Election health commitments, priorities and scorecards feature prominently in The Zap this week. The predatory marketing practices of alcohol companies, demand for alcohol treatment services, medicine shortages, aged care reforms, and unsafe health infrastructure are also addressed.
The quotable?
Those who seek to form the next government need to outline their plans to make sure palliative care is available to everyone who needs it.”
Charles Maskell-Knight writes:
The election campaign continued with health announcements from both major parties.
Health Minister Mark Butler announced funding of $10 million to “support primary healthcare providers to improve their skills and knowledge to deliver inclusive LGBTIQA+ healthcare [with] a training provider to be selected through a competitive grants process”.
The Australian Medical Association (AMA) welcomed the commitment.
Butler also announced that, following an independent review, private health insurers would be free to provide benefits for yoga, Pilates, tai chi, shiatsu, naturopathy, western herbal medicine, and Alexander technique.
(The previous Government in 2019 banned insurers from offering benefits for these treatments as well as aromatherapy, Bowen Therapy, Buteyko, Feldenkrais, homeopathy, iridology, kinesiology, reflexology, and Rolfing, following an earlier independent review.)
Butler announced a contribution to establish new medical imaging positron emission tomography (PET) services in Adelaide at the Queen Elizabeth Hospital and the Flinders Medical Centre; and a contribution to the building of a new Health and Housing Clinic to provide free healthcare to people most in need in Brisbane’s West End.
He also announced a commitment to open another eight Perinatal Mental Health Centres around the country to provide mental health support to new and expectant Australian parents, expanding the current network of 12 centres.
Australians for Mental Health welcomed this commitment. Executive Director Chris Gambian said “postnatal depression affects many new mothers and fathers, and too often it goes untreated or even undetected”.
“By investing in the mental health of new parents we are tackling the crisis head on, and setting up the conditions for better mental health for the whole family,” Gambian said.
Shadow Health Minister Anne Ruston attacked the Government for failing to meet a 2022 election promise to expand the newborn health screening test to cover 80 conditions – but did not commit a new Coalition Government to expanding the test.
Ruston did announce that a Coalition Government would provide further funding to the end of 2025-26 for the Colorectal and Pelvic Reconstruction Service at the Royal Children’s Hospital in Melbourne.
The big Coalition health announcement was that it would provide $100 million “towards upgrading regional medical training facilities across Australia and delivering 200 additional regional medical Commonwealth Supported Places, to fast track more health professionals living and working in regional, rural and remote Australia”.
A range of groups including the Australian Medical Association (AMA), the Rural Doctors Association of Australia (RDAA), the Australian College of Rural and Remote Medicine, and the National Rural Health Alliance (NHRA) supported the announcement.
The NHRA said it “is particularly encouraged by the Coalition’s plan to develop a comprehensive Rural, Regional and Remote Health Strategy, led by the National Rural Health Commissioner”.
The Department of Health and Aged Care’s website is replete with strategies and plans covering a wide range of elements of the health sector.
See, for example, the National Preventive Health Strategy 2021–2030, Healthy mouths, healthy lives – Australia’s National Oral Health Plan 2015–2024, the National Mental Health and Suicide Prevention Plan, or the National Mental Health Workforce Strategy 2022–2032).
Yet, in the absence of funding commitments, these are empty words.
The Coalition also effectively matched the Government’s commitment to provide additional support for health and aged care services in the NT.
Government
The TGA announced that Queensland-based pharmacy Summit Pharmacy Pty Ltd had paid four infringement notices totalling over $75,000 for the alleged unlawful manufacturing of medicinal cannabis products.
The Australian Institute of Health and Welfare (AIHW) released a profile of Australia’s population, prepared by the Centre for Population at The Treasury.
Over the 30 years to 2023-24, net overseas migration was the main driver of population growth, while natural increase (births minus deaths) decreased from 135,000 people in 1993–94 to 106,000 people in 2023–24.
This change was driven by dropping fertility rates and increasing death rates reflecting the ageing of the population.
Life expectancy at birth increased by six years for men and four years for women.
The median age of the population has increased from 33.4 years to 38.3 years, while the percentage of the population aged 65 and over has increased from 12 percent to 17 percent over the same period.
The AIHW released updated suicide and self-harm monitoring data, as well as an updated report including 2023-24 data on Alcohol and other drug treatment services, including an Early Insights report.
The Foundation for Alcohol Research and Education (FARE) said the alcohol and drug data showed that “alcohol was the principal drug of concern for people seeking treatment in 2023-24, accounting for two in five (42 percent) of the 219,277 episodes of treatment – compared with amphetamines (26 percent), cannabis (16 percent) and heroin (4 percent)”.
FARE said this “highlighted the urgent need to address the predatory marketing practices of alcohol companies”.
FARE Director of Policy and Research Dr Catherine Earl said “bold action from governments is needed to ensure community safeguards are adequate for our digital age”. Suggestions included changes to the Privacy Act, a ban on late night home delivery, and a two-hour safety pause between an order being placed and delivered.
The Fair Work Commission (FWC) released a preliminary decision on the gender undervaluation review of a number of awards including the Health Professionals and Support Services Award 2020.
According to the Health Services Union (HSU), the FWC “found health professionals, pathology collectors and dental assistants covered by the Health Professionals and Support Services Award and workers covered by the Aboriginal and Torres Strait Islander Health Workers and Practitioners and Aboriginal Community Controlled Health Services Award have been subject to pay undervaluation based on gender”.
“The expert panel found a boost to minimum award rates of up to 35.23 percent was justified in light of this inequity,” said the HSU.
While the HSU celebrated the decision, Australian Pathology said the Government “must immediately commit to an investment package in a phased manner that recognises the impacts and timing of the Commission’s findings”.
Before the decision was released, the AMA released its updated Pathology Position Statement, saying “current funding remains inadequate, placing additional pressures on the industry and increasing the likelihood patients will bear out-of-pocket costs”.
First Nations
A joint report developed by Infrastructure Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) found that up to $150 million was needed to replace high-risk, unsafe buildings used by ACCHOs which have failing foundations, walls or roofs.
Another $30 million a year for five years was needed to allow ACCHOs to repair existing infrastructure.
VACCHO Chief Executive Dr Jill Gallagher AO said “better infrastructure investment would allow ACCOs to focus on service delivery, rather than juggling an ever-growing list of stop-gap repairs”.
Consumer and public health groups
Many health groups commenting on the Budget and the election promises of the major parties have identified a lack of commitment to structural reform of the healthcare system.
In an article in The Conversation, Professor Stephen Duckett AM, sometime head of the health program at the Grattan Institute, said “despite big money pledged for Medicare and the Pharmaceutical Benefits Scheme, only limited attention has been paid by the major parties to key reform priorities”.
He identified the need for policy action in five areas:
- addressing the growing gap between what specialists charge and what Medicare will cover, which means some patients are delaying or avoiding necessary care altogether
- implementing the new systems proposed by the Strengthening Medicare Task Forceand the GP Incentives Review to fund general practices to facilitate multidisciplinary care for people which chronic conditions and complex needs
- a “sophisticated route” towards universal access for dental care, and continued development of the universalprogram for people with low-to-moderate mental health needs (which doesn’t require either a referral or a co-payment) announced in the last Budget
- increasing the Commonwealth share of public hospital funding to 45 percent
- expanding the scope and capacity of the health workforce by adopting revised funding models – as proposed in the GP incentives review – and allowing all health professionals to work to their full scope of practice.
COTA released the results of polling it had commissioned showing that the top three election issues for older people were the cost of groceries and other day-to-day expenses; energy bills and other utility bills; and healthcare and medicines.
COTA Australia Chief Executive Patricia Sparrow said “we’ve already seen some good cost of living measures announced by our politicians, but we’re looking forward to seeing more including on things like the introduction of a Seniors Dental Benefit Scheme and targeted housing support”.
The George Institute set out its election priorities, including:
- establishment of an Australian Centre for Disease Control that addresses both infectious and noncommunicable diseases
- implementation of a blended payment model for primary healthcare providers
- development and implementation of a First Nations-led climate action plans that address climate emergency impacts alongside food and water insecurity, as well as health prevention, management and treatment
- establishment of a new Centre of Excellence for Sex and Gender Equity in Health and Medicine
- increasing spending on supporting health systems in the region
- increasing the National Health and Medical Research Council budget by 30 percent to cover the full costs of research including indirect costs.
Palliative Care Australia (PCA) issued a statement calling for “detail on how the next steps in aged care reform will ensure a dignified death for the 400 Australians who die each day of predictable causes”.
PCA said the Support at Home End of Life Pathway, due to come into place on 1 July this year, would mean more people over 65 with terminal illness can receive end of life care at home, where 90 percent of people want to be cared for.
However, there were problems with the Pathway, PCA said.
Current plans are that eligibility will be limited to those with a life expectancy of three months or less and who are bed-bound most of the time, but PCA argued that it should be based on need. Now there’s a radical concept for aged care!
PCA Chair Dr Peter Allcroft said “with an ageing population, the need for palliative care will only increase further for the foreseeable future”.
“Those who seek to form the next government need to outline their plans to make sure palliative care is available to everyone who needs it.”
The Public Health Association of Australia (PHAA) published its Election Scorecard, rating the commitments made by the Government, the Coalition, and the Greens against seven priorities put forward by public health experts.
PHAA said “while the Greens scored seven ‘green lights’ for their commitments to increasing investment in prevention, action on obesity, Aboriginal and Torres Strait Islander health, climate and health, gambling reform, oral health care and establishing a permanent Centre for Disease Control, the Government only received two green lights, and the Coalition none”.
The Coalition made it clear in its response to the PHAA that it did not believe there was a case for an independent Australian Centre for Disease Control – see this Croakey article for more on the issue.
PHAA CEO Adjunct Professor Terry Slevin said “neither party seems to be talking about how we are going to reduce the pressure on the health system and keep more Australians out of our already strained hospitals and doctors’ waiting rooms”.
“It’s not just a health failure; it’s an economic fiasco,” Slevin said.
“Both parties are keen to establish themselves as good financial managers, but failure to invest in prevention will render our national health budget financially unsustainable.”
Trade unions
The Australasian Institute of Digital Health said that improved patient care hinges on health information sharing, and called on the “next Federal Government… to prioritise standards-based infrastructure and health information sharing to build a more efficient, connected and patient-centred health system”.
The Australian College of Nursing called for “a fundamental rethink of Australia’s approach to healthcare in the next term of government, with the current system persistently failing to address key factors that affect health and wellbeing, like poor nutrition, housing and poverty”.
It released a paper Achieving a Socialised Model of Health Care in Australia with Nurse Leadership, which “proposed a fundamental shift away from the current model, which focuses on diagnosing and treating diseases rather than addressing social determinants of health”.
The Australian Dental Association released its traditional pre-Easter advice on how to minimise the damage from eating Easter eggs, claiming “we’re the Easter bunny, not the fun police”. As if!
The AMA launched its election platform, calling for “immediate action to Modernise Medicare and lift our public hospitals out of logjam”.
Specific recommendations included:
- a new seven-tier GP Medicare rebate structure to support patients to spend more time with their GP
- a new national health reform funding agreement to end the hospital logjam, with an additional $12.5 billion from the federal Government and $15.3 billion from states and territories over four years
- establishment of a private health system authority to drive meaningful reform and ensure patients get real value from their private health insurance
- a tax on sugar-sweetened beverages
- an expansion of the Workforce Incentive Program to enable more nurses and allied health professionals to work in general practice
- an independent national health workforce planning agency.
These ideas have been the subject of AMA advocacy for some time – so far with little result.
The AMA also released its latest Ambulance Ramping Report Card, showing ambulance ramping in many states is still double what it was five years ago.
AMA President Dr Danielle McMullen said “while the Government recently locked in some welcome additional funding for public hospitals, whoever wins government must expedite a new National Health Reform Agreement”.
McMullen added “there was also a need for greater transparency in data, with each state and territory reporting data differently making it impossible to accurately compare jurisdictions”.
(Whoever prepared the report card is to be commended for their efforts in tracking down data over time.)
The Australian Primary Health Care Nurses Association (APNA) reported on focus groups it had held with Australian nurses to identify their concerns in primary healthcare.
It found that nurses are underutilised, undervalued by the health system, and not respected as highly skilled healthcare professionals.
APNA argued that “nurses must be supported to work to their full scope of practice, recognised as health care leaders, and respected as skilled health clinicians essential for quality patient care”.
The Royal Australasian College of Physicians (RACP) said “paediatricians are receiving frantic calls from parents concerned about their children’s mental, physical and emotional state should they be unable to get their ADHD medication, as further shortages are predicted”.
Last year Vyvanse was in short supply for several months; a current shortage of Concerta is predicted to last until the end of the year; and the Therapeutic Goods Administration (TGA) recently warned that other ADHD medications, including long-acting Ritalin, are also expected to be in shortage.
The RACP has been calling for action on medicine shortages for some time, but while the Government has undertaken several consultations (here and here), action has so far not eventuated.
After marking National Unicorn Day last week, the RDAA marked National Banana Day this week, saying that further action was needed to address the ability of people in rural and remote communities to access nutritious food, such as bananas, at affordable prices.
President of the RDAA Dr RT Lewandowski called on the next Government to extend the recently announced food security strategy so that everyone in rural and remote areas can buy nutritious food at affordable prices.
Industry groups
The Australian Healthcare and Hospitals Association (AHHA) called “on all parties in this election to commit to and invest in strong national stewardship that enables regional health services to innovate and reform care delivery”.
Slightly more specifically, AHHA suggested:
- an expanded role for the Australian Centre for Evaluation in developing a nationally consistent framework to measure healthcare service impact – focusing on outcomes that matter to people and communities – to guide government program design and funding toward greater value
- investment in Learning Health Systems, to foster a culture of continuous improvement by systematically integrating data, research, and practice to enhance health outcomes.
Catholic Health Australia published an extended article on the issues bedevilling the “reform” of the Prescribed List – the list of prostheses which private health insurers are compelled to fund when supplied as part of a hospital episode.
When the list was introduced in 1984, it essentially covered artificial joints, but it has since expanded to include General Use Items (many of which are in the nature of consumables) as well as high-tech items such as surgical guides and biomodels.
As long as the List exists as a funding mechanism alongside hospital contracts, there will be ongoing tension about its scope and benefit levels.
The only definitive solution would be for the Government to announce the abolition of the List entirely with a lead time of five years, allowing time for hospitals and insurers to negotiate contracts for hospital services that covered the full costs of providing episodes of hospital care including prostheses and prosthesis-like items.
At the end of March, I reported on CHA’s highly critical response to the exposure draft of the new Financial and Prudential Standards released by the Aged Care Quality and Safety Commission.
This week CHA said it was “engaged in ongoing dialogue with the Government and the Commission on the standards”.
CHA was seeking amendments to allow providers to identify and report on their own minimum liquidity amounts OR reduce the agreed percentage to between 5 to 10 per cent of RAD balances; exclude non-residential aged care business units from the calculation; ensure liquidity is broadly defined to include all relevant assets of a provider; and delay implementation for 12 months to support sector adoption.
As aged care providers hold over $38 billion in refundable accommodation deposits – about as much as the credit union sector holds on deposit – perhaps they should simply be subject to Australian Prudential Regulation Authority (APRA) supervision and standards in relation to their financial affairs.
International
United States President Donald Trump signed an executive order directed at lowering prescription drug prices, including by “facilitating importation programs that could save states millions in prescription drug costs”.
This followed a statement by Trump less than a week earlier foreshadowing the announcement of “major” tariffs on pharmaceuticals.
CNN reported that “patient advocates and drug supply chain experts warned tariffs are likely to drive the price of medicines higher and exacerbate already dangerous drug shortages”.
Yet further evidence (as if it was needed) that the Trump Administration is making things up as it goes along.
Finally
Finally this week, more on aged care quality.
Echo Law announced it had begun a class action against Bupa on behalf of residents of Bupa aged care homes between 1 July 2019 and 11 April 2025 who have experienced substandard care.
Echo said “the class action is based on allegations that Bupa Aged Care Australia has failed to provide residents with the minimum acceptable level of care required under Australian law, at each of its aged care homes. Bupa’s own reporting confirms systemic understaffing”.
Echo alleged that Bupa Aged Care failed to provide staffing levels that would meet minimum acceptable standards in each of its aged care homes, and has thus:
- breached its contractual obligations to residents
- breached consumer guarantees under the Australian Consumer Law, by failing to provide services that are fit for purpose and delivered with due care and skill.
The Aged Care Royal Commission heard that in 2017 Bupa implemented a national “save a shift” policy, under which local management were encouraged not to replace staff members who called in sick before a shift.
The Government’s aged care star ratings system, of course, allows homes that have breached one, more, or all of the Aged Care Quality Standards to receive a three-star or better rating, indicating an acceptable level of care. It also allows providers to receive a three-star rating for staffing while not meeting both the total time and registered nurse time requirements.
Perhaps Bupa’s lawyers will call Government witnesses in their defence?
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.
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
Therapeutic Goods Administration
Proposed amendments to the Poisons Standard
21 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.
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