National Cabinet met today in Brisbane to discuss key national priorities, and top of the agenda was the desperate state of the healthcare system, which the state and federal governments have all agreed is the number one priority for this year. It was the first meeting since the NSW election and saw all but one jurisdiction tasting of a particular political flavour, and even the one on the outer is keenly invested in the economics of its healthcare system above almost all else.
In Tasmania’s case that is its claim to a much desired AFL team, but even that burning issue at times takes second place to healthcare. The National Cabinet gathering followed a seriously weird episode in Australian public policy debate that saw the president of the Pharmacy Guild of Australia actually weeping over the allegedly imminent bankruptcy of the entire community pharmacy sector – get a grip, Trent – following a decision by Health Minister Mark Butler to allow for 60-day dispensing.
The new rules were claimed as a win for the superior lobbying prowess of the AMA and the RACGP by their spin doctors, and as a catastrophe of unimaginable ramifications by the Guild’s, but the list of six priorities for healthcare that National Cabinet released today show that everyone’s delicate feelings are likely to be assuaged.
The Pharmacy Guild will be asked to swallow extended dispensing, but the doctors’ lobbies are going to have to live with extended scope of practice. Number one in the list is the intention to support workforces to work at the top of their scope, with pharmacists first off the rank, above even nurses. The controversial extended scope of practice trial being planned for northern Queensland is very much in the sights of the RACGP, but they may have to learn to swallow it if they want to chalk up other wins.
The list of priorities was most interesting:
- Supporting workforces to work at top of scope, including pharmacists, paramedics.
- Expanding the nursing workforce to improve access to primary care.
- Improving access to and delivery of after-hours primary care.
- Introducing MyMedicare (patient ID) to support wrap around care for patients registered with their local GP through new blended payment models.
- Providing flexible funding for multi-disciplinary team-based models to improve quality of care.
- Investing in digital health to improve health outcomes.
All sound good, but nowhere is there a mention of increasing the Medicare rebate for GP consultations. Something about that may eventuate in the budget but there is not much of a hint of it in the government’s messaging beyond “providing flexible funding for multi-disciplinary team-based models to improve quality of care” which is part of its rather nebulous plans to use PHNs to commission multi-disciplinary care. Mr Butler also highlighted work on after-hours primary care, including “addressing gaps in regional areas and making improvements to Healthdirect”, which tends to suggest that telehealth will fill the gaps that medical deputising can’t, although this is not a surprise to anyone.
There is also the commitment to voluntary patient enrolment, being dubbed MyMedicare, details of which remain scant and the benefits or even operation of which remain unclear. We were most pleased to see a commitment to investing in digital health, but, on further inspection we realised this only mentions the government’s support for ADHA and the extra investment in My Health Record that is required.
My Health Record has always been funded in tranches through budget allocations every two to three years, mainly because the level of investment in building and improving it was never a fixed cost like operating it. We’ll see if the government comes up with long-term funding for the system or is just playing politics by blaming the former government for a lack of long-term funding.
What isn’t in doubt is that the jurisdictions are all investing in digital health, in particular for virtual health initiatives to try to help solve the crisis in emergency departments, including ambulance ramping due to bed block. The WA government plans to invest substantially in its new WA Virtual ED system, which will bring together existing virtual health pilots from the three Perth metro health services. (WA’s Country Health Service runs a nation-leading rural and remote virtual service that has led the way.)
NSW Health announced it is expanding its virtualKIDS service beyond COVID care to urgent care, not just in the three LHDs that have a paediatric hospital but to the rest of the state. And there was also interesting news about the implementation of technology first developed in the US for neonatal telehealth that is now being introduced to Queensland.
Despite all of this action, our most popular story of the week was the news that HealthShare was buying the MyHealth1st appointment booking system, formerly known as 1stAvailable. This news comes as HotDoc is seemingly cementing itself as the market leader and HealthEngine, which used to hold the crown, is undergoing a restructure, including the departure of founder and long-time CEO Marcus Tan. We’ll hopefully have more on this next week.
That brings us to our poll question for this week:
Do you support National Cabinet’s priorities for healthcare in 2023?
Vote here and leave your comments below.
Last week we asked: Are the digital health grants a wise use of money?
The majority said no: 63 per cent to 37 per cent.
We also asked, If yes, how will they help practices? If no, is there a better use for the money in digital health?
Pharmacist and pharmacy viability need to be ensured and guaranteed as it is an integral part of healthcare system. As I discussed with Milton Dick’s office recently, Labor doesn’t care about the viability of a single component of healthcare system (pharmacies) as long as *people win*
As a pharmacy owner, I remember when covid hit, we stand out and doing hundreds of vaccines a day. And spend so many night to put vaccine information into medicare system. I remember calling all kinds of supplies to find stock for customers. I remember dealing with yelling customers because there is no medications. I believe none of the colleges did less than I do. But what we get is spit on the face and cut income in half. No one get it, even the ones haven’t work and rely taxpayers. I think financial crisis is not the sadest point. The saddest point is betray.
We have a Minister that is in the Canberra Times saying that “Pharmacists only have to ring the Wholesaler to get stock in 24hrs”. He is VERY green and does not yet understand his portfolio.
He does not yet understand that Wholesalers are NOT Manufacturers. It is a Manufacturer (making heart drugs, psychiartric drugs, antibiotics etc) that makes the drugs and the supply chain that allows restocking of wholesalers. It is in the Manufacturing and the supply chain where the serious problem is. The Minister has a PBS website listing medications that are in a serious short supply. He may need to take a look at that.
There are supply issues with many more drugs than this list but it is a starting place. Senega & Ammonia Mixture for congested cough problems is in high demand for clearing COVID symptoms but has been unavailable since July22 and all possible substitutes come and go with no consistency or predictability of supply. There are long periods when we can offer nothing. This is just one example of many medications that are not listed on the PBS website that are very much needed to be consistently available.
We need to revive the Australian made Drug Industry. Scott Morrison made a good start with Australian made high tech vaccines. Will this Govt bite the bullet and restart the Australian made drug industry. This is not consistent with low cost drugs but we should realise by now that when supply chains are threatened or cut we can only rely on ourselves. It may cost more but the money stays in Australia, pays Australians and we will pick up export dollars – $2.6billion was the figure when Pan Pharmaceutical was an Australian company. Does the Minister have a Vision?
Doubling supply will potentially mean half the people will get their medication.
Doubling supply will increase wastage of drugs that will mean people will miss out on their medication because excess is sitting in another persons cupboard or rubbish bin. Remember Doctors DO change patient’s medication which means untaken medication is binned. Because of contamination of ground water and rivers etc medication should not be binned but should be returned to a Pharmacy for safe disposal.
Doubling supply will increase deaths. For months there has been argument about how much Paracetamol should be allowed to be given to anyone because of poisonings. Now we are looking at giving people double the quantity of medication. How many will forget to find a place to store and keep safe from children etc. We should be extremely concerned about people accidentally overdosing and psychiatric patients are particularly exposed by this contemplated change.
60 Day supply will bring nothing but waste, misadventure and supply problems. Because of the Safety Net designed and set up by the Govt and Guild, 60 day supply will only help a small number of Australians. Only those on a couple of very expensive medication will benefit. For chronic conditions the annual cost will be the same, for those on cheaper (80% of medications supplied) it will make little or no difference. For this we should not be risking patient safety via overdose, misadventure or unavailability of life saving drugs.
I say again. Does the Minister have a vision? Will he restart Australian Drug Manufacturing? Morrison made a good start will this Govt drop the ball?
So, do you support National Cabinet’s priorities for healthcare in 2023? Two-thirds of our readers said yes.
We also asked: If not, what should take the highest priority? If yes, why? Here’s what you said.
– Healthy people , healthy country
– Boost primary care
– Maintaining the pharmacy network. Proposed changes to 60 day dispensing will decimate the industry.
– What will the rollout of MyMedicare ID look like? What’s the point of the Individual Health Identifier number now? How will MyMedicareID, MyHealthRecord, Medicare Number, and IHN work together? What systems will be reformed? What digital integration will this take?
– I cannot find a plan on how this would work that does not complicate the system even further? Will we be replacing UR numbers with myMedicareID?
– The highest priority should be GP reform, followed by developments in MyHealthRecord.
– Raising medicare rebates by full CPI at least
– It is chronically underfunded given the increasing demand and complexity of patients, and the connection between primary and acute care needs significant work
– The Medicare Gap is a growing issue resulting in people not attending Medical Appointments or when they do, they are in an advanced state of illness. This is also creating increased demand in Emergency which is effectively cheaper. Secondly the reforms in Aged Care have failed to address the chronic shortage of staff. Implementing RN’s does not address the fundamental issues, particularly as they spend more time documenting than working at the beside. Those coming from overseas seem to be looking to fast track their way to citizenship which also seems to detract from a sector badly in need real carers. As usual poorly executed Commonwealth programs on both counts.