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The Zap: all the latest health and aged care news, and key consultations now open

Public and private hospitals have been urged to implement a new National Model for Clinical Governance to strengthen the safety and accountability of healthcare while, in other news, efforts are underway to build the health workforce’s capability to recognise and respond to family, domestic and sexual violence, The Zap reports this week.

Meanwhile, there is a push to encourage more people to complete their free at-home bowel cancer screening test under the National Bowel Cancer Screening Program; an estimated 84,000 lives could be saved by 2040 if participation was to increase to 60 percent from the current 41.7 percent.

Police brutality, women’s healthcare, and specialists’ fees are among other topics covered.

The quotable?

Given the benefits of Birthing on Country, the Government should be announcing ongoing funding to give security to the women in communities and the midwives and other care workers involved in the services – not announcing funding three years at a time.”


Charles Maskell-Knight writes:

There was a Victorian parlour game (apparently surviving in rural America into the 1930s) called Cross Questions and Crooked Answers, in which players gave previously assigned answers which bore no relation to the question asked of them.

The first hour of the Senate estimates appearance of the Department of Health, Disability and Ageing (DHDA) last week was reminiscent of the game at many points, as Shadow Minister Senator Anne Ruston asked questions about the Budget measure to save “$2.7 billion over five years from 2025–26 from health, disability and ageing programs which will be reinvested in new or expanded health, disability and ageing services”.

I wrote about the measure for Croakey after the Budget, suggesting Senators should use Senate estimates to seek further detail on exactly how the savings would be achieved.

Ruston did her best, but after an hour clarity was still elusive.

It appears that the savings are calculated as a four percent cut in the approximately $14 billion per year administered funding in non-demand-driven programs across DHDA.

Officials said they could provide a breakdown of which specific programs would be affected in 2025-26, but not for later years, as it would all depend on which specific programs were under pressure or underspending.

They did their best to portray it at “business as usual” – there are always programs that underspend, and the measure simply frees up the funds to reinvest elsewhere – while Ruston correctly pointed out that “business as usual” did not generate savings reported in Budget Paper 2 as a measure.

After an hour Ruston said she would seek details under each Program, and I had to leave the broadcast to go shopping.

Once the transcript is available, it will be interesting to see if DHDA did provide more information.

DHDA officials were also asked about plans to replace the Chief Allied Health Officer, following the departure of Anita Hobson-Powell in late May.

They were unable to provide a simple confirmation that the position would be filled at the same level. Watch this space!

A lot of time at Senate estimates was taken up with questioning on the Integrated Assessment Tool (IAT) used to determine people’s needs for Support at Home, and whether or not there was a capacity for human intervention in the process.

Aged Care Minister Sam Rae appeared on Radio National, arguing that humans were involved in the process because they collected the information that went into the IAT. The best course of action when you are at the bottom of a hole is usually to stop digging.

Rae did concede “I’m not satisfied with the prioritisation mechanism that’s a component of [the IAT]”.

“So I’ve asked the Department to conduct a rapid review and give us their findings within three months so that we can continue to make the changes to this system that get the very best outcomes for older people.”

Pharmacy expansion

The NSW Branch of the Pharmacy Guild said it “welcomed the release of new data from two NSW Government-sponsored clinical trials confirming allowing pharmacists to diagnose and treat uncomplicated urinary tract infections and providing resupply of oral contraception is delivering safe, effective care for women, while easing pressure on the health system and saving emergency departments millions of dollars”.

The Guild said reports from the University of Newcastle – (NSW Government Sponsored Clinical Trial: Management of Urinary Tract Infections (UTI) by Community Pharmacistsand NSW Government Sponsored Trial: Resupply of Oral Contraception by Community Pharmacists) – highlighted the success of expanding pharmacists’ scope of practice in improving access to timely treatment for two of the most common healthcare needs for women.

University of Newcastle’s Associate Professor Sarah Dineen-Griffin said the reports “show that patients really value having pharmacists manage uncomplicated UTIs and oral contraceptive resupply, reflected in the high satisfaction reported across both studies”.

“Women from cities, regional towns and most rural areas accessed the services, and pharmacists referred them to their GP when required by the clinical guidelines.”

The Royal Australian College of GPs (RACGP) cautioned against using findings from the UTI evaluation to justify a broader expansion of pharmacy prescribing scope, saying that while the report found high patient satisfaction and symptom resolution rates, “a lack of substantial evidence makes it difficult to fully assess these findings”.

RACGP President Dr Michael Wright said the trial “involved an unrepresentative patient cohort, lacked a clinical control group, and was more focused on measuring the dispensing of medicines rather than whether patients received the healthcare they needed”.

“These limitations make the evaluation findings too premature to base policy decisions on.”

Ministers and government

Health Minister Mark Butler announced the Government would give people with Motor Neurone Disease (MND) priority access to care under the Support at Home aged care program.

“Motor Neurone Disease is a cruel and fast-moving condition, and our care systems need to respond with the urgency it demands,” he said. “Whether it’s aged care or the NDIS, our job is to get the right support to people when they need it – not after.”

Of course, many other people waiting an average of 12 months for care under Support at Home are likely to experience a rapid deterioration in function before they receive the support they need – unfortunately, they cannot be easily classified by diagnosis.

Palliative Care Australia welcomed the announcement, describing it as “a compassionate and practical response to the needs of people living with MND, their families and carers”.

Shadow Minister Ruston described the announcement as “a clear admission” from the Government that its Integrated Assessment Tool is failing and human override must be reinstated urgently.

Assistant Minister for Indigenous Health Rebecca White joined Minister for Indigenous Australians Malarndirri McCarthy and Special Envoy for Remote Communities Marion Scrymgour in announcing the Government is spending “a further $44.4 million in Birthing on Country services across Australia to continue the great work being done to improve outcomes for First Nations mothers and babies”.

The three went on “funding will support ten Birthing on Country services to continue delivering culturally safe, community led maternity care for a further three years, through to 30 June 2029”.

What this means is that less than a month before funding for the services expired, the Government has announced a three-year extension of funding for existing services.

Given the benefits of Birthing on Country, the Government should be announcing ongoing funding to give security to the women in communities and the midwives and other care workers involved in the services – not announcing funding three years at a time.

White also announced the Government was spending $25.6 million to establish eight long-acting reversible contraception (LARC) Centres of Excellence, one in every state and territory.

She said “women will be able to access free advice and support about their contraceptive options, as well as the insertion and removal of IUDS and birth control implants, delivered by skilled providers, at no cost to the patient”.

She added “outreach services will also bring clinical support and hands-on training to health professionals into regional and remote communities to increase access to LARC for women who choose it, regardless of where they live”.

In a doorstop interview White elaborated: “The evidence tells us that here in Australia, the uptake for women of long-acting contraception is much lower than other equivalent countries, and that’s due to a couple of things,” she said. “It is lack of information and understanding, lack of confidence with having a conversation like this with a health professional, and lack of access because health professionals haven’t always been able to provide this service, and also costs have been a barrier.”

“So, through this investment we are trying to tackle all of those barriers and make access more affordable, give greater choice for Australian women and then also educate the health workforce so they feel confident to be able to insert long-acting contraception for patients who want them.”

Assistant Minister for Mental Health Emma McBride announced the Government “has launched a new professional association to recognise, support and grow the mental health and suicide prevention peer workforce”.

The Government has provided $4.3 million to set up the Australian Association of Peer Workers, to be established by the National Mental Health Consumer Alliance and supported by Mental Health Carers Australia and the Indigenous Australians Lived Experience Centre.

The Association will offer peer workers professional development and support across training, standards and opportunities for career progression.

DHDA announced the launch of a ‘Ask 1800MEDICARE’ campaign “aimed to promote awareness and understanding of the new service, ensuring Australians know how and when to use it”.

DHDA also released the report of the independent review of cohealth General Practice and related services, the day after a final draft of the report was made available to Health Services Daily. Croakey will publish an article about the implications of the report shortly.

The Therapeutic Goods Administration (TGA) issued a notice of its interim decision not to approve an application to amend the Poisons Standard to make psilocybine available for use in psychotherapy for patients experiencing existential distress at the end of life.

Applicants Mind Medicine Australia and EndWise issued a statement highly critical of the decision, and urging people to make submissions to the TGA by 3 July.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) released a new National Model for Clinical Governance “to provide contemporary, best practice governance guidance for acute health services including day hospitals”.

The ACSQHC said the new model “shifts the main focus from complying with accreditation requirements to building the culture of the organisation to one in which delivery of high-quality care is the core focus of everyone in a health service, every day…. [and] emphasises the importance of workforce wellbeing, clinician engagement, and the health of Aboriginal and Torres Strait Islander peoples”.

Health Ministers on 1 May urged public and private hospitals to implement the model to strengthen the safety and accountability of healthcare. This followed consideration of the actions of former gynaecologist Simon Gordon who was accused by Four Corners of “repeatedly removing tissue and organs from young women for ‘severe’ endometriosis when pathology showed they had little or no trace of the disease”.

Ahpra said it had joined with the National Boards and Accreditation Bodies in issuing a statement committing to building the health workforce’s capability to recognise and respond to family, domestic and sexual violence.

Ahpra CEO Justin Untersteiner said “health practitioners are often the first – and sometimes the only – trusted professionals that victim-survivors can turn to for help”.

“Ensuring practitioners have the skills to recognise and respond to family, domestic and sexual violence safely and sensitively can make a real difference in the lives of victim-survivors.”

Nursing and Midwifery Board of Australia Chair Adjunct Professor Veronica Casey AM said all health practitioners have a role to play in responding to family violence – “whether it’s the midwife who has an ongoing relationship with a mum, the optometrist treating a patient with ocular damage and an inconsistent story, or the dentist treating a patient with damaged or broken teeth”.

“Health practitioners see what others might miss, and are trusted in a way few other community members are.”

The Australian Institute of Health and Welfare (AIHW) published reports on the health of people experiencing homelessness and accessing alcohol and drug treatment services after an assessment.

The Independent Health and Aged Care Pricing Authority released the 2023-24 National Hospital Cost Data Collection Public Sector and National Hospital Cost Data Collection Private Hospital Report.

The Australian Bureau of Statistics (ABS) published an article on Household consumption of illicit tobacco and nicotine products, using wastewater (sewage) analysis from the Australian Criminal Intelligence Commission. It reported the key findings as:

  • The quantity of nicotine consumed in Australia increased by almost 40 percent from 2017 to 2025 (compared with population growth of 14 percent), with most of the increase occurring since 2021
  • The increase was underpinned by a large rise in illicit cigarettes, with consumption from illicit sources as a share of total tobacco consumed rising from 12 percent in 2017 to 80 percent in 2025
  • Prices for legal tobacco products have almost tripled since December 2016 driven by annual tobacco excise increases, while estimated prices of illicit tobacco products have remained relatively constant
  • The dollar value of household spending on cigarettes and tobacco peaked in December 2020 before returning to levels similar to December 2016, reflecting the shift towards cheaper illicit sources.

(See this Croakey article for some reaction to the data and related commentary.)

The ABS also published March quarter corrective services data, showing recent trends continuing: more people incarcerated (up four percent from the December quarter), more people incarcerated before a court has sentenced them (up nine percent), and more First Nations people incarcerated (up five percent).

The Australian Prudential Regulatory Authority published the March quarter private health insurance statistics and private health insurance performance statistics.

In a classic “what you see depends on where you stand”, the insurance and hospital sectors had completely different interpretations of the data.

The Members Health Fund Alliance (the lobby group for private health insurers which do not distribute profits) focused on the volume of benefit payments, while the Australian Private Hospitals Association (APHA) focused on benefits as a proportion of premium revenue.

Members Health also warned that the Government’s proposal to reduce the premium rebate paid to people aged over 65 to the same level as that paid to under-65s on the same income would “damage participation among battling older Australians”.

The APHA complained that the benefit payout ratio had still not returned to pre-COVID levels, and argued yet again that the Government should act to compel insurers to pay 90 percent of premium revenue in benefits.

Consumer and public health groups

Cancer Council Australia marked the launch of a new “hard-hitting” campaign for the National Bowel Cancer Screening Program “Bowel cancer waits for no one”, intended to encourage more people to complete their free at-home bowel cancer screening test.

An estimated 84,000 lives could be saved by 2040 if participation was to increase to 60 percent from the current 41.7 percent.

The Cancer Council said “backed by deep campaign research, the new creative is designed to reduce emotional and social barriers so bowel cancer screening feels normal, easy, and safe”.

It said “the campaign is running across television, radio, digital, and social media with tailored messaging for Aboriginal and Torres Strait Islander communities, culturally and linguistically diverse communities – including Arabic, Mandarin and Vietnamese-speaking Australians – and people living in rural and remote areas, where screening rates remain significantly lower than in major cities”.

On World MS Day, MS Australia said it had become a founding signatory of the Nice Declaration, “a unified, global commitment from leading MS organisations around the world, including MS Canada, MS International Federation, Associazione Italiana Sclerosi Multipla (Italian MS Society), MS Society UK and National MS Society (US), to advance MS prevention as a global priority”.

MS Australia it was collaborating with MS Canada in “leading the Global MS Prevention Initiative, representing a pivotal step toward a coordinated global strategy with the potential to fundamentally change the trajectory of MS worldwide”.

First Nations

The National Aboriginal and Torres Strait Islander Ageing and Aged Care Council (NATSIAACC) coordinated a statement with ten other First Nations health and aged care organisations “calling on the Australian Government to urgently progress the unfinished implementation of the Aboriginal and Torres Strait Islander-specific recommendations arising from the Aged Care Royal Commission”.

In particular, the statement asked the Government to:

  • Establish a permanent, independent statutory Aboriginal and Torres Strait Islander Aged Care Commissioner
  • Establish a co-designed Aboriginal and Torres Strait Islander Aged Care pathway that embeds cultural safety, connection to Country/Island Home and community-led models of care
  • Embed measurable cultural safety requirements and accountability mechanisms across aged care delivery, assessment and workforce
  • Support the growth and sustainability of Aboriginal Community Controlled Organisations delivering aged care services
  • Develop and implement a dedicated Aboriginal and Torres Strait Islander Aged Care workforce action plan aligned with the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021–2031.

Trade unions

The Australian College for Emergency Medicine (ACEM) released the results from its Sustainable Workforce Survey, held every three years since 2016.

ACEM President Dr Peter Allely said the latest survey showed many ACEM members and trainees across Australia and Aotearoa New Zealand “continue to experience high levels of stress and burnout, exacerbated by factors such as ED overcrowding, bed block, workforce shortages and other workplace challenges”.

The Australian College of Rural and Remote Medicine said the latest Medical Schools Outcomes Database report showed future doctors are increasingly attracted to rural generalist medicine.

Almost 17 per cent of domestic final-year medical students said they intended to pursue general practice and rural generalist medicine, and almost 30 percent of respondents expressed a preference to work outside metropolitan areas.

The Australian Nursing and Midwifery Federation (ANMF) said the decision by the Fair Work Commission to lift national minimum award wages by 4.75 percent “will help boost the pay of frontline care workers”.

ANMF Federal Secretary Annie Butler said the increase would provide some relief to low-paid ANMF members and other critical workers struggling to keep-up with soaring rents, groceries, energy and fuel costs.

She said “while not far above inflation, we believe the increase is a step in the right direction for our members earning minimum or award wages”.

The Health Services Union (HSU) welcomed the decision, saying it will mean increases for award-reliant workers of around $64 a week for a full-time disability support worker, $59 a week for a full-time aged care worker and $52 a week for a full-time pathology collector.

The Australian Society of Ophthalmologists said “cheap shots at specialists’ fees [are] a distraction from bigger problems” with the health system.

It said: “While headlines fixate on ‘price gouging’ surgeon fees, the Australian Society of Ophthalmologists is calling out the real culprits: a federal Government that has let Medicare wither on the vine, and private health insurers cashing in on the chaos while under-rebating patients. Doctors didn’t break this system. Canberra did.”

According to the Australian Taxation Office, five of the top six highest earning occupations are various kinds of medical specialties.

Pharmaceutical Society of Australia (PSA) marked the end of National Reconciliation Week by releasing its new module Deadly pharmacists: Providing culturally safe and responsive care in community pharmacy, “designed to support community pharmacists in delivering culturally safe, responsive care for Aboriginal and Torres Strait Islander peoples”.

PSA National President Professor Mark Naunton said the new module “will help pharmacists to reflect on their practice, gain an understanding of the impacts of culture and history on health and wellbeing, and build meaningful relationships with their First Nations patients and communities”.

“In doing so, pharmacists can help create environments where Aboriginal and Torres Strait Islander peoples feel respected, understood, and receive healthcare that they consider to be culturally safe.”

The RACGP released its submission to the Senate inquiry into epilepsy, “calling for stronger investment in primary care and services for people living with epilepsy, many of whom face major barriers accessing timely diagnosis, specialist care and ongoing support”.

RACGP President Wright highlighted the central role of GPs supporting people with epilepsy, when access to specialists was difficult and expensive.

The RACGP called yet again for “a 40 percent increase to Medicare rebates for longer GP consultations, to improve affordable care access for all patients with complex, chronic conditions”.

It also called for investment in culturally appropriate education, improved support for Aboriginal Community Controlled Health Organisations (ACCHOs), and more funding for epilepsy research, and nationally consistent evidence-based epilepsy guidelines.

(Other submissions to the inquiry may be found here.)

The RACGP also commented on the announcement that the only general practice in Kalbarri in Western Australia will close, leaving 1,500 residents without a local GP. The College said the closure “exposed the ongoing gap between Medicare funding and the cost of delivering care”, noting that Medicare funding would be indexed at only 2.6 percent, despite Consumer Price Index inflation of 4.2 percent in the past year.

RACGP WA Chair and Vice President Dr Ramya Raman said “when a town loses its only general practice despite receiving some of the highest bulk-billing incentives available, it’s clear our health funding system is not meeting the needs of communities”.

RACGP President Wright said “poor Medicare indexation demonstrates why many GPs have expressed scepticism about switching to a fully bulk billing model to secure the future of their practices”.

He again called for an independent pricing body to set Medicare rebates based on evidence.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) reacted to an ABC Four Corners investigation of brutality by NSW Police expressing “grave concern” about the treatment of a woman called Jodi Knott who was undergoing a psychotic episode.

RANZCP NSW Branch Chair Dr Ian Korbel said “people experiencing psychosis are among the most vulnerable members of our community”.

“What we saw raises serious questions about whether current response models are adequately designed to support people experiencing severe mental distress.”

Korbel said the Police Ambulance Clinical Early Response model for managing mental health crises “must be expanded statewide and underpinned by a consistent triage model, as the current system is fragmented, available in only 16 of 57 Police Area Commands and Districts, and lacks 24/7 coverage anywhere in NSW”.

The RANZCP called on the NSW Government “to review current police training and response models, while accelerating investment in evidence-based, health-led crisis responses”.

The College reiterated its concerns after the episode aired, with Korbel saying the “additional accounts and deeply disturbing vision aired last night of police degrading people during mental health crises reinforced the need for urgent reform”.

Industry groups

The Pharmacy Guild continued its campaign for pharmacists to play a role in primary care, saying “for many Australian men, the local pharmacy is the health service they visit most often, without appointment and outside standard business hours”.

“Harnessing that regular contact could transform men’s health outcomes, with community pharmacists playing a bigger role in prevention, early intervention and ongoing care.”

Private Healthcare Australia (PHA, the private health insurers lobby group) said evidence at Senate estimates showed the Government was unable to say how many of the older people to be affected by the proposed cut in the private health insurance premium rebate “were pensioners, how many earned less than $55,000 a year, and how many were on a part or full pension”.

PHA said DHDA “acknowledged at the hearing that Australians aged over 70 receive average annual health insurance benefits of more than $5,000, compared to paying average premiums after the rebate of around $2,600”.

From my perspective, this means if older people leave insurance once their rebate is reduced to the same level as younger people on the same income, the cross-subsidy required from younger people as a group will decline – meaning overall premiums should decrease.

Members Health said Senate estimates “revealed a deeply troubling lack of preparation and empathy behind the Government’s decision to reduce the private health insurance rebate for Australians over 65”.

International organisations

On 2 June Croakey published an article by Dr Lesley Russell on growing concerns about Ebola preparedness and responses.

On 5 June the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC) launched a joint continental preparedness and response plan on the ongoing Ebola outbreak, aiming “to raise US$ 518 million to support African countries together with partners to prepare for, rapidly detect and respond to the outbreak”.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said “the only way to beat this outbreak is through close partnership, working together under the leadership of the affected countries in one coordinated effort, guided by a simple principle: one plan, one budget, one team”.

“Containing Ebola depends on political commitment, sustained financing, and the trust and engagement of communities,” he said. “This plan places communities at the centre, because without their participation, contact tracing falters, safe care is delayed, and transmission continues”.

Finally

For many years I have questioned whether fee transparency will result in reduced fees for patients attending medical specialists, arguing that once low-charging doctors know what the market will bear, they will have an incentive to increase their fees.

Professor Anthony Scott from Monash University posted an article on LinkedIn reporting on a US study that found price transparency led to a small increase in overall billed charges, initially concentrated among low-fee providers.

Scott suggested “to reduce these effects in Australia, fees should only be made transparent to patients via integration into GP software at the point of referral, or on platforms only accessible to patients”.


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.

Medicare Benefits Schedule Review Advisory Committee
Review for the inclusion of audiometrists as eligible health providers for limited audiology MBS items
9 June

Department of Health, Disability and Ageing
Consultation on draft models of care for headspace Plus and Youth Specialist Care Centres
11 June

Medical Services Advisory Committee

12 June

Independent Health and Aged Care Pricing Authority
Pricing Framework for Australian Public Hospital Services 2027–28
12 June

Pharmacy Board of Australia
Public consultation on the draft Endorsement for scheduled medicines for pharmacists
15 June

Department of Health, Disability and Ageing
Surgical guides and biomodels post-listing review draft department report
15 June

Department of Health, Disability and Ageing
Consultation on sunsetting Private Health Insurance Rules
19 June

Food Standards Australia New Zealand
Health Star Rating System
21 June

Therapeutic Goods Administration
Proposed amendments to the Poisons Standard
30 June

Therapeutic Goods Administration
Public consultation on interim decision to amend the Poisons Standard in relation to psilocybine
3 July

Monash University
Dementia Guidelines
6 July

Department of Health, Disability and Ageing
Online prescribing services: sharing medicines-related information to My Health Record by default
7 July

Food Standards Australia New Zealand
Review of young child formula
7 July

Medical Services Advisory Committee

10 July

Australian Health Practitioner Regulation Agency (and all National Boards except the Medical Board)
Have your say on how practitioners stay up to date and connected with their profession
17 July

Therapeutic Goods Administration
Radiopharmaceutical regulation in Australia
31 July

Senate Community Affairs Committee
Support at Home Program
31 July

Department of Health, Disability and Ageing
Co-design the future of aged care Application Programming Interfaces
29 August

House of Representatives Standing Committee on Health, Aged Care and Disability
Inquiry into the access to and affordability of medical specialists
16 October


Author details

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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