Category: Health Reform

KENEALLY’S STILLBIRTH STORY BRINGS TEARS

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[vc_row][vc_column][vc_column_text]Senator and former NSW Premier Kristina Keneally has been a strong advocate for removing the stigma around stillbirth, having paid tribute to her stillborn daughter, Caroline, in her maiden speech before the Senate earlier this year. Senator Kenneally, who had been a driving force behind the inquiry, was given another opportunity to discuss the issue this week in the Senate as the Select Committee on Stillbirth Research and Education tabled its long-awaited report. Most significantly, the report brought to light the reality that six babies are stillborn daily in Australia. According to Senator Kenneally, part of the high rate has been an apprehension on the part of the public to discuss and share their experiences and insights of a particularly traumatic event in the life of parents and families. In Senator Kenneally’s words: “we have considered stillbirth too sad to talk about.”

When the report was handed down in the Senate, Senator Keneally was moved to tears as it became apparent that stillbirth was now part of a conversation leading to better health outcomes, better emotional support and better community awareness. She took the moment to recognise the names of the children who had been lost and the bravery of their parents who had shared their personal experience of stillbirth with the inquiry. Poignantly, Senator Keneally highlighted that the report would be “part of their legacy”. In tabling the report, Northern Territory Senator Malarndirri McCarthy also took the opportunity to acknowledge the work of Senator Keneally in bringing the issue to the public’s attention.

The report found that 1 in every 137 women who reached 20 weeks of pregnancy would experience a stillbirth, a striking figure that Senator Kenneally argued was “significantly higher than in similar nations such as New Zealand, the UK, the Netherlands and the Scandinavian countries.” In fact, the Australian rate of stillbirths is more than a third higher than other OECD countries with the best birth outcomes.

Following an eight-month investigation, 268 submissions and six public hearings, the inquiry also heard about the trauma that continues outside of the hospital – with stories of women being made redundant from their jobs and other parents being told they were no longer entitled to paid parental leave.

The report made recommendations in three key areas: prevention, investigation and support. Critical activities in these areas will involve national education campaigns, continuity of care models, training for clinicians, changes to parental leave schemes and further investigation into stillbirths at the postmortem stage.

Health Minister the Hon Greg Hunt MP responded to the report with the announcement of a national roundtable – as well as an initial commitments of $7 million to medical research and education programs.[/vc_column_text][/vc_column][/vc_row]

A Finite Resource With Infinite Demands

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[vc_row][vc_column][vc_column_text]The Medical Services Advisory Committee (MSAC) plays an important role in determining which medical services Australians have access to through Medicare.  It may be stating the obvious, but funding for healthcare is a finite resource, and there are infinite demands for healthcare.  It follows that healthcare dollars must be spent judiciously.

MSAC is charged with deciding whether a new medical service should be publicly funded based on an ‘assessment of its comparative safety, clinical effectiveness, cost-effectiveness and total cost’.  Innovations in medical technology often require the development of new medical procedures to ensure that the technology can be utilised for its best possible performance.  MSAC decides whether a medical professional can be paid for performing the procedure. If the application is successful, the procedure will be included on the Medical Benefits Schedule (MBS). If the technology is implantable then the device will likely to be eligible to be included on the Prostheses List.

Some new technologies allow patients to be treated outside of a hospital.  Treatment for varicose veins has previously involved invasive procedures to be carried out solely in the care of hospitals.  Innovation in technologies such as radio-frequency ablation hasenabled patients to access these procedures in alternative, more office based environments.  The MBS covers payment to the doctor for performing the procedure but does not, in most cases, make an allowance for any single-use technologies.  This can result in significant out of pockets for patients.  MSAC has acknowledged this structural issue on a number of occasions in their assessments of new technologies.

This problem is compounded by our strange system of private health insurance (PHI). PHI covers hospital admissions but does not cover office-based therapies, therefore hospital-based treatments may be less expensive for patients, while overall costing more.  Looking at this from an economic perspective, we can see that the least costly options of out-patient based innovations are not being incentivised by the payment system.

There is certainly an opportunity for Government to have a more flexible approach to what may be included in an MBS fee. Realistic coverage for the actual cost of delivering a service, including device cost, would be of real benefit to patients and is likely to reduce the cost to the health system overall.  Alternatively, at a time when the value of PHI is certainly being questioned, mechanisms whereby PHI could cover out of hospital procedures – that the MSAC has previously considered to represent good value, should also be considered.[/vc_column_text][vc_zigzag][/vc_column][/vc_row][vc_row][vc_column width=”1/4″][vc_single_image image=”2606″ img_size=”full”][/vc_column][vc_column width=”3/4″][vc_column_text]

About The Author

Sarah Griffin B.App.Sc (Physio), GradDIp Health Ec & Policy
Principal Medtechnique Consulting.

Sarah Griffin is the founder of Medtechnique Consulting and has more than 25 years experience in medical technology, both in Australia and the United States. Sarah expertise includes health economics, health insurance, health policy and legislation, reimbursement systems and government relations. Sarah also serves as Chair of the AusMedtech Health Economics Expert Panel and as an independent expert to the Australian Government’s Industry Working Group on Prostheses List Benefit Reform.[/vc_column_text][/vc_column][/vc_row]

$23 Million Funding Boost For Peak Health Groups

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[vc_row][vc_column][vc_column_text]The Liberal National Government will provide the nation’s peak health groups and advisory bodies with $23.5 million over three years to help build a healthier Australia.

Organisations such as the Australian College of Nursing, the Consumers Health Forum, Lifeline and the Rural Doctors Association will receive funding through the Health Peak and Advisory Bodies Programme so they can continue to contribute engaged, robust and constructive participation.

Established in 2016, the Health Peak and Advisory Bodies Programme supports a wide range of organisations, and a total of 23 organisations have been provided funding over three years.

This will enable the organisations to play their part in informing the Government’s health agenda through impartial advice, thus contributing to improved health outcomes for Australians.

This can include consulting and sharing information with their members, the wider health sector, the community and the Government, providing sector knowledge and expertise and providing education and training to health practitioners to improve the quality of health services.

These organisations are integral to building a better health care system for the nation.

Their voices are important – and those voices wouldn’t be heard without the funding the Government provides under this program.

Several of these organisations also receive funding to deliver specific health programs under different funding streams. This funding is in addition to the Health Peak and Advisory Bodies Programme.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Organisation Name Total funding
Australian College of Nursing $1,125,000
Australian Federation of AIDS Organisations $1,125,000
Consumers Health Forum of Australia $1,125,000
Allergy and Anaphylaxis Australia $652,062
Allied Health Professions Australia $459,075
Asthma Australia $667,851
Australian Association of Practice Managers $622,866
Australian Healthcare and Hospitals Association $558,300
Continence Foundation of Australia $1,125,000
Haemophilia Foundation Australia $585,000
Heart Support-Australia $819,000
Hepatitis Australia $1,125,000
Lifeline Australia $525,000
Macular Disease Foundation Australia $1,125,000
Metabolic Dietary Disorders Association $537,000
Mental Health Australia $1,650,000
National Association of People Living with HIV/AIDS $1,125,000
National Rural Health Alliance $2,910,000
Palliative Care Australia $1,125,000
Public Health Association of Australia $1,125,000
Rural Doctors Association of Australia $1,125,000
The Pharmaceutical Society of Australia $1,125,000
Vision 2020 The Right to Sight Australia $1,125,000
Total HPAB funding $23,486,154

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Victoria votes: your guide to the 2018 election health promises

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[vc_row][vc_column][vc_column_text]With health care spending accounting for 30% of the Victorian budget, or A$20 billion, health is a major policy area for the Victorian election on Saturday.

While the Commonwealth pays for general practice, private specialists, pharmaceutical benefits and aged care, the states are responsible for running hospitals, community health services and ambulance services. They also want to keep Victorians healthy and out of hospital.

This election campaign, Labor has committed $4.3 billion to health; the Coalition has promised $1.3 billion, and the Greens have pledged $1.35 billion. Much of the difference comes down to infrastructure spending.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Labor

Labor’s health policy emphasises its commitment to a public health system. A re-elected Labor government would build a new hospital in the western Melbourne suburb of Footscray ($1.5 billion) and spend $1.2 billion on capital improvements to other hospitals in outer suburban Melbourne and regional areas.

Labor’s hospital package also includes $675 million for ten new or upgraded community hospitals. These health services would provide day surgeries, diagnostic imaging and specialist outpatients, in addition to admitted and urgent care.

The remainder of nearly A$1 billion goes to a range of other promises, including:

The boost in hospital funding is likely to enhance care in the hospital catchment areas and ease the pressure on surrounding hospitals. Improved nurse-to-patient ratios will likely improve the safety and quality of care in the state’s emergency departments and hospital wards.

Is it necessary to commit $3.3 billion to hospitals, presumably on top of current levels of funding?

Much of this goes to capital improvements. Without such investments now, the existing hospital capacity in and around Melbourne will not be able to keep up. But it’s unclear where the money will come from to run these extra hospitals and hospital expansions. It’s hoped that operating costs will not then be taken from existing hospitals.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Coalition

The Coalition’s funding commitments are spread across the key sectors of health including:

There is evidence for much of the Coalition’s commitments. In particular, palliative care has been shown in trials to not only improve quality of life, but also, in some cancers, survival.

Improving access to community care for disadvantaged groups and in rural and regional areas has the potential to improve the management of chronic disease, such as asthma and diabetes, leading to better health in the long term.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Greens

The Greens’ platform is anchored in a social determinants of health and a population health approach that conceives of health more explicitly as an outcome of broader social and economic conditions.

The Victorian Greens party’s main priorities are:

The Greens’ funding for free ambulance services would ensure nobody misses out on timely care for traumatic injuries and heart attacks because they don’t have ambulance cover. A similar program operates in Queensland.

The Greens have a well-developed policy, conceiving of health and well-being broadly. The package includes substantial commitments to mental health, community health care and dental health.

But there is no extra funding for hospitals beyond the current budget.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

Comparing the three parties

The biggest difference in the health funding commitments between the three parties is Labor’s focus on hospital infrastructure funding (which accounts for 78% of its health promises). It’s not clear whether the Coalition and the Greens oppose the bulk of Labor’s hospital commitments or are simply silent.

Although this level of funding to hospitals may seem like an inordinate amount, it’s important to consider the role of modern hospitals. They have become the providers of not only admitted care, but emergency care (including GP-type visits), specialist care in outpatient clinics, chronic disease management and palliative care.

When this hospital infrastructure funding is taken out of consideration, the three parties are hard to distinguish. Labor is promising $960 million, Coalition is pledging $816 million and the Greens have committed $1.3 billion to a range of community, mental health, ambulance, chronic disease and prevention services.

The most evident gaps are Labor’s lack of funding for prevention and innovation, and the Greens’ lack of extra hospital capital funding.

A change to the Coalition would likely mean less hospital funding, particularly for a new Footscray hospital, but significant funding for community palliative care services and hospital in the home.[/vc_column_text][vc_zigzag][vc_column_text]

AUTHORS

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  1. Professor and Head of Department, Public Health, La Trobe University

  2. Professor of Health Economics, La Trobe University

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  1. Senior Lecturer in Epidemiology, La Trobe University

  2. Adjunct Professor at Simon Fraser University and Clinical Professor, University of Saskatchewan

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This article originally appeared on theconversation.com.

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RECORD DATE CHANGED AT 11th HOUR

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[vc_row][vc_column][vc_column_text]In an eleventh-hour reprieve, the Australian Senate voted to extend the opt-out period for a second time, meaning Australians will now have until January 31, 2019 to decide whether they want a My Health Record or not. Those that choose not to opt-out will have a record automatically created in the Government-run online database.

Minister for Health, Greg Hunt, who welcomed the Senate’s extension, has previously said the online health records provide “many benefits to patients, including reduced duplication of tests, better co-ordination of care for people with chronic and complex conditions, and better-informed treatment decisions.”

Speaking on the benefits of the My Health Record scheme, Consumer Health Forum CEO, Leanne Wells, had previously said the clinical benefits of My Health Record for patients are significant and compelling, including hospital admissions avoided, fewer adverse drug events, and better-informed treatment decision.

“For too long, healthcare has lagged behind in exploiting the clear benefits of information technology,” Ms Wells said.

Under the My Health Record framework, data can be linked to other datasets such as the Pharmaceutical Benefits Scheme (PBS) or the Medicare Benefits Scheme (MBS) creating an easy to access overview of a user’s profile.

Other industries, including the Medical Technology industry have welcomed the My Health Record. Medical Technology Association of Australia CEO, Ian Burgess, said the development of My Health Record will “provide tremendous opportunity to improve data collection across the whole health system and across the patient journey”.

Ultimately, Australians will be the biggest beneficiaries of the My Health Record system.[/vc_column_text][/vc_column][/vc_row]

INCREASING DOUBT ON VALUE OF PRIVATE HEALTH INSURANCE

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[vc_row][vc_column][vc_column_text]In 2014, nearly two thirds (65.8%) of fund members agreed that ‘it is essential to have private health insurance’. Each year since then it has declined further to the current level of 56.9% in August 2018.

These are some of the latest findings from Roy Morgan’s Single Source Survey (Australia) which is based on in-depth personal interviews conducted face-to-face with over 50,000 Australians per annum in their own homes, including detailed questioning of over 8,000 interviews with members of private health insurance funds about their views about private health insurance.

Declining attitudes towards private health insurance

Over many years Roy Morgan has been measuring the attitudes of fund members to ten key statements that are focused on how they feel towards having health insurance. Since 2014, there has been an adverse trend across all of these metrics.

Although the majority of fund members (72.1%) still agree that ‘above all else, private health insurance is about knowing that you’ll be able to cover the cost of big medical expenses if they arise’, this has fallen from 77.0% in 2014. The other major level of agreement with 68.9%, was for ‘health insurance gives me peace of mind’ but this also showing a gradual decline from the 74.0% recorded in 2014.

Attitudes to Private Health Insurance

[/vc_column_text][vc_single_image image=”2513″ img_size=”full” add_caption=”yes”][vc_separator border_width=”3″][vc_column_text]The biggest change in attitude over the last four years was the 8.9% point decline (to 56.9%) for ‘it is essential to have private health insurance’. Other areas to show major changes were ‘it is difficult to understand what you are covered for’ (up 8.1% points to 44.4%), ‘extras and hospital cover are equally important’ (down 5.9% points to 54.6%) and ‘I don’t see much value in having it’ (up 5.4% points to 16.4%).

It is worth noting that there are no significant differences to these attitudes in capital cities compared to regional Australia.

Generational differences in private health insurance attitudes

There are some major generational differences in attitudes towards private health insurance that must be taken into account when marketing to this very diverse group. An example of this is the high level of agreement (77.2%) among Pre-Boomers that ‘it is essential to have private health insurance’, compared to only 38.2% among Gen Z.

“It is essential to have private health insurance”

[/vc_column_text][vc_single_image image=”2514″ img_size=”full” add_caption=”yes”][vc_separator border_width=”3″][vc_column_text]Other differences include Millennials who are a major growth area for private health insurance as they enter the life-stage where they generally have more responsibilities with families and mortgages. This is reflected in the fact they are well above average in agreeing to issues that relate to the cost of health insurance, such as; ‘I want the cheapest and don’t care provider’; ‘only reason to have it is to avoid paying extra tax’; and ‘I don’t see much value in having it’.

As would be expected, it is the youngest generation who are the least engaged in private health insurance. Gen Z who are aged 14 to 27 in this analysis, have very low levels of concern when it comes to health issues and in fact are more likely to ‘rely on recommendations from friends and family in choosing a fund’.

Norman Morris, Industry Communications Director, Roy Morgan says:

“Although the attitudes of private health fund members are reasonably favourable, over recent years they have generally shown an adverse trend, which should be of some concern to both health funds and the government. It appears that the major decline in considering it essential to have private health insurance is likely be a response to the lack of perceived value due to cost and uncertainty of what is covered.

“This research has only covered the attitudes of private health fund members and so it’s likely that people without this insurance are even more adversely predisposed towards health insurance. This makes it a challenge to attract new members as well as retaining existing ones.

“To engage fund members and the general population more in health insurance, this analysis has shown that there is a need to understand what motivates different age groups and generations to take out and stay in health insurance as they cannot be treated as a single homogeneous group.

“With health funding being a major concern for both State and Federal governments, it is vital that they and the health funds continue to promote the benefits of health insurance. Any decline in fund membership will lead to more pressure on the public system and as a result increased government funding.

“The data highlighted here is only a small part of what is available on the full database that covers private health insurance in-depth and trended over many years. With a great of competition in this industry it is important to understand the relative strengths and weaknesses of all the major funds. The results shown in this release can be produced at the individual fund level, enabling unique competitive insights. To find out more ask Roy Morgan.”[/vc_column_text][/vc_column][/vc_row]

Therapeutic Goods Advertising Changes

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The following information has been provided by the TGA:

 

Advertising pre-approvals and the new code

We advise advertisers that the date on which an application for pre-approval is decided will determine the version of the code that the advertising must comply with.

Advertisements for medicines that are to appear in specified media require pre-approval under Regulation 5G of the Therapeutic Goods Regulations 1990. The requirement for pre-approval will continue until 1 July 2020.

If you intend to lodge an application for advertising pre-approval between now and 31 December 2018, you should keep this in mind and allow time for revisions if necessary.

If you are in doubt about the application of the 2018 Code to your advertising, please contact us at tga.advertising@tga.gov.au.

Application decided Assessed against
On or after 1 January 2019

(This includes decisions on applications for minor variations to advertisements that were approved before 1 January 2019.)

 2018 Code
On or before 31 December 2018 2015 Code

For pre-approval applications lodged prior to 1 January 2019 but decided on or after 1 January 2019, the decision will be made based on whether the advertisement complies with the 2018 Code.

Education activities

In addition to finalising a further two elearning modules, we are preparing a number of face to face and webinar information sessions over the next few months to educate advertisers on the 2018 Code and the advertising complaints handling framework. We are working with key industry bodies to deliver some of these activities.

To receive more information as it becomes available, please subscribe to the TGA website updates.

Advertising complaints handling framework

We have published information about the framework under which we receive and process advertising complaints. See – Complaints handling for the advertising of therapeutic goods to the Australian public.

Assessment of complaints

For complaints about pre-approved advertisements, compliance will be assessed against the version of the Code under which the advertisement was approved.

For all other advertisements, the version of the Code applied will depend on the date/s on which the advertisement aired or was published:

Advertising occurred Assessed against
On or after 1 January 2019 2018 Code
Before 1 January 2019 and is no longer occurring 2015 Code
Before 1 January 2019 and is still occurring 2018 Code

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Moving My Health Record Forward

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[vc_row][vc_column][vc_column_text]The potential benefits remain and much of the policy to date is sound. Trust and confidence can be improved through consideration of the recommendations of the report and further legislative amendments to reflect key recommendations.

The CEO of the Consumers Health Forum, Leanne Wells, said she expects the Government to work collaboratively to pass legislation before the opt-out period ends. There has been enormous public investment in getting MHR to this point, and CHF would welcome bipartisanship around additional amendments that further strengthen the policy intent and protections.

Policy and implementation need to align before any records are created. To meet the intent of legislative amendments to address privacy concerns, it is CHF’s view that these must be passed before the end of the mid November opt-out period, and that ideally no records should be created following the opt-out period until the implementation of those amendments is complete.

“It is heartening to see much of the advice submitted to the inquiry by CHF included in the report. Realising the potential of MHR requires the Australian people to have confidence that their health information is used for their benefit, with their consent.”

“CHF welcomes the Report’s recommendations to provide more legislative clarity around the secondary uses of MHR data, and further education and communication campaigns to improve understanding and use of MHR.

“The ‘digital divide’ is real and, as the Committee has said, it is important that additional effort is made to identify, engage and provide targeted support to vulnerable groups to ensure they can make an informed choice about opt-out and, if they stay in, know how to adjust their controls.”

“Consumer access to their own health records through MHR is a key step in the shift from health consumers as passive patients, to consumers as active partners in their own care.

“Further communication and education should continue to include benefits and assurances about safeguards and risk mitigation strategies, but most importantly, must now begin to include more information about how to use MHR, both in terms of how to manage its access controls, and how to use it as a tool to improve health.

“Many Australians are already finding the system beneficial in their circumstances. Providing avenues for better understanding and use of MHR is the essential next step in its ongoing development,” Ms Wells said.[/vc_column_text][/vc_column][/vc_row]