This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
or
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
Sunday, July 31, 2022
They Say Insanity Is Doing The Same Thing Over And Over And Expecting A Different Outcome!
All Australians deserve equitable access to
affordable quality primary care.
Today, the Strengthening Medicare Taskforce
held its inaugural meeting on the land of the Gadigal people of the Eora
Nation.
The Strengthening Medicare Taskforce members
are health leaders, representing a cross section of perspectives on the primary
care system.
At today’s meeting, all members undertook to
work together in the best interests of the health of Australians and the
Australian health system. I was delighted with the spirit of partnership and
collaboration.
The Australian Government established this
Taskforce to identify the highest priority reforms in primary care.
There is no doubt primary care around the
country is in a parlous state.
The Government is committed to ensuring
Australians get the care they need, when they need it and without worrying
about the cost.
The Taskforce will develop recommendations
to achieve this through five focus areas to achieve concrete results for
patients:
·a reliable training and
development pipeline, to build a strong and vibrant primary health care workforce
·increased access to
multidisciplinary care, harnessing the full skills of nurses, pharmacists and
allied health professionals
·new models of care and stronger
relationships between patients and practices, to better respond to today’s
health needs, including older Australians and those with complex and chronic
conditions
·ensuring access to care is modern,
patient-centred and easy, harnessing the power of technology, and
·providing universal health care
and access for all through health care that is inclusive and reduces
disadvantage.
Taskforce members had the opportunity to
discuss the reform journey to date from the co-chairs of the former Primary
Health Care Reform Steering Group, who guided the development of the Primary
Health Care 10 Year Plan 2022-2032.
Members also had the opportunity to share
their priorities for reform.
The Government has committed $750 million in
the Strengthening Medicare Fund to turn proposals into concrete actions for a
person-centred primary health care system.
The Taskforce agreed to develop a forward
work program, focusing on immediate priorities to deliver better health care
for all Australians. The Taskforce will report to Government at the end of 2022
and will meet again in August.
Chair
The Minister for Health and Aged Care, the
Hon Mark Butler MP
29 July 2022
Sydney
The Strengthening Medicare Taskforce is
chaired by the Minister for Health and Aged Care, the Hon Mark Butler MP. The
Membership is set out below.
Member
Organisation
Dr Omar Khorshid
President, Australian Medical Association
Adjunct Professor Karen Price
President, Royal Australian College of General Practitioners
Dr Sarah Chalmers
President, Australian College of Rural and Remote Medicine
Ms Leanne Wells
Chief Executive Officer, Consumer Health Forum of Australia
Dr Dawn Casey PSM
Deputy Chief Executive Officer, National Aboriginal Community
Controlled Health Organisation
Mr Anthony Nicholas
Board Chair, Allied Health Professionals Australia
Ms Karen Booth
President, Australian Primary Health Care Nurses Association
Ms Annie Butler
Federal Secretary, Australian Nursing and Midwifery Federation
Dr Ruth Stewart
National Rural Health Commissioner
Ms Amanda Cattermole PSM
Chief Executive Officer, Australian Digital Health Agency
Associate Professor Learne Durrington
Chief Executive Officer, WA Primary Health Alliance
Dr Nigel Lyons
Deputy Secretary, NSW Health (state and territory representative)
Professor Adam Elshaug
Director, Centre for Health Policy, Melbourne School of Population and
Global Health, The University of Melbourne
Professor Stephen Duckett
Honorary Enterprise Professor, Melbourne School of Population and
Global Health, The University of Melbourne
First in the thirty or so years I
have been watching Government Policy on General Practice we seem to be seeing
pretty much to same outcome over and over – as represented here!
Second the make-up of the taskforce
is exactly what you would select if you wanted the status quo. All those
selected have been at this and similar games for years with no discernible
change in outomes and just the typical ‘word salad’ outcomes!
Third was the glacial pace at which
anything was planned to happen. All the issues are well known and it hardly
takes six months to write them down.
As this article points out GP is
bleeding
Health Minister to focus on
‘terrifying trend’ of GP shortfall
The
new federal health minister has identified the looming shortage of general
practitioners as the most pressing medium to long-term challenge in the health
system.
Health
Minister Mark Butler, speaking at the Australian Medical Association’s national
conference on Saturday, said the low number of medical graduates applying to
specialise in general practice was “the most terrifying statistic” in health
care.
“It’s
hard enough to get a GP right now and we know that the current generation of
older GPs are pretty exhausted, particularly over the last 2½ years, and we
just do not have the pipeline coming through,” Butler said. “It is probably the
most terrifying trend that I see in primary care.”
Royal
Australian College of General Practitioners president Dr Karen Price told The
Sun-Herald and The Sunday Age
that 16 per cent of medical graduates had applied to specialise in general
practice in 2022, up slightly from the 15.2 per cent reported last year but
“not enough”.
Butler
said the issue had been discussed in the first meeting of the Strengthening
Medicare Taskforce on Friday, and he was told that several decades ago more
than half of all graduates had applied for general practice.
Australian
Medical Students Association president Jasmine Davis, who said her desire to
become a rural GP made her unusual among her peers, asked Butler what his
government would do to make general practice a career of choice.
Butler
said fixing the GP pipeline was a long-term project and there was “no silver
bullet for cities, let alone rural and regional Australia” but his government
was exploring alternative models, such as the trial of the single employer
model in the Murrumbidgee region started by the former government.
Under
this system, general practice trainees remain employed by NSW Health, allowing
easy transition between hospital and community-based general practice training
placements, and portability of entitlements such as annual leave. Several
trainees at the conference praised the program and Davis told The Sun-Herald
and The Sunday Age it was helpful
because losing entitlements by switching employers “definitely turned students
off and significantly impacted women, who were more likely to be GPs”.
Butler
said the results of the single employer model in the Murrumbidgee would inform
a possible further trial in South Australia.
All I can say is that GP is the core
of our health system and it really is time for some radically new thinking to
move forward! A little more money into the hands of he GPs might be a good
first step!
The inertia seen here reminds me
powerfully of what we see in Federal Digital Health Policy where simply no one can
figure out that we need to give up (after a decade) on the #myhealth record and start doing
things differently, It looks rather like even a change of Government cannot “unstick”
the glued down policy wheels and all the vested interests!
David.
10 comments:
Anonymous
said...
1. Maybe GPs will embrace the MyHR which will a) eat into their consulting time and b) help other GPs to poach their patients.
It's not 'just general practice'. when a Dr doesn't pick a specialty. They are choosing the specialty of "primary care, family medicine & preventative health care".
Mark Butler is pretty genuine. Unfortunately he is captive to stagnant bureaucratic processes and thinking. He asks his Department to pull together an Advisory Committee for him to Chair. Inevitably the end result is the same old bunch of advisors who have been bringing their stale thinking to such problems for years. They are incapable of bringing new thinking to the issues because that is not the way they do things. They approach the 'problem' the same way as they have always done and they cut and paste from their old documents. Of course, when they get the same result, as before, they pat each other the back. Nothing changes.
Guess it's a bit of a “most experienced” dilemma. The more individuals appear on these things, the more they are perceived as being experienced. They then form networks through attendance on one or more committees. Those advising have a finite list of individuals, and new entrants are vetted and introduced by existing members. That is simply how it works.
An alternative might be short terms, so fear and comfort do not overshadow innovative thinking and bold change.
Groupthink is a psychological phenomenon that occurs within a group of people in which the desire for harmony or conformity in the group results in an irrational or dysfunctional decision-making outcome. Cohesiveness, or the desire for cohesiveness, in a group may produce a tendency among its members to agree at all costs.[1] This causes the group to minimize conflict and reach a consensus decision without critical evaluation.
Groupthink is a construct of social psychology, but has an extensive reach and influences literature in the fields of communication studies, political science, management, and organizational theory, as well as important aspects of deviant religious cult behaviour
... or to put it a bit more bluntly - they are sheep and lack the ability to analyse and understand the real problems.
“A whole lot of ongoing health programs that I certainly thought were funded right through the forward estimates in the budget are not funded,” the Health Minister told delegates at the AMA National Conference.
These weren’t obscure programs, either.
“The after hours [Practice Incentive] Program is not funded beyond June next year, the aged care incentive … is not funded beyond next year,” he said.
“Then there’s a whole range of other very big programs – the Australian Digital Health Agency? Not funded beyond next year. My Health Record? Not funded beyond next year.”
These programs, Mr Butler said, “are just core business for the health sector”.
Some "stagnant bureaucrat" is being economical with the truth if they think ADHA and MyHR are "core business for the health sector”
If they were to evaporate tomorrow, all that would happen is the government would save money.
They will continue to be funded because they empower a department secretary that gives power to dep Agency heads and so on. The public service model is a matrix that requires a particular structure for a staffing position to exist. Everyone in public service wants a leaner structure; no one in public service wants their team to be leaner.
Mark Butler spoke at the AMA conference on Saturday and he said the taskforce meeting the day before had established some priorities, including: "Thirdly, there was a huge appetite for a deep dive into technology. I think that's going to be a really exciting part of our work."
The tech people on the taskforce are Amanda Cattermole from the ADHA and Dr Steve Hambleton, My Health Record spruiker, so how is that deep dive going to occur?
At such a pivotal time – with a hospital crisis, staffing crisis, looming GP shortage, aged care reform and a pandemic – and Butler has the same old characters contributing their 20th century view of healthcare.
Buried in an article on the AMA conference titled "Video consults find niche in mental health" https://medicalrepublic.com.au/video-consults-find-niche-in-mental-health/74266
is this nugget.
"Covid has also finally spurred consumers to use My Health Record. In December 2019, only 57% of records had data in them – by March 2021, it jumped up to 97%.
This year, the Australian Digital Health Agency will make that data more accessible.
“[The My Health app] will allow [consumers] to share health information with GPs and specialists or check their own pathology results on their phone,” ADHA project officer Jessica Carew told delegates at the NRHC.
“The app will remove the hassle of juggling multiple sources of information and there will be fewer delays in chasing up results.
“We aren’t stopping near future releases into the app we hope to include features such as medicine safety, aged care transfer summaries and, down the track, the proposed digital baby book.”
This second objective has a long way to go; only around 13% of aged care facilities are connected or have systems in place to connect to and use My Health Record, according to Ms Carew.
ADHA, she said, was working closely with the sector to lift that number.
She said there was work going on behind the scenes to make the information in the records more usable.
“The record itself is 10 years old now, as of the first of July, and originally its design was really about uploading PDFs, but we are working behind the scenes to transform that so the information is in a structured format and is discoverable,” she said."
Uploading pdfs was not the original design.
Ms Carew either does not know the original design or she is deliberately being misleading.
Then there's the statement about “[The My Health app] will allow [consumers] to share health information with GPs..."
Any GP with access to MyHR - and ADHA tells us that most do - can already have access through their practice system. So why would they want to use a phone app.
And I wonder how many MyHR records have much more than an immunisation status and MBS/PBS data? All of which is available through other systems. And just because a MyHR has data does not mean that consumers are using the thing.
Maybe someone should tell the Health Minister how he is being misled.
10 comments:
1. Maybe GPs will embrace the MyHR which will a) eat into their consulting time and b) help other GPs to poach their patients.
2. Maybe GPs aren't that stupid.
I prefer #2.
It's not 'just general practice'. when a Dr doesn't pick a specialty. They are choosing the specialty of "primary care, family medicine & preventative health care".
Mark Butler is pretty genuine. Unfortunately he is captive to stagnant bureaucratic processes and thinking. He asks his Department to pull together an Advisory Committee for him to Chair. Inevitably the end result is the same old bunch of advisors who have been bringing their stale thinking to such problems for years. They are incapable of bringing new thinking to the issues because that is not the way they do things. They approach the 'problem' the same way as they have always done and they cut and paste from their old documents. Of course, when they get the same result, as before, they pat each other the back. Nothing changes.
Guess it's a bit of a “most experienced” dilemma. The more individuals appear on these things, the more they are perceived as being experienced. They then form networks through attendance on one or more committees. Those advising have a finite list of individuals, and new entrants are vetted and introduced by existing members. That is simply how it works.
An alternative might be short terms, so fear and comfort do not overshadow innovative thinking and bold change.
https://en.wikipedia.org/wiki/Groupthink
Groupthink is a psychological phenomenon that occurs within a group of people in which the desire for harmony or conformity in the group results in an irrational or dysfunctional decision-making outcome. Cohesiveness, or the desire for cohesiveness, in a group may produce a tendency among its members to agree at all costs.[1] This causes the group to minimize conflict and reach a consensus decision without critical evaluation.
Groupthink is a construct of social psychology, but has an extensive reach and influences literature in the fields of communication studies, political science, management, and organizational theory, as well as important aspects of deviant religious cult behaviour
... or to put it a bit more bluntly - they are sheep and lack the ability to analyse and understand the real problems.
5:36 PM and 7:35 AM together are illuminating and right on target with new approaches and new ways of thinking being the sacrificial lamb.
"Mark Butler is pretty genuine. Unfortunately he is captive to stagnant bureaucratic processes and thinking."
Yes.
"Health Minister Mark Butler may have been in the job for two months, but he’s still learning something new every day."
https://medicalrepublic.com.au/fiscal-challenge-adha-funding-due-to-expire/74190
“A whole lot of ongoing health programs that I certainly thought were funded right through the forward estimates in the budget are not funded,” the Health Minister told delegates at the AMA National Conference.
These weren’t obscure programs, either.
“The after hours [Practice Incentive] Program is not funded beyond June next year, the aged care incentive … is not funded beyond next year,” he said.
“Then there’s a whole range of other very big programs – the Australian Digital Health Agency? Not funded beyond next year. My Health Record? Not funded beyond next year.”
These programs, Mr Butler said, “are just core business for the health sector”.
Some "stagnant bureaucrat" is being economical with the truth if they think ADHA and MyHR are "core business for the health sector”
If they were to evaporate tomorrow, all that would happen is the government would save money.
They will continue to be funded because they empower a department secretary that gives power to dep
Agency heads and so on. The public service model is a matrix that requires a particular structure for a staffing position to exist. Everyone in public service wants a leaner structure; no one in public service wants their team to be leaner.
Welcome to bedlam
Mark Butler spoke at the AMA conference on Saturday and he said the taskforce meeting the day before had established some priorities, including: "Thirdly, there was a huge appetite for a deep dive into technology. I think that's going to be a really exciting part of our work."
The tech people on the taskforce are Amanda Cattermole from the ADHA and Dr Steve Hambleton, My Health Record spruiker, so how is that deep dive going to occur?
At such a pivotal time – with a hospital crisis, staffing crisis, looming GP shortage, aged care reform and a pandemic – and Butler has the same old characters contributing their 20th century view of healthcare.
Buried in an article on the AMA conference titled "Video consults find niche in mental health" https://medicalrepublic.com.au/video-consults-find-niche-in-mental-health/74266
is this nugget.
"Covid has also finally spurred consumers to use My Health Record. In December 2019, only 57% of records had data in them – by March 2021, it jumped up to 97%.
This year, the Australian Digital Health Agency will make that data more accessible.
“[The My Health app] will allow [consumers] to share health information with GPs and specialists or check their own pathology results on their phone,” ADHA project officer Jessica Carew told delegates at the NRHC.
“The app will remove the hassle of juggling multiple sources of information and there will be fewer delays in chasing up results.
“We aren’t stopping near future releases into the app we hope to include features such as medicine safety, aged care transfer summaries and, down the track, the proposed digital baby book.”
This second objective has a long way to go; only around 13% of aged care facilities are connected or have systems in place to connect to and use My Health Record, according to Ms Carew.
ADHA, she said, was working closely with the sector to lift that number.
She said there was work going on behind the scenes to make the information in the records more usable.
“The record itself is 10 years old now, as of the first of July, and originally its design was really about uploading PDFs, but we are working behind the scenes to transform that so the information is in a structured format and is discoverable,” she said."
Uploading pdfs was not the original design.
Ms Carew either does not know the original design or she is deliberately being misleading.
Then there's the statement about “[The My Health app] will allow [consumers] to share health information with GPs..."
Any GP with access to MyHR - and ADHA tells us that most do - can already have access through their practice system. So why would they want to use a phone app.
And I wonder how many MyHR records have much more than an immunisation status and MBS/PBS data? All of which is available through other systems. And just because a MyHR has data does not mean that consumers are using the thing.
Maybe someone should tell the Health Minister how he is being misled.
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