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."

Friday, April 17, 2015

COAG Health Council Has Zilch To Stay On E-Health - As Usual!

COAG Health Council Communique - 17 April 2015

The Federal and State and Territory Health Ministers met in Sydney at the COAG Health Council to discuss a range of national health issues.
Page last updated: 17 April 2015
17 April 2015

The Federal and State and Territory Health Ministers met in Sydney today at the COAG Health Council to discuss a range of national health issues.

Chaired by the NSW Minister for Health, Jillian Skinner, topics included health workforce programs, accreditation for health care professionals, health performance and pricing, clinical trial planning and management of the risk of Ebola virus disease in Australia. Ministers also took the opportunity to discuss the recent Review of Mental Health Services released by the Commonwealth.

Major items discussed included:

Release of the Report of the National Review of Mental Health Programmes and Services


Ministers took the opportunity to explore some of the recommendations of the recently released Mental Health Review with all ministers welcoming the announcement that the Federal Minister for Health, Sussan Ley, had rejected the recommendation to move a billion dollars of mental health funding out of public hospital services.

Ministers agreed to work cooperatively with the Commonwealth on a national approach through the COAG Health Council.to progress a response to the recommendations of the Review.

A National Code of Conduct for health care workers


Ministers considered the final report A National Code of Conduct for health care workers and the results of a national consultation on standards of conduct for all health care workers who are not registered under the National Registration and Accreditation Scheme for health practitioners. The Report is being released today.

Ministers agreed to the terms of the first National Code of Conduct for health care workers, which will set standards of conduct and practice for all unregistered health care workers. Ministers agreed that jurisdictions would now examine the implementation of the National Code and code-regulation regime.

Persons holding themselves out to be registered health professionals


Ministers agreed to refer the issue of registration verification to the Health Workforce Principal Committee for that committee’s advice on the veracity of the current registration verification system, and any potential system improvement opportunities.

The Independent Review of the National Registration and Accreditation Scheme for Health Professionals


Health Ministers were briefed on the final Report of the NRAS Review, conducted by Mr Kim Snowball, the former Director General of WA Health. The NRAS Review comprised an extensive consultation process which included over 230 written submissions and the involvement of more than 1000 individuals in consultation forums held in each capital city.

Given the wide ranging nature of the NRAS Review and the importance on the National Scheme to the health system, Health Ministers have requested time to consider the recommendations from the NRAS Review in detail and have agreed to consider each of the recommendations at their meeting in August 2015.

Registration of Paramedics


COAG Health Council is in the process of considering a proposal for national registration of paramedics in Australia with a proviso that individual states have the option of not being included. WA will now develop the proposal to the next meeting of COAG Heath Council subject to the regulatory impact statement.

Indigenous Teenage Sexual and Reproductive Health and Young Parent Support (Project Agreement)


Health Ministers discussed the impending expiry of the Project Agreement and the impact on Aboriginal and Torres Strait Islander people if funding for initiatives under the Project Agreement does not continue beyond 30 June 2015. The Project Agreement seeks to support delivery of pre-pregnancy, antenatal, sexual and reproductive health services and programmes for young Indigenous Australians. States and Territories have sought a commitment from the Commonwealth to provide ongoing funding towards Aboriginal and Torres Strait Islander teenage sexual, reproductive health and young parent support initiatives

Management of the risk of Ebola virus disease in Australia


The Commonwealth and state and territory governments have worked closely together to minimise Australia’s risk to Ebola and ensure that Australia is prepared to quickly respond and treat a case should one occur.
National guidelines are in place for public health management of a person with Ebola, and new infection prevention and control guidelines have been developed outlining the appropriate use of personal protective equipment in healthcare settings.

Privately Practising Midwives


Ministers agreed to extend the current exemption for Professional Indemnity Insurance for midwives in private practice providing intra-partum care for women who choose to have home birth to December 31 2016 while further work is being undertaken.

Chair of the COAG Health Council


SA Minister for Health, Jack Snelling, was elected the incoming chair of the COAG Health Council. The Council members paid tribute to the outgoing Chair, NSW Minister for Health, Jillian Skinner, for her dedicated efforts.

Media contact: Kay McNiece, 0412 132 585

This Might Be A Good Explanation Of Why We Have Seen The PCEHR Not Go All That Well.

This appeared a few days ago:

Why DoD EHR modernization will fail

April 10, 2015 | By Susan D. Hall
As evidence, he uses the words that Christopher A. Miller, the program executive overseeing the project, used in testimony before the Senate's defense appropriations subcommittee.
In prepared remarks, Miller said the Defense Department proposes to buy an "off-the-shelf" commercial product already in use by the healthcare profession and adapt it to military needs. This will be "state-of-the-market" commercial technology, Thompson writes.
The article echoes one he wrote for Forbes, in which he explained: "[I]t is seeking to acquire an electronic health record system that already exists in an industry noted for its antiquated approach to the movement of information."
And despite claims that the project will avoid vendor lock-in, the project manager told Politico he envisions the contract as "an extensive prenup and no divorce," Thompson writes.
…..
To learn more:
- read Thompson's
article
- find the Politico
story
The full article is found here:
The term "state-of-the-market" really caught my imagination. It is clear what we got with the PCEHR was the state-of-the-market circa 2010 or even a little earlier and that really explains why the whole thing is now very far from the "state-of-the-art" of 2015!
Worse it seems in the haste to implement there was no real planning on just how the state of the art in Health Information Exchange was going to be incorporated as this dynamic area progressed.
This is an issue any software purchase - think the planned new Centrelink systems - must really address.
David.

Thursday, April 16, 2015

2016 Budget Watch. Parliament Closed Until Budget Day. The Leaks Begin To Flow Quickly!

Last Budget Night was on Tuesday 13th May, 2014 and it is still not finalised -apparently $27Billion still unresolved!
We now look forward to see what we might see next time. I am sure this will be fun.
Last week was just huge with early leaks and a Tax White Paper and a Competition Final Report released. Too much for most to even start to get their heads around!
This week the leaks have started in earnest so it begins to get interesting! News on Super, Pensions and new Taxes are all coming into view!
Making it hard to avoid vaccination is a great idea!
Budget Night is May 12, 2015.
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Articles looking forward and back this week include.

General Budget Issues.

BCA urges leaders to decouple key reforms from budget

David Crowe

Australia is suffering from a “contaminated” political process that is weakening community support for difficult reforms according to a scathing new assessment from the nat­ion’s peak business group that warns against repeating the folly in next month’s federal budget.
Urging a return to a robust cabinet process, the Business Council of Australia is calling for major reforms to be carved out of the federal budget in order to provoke full public debate over contentious ideas.
The call comes with a rebuke to national leaders over the tactics of obstruction in parliament, raising fears that political parties are putting their own quest for power ahead of serving the ­national interest by being willing to compromise.
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The sobering reality of economic despair

  • Editorial
  • The Daily Telegraph
  • April 07, 2015 12:00AM
MEDICAL professionals are familiar with one infrequent but regrettable response from patients receiving bad health news. Occasionally, people will initially become angry with the doctor or specialist ­delivering that news. In time, that sort of response usually gives way to something more mature.
This scenario is analogous to Australia’s economic situation. The Coalition not only inherited woeful budget figures from the incompetent Labor government, which promised surpluses even as it drove the country deeper into debt. The Coalition was also elected, at least in part, to repair that budget.
Treasurer Hockey’s first budget, handed down almost one year ago, made steps towards achieving that repair, with a range of prudent but far from extensive cuts. Everybody knows what happened next. Led by Labor, a broad characterisation of the budget as unfair took hold across a wide section of the public.
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Business groups slam Abbott and Shorten over budget

April 7, 2015
by Phillip Coorey
Prime Minister Tony Abbott's political caution and Labor leader Bill Shorten's focus on fairness have been attacked by the nation's peak business and industry lobby groups for setting the nation on a path to "economic despair".
In a joint statement, nine groups have urged all sides of politics to show the same courage and zeal for economic reform as shown by the Hawke and Keating governments and the Howard government in order to rebalance the budget and drive economic growth.
"With the Prime Minister signalling a 'dull' budget and the Opposition Leader continuing to focus almost exclusively on budget 'fairness' you could be mistaken for thinking there is no significant problem with the state of the nation's finances," the groups said.
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4:08pm April 8, 2015

Consumers not falling for budget promise

The Abbott government's insistence its May budget will not be as harsh as last year's does not appear to be holding sway with the public.
Just weeks from Treasurer Joe Hockey's second budget, consumer confidence has sunk to its lowest level in eight months.
The latest ANZ-Roy Morgan consumer confidence gauge fell 2.3 per cent in the past week, continuing a steady decline since the end of last year.
Mr Hockey was keen to spruik his budget measures on Wednesday as "responsible, reasonable and fair" with a focus on growth, jobs, families and small business.
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Joe Hockey seeking to reap ‘billions’ from tech taxes

Sid Maher

David Uren

Closing the deficit gap

Joe Hockey could raise billions in extra revenue by extending the GST to services provided by offshore companies such as Netflix, and an Australian version of ­Britain’s “Google’’ tax that is expected to be announced in the May budget.
The Treasurer yesterday flagged a crackdown on tax avoidance by multinational companies in the budget, declaring that tax should be paid in the jurisdiction where it was earned.
The move came as technology giants Google and Microsoft revealed this week they were routing the bulk of their Australian sales through low-tax Singapore and, along with fellow multi­national Apple, were being audited by the Australian Taxation Office.
Mr Hockey said the government was working on GST integrity measures to require offshore service providers, such as the online entertainment provider Netflix, to register for GST and remit the money to the government.
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Abbott government to announce anti-vaccination parents will lose benefits

Date April 11, 2015 - 12:15AM

Mark Kenny and Julia Medew

Parents who do not vaccinate their children will lose welfare payments of up to $2100 per child under a federal government policy set to be announced before the May budget.
Under changes that could save more than $50 million a year, Social Services Minister Scott Morrison is preparing to scrap a "conscientious objection" provision which allows anti-vaccination parents to still claim welfare benefits including childcare assistance and Family Tax Benefit A.
Fairfax Media understands the Family Tax Benefit A is worth up to $2100 per child.
Parents of about 39,000 children have signed "conscientious objection" forms that certify they have a "personal, philosophical, religious or medical" objection to immunisation. This form, which requires a consultation with a doctor or immunisation nurse, is necessary for the parents to receive Family Tax Benfit A. But access is means tested so not every one of those parents would be receiving the payment.  
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Abbott announces 'no jab, no pay' policy

  • April 12, 2015 10:58AM
  • AAP
NO jab, no pay.
IT'S a catchy title for a policy designed to stop children catching diseases.
The federal government wants to strip childcare and welfare benefits from any parent who refuses to immunise their children.
It's in response to an "escalation of objections" to childhood immunisation under the conscientious objection clause for payments.
That clause will be removed under the policy.
Prime Minister Tony Abbott on Sunday announced the policy, which could leave non-complying parents up to $15,000 worse off.
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Apparent Budget Leaks.

Liberals flag age pension review

Joe Kelly

Stefanie Balogh

The government is clearing the way for a fresh review into retirement incomes in a bid to deliver more equitable budget savings and wedge Labor over its position on superannuation and Age Pension reform.
With Labor refusing to entertain GST changes that could open the door to a broader tax mix shake-up, Joe Hockey is considering a review to shift the debate towards the interrelationship between the taxation system, the pension and compulsory superannuation.
Assistant Treasurer Josh Frydenberg flagged the likely review yesterday after key crossbenchers welcomed moves by Social Services Minister Scott Morrison to initiate a new debate on tightening up eligibility rules for the pension, including the assets test for wealthy retirees.
Any new review would be anchored around improving equity in the pension and superannuation systems while providing structural budget savings over the long term, putting pressure on Labor after it elevated fairness as a guiding principle for economic reform.
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Pension reform: New target as Howard’s taper rates under review

David Crowe

The federal government is preparing to unwind a $1 billion annual boost to the Age Pension ­that was announced almost a decade ago amid growing evidence it has failed to achieve its promised benefits despite its soaring cost.
Offering a new compromise on pension reform, the government is willing to reverse John Howard’s generous increase in payment rates for retirees with substantial private assets in addition to their family homes.
The Australian understands the cut in the pension taper rate for wealthier retirees is now a leading target for savings to replace the changes proposed in last year’s budget to the way payments are indexed for all the ­nation’s 2.4 million age pensioners.
Talks on the compromise are being stepped up this week as ­social welfare organisations, seniors’ groups and crossbench sen­ators admit the pension is unsustainable in its current form.
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Tax relief for rich superannuation holders costs budget $6b a year: analysis

Date April 8, 2015 - 8:31AM

Heath Aston

Political reporter

Exclusive
Tax breaks enjoyed by mainly wealthy superannuation account holders are costing the federal budget $6 billion a year in lost revenue, independent analysis shows.
The true extent of the damage to tax receipts by a system which allows tax-free earnings for those over 60 is revealed in research by the Parliamentary Budget Office.
It found that the refund of franking credits on share dividends – which has resulted in people with millions of dollars in self-managed super receiving cash cheques from the Australian Taxation Office at the end of the year – are a net negative on tax receipts.
That's despite the pool of superannuation growing from a few hundred billion dollars just over a decade ago to more than $1.9 trillion today.
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Senate closer to pension deal as Greens mull support

David Crowe

David Uren

Agreement on pension reform is within reach as the federal government negotiates an $8 billion saving that is gaining qualified support from the Greens as long as it is part of a thorough review of retirement incomes.
The Greens are willing to consider voting for the new savings proposal as the first stage of a wider reform to retirement incomes that will throw the spotlight on generous tax breaks on superannuation.
The move builds support in the Senate to reverse the Howard government’s decision in 2006 to allow wealthier retirees to keep more of their pension payments even as their personal investments rise to as much as $1.1 million in addition to their family homes. In a clear sign a sweeping review is being planned, Treasury secretary John Fraser declared yesterday that the nation needed a fresh look at the interaction ­between super and tax and the entire welfare system.
“The design of our safety net must protect and serve the most vulnerable — and it is hard not to speak about middle-class welfare and the array of concessions and incentives around the Age Pension, super and housings,” Mr Fraser said. Joe Hockey revealed the government was “quite ­actively considering” a thorough “stocktake” of the retirement ­incomes system.
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Superannuation, pension perks in Hockey's sights

There is a "compelling" case to split access to health concession cards from pensions, particularly for high income earners, Treasurer Joe Hockey says, while ruling out major retirement income changes in next month's budget.
Mr Hockey says many higher income earners are arranging their financial affairs so that they can get the age pension, purely so that they can, in turn, become eligible for health concession cards, which give them access to cheap healthcare and medicines.
In an interview with AFR Weekend, Mr Hockey foreshadowed there were likely to be "integrity measures" in the budget on superannuation and pensions – measures designed to stop rorting of particular payments.
But at a broader level, retirement incomes policy – covering superannuation, the aged pension, the aged-care system and housing – had become even more complex than it was 10 years ago, he said.
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Taxpayers must be on red alert

  • Business Spectator
  • April 10, 2015 8:29AM

Robert Gottliebsen

All groups of taxpayers need to be on red alert. Australia, along with many other Western countries, is engaged in a complete review of taxation and pensions. There is simply less money available, so long-term changes must be made.
The “rich” are the most obvious targets — both large corporations and individuals. But there are simply not enough rich individuals to make a significant difference. Accordingly, in Australia, on the individuals’ front we are going to attack the battlers with small amounts of savings. As I will explain below, this will take place because Opposition Leader Bill Shorten and his shadow treasurer Chris Bowen have removed themselves from the debate.
But first, the sight of the Australian chiefs of Google, Microsoft and Apple appearing before our politicians and not performing all that well is a clear sign they will also be hit. We are looking at a global attack on the way multinationals do business.
Many decades ago, global companies would organise their operations so that the local chief of a global company had real authority and would ensure the tax due was fully paid.
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So-called Netflix Tax to extend GST reach to online downloads

  • April 10, 2015 4:12PM
  • Daniel Strudwick and wires
  • News Corp Australia Network

Netflix to net-tax

THE movies, songs, books and streaming services Australians buy online could be more expensive from next month as Joe Hockey looks to extend the reach of the GST.
Such a move — being dubbed the “Netflix Tax” — would make those products 10 per cent dearer for consumers but could add billions of dollars to the public purse.
Mr Hockey said the plan was an “integrity” measure, not a broadening of the GST; something the Abbott Government has promised it wouldn’t do.
The plan would update the GST to include “intangible services” such as online downloads, which obviously weren’t thought of when the Goods and Services Tax was conceived two decades ago.
It’s been flagged after a week of tax-related hearings in Canberra, including a Senate inquiry into big companies avoiding Australian tax and a meeting of state treasurers discussing a fairer carve-up of GST revenue.
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Samantha Maiden: Time we ripped up the golden ticket for those seniors with lots of lolly

  • The Sunday Telegraph
  • April 12, 2015 12:00AM
WHEN Peter Dutton was health minister, colleagues recall he used to privately wonder out aloud why they didn’t just sever the link between the aged pension and the seniors healthcare card.
Not take it away from people who need it, but do something about the incentive to claim the aged pension simply to get the card.
The Willy Wonka style golden ticket of seniors, the card ensures that cashed up retirees can spin into the chemist for $6 a script PBS medicines, even if they are living in million dollar houses with tax-free retirement income and assets beyond that.
Maybe they should just give one to just about every senior in Australia and tell them to stop madly applying for piddling amounts of part-pension just to get one.
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Health Budget Issues.

Australian public health advocates seek access to regional trade pact negotiations

Date April 7, 2015 - 11:02PM

Harriet Alexander

The peak lobby group for American pharmaceutical manufacturers has been given privileged access to negotiations for a major regional trade pact that could see the cost of medicines skyrocket in Australia.
Public health advocates and business groups are concerned that pharmaceutical giants will be able to advance their commercial interests in the once-in-a-lifetime pact through their seat at the negotiating table, while the details are kept secret from the Australian public.
Some of the measures that Pharmaceutical Research and Manufacturers of America (PhRMA) has publicly lobbied to be included in the Trans Pacific Partnership have subsequently appeared in draft versions of the agreement that have been leaked by Wikileaks.
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Bill the wealthy to keep Medicare healthy for all

  • TERRY BARNES
  • Herald Sun
  • April 09, 2015 12:00AM
WHILE the Abbott Government’s flawed and overreaching plan for mandatory GP co-payments is, in the words of the PM, “dead, buried and cremated”, and the Australian Medical Association keeps warning of “co-payments by stealth” due to Medicare rebate freezes, Health Minister Sussan Ley insists the principle of a “value signal” for those who could afford it is still on the agenda. Good on her!
Medicare ensures affordable access to world-class healthcare, regardless of means. Those on very low incomes and pensions, the elderly or those with chronic conditions do need protection from the financial impact of their health needs. They’re the ones for whom bulk-billed “free” medical services were intended. But for millions of us in good health and on equally healthy incomes who visit a GP just two or three times a year, Medicare should be about fair, not free, access. If a key underlying principle of Medicare is that everyone pays according to their means, surely those with adequate means can pay more as they go.
It’s misguided to say, self-righteously, “I pay my Medicare levy so I’m entitled to bulk-billing”. That levy covers just two-fifths of the cost of Medicare and pharmaceutical benefits. Other taxes and government borrowings do the heavy lifting.
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Pharmacy Issues.

Harper Competition Review finds bitter pills in pharmacy industry

Date April 7, 2015 - 12:40AM

Peter Martin

Economics Editor, The Age

Existing rules for pharmacies protect them from price competition.
Do you ever yearn for a return to the days before supermarkets, when shopping meant a separate trip to the greengrocer, the dry goods grocer, the butcher, the baker and the delicatessen?
Me neither. Life has become busy. Two-earner families shop at one-stop shops because we no longer have time for repeated stops.
The rules governing pharmacies are so strange we’ve come to think of them as normal. 
Except for chemists, where we are forced to.
Hours after last week's Harper Competition Review recommended an end to pharmacy ownership and location rules the Pharmacy Guild defended them by appealing to nostalgia.
"By ensuring that pharmacy ownership is widely spread, the major supermarket chains are prevented from securing the high degree of market dominance they have obtained in other areas such as grocery retailing" it said, apparently under the delusion that we would prefer our groceries to be sold by someone other than the big supermarket chains.
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Attacks on pharmacy continue

7 April, 2015 Chris Brooker
Media criticism of community pharmacy regulation has continued unabated over the Easter long weekend.
A series of articles in major newspapers has sustained the ongoing public critique of the lobbying power of the Pharmacy Guild of Australia.
The Age’s economics editor Peter Martin posed the question “do you ever yearn for a return to the days before supermarkets, when shopping meant a separate trip to the greengrocer, the dry goods grocer, the butcher, the baker and the delicatessen?”
“Me neither. Life has become busy. Two-earner families shop at one-stop shops because we no longer have time for repeated stops. Except for chemists, where we are forced to”.
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Pharmacies suffering under media attacks

9 April, 2015 Chris Brooker
A large majority of pharmacists fear that their business will suffer from the spate of recent media attacks on the profession.
More than 67% of respondents to a Pharmacy News poll said that “recent negative media reports” have “hurt” their business. 
Only 19.91% believed there had been no adverse effect from the coverage 
In the wake of recent reports from the Australian National Audit Office and the Competition Policy Review, national media has regularly run articles critical of the administration of the Fifth Community Pharmacy Agreement, advocating deregulation of the sector, and even lambasting the riches supposedly accumulated by some pharmacists. 
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Local pharmacists fighting deregulation

10 April, 2015 Megan Pigram
Community pharmacists are taking the fight over deregulation to their local politicians and media organisations.
Local pharmacists are speaking out to their local media and politicians in a bid to have the Harper Competition Review recommendations reconsidered for the fear of pharmacy deregulation.
Pharmacists have rejected proposals in the review which deregulate the industry and boost competition, making pharmacy a profession about profit not healthcare.
Culburra Beach pharmacist David Heffernan told his NSW local newspaper, South Coast Register, that he believes allowing pharmacies to be set up in supermarket giants endangers patient care.
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Pharmacists given green light to give flu jabs on the spot instead of doctors or nurses

  • LINDA SILMALIS chief reporter
  • The Sunday Telegraph
  • April 12, 2015 12:00AM
PHARMACISTS have won a protracted battle to administer flu injections to walk-in customers with the NSW government changing its laws to give chemists a greater role in treating the community.
Under the move, pharmacists will no longer have to hire a nurse or doctor to give the jab with customers able to request a vaccination costing from $24.90 to $30 on the spot from as early as midyear.
However, pharmacists are already lobbying both the State and Federal governments to take on a greater role in treating their customers such as dispensing antibiotics for ailments such urinary tract infections and chlamydia, dressing wounds and sorting medications for hospital discharge patients.
In a move opposed by the NSW Australian Medical Association (AMA), the State government quietly amended its Poisons and Therapeutic Goods laws last month to allow trained pharmacists to administer the flu vaccine to customers aged over 18 years with patient records to be sent back to their local GP.
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Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the 2016 Budget (or the Government) at the end of the day.
Nonetheless I am sure there will be lots of fun to observe over the next few weeks.
Enjoy.
David.