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The Zap: growing the First Nations workforce, aged care news, pharmacy owner profits – and a buzzword salad of a consultation

Developments in the First Nations health workforce, aged care, pharmacy and nursing are covered in the latest edition of The Zap.

Policy analyst Charles Maskell-Knight also hopes that the impending “refresh” of the 2017 National Strategic Framework for Chronic Conditions brings less verbiage, fewer platitudes and greater impact.

And he sounds a note of caution about the COVID-induced rush on pet ownership.

The quotable?

Fido and Felix may be good for your wellbeing, but make sure you don’t fall over them.”


Charles Maskell-Knight writes:

Last week saw two major aged care stories emerging from government.

The first was the release – three months after completion – of the report of the Aged Care Taskforce. However, despite the fact the Aged Care Minister chaired it, and despite having had three months to think about it, the Government is still considering its response to the 23 recommendations from the Taskforce.

For non-paywalled commentary on the report, see Michelle Grattan in The Conversation, Anne Connolly at the ABC, and my article in Croakey.

Professor Kathy Eagar summed up the situation in a pithy tweet: “Aged Care Taskforce, chaired by the Minister Anika Wells and composed of aged care sector representatives with vested interests, wants older people to pay more. No surprises there. Where are proposals to improve transparency, improve quality & regulate profit?”

The second major aged care story was the decision by the Fair Work Commission in the latest stage of the work value case for the aged care sector. It awarded a further wage increase for direct care workers of an average 23 percent, including the 15 percent awarded in an interim decision in late 2022. Support staff who regularly deal with residents received an increase of almost seven percent.

In a brief statement Ministers Mark Butler and Anika Wells joined Workplace Relations Minister Tony Burke in welcoming the decision, and reiterating the Government’s commitment to “provide funding to support increases to award wages made by the Fair Work Commission in this matter and… help deliver a higher standard of care for older Australians”.

Health Services Union National President Gerard Hayes said the decision was an historic improvement: “Most of the aged care workforce itself can now imagine and plan for fully fledged careers, where people can plan a life around their work and really commit to it. Many workers have subjected themselves to the edges of poverty and homelessness to work in this industry. Now they can care for the elderly and also provide for themselves and their family.”

Ministers and government

As I foreshadowed in The Zap for last week, Assistant Minister Ged Kearney convened a Women’s Health Summit on 14 March. Dr Lesley Russell will be reporting on the summit as part of a wider report on women’s health in the next edition of The Health Wrap.

Assistant Minister Malarndirri McCarthy attended the launch by the National Aboriginal Community Controlled Health Organisation (NACCHO) of the First Nations Health Worker Traineeship program, which aims to certify up to 500 First Nations individuals as either Aboriginal Health Workers or Aboriginal Health Practitioners by 2027.

NACCHO said that “the program has been developed and designed by Aboriginal and Torres Strait Islander organisations and is being delivered in genuine partnership with government”.

NACCHO Chair Donnella Mills said that the program would “not only strengthen pathways for our existing workforce but also open doors for individuals in local communities to embark on careers as Health Workers and Health Practitioners”.

Minister Butler and Pharmacy Guild President Trent Twomey both announced that the Government and the Guild had signed a Heads of Agreement for the 8th Community Pharmacy Agreement (8CPA).

Butler said that “the Agreement will deliver cheaper medicines, improve patient health outcomes and secure a strong community pharmacy sector… and provide up to an additional $3 billion for community pharmacy and cheaper medicines”. The parties will work to finalise the deal by 1 July.

Butler also announced a trial of six nurse practitioners in general practices in SA. The nurse practitioner service will be free of charge, and “increase the capacity of GP clinics and other primary care providers to see and treat more patients”. The announcement did not include any details of an evaluation process.

In the associated media conference, Butler said that next week he will be “introducing legislation to remove the so-called ‘collaborative arrangements requirement’ [which] means that nurse practitioners can only work under the direct supervision of a doctor, effectively having a doctor look over their shoulder when they’re delivering care that they’re fully qualified to deliver. We’ll remove that so that nurse practitioners will be able to work with the autonomy that their qualifications and their experience deserve”.

This legislation appears to be the culmination of the Collaborative Arrangements Project described on the Department’s website.

Assistant Minister Emma McBride announced that she would be attending the “High-Level Segment” of the UN Commission on Narcotic Drugs in Vienna on 14-15 March to discuss “a diverse range of drug-related matters”.

Her announcement coincided with the release by the Australian Criminal Intelligence Commission of its 21st report on Wastewater Drug Monitoring, covering the year to August 2022. It estimated that more than 30 tonnes of methamphetamine, cocaine, heroin, MDMA and THC (cannabis) were consumed across Australia during that time.

Methamphetamine consumption increased from about nine tonnes to 10.5 tonnes, which the Commission described as a “considerable concern, due to the significant community harms caused by the drug”. On this basis the seizure of 106 kilograms announced by Border Force recently only reduced supply by one percent.

The Department of Health and Ageing opened consultation on a “refresh” of the 2017 National Strategic Framework for Chronic Conditions, which “is the overarching policy for chronic conditions in Australia and provides guidance for the development and implementation of relevant policies, strategies, actions and services”. Reading the existing framework is like wading through a trough of regurgitated buzzword salad.

The first objective of the existing framework is focusing on prevention, and the first measure of success is that “the proportion of Australians living with preventable chronic conditions or associated risk factors is reduced”.

Given that the proportion of Australians who are overweight or obese continues to increase, the framework has fallen at the first hurdle. Perhaps a refreshed version with less verbiage and fewer platitudes will be more successful?

The consultation closes on 19 April.

Consumer and public health groups

The Public Health Association of Australia, in Partnership with Beyond Blue, held a Preventive Mental Health Symposium on Tuesday 12 March 2024.

Advertising the event, the organisers said “The situation is urgent. The prevalence and impact of mental health conditions continues to rise and the demand for mental healthcare services is exceeding their availability… A growing number of evidence-based programs are available to promote people’s mental wellbeing and reduce their risk of experience a mental health condition but there remains a substantial gap between ‘what works’ and what is happening in practice and policy”.

COTA, OPAN, and National Seniors Australia joined nine other organisations in making a joint submission to the consultation process on the new Aged Care Act, highlighting the need for:

  • enforceable rights of older people that address the current power imbalance
  • a robust, independent complaints system
  • transparency of timelines and funding
  • strong regulation and penalties for those found guilty of not upholding the rights of older people
  • a guaranteed right to aged care visitors at all times.

COTA issued a delightfully noncommittal statement about the Aged Care Taskforce report, supporting the process but avoiding endorsement of any particular recommendation. COTA is “looking forward to seeing the Federal Government’s response to the Taskforce report”. Aren’t we all?

National Seniors Australia CEO Chris Grice took a broadly similar approach in an interview with the ABC, while Dementia Australia issued a media release supporting the recommendations.

The Consumers Health Forum welcomed the release of the End Gender Bias report at the Women’s Health Summit. CEO Dr Elizabeth Deveny said “when consumers can advocate their needs in the health system, we know it results in better service design, delivery and update. We need women who have experienced gender bias involved in healthcare policy decision making and program design”.

Trade unions

The Royal Australian College of General Practitioners (RACGP) issued a heated media release headed “Patients must come ahead of incumbent pharmacy owner profits”, occasioned by a bill introduced to the Queensland Parliament to replace the Pharmacy Ownership Act 2001. The bill preserves the current limitations in section 139B of the Act on anyone but a pharmacist owning a pharmacy.

RACGP Queensland Chair, Dr Cathryn Hester, said that “review after review after review has recommended the removal of pharmacy location and ownership rules… the Productivity Commission has called out that existing ownership rules clearly have harmful consequences for consumers in terms of reduced access to medicines, reduced competition, and innovation”.

The Queensland branch of the Australian Medical Association (AMA) joined in, with branch president Dr Maria Boulton saying that “removing pharmacy ownership restrictions to enable Aboriginal health services to own and operate pharmacies would support commitments made by all governments in the National Agreement on Closing the Gap. It is outrageous that the Queensland Government is completely disregarding its own Closing the Gap commitments with these unnecessary, anti-competitive regulations that only serve to entrench the power of existing pharmacy owners”.

While I agree that pharmacy ownership restrictions are a nonsense, unless the Commonwealth also amends its rules around the PBS, changes to state law are nugatory.

The RACGP called on the Queensland Government to match the WA one in introducing a free infant immunisation program for RSV (respiratory syncytial virus). It also