Australians’ unhealthy diets, new releases from the Australian Commission on Safety and Quality in Health Care, yet more concerns about vaping, and the latest on the Commonwealth Home Support Program (CHSP) are among the topics covered this week.
Meanwhile, the Government is under renewed pressure to expand the Commonwealth Prac Payment program to include allied health students, and the Royal Australian College of GPs now has a Men’s Health Specific Interest group.
And the financial crisis affecting private hospitals appears to be greatly over-stated, our columnist reports.
The quotable?
Indeed, of the 94 industry sectors reported in the data, only five had a higher proportion of businesses making a profit or breaking even than private hospitals.”
Charles Maskell-Knight writes:
For the last several years the Australian Private Hospitals Association (APHA) has been issuing media releases about the dire financial situation facing the private hospital sector, and calling on the Government to legislate to compel private health insurers to disburse 90 percent of premium revenue as benefits.
The most recent APHA media release appeared on 22 June, based on Australian Bureau of Statistics (ABS) 2024-25 data on Australian industry, and highlighting the $756 million loss the sector incurred.
APHA CEO Brett Heffernan said: “The Government’s own data dispels any suggestion that the crisis facing private hospitals is overstated. Nobody can say they weren’t warned about the state-of-play or the consequences to come.”
Catholic Health Australia issued a similar statement.
Given 2024-25 was the year Healthscope went into receivership, I am sure that a large proportion of the $756 million loss can be attributed to that one business.
As well as data on profit or loss by sector, the ABS release also included data on the percentage of businesses by sector that made a profit or broke even, or made a loss.
It shows that in 2024-25, 88.1 percent of private hospital businesses made a profit or broke even (ABS reference 81550DO001_202425, table 4, cell AD373), compared with 78.7 percent the previous year, and 80.8 percent in 2022-23.
A proportion of 88 percent of businesses making a profit or breaking even is right on the average for the healthcare and social assistance sector as a whole, and compares favourably with total education and training (77 percent), computer system design and related services (72 percent), gambling (56 percent), and mining (50 percent).
Indeed, of the 94 industry sectors reported in the data, only five had a higher proportion of businesses making a profit or breaking even than private hospitals.
What was that crisis again?
As the APHA noted, total employment in the sector increased, and new capital expenditure amounted to just over three-quarters of a billion dollars (albeit down 3.5 percent from the previous year). These are hardly the indicia of a sector in crisis.
Ministers and government
Health Minister Mark Butler announced: “From 1 July, women across Australia will be able to access menopause and perimenopause care and support through all 33 Endometriosis and Pelvic Pain clinics.”
Butler said the clinics will “continue to provide specialised support for endometriosis and persistent pelvic pain, while expanding access to provide women with perimenopause and menopause care, to help with the treatment and management of symptoms”.
Aged Care Minister Sam Rae announced the appointment of Jodi Cassar PSM as the second Interim First Nations Aged Care Commissioner. She succeeds Andrea Kelly, who was appointed in January 2024.
Part of Kelly’s remit was to consult on the possible role and functions of the permanent Commissioner. Following an extensive consultation process, she released her report covering this and many other issues in late 2024.
Eighteen months later, Rae is promising legislation to establish the permanent position will be introduced in the winter session.
Rae also sought applications for membership of the Aged Care Quality and Safety Advisory Council, established to “provide expert advice to the Aged Care Quality and Safety Commissioner and the Aged Care Complaints Commissioner – identifying emerging risks, making recommendations and monitoring the effectiveness of the Commission’s work to uphold and protect the rights of older people”.
The Department of Health, Disability and Ageing (DHDA) released the report of the independent review of the National Rural Health Commissioner (NRHC) legislative framework, presented to Assistant Minister for Rural and Regional Health Emma McBride on 1 May.
The review found “the NRHC commands a high degree of respect and is perceived as a truly independent voice that can ‘funnel’ the views of many stakeholder organisations”.
Apart from recommending an expansion in the role of the NRHC to produce a biennial overview of key issues in rural health (highlighting the key issues that the NRHC is seeing in the performance of its activities and the key areas of both concern and good practice), the review essentially endorsed the current arrangements.
The Australian College of Rural and Remote Medicine welcomed the review, describing it as a strong endorsement of the Commissioner’s role and continued investment in rural health leadership.
The Australian Institute of Health and Welfare (AIHW) released the Essential vaccines performance report 2024-25, providing an assessment of state and territory performance against the benchmarks outlined in the Essential Vaccines Schedule for the year ending 31 March 2025. It found five jurisdictions met all benchmarks.
The AIHW released a depressing report on diet, finding:
- 96 percent of children did not meet the recommended serves of fruit and vegetables (with 5.8 percent not usually eating any fruits and 4.5 percent not usually eating any vegetables)
- 56 percent and 94 percent of adults failed to eat enough fruit and vegetables respectively
- people of all ages generally did not eat the recommended serves of grains, meat and alternatives, and dairy products and alternatives
- people eat too much food that is high in energy and low in nutrients (“discretionary food”), which accounted for 35 percent of the daily energy intake for children aged 2‑17, and 31 percent of daily energy intake for adults
- dietary risk factors contributed to 50 percent of coronary heart disease burden and 26 percent of bowel cancer burden, and collectively accounted for $4.4 billion of spending on health conditions.
The article also noted “dietary behaviours and patterns are greatly influenced by the wider determinants of health – the broad contextual factors that determine the health of a society and the individuals within it”.
“In 2023, one in eight (13 percent) of households experienced food insecurity.”
The AIHW released a related report on overweight and obesity, finding two-thirds of adults and a quarter of children lived with overweight and obesity in 2022-24.
Food for Health Alliance Executive Manager Jane Martin said the findings “point to the urgent need for Government action to protect children’s health now and into the future”.
The Alliance called for the Government to:
- Limit unhealthy food and drink marketing, especially to children
- Mandate the Health Star Rating system on all packaged supermarket foods
- Introduce a tax on sugary drinks companies to encourage them to cut sugar from their products
- Improve how all baby and toddler foods are made and marketed.
It is now 34 years since the Government published the first (and last) Food and Nutrition Policy, focusing on the link between health and nutrition, and intended “to improve health and reduce the preventable burden of diet-related early death, illness and disability among Australians”.
Perhaps it is time for an update?
The AIHW released a report on sports injury, finding sports injuries led to 61,000 hospitalisations in 2024-25. The rate of hospitalisation injury was highest among males aged 15-19, and the most common injuries were fractures of the arm or shoulder.
The AIHW also released articles on the health of children and the health of young people, a report on Alcohol and other drug treatment services in 2024-25, an updated report on suicide & self-harm monitoring, and monthly Medicare Benefits Scheme funded services data.
The Australian Commission on Safety and Quality in Health Care (ACSQHC) released the updated National Consensus Statement on essential elements for safe and high-quality paediatric end-of-life care with the latest guidance for clinicians and health services.
The ACSQHC also issued a revised Open disclosure framework, providing “a nationally consistent basis for effective communication following unexpected healthcare outcomes and harm… designed to enable all health care professionals working within Australian health service organisations to communicate openly with patients when healthcare does not go to plan”.
In late 2024 DHDA asked the Psychology Board to “explore feasible options for a redesigned, shorter, and more practical pathway to registration, starting from undergraduate study and including the fifth and sixth years of training”.
The Board has just finished consultation on an option involving a five-year Bachelor of Professional Psychology course leading to registration. Students could also exit psychology education after three years with a Bachelor of Psychological Assistance, and enter the workforce as a psychology assistant, in a non-related profession.
The Board noted that further scoping was required to develop this element of the option.
The Psychotherapy and Counselling Federation of Australia (PACFA) has now issued a statement calling on the Government and the Board “to remove the proposed ‘Psychology Assistant’ role from the current redesign of psychology training pathways”.
It said “the proposal would commit public funding to a new, undefined and potentially unregulated workforce, one for which no case has yet been made while tens of thousands of qualified, registered counsellors and psychotherapists remain profoundly underutilised”.
PACFA argued: “Government investment should focus on better utilising the existing counselling and psychotherapy workforce, which already operates under established professional standards and registration frameworks.”
Two points to make here.
First, I’m sure the Psychology Board thinks there is a clear distinction between the practise of psychology and the practise of counselling and psychotherapy.
Second, the “established professional standards and registration frameworks” PACFA refers to are a matter of self-regulation outside the Ahpra framework.
Consumer and public health groups
Lung Foundation Australia said it was “concerned by reports that a powerful sedative [etomidate] has been detected in vaping products being sold in Australia, highlighting the unpredictable and potentially dangerous nature of illicit vaping products”.
Foundation CEO Mark Brooke said “people who use illicit vaping products have no way of knowing exactly what substances they are being exposed to”.
“The reported detection of a powerful sedative in vaping products demonstrates just how unpredictable these products can be and reinforces why vaping remains a significant public health concern.”
First Nations
As recently reported at Croakey, Gayaa Dhuwi (Proud Spirit) Australia and Indigenous Allied Health Australia issued a joint statement calling for “urgent national action to recognise, resource, and embed the Aboriginal and Torres Strait Islander social and emotional wellbeing, mental health, suicide prevention and postvention workforce as a core pillar of Australia’s mental health system”.
They released a joint position paper with “clear, actionable recommendations to governments to deliver culturally strong, community-led reform as a blueprint for transformational change”. These include:
- Formal recognition of the social and emotional wellbeing, mental health and suicide prevention workforce in national frameworks
- Investment in workforce development across community, lived experience, and professional roles informed by the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework and Implementation Plan 2021- 2031
- Accurate and timely collection and reporting of disaggregated and comprehensive workforce data
- Collaborate commissioning and funding reform to enable cultural ways of working and to respond to the needs and preferences of Aboriginal and Torres Strait Islander people
- Investment in locally designed, interdisciplinary teams centred on cultural knowledge and community authority, supported by development of further knowledge and understanding of their value and impact
- Aboriginal and Torres Strait Islander governance embedded in all workforce planning, funding, program delivery and evaluation.
Trade unions
Allied Health Professions Australia (AHPA) said Dr Helen Haines MP and Senator David Pocock were about to table a petition in Parliament calling on the Government to expand the Commonwealth Prac Payment program.
AHPA CEO Bronwyn Morris-Donovan said “with more than half the allied health professions in national shortage, expanding the Prac Payment [beyond social work, nursing and midwifery students] should be an easy choice for Government to address workforce gaps and ensure consumers can continue to access the services they rely on across our health, disability and aged care systems”.
“Students should not have to choose between completing their degree and keeping a roof over their head and food on the table,” she said. “Too many students face significant barriers to completing their studies, especially those from rural and regional areas, mature‑age students with caring responsibilities, Aboriginal and Torres Strait Islander students, or those with limited financial means.”
The Australian Association of Psychologists (AAPi) said the Kids Helpline Impact Report, which found 129,000 young people contacted the helpline in 2025, with counsellors taking on average 14 emergency interventions a day, was deeply concerning.
AAPi Executive Director, Tegan Carrison said “when children and young people are reaching the point of attempted suicide, abuse-related crises or emergency intervention before they can access support, it is a clear sign our mental health system is intervening far too late”.
Carrison said the AAPi Budget submission called for:
- all Commonwealth-funded youth mental health services to include dedicated workforce development and clinical placement programs to build the future workforce
- a Medicare bulk-billing incentive for psychology services
- expanding Better Access from 10 to 20 Medicare-subsidised psychology sessions for people with higher support needs
- a minimum ratio of one school psychologist for every 500 students.
The Australian Medical Association (AMA) released its Ambulance Ramping Report Card 2026, which it said shows “shows record demand, worsening handover delays, and a system struggling to keep pace, with more than 2.4 million Australians arriving at emergency departments by ambulance in 2024‒25”.
AMA President Dr Danielle McMullen said: “Governments must tackle access block head-on by expanding hospital capacity, improving patient flow, and investing in the health workforce.
“These reforms are essential to prevent further harm, restore confidence in the system and ensure ambulances are available when people need them.”
The Pharmacy Guild said the Report Card “reinforces the need for governments to improve access to timely, community-based health care and make better use of Australia’s highly skilled health workforce”.
Guild President Professor Trent Twomey said “a nationally consistent approach to pharmacist prescribing would help patients get care sooner, free up GP capacity to focus on more complex cases and reduce avoidable pressure on hospitals and emergency departments”.
“If we are serious about prevention, early intervention and keeping people out of hospital, we need to make it easier for patients to access care in their local community pharmacy,” he said.
The AMA also released its submission to a consultation on patient election and rights of private practice changes under the 2026–2031 National Health Reform Agreement Addendum.
Schedule J of the Addendum provides inter alia “States agree to the following minimum requirements for right of private practice agreements… rights of private practice are granted only when services offered under the agreement are also available at the hospital, free of charge as public hospital services”.
It also provides for a patient election process to apply to all services delivered through a public hospital, rather than only admitted patient services.
The AMA said “the proposed changes represent a significant shift in operational, administrative, and clinical workflows, particularly in outpatient and mixed public–private settings”.
“Careful implementation will be critical to avoid unintended consequences for clinicians, patients, and system efficiency,” it said.
As I had not seen a public call for submissions, I asked DHDA if this was a targeted consultation.
I was told “the Department is consulting broadly with medical colleges and peak bodies, nursing and midwifery organisations, diagnostic imaging and pathology industry bodies, workforce representative groups, and the medical software industry. Separate discussions are being held with state health departments on the NHRA changes”.
Apparently patient groups are not being consulted, even though the intent of the revised arrangements is to improve patient choice.
And state health departments are being consulted, even though the states have signed an agreement incorporating the new arrangements.
The DHDA document distributed as part of the consultation process can be found here.
The Royal Australian College of GPs (RACGP) endorsed the formation of a Men’s Health Specific Interest group to address the significant gaps in men’s health outcomes and engagement with preventive care.
The group’s inaugural Chair, Dr Alex Romain, said “too often male patients’ worse health outcomes are treated as an unchangeable fact of life or accepted due to stereotypes about male self-neglect”.
RACGP Vice President Dr Ramya Raman said “compared to women, men not only visit the doctor less often, but when they do, the appointments are shorter – and usually happen when a problem has already become serious”.
“We want men to see their GP, whenever they need to, and for as long as they need to.”
Needless to say, part of the solution is higher MBS rebates for longer GP consultations.
This column reported last week on the release of the DHDA Whole of Medical Workforce Supply and Demand Study, and the AMA response.
The Rural Doctors Association of Australia (RDAA) has also responded to the study, saying it “confirms rural doctor shortages won’t fix themselves”, and “highlights the urgent need for smarter workforce planning, stronger rural training pathways and solutions tailored to the needs of rural and remote communities”.
RDAA President Professor Sarah Chalmers said while the study showed growth in the medical workforce in metropolitan and larger regional areas, “for most ‘Real Rural’ areas, MMM4 and beyond, the picture is largely one of stagnation”.
The RDAA is working to update its Rural Medical Workforce Plan by the end of the year to help guide future advocacy and policy development.
Chalmers said “many of the reforms identified in our 2021 workforce plan would not require substantial new funding”.
“They are practical measures that would improve efficiency, productivity and workforce outcomes across the health system.”
Industry groups
Medicines Australia said “a major new report has found Australia is missing significant productivity, workforce and economic benefits because cancer patients are waiting years to access innovative medicines already available in comparable countries”.
The report was prepared by Community and Patient Preference Research (CaPPRe) on behalf of the Medicines Australia Oncology Industry Taskforce.
Politicians and parliamentary committees
The Senate inquiry into the Transition of the Commonwealth Home Support Program to the Support at Home Program tabled its report, recommending that “the Commonwealth Home Support Program (CHSP) be retained as a separate block-funded program, and not transitioned into the Support at Home Program”.
However, the inquiry also recommended that “the Government extend funding to the CHSP for an additional three years after July 2027 to allow time for consultation and co-design to occur”.
“This additional time will also allow for the operation of the Single Assessment System and the Support at Home Program to be assessed in order to inform any future consideration of the transition of the CHSP.”
The CHSP Alliance said it welcomed the report, noting it was based on “compelling evidence that the new Support at Home Program is not fit for primary aged care services such as those that CHSP provides”.
Alliance Co-Convenor and Chair of Meals on Wheels Australia Paul Sadler said “the Committee recommended that a cost-benefit analysis of CHSP be conducted, including looking at the level of funding needed to meet current and future demand”.
“We now call on the Government to publicly announce its intention to not proceed with the amalgamation and to instead engage in a co-design process as recommended by the Committee,” he said.
“The CHSP Alliance welcomes the opportunity to partner with Government in designing the next stage in the life of CHSP as the national primary aged care program.”
Ageing Australia (the lobby group for aged care providers), COTA Australia and the Older Persons Advocacy Network issued a joint statement welcoming the inquiry report “recognising the role the CHSP plays in helping older people remain independent and connected to their communities”.
Ageing Australia CEO Tom Symondson said “we’re deeply concerned that moving CHSP into Support at Home, before the new program is operating effectively, creates significant risks for over 860,000 older Australians who rely on these services, as well as the providers delivering them”.
Shadow Health and Aged Care Minister Anne Ruston announced the Coalition had introduced the Aged Care Amendment (Restoring Human Override for Aged Care Needs Assessments) Bill 2026 to “force the Government to do what it has refused to do for months and put qualified assessors – not a computer algorithm – back in charge of aged care decisions”.
The bill was co-sponsored by Greens aged care spokesperson Penny Allman-Payne and independent ACT Senator David Pocock.
Ruston “urged Labor to support the Bill and, as a separate urgent priority, commit to a full redesign of the IAT with proper clinical input and a genuine trial before any further rollout”.
The Senate inquiry into the Support at Home Program held a hearing on 24 June to take evidence from the departing Inspector-General of Aged Care, Natalie Siegel-Brown.
While the transcript was not available when I finalised this column, the Office of the Inspector-General posted a summary of her evidence on LinkedIn.
Siegel-Brown told the inquiry that “Support at Home is not operating effectively to support older people to stay at home for longer”.
“The issues we are seeing with [the program] are not due to a failure of principle, but a failure of design. The current settings appear to be disproportionately impacting those with the least capacity to pay – potentially entrenching disadvantage rather than alleviating it.”
She “noted that the Government has shown it wants Support at Home to succeed and has demonstrated a willingness to make positive changes”.
I am more pessimistic than Siegel-Brown. While the Government has made some positive changes to Support at Home, it has been dragged there kicking and screaming by the weight of public opinion.
A fundamental element of the Aged Care Royal Commission’s vision for aged care was that access should not be rationed. So far, the Government has shown no intention of removing rationing for Support at Home, even when waiting times have increased to about a year.
International organisations
The King’s Fund, a UK health policy think tank, published an article by Fellow Helen Gilburt Delivering Care For People With Dementia – Why Data Matters.
Gilburt argues “data is vital for understanding the scale and nature of demand, planning care, ensuring equitable access to, and outcomes from existing care, and measuring the impact of new treatments and services”.
“Despite a range of available data on dementia across health and social care, the quality and consistency of that data lead to an incomplete and fragmented picture of care.”
(At this point I stopped to check she was writing about England and not Australia.)
Gilburt went on: “Addressing the data requirements for delivering effective health and social care, including data infrastructure, is key to ensuring that… future actions result in meaningful change for people living with dementia, their families and carers.”
Also in the UK, The Healthcare Improvement Studies (THIS) Institute published a blog post by Director Professor Mary Dixon-Woods, How can improvement and innovation save the NHS?
She wrote: “Innovation and improvement efforts have the potential to make a big difference to the NHS, although poor problem diagnosis, weak solution design, failure to address deep structural and cultural challenges, fragmentation, and inadequate evaluation remain major challenges.
“But there is hope. If the NHS adopts three capabilities: understanding problems, developing solutions, and evaluating them, it has the potential to succeed in a context of constrained resources.”
According to Professor Stephen Duckett AM, more or less every word in the post applies to Australia.
Finally
I am having a holiday next week. Croakey’s Dr Melissa Sweet has very generously agreed to prepare an abbreviated version of this column covering the main issues for publication on 6 July.
I will be back on deck the following week.
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.
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
- 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
Therapeutic Goods Administration
Consultation on increasing transparency of Good Manufacturing Practice inspection outcomes
13 July
Department of Health, Disability and Ageing
Feedback on consumer input on HTA committee agenda items
16 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
Department of Health, Disability and Ageing
Consultation on Sunsetting of Narcotic Drugs Regulations
19 July
Food Standards Australia New Zealand
Cell cultured duck (Anas platyrhynchos domesticus) biomass
22 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
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
9 October
House of Representatives Standing Committee on Health, Aged Care and Disability
Inquiry into the access to and affordability of medical specialists
16 October
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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