During National Reconciliation Week, the call is for Australians to be ‘All In’. What this means for the health sector is examined in The Zap, together with governments’ “dismal implementation” of the landmark Bringing them home report over the past 29 years.
Also covered this week are new campaigns to promote free routine immunisations for children, and greater awareness of menopause and perimenopause. Updates on oral health, sunscreen regulation and ADHD are also included. Don’t miss the bonus quiz.
The quotable?
Medicare was built in 1984 for a health system that no longer exists, designed around a population with far less chronic disease. Our workforce is fragmented, our medicine approvals too slow, and our private and public hospitals under structural strain. Our research infrastructure is underfunded and our out-of-pocket health costs among the highest in the developed world – in a nominally universal system.”
Charles Maskell-Knight writes:
National Reconciliation Week runs from 27 May to 3 June, immediately following National Sorry Day on 26 May.
This column reported last week on acknowledgements of the week by the Pharmaceutical Society of Australia and Catholic Health Australia. Many other organisations have since also issued statements about the day and the week.
Indigenous Allied Health Australia (IAHA) said it stands with Stolen Generations survivors, their families, and communities on National Sorry Day, and every day, and that it supported the Healing Foundation’s From Sorry to Action – A plan to act on Bringing them home (2026-2028).
“With only five of 83 recommendations of the Bringing them home report fully implemented to date, this strategy is essential to finally and tangibly implement the recommendations, nearly 30 years after they were tabled,” it said.
The National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP) also referred to the dismal implementation of the Bringing them home recommendations.
“Nearly 30 years since the handing down of this significant report, many of its crucial recommendations remain unimplemented, while policy decisions continue to be made in ways that prioritise control and intervention over self-determination and community led solutions, NAATSIHWP said.
It cited “the recent decision by the NT Government to roll back the Aboriginal and Torres Strait Islander Child Placement Principle in the Care and Protection of Children Act [which] will make it easier to separate Aboriginal and Torres Strait Islander children from their parents and place them with non-Indigenous carers”.
NAATSIHWP concluded: “All Australians must understand that repeating policies of the past will not make our children safer, and simply acknowledging past injustices is not enough.”
“We must act now to support survivors and ensure future generations are never subjected to the same injustices.”
The Joint Colleges Training Services, the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP) issued a joint statement to mark the beginning of National Reconciliation Week, saying ‘All In’ was a call for all Australians to commit wholeheartedly to reconciliation every day.
The three organisations said they were “committed to working in genuine partnership with Aboriginal and Torres Strait Islander peoples, embedding cultural safety across the health system, and supporting a workforce that delivers care grounded in respect, trust, and understanding”.
They were also “supporting the delivery of tailored programs for Aboriginal and Torres Strait Islander registrars in partnership with Indigenous General Practice Trainee Network (IGPTN), contributing to the growth and empowerment of Australia’s Aboriginal and Torres Strait Islander medical health workforce”.
ACCRM issued a separate statement, “reaffirming its commitment to reconciliation through its ongoing partnership with the Cultural Educators and Cultural Mentors Network (CECM)”.
CECM chair Professor Marlene Drysdale said “our work with ACRRM helps Rural Generalists build the understanding and confidence needed to provide culturally safe care throughout their careers”.
The National Rural Health Alliance (NRHA) addressed Reconciliation Week in its Bushwire newsletter, saying that ‘All In’ in our context “is not a slogan – it’s a systems commitment, albeit in the small and steady actions”.
“It means continued advocacy for co-designed policies, community-led solutions, sustained investment, and measurable outcomes tied to equity – not averages or inflexibility in policies due to historical ‘ways we have always done it’,” the NRHA said.
“It also requires institutions to operate with cultural intelligence, transparency and humility, recognising that trust is built locally, not declared nationally.”
At an individual level, it said ‘All In’ becomes operational through small, disciplined shifts:
- Are we listening to understand, not to respond?
- Do our decisions include voices and sources that are usually excluded?
- How do we build trust, so that people listen to the situation for Indigenous communities in our immediate environments – family, workplace, community?
- Are we reinforcing stereotypes, or actively challenging them through informed behaviour?
- Where can we redirect time, influence or resources to support equity in tangible ways?
The Royal Australian and New Zealand College of Psychiatrists (RANZCP) said it was “committed to strengthening and sustaining the Indigenous psychiatric workforce, embedding cultural safety across training and professional practice, and ensuring our policy, advocacy and leadership are grounded in culturally responsive and accountable approaches”.
RANZCP said it has completed a majority of the actions identified in its Innovate Reconciliation Action Plan 2024–2026, lobbied the Government to expand rural psychiatrist training with priority for First Nations applicants, and to include Aboriginal and Torres Strait Islander peoples as a priority group in the National Mental Health and Suicide Prevention Agreement Review.
The College has also joined the Australian Indigenous Doctors’ Association and other organisations to call on the Government to adopt and implement the Australian Human Rights Commission’s National Anti-Racism Framework in full across all areas of government.
As well, it has provided grants up to A$5,000 for Aboriginal and Torres Strait Islander trainees to return to Country for cultural responsibilities, family obligations, and to reconnect with culture and community.
Ministers and government
Health Minister Mark Butler announced the launch of the first ever national Menopause and Perimenopause Campaign, intended to “help women to better understand their symptoms, access trusted information and feel more confident seeking care and support”.
Butler said the campaign followed recommendations from the Senate Inquiry into Menopause and Perimenopause, which reported in September 2024, and found “many women entered this stage of life without enough information about symptoms, treatment or available support”.
The inquiry recommended the Government “launch a national menopause and perimenopause awareness campaign, providing information and resources for women and communities across Australia”.
The Government supported the recommendation in its February 2025 response to the Senate report.
The Australian College of Nursing (ACN) welcomed the campaign, and “called for urgent reform to the Medicare Benefits Schedule (MBS) so that nurse practitioners can effectively and efficiently contribute to meeting the growing demand for menopause and perimenopause care”.
Butler also welcomed the March quarter GP bulkbilling statistics, showing a national rate of 81.9 percent, up 4.6 percentage points on the same period last year. He said: “We haven’t just stopped the Medicare freefall under the previous Government, we have reversed it and strengthened it – dramatically”.
Meanwhile the average fee charged by specialists continues to be double the Medicare rebate, and the Government’s response has been to announce a Parliamentary inquiry. (I’m not sure if the date of the announcement – 1 April – means it should not be taken seriously.)
At a media conference following the menopause campaign announcement, a journalist asked Butler: “Last year we spoke about the inequity that oral cancer patients are facing, having to re-mortgage their homes or drain their super to pay for dental prosthetics. You said that you were looking at that. Can we just have an update on where that’s gotten to?”
Butler responded: “We haven’t landed a particular position with that group… I realise this is an area where people, understandably, would like to see more progress. I don’t have anything in particular I can say about that today except, as I said last week, I want to continue to engage with this group of stakeholders on what more we can do.”
In its 2025 pre-election submission, Head and Neck Cancer Australia (HANCA) costed a prostheses scheme for survivors of head and neck cancer surgery at an annual $13 million.
So far this year Butler has issued nine media releases about new listings on the PBS for a range of diseases including lung cancer, bladder cancer, prostate cancer, lymphoma, and a range of rare cancers. The total annual cost of these new medicines is about $1.4 billion.
One-tenth of one percent of this expenditure would fund the prostheses scheme for cancer survivors proposed by HANCA – yet all Butler can do is engage with stakeholders.
Aged Care Minister Sam Rae announced Andrea Kelly was stepping down from her role as Interim First Nations Aged Care Commissioner.
Kelly was appointed in January 2024. In December 2024 (18 months ago), following an extensive consultation process, she released a report Transforming Aged Care for Aboriginal and Torres Strait Islander People.
Rae described the report as “a landmark piece of work…. deeply informed and grounded in the voices of the people it is written for”.
“It will guide this Government’s work for years to come, and it stands as a lasting contribution to the lives of older First Nations Australians,” Rae said.
The Minister said “the Government is actively progressing a response to this critical report”, and “continuing to work with the community to establish a Permanent Commissioner”.
You can’t rush these things!
Assistant Minister for Health Rebecca White announced the Government would provide almost $7 million to the Australian Preterm Birth Prevention Alliance and Women’s Healthcare Australasia to continue implementing the Every Week Counts National Preterm Birth Prevention program.
White said the interim evaluation report into the program reveals it has delivered on its goals and reached more than half of Australian public births in its first phase.
The Department of Health, Disability and Ageing (DHDA) posted on GrantConnect the names of the 12 organisations to receive funding for the next four years under the Health Peak and Advisory Bodies Program. While nine of these receive grants under the existing program, funding for a dozen other organisations will stop. More details are available in my article here.
DHDA also announced ‘One more way you keep them safe’, a campaign to promote free routine immunisations for children, which it said had been developed “in response to declining childhood immunisation rates and growing uncertainty about vaccines among some parents and carers”.
“It aims to provide reassurance about vaccine safety and highlight the importance of completing the immunisation schedule on time.”
The Centre for Disease Control (CDC) said the Chief Medical Officer of DHDA, Professor Michael Kidd AO, had declared diphtheria a Communicable Disease Incident of National Significance. The fact that it is the CMO making the declaration, not the CDC Director-General, tells you everything you need to know about the CDC’s powers.
The CDC also issued a statement about human papilloma virus (HPV) vaccine, saying: “Australia has made remarkable progress in the fight against [the virus], achieving a 90 percent reduction in HPV prevalence since the national vaccine program began in 2007.”
However, a recent report the CDC funded from the Kirby Institute had raised concerns about declining vaccination rates and unequal access to the vaccine, with vaccination coverage in adolescents aged 15 years falling from a peak of 85.7 percent in 2020 to 79.5 percent in 2024.
As well as Medicare GP bulk billing statistics, the Australian Institute of Health and Welfare (AIHW) released monthly statistics on Medicare Benefits Scheme funded services, and Pharmaceutical Benefits Scheme prescriptions, and an updated report on Suicide and self-harm monitoring.
It released a series of “Australian facts” reports on Chronic kidney disease, Diabetes, and Heart, stroke and vascular disease, with key information for monitoring the diseases, including risk factors, major subtypes, treatment and impact.
The AIHW published updated data on hospitals, including 2024-25 information on admitted patient care and non-admitted patient care.
Finally, on 29 May the AIHW posted a number of reports on aged care, including:
- Admissions into aged care
- Interfaces between the aged care and health systems
- People’s care needs in aged care
- People leaving aged care
- People using aged care
- Providers of aged care.
It also published a user guide to the National Aged Care Data Clearinghouse and a paper setting out practical considerations for researchers using CHSP data linked to other aged care data.
The Independent Health and Aged Care Pricing Authority (IHACPA) released its Support at Home Pricing Advice 2026–27 and Support at Home Cost Collection 2025 Final Report.
IHACPA Chair David Tune AO PSM said the “pricing advice is grounded in evidence, informed by real cost data and direct engagement across the sector”.
He thanked everyone who participated in the cost collection and consultation process, saying “stakeholder feedback is vital to ensuring our advice reflects not only financial considerations, but also the practical aspects of delivering in-home aged care”.
IHACPA said that in developing its advice it “accounted for recent Fair Work Commission decisions, superannuation guarantee increases, and the indexation of historical cost data”.
Ahpra said Sydney man David Nasr, who conducted more than 600 bogus consultations pretending to be a podiatrist, had been sentenced to two years’ jail and ordered to pay $51,900 in legal costs after pleading guilty to 16 breaches of the National Law.
Ahpra said Nasr “used fraudulent documents to secure contracts with businesses supporting aged care facilities and in-home care services”.
First Nations
AMSANT CEO Donna Ah Chee wrote an article for The Guardian, arguing diphtheria is a disease of poverty that has no place in modern Australia. She wrote “when we talk about Closing the Gap, this is the gap”.
“It is overcrowded housing that allows infectious diseases to spread quickly in communities with high levels of poverty and food insecurity,” she said. “It is practical barriers to transport and healthcare access. It is the lack of affordable healthy food in remote communities and poor environmental health conditions.
“These are the conditions that allow diseases of poverty to persist in one of the richest countries in the world.”
Australian Indigenous Doctors’ Association (AIDA) CEO Dr Peter Malouf said the outbreak must be treated as both a clinical and an equity issue.
He said diphtheria is not simply a disease-control issue and that this outbreak “is occurring in the context of known gaps in access to primary care, immunisation follow-up, housing, wound care, health infrastructure and culturally safe services in remote and regional communities”.
AIDA called on all Governments to “work transparently with Aboriginal Community Controlled Health Organisations, public health units, general practice, hospitals and local leaders to ensure the response is adequately funded, culturally safe and clinically effective”.
(Croakey has previously covered the outbreak here and here.)
Trade unions
ACCRM said it had launched a “new online course ‘ADHD: Assessment and Management for Rural Generalists’, designed to support doctors to build confidence in recognising ADHD presentations, undertaking assessment, and participating safely in management and shared care models”.
ACCRM President Dr Rod Martin said many communities across rural and remote Australia faced extended waiting times to access ADHD assessment or support, and specialist services were limited or not available at all, meaning Rural Generalists were becoming “frontline clinicians in ADHD care”.
The Australian Dental Association (ADA) urged members to use World No Tobacco Day (31 May) to begin a conversation with patients about quitting, using “ADA-created, trustworthy consumer oral health information”.
The Australian Medical Association (AMA) released its submission to the Therapeutic Goods Administration review of sunscreen regulation, saying stronger sunscreen rules were needed to restore confidence and protect Australians.
The AMA called for more reliable and transparent SPF testing, emphasised the importance of robust and consistent water-resistance standards, and supported “a consistent SPF cap for secondary (cosmetic) sunscreens to reduce consumer confusion and ensure these products are not mistaken for primary therapeutic sunscreens”.
AMA Vice President Associate Professor Julian Rait warned “sunscreen must also remain affordable and accessible”, cautioning that regulation changes” must not inadvertently reduce its use”.
The AMA also said it was “disappointed by the Government’s decision to release its delayed responses to two significant inquiries [gambling and diabetes] behind a veil of distraction, and is concerned the move is indicative of further inaction on health crises facing Australia”.
AMA President Dr Danielle McMullen said the timing of the responses on Budget day “appeared to be a deliberate attempt to avoid media and public scrutiny, rather than acknowledge and respond to concerns that it is not doing enough to tackle these public health crises”.
“It seems the chief consideration has been avoiding accountability for not only the delay in publishing these responses but the content itself,” she said.
“While waiting for the Government’s response, Australians have suffered cumulative losses to the gambling industry of more than $90 billion, and an estimated 2,500 lives have been lost to Type 1 and Type 2 diabetes.”
The Royal Australian College of GPs (RACGP) launched its Advocacy Plan 2026–30, which it said “set a clear, long‑term agenda to improve patient outcomes and strengthen the voice of general practice across Australia”.
The five priorities in the Plan are to:
- Increase investment in general practice to value the critical role of specialist GPs in the health system
- Ensure changing models of care are evidence-based, value and prioritise safety and quality, and do not fragment care
- Grow and sustain our specialist GP workforce and better support International Medical Graduates
- Realise a health care system that is culturally safe and inclusive
- Unlock the full potential of general practice by reducing red tape, embracing innovative technologies and enhancing research.
Industry groups
The Pharmacy Guild quoted Minister Butler as saying he would “consider introducing a payment for pharmacists who administer diphtheria vaccines” to patients who were not eligible under the National Immunisation Program.
(Pharmacists administering a vaccine to an eligible patient receive $20.05.)
Pharmacy Guild NT Branch President Peter Hatswell said the Minister’s commitment to consider funding was not enough.
“If the Government is serious about prevention and keeping Australians well, this must be treated as a priority. Funding these vaccinations is a practical step that directly benefits patients and strengthens public health.”
Of course, if the Guild was serious about positioning pharmacies as healthcare providers rather than shopkeepers it could recommend they vaccinate first and sort out the money later.
Parliamentary committees
Senate estimates hearings for the Health, Disability and Ageing portfolio will take place on Tuesday 2, Wednesday 3, and Friday 5 June.
The program schedules whole of portfolio issues for Tuesday morning, followed by aged care for the rest of the day.
Wednesday sees health benefits programs until 4pm, followed by other health programs including mental health, First Nations health, health workforce, preventative health, the TGA, and immunisation.
Disability is scheduled for the whole day on Friday.
Anybody wishing to watch the livestream can find links here.
International organisations
The World Health Organization (WHO) issued a statement on the outcomes of meetings of various advisory groups considering potential vaccines and therapeutics for both prevention and treatment of Bundibugyo virus disease (BVD), the particular strain involved in the Ebola outbreak in the Democratic Republic of Congo.
WHO said “there are currently no licensed therapeutics or vaccines specifically approved for the prevention and treatment of BVD”.
“Nevertheless, WHO advisory groups considered several candidate products that are promising enough to warrant prioritisation for evaluation in clinical trials. WHO is now working closely with the governments of the Democratic Republic of the Congo and Uganda to facilitate the implementation of research evaluation of these products.”
It is at least two to three months before any candidate vaccines will be available for efficacy assessment through a clinical trial.
The experts also reviewed the potential role of Ervebo, the only licensed Ebola vaccine approved for use during outbreaks caused by the most common Ebola virus in Africa, and concluded “evidence on cross-protection to other Ebola virus species remains limited and inconclusive”.
WHO recommended that Ervebo should only be used in carefully designed research settings, to allow for its performance against BDV to be assessed.
Finally
It has been a while since this column has included a quiz – so here we go.
Who wrote this?
“Medicare was built in 1984 for a health system that no longer exists, designed around a population with far less chronic disease. Our workforce is fragmented, our medicine approvals too slow, and our private and public hospitals under structural strain. Our research infrastructure is underfunded and our out-of-pocket health costs among the highest in the developed world – in a nominally universal system.”
“The Government has spent money, some of it well. Yet spending more money on 1984 architecture is not the same as building a system fit for 2035… Much of what is needed is already in reviews before the Government. What is missing is the political will to build a brave new medical system for our future rather than just patching up the one we have.”
A: Shadow Health Minister Anne Ruston
B: AMA President Dr Danielle McMullen
C: RACGP President Dr Michael Wright
D: Member for Kooyong, Dr Monique Ryan
E: One Nation leader Pauline Hanson.
(*** Answer at end of column)
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.
Office of the Gene Technology Regulator
Commercial supply of multivalent cat vaccines containing a genetically modified component for the prevention of feline leukemia virus infection
2 June
Australian Commission on Safety and Quality in Health Care
Acute Coronary Syndromes Clinical Care Standard Review
2 June
Department of Health, Disability and Ageing
Tobacco Act Compliance Strategy
3 June
Department of Health, Disability and Ageing
Consultation on the National Standard Operating Procedures for Clinical Trials in Australia
3 June
Therapeutic Goods Administration
Approach to Predetermined Change Control Plans for Medical Device Software
5 June
National Health and Medical Research Council
Public Consultation on Draft Guidance for the Australian Drinking Water Guidelines
5 June
Australian Commission on Safety and Quality in Health Care
Pathology sector remote working
7 June
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
Catheter-based renal denervation for uncontrolled elevated systolic blood pressure
Genetic testing to detect estrogen receptor 1 (ESR1) variants in patients with estrogen receptor (ER)-positive, HER2-negative, locally advanced or metastatic breast cancer, to determine eligibility for treatment with PBS subsidised elacestrant
Positron emission tomography/computed tomography (PET/CT) dopaminergic imaging for evaluating Parkinsonism
Diagnostic genomic testing for fetal anomalies
FreeStyle Libre 2 continuous glucose monitoring (CGM) System for people with insulin-dependent type 2 diabetes, gestational diabetes and type 3c diabetes
Transcatheter Edge-To-Edge Repair (TEER) for the treatment of severe tricuspid regurgitation (TR) using the TriClip device
Dexcom ONE+ Continuous Glucose Monitoring (CGM) System for people with insulin-dependent type 2 diabetes
Expansion of specialist supervision criteria for MBS and PBS items for integrated, closed-system, extracorporeal photopheresis and methoxsalen (UVADEX®) for the treatment of Cutaneous T-Cell Lymphoma and chronic Graft Versus Host Disease
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
Monash University
Dementia Guidelines
6 July
Food Standards Australia New Zealand
Review of young child formula
7 July
Medical Services Advisory Committee
177 Lutetium PSMA-617 for prostate specific membrane antigen (PSMA)-positive, taxane-naïve patients with metastatic castrate resistant prostate cancer
F-18 Fluorodeoxyglucose positron emission tomography for evaluation of complex infection
Transcranial Doppler bubble test for patent foramen ovale
Testing for Chromogranin A in patients with neuroendocrine neoplasms
In situ hybridisation testing of tumour tissue to detect viral genomes (EBV and HPV)
Investigations to support the use of PBS-subsidised lecanemab in people with mild cognitive impairment and mild dementia due to Alzheimer’s disease
Testing for hepatitis B virus and hepatitis B virus surface antigen to support the use of PBS subsidised bepirovisen in people with chronic hepatitis B
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
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
*** Quiz answer: Dr Monique Ryan, in an article in The Saturday Paper.
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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