Governments are urged “to formally recognise severe and enduring mental illness as a distinct policy priority”, and to push back against efforts to undermine effective tobacco control policies, The Zap reports this week.
In other calls to action, the Australian College of Nursing has joined other health groups in urging the Federal Government to legislate to remove the de facto ban on voluntary assisted dying services being provided by telehealth.
And there are calls for medical school leaders to cede space, prioritise First Nations self-determination, and embed robust First Nations governance to lead the essential work of implementing the revised Australian Medical Council Standards for Assessment and Accreditation of Primary Medical Programs.
The quotables?
We are all deeply concerned about policies to make cigarettes cheaper and open the door to widespread commercial vape sales. This will kill more Australians.”
AND
I give confidential security briefings. You leak. He has been charged under section 2A of the Official Secrets Act.”
Charles Maskell-Knight writes:
The Senate inquiry into the Government’s proposed changes to the private health insurance premium rebate tabled its report.
Unsurprisingly, the Government majority recommended the legislation be passed, while Coalition Senators warned “the Albanese Government is engaging in an ideological crusade against private health at a time where a strong private health system is needed more than ever to support the overburdened public health system”.
Greens Senator Jordon Steele-John observed the party has “a policy position of redirecting public funds that are currently used to subsidise private health insurance, including the tax rebates, to the public health system”.
“The Government has not linked the revenue enabled by this bill to investment in the public health system,” he said.
“We welcome constructive engagement with the Government on amendments that would address [our concerns with the bill] and ensure it does not cause unintended harm to older people, particularly those on low and fixed incomes.”
Private Healthcare Australia (PHA, the private health insurers lobby group), the Members Health Fund Alliance (the lobby group for insurers which do not distribute profits), Bupa, and COTA all urged the Government to reconsider the policy following the report.
Reporting on the issue, Sally Sara of ABC Radio National interviewed Professor Stephen Duckett AM, who reiterated his message, reported at Croakey last month, that the sky will not fall in as a result of the Government’s proposal.
Government
I have now reported several times that, while Allied Health Professions Australia welcomed the appointment of Tracy Thomson as Commonwealth Chief Allied Health Officer (CAHO) on 10 September, the Government has not made any announcement of the appointment.
On 7 October, I asked the Department of Health, Disability and Ageing (DHDA) what was going on.
I was told “the Chief Allied Health Officer role has been filled by Tracey Thomson, who commenced in the role on 28 September 2026. DHDA notified allied health stakeholders of the appointment on 8 September 2026”.
I then asked DHDA to provide more information about Thomson.
I was told she has “a recognised background in nutrition and dietetics and broad experience across health, community, disability and Government settings. She completed a Master of Nutrition and Dietetics at Griffith University and has worked as a clinical, community and public health dietitian in Tasmania, including at the Royal Hobart Hospital, the Community Nutrition Unit and Diabetes Tasmania”.
Despite Thomson’s appointment over a month ago, the CAHO page of the DHDA website (last updated on 26 June) still did not mention her when this column was finalised on 10 October.
The Australian Institute of Health and Welfare (AIHW) released the first in a planned series of reports on polypharmacy, finding seven percent of people were regularly dispensed five or more medicines at a time in 2025. Of these, one in nine regularly received ten or more medicines.
While the rate of polypharmacy increased with age, there was little difference by gender at any age.
The AIHW said “in younger age groups, polypharmacy was characterised by medicines for mental health and neurological conditions, particularly antidepressants, antipsychotics and psychostimulants”.
“In older adults, the pattern shifted towards medicines used to manage chronic physical health conditions, including diabetes, cardiovascular disease, dyslipidaemia and gastro-oesophageal reflux disease.”
The AIHW also released updated reports on illicit drug use and alcohol consumption, updates to the chronic conditions dashboard, and a suite of reports on mental health including:
- Mental health crisis support
- A dashboard on young people’s mental health
- Online mental health resources and support
- Mental health MBS services and PBS prescriptions.
The Independent Health and Aged Care Pricing Authority (IHACPA) opened a consultation on Australia’s admitted care classifications and coding standards, seeking feedback across several key areas, including:
- ICD‑10‑AM/ACHI/ACS Fourteenth Edition
- AR‑DRG V13.0
- priority areas for future ACHI and AR‑DRG development.
Submissions are due by 13 November.
The Australian Commission on Safety and Quality in Health Care said it is “conducting a preliminary assessment of the Antimicrobial Stewardship Clinical Care Standard (2020) to assess whether it still reflects current best practice and remains focused on areas where improvement is needed”.
It invited clinicians to complete a short survey by 30 October to share their experience of antimicrobial stewardship, including current practice and whether quality improvement priorities are reflected in the Standard.
The Department of Veterans’ Affairs (DVA) responded to an ABC Four Corners report alleging a range of fraudulent practices in relation to health services provided to veterans.
Consumer and public health groups
The Australian Council on Smoking and Health (ACOSH) led a group of 30 health sector organisations in an open letter to “Australia’s political leaders”.
“We write as Australia’s leading health peak bodies, alongside doctors, nurses and community advocates,” they said. “We are all deeply concerned about policies to make cigarettes cheaper and open the door to widespread commercial vape sales. This will kill more Australians.”
The group said “the illicit trade was not caused by tobacco-control policies”.
“It has flourished because organised crime has access to a global oversupply of cheap tobacco – reportedly manufactured for less than a dollar a pack,” they said.
“There are 40,000 shops selling legal tobacco in Australia, compared to 9,500 supermarkets. We have allowed far too many tobacco retailers to operate alongside weak regulation and poor enforcement.
“This has allowed illicit sellers to take root street by street and suburb by suburb for too long. Criminal groups saw a low-risk, high-profit market and moved in.
“Making cigarettes cheaper and vapes available everywhere will not change that.”
The Lung Foundation said a survey it commissioned from YouGov showed: “Australians want Governments to prioritise public health over revenue from tobacco and vaping products, and keep those industries out of influencing public policy.”
Over 80 percent of respondents agreed that:
- protecting public health should be prioritised over government tax revenue from tobacco and vaping products
- tobacco and vaping companies should not influence public policy
- politicians should not accept donations from tobacco-related industries
- nicotine addiction among children aged 12–17 years and young people aged 18-24 who use vapes and other nicotine products is a problem.
The Lung Foundation said the results “show the vast majority of Australians are more concerned about nicotine addiction and health harms than government revenue, and support stronger measures to reduce nicotine addiction, not make nicotine products more readily available”.
National Seniors Australia (NSA) released a report on Older Australians’ Experiences as Carers, based on results of the 2026 National Seniors Social Survey.
Findings included:
- 89 percent of informal carers had not accessed respite care, and half of those who had accessed it reported difficulties in doing so
- the Government’s Carer Gateway is effectively invisible, with fewer than three percent of informal carers aware of it.
National Seniors Australia recommended the Government:
- implement the recommendations of the 2023 parliamentary inquiry into the recognition of unpaid carers, and legislate carers’ rights, following international examples such as the UK
- intensify communications campaigns to promote existing carer supports, including Carer Gateway, using language that recognises the enormity [sic] of what carers do and the real barriers they face to accessing help.
First Nations
The Australian Indigenous Doctors Association highlighted an article published by The Medical Journal of Australia, ‘Responding to the Revised First Nations Health and Cultural Safety Accreditation Standards in Australian Primary Medical Education: Institutional Principles and Qualities for Meaningful Progress’.
The authors – Sophie Pitt, Ashlee Williams-Barnes, Dr Ryan Dashwood, Keira Edwards and Associate Professor Paul Saunders, said they wrote the paper “to challenge the reliance on performative allyship and performative compliance visible only at accreditation time”.
“We want medical school leaders to understand that surface-level curriculum additions are insufficient for genuine transformation,” they wrote.
“Meaningful progress requires genuine, reciprocal partnership-building, with First Nations Communities positioned as experts in their own health and wellbeing. Ultimately, we are asking institutional leaders to cede space, prioritise First Nations self-determination, and embed robust First Nations governance to lead this essential work.”
They said “for medical schools responding to strengthened accreditation expectations, the message is clear: accreditation may create an impetus for action, but meaningful progress requires sustained commitment and institutional transformation led by First Nations knowledge, expertise and governance”.
Trade unions
The Australian College of Nursing (ACN) joined the ranks of health sector groups calling on the Government to legislate to remove the de facto ban on voluntary assisted dying (VAD) services being provided by telehealth.
ACN CEO Adjunct Professor Kathryn Zeitz said “a nurse practitioner may lawfully administer a voluntary assisted dying substance in several jurisdictions, but cannot safely discuss that same lawful care with the patient by telephone”.
“A care navigator cannot confidently answer an emailed question from a family in a remote community.”
ACN pointed out removing the Commonwealth ban would leave every existing safeguard under state and territory legislation intact, including “multiple independent assessments, formal witnessed declarations, repeated confirmation of decision-making capacity and voluntariness, and mandatory reporting to review boards”.
The Australian Dental Association (ADA) said the Queensland Child Oral Health Study (QCOHS) 2022-24 study “found that water fluoridation has led to significant reduction in dental decay across all age groups of children aged 5-14 years over a period of ten years”.
ADA President Dr Chris Sanzaro said “tooth decay is dropping across Queensland, which proves fluoridation works”.
“But thirty percent of Queensland kids are still missing out, and councils that opted out of water fluoridation over the last ten years are still being left behind.”
The ADA called for the Queensland Government to resume responsibility for water fluoridation, a decade after the responsibility was ceded to local governments.
The Australian Medical Association (AMA) called for urgent reform of the mental health system, “warning that people living with severe and enduring mental illness are being left behind by care models that are fragmented, crisis-driven, and unable to provide the long-term support many patients need”.
The AMA released a new position statement, Supporting Australians with severe and enduring mental illness, and called for governments “to formally recognise severe and enduring mental illness as a distinct policy priority and to invest in integrated, medically led models of care that support patients across the course of their illness”.
The position paper also argued for:
- increased mental health bed capacity
- expanded rehabilitation, step-up and step-down services
- greater investment in multidisciplinary community mental health teams that can provide coordinated, long-term care.
The Australian Physiotherapy Association (APA) called for “physiotherapy to be recognised within GLP-1 treatment pathways so people with identified clinical and functional needs can access support to maintain strength, mobility, physical function and independence”.
It released a position statement recommending:
- physiotherapy be explicitly recognised in national GLP-1 guidance
- referrals remain based on individual patient need and practitioner capability
- function outcomes including strength, mobility, balance, participation, physical capacity and independence be incorporated into treatment planning and evaluation
- expanded access to allied health services under the MBS Chronic Condition Management arrangements.
Regular readers of this column would be aware of the Pharmacy Guild’s relentless campaign to expand pharmacists’ role to include diagnosis and treatment of a range of conditions, justified on the basis of improved access and convenience for patients.
The Royal Australian College of GPs (RACGP) returned fire on 6 October, “calling for long-overdue reform of pharmacy ownership and location rules to give patients more choice, increase competition and support better integrated health care”.
RACGP President Dr Michael Wright said the “outdated rules that restrict where pharmacies can open and who can own them… limit competition and patient choice”.
“At a time when households are under pressure from the cost of living, governments should be looking closely at rules that can keep prices higher and stand in the way of better services,” Wright said.
“It’s time to ask whether [the rules] still serve patients – or whether they primarily protect existing pharmacy owners from competition.”
Wright said the RACGP wanted to see pharmacists working alongside GPs and other health professionals as part of coordinated teams, rather than creating more fragmented services.
He said innovative models such as dispensing pharmacists working within general practice would mean “patients could have more of their healthcare team working together, with better communication and continuity of care – that’s what integrated care looks like and that should be the goal”.
The virtual ink was barely dry on the RACGP statement when the Guild issued a statement welcoming the Victorian Government’s commitment to expand pharmacist prescribing (‘Chemist Care Now’) to cover menopausal hormone therapy and gastro-oesophageal reflux disease.
The RACGP responded saying “Victorian women need better access to ongoing menopause care, not just another way to obtain medication”.
RACGP Victoria Chair Dr Anita Muñoz said: “Menopause affects women in different ways. GPs help patients manage their symptoms, review treatment, identify other health concerns and make decisions about their long-term wellbeing.
“A repeat prescription might be one part of that care, but it cannot replace the value of an ongoing relationship with a GP who understands your medical history.”
Muñoz said that before expanding Chemist Care Now further, the Victorian Government “should independently evaluate its impact on patient outcomes, affordability and continuity of care”.
The RACGP also marked World Mental Health Day with a statement calling on the Government to increase Medicare rebates for longer consultations.
Industry groups
As I reported last week, the Government’s estimate of aged care spending for last financial year at the time of this year’s Budget on 12 May proved to be overcooked by $1.4 billion at the end of the year several weeks later.
Ageing Australia (the peak body for aged care providers) said the underspend “exposes a stark gap between the funding allocated to aged care and the care reaching older Australians, with money left unspent despite significant and growing unmet demand”.
Ageing Australia CEO Tom Symondson said “we don’t have $1.4 billion less need for aged care”.
“We have more than 106,000 older Australians waiting for ongoing Support at Home funding and thousands stuck in hospital because there is nowhere appropriate for them to go,” he said.
“Whatever the reason for the underspend, the result is both crystal clear and totally impossible to justify when so many older Australians are waiting for the care and support they desperately need.”
Ageing Australia said the underspend could fund all three of its emergency residential aged care measures this financial year:
- lifting this year’s AN-ACC increase from 2.55 percent to five percent
- increasing the hotelling supplement by 3.5 percent pending a review of the real funding need
- bringing forward the planned $5 increase to the accommodation supplement from March 2027 to October 2026.
These would cost $510 million, leaving around $900 million, which could immediately take 30,000 older Australians off the Support at Home waiting list.
(The fiscal fiends at the Department of Finance would of course argue that these measures would increase the funding base, adding $1.4 billion a year to aged care spending forever.)
Ageing Australia also issued a statement claiming members had told it “more than 3,000 planned aged care beds have now been shelved as a direct result of the Government’s decision to deliver a real-term cut to residential aged care funding”.
(The Government decided to adopt the recommendations of the independent IHACPA on aged care pricing.)
Symondson said “the Government knows all too well how desperately Australia needs more aged care beds”.
“It has repeatedly acknowledged the scale of the challenge and even committed funding for new builds in this year’s Budget,” he said.
“So its decision to cut, in real terms, the funding providers use to pay the salaries of our hard-working nurses and carers is bewildering. No provider can build a home they will not be able to afford to staff, particularly when providers are losing money on existing beds.”
The Australian Private Hospitals Association (APHA) “welcomed the Government’s recognition that restrictions preventing overseas-trained psychiatrists from working in private hospitals need to change”.
Unfortunately the APHA did not cite a source for this recognition, and I have been unable to find one.
PHA released its submission to the DHDA consultation on private health insurance reform, saying “while it can be tempting to generate a laundry list of problems and reform targets in a particular sector, regulatory reform of the private health sector should have a strategic focus and not get distracted by Band-Aid measures and quick fixes”.
“We need to develop a clear understanding of the role our sector plays in the funding and delivery of healthcare, what role we want it to play, and what needs to change to achieve this.”
Indeed. There is no sign that the “reform” process so far has considered these fundamental issues, and the DHDA consultation paper reads exactly like a laundry list of every idea advanced by interest groups over the past decade.
Politicians and parliamentary committees
The Senate second inquiry into the Aged Care Legislation Amendment (Aboriginal and Torres Strait Islander Aged Care Commissioner and Other Measures) Bill 2026 also produced its report, again recommending the bill be passed.
This inquiry considered the provisions included in the bill as a result of Government amendments to create a review pathway for assessment decisions under the Aged Care Act.
Coalition Senators observed those amendments are “a Band-Aid on a symptom, not a fix for the cause”.
“The evidence shows that the fundamental problem in the assessment system under the Support at Home program lies in the Integrated Assessment Tool’s classification algorithm…,” they said.
“Despite the weight of evidence, the Department told the committee it does not agree the tool is flawed.”
They concluded that “unless the Government is prepared to acknowledge that the algorithm has failed and set out a clear plan to correct it, Coalition Senators are not willing to support a measure that treats only the symptom”.
“Doing so risks entrenching a flawed system and relieving pressure on the Government to undertake the fundamental reform that is required.”
In his dissenting remarks, Senator Steele-John said “any reforms to the aged care assessment system that do not have a view to the abolition of the IAT, full reworking of any algorithm and the restoration of human override by clinicians, are inadequate”.
“The Greens will not give cover to the continuation of this broken algorithm, the bypassing of clinical assessors and the systematic under-assessment of older Australians’ needs,” he said.
“We remain committed to a total reform of the aged care assessment system.”
International organisations
The World Health Organization (WHO) released its first guidelines “addressing the sharp rise in obesity among children and adolescents, setting out how health systems and health workers can deliver timely, evidence-based and people-centred care”.
Dr Luz María De Regil, Director of the WHO Department of Nutrition and Food Safety, said “the foundation of obesity care for children and adolescents is not medicine or surgery, but access to comprehensive support that enables healthy eating, physical activity and sustainable behaviour change”.
WHO also launched a new global roadmap to tackle hypertensive disorders of pregnancy, including pre-eclampsia, which affect millions of women every year.
It said these disorders remain among the leading causes of death and serious illness for pregnant women and their babies, with tragic long-term impact on their families.
There is “a striking innovation gap between the scale of the problem and the lack of medicines specifically developed and approved by regulators for the prevention or treatment of pre-eclampsia or eclampsia”, the WHO said.
“Research investment has largely focused on diagnostics, with chronic underinvestment in new preventive and treatment options.”
Finally
One of my favourite Yes Minister quotes is from Bernard Woolley on irregular verbs, giving as an example the conjugation: “I give confidential security briefings. You leak. He has been charged under section 2A of the Official Secrets Act.”
On 9 October, following the Four Corners report on veterans’ care, the Pharmacy Guild issued a statement calling on the Government “to examine whether Australia’s healthcare regulations are keeping pace with the growth of vertically integrated healthcare models”.
It appears the vertical integration being aggressively pursued by the Guild, where pharmacists combine the roles of diagnosis, prescription, and dispensing, is acceptable, while other vertical integration is not.
It is all about the conjugation.
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.
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
Australian Commission on Safety and Quality in Health Care
A short survey to assist in a preliminary assessment of the Antimicrobial Stewardship Clinical Care Standard (2020)
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
Independent Health and Aged Care Pricing Authority
Consultation on ICD-10-AM/ACHI/ACS Fourteenth Edition and AR-DRG V13.0 Development
13 November
Office of the Gene Technology Regulator
Cost Recovery Implementation Statement
13 November
Senate Community Affairs Committee
2025 National Health Reform Agreement with Western Australia
27 November
Department of Health, Disability and Ageing
“We want to hear about your experience with aged care assessments and the Support at Home program”
14 December
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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