Sunday, August 18, 2019

I Reckon The ADHA Is Really Slipping Into Irrelevance And Fantasy. Here Are My Reasons.

The first reason flows from the following release for the Federal Health Department.

Building a Mentally and Physically Healthy Australia

Delivering the world’s best mental health system – stigma-free and focused on prevention, starting with children under 12 – is the major focus of the Australian Government’s Long Term National Health Plan, outlined today.
Date published: 
14 August 2019
Delivering the world’s best mental health system – stigma-free and focused on prevention, starting with children under 12 – is the major focus of the Australian Government’s Long Term National Health Plan, outlined today.
Under this Plan, we will build a mentally and physically healthy Australia. For the first time, mental health will be rated equally alongside physical health.
The Long Term National Health Plan recognises that depression, anxiety, bipolar disorder and psychosis are health problems to be treated just like diabetes, asthma and broken bones.
It charts the way forward over the next three and 10 years in the key areas of mental health, primary care, hospitals, preventive health and medical research.
The Long Term National Health Plan includes:
  • The 2030 mental health vision, including a new strategy specifically for children under 12 years
  • The 10-year Primary Health Care Plan
  • Continued improvement of private health insurance
  • The 10-year National Preventive Health Strategy
  • The 10-year Medical Research Future Fund (MRFF) investment plan.
To help inform the Plan, the Government is commissioning a multi-year study of more than 60,000 Australians to provide the most complete picture ever of our physical and mental health.
The Intergenerational Health and Mental Health Study will cover mental health, general health, nutrition and physical activity.

Mental health

The Government will build a mental health system that is integrated, simplified, trusted and comprehensive.
The new Children’s Mental Health Strategy focuses on the 0–12 age group, and aims to maintain mental wellbeing and prevent mental ill health. It will improve delivery of supports for early childhood, parenting and early education.
We know that half of all symptoms of mental illness begin before the age of 14, and that neuropsychiatric conditions are the leading cause of disability in young people. If untreated, these conditions severely influence how children develop, and how they do at school and in life.
The Children’s Mental Health Strategy will provide a framework to embed protective skills in early childhood, create mentally healthy home environments, support parents, and prevent or treat early childhood trauma.
The expert working group developing the Strategy will be co-chaired by Professor Frank Oberklaid and Professor Christel Middeldorp. Two internationally recognised leaders in child mental health.
Professor Oberklaid, Director of the Centre for Community Child Health at The Royal Children's Hospital, and Professor Middeldorp, conjoint Professor of Child and Youth Psychiatry at the Child Health Research Centre and Children’s Health Queensland Hospital and Health Service, are two of Australia’s leading child mental health experts.
The Government will continue to tackle stigma around mental illness and encourage people to seek help – and seek it early.
Enormous progress has been made on destigmatisation, but self-stigma – people’s self-consciousness about their own mental health concerns remains high. It is the main barrier to people seeking help.
As a Government, and through the nation’s leaders, organisations, schools and the community, we will work to ensure there will be no shame – in particular, no shame in our own mental health challenges – when we reach out for help.
The Government is undertaking unprecedented action to reduce the rates of suicide, particularly for our young people and Indigenous Australians. More than 3,120 recorded suicides in 2017 – part of an upward trend over the past decade – is a national tragedy.
The Government will establish a ‘towards zero’ suicide target and culture through a whole-of-government approach driven by Australia’s first National Suicide Prevention Adviser, Christine Morgan.
One of the specific priority areas for the next round of the Government’s Million Minds mental health research mission will be research on suicide prevention. Funding of $8 million will be made available to support this research with a round to be opened for competitive application in November 2019.
We will continue to improve service delivery. Funding of $111 million will establish 30 more headspace centres in this term, taking the total to 145 around Australia.
Funding of $110 million is allocated for the Early Psychosis Youth Services Program; $114.5 million to establish eight adult mental health centres; $63 million for residential eating disorder centres in each state and territory; and $36.7 million to expand Way Back services in selected regions, to support people after attempting suicide.
Between now and 2030, we will establish a network of adult mental health centres.
Australia’s mental health system needs to be better integrated. The Government will work towards a New National Mental Health Partnership with states and territories. This Partnership will be informed by the National Mental Health Commission and the Productivity Commission, which are currently working together on Vision 2030: Blueprint for the Future.
The Partnership will identify individual and shared responsibilities for states and territories, and the Commonwealth.
The goal of national partnerships with each of the states and territories is for a simplified mental health system from prevention to treatment to recovery.

Primary care

The Government will implement the 10-year Primary Health Care Plan.
A key reform is support for GPs to provide more flexible care for patients over 70 with chronic and complex conditions, through a new patient enrolment payment model rather than fee-for-service MBS items.
We will develop genomics testing as the new standard of care. Genomics will transform prevention, prediction, diagnosis and treatment by providing precision medical care, targeting the unique genetic makeup of individuals.
We will progressively roll out universal telehealth, modernising general practice, improving continuity and convenience, and particularly benefiting rural and remote Australia.
We will encourage more nurses to enter the primary care workforce.
We will make pharmacy an even more essential part of primary care. The Government is committed to early and inclusive negotiations for a new Community Pharmacy Agreement.
Through our Stronger Rural Health Strategy, we will better distribute the health workforce, with 3,000 new doctors and nurses and hundreds of allied health professionals to be located in areas of need, especially in regional and rural Australia.
Indigenous health is a key priority. We will complete the next iteration of the National Aboriginal and Torres Strait Islander Health Plan by mid-2020.
Through Medicare and the Pharmaceutical Benefits Scheme (PBS), we will continue to ensure Australians have guaranteed access to subsidised health care and medicines. We have provisioned $40 billion for PBS medicines over the next four years. Of this, more than $10 billion is for cancer medicines. We are also looking at ways to improve subsidised access, including streamlining processes for medicines that offer a real therapeutic advance.

Hospitals and private health insurance

We have begun the next wave of private health insurance reforms. We are working collaboratively with insurers, hospitals and doctors to deliver a better outcome for consumers. Our first round of reforms delivered the lowest premium changes in 18 years.
With $131 billion in record public hospitals funding on the table for the next five years under the National Health Reform Agreement, we will work with states and territories to better coordinate care for complex and chronic conditions, keep people out of hospital, and improve management, including self-management, of people with chronic and complex conditions.
Under our landmark $1.25 billion Community Health and Hospitals Program, we will continue to allocate funds for important health and hospital projects. So far, $100 million in signed bilateral agreements with states and territories has been released for 65 projects, including the Peter MacCallum Cancer Centre to bring CAR T – cell treatment to Australia ($80 million), Sydney Children’s Comprehensive Cancer Care Centre ($100 million), the Repat Brain and Spinal Centre, South Australia ($20 million), and the Logan Urgent and Specialist Care Centre, Queensland ($33.4 million).

Preventive health

The Government will develop and implement a 10-year National Preventive Health Strategy. This strategy will provide a better balance between treatment and prevention. It will be designed to keep people healthier and out of hospital.
We will continue to lift cancer screening rates across the three current population-based cancer screening programs – bowel, breast, and cervical – and have requested Cancer Australia to investigate the potential for a national lung cancer screening program.
Australia is set to be the first country in the world to eliminate cervical cancer through vaccination and screening.
We will continue to invest in the National Immunisation Program – $400 million for this year. We will develop a national obesity strategy with states and territories. A $20 million National Tobacco Campaign over four years will continue to reduce tobacco use. Our goal is to reduce smoking rates to below 10 per cent by 2025.
The National Preventive Health Strategy includes an Indigenous Preventive Health Plan. Under this plan, targets for improved health outcomes include:
  • Ending avoidable blindness by 2025
  • Ending avoidable deafness by 2025
  • Eradicating rheumatic heart disease by 2030
  • A 10 per cent annual increase in the number of people having at least one health check a year
  • 60 per cent of pregnant women to have at least one health check in the first trimester
  • Stopping the growth in type 2 diabetes among children and young people within five years.

Medical research

The 10-year, $5 billion MRFF investment plan and the $500 million Biomedical Translation Fund are giving funding certainty to our best and brightest researchers and start-ups. They are reaffirming Australia’s reputation as a world leader in the health and medical research.
A total of 54 clinical trials are now being funded through the MRFF. Within 10 years, we will have established Australia as a global centre for clinical trials.
Eight research missions covering brain cancer ($124.7 million), mental health ($125 million), genomics $500 million), ageing, aged care and dementia ($185 million), Indigenous ($160 million), stem cell ($150 million), cardiovascular ($220 million) and traumatic brain injury ($50 million) are funded through the MRFF. Over time, they will transform health care.
Work on breakthrough treatments includes the $20 million Mackenzie’s Mission to research rare genetic conditions like spinal muscular atrophy and fragile X syndrome, and the $50 million Genomic Cancer Medicine Program.
Here is the link:
A search of the document for “health record” or “digital” comes up with exactly zero hits – so we can see just how central the myHealthRecord and Digital Health is to the forward plans of the Health Department! And remember this is their long term plan!
Of course there is also this is well:

Why our new “long term national health plan” does not deserve its name

The image above indicates how much Australia’s new “long term national health plan” has to say about a critical health threat confronting us, now and into the future: climate change.
It also indicates what journalists asked about this pressing health issue following Minister Greg Hunt’s presentation to the National Press Club today.
Perhaps they missed the news that “climate change is the greatest health challenge of the 21st century, and threatens all aspects of the society in which we live”.

To earn its title, Minister Hunt’s plan would have laid out a vision for reducing the health system’s greenhouse gas emissions and waste, and for developing health services’ capacity to cope with the impacts of climate change, whether upon infrastructure or the health of communities.
It also would have laid out a wide-ranging public health response, with a particular focus on those most vulnerable to the health impacts of climate change, including the elderly and people with disabilities and chronic conditions.
Lots more here:
A long term plan that does not mention climate change and its recognized health consequences. Which would is Minister Hunt living in? The recommendations at the end of the article make good sense to me!
Closer to home, and as my second reason, we have this sort of nonsense springing up.

Australian Digital Health Agency visits our region

Thursday, 15 August 2019

Today we welcomed the Australian Digital Health Agency to our PHN to learn more about the use of My Health Record on the ground.

Today we welcomed the Australian Digital Health Agency’s CEO Tim Kelsey, Chief Medical Advisor, Clinical Professor Meredith Makeham, and Education and Clinical Use Lead Carey Doolan to our PHN to learn more about the use of My Health Record on the ground.
COORDINARE supported the expansion of My Health Record across the South Eastern NSW region by raising awareness and understanding of this important initiative in our region’s diverse communities.
This visit provided an opportunity for Mr Kelsey, Professor Makeham and Mr Doolan to meet with health consumers, to hear about the real life impact My Health Record is having on their daily lives, and how it could be made more useful for consumers and healthcare providers.
The input from community members was highly valuable, and we thank them for sharing their stories and suggestions of areas for improvement.

Mr Kelsey, Professor Makeham and Mr Doolan also met with local health professionals at TeamMed Medical and Dental Centre and the Illawarra Aboriginal Medical Service in Wollongong, who shared their insights and experiences using the system. Discussions were had around some of the challenges, learnings and barriers which might be overcome with digital solutions.
We continue to work closely with primary healthcare providers to increase their knowledge and usage of digital health initiatives, to help facilitate better health outcomes in our region.
Here is the link:
So we have the three amigos wandering around spruiking the benefits of a desperately obsolete shared health record system while the central Health Department policy makers seem to think there will be no impacts of climate change in the long term that are worth planning for. (Climate and warming don’t get a mention!).
Here is a link to the WHO release from last year:
I think they disagree!

I really do despair with all this.

What do you think?

David.

9 comments:

  1. David, re "What do you think?"

    I think your analysis is spot on.

    ADHA is living in an echo chamber of ignorance and hope, uninformed by facts and what doctors really want. And it's not more old data that costs squillions to collect and store - and then gets old, unreliable and irrelevant.

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  2. how about those other drivers of mental health problems and suicide - depression, lack of hope, poverty, loneliness, social exclusion, domestic violence, unemployment, Newstart, robodebt etc etc.

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  3. @ 2:11 PM "an echo chamber of ignorance and hope uninformed by facts of what doctors really want" (and need). This comment combined with the ADHA story led me to ask "who is the third amigo mentioned - Clinical Use Lead Carey Doolan"?

    After checking his 'profile' on Linked In. Since 2006 the many positions he has held have all lasted between 8 - 20 months. Mmmm .... longevity in a job is a rarity these days. It's a bit like swinging on monkey bars - no time to build substance in Digital Health. Perhaps this is why so many systems, including the My Health Record, are so flaky. No-one hangs around long enough to fix the problems.

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  4. To be fair there is extensive experience in the NHS “transformation”. Another unsuccessful transformation Tim was a drummer-boy for.
    The interesting bit is that now the MyHR has made it into the stage they all seem a bit lost. Ideas and borrowed slogans seem to be non-existent. For people who claim leadership in innovation and transformation they seem incapable of any form of strategic ambidexterity. They are clearly all exploration and no exploration.
    Clearly some need to get out of the kitchen.

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  5. If ADHA stopped tomorrow what would the clinical safety risk be? Would patients and citizens in general be at a disadvantage? Would the Minister loose political capital with peak bodies and colleges? Would the closure of ADHA and all it exist for strengthen the governments position?

    Would it contribute to improving the perception and reputation of the APS?

    Important to understand the value before recycling

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  6. If ADHA stopped tomorrow what would the clinical safety risk be? – there is always risk when improving. There is more risk being stuck in a static information paradigm where CDA Level 1 is the norm and no other shall be tolerated. Look at there software releases, about as innovative as sliced bread.

    Would patients and citizens in general be at a disadvantage? Quite the opposite

    Would the Minister loose political capital with peak bodies and colleges? I doubt it would be mentioned in polite society.

    Would the closure of ADHA and all it exist for strengthen the governments position? Strengthen, especially when it comes to serving the people.

    Would it contribute to improving the perception and reputation of the APS? Would not do any harm

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  7. I can’t find any value that ADHA deliver currently so if they closed shop tomorrow I doubt there would be much impact. A few cash forecasts might take a hit but that would be short lived.

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  8. But if ADHA closed shop tomorrow, who could you ring to delete your My Healthrecord?

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  9. The temp working at some random pharmacy during school holidays should do it.

    Does the delete HARD thing actually work?

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