Competing perspectives on Urgent Care Clinics, a boost to Australia’s sovereign capability to manufacture intravenous fluids, and proposed private health insurance reforms are covered in the column this week.
The Zap also addresses the imperative for reforms in palliative care and primary care, and the under-funding of the Aboriginal Community Controlled Health Organisation (ACCHO) sector.
Also see why Allied Health Professions Australia has taken a swipe at the Royal Australian College of GPs.
The quotable?
To somebody seeking funding for a hammer, every problem can be portrayed as a nail.”
Charles Maskell-Knight writes:
The Government’s pre-election health largesse continued last week, with Prime Minister Anthony Albanese and Health Minister Mark Butler announcing a further 50 Urgent Care Clinics, with a cost over the next four years of almost $650 million.
Together with the bulkbilling and workforce measures announced on 23 February and the women’s health package announced on 9 February, the Government has now announced additional health funding of over $9.7 billion in the last month.
Unlike the bulkbilling package, which the Opposition quickly committed to copy, there was a restrained response to the Urgent Care Clinics announcement from Shadow Health Minister Anne Ruston.
She said “a Dutton Coalition Government will deliver Urgent Care Clinics as they were intended – focused on relieving pressure on local hospitals and providing real access to bulk billed urgent healthcare”.
“[We] will continue existing Urgent Care Clinics and we have already announced that we will establish additional Clinics in Sorell, Cairns, Maitland and Reid. We will make further announcements in due course,” the Shadow Minister said.
The Royal Australian College of GPs (RACGP) warned that new Urgent Care Clinics won’t solve Australia’s patient care challenges, and once again raised concerns about how they will be properly staffed.
President Dr Michael Wright said the RACGP did not support ongoing investment in Urgent Care Clinics without an evaluation demonstrating that they are effective.
He argued that “the best solution to increase access to urgent care and ease pressure on our hospitals is funding existing general practices to expand their current services, including more after-hours services”.
He also questioned how the new clinics would be staffed.
As far as I can see, if the workforce is not available to staff urgent care clinics, it will not be available to expand services from existing general practices.
The Australian Primary Health Care Nurses Association welcomed the announcement, saying it “recognises the capacity of nurse-led care to reduce pressure on emergency departments and improve access to timely, high-quality care”.
Ministers and government
Minister Butler announced that the Government and Baxter Healthcare were both investing $20 million in expanding Baxter’s production facility in Western Sydney to help to secure supply and shore up Australia’s sovereign capability to manufacture IV (intravenous) fluids.
This will increase domestic supply by 20 million units annually to 80 million units a year.
The announcement was welcomed by Advanced Pharmacy Australia and the Australian Private Hospitals Association (APHA).
Palliative Care Australia (PCA) said that “Australian made IV fluids will be a huge step forward in establishing an Australian-made supply of critical health products, but we should be aiming higher and adding pain relief medications to our ‘Made in Australia’ plans”.
A number of groups responded to a request that Minister Butler apparently made to private health insurers to “outline steps to increase their payout rate”.
As I could not find any reference to this request on Minister Butler’s media page or health.gov.au, I asked the Department for clarification, which was not forthcoming by my deadline.
Catholic Health Australia (CHA) and the APHA both welcomed the request.
APHA CEO Brett Heffernan said the Minister’s request “is important positive recognition that the funding system needs reform, and that the health insurance industry has a responsibility to meet hospital costs”.
CHA Director of Health Policy Dr Katharine Bassett said “the Government is right to focus on ensuring patients are the priority in private health insurance”.
The Australian Nursing and Midwifery Federation (ANMF) also supported the Minister’s request. The ANMF said the Minister had “directed that insurers have until June to increase their private hospital funding or face consequences, including potential regulatory action”.
Federal Secretary Annie Butler said “ANMF believes the Government should regulate the quantum of funds that insurers must pass to private hospitals… [and that the] regulation must include a requirement to pay nurses and midwives properly and guarantee safe working conditions, including mandated ratios”.
If the Government was serious about increasing the payout ratio, it should have stopped insurers from growing their revenue by unnecessarily increasing premiums.
Private Healthcare Australia (PHA, the private health insurance lobby group) responded to the request with a proposal to provide “a hardship package… to hospitals that open their books and can demonstrate a genuine need for short-term funding assistance in areas where there are no other private hospital services nearby”.
However, the proposal was conditional on “the Government agreeing to implement promised reforms to bring the cost of medical devices and surgical supplies in the private sector down to match the prices for public hospitals”.
At the time of writing other parties had not responded to this proposal.
The Department of Health and Aged Care announced the release of a handbook of tools to support medicine management in multimorbidity and polypharmacy.
As this column reported last month, on 28 January the Department suddenly announced progress on the development of the National Oral Health Plan 2025-34, including two “stakeholder workshops” last December.
I am told that a third workshop, intended to consider a draft of the plan, was scheduled for 6 March, but was cancelled late on Friday 28 February.
As my informant said “the message of the low importance of oral health improvements within the Department and both major parties were clearly apparent by the delays in commencing work on a new plan”.
“After all we have all known that the existing plan ended in 2024 for ten years! So only commencing the work on the new plan in the late stages of 2024 is already unacceptable.
“The Department had acknowledged the possible disruption that may be faced on the announcement of the Federal election and entering caretaker mode but given that this has not happened to date, the planned workshop to review the first draft of the new plan should have proceeded”.
The Australian Institute of Health and Welfare (AIHW) released data updates on suicide and self-harm monitoring, including ambulance attendance data and suicide among people receiving specialist homelessness services.
The AIHW also released a 645-page report on Closing the Gap targets: key findings and implications presenting results and analysis around 14 of the 17 Closing the Gap targets.
At a very high level the report concluded that increased remoteness is associated with poor performance against many of the targets.
The AIHW released an interactive (data visualisation) information resource detailing all the data held in the National Perinatal Data Collection, including information on data availability at the national and state/territory level, detailed information on the history of data elements, and practical information for users of the data.
Ahpra (re)-announced that the Expedited Specialist pathway – a fast track to specialist medical registration in Australia – opened to eligible internationally qualified obstetricians and gynaecologists on 5 March 2025.
Ahpra said that “general medicine, general paediatrics and diagnostic radiology are the next priorities for the Expedited Specialist pathway and will be added to the list later in 2025, after a robust qualifications assessment process”.
The Australian Bureau of Statistics released a report on multiple job-holders, finding that “9.9 percent of people who were a community and personal service worker in their main job were most likely to be a multiple job-holder”, the highest of any occupation.
Consumer and public health groups
In an article first published in Pearls and Irritations, Peter Breadon and Elizabeth Baldwin from the Grattan Institute argued that the bulkbilling package announced by the Government and endorsed by the Opposition “won’t fix primary care’s underlying problems”.
“Whoever wins the imminent election… should build on this announcement with broader primary care reform,” they said.
They said that who provides care and how they’re paid both need to change. They point out that most health systems similar to Australia’s use so-called blended funding for primary care.
“The bulk of a clinic’s funding is for managing on-going care of patients, with extra funding to care for sicker patients with more complex needs. That funding sits alongside a payment for each visit or service,” they said.
They argue that the bonus payment for 100 percent bulkbilling practices could potentially be used to employ a broader range of workers.
They also suggest it should be expanded, with practices able to opt for larger risk-adjusted practice payments and reduced fee-for-service, to “support a broader workforce, more prevention, and more effort on improving care”.
National Seniors Australia released an article on private health insurance premium increases, arguing that “election candidates from all sides should support our call for an in-depth independent inquiry into the private health system, with the focus on making private healthcare more accessible and affordable for older Australians”.
The principle of community rating underpinning private health insurance and supported through the risk equalisation arrangements means that older policyholders already receive massive subsidies from younger people.
PCA released the case for improved remuneration of palliative care in primary care based on its 2024 National Palliative Care Workforce Survey, which included 129 respondents working in primary care settings.
PCA is arguing for:
- a new practice-level payment to remunerate palliative care
- guidance for general practice about the use of longer consultation items in palliative care
- additional funding for home visits, after-hours care (in-person and via telehealth), and shared care arrangements with specialist palliative care teams
- creation of an expert working group to advise the Government on how to increase palliative care activity in primary care
- and development of a Palliative Care in Primary Care Monitoring and Evaluation Framework.
First Nations health
Late last year the Senate established a Select Committee on Measuring Outcomes for First Nations Communities, and on 6 March it held its second public hearing and took evidence from NACCHO CEO Pat Turner.
According to a statement from NACCHO, Turner “called for immediate and meaningful government action to reverse the worsening Closing the Gap targets”.
She said that “the increasing regression of key socioeconomic outcome targets, including early childhood development, incarceration rates, out-of-home care, and suicide, is unacceptable and requires an urgent, coordinated response”.
She went on: “The evidence is clear – community-led solutions work.
“Our model of care delivers better health outcomes, higher treatment adherence rates, and greater cost-effectiveness than mainstream services. Yet, ACCHOs continue to be underfunded while facing a greater burden of disease.”
Trade unions
Advanced Pharmacy Australia (AdPha) released its diversity, equity and inclusion (DEI) strategy ahead of International Women’s Day. Let’s hope the Trump administration doesn’t find out.
Allied Health Professions Australia (AHPA) CEO Bronwyn Morris-Donovan responded to an article in the RACGP’s NewsGP regarding the Department of Health and Aged Care’s Draft National Allied Health Workforce Strategy.
Morris-Donovan said she was “bemused to read the RACGP’s demand for recognition in the inaugural… Strategy”.
“Given the general practice sector is well resourced in comparison to primary allied health, it feels petty for the RACGP to complain they are not part of a workforce strategy that does not belong to them,” she said.
Given there were six times as many primary allied health professionals as GPs, she said it was “simply not practical for GPs to be the leader of every multidisciplinary team”.
APHA also released its submission to the Department on the strategy, noting the need to:
- prioritise the national collection of workforce supply and demand data for all allied health professions
- focus more heavily on the workforce impacts of funding policy and income differences across government programs
- consider practical options to address clinical placement challenges for allied health students, drawing on approaches from other programs
- expand rural and remote workforce initiatives focused on place-based training.
The Australian College of Rural and Remote Medicine (ACCRM) called on “all political parties to outline their policies to address the worsening crisis in rural maternity care, as closures and service downgrades put women, babies, and families at risk”.
ACCRM said its pre-budget submission outlined practical steps, including:
- a commitment to stopping rural maternity service closures
- targeted funding to attract and retain the rural maternity workforce, including Rural Generalists skilled in obstetrics and anaesthetics
- an intergovernmental taskforce to secure funding and ensure the continuity of rural maternity and women’s health services at risk of closure.
The Australian Society of Ophthalmologists (ASO) said an e-petition it had established on the Parliament of Australia website in late 2024 requesting the establishment of a private health commission or independent private health authority “to restore balance to the divided and failing sector” had met the requirements to be referred to the relevant Minister for a response within 90 days.
ASO President Dr Peter Sumich said “we need balance and regulation – which a private health commission or independent authority can provide – to ensure fair and reasonable distribution of power” between insurers and hospitals.
When I asked the ASO what functions and powers the authority would have, I was told it would have the “power to investigate and the authority to decide and implement decisions, including forcing the resolution of issues between insurers and health service providers”.
I also asked if the authority would have any power to regulate the level of above MBS fees charged by doctors.
The ASO responded that “where gap payments are required for a private health practitioner – fees in excess of MBS patient rebates – a proposed authority would have the ability to investigate, decide, and implement decisions, especially if there is evidence or reports of misuse, such as overbilling”.
The proposal for a private health system authority was the focus of the private health chapter of the Australian Medical Association’s pre-budget submission.
The RACGP marked World Obesity Day by releasing a new position statement on obesity prevention and management, calling for more government funding to address inequities in access to care.
President Dr Michael Wright said the RACGP was continuing its call for “increased funding for longer consults and mental health consults, because we know it will improve health and wellbeing – and this will reduce the number of people who end up in hospital due to the many chronic illnesses that are linked to obesity”.
To somebody seeking funding for a hammer, every problem can be portrayed as a nail.
Industry groups
CHA warned that “allowing Healthscope hospitals to fall into the hands of private health insurers will open the floodgates to a US-style healthcare system that reduces choice and quality of care for patients”, and released a position paper on vertical integration of insurers and service providers.
Given CHA’s general position that insurers are making huge profits and private hospitals are going broke, allowing an insurer to own private hospitals could be seen as solving both these problems?
The position paper points to insurers operating dental, optical and hearing clinics, noting that this allows insurers to provide policyholders with more affordable services by reducing out-of-pocket costs while ensuring quality. What’s not to like?
The problem according to CHA is that it impedes other providers in “competing in a fair market”.
The Pharmacy Guild continued its campaign for a reduction in PBS copayments with a media release claiming “women are twice as likely as men to say they can’t afford a prescription for themselves or their family, with the number of women who said they couldn’t afford medicine increasing by one third since 2022”.
Politicians and parliamentary committees
The Senate inquiry into PFAS is due to hold a public hearing in Launceston on 12 March.
Finally
US Secretary for Health and Human Services and well-known vaccine sceptic Robert F Kennedy Jnr wrote an opinion piece for Fox News saying he was “deeply concerned” about the measles outbreak in west Texas.
However, rather than issuing a full-throated call to action to parents to get their children vaccinated, he concluded that “all parents should consult with their healthcare providers to understand their options to get the MMR vaccine”.
“The decision to vaccinate is a personal one,” he said. “Vaccines not only protect individual children from measles, but also contribute to community immunity, protecting those who are unable to be vaccinated due to medical reasons”.
Consultations and inquiries
Here is our weekly list of requests by government bodies and parliamentary committees for responses to consultations or submissions to inquiries, arranged in order of submission deadlines. Please let us know if there are any to add for next week’s column.
The Treasury
Consultation – ban on the use of adverse genetic testing results in life insurance
12 March
Inspector-General of Aged Care
Consultation on the Australian Government’s implementation of the Aged Care Royal Commission recommendations
14 March
The National Health and Medical Research Council
Call for citations addressing research question as part of the review of the Australian Dietary Guidelines
14 March
Department of Health and Aged Care
Consultation on Assignment of Medicare Benefits for Simplified Billing Services
28 March
Department of Health and Aged Care
Consultation on PHI Rules sunsetting in October 2025
31 March
Australian Commission on Safety and Quality in Health Care
Public consultation on potential changes to the accreditation of general practices
4 April
Food Standards Australia New Zealand
Caffeine in sports foods and general foods
15 April
Coalition of Peaks
Independent Aboriginal and Torres Strait Islander-Led Review of the Closing the Gap agreement
16 April
Department of Health and Aged Care
Design of a national registration scheme to support personal care workers employed in aged care
17 April
Department of Health and Aged Care
Draft Quality Standards for Human Research Ethics Committees and their Host Institutions
17 April
Department of Health and Aged Care – Gene Technology Regulator
Invitation to comment on a field trial of genetically modified canola
17 April
National Health and Medical Research Council
Scoping survey on clinical practice guidelines on the diagnosis and management of myalgic encephalomyelitis / chronic fatigue syndrome
27 April
Department of Health and Aged Care
Updating clinical guidelines for dementia care
31 December
Charles Maskell-Knight PSM was a senior public servant in the Commonwealth Department of Health for over 25 years before retiring in 2021. He worked as a senior adviser to the Aged Care Royal Commission in 2019-20. He is a member of Croakey Health Media; we thank and acknowledge him for providing this column as a probono service to our readers. Follow on X/Twitter at @CharlesAndrewMK, and on Bluesky at: @charlesmk.bsky.social.
Bookmark this link to follow The Zap
