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The Zap: all the latest on health and aged care, including non-announcements and some sad news

Women’s health, inequalities in access to medical specialists, and the impact of heat upon physical and psychological health for people on low incomes are among the topics covered in The Zap this week.

Health policy analyst Charles Maskell-Knight also reports researchers’ concerns that provision of adequate healthcare to Northern Queensland rural and remote communities is being hindered by restrictions on public access to information about health service delivery, combined with reliance on health data sources that are not fit for purpose.

Our columnist raises questions about research grants that appear to be promoting the role of private health insurance in general practice, and also laments the closure of the Health Issues Centre, established in Melbourne in 1985, which advocated for consumers in the health system for almost 40 years.

The quotable?

“This column is dedicated to reporting announcements and statements in the health and aged care areas, but every so often non-announcements are just as interesting:

  • for the 12th week since the Aged Care Taskforce held its final meeting on 15 December, Aged Care Minister Anika Wells did not release its final report; and
  • the Government is now a week late in responding to the report of the Senate select committee inquiry into dental services, which was due on 29 February.”

Charles Maskell-Knight writes:

I have always wondered if there was a United Nations committee somewhere which decided on how to allocate days of the year to different causes, and if so, which criteria it uses. Anyway, last Monday, 4 March was both International HPV Awareness Day, and World Obesity Day.

And of course, Friday, 8 March was International Women’s Day.

Assistant Minister Ged Kearney marked the first of these with a media release about the success of the self-collection option for cervical cancer screening introduced in July 2022. So far 315,000 Australian women have used the option, and 27 percent of all screening tests are now done this way.

Kearney said: “The increase in testing rates in the Northern Territory and among First Nations Australians is a big success story. It puts us closer to closing the gap on First Nations testing rates so we can drive down the rate of cervical cancer in these communities”.

Kearney also did a series of radio interviews associated with International Women’s Day, discussing women’s health and the End Gender Bias survey commissioned by the National Women’s Health Advisory Council. Talking to ABC Radio Perth, Kearney said she had been told that the health system was designed for a fifty-year-old white man from Pennsylvania, and that it often let down women.

She is convening a women’s health summit on Thursday, 14 March to discuss how to improve how the health system works for women.

While World Obesity Day saw a plethora of media stories about Australians’ expanding waistlines, there was no Government acknowledgement of the day.

Ministers and government

Minister Mark Butler announced that on 1 March a further 94 medicines were added to the list of drugs available under a 60 days prescription, including treatments for diabetes, epilepsy and breast cancer. He said that Australians had already saved $11.7 million on almost three million scripts since the policy began in September last year, and foreshadowed adding a further 100 medicines to the list on 1 September this year.

The announcement was welcomed by many groups including the Australian Medical Association (AMA), the Royal Australian College of General Practitioners (RACGP), Diabetes Australia,  and the Breast Cancer Network Australia. The Pharmacy Guild, which vociferously opposed the initial change, did not comment.

Butler also announced he had approved private health insurance premium increases averaging 3.03 percent to apply from 1 April. He noted that the increase was below the rate of increases in wages and inflation, and “much lower than the increase to the cost of other insurance products, which rose by around 17 percent in 2023”.

All very true, but I still don’t see why the five insurers who had net reserves greater than a year’s worth of premium income at the end of last year need to have any premium increase.

Shadow Health Minister Anne Ruston criticised the Government for delaying the announcement until after the Dunkley by-election. I’m sure she’s right, but is it any worse than announcing a premium increase on Thursday, 23 December when the national media have already checked out for the holidays?

This column is dedicated to reporting announcements and statements in the health and aged care areas, but every so often non-announcements are just as interesting:

  • for the 12th week since the Aged Care Taskforce held its final meeting on 15 December, Aged Care Minister Anika Wells did not release its final report
  • the Government is now a week late in responding to the report of the Senate select committee inquiry into dental services, which was due on 29 February.

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

  • access to and spending on general practice, allied health and other primary care services
  • Medicare-subsidised GP, allied health and specialist health care by local areas for 2022-23
  • emergency department attendances and hospitalisations for spinal injuries in Australia 2020-21.

If I had to pull one striking headline statistic from these reports, it would be this: the rate of specialist attendances for people living in the North Sydney Primary Health Network is almost three times the rate for people living in the Northern Territory. Another example of the inverse care law?

The AIHW also released a massive dataset covering “up to 20 years of weekly health service use data by Statistical Area Level 4 geography…includ[ing] data relevant to respiratory, cardiovascular, and mental health conditions, as well as other health conditions”. The dataset was developed to support “research on the impact of environmental events (in particular, bushfire) on health service use”.

Finally, the AIHW published a report about the COVID-19 Register linkage project as a resource for researchers wanting to use the data, setting out the linkage method and process, and comparing high level linkage results for previous and current versions of the COVID-19 Register.

The ABS released data on multiple job-holders. As at November 2023, 10.3 percent of people who were a “community and personal service worker” in their main job also held another job. This was the highest percentage for any main occupation, possibly reflecting the prevalence of part-time shift work in the caring sector, not to mention low rates of pay.

First Nations health

The Australian Indigenous HealthInfoNet at Edith Cowan University released its Overview of Aboriginal and Torres Islander Health Status 2023, containing detailed information against a wide range of performance indicators. The overall picture is consistent with the Closing the Gap report and the data on First Nations health in the Productivity Commission Report on Government Services: First Nations peoples have worse health than the non-indigenous population, and across many indicators the difference is not reducing.

The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) issued a statement condemning the Victorian Department of Justice for dismissing testimony given by Aboriginal people about their experience of health services in prison.

Although an investigation by the Victorian Ombudsman found “common themes of inadequate mental health, delays in accessing healthcare, and harmful attitudes held by custodial and healthcare staff”, the Department of Justice’s response was “to question the veracity of experiences shared by Aboriginal people”. [Read more about this investigation in a previous Croakey article by Professor Megan Williams and Jack Bulman].

Consumer and public health groups

The Consumers Health Forum expressed concern that the boom in demand for Ozempic as a weight loss product meant that “suddenly people living with conditions, like diabetes, who need the drug for medical purposes can’t get it”. CHF said while it understood the reasons for the TGA’s proposed ban on compounding pharmacists preparing Ozempic-like products, action was need to address supply issues.

It called on the Government to continue its efforts to get more Ozempic into Australia, noting that this is a global supply issue; and “convene a roundtable of consumers, industry and clinicians to see how we can work together to find solutions to medication supply and use issues”.

CHOICE published an article on the private health insurance premium increases, pointing out that in many cases it was possible to avoid the increase on 1 April by prepayment for a year. Good advice for families with a lazy $5,000 lying round not earning interest. However, if the money would otherwise be sitting in a mortgage offset account, or a term deposit earning interest, it would be better left there. (This is not to be taken as financial or investment advice!)

ACOSS reported on a survey of over 1,000 people experiencing financial and social disadvantage, which found 80 percent of them were living in homes “that are too hot in summer” and made them unwell. Fourteen percent of respondents (25 percent of First Nations respondents) had sought medical attention for heat stress.

CEO Dr Cassandra Goldie said that “due to skyrocketing energy costs, inefficient homes and the glaring inadequacy of income support, people on low incomes cannot keep themselves cool, badly impacting their physical and psychological health. In the May budget, the Government must invest further in energy efficiency, electrification and rooftop solar across all low-income housing types, incentivise minimum energy efficiency rental standards, and raise the rate of JobSeeker and related paym