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

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More than 500 health professionals have called on the Australian Government, the Parliament, the Australian Medical Association, medical colleges, specialist societies, doctors’ unions and health sector peak bodies to do more to stop the “indefensible” trauma inflicted upon Palestinian children (and others) by Israeli authorities.

“If these were Australian children, our nation would be united in grief and outrage, and we would demand protection, accountability and justice,” they write in an open letter. “We cannot value Palestinian children any less. Their lives are worth no less, their pain is no less real, and their right to safety, care, food, shelter and a future is no less absolute.”

The Zap asks the Australian Health Practitioner Regulation Agency (Ahpra) for its views on the open letter, and also reports on calls for tighter regulation of lobbyists, as well as developments in women’s health, aged care, and tobacco control.

And our columnist details a recent poll that found more people (41 percent) would rather pay more tax to fund free or low-cost mental health support than accept the current state of mental health funding (32 percent).

For readers in need of some levity, don’t miss the statistically challenging humour.

The quotable?

…if governments repeatedly acknowledge evidence, promise reform, and yet struggle to deliver different outcomes, what does that do to public trust in government and democracy?”

Charles Maskell-Knight writes:

Deepcut News published an open letter from over 500 health professionals on Gaza calling on the Australian Government and Parliament to:

  • Move from statements of concern to action, using every diplomatic and legal mechanism to compel an immediate and permanent end to the killing and to protect children, civilians and healthcare workers
  • Undertake a full review of Australia’s diplomatic, trade and defence relations with Israel, and immediately impose a comprehensive arms embargo, ending all defence-related trade including dual-use products, components and technology, so that no Australian support can enable violations of international humanitarian law
  • Demand that Israeli authorities lift the blockade and allow the unobstructed entry of food, medicine and humanitarian and medical supplies
  • Pursue accountability through the International Court of Justice, the International Criminal Court and targeted sanctions, and press for the immediate release of detained Palestinian healthcare workers, including paediatrician Dr Hussam Abu Safiya, held without charge
  • Fund paediatric medical evacuations, surgical and rehabilitative care, prosthetics, and long-term mental health support for Palestinian children and families
  • Support international efforts to rebuild the homes, hospitals, schools and essential infrastructure children depend on, and to restore the land, water and environment devastated by the conflict.

Deepcut News characterised the letter as “an act of defiance” against the decision by the Australian Health Practitioner Regulation Agency (Ahpra) to adopt the controversial IHRA definition of antisemitism in June”.

Croakey has published a number of articles on the Ahpra adoption of the IHRA definition and access to care in Gaza – see here, here, here, here, and here.

The Zap asked Ahpra whether it or the Medical Board believed the open letter constitutes antisemitism within the IHRA definition, and if so, what disciplinary action the Medical Board intended to take against such a large number of signatories, including many health sector leaders?

Ahpra responded that it “is committed to free speech and the right of registered health practitioners to enter into professional and public debates”.

“Ahpra is equally committed to the prevention of the harm caused by racism and discrimination. If commentary becomes demeaning or denigrating and directed toward specific members of the community, this is where Ahpra and the National Boards might undertake regulatory action,” the agency said.

As the commentary does not appear to be “demeaning or denigrating and directed toward specific members of the community”, I think this means the signatories are in the clear.

R U OK?

10 September was R U OK? Day and World Suicide Prevention Day.

The Department of Health, Disability and Ageing (DHDA) used the occasion to remind people of the availability of the Medicare Mental Health Check.

RACGP President Dr Michael Wright backed R U OK?’s message that a simple conversation can change a life, saying: “If someone tells you that they are struggling, you don’t have to solve everything yourself. Encourage them to get help – and their GP is a great place to start.”

Wright said: “GPs do much more than refer people to other mental health services. We can assess what’s going on, provide treatment, develop a plan for their care and connect them with other support when they need it.”

The Australian College of Rural and Remote Medicine (ACRRM) urged Australians “to look out for their mates, families and neighbours this R U OK? Day”, saying Australian Bureau of Statistics (ABS) data shows the suicide rate in remote and very remote Australia is almost two-and-a-half times the rate in major cities.

ACCRM President Dr Rod Martin said “behind every one of those statistics is a person, a family, a group of mates and often an entire community”.

Martin said people living outside major cities can face additional challenges including distance, isolation and more limited access to mental health services.

“That’s why having rural generalist doctors living and working in rural and remote communities matters.”

Health Minister Mark Butler announced grants totalling $82.9 million through the National Suicide Prevention Leadership and Support Program (NSPLSP) to support 36 organisations delivering evidence-based suicide prevention initiatives across the country, and Assistant Minister Emma McBride spoke at a World Suicide Prevention Day breakfast.

Ministers and government

On 4 June, under pressure over the fact the Integrated Assessment Tool for access to aged care services did not allow for manual override, Aged Care Minister Sam Rae told the ABC: “I’ve asked the Department to conduct a rapid review and give us their findings within three months so that we can continue to make the changes to this system that get the very best outcomes for older people.”

On 9 September, independent MP Dr Monique Ryan told Parliament “that three-month mark passed last week, and my team has reached out to Minister Rae’s office for an update on his ‘rapid’ review”.

“But we’ve been told that the review hasn’t yet landed with his office.”

Ryan quoted Rae’s platitude, that “we’ll make whatever changes are necessary to get the best outcomes for older people”.

She said: “There is an immediate fix on the table: restore human oversight.”

Minister Rae said the Government is inviting applications for membership of the National Aged Care Advisory Council (NACAC), closing on 8 October.

He said “expert members are selected for their strong connections within the aged care sector in a variety of areas and their ability to deliver constructive feedback to the Government as we deliver our once-in-a-generation reforms”.

A DHDA consultation on the draft report on MBS Time Tiered Items from the Medicare Benefits Schedule Review Advisory Committee began on 3 September and closes on 15 October.

The draft report “seeks the adoption of five key principles for items which should be applied to time-tiered attendances in primary care [and] provides a range of recommendations to align current MBS time-tiered items with these key principles”.

AMA President Dr Danielle McMullen said: “One of the most encouraging aspects of the draft report is its recognition that the current rebate structure disadvantages patients who need longer consultations and the doctors who provide them.

“The report recommends reforms that would better support longer consultations and improve rebates for more complex care. Importantly, it also explicitly considered the AMA’s proposed seven-tier consultation model and acknowledged that longer-term structural reform remains necessary.”

However, she warned that “there is still a long road ahead”. Government will consider the report, the profession will provide feedback, and many of the details remain to be worked through, she said.

On 9 September, DHDA released a consultation paper on Specialist Affordability: Options to Address Excessive Fees.

After considering the definitional issue, the paper set out a range of intervention options.

At the time of writing, I have not seen any reaction from medical groups.

The Therapeutic Goods Administration (TGA) announced “changes to the Personal Importation Scheme, to help authorities identify imported therapeutic goods and reduce the risk of unidentified, mislabelled or counterfeit products entering Australia”.

Under the changes “medicines imported under the scheme should remain in their original packaging where possible, including any dispensing labels or product information needed to accurately identify the goods”.

The changes also clarify:

  • the types of therapeutic goods covered by the scheme, including goods imported for therapeutic use such as contraception and testing kits
  • who is considered an immediate family member under the scheme
  • evidence requirements for people travelling to Australia with prescription-only medicines.

The TGA also said that following a review it was consulting on options for additional safeguards for 4-methylbenzylidene camphor (4-MBC), an active ingredient used in some Australian sunscreens. The consultation process ends on 12 October.

The Centre for Disease Control (CDC) issued a statement marking World Field Epidemiology Day. It said that this year field epidemiologists from the CDC have supported work on a range of public health priorities “from infectious syphilis and diphtheria to Ebola disease risk assessments and highly pathogenic H5N1 avian influenza (bird flu)”.

The CDC also marked Women’s Health Week (the five days from 7 to 11 September), saying the week “is a great opportunity to shine a spotlight on the health issues that matter most to women and to encourage conversations about prevention, early detection and access to care”.

During the week, the Australian Commission on Safety and Quality in Health Care (ACSQHC) released new resources to help consumers understand more about diagnostic and non-diagnostic ultrasounds during pregnancy and empower patients to make informed decisions about their care.

The resources include a fact sheet for consumers on different types of pregnancy ultrasounds and a poster for display in practices (with a QR code link to fact sheet).

The ACSQHC also spruiked its new Women’s Health webpage with other practical information for healthcare professionals on pregnancy and childbirth, heavy menstrual bleeding, and use of pelvic mesh for pelvic organ prolapse and incontinence.

Other health groups also acknowledged the week, including:

  • The Cancer Council, which urged Australian women to book their next screening appointment, and to adopt health habits that can help reduce their cancer risk
  • The Heart Foundation, which welcomed a new global definition of heart attack it said will improve the diagnosis of women and help address longstanding gaps in recognition of women’s heart disease.
  • The Rural Doctors Association of Australia.

The Australian Institute of Health and Welfare (AIHW) released a report presenting “an updated analysis on the health and wellbeing of Stolen Generations survivors aged 50 and over and of descendants of Stolen Generations aged 18 and over”.

It said “the findings show that both groups face significant challenges compared with other Indigenous Australians of the same age and compared with the non-‍Indigenous population”.

Among survivors, 71 percent had a disability or restrictive long term health condition, while 49 percent suffered high psychological distress. Survivors were 2.7 times as likely as other First Nations people to have a severe or profound disability.

The report found “after accounting for differences in age, sex and remoteness, outcomes for Stolen Generations descendants tend to be somewhat poorer than those for other Indigenous Australians of the same age across many of the domains explored”.

“Differences were found across physical health and care needs, social and emotional wellbeing, health risk factors and socioeconomic circumstances.”

Read more in this Croakey article from Professor Steve Larkin, Chair of The Healing Foundation.

The AIHW also published a report on mortality outcomes among people receiving income support, focusing on individuals aged 18 to 64 receiving income support payments from 2012 to 2022.

It found people receiving an income support payment had an average mortality rate of 610 deaths per 100,000 person-years, substantially higher than for people not receiving income support (on average 67 deaths per100,000 person-years).

While the age-adjusted mortality rate for income support recipients was subject to variation as a result of COVID-related eligibility changes, the rate of 541 per 100,000 person-years in 2022 compared with a rate of 67 for non-recipients.

The report also found:

  • Rates of death from accidental poisoning were 22 times as high among people receiving income support, at an average of 39 deaths per 100,000 person-years, compared with 1.8 deaths per 100,000 person-years for people not receiving income support
  • Rates of death from alcoholic liver disease were 21 times as high among people receiving income support, an average of 25 deaths per 100,000 person-years, compared with 1.2 deaths per 100,000 person-years for people not receiving income support
  • Suicide deaths were 5 times as high among people receiving income support, an average of 38 deaths per 100,000 person-years, compared with 7.7 deaths per 100,000 person-years for people not receiving income support.

(The report made it clear the “analysis does not examine, nor does it provide evidence of a causal relationship between receiving an income support payment and death”.)

The Independent Health and Aged Care Pricing Authority (IHACPA) said it “wanted to hear from people from across the health and aged care sectors to better understand how they use our information, what they need from the website and where their experience could be improved”.

People interested in taking part in the research can register here by 18 September.

In a move welcomed by the AMA, Ahpra announced it was launching a fee deferral pilot for medical graduates to lessen the impact of upfront registration costs.

The Aged Care Quality and Safety Commission (ACQSC) announced that following its scrutiny, “one of Australia’s largest aged care providers has refunded or credited more than $190,000 to almost 350 residents as part of reviewing Higher Everyday Living Fee (HELF) arrangements”.

While legislative confidentiality provisions apparently prevented the ACQSC from identifying the provider, SBS identified it as Opal Healthcare.

The ACQSC action followed a request in March from Aged Care Minister Sam Rae that it investigate complaints against Opal.

The ACQSC announcement coincided with an announcement by Minister Rae that the Government will amend the Aged Care Rules 2025 to protect aged care residents from being charged a HELF for services they were receiving at no extra cost before the new Aged Care Act began in November last year.

Older Persons Advocacy Network (OPAN) Director Policy, Education and Systemic Advocacy, Samantha Edmonds, said the changes provide important protection for existing residents but do not resolve broader concerns about Higher Everyday Living Fee arrangements.

Edmonds said the change will “not establish a clearer boundary between what is considered standard aged care and what can legitimately be charged as a HELF”.

“OPAN continues to hear concerns about HELF charges relating to services many older people reasonably expect to be part of everyday residential aged care, including televisions, access to basic internet and food options.”

“We remain concerned that by excluding new residents from access to what should be provided services, such as in-room TVs and WiFi, the new rights-based Act won’t be able to deliver on its intent, and HELF risks creating a two-tiered aged care system, where quality of life may depend on an older person’s ability to pay rather than genuine choice.”

Under section 341 of the Aged Care Act 2024, DHDA is required to maintain a publicly available register of reports sent by state and territory coroners to DHDA about the death of an individual accessing funded aged care services where those reports include a recommendation to the Department.

Lawyer and aged care and dementia advocate Stef Todorov drew attention to the non-compliance by DHDA with the requirement, saying the register did not contain any entries, even though Victorian Coroner Ingrid Giles in findings released on 29 July called for the development of a national medication safety standard for safe prescribing, dispensing and administration of medications in residential aged care facilities.

Giles’ inquiry covered three deaths in 2024 and 2025.

Todorov said she had written to the Inspector-General of Aged Care “raising my concerns about the Department’s delay in updating the register after receipt of a relevant coroner’s recommendation”.

Following Todorov’s post on LinkedIn, the register has been updated to include the SA coroner’s recommendation in relation to a death that occurred in 2020.

Perhaps other updates are in the pipeline?

Consumer and public health groups

The Cancer Council joined 75 other organisations in a statement coordinated by the Australian Democracy Network calling for a National Lobbying Act to:

  • Ensure all lobbyists are held to the same standard, whether they work for professional lobbying firms, industry associations, or corporations
  • Strengthen and enforce lobbying bans for former ministers, advisors and public servants to prevent conflicts of interest
  • Shine a light on the process by publishing ministerial and advisor diaries, and requiring detailed, public reporting of lobbying activity
  • Appoint an independent body with the authority to enforce rules and ensure system integrity
  • Give the regulator teeth to investigate breaches and impose penalties that actually deter misconduct.

COTA said: “The Government must urgently introduce consistent safeguards for automated decision-making, with aged care showing the risks of allowing technology to outpace protections.”

COTA CEO Patricia Sparrow said the private members bill introduced by independent MP Kate Chaney shows what practical safeguards look like in legislation and should provide further momentum for the government to deliver its promised whole-of-government framework.

“Government should not be using automated systems to make important decisions about people today and promising to work out the rules tomorrow,” Sparrow said.

Mental Health Australia (MHA) said new national polling by Essential Media found two in three people (68 percent) believe governments should invest more in mental health support.

MHA called on Governments to get mental health reform back on track, following the 4 September Health Ministers meeting, “which failed to deliver meaningful progress on a new National Mental Health and Suicide Prevention Agreement”.

MHA CEO Carolyn Nikoloski said: “Governments have already delayed the next National Agreement by 12 months.

“At a time of increasing mental health challenges and pressures, communities cannot afford further delays and ongoing uncertainty.”

The Essential Research polling also found:

  • More people (41 percent) would rather pay more tax to fund free or low-cost mental health support than accept the current state of mental health funding (32 percent)
  • More than two in five people (43 percent) say governments are handling mental health poorly
  • Two in three people (65 percent) believe there is a gap between the mental health support people need and what is currently available
  • Fewer than half (49 percent) of people believe they could afford mental health care if they needed it
  • Four in five people (81 percent) agree cost should not prevent people from accessing mental health support
  • There is strong concern for mental health and wellbeing of families and younger generations (64 percent).

The Australian and New Zealand Journal of Public Health published the results of one of the largest and most recent surveys to examine patterns of lifetime e-cigarette, tobacco cigarette and nicotine pouch use among Australian adolescents.

It found that over 12 percent of teens had used e-cigarettes in their lifetime, almost six percent had used tobacco, while 3.5 percent had used nicotine pouches, and over two percent of all respondents had used all three.

Males had nearly three times greater odds of nicotine pouch use than females and over one and a half times greater odds of cigarette use.

Lead author Dr Lauren Gardner from the University of Sydney said the study shows the need for targeted strategies to prevent teenage nicotine addiction and to support young people to quit.

“The teenage years are a critical period for preventing nicotine use – it’s the period when the brain is most susceptible to addiction, which they can then carry for life. Our study shows that teenage boys may benefit from targeted support.”

“Many teens who have used one nicotine product have also tried others, so we need effective prevention strategies that address shared risk factors for nicotine use more broadly, rather than focusing on just vaping or smoking.”

First Nations

The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) celebrated the “groundbreaking work that the organisation and its Members have undertaken over the past 30 years” at a special event at the Victorian Parliament House.

VACCHO CEO Dr Jill Gallagher AO highlighted the crucial role ACCOs play in advocating for the rights of Aboriginal and Torres Strait Islander people.

“ACCOs are an Aboriginal-led response to the intergenerational impact of colonisation and the policies of dispossession and assimilation that have caused damage to the health and wellbeing of Aboriginal people in Victoria.”

“For 30 years, VACCHO has stood alongside our members and community – championing a model of care that is led by Aboriginal people, for Aboriginal people.”

Executive Director of VACCHO’s Balit Durn Durn Centre Sheree Lowe once again drew attention to the urgent need for Government to fund two Healing Centres.

Lowe said “Healing Centres are a key example of Aboriginal-led evidence-based solutions – and this would help finalise recommendation 33 of the Royal Commission into Victoria’s Mental Health System”.

Trade unions

Allied Health Professions Australia (AHPA) said it “warmly congratulated Tracey Thomson on her appointment as the DHDA Chief Allied Health Officer”.

I’m glad AHPA reported this appointment, because I can find nothing about it on the DHDA website.

The Australian Nursing and Midwifery Federation (ANMF) launched an aged care campaign – Australia needs care you can count on – calling on the Government to “address the deepening aged care crisis”.

The ANMF demanded action on:

  • Mandating staffing ratios and skills mix across all shifts to replace the current care minutes system and align with evidence-based benchmarks, delivering higher quality care and mandating a proper framework for aged care providers to meet
  • Preventing workplace violence and aggression by implementing a 10-point plan and person-centred care planning to better protect nurses and care-workers from physical, verbal and emotional violence
  • Ensuring accountability and transparency for $25 billion in aged care funding by introducing public reporting of aged care providers’ financial performance and use of public funding.

The Pharmaceutical Society of Australia (PSA) welcomed an announcement by NSW Premier Chris Minns that:

  • Community pharmacies in NSW will be able to deliver all vaccinations under the National Immunisation Program from 1 January 2027
  • There will be a trial for expanded scope of practice to include wound care, chronic disease management, otitis externa, and otitis media
  • Pharmacists who receive an appropriate post graduate qualification from the University of Newcastle or the University of Technology Sydney will be able to treat a range of conditions and will be authorised to prescribe and initiate the oral contraceptive pill.

PSA National President Professor Mark Naunton said it would continue to work with the NSW Government to ensure PSA’s Graduate Certificate in Pharmacist Prescribing is recognised in NSW as it is in Victoria, Queensland, WA, Tasmania, and the NT.

The RACGP also commented on the Minns announcement, saying the NSW Government “has once again seemingly prioritised politics over patient safety by expanding its pharmacist prescribing scheme to appease powerful donors”.

RACGP NSW and ACT Chair Dr Rebekah Hoffman said “the NSW Government is expanding pharmacy prescribing into more complex care when the evidence for the existing model remains weak”.

“Health policy should follow the evidence, not the money,” she said.

The RACGP also urged the Federal Government “to judge its national women’s health pharmacy trial on whether women actually get the care they need and whether they get better – not simply how many prescriptions are written”.

RACGP President Dr Michael Wright said: “If this trial is going to help shape the future of women’s healthcare, we need to know what happens after the pharmacy visit.

“Did the treatment work? Did the woman need more care? Were important health issues picked up? And did the service connect her with the rest of her health care, or make that care more fragmented?”

“The Government has called this a trial. It should give us clear answers to those questions – not simply tell us how many services were delivered or whether people found it convenient.”

The Australian and New Zealand Association of Neurologists (ANZAN), a specialty society of the Royal Australasian College of Physicians (RACP), and the Epilepsy Society of Australia (ESA), warned: “Australians with epilepsy are waiting months, and in some cases more than two years, to access specialist care, putting them at risk of avoidable hospitalisation, injury and death.”

The joint ANZAN and ESA submission to the Senate inquiry into epilepsy calls for the Government to:

  • Establish a national strategy for epilepsy care
  • Develop clear national referral criteria and service benchmarks for escalation to epilepsy-specific and comprehensive epilepsy centre assessment
  • Improve access to regional and remote epilepsy services by improved telehealth access
  • Invest in culturally safe, multidisciplinary epilepsy pathways delivered in partnership with Aboriginal Community Controlled Health Organisations
  • Expand the epilepsy workforce with investment in Neurology Specialist training, general practitioner (GP) education and training and an expansion of the Epilepsy Consultant Nurse network
  • Establish government-funded early-career research fellowships for junior epilepsy investigators
  • Create a Commonwealth fund to support the development of new epilepsy therapies
  • Establish a national epilepsy registry and data platform.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) said: “Australians living with severe mental illness have been left waiting longer for much-needed reform after the Government deferred discussions on the National Mental Health and Suicide Prevention Agreement until December.”

“People should not have to understand which Government funds which service before they can get help,” said RANZCP President Dr Astha Tomar. “They need Governments to work together and a mental health system that works around them.

“That is the purpose of a national Agreement. It must make clear who is responsible for what, what will be funded, what will be delivered and by when.”

The RANZCP also said research released by Women’s Mental Health Australia “exposed a mental health system that continues to overlook the biological, social and structural factors shaping women’s mental health, despite half of Australian women experiencing mental ill-health”.

The research found one in two Australian women experienced a mental health issue in 2026, while almost one in four were experiencing severe psychological distress.

RANZCP said the findings point to the need for :

  • Greater research investment in women’s mental health
  • Action on the social and economic drivers of psychological distress
  • Safe and trauma-informed mental health facilities
  • Culturally safe services for Aboriginal and Torres Strait Islander women
  • Improved access to specialist perinatal mental healthcare.

Industry groups

Ageing Australia (the lobby group for aged care providers), the Australasian College for Emergency Medicine (ACEM) and the Royal Australian College of General Practitioners (RACGP) jointly called on “Governments at all levels to head off a looming national crisis in aged care capacity, which is spilling over to hospitals and community-based healthcare”.

The statement was long on diagnosis and remarkably short on treatment options.

Ageing Australia issued another statement claiming “aged care providers across Australia have cancelled plans for over 2,000 new beds, and counting, as a direct result of the Government’s decision to implement a real terms cut in residential care funding”.

(This is a reference to the Government’s decision to adopt advice from the Independent Health and Aged Care Pricing Authority (IHACPA) on the price of aged care services.)

Ageing Australia said “from 1 October, the AN-ACC price will be $303.19 per resident, an increase of just 2.55 percent from the current price of $295.64. This compares to pay rises of 4.75 percent for aged care staff and inflation of 3.5 percent”.

The hotelling supplement will also remain unchanged pending a review.

Ageing Australia CEO Tom Symondson said “far from encouraging new beds, this decision is likely to see national bed numbers decline, not to mention it will put at risk the significant improvements in care and resident satisfaction we have seen over the past five years”.

Symondson concluded: “The Royal Commission described inadequate government funding as ‘a major contributor’ to the problems it saw in aged care.

“Why would we risk the enormous gains we have made in quality of care for older people in the past five years, let alone building enough beds to meet demand, by ignoring that lesson?”

The Australian Association of Medical Research Institutes (AAMRI) said more than 30 leading medical research institutes had joined forces on 9 September for the Medical Research Giving Day, “the nation’s first landmark campaign encouraging Australians and businesses to back the discoveries that improve and save lives”.

Catholic Health Australia (CHA) republished on its website an article by CEO Tom Udorovic first published in The Canberra Times, saying “the deal with private health insurance was always a simple one. Pay your way and you will be rewarded for sticking with it later in life. This deal has underpinned our system for decades”.

It then goes on to argue that the Government’s proposal to align the premium rebate for people aged 65 and older with younger Australians is breaking the deal.

This is nonsense. The real mechanism that rewards older Australians for sticking with private health insurance, which has been in place for decades, is community rating and the system of risk equalisation that underpins it.

Community rating – which has been in place for well over 60 years – means every policyholder pays the same premium for the same policy, regardless of their age or health status. To avoid disadvantage to insurers with higher proportions of older and sicker policyholders, the marginal costs of people aged 55 and over (amounting to over $9 billion annually) are pooled and distributed across all policies under the risk equalisation arrangements.

While all policyholders pay about $5,200 a year for Gold level hospital insurance, the cost of the policy would be considerably less for a 25-year-old but for community rating and risk equalisation. And per contra the premium for a 70-year-old would be much higher.

The impact of community rating can be seen by reference to private health insurance premiums in Aotearoa New Zealand, which does not have such a policy.

nib New Zealand offers Premium Hospital Cover with a $500 excess to a 25-year-old for $1,547 a year. The same policy purchased by a 70-year-old costs $8,998 – almost six times as much.

When the Government starts dismantling community rating, CHA can fulminate about breaking the deal with older policyholders.

Removing an unjustified differential subsidy that has been in place for only 20 years isn’t breaking the deal.

The Medical Technology Association of Australia welcomed the release of the Government’s exposure draft legislation on Capital Gains Tax and Research and Development Tax Incentive reforms, saying it “demonstrates growing recognition of the unique investment and commercialisation challenges facing Australia’s medical technology industry”.

In June, the Pharmacy Guild announced with much fanfare that independent modelling it had commissioned showed “pharmacist prescribing will create $1 billion in annual health system savings; free up over 10 million GP appointments and prevent 30, 000 hospitalisations annually”.

The report of the modelling (available from the Guild on request) did not contain any of the detailed work supporting these conclusions, as these were in “case studies” to be released later.

The Guild has now released the first case study, purporting to estimate the impact of specially trained pharmacists undertaking consultations for hormonal contraception.

The claimed benefits include:

  • 730,000 GP appointments avoided annually and freed up for other conditions, saving the Government $32 million in MBS rebates and women $23 million in out-of-pocket costs
  • 194 unintended pregnancies avoided, with direct savings of $3.6 million and indirect saving of $5.1 million
  • Productivity gains of $30 million, justified on the basis that “shifting routine hormonal contraception consultations from general practice to community pharmacy reduces the need for time taken off work to attend GP appointments. Fewer in-person consultations translate into meaningful productivity gains, generating substantial annual savings through reduced workforce absenteeism”.

Two points about this.

First, while the report provides sources for the data it has used, it does not give any detail of the assumptions and calculations used to derive the results. On this basis the editorial review panel of any respectable peer-reviewed journal would laugh it out of the room.

Second, it would appear that pharmacists are going to be donating their time to undertake the consultations – further evidence that the remuneration per script provided under the Community Pharmacy Agreement is completely disproportionate to the cost of dispensing, thus providing pharmacists with a source of remuneration to undertake other activities.

The Guild also issued a statement calling on the Queensland, Victoria, NT, ACT and Tasmanian Governments “to urgently strengthen protections for community pharmacists and pharmacy assistants amid growing concerns about increasing rates of violence and abuse directed at frontline pharmacy staff”.

Why only those jurisdictions? Apparently the others have a criminal provision along the lines of section 60AE of the NSW Crimes Act 1900 which creates a range of offences for assaulting, stalking, intimidating or harassing frontline health workers in the course of the worker’s duty, with penalties greater than those applying for common assaults.

I am reasonably confident that a would-be assailant in NSW is unlikely to be deterred by reading the Crimes Act and discovering that assaulting a health worker and inflicting actual bodily harm attracts a greater potential penalty (seven years imprisonment) than a similar assault on someone in the street (five years imprisonment).

Perhaps the Guild can provide data on the relative rate of assault on pharmacy staff in jurisdictions with and without the special provisions to bolster its case for action.

Politicians and parliamentary committees

On 17 August, Nationals MP Llew O’Brien introduced the Human Rights (Children Born Alive Protection) Bill 2026 into the House of Representatives.

The bill seeks to impose a duty to provide medical care for babies born alive after an abortion, and creates an offence with a penalty of up to 2,000 penalty units (currently $728,000) for breaching the duty.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) said it strongly opposes the bill, which falsely “insinuates that medical professionals may fail to provide care to a live fetus during an abortion”.

RANZCOG President Dr Nisha Khot said the bill “does not address any demonstrated gap in the existing legal or professional framework governing healthcare…”

“What this bill will do instead is add barriers to abortion access for women and vulnerable communities through creating fear and uncertainty amongst providers.”

RANZCOG concluded “fundamentally, not only is this Bill redundant in the face of robust professional guidelines around medical practice, but it is also a step backwards for access to equitable healthcare in Australia”.

The Senate inquiry into the private health insurance premium rebate changes held a hearing in Canberra on 11 September, with evidence from the Australia Institute, DHDA, Treasury and the Australian Prudential Regulatory Authority.

At the behest of WA Liberal Senator Dean Smith, the Senate also began an inquiry into “the effectiveness of the 2025 National Health Reform Agreement with Western Australia in the provision of public hospital services in Perth and northern suburbs. It will have particular reference to:

  • strong population growth in the area
  • increasing emergency department attendances
  • ageing-related demand, and
  • any other related matters.

The inquiry is due to report on 30 October. It is unlikely to add to the sum of human knowledge.

Finally

To mark Fathers’ Day on 6 September, the ABS released some Dad jokes (answers at the end of the column):

  • Why did the statistician hate averages?
  • What’s a statistician’s favourite music genre?
  • What’s a statistician’s favourite dessert?
  • Why was the chart arrested?

On a more serious note, former Inspector-General of Aged Care Natalie Seigel-Brown posted on LinkedIn:

“I never understood why Maya Angelou’s ‘When you know better, do better’ was considered profound (albeit I am her star fan!). Then I spent twenty years in public policy. Turns out we know better all the time. Doing better is where we struggle.

We know a great deal about what helps older people remain independent for longer. We know what reduces reoffending. We know that communities often hold deep insight into the solutions to the challenges they face.

Yet some of our most persistent public policy failures continue long after we understand both the problem and many of the answers.

We don’t have a shortage of evidence. We have a shortage of systems and incentives capable of acting on what the evidence tells us…

[The question is] not why governments sometimes get things wrong.

But why meaningful change can remain so difficult even when evidence is compelling, public scrutiny is intense, and there is broad agreement that improvement is needed.

And then there’s that scarier, deeper question: if governments repeatedly acknowledge evidence, promise reform, and yet struggle to deliver different outcomes, what does that do to public trust in government and democracy?”

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.

Pharmaceutical Benefits Advisory Committee
Public consultation on items to be considered by the PBAC in November 2026
16 September

Department of Health, Disability and Ageing
Public consultation on items to be considered by the PBAC
16 September

Office of the Gene Technology Regulator
Commercial supply of a genetically modified multivalent vaccine for chickens
25 September

Department of Health, Disability and Ageing
Medical Research Future Fund Reducing Health Inequities Mission – Consultation on the Roadmap and Implementation Plan
25 September

Australian Commission on Safety and Quality in Health Care
Draft National Safety and Quality Health Service Standards (third edition)
25 September

Australian Commission on Safety and Quality in Health Care
Revised Australian Guidelines for the Prevention and Control of Infection in Health Care
29 September

National Health and Medical Research Council

30 September

Pharmaceutical Benefits Advisory Committee
Rapid Review of PBS medicines for relapsing-remitting multiple sclerosis
1 October

Australian Commission on Safety and Quality in Health Care
Requirements in the draft National Safety and Quality Health Service Standards to improve the cultural safety and quality of care for Aboriginal and Torres Strait Islander peoples
2 October

Therapeutic Goods Administration
Consultation on sharing more information about medical devices
2 October

9 October

Therapeutic Goods Administration

12 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

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

Therapeutic Goods Administration
Additional public consultation on amending the Poisons Standard regarding ethylene oxide, propylene oxide and epichlorohydrin
26 October

ABS Dad jokes

Why did the statistician hate averages? They were too mean.

What’s a statistician’s favourite music genre? Pop-ulation.

What’s a statistician’s favourite dessert? Pie (chart).

Why was the chart arrested? It was plotting something.

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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