As National Reconciliation Week (27 May-3 June) draws to a close, The Zap covers news from the Coalition of Peaks, and reports on a new guide promoting culturally safe and responsive primary care for Aboriginal and Torres Strait Islander patients.
Our columnist also reports the latest on a sugar tax, and details of the Shadow Ministry, a new publication on the digital determinants of youth mental health, and a war of words over private hospital funding matters. Plus there’s a job going at the Grattan Institute that may be of interest.
Meanwhile, the private hospital sector has been challenged to improve the value it provides, at a time of concern about unpredictable and rising out of pocket costs.
The quotable?
… when hospitals are owned by private equity firms, as in the case of Healthscope, there’s growing concern, backed by international evidence, that quality of care will take a back seat to profit.”
Charles Maskell-Knight writes:
Several weeks ago I included in this column reports that Brookfield, the North American owner of the Healthscope private hospital group, was proposing to transfer control of the hospitals to the owners of the debt Brookfield had issued to fund the acquisition.
It appears that the debt owners were not interested in becoming hospital operators, and on 26 May receivers were appointed to Healthscope’s parent entities with a view to selling the business.
The hospitals have a current cash balance of $100 million, and the Commonwealth Bank has provided a new $100 million funding package to support operations during the sale process if required.
Healthscope said its “37 hospitals all remain open and operating on a business-as-usual basis with no impact on staff, doctors or patient care”.
Health Minister Mark Butler said: “Government has been meeting regularly with Healthscope and we have clear expectations the hospital group, lenders, and landlords [will] act cooperatively and deliver the least disruptive outcome for patients, staff, and the broader health system”.
He added that “there will be no taxpayer bailout”.
“An orderly sales process that maintains the integrity of the entire hospital group will provide the best outcome for patients, staff, landlords and lenders,” he said.
Asked in a media conference about the wider implications of the receivership for private hospitals, Butler said: “I think people who observe this part of our healthcare system understand that Healthscope and its ownership structure, particularly over the last several years, is something of a unique case, something of an outlier.
“I wouldn’t draw any sector-wide extrapolations from what’s happening in this company.”
Several days later at another media conference, Butler was asked if he would be happy to see private health insurers buying Healthscope hospitals.
He responded “for a long time now we’ve had a position in Australia that the funders or the insurers should not also be vertically integrated into the delivery of care services”.
“I know the Australian Medical Association and other stakeholders have a strong view about that,” he said. “We would want to look at that very, very closely before we saw any further vertical integration between insurers into the delivery of care.”
Australian Medical Association (AMA) President Dr Danielle McMullen said the AMA “welcomed the commitments given as part of today’s announcement that the operation of Healthscope’s hospitals will continue as normal and that additional funding has been provided to support their operation [and] the receiver’s stated intention to transition all hospitals to new ownership, with no plans for hospital closures or redundancies”.
The Australian Nursing and Midwifery Federation (ANMF) said it was “extremely disappointed and concerned by the financial collapse of Healthscope”, but “reassured to hear from Healthscope that additional funding had been guaranteed to ensure all its hospitals keep operating without impacts on staff or patients”.
ANMF Federal Secretary Annie Butler said the union was “working with state and federal governments and all stakeholders to ensure that we are front and centre of discussions with potential buyers so we can ensure our members will be in safe hands”.
The Australian Healthcare and Hospitals Association (AHHA) used Healthscope’s announcement as the occasion to argue that “with the renewed momentum from the recent federal election, now is the time to seize the opportunity to host these challenging conversations about health system reform and deliver care that reflects what matters to Australians in a sustainable and equitable way”.
AHHA seems to have confused the re-elected Albanese Government with one that is interested in health system reform.
The Pharmacy Guild used the announcement as an excuse for a sermon on the evils of corporate ownership of health services.
Guild President Professor Trent Twomey said “the Healthscope collapse is a sobering reminder of the risks posed by the corporatisation of essential health services”.
“Outside of public ownership, the only proven model of healthcare delivery that maintains accessibility and affordability is practices that are owned by practitioners,” he said.
I am not sure how this model can be applied to private hospitals. Perhaps they will be owned and operated by anarcho-syndicalist communes of specialists, who will take it in turns to act as executive officer for the week.
Elizabeth Baldwin and Peter Breadon from the Grattan Institute wrote an article arguing that “instead of yet more subsidies, or a sharp rise in premiums for patients, the best path to viability [for the private hospital sector] is value”.
“The key is changing how insurers and patients pay for care,” they said.
They propose:
- a minimum “efficient price” for private hospital episodes, set by the Independent Health and Aged Care Pricing Authority
- allowing insurers to refuse to pay for low-value or unsafe care, as determined by the Australian Commission for Safety and Quality in Health Care
- requiring hospitals to provide patients with a single, bundled bill that covers the surgeon, anaesthetist, prosthesis, imaging and rehabilitation.
Professor Anthony Scott from Monash University explored some of the implications of the issue in an article in The Guardian, concluding that “the private system must reckon with its value proposition”.
“While it may offer shorter wait times, care from senior specialists and private rooms, these benefits are increasingly offset by unpredictable and rising out of pocket costs,” he said.
“And when hospitals are owned by private equity firms, as in the case of Healthscope, there’s growing concern, backed by international evidence, that quality of care will take a back seat to profit.”
Shadow Ministry
Leader of the Opposition Sussan Ley announced the Shadow Ministry on 28 May.
Senator Anne Ruston retained her role as Shadow Minister for Health, Aged Care and Sport, but added disability and the NDIS to her responsibilities.
Phillip Thompson OAM became Shadow Assistant Minister for the National Disability Insurance Scheme, Zoe McKenzie became Shadow Assistant Minister for Mental Health, and Sam Birrell became Shadow Assistant Minister for Regional Health.
Outside the health portfolio Senator Kerryanne Liddle became Shadow Minister for Indigenous Australians.
In a sign of how health policy is not a subject of contention between the major parties, the ABC news blog report on Wednesday afternoon of the ten “the most significant shadow ministry appointments” did not include the health portfolio.
The Australian College of Nursing welcomed the new shadow ministry, and “urged the Coalition to adopt a bipartisan approach to support the transformative health reform agenda awaiting implementation by the returned Labor Government”.
The Australian College of Rural and Remote Medicine (ACRRM) said the reappointment of Shadow Minister Ruston “will bring continuity and experience at a time when rural healthcare reform remains a national priority”.
Ministers and Government
Minister Butler announced the Government was extending the MBS Heart Health Check items for a further three years.
The ABC reported that Minister Butler had asked the Department of Health, Disability and Ageing to investigate clinics offering ultrasounds to pregnant women for “reassurance” purposes, without providing reports to the women’s obstetrician or GP.
Under current arrangements, sonographers are not covered by the National Registration and Accreditation Scheme (NRAS), so are not registered and are not subject to requirements such as competency standards or recency of practice requirements.
The Australasian Sonographers Association has been advocating for some time for sonographers to be regulated under NRAS through the Medical Radiation Practice Board of Australia.
The Australian Institute of Health and Welfare (AIHW) released data on Attitudes and perceptions towards drugs by region drawn from the 2022-23 National Drug Strategy Household Survey.
The AIHW also released monthly data on Medicare billing, Pharmaceutical Benefits Scheme prescriptions, and GP consultation bulkbilling rates.
The Independent Hospital and Aged Care Pricing Authority (IHACPA) released the Pricing Framework for Australian Residential Aged Care Services 2025–26, accompanied with a report on the outcome of consultations on the draft framework.
One of the issues in pricing care services is the choice between pricing how care is delivered or pricing how care ought to be delivered.
This is particularly important for allied health services in aged care.
IHACPA said “stakeholders were concerned with the current approach to pricing and costing of allied healthcare, which accounts for the level of care currently provided, not the level of allied health care clinically assessed for residents”.
Ahpra said the Nursing and Midwifery Board of Australia (NMBA) had released an advance copy of the new Registration Standard: Endorsement for Scheduled Medicines – Designated Registered Nurse Prescriber.
This standard to take effect in September this year will allow qualified RNs to apply for endorsement to prescribe Schedule 2, 3, 4, and 8 medicines “in partnership with authorised health practitioners under a clinical governance framework and an active prescribing agreement”.
Ahpra and the Medical and Dental Boards issued a joint statement on the compassionate release of superannuation (CRS) to fund medical and dental treatment.
This statement said “the significant increase in approvals for the use of CRS for dental treatments in recent years, raises concerns that some practitioners may be placing profits over patient care”.
It also said that “the practice of practitioners with high rates of report writing that indicate inappropriate patient assessment may be occurring” was under close examination.
The statement said practitioners should “put their patients’ best interests first, providing treatment options that are based on the best available information and are not influenced by financial gain or incentives [and] be honest and not misleading when writing reports to support the release of superannuation”.
The Australian Bureau of Statistics (ABS) released data on serum levels of per- and polyfluoroalkyl substances (PFAS) drawn from the National Health Measures Survey 2022-24.
First Nations
Reconciliation Week runs from 27 May to 3 June.
Croakey has published a number of pertinent articles, including Romlie Mokak’s 2025 Lowitja O’Donoghue Oration.
NACCHO issued a statement marking the week and supporting the National Closing the Gap Agreement.
NACCHO CEO and Lead Convener of the Coalition of Peaks, Pat Turner AM, said “a reconciled Australia is a country in which Aboriginal and Torres Strait Islander people have full control over our own destinies”.
“A country where we live freely and equally, unencumbered by trauma and poor life outcomes, and where there is true recognition of our rights as First Peoples of this land, and our cultures and languages are honoured, protected and flourish,” she said.
The Coalition of Peaks challenged those wanting to be brave and make change this National Reconciliation Week to:
- become familiar with and learn about both the Partnership and National Agreements
- support their implementation and promote them in your own organisation or business
- encourage your community to become involved
- talk to governments on how to apply the commitments under the Agreements to communities and organisations across the country.
The Rural Doctors Association of Australia (RDAA) said Reconciliation Week is a time for Australians to come together and look for ways to build a united and respectful future for our country.
RDAA President Dr RT Lewandowski said “many Aboriginal and Torres Strait Islander people are part of rural and remote communities and cared for by rural doctors”.
“As doctors we have certainly seen the impact that Australia’s reconciliation journey has had, is having and will continue to have on the health and wellbeing of our First Nations patients,” he said.
“We join Reconciliation Australia in calling all Australians to reflect on the connection between our lives today, the lives of the past and how Australia will be shaped going forward.”
The Royal Australian College of GPs (RACGP) and the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP) launched a new guide to help ensure the primary care Aboriginal and Torres Strait Islander patients receive is culturally safe and responsive.
RACGP President Dr Michael Wright said “National Reconciliation Week is the perfect opportunity to promote this comprehensive resource”.
NAATSIHWP CEO Karl Biscoe said “it was an honour to collaborate with the RACGP and offer this guide as a tool for general practices to strengthen their multidisciplinary teams, through the sustainable integration of our Aboriginal and/or Torres Strait Islander Health Worker and Practitioner Workforce”.
Consumer and public health groups
The Grattan Institute is advertising for a Senior Associate in its Health Program.
As well as at least five years’ work experience overall and a minimum of a year working on health policy, the ideal candidate will have excellent communication, analytical and research capabilities, and will thrive on complexity.
There must be a Croakey reader out there looking for a change of scene!
The Public Health Association of Australia (PHAA) said that recent research published in the Australian and New Zealand Journal of Public Health found that:
- 83 percent of Australians were in favour of better labelling of sugary drinks to warn consumers that they contain added sugars
- 73 percent were supportive of stopping sugary drinks from being marketed to children
- more than half of Australians (56 percent) believed that sugary drinks should have a health levy tax applied.
Lead author Professor Caroline Miller, Director of the Health Policy Centre at SAHMRI and PHAA President, said the research “should encourage the Government to take proactive steps that put the health of Australians above the profits of commercial beverage companies”.
It appears the Government is not yet encouraged. Asked to respond to the research on Sunrise, Minister Butler said “there is no plan in our Government for a sugar tax”.
“We’re instead focusing on education and also working with food manufacturers to reduce the amount of sugar that they put into their products,” he said.
Given one popular soft drink increased its sugar content by 60 percent between 2020 and 2024, “working with food manufacturers” does not appear to be working too well!
Universities
Charles Darwin University (CDU) said some of its pharmacy graduates have become the first in Australia to be awarded the title of “Doctor of Pharmacy”.
This follows accreditation changes announced by the Government in late 2024, which recognise extended master’s programs under the Australian Qualifications Framework (AQF) Level 9.
CDU said the new title “marked a significant advancement in acknowledging the evolving clinical responsibilities of pharmacists”.
Trade unions
The Australian Association of Psychologists (AAPi) said while it supported the NSW Government’s decision to allow trained GPs to provide more support for patients with ADHD, it would like to see the important role of psychologists in the assessment, diagnosis and treatment of ADHD acknowledged.
AAPi Chief Services Officer Amanda Curran said the general practice reforms would make diagnosis and treatment more accessible for NSW residents, but “it is imperative that there also be processes in place to ensure that a psychologist’s assessment and treatment are accessible and affordable”.
The RACGP threw its support behind the Queensland Government’s announcement of a $40,000 incentive package available for all GPs in training to boost the GP workforce starting their primary care training anywhere in Queensland in 2025.
RACGP Queensland Chair Dr Cathryn Hester said “the RACGP is pleased to have worked behind the scenes with the Crisafulli Government to provide this crucial support to GPs in training”.
“We know it will boost GP availability in communities across the state, and supporting the GP workforce is essential for a healthy Queensland,” she said.
ACRRM also welcomed the announcement.
The RACGP “urged leaders at all levels of government to ensure no rural Tasmanian communities miss out on vital general practice care”.
Associate Professor Michael Clements said more could be done to boost rural general practice care across Australia, including Tasmania, including “incentives such as a helping hand on childcare, housing, and spousal employment [and] additional support to rural practices taking on GPs in training”.
The Royal Australasian College of Physicians (RACP) said a new study featured in this month’s Internal Medicine Journal “suggests that liver cancer patients in rural areas have lower survival than metropolitan patients, with patients in rural areas passing away 2.53 years after diagnosis, compared with 4.7 years for patients in metropolitan areas”.
The RACP said the research highlights the health inequities faced by rural patients wanting to access specialist care and the dire need to address them.
Senior author Dr Tim Mitchell commented: “To improve health outcomes for liver cancer patients, state and federal Governments need to be investing in technology and supports we know our patients need: improving the awareness and diagnosis of chronic liver disease, services that address the underlying cause of liver disease, for example addiction medicine, and accessibility of medical technology.
“We also need investment in research to optimise liver cancer surveillance, ideally using a blood test rather than a scan, which is critical to improve access and timeliness of diagnosis and treatment”.
Industry groups
Australian Pathology said “throughout the election campaign, we called on the Government to reverse the cuts [to pathology benefits], and increase the funding”.
“Unfortunately, no such commitment has been made, which means that out of pocket costs to patients are becoming imminent,” the organisation said.
The Australian Private Hospitals Association (APHA) reacted to news of the imminent closure of the Toowong Private Hospital (an independent psychiatric hospital in Brisbane) with a statement lambasting greedy private health insurers for underpaying hospitals and Minister Butler for not fixing the problem.
APHA CEO Brett Heffernan said “make no mistake, Toowong’s closure is due to insurance company greed and the Federal Government’s failure to act to fix the failed, abuse-riddled funding model”.
Just to be clear, the funding model involves insurers and hospitals negotiating contracts setting the terms under which patients will be treated, with the Government regulating a default benefit regime if a contract cannot be agreed.
The APHA, Catholic Health Australia (CHA), and Private Healthcare Australia (PHA – the private health insurers lobby group) all responded to the release of the March quarter private health insurance statistics by the Australian Prudential Regulation Authority (APRA).
The APHA said “Insurers paying even less from their growing coffers”; CHA said “Private health insurers paying out less to patients”; and PHA said “Private hospitals receiving record high payments from health insurers as more people take out health cover”.
And, yes, they were all talking about the same set of figures.
APHA and CHA focused on the benefits to premium ratio, which fell to 80.7 percent in the March quarter (due largely to reduced elective surgery activity as a result of summer holidays).
PHA focused on the 7.7 percent increase in hospital benefits in the year to March 2025 compared with the previous year.
Readers seeking a more disinterested and nuanced discussion of the private hospital funding issue should read this LinkedIn post by Andrew Gibbs, which suggests that service volume rather than price per episode is the underlying problem affecting private hospitals.
The Pharmacy Guild said “community pharmacies can provide the RSV vaccine for free for eligible patients which will provide important protection during the winter months”.
The Guild is “encouraging those in higher risk groups, or who are concerned, to visit their community pharmacist”.
International organisations
The World Health Organization Regional Office for Europe released a policy brief Addressing the digital determinants of youth mental health and well-being.
The brief notes that “the evidence on the impact of technology use is mixed: studies indicate both positive and negative associations between technology use and young people’s well-being…
“Notably, the effects of technology are not uniform across all young people: the most vulnerable young people disproportionately experience negative impacts.
“Furthermore, certain online activities may have both positive and negative effects simultaneously, such as enabling self-expression while exposing young people to harmful content or behaviours. This dual impact highlights the complexity of technology’s influence on well-being”.
The brief proposes eight priorities for policy action. These do not include a ban on social media for children and adolescents, as is due to come into effect in Australia later this year.
Insightful exchange
Finally this week, an insight into journalism rather than health from this exchange at a Minister Butler media conference:
JOURNALIST: Is it disappointing Sussan Ley has promoted women over men?
BUTLER: Has promoted men over women?
JOURNALIST: Women over men, it says here.
BUTLER: I think that might be a typo, because what we’ve seen is a number of women punted from Shadow Cabinet and replaced by men, and that just shows again that the Liberal Party, and the Coalition more broadly, just hasn’t got the message about the representation of women in Australian politics.
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.
Independent review of the National Registration and Accreditation Scheme
Second consultation paper
6 June
Productivity Commission
How to deliver quality care services more efficiently
9 June
Independent Health and Aged Care Pricing Authority
Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2026–27
13 June
Therapeutic Goods Administration
Proposed amendments to the Poisons Standard
13 June
Paramedicine Board of Australia
Proposal to regulate advanced practice paramedics
20 June
Aboriginal and Torres Strait Islander Health Practice Board
Accreditation Consultations
25 June
Chinese Medicine Board of Australia
Accreditation Consultations
25 June
Medical Radiation Practice Board of Australia
Accreditation Consultations
25 June
Podiatry Board of Australia
Accreditation consultations
25 June
Therapeutic Goods Administration
Adoption of International Scientific Guidelines in Australia
30 June
Office of the Gene Technology Regulator
Risk Assessment and Risk Management Plan for a commercial release of a genetically modified (GM) mosquito strain to help prevent dengue outbreaks.
7 July
Australian Commission on Safety and Quality in Health Care
Australian Safety and Quality Medical Imaging Accreditation Scheme
18 July
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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