Efforts to improve aged care, falls prevention, out of pocket costs for cancer patients, and the importance of the community controlled sector for improving Aboriginal and Torres Strait Islander health are among the topics covered this week.
As Australian Private Hospitals Association CEO Michael Roff left the organisation after 30 years (24 as CEO), he said the secret of his success was “to employ people who are smarter than me, and then… do what they tell me”.
The quotable?
Older people’s right to safe, high-quality care, and a system that can financially support that, transcends politics.”
Charles Maskell-Knight writes:
The Ministerial reshuffle announced by Prime Minister Anthony Albanese on 28 July saw Assistant Minister for Indigenous Health Malarndirri McCarthy promoted to Minister for Indigenous Australians, while Assistant Minister for Health and Aged Care Ged Kearney took over responsibility for Indigenous health.
Minister for Aged Care Anika Wells is apparently working so hard that she needs an assistant – who knew? Kate Thwaites (aged 44) has been appointed as Assistant Minister for Ageing.
COTA welcomed the appointment as “a positive sign of the Government’s intent to address the significant challenges of ageism and an ageing population”, while National Seniors Australia said the appointment “is recognition that older Australians need to be better represented in the deliberations of the Federal Government”.
Croakey editor in chief Dr Melissa Sweet covered the changes and reaction from the health sector in this article.
Ministers and government
In an interview with ABC Adelaide radio on Wednesday 31 July, Health Minister Mark Butler spoke about the shortage of intravenous saline. Apparently over 80 percent of Australian supply comes from one local manufacturer, which is working at full capacity. As hospital activity has increased post-COVID, demand for saline has increased globally.
Butler said that the Therapeutic Goods Administration had approved a number of alternative overseas suppliers, and the Government was “pretty actively managing [saline supply]… working with states and territories, but also with private hospitals, very carefully to make sure that there’s no interruption to [hospital] activity”.
However, by Friday The Sydney Morning Herald was reporting on the potential cancellation of non-urgent elective surgery in NSW hospitals.
Butler was also questioned on the bigger issues of pressure on hospital services and general practice. He said: “I’ve just got to be honest, we are not going to change things overnight or even in a very short period of time. We are dealing with years of pressure that have built up on these systems, both our hospital system and also general practices.”
On 2 August Butler spoke at both the Australian Medical Association National Conference and the Pharmaceutical Society of Australia National Conference.
Minister for Aged Care Anika Wells announced that the Government is spending $8 million on an education program to boost the capability of aged care workers to deliver high quality, dementia-specific respite care.
Over the next two years the program aims to deliver education, training, and mentorship to 5,200 “respite workers”. Given there are about 200,000 direct care workers in residential aged care, the whole workforce will be covered by the year 2066.
Wells also issued a release about the Government’s “big mission to ensure all older Australians in aged care receive nutritious, safe and appetising food”, spruiking the benefits of the Aged Care Quality and Safety Commission’s Food, Nutrition and Dining Unit Hotline which “gives older people, their families and carers, and aged care workers and providers an easy way to raise concerns, get advice or make a complaint about the food, nutrition and dining in aged care”.
Assistant Minister Kearney launched Donate Life Week, saying that she had worked on an organ transplant ward, and she understood the impact a transplant could have on the lives of recipients. She encouraged people to register as a donor, and make sure their families understand their wishes.
Lucinda Barry AM, CEO of the Organ and Tissue Authority, said that donation rates had returned to pre-COVID levels, and that last year saw the highest ever number of donations.
Kearney also announced Government funding for the National Allergy Centre of Excellence to deliver the ADAPT Oral Immunotherapy Program for infants suffering from a peanut allergy.
The Department of Health and Aged Care called for volunteers to take part in focus groups to provide feedback on the aged care quality indicators. Interested people should submit an expression of interest by 27 August.
On 2 August the Department invited people who are (or had been, or intended to be) involved in health and medical research to complete the Australian Health and Medical Research Workforce Survey as part of an “audit” of the health and medical research workforce. It said that “the outcomes of the audit will inform the National Health and Medical Research Strategy, future policy and decision-making”.
The deadline for responses: 9 August.
Now, according to the Department’s website, the Minister “announced that we would develop the strategy” in May this year. It goes on “we are in the early stages of development. As this work progresses, we will hold extensive public consultation”.
So why on earth run a survey for only one week?
The Department also announced (on 1 August) that “the Requirements for cervical screening (First edition 2023) will no longer come into force on 1 August 2024… follow[ing] the identification of a number of matters relating to the Standard that require further consultation with the pathology sector before it comes into effect”.
The Therapeutic Goods Administration issued a minatory statement “remind[ing] businesses and media outlets that it is unlawful to publicly advertise prescription-only medicines, including prescription-only weight loss medicines”.
This followed a number of reports that Wegovy (a prescription-only weight loss drug) would shortly be released in Australia, even though it has not been listed on the PBS.
The Australian Institute of Health and Welfare released the latest monthly data on MBS funded services, a report on mothers and babies using final data for 2021, and a report on ex-serving ADF members hospitalised for self-harm.
The Productivity Commission released the fourth Closing the Gap Annual Data Compilation Report, including new data for nine of the 19 targets. According to the Commission, five of the targets are on track to be met, including healthy birthweight.
Of the other three health, wellbeing and development targets:
- the life expectancy gap is closing, but will not meet the 2031 target
- the proportion of Aboriginal and Torres Strait Islander children assessed as developmentally on track has declined and the target is not on track to be met
- the rate of deaths by suicide of Aboriginal and Torres Strait Islander people is increasing and the target of a significant and sustained reduction is not on track to be met.
Commissioner Natalie Siegel-Brown said “the consistent theme to improved outcomes was governments enacting the Priority Reforms: a strengthened Aboriginal Community Controlled sector, shared decision making, shared data and the government changing its operation. The aspirations of the Agreement are not only achievable, but equity of outcomes for Aboriginal and Torres Strait Islander people is within reach if governments breathe life into the Priority Reforms”.
In a statement the Coalition of Peaks said the data showed that the targets being met are those where community control is in place.
Coalition of Peaks co-convenor Catherine Liddle said “the data is there, the stories are there, it’s clear that when we control our services we get better outcomes for our people”.
“The saying ‘nothing about us without us’ absolutely applies to getting the best results for all Aboriginal and Torres Strait Islander people, from birth right through to our Elders and how they are cared for.”
Read more reaction in this Croakey compilation of statements.
The Australian Bureau of Statistics released updated microdata from the National Health Survey, and updated mental health data to include modelled estimates of mental disorders by Primary Health Network.
It also released the June quarter Consumer Price Index data, showing health price inflation in the 12 months to June of 5.7 percent, compared with the All Groups average of 3.8 percent.
AHPRA announced that a registered nurse who had served on the clinical governance committee of the Oakden Older Person’s Mental Health Facility in South Australia had been disqualified from applying for registration for three years.
The decision comes over seven years after the facility was closed by the SA Government following years of allegations of mistreatment of residents. At the time of the closure, 21 staff were reported to AHPRA. So far – including the current case – three staff have been sanctioned.
AHPRA and the National Boards also released guidance on Good virtual care practices, including information for practitioners, the public, and employers. The guidance operates in conjunction with the Medical Board’s Guidelines on telehealth consultations with patients.
Consumer and public health groups
The Cancer Council NSW released the results of a study of out of pocket costs for patients with cancer, which showed that “more than half of the people diagnosed with cancer in the past two years paid more than $1,000, with almost one in 10 paying costs higher than $10,000”.
David Goldsbury, lead author of the study, said “we know high out of pocket healthcare costs can increase financial strain, which raise equity concerns for people with limited financial resources”.
Craig Gear OAM, the CEO of the Older Persons Advocacy Network, made the case for aged care reform.
He wrote: “The current Aged Care Quality Standards are not fit for purpose. They need to be strengthened. And older people need to be assured of their basic human rights. Older people also want the care they deserve – care that is accessible, based on their needs, and provided in their homes.
“This won’t happen without legislation that enshrines and enforces older people’s human rights. And that can’t wait to the next year. The older people and families I have spoken to over the past few weeks have begun to despair that the new Aged Care Act won’t be delivered, as promised, in this term of parliament.
“The Opposition and the Government must come to an agreement on the new Act and how to fund it. Older people’s right to safe, high-quality care, and a system that can financially support that, transcends politics.”
I couldn’t put it any better.
The Public Health Association of Australia (PHAA) acknowledged the publication of an article examining projects and grants funded through the Medical Research Future Fund, which found that “despite public health being a clear priority for the MRFF, many research projects classified as being about ‘public health’ or ‘prevention’ were more focussed on clinical aspects, such as treatment and cure”.
Croakey colleague Dr Lesley Russell summarised the research in this article, describing the findings as disturbing, troubling and perplexing.
First Nations health
The Lowitja Institute issued a media release on what would have been Dr O’Donoghue’s 92nd birthday, marking the second anniversary of the establishment of the Lowitja O’Donoghue Foundation, which provides scholarships to “support Aboriginal and Torres Strait Islander people interested in study, internship, and a career in… nursing and the public service sector”.
Trade unions
The Australian Dental Association foreshadowed dental health week (starting 5 August) with a media release highlighting the need for flossing or interdental brushing as an aid to maintaining healthy gums.
The AMA held its national conference starting on 2 August, and released its Vision for Australia’s Health.
The Royal Australian College of GPs endorsed the Maudsley Deprescribing Guidelines for antidepressants, and said “people who want to stop taking antidepressants should see their GP for support”.
College President Dr Nicole Higgins said “we’re continuing to call for higher Medicare rebates for patients who need longer consultations, which are essential for mental healthcare”.
If I ever see a RACGP media release without a call for higher rebates for longer consultations, I will assume it’s a fake.
The Royal College of Pathologists of Australasia urged Australians “to prioritise regular testing for sexually transmitted infections”, given substantial increases in gonorrhoea and syphilis notifications in recent years.
The RCPA said that “that testing levels have not notably increased, including among older adults”. (See this recent Croakey article, Investigating solutions to a syphilis crisis…).
Industry groups
The Australian Healthcare and Hospitals Association (AHHA) Deeble Institute for Health Policy Research released an Issues Brief, Reinforcing the role of eye care practitioners in falls prevention among older adults, highlighting the importance of including eye care practitioners in multi-disciplinary teams working towards fall prevention.
AHHA Chief Executive Kylie Woolcock said that “around 75 percent of the patients admitted to hospital following a fall have a correctable vision problem, which can be corrected either by updating a spectacle prescription or by surgical removal of a cataract”.
As well as recommending the inclusion of eye care practitioners in falls prevention teams, the brief also argues for “enhancing funding for public ophthalmology services in Australia and increasing funding for outreach cataract surgeries to address the shortfall that disproportionately affects First Nations Australians and those living in rural and remote areas”.
Catholic Health Australia (CHA) announced the release by Australia’s Catholic bishops of a document “to guide priests, chaplains and pastoral workers who are asked to provide pastoral support to Catholics who are considering accessing the Voluntary Assisted Dying (VAD) scheme”.
CHA CEO Jason Kara said that funding shortfalls are limiting access to quality palliative care services.
“Without quality and accessible palliative care, there is a real risk that some patients decide to explore the option of ending their own lives when they may not otherwise have done so.”
The Victorian branch of the Pharmacy Guild launched a digital marketing campaign “highlighting the range of healthcare services available through community pharmacies as part of the Victorian pharmacist prescribing pilot”.
The services include provision of oral contraception repeat prescriptions, treatment for uncomplicated urinary tract infections, shingles, and flare-ups of mild plaque psoriasis, and provision of travel and public health vaccines.
Politicians and parliamentary committees
Senator Jordon Steele-John joined the chorus of criticism of the Government’s response to the report of the Disability Royal Commission (see Croakey’s coverage of the reaction from disability organisations here).
Steele-John described the response as an insult to the disabled community, and said that “the disability community has been waiting for the Government’s response to the Disability Royal Commission for 11 months”.
“Given the length of time, the disability community was hoping for a comprehensive and considered response. What they have received appears to be neither.”
After hearings last week in Brisbane and Canberra, the Senate menopause inquiry will hold hearings in Adelaide and Perth on 5 and 6 August.
International organisations
The World Health Organization and UNICEF issued a joint release marking World Breastfeeding Week, noting that 48 percent of infants under six months of age were now exclusively breastfed. They called on policymakers to:
- increase investment in programs and policies that protect and support breastfeeding
- implement and monitor family friendly workplace policies, such as paid maternity leave, breastfeeding breaks and access to affordable and good-quality childcare
- ensure at-risk mothers receive breastfeeding protection and support; in line with their unique needs, including timely, effective breastfeeding counselling as part of routine health coverage
- improve monitoring of breastfeeding programs and policies to inform future policy
- develop and enforce laws restricting the marketing of breast-milk substitutes.
Finally
Last week Australian Private Hospitals Association CEO Michael Roff left the organisation after thirty years (24 as CEO).
He said the secret of his success was “to employ people who are smarter than me, and then… do what they tell me”.
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.
Department of Health and Aged Care
Reclassification of Sports and Exercise Medicine Physicians as consultant physicians
5 August
Therapeutic Goods Administration
Legislating regulatory categories for some boundary and combination products
6 August
National Indigenous Australians Agency
National strategy for food security in remote First Nations communities
11 August
Therapeutic Goods Administration
Proposed exposure model for assessing the safety of sunscreen ingredients in Australia
13 August
Therapeutic Goods Administration
Revised TGA Instructions for Disinfectant Testing
16 August
Therapeutic Goods Administration
Reforming Australia’s Therapeutic Goods Testing Regulations
18 August
Australian Technical Advisory Group on Immunisation
Removal of information about Zostavax in the Australian Immunisation Handbook
27 August
Department of Health and Aged Care
Clinical Categories Review Advisory Committee Report
30 August
Department of Health and Aged Care
Multi-Purpose Service trial sites direct care targets
30 August
Department of Health and Aged Care
How to implement the MSAC advice about the cost of technical support services for cardiac implantable electronic devices
6 September
Food Standards Australia and New Zealand
Amend the definitions in the Australia New Zealand Food Standards Code (the Code) for ‘food produced using gene technology’ and ‘gene technology’
10 September
Australian Commission on Safety and Quality in Health Care
National Safety and Quality Medical Imaging Standards (to replace the Diagnostic Imaging Accreditation Scheme Standards).
27 September
Department of Health and Aged Care
Review of MBS health assessment items
30 September
Therapeutic Goods Administration
Future regulation of assistive technologies
13 October
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.
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Are there any numbers on how many of the recommendations of the disability enquiry are exclusively or primarily the province of the Federal government. There is talk about how various levels of government are effected by the findings. So it would be good to know.
Hi Evan, yes that was published in one of our stories, if you search on the category. Melissa