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The Zap: your one-stop guide to the latest health and aged care news

In the latest edition of The Zap, health policy analyst Charles Maskell-Knight provides an overview of key developments in health and aged care, including new data raising concerns about the mental health and wellbeing of LGBTQ+ Australians.

The benefits of an Indigenous-led model of maternity care are highlighted, while Diabetes Australia pushes for emergency research funding, and authorities are urged to address the excessive use of painkillers in aged care facilities.

The quotable (which comes from the UK but is no doubt more widely relevant):

Ask a clinician about waste in their service – the things that waste their time, that waste their patients’ time, and that waste taxpayers’ pounds – and you will see them light up with ideas on ways to improve how services are run.”


Charles Maskell-Knight writes:

The release of the National Drug Strategy Household Survey last week generated comments from the Foundation for Alcohol Research & Education (FARE) – about alcohol industry marketing targeting younger women – and the Royal Australian College of General Practitioners (RACGP), calling for more support for GPs treating people with problematic alcohol and other drug use, while the Alcohol and Drug Foundation published this helpful guide.

The survey’s findings on the rise in vaping emphasised the need for Government action, such as the “new influencer-led youth [anti-]vaping campaign, to spark a conversation with the next generation of Australians about the harms of vaping and nicotine addiction”, announced by Minister Mark Butler. (Read more in my report, Greater efforts are needed to tackle a “staggering” increase in vaping rates.)

Butler said that “social media is awash with pro-vaping content: misinformation cynically promoted and stoked by the vaping and tobacco industry. TikTok is home to more than 18 billion posts with the hashtag #vape and Instagram is home to more than 18,000 ‘vaping influencer’ profiles solely dedicated to promoting vaping”.

The campaign will feature Ellyse Perry; Ella Watkins; JackBuzza; Fairbairn Brothers; Zahlia and Shyla Short; Sam Fricker; Lottie Dalziel; HeyImZed. Although I am 45 years older than the target audience, even I confidently recognise one of these names…

In an associated media conference, Butler was asked about an article in The Australian claiming that the Government was in a war of words with the private health insurance sector because he had not yet announced his decision on premium increases to apply from 1 April.

He responded that the insurers had said the story was a beat-up, and that he was focussed on getting the best deal for consumers. The article prompted an amusing duel by press release between the insurers, the hospitals, and the prostheses sector, of which more later.

Other ministerial and government announcements

Apparently Leap Day is also Rare Disease Day, prompting Butler to announce that “the Medical Services Advisory Committee has recommended the addition of X-linked adrenoleukodystrophy (X-ALD) and sickle cell disease to Australian Newborn Bloodspot Screening programs”. The states and territories now need to agree to implement the recommendation.

The Minister also announced that the Government had accepted the Australian Technical Advisory Group on Immunisation (ATAGI) recommendations for COVID-19 vaccinations for 2024: biannual for over 65s and severely immunocompromised adults; and annual for other adult and severely immunocompromised children.

Assistant Minister Ged Kearney issued a media release marking the publication of the 2023 Australian Donation and Transplantation Activity Report, showing that the number of deceased organ donations increased by 13 percent over the previous year, and that 1,400 people received a donated organ.

However, “only 55 percent of families said yes to donation in the hospital last year, down from 59 percent pre-pandemic”. Kearney called on Australians to register as organ donors, and tell their family of their wishes.

Aged Care Minister Anika Wells announced that “older Australians and their families can now see how much aged care services are spending on their care, food, wages and more”. The data is available on a home-by-home basis through the incredibly clunky MyAgedCare platform.

It is a start, but there are two issues: it is only home-by-home, so aggregating results for a provider (or a sector, or nationally) requires a lot of manual work; and it still suffers from the GIGO problem, because the raw data is not adjusted for third party transactions.

As I mentioned earlier, the Australian Institute of Health and Welfare (AIHW) released the results of the National Drug Strategy Household Survey for 2022-23. Headline results included:

  • a reduction in the overall smoking rate to less than 10 percent for the first time;
  • an (almost) tripling in the vaping rate since 2019 (2.5 percent to 7.0 percent), with rates for cohorts aged under 25 increasing four- or five-fold;
  • almost a third of Australians drank alcohol in ways that endangered their health in the last twelve months;
  • 2.5 million people (11.5 percent of the over-14 population) had used cannabis in the last twelve months.

The Alcohol and Drug Foundation published a helpful guide to the survey results, noting in particular increasing support for health-based policies aimed at reducing drug-related harm, including pill testing (64 percent in favour) and supervised injection rooms (53 percent in favour).

The consultation period for the Working Better for Medicare Review closed on 1 March. The review is being carried out by Professor Sabina Knight and Adjunct Professor Mick Reid, and is examining the effectiveness of the laws and policies that the Government uses to encourage or require health professionals to work in areas of workforce shortage. It is due to report in July.

Despite the importance of this project, the request for public input did not appear on the Department of Health and Aged Care “consultation hub”. Perhaps the Department thinks that people living in areas of workforce shortage can’t access the internet, so there was no point including it on the list of public consultations?

The TGA announced it was beginning a targeted consultation on a proposal to prevent pharmacists from extemporaneously compounding medicines containing glucagon-like-peptide 1 receptor agonist (GLP-1 RAs) analogues.

Apparently extemporaneous compounders are producing Ozempic-like medications for weight loss. The TGA states that “public health and safety concerns have emerged around the complexity and commercial scale of some compounding of extemporaneously prepared GLP-1 RAs, which are sterile medicines containing high-risk active substances”. It intends to make a decision on amendments to the law by June.

On Friday 1 March the TGA announced that it had executed a search warrant at a compounding pharmacy in South Yarra and seized a number of items, including a large amount of semaglutide (the active ingredient in Ozempic) which it will allege had been illegally manufactured.

The Australian Bureau of Statistics (ABS) released an article reporting on data from the National Study of Mental Health and Wellbeing 2020-22 relating to the mental health of LGBTQ+ Australians. Among LGB+ people, just under 60 percent had a mental disorder in the past 12 months, compared with just under 20 percent of heterosexual people. The pattern was similar for non-binary people (over 80 percent experiencing a mental disorder in the past 12 months), but different for trans people (33 percent). The article also included data on suicidal ideation, self-harm, psychological distress, and service utilisation.

The ABS also released the monthly consumer price indicator for January. Compared with an overall increase in the twelve months to January of 3.4 percent, health prices increased by 3.9 percent, far behind insurance and financial services (8.2 percent) and rents (7.4 percent). This may reflect some of the Government’s measures such as increased bulk-billing incentives and 60-day prescribing.

APRA (the financial regulator, not the performing right association) released the December 2023 quarterly statistics for the PHI sector, showing 55,000 people took up hospital insurance during the quarter. Despite this increase, the proportion of the population covered declined by 0.1 percentage point. The two PHI lobby groups welcomed the increase (here and here).

First Nations peoples’ health

The National Indigenous Times reported on research showing that “women who receive support through an Indigenous-led model of maternity care are three times less likely to have Indigenous newborn children removed by child protection services”.

The research was carried out by the Institute for Urban Indigenous Health, and followed almost 2,000 women with children born from 2013 to 2019.

Kristie Watego, service development manager for the Birthing in Our Community (BiOC) program, said that “existing maternity care models, and child protection systems, lack preventative measures and fail to prioritise family preservation”.

By contrast, the BiOC care improved family outcomes, reduced child protection intervention, and significantly reduced related costs for the health system.

Consumer and public health groups

Rare Voices Australia (the peak body for Australians living with a rare disease) used Rare Disease Day to launch a set of national recommendations to help health professionals provide quality care for people living with rare disease. The recommendations were developed by a collaboration between Rare Voices Australia, UNSW, Macquarie University, and UWA, and funded by the Australian Government.

Diabetes Australia released its pre-budget submission, asking for a Government contribution of $10 million in emergency research funding to offset a decline of 35 percent in NHMRC research funding over the last decade.

The organisation also called for a diabetes and obesity mission under the MRFF, and a range of other measures including expanded access to continuous glucose monitoring, a funded implementation plan for the National Diabetes Strategy, and MBS funding for a number of services provided by credentialed diabetes educators.

Trade unions

The RACGP used its submission to the Senate inquiry into menopause and perimenopause to argue for better funding for longer consultations, as well as better funding for hormone therapies, research into “culturally appropriate best practice menopausal care for Aboriginal and Torres Strait Islanders, the LGBTQIA+ community, and culturally and linguistically diverse people”, and funding for GPs to undertake refresher training in menopause care.

Following the release of the National Drug Strategy Household Survey, the College also called for “the government to help GPs and practice teams help more people with alcohol and other drug issues, including opioid drugs”. It wasn’t made clear exactly what form this help should take.

The RACGP also called on the G