The Zap is a newish column at Croakey providing a weekly summary of health-related reports, announcements and media releases from Commonwealth government agencies, Health and Aged Care Ministers and other politicians, national health sector organisations, and some international bodies.
Below is the third edition, compiled by health policy analyst Charles Maskell-Knight.
The quotable?
No wonder we can’t afford nice things, like unemployment benefits one can live on, affordable access to medical specialists, or high quality aged care.”
Charles Maskell-Knight writes:
Last week may have had only four working days (while acknowledging that many organisations and individuals choose to work through on 26 January), but the health and aged care policy world began to stir from its post New Year torpor.
Ministers and government
Minister Mark Butler was busy on several fronts. He announced the addition of Opdualag (new cutting-edge immunotherapy for advanced melanoma) to the PBS from 1 February. At the same press conference he also spoke about the Better Access to psychology services program – of which more later.
Butler and Assistant Minister Emma McBride announced the implementation of the Rural Advanced Skills payment, included in the October 2022 budget, under which GPs with qualifications in areas such as obstetric or First Nations health can receive an annual payment of up to $10,500. A separate payment of up to $10,500 is also available to eligible doctors providing emergency care. Payment levels depend on locations and activity level.
This announcement was welcomed by the Royal Australian College of General Practitioners (RACGP) and the National Rural Health Alliance.
Attorney-General Mark Dreyfus KC announced the Terms of Reference for an Australian Law Reform Commission inquiry into justice responses to sexual violence. The Commission is to consider the particular impacts on “cohorts that are disproportionately reflected in sexual violence statistics” including people in residential care settings – an inclusion welcomed by OPAN (the Older Persons Advocacy Network).
The Department of Health and Aged Care announced the opening of a consultation process on three new staffing indicators for the aged care quality indicator program. The indicators will focus on enrolled nursing, allied health, and lifestyle services, and “aim to understand the impact of the new 24/7 nursing requirements on the aged care workforce”. Comments close on 5 March.
The Department also announced that aged care providers could now apply for “free, independent and confidential advice to improve their operations”. It has contracted consultancy firm EY to provide a Business and Workforce Advisory Service to provide advice on business management, financial strategies, and workforce challenges. Let’s hope the contract has robust conflict of interest provisions precluding EY from carrying out any audit or inspection work for the aged care quality regulator.
The Scope of Practice Review (led by Professor Mark Cormack) released an issues paper, seeking comments by 8 March. The paper is intended to “provide an overview of the evidence collected to date, outline the emerging themes from this evidence, and describe the direction and next steps for the Review”. After a consultative process, a further issues paper will be released which “will explore the specific policy and system reforms available to address identified barriers associated with health professionals working to full scope of practice”. Watch out for fireworks at that point.
In the meanwhile, the Australian Primary Health Care Nurses Association said the issues paper “embraces a contemporary understanding of collaborative practice and what nurses are capable of providing to keep people well in the community”.
The Australian Institute of Health and Welfare released a report on specialist paediatric palliative care delivered to children who died in 2021. It found that 46 percent of children who died in Australia in 2021 with a life-limiting condition received specialist paediatric palliative care from a children’s hospital. There was a socioeconomic gradient – only 40 percent of children from the most disadvantaged areas received this care, compared with 68 percent of children from the least disadvantaged areas. Of the small number of children from remote and very remote areas who died with a life-limiting condition, 73 percent received this care, compared with around 45 percent of children elsewhere.
The Australian Bureau of Statistics released an update to its latest estimates of First Nations peoples’ life expectancy, reporting that life expectancy at birth continues to lag the rest of the population by eight to nine years. There is still a long way to go to Close the Gap.
The Productivity Commission began to release tranches of the Report on Government Services, including the community services chapter on 22 January. Table 41 of the 66 in the aged care section shows that of the 1,583 nursing homes subject to a site audit in 2022-23, almost 15 percent failed the Personal Care and Clinical Care standard. Yet the aged care star ratings system spruiked by Minister Wells shows only two percent of homes receiving 1 or 2 stars.
The Australian Health Practitioner Regulation Agency (AHPRA) marked 26 January with LinkedIn and X posts “acknowledging the ongoing and detrimental impact of colonisation on the health and wellbeing of Aboriginal and Torres Strait Islander Peoples and our role in improving outcomes by eliminating all forms of racism – systemic, institutional and interpersonal – from healthcare”. AHPRA clearly have not accepted Senator Jacinta Nampijinpa Price’s views that First Nations people are not suffering the negative effects of colonisation.
Consumer and public health groups
Early in the week the Public Health Association of Australia joined the stage 3 tax cuts debate, pointing out that low-income Australians have the worst health outcomes, while middle- and high-income Australians are among the healthiest people on earth. CEO Adjunct Professor Terry Slevin said “better income support, better housing, and better childcare will ultimately benefit us all. The Government can achieve those outcomes – if it does not diminish its revenue base by hundreds of billions of dollars over the next decade”.
While the Government has now decided to modify the cuts to give less of a gain to the wealthiest 10 percent or so of taxpayers and more to everyone else, it appears that overall revenue will not increase over the next four years. According to the OECD, general government revenue as a share of GDP in Australia (about 36 percent) is about 10 percentage points lower than the EU average. No wonder we can’t afford nice things, like unemployment benefits one can live on, affordable access to medical specialists, or high quality aged care.
Research reported in The Medical Journal of Australia examined the link between water fluoridation and area socioeconomic status in Queensland, finding that “the 2012 decision [by the Newman Government] to devolve responsibility for water fluoridation decisions and funding from the Queensland Government to local councils means that residents in lower socio‐economic areas are less likely to have access to fluoridated water than those in more advantaged areas, exacerbating their already greater risk of dental disease”. The authors called for the policy to be changed so that everybody can benefit from the proven benefits of fluoridation.
Trade unions
The RACGP issued a statement based on its submission to the Effectiveness Review of General Practice Incentives calling for support for general practice to: employ multidisciplinary teams; prioritise preventive care; and provide more after-hours care and expand services to meet the needs of their community and improve access for patients. It also asked for increasing support for Indigenous health services and practices to provide better care for First Nations patients, and unlocking health data to improve patient care.
The Guardian reported on a call from the Australian Association of Psychologists Inc (not to be confused with the Australian Psychological Society or the Australian Clinical Psychology Association) to increase the number of Medicare-subsidised sessions from 10 to 20, and increase the rebate by at least $50 for some sessions. The original limit on sessions under the so-called Better Access program was 10, but this was increased to 20 during the pandemic. Following a review of the program which found access by new patients had declined, the limit was reduced to 10 in December 2022.
Minister Butler said that he was working with the sector to improve equity of access and service mix, and would have more to say “in due course” – essentially what he said in December 2022.
The Australian Medical Association (AMA) congratulated members recognised in the Australia Day honours list, including Dr Kelvin Kong AM, “Australia’s first Indigenous surgeon, and one of the first winners of the AMA’s Indigenous Medical Scholarship”. Dr Kong was the 2023 NAIDOC person of the year, noted for his work in addressing the disparity in health outcomes between Indigenous and non-Indigenous children, and improving pathways into specialist medical training and Indigenous workforce across the health and research sector.
The AMA also acknowledged former Tasmanian Premier Lara Giddings, now working as the CEO of AMA Tasmania, who was appointed as an AO.
The Pharmacy Society of Australia used the approval of a RSV (respiratory syncytial virus) vaccine by the TGA as an opportunity to call for all state and territory governments to authorise pharmacists to provide the vaccine.
Industry groups
The Pharmacy Guild welcomed the announcement of a Victorian Government inquiry into Women’s Pain, and encouraged community pharmacists to participate: “sharing your experiences of the current care, treatment and services for pain conditions as part of this inquiry will help to identify opportunities for future improvement”.
Politicians and parliamentary committees
Shadow Health Minister Senator Anne Ruston issued her regular media release on the difficulty of accessing primary care services, especially in regional areas. She also spoke to Ben Fordham on 2GB, lamenting the fact Cricket Australia wasn’t making a fuss about Australia Day on day two of the Brisbane Test match. I imagine most cricket fans are only relieved that the game lasted into day two!
The Senate Community Affairs Committee inquiry into “equitable access to diagnosis and treatment for individuals with rare and less common cancers, including neuroendocrine cancer” is gearing up for hearings in Sydney and Melbourne on 31 January/1 February. The inquiry is due to report by 21 March.
International organisations
The OECD released an updated health system performance assessment framework, incorporating “new performance dimensions, notably people-centredness, resilience, and environmental sustainability, and plac[ing] increased emphasis on addressing inequalities, including those related to gender”.
The OECD also held a Health Ministerial Meeting on Better Policies for more Resilient Health Systems. Countries committed to everything you would expect (including better primary care, better health surveillance, addressing workforce shortages and antimicrobial resistance, and working towards climate-neutral health systems).
The World Health Organization (WHO) announced the appointment of former Tongan Health Minister and experienced doctor Saia Ma’u Piukala as director of the Western Pacific Region (including Australia).
The (US-based) Commonwealth Fund reported on a survey of 1,001 hospital-based clinicians on their views of what health systems can do to address climate change. It found that:
- about four in five clinicians surveyed believe that it’s important for their hospital to address climate change and that doing so is aligned with their organisation’s mission;
- three in four surveyed clinicians feel it’s important that they themselves work to reduce their environmental impact, both at work and at home; and
- about six in 10 clinicians indicated a prospective employer’s policies and actions on climate change would impact their decision to apply for a job.
I wonder what an Australian survey would find?
• 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.
