trump Administration’s war on global health and health research to fill this column every week.
In an article in Croakey this week Alison Barrett compiled the views of a range of experts on the implications for the health and wellbeing of nations, communities and people of the sweeping disruption, upheaval and uncertainty created by Trump’s tariff “policy”.
Another alarming issue this week was Secretary for Health and Human Services Robert F Kennedy Jr’s statement that he plans to tell the Center for Disease Control (CDC) to drop its guidance recommending drinking water fluoridation – guidance which has been in place for over 70 years.
The CDC website currently states “community water fluoridation is a practical, cost-effective, and equitable way for communities to improve oral health regardless of age, education, or income by preventing cavities. This results in less mouth pain, fewer fillings or teeth pulled, and fewer missed days of work and school”.
Last May the CDC released a statement on the evidence for and against fluoridation, saying that “expert panels consisting of scientists from the United States and other countries, with expertise in various health and scientific disciplines, have considered the available evidence in peer-reviewed literature and have not found convincing scientific evidence linking community water fluoridation with any potential adverse health effect or systemic disorder such as an increased risk for cancer, Down syndrome, heart disease, osteoporosis and bone fracture, immune disorders, low intelligence, renal disorders, Alzheimer disease, or allergic reactions”.
In 1999 the CDC named community water fluoridation as one of the ten great public health achievements of the 20th century.
Kennedy now says he will “assemble a task force of health experts to study the issue and make new recommendations”.
Kennedy has previously described fluoride as a “dangerous neurotoxin”. I expect the “task force of health experts” will be drawn from the fringes of the public health world which shares his views.
At the same time, CBS and numerous other sources have reported that the CDC has laid off its team of lead poisoning experts, halting “multiple efforts to help local health authorities… including for lead poisoning responses that could have helped children in Milwaukee and on an American Indian reservation”.
Lead is, of course, a proven dangerous neurotoxin.
Finally
Finally, this week, an “I told you so moment”. And no, it isn’t Kamala Harris reflecting on the second Trump presidency.
This week the HelloCare website published an article about the aged care star ratings system, calling it “a costly mirage the Department won’t admit is broken”.
The article argues that “the system isn’t just flawed; it’s a betrayal of trust, misleading families while haemorrhaging millions on development, fixes, and glossy campaigns to mask its failures. Worse, the Department’s refusal to own these mistakes – despite mounting evidence of deception – reveals a department more invested in optics than outcomes, leaving vulnerable seniors and their families to pay the price”.
Over the last two years Associate Professor Rodney Jilek has published a series of reports highlighting aged care homes receiving three, four, or even five-star ratings while the regulator had found them non-compliant with as many as eight of the eight aged care quality standards.
His concerns were first picked up in the mainstream media early last year.
His most recent report Groundhog Day – the continuing failure of the aged care star rating system was issued in March this year, and found that “the only reasonable conclusion that can be drawn from this exercise is that absolutely no progress has been made to improve the transparency, accuracy and ease of use of the Star Rating System and there has been no serious attempt to meet the general public’s need for an accurate reflection of aged care service performance”.
Last year the Commonwealth Ombudsman stated “in my view, while noting the department’s advice about steps it has taken and is intending to take to improve the star ratings system, currently star ratings are not sufficiently meaningful to help people make informed decisions about their aged care”.
Where were these issues first raised? In Croakey, of course.
Soon after the first set of ratings were issued I wrote an article in January 2023 explaining the system and discussing its potential failings, concluding that:
“The current star rating system would not be out of place as a plot device in an episode of Utopia. The only problem is that viewers would find it hard to believe even the Government could invent a system that awarded three stars for an ‘acceptable level of care’ to providers that the regulator found were not meeting the standards for acceptable care.
“The Department needs to go back to the drawing board.”
Over two years later this is still true.
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.
Food Standards Australia New Zealand
Caffeine in sports foods and general foods
15 April
Coalition of Peaks
Independent Aboriginal and Torres Strait Islander-Led Review of the Closing the Gap agreement
16 April
Department of Health and Aged Care
Design of a national registration scheme to support personal care workers employed in aged care
17 April
Department of Health and Aged Care
Draft Quality Standards for Human Research Ethics Committees and their Host Institutions
17 April
Department of Health and Aged Care – Gene Technology Regulator
Invitation to comment on a field trial of genetically modified canola
17 April
National Health and Medical Research Council
Scoping survey on clinical practice guidelines on the diagnosis and management of myalgic encephalomyelitis / chronic fatigue syndrome
27 April
Department of Health and Aged Care – Gene Technology Regulator
Trial of a genetically modified (GM) vaccine for the prevention of respiratory disease in horses
28 April
Food Standards Australia New Zealand
Permitting small dogs and cats in aircraft cabins
30 April
Department of Health and Aged Care – Gene Technology Regulator
Clinical trial of a genetically modified human adenovirus for treatment of melanoma
6 May
Therapeutic Goods Administration
Proposed changes to the IVD medical device classifications and definitions
8 May
Food Standards Australia New Zealand
Egg food safety and primary production requirements
12 May
Ahpra
Revised National Prescribing Competencies Framework
30 May
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.
Bookmark this link to follow The Zap
