New gov, new ministers, new name: same old story?

A new era in Australia’s health and aged care sector got off to a big start this week, with a new government elected, a new set of ministers announced, and a new name for the Department of Health (see below) revealed to a thrilled audience (see tweet).

Mark Butler has taken on the big job of Minister for Health and Aged Care, and with both sectors in crisis, it will be a massive task. He has an assistant in new minister for aged care Anika Wells and three junior ministers in Ged Kearney and Emma McBride – both of whom have clinical experience – and Malarndirri McCarthy, who has a great deal of experience in Indigenous policy.

We wish them all the very best but we’ve been here before, and it never gets easier. The same questions that faced Nicola Roxon and co in 2007 and Peter Dutton and co in 2013 also face the new Labor ministry. Mr Bishop has been there before as aged care minister in the early teens, when he was in charge of introducing consumer-directed care (CDC) to the aged care sector – perhaps not a great idea in retrospect – and he’ll know what he’s facing. He attempted a pep talk to health department staff today (pictured) but it’s going to require a lot more effort than that.

Bucketloads of effort, and bucketloads of money. Even the state governments these days recognise that general practice is about to keel over and needs a desperate injection of funds, far beyond the $750 million for VPE (and $220m in “grant” money to invest in IT systems, most of which are subsidised up the wazoo in the first place) that were promised to primary care before the election.

Adequate, 50:50 funding for acute care needs to be part of the mix, and while the two most populous states continue to spend the bulk of their funds on shiny new buildings and hospital car parking rather than staff and resources, even they admit a fix is needed for primary care in order for the problems in acute care to be solved.

Then there’s aged care. Good luck, Ms Wells. The ASX-listed private residential aged care providers are rubbing their hands with glee at the thought of the riches that will be raining down upon them, while the private and not-for-profit industry groups have now merged and will finally, after decades of talking about it, show a united front to the government. And what will that united front demand? More money, and nothing less.

New Zealand is in exactly the same situation. Its budget was handed down a fortnight ago, providing funds for a new regime that will see all the district health boards come under the banner of Health New Zealand and a new Maori health agency. The budget provided funds for some digital health projects and also towards writing off some of the debt accumulated by the DHBs during the pandemic, but this week the general practice sector protested yet again that it is incensed by the offer of a three per cent rise in capitation payments, the nurses are still fuming, and even the laboratory scientists have had enough. The local doctors’ union has completely given up the ghost.

And to top it all off, the new Australian government has decided to change the name of the health department yet again. We admit we weren’t around in 1921 when the first Department of Health (1921-1987) was constituted, but some of us were there to see the Department of Community Services and Health (1987-1991) formed, followed by the Department of Health, Housing and Community Services (1991-1993), the Department of Health, Housing, Local Government and Community Services (1993), the Department of Human Services and Health (1993-1996), the Department of Health and Family Services (1996-1998), the Department of Health and Aged Care (1998-2001), the Department of Health and Ageing (2001-2013), the Department of Health (2013-2022, during which time the aged care portfolio was sent over to social services and then promptly brought back again) and now, ta-da! The Department of Health and Aged Care returns (2022-?).

Pulse+IT’s love of acronyms has followed this convoluted path, having pogoed between DoHA and DoH (fondly known here at Pulse+IT as Doh!), but we are reluctant to use DoHAC. How do you reckon we should refer to them? Let us know here.

Meanwhile, digital health and health IT march on. We had a great response to our story on Northern Health’s roll out of its virtual emergency department statewide to form the VVED, but our most popular story was an opinion piece by by Tasmanian doctor and health informatics legend Terry Hannan, who was not as keen as we were about Tasmania’s digital health strategy.

That brings us to our poll question for the week. Last week, we asked: Is Tasmania’s digital health transformation plan on the money? The vast majority said it was good: 88 per cent to 12 per cent who were negative.

We also asked what could have been done differently, or even better. Here’s what you said.

This week, we ask:

Can the Australian and NZ health and aged care systems be fixed?

Vote here or leave your comments below.

Comments  

0 # Kate McDonald 2022-06-10 19:09
Last week, we asked: can the Australian and NZ health systems be fixed? Yes, 70 per cent of you said, a good majority. We also asked what you would do first. Here’s what you said:

- Digital transformation

- We have to move to value based funding rather than episodic and fee for services. There is so much low value care and doctor/system driven intervention that patents don't want (eg, end of life care) that resources could be redirected to gaps in mental health, and prevention and early intervention services.

- They can but it's neither easy nor quick. The undervaluing of Primary Health Care needs to be addressed urgently.

- Give the states Primary care as well as acute care!

- Too much money needed, not enough people to provide the services needed

- Start working through the commission recommendations and maintain a constant accreditation and problem collection. Just be active and spend some funds - and get results that matter.

- There’s not enough money, not enough staff.

- Big pharma and politicians need to be banned from planning and decision making. Doctors, specialists, nurses, clinical support staff on the floor and admin staff with clinical experience need to lead planning processes, and should be the only ones in decision making. And they all should be independent from any lobby groups, money incentive or other big influencers. We need to go back to what practicing medicine actually means and not to how we can prolong life till death the most profitable way. Its disgusting what's going on at this moment in time.

- People in aged care facilities rarely vote

- Not without resetting consumer expectations

- No, because governments like shiny new hospitals rather than supporting the real health delivery locations of GPs in rural towns and cities, Chiropractors to keep our workforce at work (versus having every back injury from work or sport on compo or addicted to opioids) and supporting our rural district nurses and midwives at the coalface.
it will need resolve and a very large amount of funding

- More emphasis on clinical consulting, not proceedures, accept that consultations of less than 15-20min are often inadequate and reimburse accordingly, talk with rural GPs re solutions for afterhours and acute work,
- Aged care should not be for profit, and needs more staffing and accountability to govt bodies, and they must monitor the care given.

- Tiers of personnel. Bring back Assistant Nurses, Enrolled nurses and then RN's won't be so stretched. Overseers instead of all doing. Put a recording person with Consultants, less cost. Consultants then need to oversee instead of do. Less cost, more time for consultants.

- Listen to those affected and take their advice for the sector - e.g. stop listening to the AMA re issues affecting general practice or pharmacy; merge the entire system from primary care through to acute and palliative and don't split the system between Cwlth and the State/Territori es. We need a seamless system that minimises duplication and has no game playing / cost shifting between the two sectors.

- improved conditions and pay for staff in aged care

- National strategic plan (transition to remove barriers to effective and efficient care) then a National (COAG agreed) operational plan with budget (50:50 Feds & States/Territor ies implementaiton $)

- Diversify Medicare funded primary care to offer walk-in nurse led clinics, urgent care clinics and other integrated options for regional, rural and remote communities, as fee-for-service GP dominated primary care has seen its day.

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