Negotiations on aged care funding, news from NAIDOC Week, submissions to the Scope of Practice Review, and the role of general practitioners in disasters and emergencies are among the topics covered by this week’s edition of The Zap.
Columnist Charles Maskell-Knight also covers a stack of new publications, including data showing that the age-standardised death rate from alcohol has been trending steadily upwards from 2018 to 2022, while the death rate from illicit drugs has trended downwards since 2017.
Meanwhile, in case anyone needs reminding about the political and economic power of big consultancies, the Nous Group won 26 contracts with the Department of Health and Aged Care last financial year, worth a total of $18.9 million.
The quotable?
It seems to me that the Government wants to reach an agreement with the Opposition on an approach to aged care funding, so that the Opposition cannot attack it; while the Opposition wants the Government to put forward a position publicly, so that the Opposition can gain credit from attacking, amending, or blocking it.”
Charles Maskell-Knight writes:
Last week was the first week of the winter recess for the Australian parliament. It also saw widespread cold weather for the winter school holidays.
As temperatures fell, the health policy sector generally seemed to enter a state of brumation (a period of sluggishness, inactivity, or torpor during winter or extended periods of low temperature).
NAIDOC Week, which ran from 7 to 14 July, was an opportunity, however, for activities and discussions in keeping with the appropriately warming theme of Keep the Fire Burning! Blak, Loud and Proud.
Some of the sector’s responses are summarised below – apologies to those I have missed.
The Australian Indigenous Doctors Association (AIDA) published a reflection from members on NAIDOC Week. “This year’s NAIDOC theme calls for a reclamation of narratives, an amplification of voices, and an unwavering commitment to justice and equality,” said the report.
The Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM) celebrated founding member and Elder Aunty Dulcie Flower AM, who received the 2024 National NAIDOC Lifetime Achievement Award.
The National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP) issued a statement recognising “the vital role of our workforce in improving Aboriginal and/or Torres Strait Islander health and wellbeing”.
“For Aboriginal and Torres Strait Islander communities, this is a week of gatherings at kitchen tables, on footy fields, in city areas and deep in Country. We will dance, eat, sing, and celebrate the over 60,000 years of our existence on this continent, the strength of our nations, the wisdoms of our Elders, and the hopes we have for our young people,” the statement said.
Other Aboriginal and Torres Strait Islander health organisations celebrated by hosting events, and attending NAIDOC balls, marches and rallies.
Rural Doctors Association of Australia President Dr RT Lewandowski said: “We have some great Aboriginal and Torres Strait Islander leaders in the rural health space, and we have learned much from them… the Aboriginal Health curriculums taught to medical students and junior doctors today were largely developed through partnerships between Indigenous and non-Indigenous rural doctors, who led the way in recognising the integral role culture plays in health”.
The Australian Association of Psychologists highlighted “resources available to celebrate NAIDOC week and foster connection with, and support for, First Nations communities”.
The Australian Physiotherapy Association acknowledged the work of physiotherapist Jye Murray, a Wiradjuri-Ngemba man from Canberra, who embodies the spirit of the NAIDOC Week theme. The APA said that Jye’s commitment to closing the healthcare gap and participation in the Indigenous Marathon Project exemplify the NAIDOC week theme’s call to be proud of First Nations heritage and to advocate loudly for positive change.
The Pharmaceutical Society of Australia encouraged all pharmacists practising in Australia “to undertake the Deadly Pharmacists Foundation Training Program developed in co-design with the National Aboriginal Community Controlled Health Organisation (NACCHO), growing the cultural knowledge and understanding that underpins quality health care”.
The Australian College of Rural and Remote Medicine (ACCRM) President, Dr Dan Halliday, said NAIDOC Week was “an opportunity to develop a deeper understanding and respect for Country and community and the link between connection to Country and health and wellbeing”.
Finally, to mark NAIDOC week the Wiley scientific publishing company released a “multidisciplinary research collection showcasing Indigenous research excellence”, including several dozen articles related to First Nations health. (Other parts of the collection covered anthropology and archaeology; geography, environment and ecology; and social policy, politics and economics.) Access to the collection is free for the month of July.
Ministerial and government
Minister Mark Butler visited the Batemans Bay urgent care clinic and Headspace on his way to the Shoalhaven and then Sydney.
The Department of Health and Aged Care released the National Aged Care Design Principles and Guidelines, including “simple, low-cost changes for existing homes, through to more substantial features for new buildings”.
The Department also released the results of a consultation on the Hearing Services Program carried out earlier this year.
The consultation process involved two surveys – one of service providers, suppliers, and professional groups which elicited 132 responses, and one of program clients which received 60 responses.
However, the results are presented as percentages of the total number of respondents. It would have been interesting to see the responses from each surveyed group separately, as clients often have different interests to service providers.
The Department will now engage an external consultant to model a possible new fee structure.
The Therapeutic Goods Administration (TGA) announced it had “issued three infringement notices totalling $56,340 to News Life Media Pty Ltd for alleged unlawful advertising of medicinal cannabis on their popular lifestyle website Body+Soul”. It is good to see News Corp paying something to the Australian Government.
The Australian Institute of Health and Welfare (AIHW) released data on the use of health check items by First Nations people, showing that the utilisation rate had almost returned to pre-pandemic levels (28 percent in 2023, compared with 29 percent in 2019, after falling as low as 23 percent in 2021-22). ACCHOs provided around 44 percent of the total number of checks.
The Institute also released a range of aged care data, including:
- Admissions to aged care
- People leaving aged care
- People using aged care by region
- Commonwealth Home Support Program users and services.
The admissions data show that over the decade to 2022-23, the number of admissions for home care increased by 267 percent. While admissions to permanent residential care increased by almost 4,400 admissions or 5.9 percent, the rate of admissions to permanent residential care for people aged 65 and over decreased from 21 admissions per 1,000 people in 2013–14 to 17 per 1,000 in 2022–23.
The AIHW also released updated reports and data on drug use, including alcohol, tobacco and other drugs, and illicit drug use.
The data show that the age-standardised death rate from alcohol has been trending steadily upwards from 2018 to 2022 (4.7 deaths per 100,000 population to 6.0 deaths), while the death rate from illicit drugs has trended downwards since 2017 (from 8.2 deaths per 100,000 population to 6.5).
Consultants
The Nous Group announced it had acquired specialist health consultancy Health Policy Analysis with effect from 1 August. Nous said that “working together, Nous and HPA will provide clients with a smoother, end-to end experience and open up access to new opportunities in the market”.
Last financial year the Department of Health and Aged Care reported it had let 26 contracts with Nous, worth a total of $18.9 million. It reported only one contract with HPA, for the evaluation of the urgent care clinics program, worth $2.9 million over the period September 2023 to December 2026. I presume that contract will now be novated to Nous.
Consumer and public health groups
The Alcohol and Drug Foundation released the results of a survey which found that 64 percent of people worried about a friend or relative’s alcohol or other drug use didn’t feel they knew how to provide support.
It also found that while 78 percent of concerned people understood the importance of accessing information and support early, more than half did not do so due to “not knowing the right questions to ask or where to get help, perceived lack of privacy, concerns over what people might think about them or their relative/friend, or feeling embarrassed”.
ADF CEO Dr Erin Lalor AM said the survey findings showed the need to reduce the barriers that prevent people from accessing information and support.
She said “given that a major source of support for people experiencing alcohol or other drug harms are family and friends, it’s crucial that people within these support networks have better awareness and access to help and support information for both them and for those that they’re worried about”.
The Consumers Health Forum welcomed the recommendations from the House of Representative diabetes inquiry (as previously reported at Croakey here and here).
CEO Dr Elizabeth Deveny said “we are really pleased to see the Committee’s recommendation that equitable access to healthcare for people living with all forms of diabetes be improved through a variety of funding measures which will help people get the management care they need, when they need it”.
These included longer subsidised appointments with care providers, access to telehealth, remote case conferencing, access to diabetes educators and an increase in the amount of item numbers for allied health consultations related to diabetes care management.
The CHF also supported the recommendations concerning improving access to Continuous Glucose Monitors, regulating the marketing and advertising of unhealthy food to children, improving food labelling; and imposing a levy on sugar-sweetened beverages.
National Seniors Australia issued a media release “slamming scammers” who scammed previous scam victims by promising to recover the money that had been lost in return for recovery fees. CEO Chris Grice said it was concerning that Australian Competition and Consumer Commission (ACCC) data showed older Australians were most likely to report such scams, and incurred the largest losses.
Palliative Care Australia and the Australasian College of Paramedicine released their joint submission to the Scope of Practice Review, calling for changes including giving paramedics “access to electronic medical records to view patients’ advance care planning and palliative care details in real time [and allowing them] to deliver specific medications for common end-of-life symptoms, reducing unnecessary hospital transfers”.
ACP CEO John Bruning said “paramedics want to be able to better support palliative care patients but currently face a number of barriers in doing that, resulting in unnecessary emergency department presentations and potential ambulance ramping”.
Palliative Care Australia also welcomed news that the National Disability Insurance Agency (NDIA) had established a Priority Access Application Pathway to assess applications for NDIS support from people with a terminal illness.
However, CEO Camilla Rowland said it was important to remember that “over time, many services outside the NDIS that people with a terminal illness rely on have experienced reduced funding, been reprioritised, and closed”.
Trade unions
The Australian Medical Association (AMA) supported the appointment by Minister Butler of Associate Professor Antonio Di Dio as Director of the Professional Services Review (PSR).
The RACP (Royal Australasian College of Physicians) welcomed the release of a report by the MBS Review Advisory Committee on telehealth.
College President Professor Jennifer Martin said “the recommendations to retain initial consultations via video and restore subsequent consultations via telephone with a specialist are important wins, but we would have preferred if patients were able to access all consultations via phone or video, depending on their circumstances and preference…”
“We see a missed opportunity in not reinstating initial telephone consultations, because not everyone has access to the technology, reliable internet coverage, data packages or digital literacy to participate in video consultations.”
The Royal Australian College of General Practitioners (RACGP) “called on all local health authorities to empower GPs to volunteer and practice as part of response teams in evacuation centres during disasters”, and issued a position statement on the role of GPs in disasters and emergencies.
The College also released the highlights of its submission to the recent consultation by the Department of Health and Aged Care on the 2025-2030 National Immunisation Strategy.
It argues that falling vaccination rates are a problem; 80 percent of Australians have a regular GP; and GPs are best placed to address vaccine hesitancy and boost vaccination rates.
RACGP President Dr Nicole Higgins said that “changing rules allowing more health professionals to vaccinate has resulted in fragmented care and missed opportunities for children and family health checks in general practice”.
Industry groups
AAMRI (the Association of Australian Medical Research Institutes) demonstrated that if you want funding for a hammer, you depict every problem as a nail.
It released its submission to the NHMRC consultation on its draft Good Institutional Practice Guide, saying that while it supported “the importance of promoting an institutional culture that supports the conduct of high-quality research… we are concerned that some of the suggested recommendations will place additional financial burden on our sector”.
It argued that “to enable medical research institutes to continue to deliver high-quality, impactful research, consideration needs to be given to funding the full costs of research and the development of tools and resources that can be shared throughout the sector”.
Politicians and parliamentary committees
Shadow Health Minister Anne Ruston told Sky News that the Opposition had been “having good-faith negotiations with the Government for a few months now” on aged care funding.
She went on “one of the things that we’ve been saying is that we think that this discussion shouldn’t just be had behind closed doors with the Opposition. It needs to be had more broadly with the wider community…”
“So we’re calling on the Government to get this out there, let the public see it, and then we’ll have a conversation about how we can amend whatever they are proposing so that we get the best possible outcome.”
What is going on here?
It seems to me that the Government wants to reach an agreement with the Opposition on an approach to aged care funding, so that the Opposition cannot attack it; while the Opposition wants the Government to put forward a position publicly, so that the Opposition can gain credit from attacking, amending, or blocking it.
A transcript of the “good-faith negotiations” would be fascinating: I imagine it would sound a bit like two blind people arguing about how to describe the Mona Lisa – and about as likely to lead to an agreed outcome.
International organisations
The World Health Organization announced the introduction of an online platform called MeDevIS (Medical Devices Information System), “designed to support governments, regulators and users in their decision-making on selection, procurement and use of medical devices for diagnostics, testing and treatment of diseases and health conditions”.
Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products, said the platform aims “to provide a one stop shop of international information, which can be invaluable for those making decisions on life-saving medical technologies, especially in resource-limited settings, and to improve access”.
Finally
The Grattan Institute’s work on the health and aged care sector is always interesting and often influential – in the long term if not immediately.
The Institute is now advertising for a deputy director of the health program. The ideal candidate would have a background in policy analysis, health economics, and/or health service management; a track record of creative policy problem-solving; strong research and analytical skills; excellent people and project management skills; and good writing and speaking skills.
Readers who think this describes them have until 4 August to apply.
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.
NHMRC
Evidence to support dietary guidelines for older Australians
24 July
Department of Health and Aged Care
Post-implementation review of changes to MBS electrocardiogram items
25 July
AHPRA and national registration boards
Criminal history registration standard
30 July
Department of Health and Aged Care
Feedback on the Addressing Critical Psychology Shortages – Postgraduate Psychology Incentive Program grants
31 July
Department of Health and Aged Care
Health professionals included in private health insurance Chronic Disease Management Programs
2 August
Department of Health and Aged Care
Reclassification of Sports and Exercise Medicine Physicians as consultant physicians
5 August
National Indigenous Australians Agency
National strategy for food security in remote First Nations communities
11 August
Department of Health and Aged Care
Clinical Categories Review Advisory Committee Report
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
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.
