Medical Observer

Organ donor families need more support

PARENTS of deceased organ donors say providing more support to families while they are making the difficult decision to consent will help drive up the rate of donation.

TGA reform delays slammed

INDEFINITE delays to several key elements of the blueprint for reform of the Therapeutic Goods Administration (TGA) have been slammed by a prominent industry expert.

AMA calls for permanent change to privacy laws

THE AMA has called for privacy laws to be permanently changed so doctors can record patient family medical histories without the threat of being prosecuted.

Tough and transparent: TGA set for overhaul

THE TGA will work to improve its “engagement with the community”, establish a new advisory council and toughen penalties for advertising breaches in a sweeping overhaul aimed at broadening its industry focus to include consumers.

Hambleton to take AMA reins

AMA vice-president Dr Steve Hambleton is set to take the association’s top job at its federal conference at the end of the month as the only candidate for the presidency at the close of nominations this morning. Dr Hambleton will take the reins from outgoing president Dr Andrew Pesce, who wished him well for the next two years. “I think Steve will be an excellent president,” Dr Pesce said. “That continuity will be important in continuing the work the AMA has done to engage with government and the medical profession. “I think it is probably ...

Doctors wary as Gillard’s new deal puts reform in doubt

PRIME Minister Julia Gillard's health funding agreement with the states and territories has received a mixed response from doctors groups, amid warnings the deal could actually stymie reform. After a six-hour meeting with premiers in Canberra on Sunday, Ms Gillard announced a new national pool of state and federal money will fund hospitals from 2012 - effectively dumping Kevin Rudd's 2010 GST-based agreement. The Federal Government will inject $16.4 billion in growth funding into the pool from 2014 to 2020. As part of the new deal agreed to by the states yesterday, the Federal Government will ...

Changes to Govt health reform plans revealed

PRIME Minister Julia Gillard has unveiled the Government’s revised health reform plans including a number of sweeteners and concessions aimed at winning over the states ahead of this Sunday’s Council of Australian Governments meeting. As part of the new deal to be put to the states, the Federal Government would expand the number of Medicare locals above the previously planned 57 while increasing the number set to become operational this year. It would also fast-track reforms to after-hours GP care, through which Medicare Locals will plan and support local face-to-face GP after-hours services. The planned clawback ...

Gillard to unveil health reform changes at COAG meeting

PRIME Minister Julia Gillard is reportedly preparing to abandon Labor’s widely criticised proposal to impose four-hour waiting time targets on hospital emergency departments, as she attempts to convince state leaders to sign up to her government’s health reforms. Media reports indicate Ms Gillard is prepared to make key concessions on the Federal Government’s planned reforms. The latest touted concession by the PM to dump the proposed mandatory four-hour waiting time targets for hospitals, reported by News Limited newspapers today, follows advice from doctors and other medical experts who have argued such targets are unachievable. The PM ...

Top 10 - A year living on the edge

It’s been a tumultuous year on the political scene. MO counts down the major events of 2010.

Reform council finds COAG needs to be faster, more accountable

THE Council of Australian Governments (COAG) has been criticised by its own Reform Council, which says the true progress of reforms is impossible to assess. In its Report on Progress 2010, released last week, the council said a lack of clarity on COAG priorities and measures meant reform – including health reforms outlined under the landmark COAG health agreement signed in April – could not be monitored. The overall slow progress of reform was also criticised. Council chair Paul McClintock said after the release of the report: “If we are going to be able to paint ...

GP groups seize chance to lobby independents

GP groups plan to use the Gillard Government’s narrow grip on power to full advantage, and are now looking for opportunities to renegotiate unpopular health reforms. With a minority government held together with a coalition of three independents and one Greens MP, Labor’s second term is likely to be marked by compromises on controversial legislation, according to AMA vice-president Dr Steve Hambleton. The diabetes scheme, practice nurse incentive payments and 23 new GP super clinics will be the subject of renewed lobbying, he said. “The fact that it was so close means that the Government and Coalition ...

AMA enlists patient support to stand up for GPs

THE AMA has come out fighting on general practice issues, launching a campaign in the lead-up to the federal election amid concerns over the profession’s future under planned sweeping health reforms. As part of the campaign, Family Medicine is running out of time, the association has called on all parties to develop policies which “support and preserve” the vital role of GPs. And, in a rare move, it is now seeking to enlist the support of patients. A patient petition demanding that the Government cut red tape, ensure patients have the right to choose their ...

AMA mobilises patients to highlight value of family doctors

THE AMA is enlisting the help of patients in its efforts to put health front and centre of the political debate in the lead-up to the 21 August federal election. Posters and a petition are being distributed to practices across the country urging both Labor and the Coalition to “release policies that support and preserve the vital role of family doctors in local communities”. AMA president Dr Andrew Pesce said with an ageing population and rising chronic and complex health conditions, GPs remained under intense pressure. Dr Pesce also criticised the location of some of the ...

Expert claims reform think tanks biased

ATTEMPTS by the Federal Government to overhaul the health system were flawed from the start, a health policy expert has argued, as the independent think tanks steering reform directions were loaded with industry figures unable to “think outside the box”. Speaking at a health reform forum hosted by the Australian National University last week, Ian McAuley, a fellow of the Centre for Policy Development, said the Government’s advisory bodies, including the National Health and Hospitals Reform Commission, had too much representation by health industry insiders. The bodies had failed to deliver a blueprint for a better integrated ...

College pushes for GP input on MBS item changes

A GENERAL practice committee should inform the framework set up to manage the MBS, the RACGP has argued, as without this input future MBS reforms may have a detrimental impact on GPs. Under measures announced in the 2009-10 Budget, the Federal Government allocated $9.3 million over two years to develop the MBS Quality Framework, an evidence-based structure for managing the MBS. It will review the cost and effectiveness of MBS item numbers. In a response to the Federal Health Department’s discussion paper on the framework, the RACGP has voiced concern that the structure and makeup of the ...

Expert claims reform think tanks biased

ATTEMPTS by the Federal Government to overhaul the health system were flawed from the start, a health policy expert has argued, as the independent think tanks steering reform directions were loaded with industry figures unable to “think outside the box”. Speaking at a health reform forum hosted by the Australian National University last week, Ian McAuley, a fellow of the Centre for Policy Development, said the Government’s advisory bodies, including the National Health and Hospitals Reform Commission, had too much representation by health industry insiders. The bodies had failed to deliver a blueprint for a better integrated ...

Election speculation casts cloud over future of health reforms

WITH speculation rife that Prime Minister Julia Gillard will call a snap federal election, questions still hang over key planks of the Federal Government’s health reforms. While the landmark Council of Australian Governments deal struck early this year will see new monies flow to health services around the country, a sudden election could see key pieces of health reform legislation delayed. The National Health and Hospitals Network Bill – which includes provisions for the controversial diabetes scheme – remains before the House of Representatives. While it is expected to pass through the Lower House, an easy passage ...

Patients’ voice to be heard in petition presented to Parliament

GRASS roots GP lobby group Doctors Action has enlisted 12,000 patients in its latest request for Labor to ensure the doctor patient relationship is not damaged amid ongoing health reform. Doctors Action president, Western Sydney GP Dr Adrian Sheen, last week presented Liberal shadow health minister Peter Dutton with his patient petition. More than 12,000 patients registered their concerns that the health reforms, such as GP Super Clinics and greater roles for nurse practitioners, risked undermining the doctor-patient relationship. The petition was launched late last year following the establishment of the Doctors Action group at a ...

Senate inquiry rejects reforms as answer to health blame shifting

A SENATE inquiry has criticised Labor’s health reform proposals as a “wasted opportunity”, saying the sweeping plans will not end the blame game. The final report of the Senate Finance and Public Administration References Committee echoed fears from doctors groups the reforms would add to the bureaucracy while potentially limiting clinician involvement. The recent inquiry into the Council of Australian Governments (COAG) reforms found that far from ending the blame game between the federal and state governments over health system funding, there had been “no fundamental change in the roles and responsibilities of the Commonwealth and the ...

Senate inquiry rejects reforms as answer to health blame shifting

A SENATE inquiry has criticised Labor’s health reform proposals as a “wasted opportunity”, saying the sweeping plans will not end the blame game. The final report of the Senate Finance and Public Administration References Committee echoed fears from doctors groups the reforms would add to the bureaucracy while potentially limiting clinician involvement. The recent inquiry into the Council of Australian Governments (COAG) reforms found that far from ending the blame game between the federal and state governments over health system funding, there had been “no fundamental change in the roles and responsibilities of the Commonwealth and the ...

Top academic resigns over Govt’s mental health policy

THE chair of the Federal Government’s National Advisory Council on Mental Health, Professor John Mendoza, has resigned amid mounting criticism of the Rudd Government’s handling of mental health. Professor Mendoza tendered his resignation on Friday via a letter, reportedly addressed to Health Minister Nicola Roxon and council members, in which he was highly critical of the Government’s mental health care policy. "It is now abundantly clear that there is no vision or commitment from the Rudd Government to mental health," wrote Professor Mendoza. "The Rudd Government is publicly claiming credit for the increased investment in mental health ...

Jackson backed for top RACGP job

RACGP president Dr Chris Mitchell has thrown his weight behind Professor Claire Jackson, the first contender to officially announce her candidacy for the RACGP presidency. As nominations for the role officially opened last week, Dr Mitchell said it would be “hard to imagine anyone who would be better placed to be president of the college but at the end of the day that election is decided by the members”. While Dr Mitchell said he would fully support whoever took the role, he said many members of the college were very pleased Professor Jackson was standing “because she ...

Rudd’s reforms a ‘poisoned chalice’

THE Rudd Government’s health reform plans have come under renewed fire for failing to end health cost-shifting and the ‘blame game’ between the federal and state governments as experts continue to deconstruct them. Professor Jeff Richardson, foundation director of the Centre for Health Economics at Monash University, labelled the reform package a “poisoned chalice”, and said the funding arrangements would not stop public hospitals attempting to push their patients back on to GPs. Professor Richardson was one of several experts who criticised the reforms in the latest MJA. The proposals agreed at the recent Council of Australian ...

New health blame game could be in store

Establishing Local Hospital Networks and regional Primary Health Care Organisations (PHCOs) could create a new frontier for the ‘blame game’ within the health system. Addressing a forum hosted by the Australian National University, RDAA CEO Steve Sant warned the bodies might use each other as scapegoats if the system did not work. “Are we going to see another report in a few years titled Shifting the Blame Game about the networks blaming PHCOs and vice versa because they have not changed the health outcomes of [those] they serve?” he asked. Philip Davies, professor of health systems ...

WA docs say no to reforms

WEST Australian doctors have backed their premier’s decision not to sign up to the Federal Government’s hospitals reform package. With all other states and territories agreeing to the proposed reforms, Prime Minister Kevin Rudd said he would work with the nation’s only Liberal Premier to reach a compromise. But he signalled the reform could go ahead without the resistant state. WA Premier Colin Barnett’s refusal to hand over 30% of the state’s GST revenue into a pooled funding arrangement has won support from local doctors. Geraldton GP Dr Murray James-Wallace welcomed the stand. He said little ...

Guess what’s next? Primary care report cards

GENERAL practice will soon be asked to measure up to a new set of clinical safety and quality standards as part of the Federal Government’s National Health and Hospitals Network (NHHN) plan. Under the plan, which was thrashed out with the states at last week’s prolonged Council of Australian Governments (COAG) meeting, the Federal Government will establish a permanent Australian Commission on Safety and Quality in Health Care that will set standards for hospitals and primary care. An independent National Performance Authority will be established and charged with drawing up hospital performance reports and healthy community reports. ...

Money for mental health is ‘inadequate’ for reform

HOPES for reforming the mental health system have suffered a blow, with experts heavily critical of the commitments made at last week’s Council of Australian Governments (COAG) meeting. Key figures have welcomed the investment in mental health but say the $174 million falls far short of what is needed for genuine change. Australian of the Year Professor Patrick McGorry, from the Centre for Youth Mental Health at the University of Melbourne, said mental health “had missed out”. “When you contrast it with the billions that have been pumped into the system over the last few weeks ...

Rudd claims victory in reform battle with states

PRIME Minister Kevin Rudd has claimed success in winning over state and territories to his sweeping healthcare reforms, despite Western Australia refusing to sign up to the plan. The new deal, thrashed out over the past two days, will see states and territories surrender 30% of their GST revenue to a pool of funding which will be used to finance health and hospital services. Each state’s retained GST will be allocated to their own services. The Council of Australian Governments (COAG) deal will usher in a suite of reforms detailed in the National Health and Hospitals Network ...

Architect of divisions evolution reviews the Rudd reforms

NSW GP Dr Tony Hobbs was last year given the task of developing a new way forward for primary health care in Australia, as part of his role as the chair of the National Primary Health Care Strategy External Reference Group. Here the former AGPN chair shares his views with Medical Observer on the Rudd Government’s plan to transform divisions of general practice into Primary Health Care Organisations. Are divisions currently capable of transforming into PHCOs? “I don’t think all divisions would be up to it at the moment and ...

Govt reveals plans for division-primary care evolution

THE landscape of primary care is set to be overhauled with the Federal Government today unveiling plans to transform divisions of general practice into primary health care organisations. The move has long been expected following its recommendation by two independent think tanks – the National Health and Hospitals Reform Commission and the Primary Health Care Strategy External Reference Group – last year. According to plans announced by Prime Minister Kevin Rudd and Health Minister Nicola Roxon the primary health care organisations (PHCOs) will ensure better collaboration between primary health care, allied health and hospital services. PHCOs ...

Federal Government unveils hospital takeover plan

THE Federal Government has announced plans to become the dominant funder of hospital services across the country, as the first step in its long-awaited health and hospitals reform plan. Under the new funding arrangements outlined today by Prime Minister Kevin Rudd, the Government plans to take over 60% of the funding for public hospitals with Local Hospital Networks, to be run by local clinical leaders, established to administer services. The Government will also assume responsibility for all GP and primary care services. “By taking full funding and policy responsibility for primary care we can also reduce ...

Youth mental health care $200m short

THE Federal Government needs to invest $200 million in new youth mental health services as a matter of priority, rather than wait for its health reform blueprint to be finalised, a mental health expert has claimed. Australian of the Year Professor Patrick McGorry, from the Centre for Youth Mental Health at the University of Melbourne, has called for $100 million to be ploughed into tripling the number of headspace centres, from 30 up to 90. The youth mental health centres currently draw together GP, mental health, drug and alcohol services and employment services in one ...

GPs show solidarity against Rudd’s reforms

FOR Sydney GP Dr Hilton Lowe, a day off work is a rarity. However, as MO went to press, Dr Lowe was planning a day out of the practice in order to attend the 9 November day of action meeting organised by fellow GP Dr Adrian Sheen. “I’ve never had a day off for something like this – I have always spent my days looking after my patients,” Dr Lowe told MO . “But I have just had enough. I believe these proposed reforms [around nurse practitioners] will lead to fragmentation of patient care.” ...

Opposition refuses to show its hand on health

GPs appeared less than impressed with shadow health minister Peter Dutton’s unwillingness to discuss Opposition health policy at this year’s AGPN National Forum. Addressing the AGPN audience just ahead of Federal Health Minister Nicola Roxon, Mr Dutton declined to elaborate on the Opposition's plan for the health system, describing it only as a progressive picture for the future of Australian health. “We have spent the past 12 months working on a document that’s full of ideas but we will release that at a time when it suits us,” he said. He suggested this timing would be ...

Roxon urges doctors to be mindful of costs

DOCTORS have hit back at comments made by Federal Health Minister Nicola Roxon that they need to re-examine their practice to ensure a cost-effective health system. Speaking at the Committee for Economic Development of Australia health reform forum in Sydney earlier this week, Ms Roxon said that while clinicians were broadly free to choose whichever clinical approach they felt most appropriate, they also had a responsibility to be mindful of the costs. She pointed to the low use of generic statins as one example of where clinicians could reconsider their practice. “Only some patients require more ...

Government’s glowing report card for health unjustified: GPs

THE Federal Government has given itself a “gratuitous” tick of approval for its management of health in a recently released mid-term progress report, doctor groups say. Among the list of top 50 achievements during the first 18 months in office, the Government listed the introduction of controversial health reform measures, including the signing of contracts for 15 of its promised 31 GP super clinics and the granting of PBS and MBS rights to nurse practitioners. Dr Brian Morton, deputy chair of the AMA council of general practice, said many of the Government’s health achievements lacked an evidence ...

Prevention push

Will the federal government’s new health prevention agenda amount to anything? Amanda Sheppeard takes a look. PREVENTION is better than cure – it’s a truism played out in the nation’s general practice surgeries every day. But, as most GPs will attest, sticking to the health prevention agenda can be a tough ask in a Medicare system that financially penalises longer consultations. However, the new federal government is banging the prevention drum – loudly proclaiming its intention to overhaul the health system using the prevention weapon to battle spiralling rates of chronic disease. The ...

Jury is out on merits of the jury system

SURELY the jury system has outlived its usefulness? What got me fuming on this issue again was seeing convicted paedophile Dennis Ferguson facing fresh charges of child molestation and then being released from custody after a Brisbane District Court Judge granted a permanent stay on proceedings on the grounds that he would not receive a fair trial by jury. According to the judge, it would be unlikely that a jury could be found who had not had media exposure to the accused. Why this grub is even back out on the streets is a mystery known ...

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