Media alerts 19 February
Consumer group wants funding guaranteed for e-health records
Brian Owler: public-private partnerships can work in health
Some of the challenges facing mental health research
Government considers downsizing the census
Skinner to rebuild doctors’ engagement
18th Feb 2015
NSW Health Minister Jillian Skinner says she will bring clinicians inside the tent for health policy development under a landmark agreement with two doctors’ groups.
The minister has agreed with the NSW branch of the AMA and the Australian Salaried Medical Officers’ Federation (ASMOF) on new pathways for doctors to report on what’s not working in the health system and have input into policy.
“This is serious stuff, not just a motherhood statement,” Mrs Skinner said at a signing ceremony for the cooperation statement in Sydney yesterday.
Mrs Skinner said she met regularly with the chairs of local health boards and wanted a parallel engagement with doctors in the health system.
“I want clinicians to have that same interaction. The best ideas for improving the health system come from clinicians on the ground,” she said.
The accord is the first of its kind in NSW and possibly the country, according to the minister’s office.
ASMOF NSW president Dr Tony Sara said the stronger engagement would boost doctors’ morale, adding the 2008 Garling Report on the NSW public health system had found half of ASMOF members did not trust their managers.
Annual surveys of members of the two doctors’ organisations to measure their level of engagement would be the “nub” of the initiative, he said.
“By surveying doctors we can sense whether management teams really want to engage with clinicians. The culture of management will have to evolve,” Dr Sara said.
“We want to move up the whole baseline of quality of care.”
Feedback from the AMA and ASMOF surveys will be considered in assessments of the performance of district health management teams and executives.
Among other commitments, one or more executive clinical directors will be appointed to each local health district and specialty network, and local doctors will sit as members of district and network boards.
Mrs Skinner said engagement with GPs could also be expanded after new Primary Health Networks (PHNs) replaced Medicare Locals in July, in a shake-up the federal government says will be more “GP-centric”.
“We will continue projects we are doing now with Medicare Locals [with the PHNs],” she said.
“It makes a profound difference to me as a health minister, hearing the views of people delivering services on the ground.”
AMA (NSW) president Dr Saxon Smith said Tuesday’s MOU represented a new era of communication between senior clinicians and hospital management.
Separately, ahead of next month’s NSW election, NSW (AMA) is calling on Mrs Skinner to set aside $30 million over four years to create 60 new registrar positions and 60 specialist positions to address shortages in rural and regional NSW.
It also wants funding for regional local health districts (LHDs) to build a medical workforce based on long-term need, not after gaps appear.
Dr Smith said filling vacancies in regional hospitals was not enough.
“Regional LHDs need to be able to identify their own medical workforce requirements and be funded appropriately to meet them,” he said in a statement.
“This would go a long way to encouraging more doctors to practise in regional areas.”
Pay doctors more, funds urge
Herald Sun, Melbourne
19 Feb 2015 Page 2
DOCTORS would be paid 30 per cent more by Medicare and health funds but only when they provided quality care under a controversial plan being pushed by private health insurers.
Private Healthcare Australia chief Dr Michael Armitage has presented a plan to the Federal Government that shows taxpayers could save billions if Medicare and health funds paid for evidence-based care in line with clinical guidelines. It comes as health funds are poised to this month win approval for a premium rise of more than 6 per cent, or about three times the inflation rate.
A recent Productivity Commission Report found GPs were failing to do their job properly with many not devising asthma or diabetes plans for their patients, and some prescribing antibiotics for viruses. He says a study into how doctors took up Heart Foundation guidelines on coronary care showed fewer than 5 per cent followed them.
And a Grattan Institute Report found major variations in the way different doctors cared for their patients. “We should no longer be relying solely on fee for service,” Dr Armitage said.
Minister says MRFF no longer linked to co-payment policy
Australian Financial Review
19 Feb 2015 Page 10
Health Minister Sussan Ley said on Wednesday that it would be “duplicitous” to guarantee where the savings would be directed from the government’s as-yet-unannounced new co-payment policy, as the matter was still subject to consultation.
“The medical research future fund has money coming into it now and it’s not dependent on one particular policy or another,” Ms Ley said.
A spokesman later clarified that Ms Ley intended to say money was being set aside for the fund, which has not yet been established by legislation.
The fund was announced on budget night in 2014 as a sweetener for major savings measures in the Health portfolio, and was to be built up to a capitalisation of $20 billion by 2020.
The interest payments from the fund, approximately $1 billion a year, would then be disbursed to medical researchers.
The government’s $5 optional co-payment announced in December last year, now subject to change, was to contribute at least $800 million. It also lost a planned $1.3 billion in savings from increases to co-payments and safety nets under the Pharmaceutical Benefits Scheme (PBS) when it indefinitely delayed the measure beyond its start date of January 1, 2015. But other major savings, such as $1 billion of uncommitted funds from the Health and Hospitals Fund, $1.8 billion from the cessation of funding under the National Health Reform Agreement and $1.7 billion from the freezing of Medicare rebates, could still be ploughed into the fund.
Australian Medical Association president Brian Owler said it was good news the controversial co-payment would be separated from funding for medical research, which had politicised the establishment of the fund.
“I think people have almost assumed that all of the money for the MRFF comes from the co-pay, and that”s just simply untrue. There are billions of dollars from agencies that have been defunded and public hospitals. That will actually be a very substantial amount” Dr Owler said.
“The fund was also the vehicle, which allowed the government to say no cuts to health. I think that’s the issue – have the fund but don’t hold it hostage to the co-payment” Chair of Research Australia Christine Bennett said “from the outset” the co-payment furore had overshadowed the fund and its importance in potential major medical discoveries in the future.
“There has been huge confusion with people conflating the two,” Dr Bennett said.
“In fact the co-pay has always been just one of a number of measures in the government’s plan contributing to the endowment over a number of years.”
Dr Bennett urged the government to commit to the original timeline and quantum of funding for the Research Fund if it was no longer going to receive the co-payment savings.
Brendan Crabb of the Association of Australian Medical Research Institutes said while his organisation was agnostic about the source of funding, it was crucial it eventually reached the $20 billion as planned.
“We think there is considerable urgency to get this fund established and to chart a course towards the $20 billion. Which will roughly double the existing commitment,” Professor Crabb said.
“The appearance that it is a windfall for medical research is not the right one. Anything substantially less than that will not bring us to the OECD average. That is a significant concern.”
Establishment of MRFF delayed pending policy negotiations
THE AUSTRALIAN FEBRUARY 19, 2015 12:00AM
THE establishment of the Abbott government’s Medical Research Future Fund could be delayed for months.
The MRFF was meant to have started by January 1, receiving an initial $1 billion in uncommitted money from the Health and Hospitals Fund, but The Australian understands the government does not anticipate putting the legislation before parliament until later this year.
The government had proposed using the GP co-payment and indexation freeze on the Medicare rebate to subsidise the fund but, as negotiations on healthcare reform continue, the MRFF’s future remains uncertain.
Health Minister Sussan Ley could not confirm how it would be financed. “While I’m in this consultative phase I’m not going to make demands on doctors about where particular dollars go,” Ms Ley said. “I want to make sure that in listening to them I get their ideas.”
Crossbench senators Nick Xenophon and Zhenya Wang urged the government to decouple the MRFF from the co-payment, saying it was a good idea linked to bad policy.
“You don’t need to be a brain surgeon to know it should be uncoupled from the co-payment,” Senator Xenophon told The Australian.
“If the government is interested in good government they should start by uncoupling a very worthy idea with a very lousy piece of policy.”
The independent senator said all parties needed to look at alternative funding models, which he argued should be driven by “innovative” savings in health.
Senator Wang, whose Palmer United Party is against the co-payment, said he “loved” the idea of the MRFF and agreed that different funding mechanisms needed to be canvassed.
“How about a tax or levy on junk food and sugary drinks? There’s an obvious connection between those two,” he said. “But one tax won’t solve the problem. We can also look at funding coming from the private sector.”
Brendan Crabb, a former president of the Association of Australian Medical Research Institutes and a member of the MRFF action group, said the fund was needed “urgently”.
“It would be really disappointing if there was a significant delay in the establishment of the fund,” Professor Crabb said.
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