New publications aim to improve Australia’s response to tuberculosis in Aboriginal and Torres Strait Islander communities, and also to improve prevention and management of heat-related illnesses at mass gatherings globally.
Also covered this week are an assessment of specialist college medical training programs, recommendations for the Thriving Kids program rollout, and concerns about a pharmaceutical company’s plans to deliver its GLP-1 medication directly to consumers’ doors.
The quotable?
It is remarkable that with seven weeks to go in the financial year the Government could underestimate aged care spending by $1.4 billion – or 3.4 percent of the total annual allocation.”
Charles Maskell-Knight writes:
Eli Lilly launched LillyDirect, “an online pharmacy fulfilment platform, providing Australians living with obesity, type 2 diabetes and moderate to severe obstructive sleep apnoea, a simple and affordable way to access the select Lilly medicines that have been prescribed to them, with the added convenience of included home delivery”.
I’m not sure if the company intended to create a unity ticket between the medical and pharmacy professions, but that is what happened.
As the ABC reported, “a move by a multi-billion-dollar global pharmaceutical company to bypass bricks-and-mortar pharmacies and deliver its GLP-1 medication directly to consumers’ doors has been broadly condemned by doctors and pharmacists, who argue it poses a risk to patient safety”.
Royal Australian College of GPs (RACGP) president Dr Michael Wright said GLP-1 agonists were powerful medications with serious side effects, and needed proper oversight and continuity of care.
“What concerns me about this model is that potentially they can be prescribed in some situations and delivered by someone who doesn’t actually have full access to your whole record and I think that really creates risks for patients,” he said.
The Pharmacy Guild and the Pharmaceutical Society of Australia (PSA) issued a joint statement, “expressing serious concerns about Lilly Australia’s new Big Pharma-driven medicine supply model, warning it sets a dangerous precedent that risks the Americanisation of Australia’s healthcare system”.
They said the arrangement “diminishes the established relationship between patients and their pharmacist and reduces opportunities for face-to-face clinical interaction where medicine-related problems can be identified and addressed”.
Ministers and government
The Government’s decision to remove the copayments it had previously introduced on personal care services (such as showering, dressing, medication administration and continence products) for people accessing the Support at Home aged care program took effect on 1 October, and was marked by a media release from Aged Care Minister Sam Rae.
He said the change “will ensure older people receiving these services through Support at Home pay no out-of-pocket costs, helping them maintain their independence and continue living at home for longer”.
It’s a pity the Government didn’t think about the impact of the copayments before deciding to introduce them.
Rae added that “after a decade of neglect that left too many people waiting too long for care, the Government is responding to older people, carers and providers to improve our aged care system”.
Given there are now several hundred thousand people either waiting for an assessment, or waiting for care they have been assessed as needing, this statement shows more front than Myer.
Older Persons Advocacy Network CEO Craig Gear said: “We’ve been concerned that older people have been jeopardising essential personal care, including hygiene and showers, due to the cost of care and co-contributions. That’s why these changes are so important.”
The Therapeutic Goods Administration (TGA) announced it had begun Federal Court action against A.C.N. 641 483 703 Pty Ltd (in liquidation), formerly BioV8 Pty Ltd, and its former directors, Edward McGill and Nicholas Austin, in relation to the alleged unlawful advertisement of prescription-only therapeutic goods, including peptides.
The TGA is alleging the company “promoted the use of peptides for the treatment of serious diseases, conditions and disorders, including but not limited to cancer, HIV/AIDs and mental illnesses”.
The Centre for Disease Control (CDC) released new National guidance for the prevention and response to tuberculosis in Aboriginal and/or Torres Strait Islander communities, developed jointly by the National Aboriginal and Torres Strait Islander Health Protection and National Tuberculosis Advisory Committees.
The CDC said the guidance “aims to improve Australia’s response to TB in Aboriginal and Torres Strait Islander communities and reduce ongoing health inequalities”.
The Australian Institute of Health and Welfare (AIHW) released a number of publications, including national palliative care measures, which found improvement in two measures, stasis in four, and marginal regression in one (“Proportion of palliative care phases for people with life-limiting illnesses for which the distress related to pain improved or remained at a low level after intervention”).
The AIHW also released the BreastScreen Australia monitoring report 2026, and updated Cancer screening.
It published a 2025-26 update on Practice Incentives Program Quality Improvement Measures, the sixth national report based on the de-identified aggregate Practice Incentives Program Quality Improvement (PIPQI) Eligible Data Set, covering 10 measures across over 6,000 general practices.
The AIHW noted there are now four data extraction tools used to prepare PIPQI data files submitted for inclusion, and “we expect further diversification in the PIPQI data files as PHNs and practices change the tools they use to prepare and submit these data over time”.
It appears different software providers have different interpretations of the technical specifications and coding of QIMs, leading to variation in reporting rates due to different platforms rather than different performance.
The AIHW also released the latest chronic conditions dashboard, covering eight broad kinds of conditions, and almost four dozen specific conditions.
The Australian Bureau of Statistics (ABS) released the latest publication of Deaths Australia including 2025 data. While 188,421 deaths were registered in 2025 – 1,153 more than in 2024 – the standardised death rate decreased to 4.955 deaths from 5.078 in 2024 (deaths per 1,000 standard population).
The Psychology Board of Australia published a report summarising feedback received during public consultation on the proposed redesign of the psychology higher degree pathway.
The Board said “feedback demonstrated strong stakeholder interest in the future of psychology education and training, with widespread recognition of the need for reform to meet growing community demand for psychological services”.
“Consultation also identified potential challenges with implementation, supervision capacity, training quality and education provider impacts.”
Consumer and public health groups
COTA said this year’s UN International Day of Older Persons theme of ‘Rethinking Systems for Longer Lives’ highlights the need for a long term, whole-of-government plan for ageing.
COTA CEO Patricia Sparrow said: “Australians are living longer than ever, and that is good news. Too often, older people are treated as a problem to be managed, but longer lives are an opportunity, as long as we plan for them.”
Sparrow called for the Government “to commit to a ten-year plan for ageing, so the extra years Australians are gaining are good years”.
The Saturday Paper published an article by Grattan Institute Health Program Director Peter Breadon examining the secret power of the Pharmacy Guild.
“There are few better examples of what happens when politics and policy are left exposed to vested interests than community pharmacy,” he wrote.
“Dispensing fees are not based on evidence. They include surcharges that are hard to justify and one that can be added to the bill for no reason at all.”
As he points out, there hasn’t been a comprehensive study of pharmacy dispensing costs since 1989, when the independent Pharmaceutical Benefits Remuneration Tribunal decided fees were too high and moved to reduce them – leading to Ministerial intervention and the first Community Pharmacy Agreement.
Breadon argues that “the Independent Health and Aged Care Pricing Authority should collect pharmacy cost data and determine efficient pharmacy fees, applying the same principles of evidence, transparency and independent pricing that operate in other parts of the health system”.
Mental Health Australia (MHA) marked the start of Mental Health Month by releasing research showing “nearly two-thirds of people (64 percent) believe we are becoming more disconnected from each other, despite recognising the positive impact connection and belonging have on their mental health”.
MHA launched the national 2026 Mental Health Month campaign under the theme ‘Together We Thrive’, “highlighting the critical role that connection, belonging and community play in mental health and wellbeing”.
First Nations
NACCHO and ASHM Health called for continued action to address syphilis and its disproportionate impact on Aboriginal and Torres Strait Islander communities.
The two organisations released a report on the Second National Roundtable on Congenital Syphilis, setting out eight priority areas and more than 25 proposed actions to strengthen access, coordination and accountability across Australia’s response.
These included “prioritising community-controlled care, addressing health workforce shortages, and managing supply of the medications used to treat syphilis, which are facing recurrent shortages”.
The report said community-controlled care should be at the centre of national action, and identified ACCHO-led services, Birthing on Country programs, and Aboriginal and Torres Strait Islander Health Worker and Health Practitioner-led models as critical ways to build trust, strengthen continuity of care and keep people connected to testing and treatment.
Trade unions
The Australian Medical Association (AMA) released its latest Specialist Trainee Experience Health Check showing that while some progress has been made with specialist medical college training programs, many longstanding concerns remain unresolved.
The AMA said the report “found no specialist college received an A grade in any area assessed by trainees, while no training program achieved an overall A grade rating”.
“Longitudinal analysis also showed trainee experiences have remained largely unchanged over the past five years, with many indicators showing little or no meaningful improvement.”
AMA Doctors in Training Committee Chair Dr Natasha Abeysekera said: “While there have been some improvements in areas such as access to protected study leave and payment for un-rostered overtime, progress across the sector remains frustratingly slow.”
Sixty percent of doctors reported training costs caused financial stress.
Abeysekera said: “Doctors invest years of their lives in specialist training and deserve timely feedback, affordable training pathways and confidence that their voice is being heard by the colleges responsible for their training.”
The Australian Psychological Society and Australian Association of Psychologists warned children and families could miss out on vital early support if psychologists are not embedded in the Government’s new Thriving Kids model.
The bodies released a joint position statement, Embedding the expertise of psychologists in Thriving Kids, intended as a resource for governments, commissioning bodies, service planners and providers. It sets out where and why psychological expertise is relevant across the Thriving Kids model, from early identification through to referral and escalation, along with practical considerations for commissioning, workforce planning and collaboration.
The Royal Australasian College of Physicians said the Government should “establish the role of a National Chief Paediatrician to oversee rollout and implementation of the Thriving Kids program”.
And the Royal Australian and New Zealand College of Psychiatrists called for “psychiatrists and the broader child and adolescent mental health sector to be meaningfully involved in national and jurisdictional implementation planning” of the program.
Dieticians Australia and Exercise and Sports Science Australia (ESSA) said they had made a joint submission to the Pharmaceutical Benefits Advisory Committee, recommending the Committee:
- Advise the Government that PBS-subsidised GLP-1 treatments be accompanied by funded, voluntary referral pathways to Accredited Practising Dietitians and Accredited Exercise Physiologists during treatment and following dose reduction or cessation
- Refer the need for complementary Medicare funding to the Government, including up to 12 funded APD and AEP services in the first year of GLP-1 treatment, with ongoing access in later years during treatment and following dose reduction or cessation
- Recommend that post-listing evaluation by the government includes nutrition status, muscle strength and physical function alongside weight loss and cardiovascular outcomes.
The RACGP said: “The recently released evaluation of Tasmania’s community pharmacy urinary tract infection (UTI) pilot recorded 6,534 episodes of care and found around nine in 10 patients were supplied antibiotics.
“But it did not adequately track the most important measure – whether patients got better and received safe care.”
RACGP President Dr Michael Wright noted only 120 patients (1.8 percent) responded to the survey conducted as part of the evaluation, and among this group one in five said they needed further medical care after treatment.
“Before governments expand prescribing models, evaluations need to measure what matters most – whether patients get safe, effective care,” Wright said.
The RACGP also marked Breast Cancer Awareness Month, “urging patients to talk to their GP about their breast cancer risk and screening options, and to book an appointment promptly if they notice any changes in their breasts”.
The College called on the Government “to better fund longer consultations, which are critical for cancer prevention, early detection, and ongoing care after a diagnosis”.
Industry groups
The Australian Private Hospitals Association welcomed an election commitment from the Victorian coalition parties “to enlist the specialist surgical capacity of private hospitals to fast-track stranded patients waiting for surgery in the public hospital system”.
The Pharmacy Guild called on the Government “to freeze the maximum PBS co-payment at $25 until 2030, matching the existing freeze already in place for concession card holders”.
President Professor Trent Twomey said: “Australians deserve confidence that while other household expenses may rise, affordable access to medicines will remain protected.”
International organisations
The World Health Organization (WHO) said that “heat-related illness at mass gatherings, such as major sporting, religious and cultural events, has become a significant public health and operational risk, affecting spectators, attendees, volunteers and workers”.
It published a new review of evidence with guidance “showing that most of the heat-related illnesses at major events can be prevented or treated on site when timely risk management measures are put in place”.
WHO said the most effective approaches combine multiple measures, including:
- accessible and safe drinking water and toilets
- cooling infrastructure
- schedule adjustments
- crowd-flow management
- workforce protection measures
- public communication
- real-time surveillance
- well-prepared on-site medical services.
Finally
The Government released the Final Budget Outcome for 2025-26, showing a $6 billion reduction in the final deficit for the year compared with the estimate included in the 2026 Budget on 12 May – an improvement of $122 million a day!
While receipts were $4.6 billion higher than estimated, expenditure was $1.4 billion lower than estimated.
Although there were ons and offs, a major contributor was the aged care program which underspent by $1.4 billion, “largely reflecting lower-than-anticipated payments under the Support at Home program due to provider capacity constraints, and lower-than-anticipated residential aged care claim volumes”.
It is remarkable that with seven weeks to go in the financial year the Government could underestimate aged care spending by $1.4 billion – or 3.4 percent of the total annual allocation.
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.
Medical Services Advisory Committee
- Surgical Procedures for Gender Affirmation in Adults with Gender Incongruence
- Breyanzi (lisocabtagene maraleucel) for the treatment of large B-cell lymphoma
- Implantation of an active middle ear implant (Vibroplasty) for treatment of mixed and conductive hearing loss
- Supervised oral food challenge in patients with suspected food allergy
- Genomic testing for the diagnosis of primary immunodeficiency
- Procedures for the implantation and refill-exchange of the Port Delivery System with ranibizumab to treat neovascular age-related macular degeneration
9 October
Therapeutic Goods Administration
- Proposed amendments to the Poisons Standard in relation to 4-methylbenzylidene camphor (4-MBC)
- Proposed amendments to the Poisons Standard in relation to nitrous oxide
- Other proposed amendments to the Poisons Standard
12 October
Department of Health, Disability and Ageing
Aged care providers and workers delivering Support at Home
14 October
Department of Health, Disability and Ageing
New Framework Planning and NDIS Supports
14 October
Medicare Benefits Schedule Review Advisory Committee
MBS Time Tiered Items Draft Report
15 October
Australian Health Practitioner Regulation Agency and the National Boards
Scoping survey to help shape the review of the codes of conduct
15 October
House of Representatives Standing Committee on Health, Aged Care and Disability
Inquiry into the access to and affordability of medical specialists
16 October
Department of Health, Disability and Ageing
Specialist Affordability: Options to Address Excessive Fees
19 October
Productivity Commission
Closing the Gap Review
26 October
Therapeutic Goods Administration
Additional public consultation on amending the Poisons Standard regarding ethylene oxide, propylene oxide and epichlorohydrin
26 October
Food Standards Australia and New Zealand
Proposed addition of phytosterols, phytostanols and their esters as a novel food to bread
27 October
Australian Commission on Safety and Quality in Health Care
Consultation on draft Point of Care Testing Guide for Health and Aged Care Services |
30 October
Medical Services Advisory Committee
- F-18 Fluorodeoxyglucose positron emission tomography for evaluation of complex infection
- Kappa free-light chain index testing for the diagnosis of multiple sclerosis
- Detection of measurable residual disease in patients with multiple myeloma
- Genetic testing to identify homologous recombination repair gene alterations in patients with metastatic castration-sensitive prostate cancer to determine eligibility for treatment with PBS-subsidised talazoparib
- Anti-Müllerian hormone testing for identification of Polycystic Ovarian Morphology, to support the diagnosis of Polyendrocrine Metabolic Ovarian Syndrome (PMOS)
- Review of devices used in catheter-based cardiac ablation for the treatment of patients with cardiac arrhythmias
- Defensive Antibacterial Coating with antibiotics for reducing the risk of periprosthetic surgical site infection
- Lifileucel for the treatment of patients with previously treated unresectable or metastatic melanoma
- Efanesoctocog alfa for routine prophylaxis in patients with haemophilia A
6 November
Senate Community Affairs Committee
2025 National Health Reform Agreement with Western Australia
27 November
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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