Tuesday, April 22, 2014

Pre - Budget Review Of The Health Sector - 22nd April 2014.

As we head towards the Budget in Early to Mid-May 2014 I thought It would be useful to keep a closer eye than usual on what was being said regarding what we might see coming out of the Budget.
According to the Australian Parliament web site Budget Night will be on Tuesday 13th May, 2014.
Here are some of the more interesting articles I have spotted this week.

Disability pension attack

Date April 19, 2014 - 11:59PM

Jonathan Swan

National political reporter

Thousands of disability pensioners would be examined by independent doctors to see whether they are still entitled to their pensions, under dramatic changes being considered by Social Services Minister Kevin Andrews. Mr Andrews, who is overhauling the $15 billion-a-year disability support pension – which he considers the most troublesome welfare entitlement – also said changes to the pension could begin as soon as the May budget.
"Potentially we could say, right, back to a certain point we'll just reassess people," Mr Andrews said. "The question then is how far back would you go in doing some reassessments of them?
"You could probably go back a couple of years," he said, "[but] if someone's been on the DSP for five or six years, the chances of them being assessed again as being capable of working is fairly remote."

New Premier Mike Baird shares his private views

Date April 20, 2014

Kirsty Needham

State Politics Editor

Premier Mike Baird wants to push ahead with the privatisation of public hospitals, saying Sydney's dilapidated health facilities are in need of upgrading.
The privatisation model used in Western Australia, where non-clinical staff were privately employed and public hospitals were privately built and managed, could provide a ''fantastic opportunity'' to give NSW patients the best services, he said.
Don't be afraid of the private sector. 
Mr Baird said he was concerned by the ageing of NSW's health facilities. ''The quality of doctors and nurses is world-class and they need world-class facilities,'' he said.

Pension age on fast path to 70

  • The Australian
  • April 19, 2014 12:00AM
The rising pension age. Source: TheAustralian
THE pension age will be pushed out to 70 in next month’s budget and may come into effect as early as 2029 under a razor-gang proposal to accelerate Labor’s plan to raise the pension age from 65 to 67.
There are no plans to cut the existing pension but consideration is being given to changing the rate of indexation for age-pension payments.
Under a “live option” being reviewed by the Abbott government’s expenditure review committee, the planned rises in entitlement age for the pension, between 2017 and 2023, would continue from 2023 to 2029. Every worker entitled to an age pension born since 1959 would be affected by the new retirement age of 70, effective in 2029.

Doctors delay vote on unseen contracts

Date April 16, 2014 - 11:05PM

Amy Remeikis

State political reporter

The state's senior medicos have so little trust in the government, doctors have refused to vote on whether they will even consider the new contracts, without seeing them first.
But while resignations have still not been ruled out, doctors at Wednesday's 'Pineapple Group' meeting did vote to take the threat of mass resignations off the table - for now.
But many questioned why they were still being asked to accept contracts which left them "worse off" than they were in November, when the government first stated its intentions to change doctors' employment conditions.
Lawyer Luke Forsyth, who formed part of the doctors' taskforce negotiating team, said he believed "this is as far as we can get it [the contracts], given the current government's ideologies in respect to this".

Dutton compares Medicare to Kingswood

16th Apr 2014
LETTING private health insurers loose on primary care may be the answer to upgrading Australia’s outdated ‘Holden Kingswood-era’ Medicare system, according to Health Minister Peter Dutton.
Writing in the journal Health Voices, published by the Consumers Health Forum, Mr Dutton gave his strongest indication yet that private insurers may be allowed to become more involved in GP care, saying there was little argument against such reform.
In his editorial, Mr Dutton likened Medicare to a 1980s Holden Kingswood. He said both were successful in their day but neither were able to meet public needs or expectations in 2014.

Dutton blasts public sector

HEALTH Minister Peter Dutton has narrowed his reform gaze to the services provided to concession card holders and the chronically ill, believing only the private sector has the “bold new ideas” needed to make the budget sustainable.
In an editorial written for the Consumers Health Forum journal, Mr Dutton continued his call for the private sector to be more involved in primary care — some insurers have already moved to better manage the services available to members — and also criticised the state of the public hospital system.
“Dramatic improvements in productivity and efficiencies that are part and parcel of the private sector are essential,” Mr Dutton wrote. “The public sector can no longer be shackled by archaic practices that deliver the waiting lists that leave tens of thousands of Australians in pain and unable to access a service for extended periods of time.”

How Joe Hockey should spread the budget pain

Stephen Anthony
Macroeconomics’ latest Budget Bulletin released on Monday tells the story of the fiscal challenges facing the Abbott government and in particular Treasurer Joe Hockey – and some of the options he has to meet those challenges.
The legacy of a decade of fiscal largesse by both sides of politics is a significant budget structural deficit that will require remedial action to correct.
The key reason the structural deficit will not necessarily correct itself is that there is significant spending growth just beginning at the end of the forward estimates period.
This is due to programs such as Disability Care, commitments such as raising defence spending to 2 per cent of gross domestic product, increasing the Commonwealth’s funding share of public hospitals, and matching Gonski education funding. Then there are longer term spending pressures related to population ageing and the environment.

Hockey budget to raise taxes and charges

Laura Tingle Political editor
The Abbott government plans to raise taxes and charges in the May 13 budget, as well as cut spending, as it scrambles to rapidly return to surplus.
However, it will argue that any revenue hikes now will be designed with an eye to giving it room to offer major tax reforms at the 2016 election.
The move is likely to be met with outrage by the opposition, given that the Coalition is in the process of repealing Labor revenue measures including the carbon price and mining tax.
Government sources say there will be “nothing pretty” about the revenue increases, but they will be made in an environment where the government believes the scope to take an axe to ­welfare spending in the short term is constrained by the impact this would have on the economy.

Health Minister Peter Dutton vows to unshackle public hospitals

Date April 15, 2014 - 6:09PM

Dan Harrison

Health and Indigenous Affairs Correspondent

Health Minister Peter Dutton has declared public hospitals are "shackled by archaic practices" and must embrace efficiencies.
In a piece written for the Health Voices journal published by the Consumers Health Forum of Australia, Mr Dutton wrote that the healthcare system must "be open to the innovation and the bold new ideas that come from the private sector".
"In our public hospitals dramatic improvements in productivity and efficiencies that are part and parcel of the private sector are essential," Mr Dutton wrote in the article, which was published on Wednesday.
"The public sector can no longer be shackled by archaic practices that deliver the waiting lists that leave tens of thousands of Australians in pain and unable to access a service for extended periods of time."

Dutton points to Medicare rejig

Joanna Heath
Health Minister Peter Dutton has given his strongest indication yet that Medicare will be overhauled in the May 13 budget by comparing the health system to an outdated Holden Kingswood.
In an opinion article published on Wednesday, Mr Dutton says private sector efficiencies must be introduced in the public hospital system, the primary care system needs to be improved, and private health insurers should be involved in the care of chronically ill patients.
It is the latest in a series of pronouncements by Mr Dutton in the lead-up to the budget, which have focused on the fiscal unsustainability of Medicare. He has hinted strongly at the introduction of patient payments for GP and emergency department visits.

Avoiding hospitals and doctors the best cure for healthcare woes

Date April 15, 2014 - 11:45PM

John Dwyer

"There are a number of valid reasons for sick people to visit an emergency department."
The Coalition government has told us we need to have an “everything on the table” debate on how to rein in healthcare expenditure.
Yet signs of a vigorous debate are as hard to find as therapeutic molecules in a homeopathic preparation. In essence, we are being told we must pay more for our health programs while simultaneously denuding them of millions of dollars. 
The intellectual property underpinning the government’s plan is focused on the introduction of a co-payment of $6 when visiting a GP and, more recently, the introduction of a fee for visiting a hospital’s emergency department with a “GP problem”.
Virtually all commentators have rejected the co-payment idea as poor policy that would raise very little money. Hospital expenditure dwarfs Medicare spending yet our inadequate primary care infrastructure fuels one of our most telling statistics. About 600,000 admissions to hospital each year (at an average cost of $5000) could be avoided if we had the infrastructure to provide community based interventions in the three weeks prior to a hospitalisation. This would cost only $300 a person treating at a community health level, compared with $5000 for a hospitalisation.

Mass doctor resignation threat off the agenda as doctors decide if their contracts suit them

AUSTRALIAN Medical Association Queensland president-elect Dr Shaun Rudd has endorsed the new individual doctors’ contracts, declaring the “one-sideness” has “dramatically changed”.
Speaking on ABC radio this morning, Dr Rudd said while he had no indication of the number of public sector doctors considering signing the new contracts, he would be “very surprised if it wasn’t the vast majority”.
“We are recommending … that these contracts are a much better contract than we initially started with,” he told ABC radio.
“As we’ve always said all along that individuals have to (make that individual decision) but we are in a position to believe they are reasonable.”

Qld doctors' contract dispute breakthrough

15th Apr 2014
QUEENSLAND doctors are on the verge of agreeing to move onto individual contracts, ending one of the longest and most bitter industrial disputes during the Newman government so far.
A handful of union and lobby groups have reached an in-principle agreement after Health Minister Lawrence Springborg made a raft of concessions over the last month.

Spokesman and president of the Australian Salaried Medical Officers' Federation Tony Sara said the amendments will guarantee patient safety is not compromised to meet bureaucratic needs.

Super clinics little more than a sick joke on the taxpayer

WE were told they would be super. Bulk-billed services, out-of-hours care, one-stop shops for medical and allied health services. And all located in areas of need where the provision of general practitioner services was clearly inadequate.
Labor took the dream of GP Super Clinics to the 2007 election. Notwithstanding the wholly unimpressive start to the program, the dream was re-promised in the 2010 election.
There were to be 64 clinics in all. They would relieve the pressures on public hospitals. They would also cater for the special needs of patients with chronic conditions. What was not to love about the GP Super Clinics?
As it turns out, quite a lot. In keeping with other Labor thought bubbles, the GP Super Clinic scheme has run over budget and over schedule. It has been a politically motivated shemozzle in which taxpayer funds have been frittered away in an almost completely uncontrolled fashion.

Government urged to target seniors, families in budget cuts by economics group Macroeconomics

April 14, 2014
An economic forecaster is urging the Federal Government to "cut hard and cut early" in next month's budget, targeting seniors, families and businesses.
In its annual pre-budget forecast, Macroeconomics has backed the numbers in the Government's most recent fiscal update handed down in December.
The group is urging the Government to target the middle and upper classes with cuts to assistance to seniors and families with children, as well as corporate welfare.
A director at Macroeconomics, Stephen Anthony, has told the ABC the Government must act quickly.

Hockey must spread the pain

The Australian Financial Review
Treasurer Joe Hockey has raised the prospect of increasing the retirement age and reviewing access to the aged pension as the critical May budget looms. Mr Hockey, speaking from Washington, has made it clear no one group can be immune from the tough decisions, such is the size and seriousness of the budget challenge facing the government and the nation.
Pensioners are already aware changes may include further increases in the retirement age and that pensions may be indexed to the inflation rate, rather than the existing, more generous system of indexing to percentage of male average wages.
But as this newspaper has noted before, it makes little sense for the government to talk about budget cuts and inflicting pain on different groups in the community, when it is also promising a $5.5 billion a year scheme to give new parents, younger taxpayers, up to $75,000 so that they can spend time looking after their children.

Nurses to screen for bowel cancer in proposed overhaul

  • April 14, 2014 9:49AM
·         SUE DUNLEVY
·         News Corp Australia
NURSES would take over the job of screening for bowel cancer and administering low grade anaesthetics under a radical plan to save public hospitals $430 million a year.
The proposal from former secretary of the health department Stephen Duckett has been put to Health Minister Peter Dutton as he searches for ways to rein in the budget deficit.
Under the plan up to 17,000 nurse assistants would be employed to take over nurses roles in feeding and bathing patients, turning them in their beds and stocking medications.
These nurse assistants would receive their training on the job and they would be paid $49,000 a year, thirty per cent less than a registered nurse.

Doctors ‘squandering’ skills cost hospitals $430m a year

April 14, 2014
Mark Ludlow
Australia’s public hospital system could save up to $430 million a year if doctors didn’t ‘squander’ time doing jobs that could be done by other staff members, a new report has found.
With health budgets under strain across the country, the Grattan Institute report warned hospital waiting times would get worse unless there was a significant shake-up to the way big hospitals are run.
It found there needed to be a more efficient allocation of resources in hospitals, including making sure highly trained medical specialists did not spend their time doing straightforward work.

Budget pain to hit all: Hockey

Laura Tingle Political editor
Treasurer Joe Hockey says no group will be safe from cuts in the May budget, as he braces voters for potential changes to the age pension and tighter asset tests.
The ramping-up of the Treasurer’s pre-budget rhetoric came as he wound up a visit to Washington and ahead of a meeting of federal cabinet and its expenditure review committee in Canberra on Monday.
In a statement about the ­economic task facing not just the government but the country, if it wished to stay competitive, Mr Hockey said that real wages may fall in coming years and that pension rates could also fall, noting that 60 per cent of male workers in the US “have had a real cut in their incomes” in the past 40 years.
“We’ve been the beneficiaries of having real income increases. Now the pension is attached to male total average weekly earnings, which is a higher rate but it’s not always going to remain a higher rate. So we have to look at how sustainable pension increases are.”
The Treasurer said the budget “is not going to target any one particular group. Every Australian is going to be asked to contribute to the budget repair, including politicians, and it’s going to be as fair an ask as is possible under the circumstances.”

Prepare for a retirement age of 70: Joe Hockey

GENERATION X Australians may have to keep working until the age of 70, Joe Hockey has warned.
In another indication that a further rise in Australia’s pension age is on the cards, the Treasurer, 48, said his contemporaries may have to keep working until their eighth decade.
Labor raised the retirement age from 65 to 67 from 2023.
“It may be that my generation has to work for an extra three years (to age of 70) and we need to redesign our systems to manage that fact, “ Mr Hockey told ABC TV from Washington.
“It will affect my generation. This doesn’t happen overnight.’’

Joe Hockey confirms pension age could rise to 70

Date April 13, 2014 - 10:40AM

Gareth Hutchens and James Massola

Joe Hockey says Australia has no choice but to take tough decisions in the federal budget, giving his clearest signal yet the pension age will rise to 70 in the May budget and holding out the prospect of future governments not being able to afford medicine for sick children.
Fairfax Media reported on Saturday that a rise in the pension age to 70 was under "active consideration" by the government, while changes to the indexation of pensions to slow the rising cost of the payment could also be made.
On Sunday, Mr Hockey said his generation will have to work for longer because there will be serious future budgetary stresses from an ageing population.
“That’s certainly one of the issues that needs to be addressed,” Mr Hockey told the ABC’s Insiders.
The drumbeat suggesting a tough budget continues to build. The final report of the Commission of Audit (COA) has been handed to Government and as I predicted we are starting to see some hints and leaks.
Economically we now have the Treasurer as well as both the Reserve Bank Governor and the Secretary of The Treasury saying we have very serious budgetary problems - and we can be sure all three have seen the COA.
Rumour is there will be a public release this week - we will wait and watch.
If what we read here is correct it is pension age up, skill replacement, disability pension exclusions and less funds overall. That is enough to be going on with.
To remind people there is also a great deal of useful discussion here from The Conversation.
As usual - no real news on the PCEHR Review.
More next week.

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