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."

Thursday, June 07, 2018

The Macro View – Health, Financial And Political News Relevant To E-Health And The Health Sector In General.

June 07, 2018 Edition.
On the international front it seems Italy now has a government, Spain has managed a transition and Trump says (for now ) he is going to Singapore while applying tariffs on all his friends. The man is a bloody menace I reckon.
In OZ One Nation appears to be imploding,  the ACCC is bringing criminal charges against the ANZ and two international investment banks and Barnaby appears to have also imploded and gone on extended leave.
The Productivity Commission Report on Superannuation is an amazing document which needs a major response to fix the issues raised.
The Financial Services Royal Commission again made on feel sorry for some bank customers who were not smart enough to get out of the way of some pretty difficult steamrollers. They are now having a rest for a few weeks before going to Brissie and Darwin.
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Here are a few other things I have noticed.
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Major Issues.

Australia’s shadow banking Ponzi scheme

  • The Australian
  • 12:00AM May 26, 2018

Alan Kohler

Non-bank lending in Australia is really big. How big? No one knows, although moves are afoot to find out — next year.
Australia’s version of shadow banking is based on four things that are special to this country — first, the fact that virtually all residential development is “build to sell”, as opposed to “build to rent”, as it is in the United States; negative gearing; the retreat of the banks from ­financing property development; and finally, immigration — lots of it.
In the absence of the banks, a huge industry has developed to funnel yield-hungry high-net-worth individuals’ and family office money into property development outside the banking system.
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  • Updated May 27 2018 at 1:57 PM

Lack of 'Powell put' tightens financial conditions

by John Authers
Are financial conditions really tightening? And if they are, will they be allowed to tighten enough to make a difference?
The impression had been of late that at last financing was growing a little harder to come by, and that speculators and investors were at last finding it more difficult to fund their activities after years of exceptionally easy money after the crisis.
After all, the Federal Reserve, the world's most powerful central bank, has now raised rates six times, in a process of steady tightening that started back in 2015. Money is fungible, and other central banks are as yet only talking about tightening. In the case of the Bank of England, an alarming slowdown as a hard Brexit approaches has even prompted the abandonment of a rate hike that had been clearly signalled. So the effect of the Fed's activities is limited by continuing liquidity elsewhere.
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Turnbull government told to fix $474 billion superannuation sector

By David Crowe
27 May 2018 — 11:47pm
The Turnbull government will be urged to fix a chronic problem in the superannuation industry by setting up a new body to allocate some of the $474 billion in retirement savings for workers who never nominate their preferred fund.
The government's peak economic adviser has prepared a damning report on the industry woes and recommends sweeping new measures to help choose the best funds for millions of workers to boost their retirement nest eggs.
The report, to be released on Tuesday, will dash the hopes of the major banks in their quest to break open the existing system where unions and employers choose the default funds for workers.
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ABC radio is world class. ABC TV? Not so much

By Tony Walker
27 May 2018 — 11:21pm
Melbourne lawyer and property investor Joe Gersh is the latest addition to an otherwise ineffectual ABC board presiding over a decline of the national broadcaster.
Whether Gersh, whose experience is in backroom deal-making on behalf of wealthy clients, will add value to a lacklustre board remains to be seen.
However, it is not overstating things to say the ABC finds itself in one of its most perilous moments in a political environment that could hardly be more hostile.
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EU law reflects belated public interest in privacy

  • The Economist
  • The Australian
  • 12:00AM May 25, 2018
Today marks the deadline for companies to comply with the General Data Protection Regulation. The law, passed two years ago by the EU, requires firms to take better care of their customers’ data.
Meeting its requirements is a tall order. To pass muster, businesses have to appoint a data protection officer, conduct impact assessments, ensure that customers provide explicit consent to use their information, and give them the ability to inspect, correct or delete their records. The regulations apply even to companies outside the EU that deal with European consumers.
In the past, companies with sloppy approaches to data have been able to count on their customers’ lack of interest in cyber security which, perhaps surprisingly, has dwindled through the years despite a succession of hacking scandals. The share of people around the world asking Google about faulty passwords, email spam and computer viruses has plummeted since 2004, when the first data is available.
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Chinese downturn would not hurt Australia much: IMF

  • The Australian
  • 12:00AM May 28, 2018

David Uren

A sharp downturn in the Chinese economy would have only a modest effect on Australia, provided it did not turn into a broader financial crisis, an International Monetary Fund modelling exercise has found.
Australia’s other trading partners in Asia and the US would pick up much of the slack left by a collapse of exports to China, helped by a depreciation of the Australian dollar.
The IMF’s new study of the links between the Chinese and Australian economies comes amid a fresh bout of concern about China’s ability to manage its high level of corporate and local government debt as the economy slows.
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  • May 28 2018 at 5:00 PM

Why Australia and Julie Bishop are in Beijing's cross-hairs

China's latest efforts to embarrass the Turnbull government serve at least two purposes, according to seasoned Sino watchers in Canberra and Washington.
Foreign Affairs Minister Julie Bishop has been perhaps the toughest critic of China's militarisation of contested islands in the South China Sea.
Beijing is annoyed by her principled stand backing an international rules-based system to determine competing sovereignty claims between Asian nations and to ensure freedom of navigation through the strategically positioned trade corridor.
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  • Updated May 29 2018 at 12:15 AM

Productivity Commission blows up default super system

Employers and unions would have no influence over the $600 billion default superannuation system under a Productivity Commission proposal that would cleave super from the workplace relations system entirely.
An expert panel would be empowered to select the 10 best performing no-frills superannuation products to act as defaults after the commission found the super savings of millions are languishing in underperforming funds, dragging down retirement balances by as much as $635,000, or the equivalent of 13 years' pay.
In more bad news for the battered banks, the commission found a clear "performance divide", with union-aligned "industry" funds delivering average returns of 6.8 per cent compared to 4.9 per cent for bank-owned "retail" funds.
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Revealed: Why the sale of Ausgrid to Chinese buyers was vetoed

By Peter Hartcher
28 May 2018 — 11:51pm
A number of countries around the world, from Canada and the US to Malaysia, are starting to take a more sceptical view of foreign investments from China, especially when they're from state-controlled firms.
The NSW government was furious at the disruption of its planned part-privatisation of its electricity distributor. And why did the Turnbull government intrude into the sale process just 10 days before the deal's deadline?
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The fix for Australia's multibillion-dollar superannuation 'mess'

By Peter Martin
28 May 2018 — 7:07pm
The biggest shakeup in the history of Australia’s $2.6 trillion superannuation system would see new workers able to choose an approved high-performing fund for life, saving as much as $407,000 by avoiding underperforming funds and multiple accounts.
Recommendations from the Productivity Commission will boost your super and simplify the system. Economics editor Peter Martin explains.
A landmark Productivity Commission review has found that almost one third of default super accounts are chronic underperformers, actually costing members more than if they had invested in the underlying assets themselves and paid management fees. Another third, some 10 million, are unintended multiple accounts whose extra fees and duplicate insurance policies cost members $2.6 billion per year despite decades of government programs aimed at encouraging members to consolidate accounts.
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We no longer have need for Manus and Nauru as deterrents

By Tony Ward
28 May 2018 — 11:43pm
 “An almost insoluble mess”; “a Pacific purgatory”; “a weeping sore on Australia’s collective psyche”. It is hard to dispute Roman Quaedvlieg’s descriptions of the situations in Nauru and Manus Island in Friday’s paper.
Quaedvlieg argues that the issue is creating major tensions between “the ideologues and the pragmatists” of the Labor Party. He warns that “any softness” in Labor policy, “will be undoubtedly be used as a people smuggler’s marketing ploy to inveigle clients onto boats headed for our shores”.
But do we still need Nauru and Manus as deterrents?
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Young adults living at home are costing Aussie parents $12.2b a year

By Nicole Pedersen-McKinnon
Updated29 May 2018 — 10:59amfirst published 28 May 2018 — 4:32pm
It’s time I apologised to all fellow parents … and confess that I tell every graduating class I address that their best wealth-building opportunity is to stay living at home and save, save, save.
“But pay board – it’s great practice managing money and you might even be able to convince your mum and dad, if they can afford it, to stash your cash and return it to you later,” I disloyally divulge.
Because, for parents, the “afford it” bit is the rub. And you can’t have missed last week the rather entertaining story of a US couple who turned to the courts to evict their 30-year old s(p)on(ge).
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Great superannuation rip-off exposed

  • The Australian
  • 12:15AM May 29, 2018

Michael Roddan

The biggest shake-up of the $2.6 trillion superannuation sector for three decades would unshackle the retirement system from workplace bargaining agreements, end the proliferation of multiple ­accounts and rip $1 billion a year in contributions out of under­performing funds, under the proposals of a draft Productivity Commission report.
The proposals, if adopted, could give some Australians an extra $400,000 in their nest eggs over the course of their working lives.
After a two-year review, the Productivity Commission has spurned the wishes of the wealth management industry, which wanted the $500 billion default super market to be open slather for all competitors.
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  • May 29 2018 at 3:34 PM

Navy to embark on Pacific Island deployment amid fears over China's rising influence

The Australian navy will soon be deployed to the south-west Pacific in a goodwill mission with neighbouring countries amid criticism the Turnbull government has neglected the region and allowed China to fill the strategic vacuum.
Outgoing Chief of the Defence Force Mark Binskin said four ships and 1000 personnel would take part in this year's iteration of its annual Indo-Pacific Endeavour exercise.
"The 13 week deployment wll focus on the south-west Pacific, with an emphasis on planning for disaster assistance, multinational naval manoeuvres and training activities with partner nations."
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  • Updated May 30 2018 at 12:00 AM

Flashpoints emerge across the world economy

As Donald Trump's tax cuts power up the American economy, rising US interest rates are driving the greenback higher and sucking liquidity from the global economy. That's hitting emerging market economies, such as Argentina, Turkey and, to a lesser extent, Indonesia on our northern doorstep. At the same time, Italians are trying to cobble together a bizarre coalition government that wants to both increase public spending and cut taxes. The Mediterranean refugee crisis has devastated support for the European Union among Italian voters who once saw Brussels as a safeguard against their own unstable governments. The result is a re-emerging euro crisis.
Australia's national complacency is now being fed by a commodity price rebound for our energy and iron exports, and by assumptions of an improving global economy. That's feeding the conceit that an capital-importing economy, such as ours, can costlessly maintain a tax penalty on imported capital while the nation squabbles about the "fair" spoils of a stagnating pie. At some stage, this national drift will run aground, perhaps magnifying the next external shock. Australia sailed through the 1997 East Asian economic crisis, the early 2000s US tech-wreck and the 2008-09 global financial crisis. But did anyone mention the alarming build-up in debt in China, which now takes nearly 30 per cent of our exports, compared to only 5 per cent in the early 2000s? Hey, Reserve Bank governor Philip Lowe did, just last week.
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'We make mistakes': ATO agrees to trial independent tax reviews for small businesses, individuals

By Nassim Khadem
30 May 2018 — 10:29am
Tax Commissioner Chris Jordan says the Australian Taxation Office has agreed to trial independent reviews when small businesses and individuals are in dispute with the agency over a tax matter, following a joint Fairfax-Four Corners investigation into the agency.
Appearing before Senate estimates on Wednesday morning, Mr Jordan took issue with the joint investigation's revelations of small business taxpayers being harassed intimidated and bullied by the agency, and then having insufficient avenues to appeal the decisions and get adequate compensation.
Mr Jordan acknowledged that the ATO "are not perfect and we make mistakes" but said that the investigation gave a "distorted" picture about the extent of tax disputes.
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'Major financial crisis' could be on horizon, warns billionaire

By Nikos Chrysoloras & Helene Fouquet
30 May 2018 — 5:51am
A surging US dollar and a capital flight from emerging markets may lead to another "major" financial crisis, investor George Soros said, warning the European Union that it's facing an imminent existential threat.
The "termination" of the nuclear deal with Iran and the "destruction" of the transatlantic alliance between the EU and the US are "bound to have a negative effect on the European economy and cause other dislocations," including a devaluing of emerging-market currencies, Soros said in a speech in Paris on Tuesday.
"We may be heading for another major financial crisis."
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OECD says Australia and the globe are doing well, with risks down the track

By Peter Martin
Updated30 May 2018 — 6:38pmfirst published at 6:30pm
The Organisation for Economic Cooperation and Development expects world economic growth to roar back to 4 per cent this year, a peak not seen since the global financial crisis, but it warns that the jump will be fuelled by tax cuts and looser government spending, meaning it may not last.
For Australia, the 2018 Economic Outlook predicts a pick-up in wages and prices towards the end of the year that will allow the Reserve Bank to start “gradually tightening” interest rates.
It nominates housing prices and high household debt as the two biggest risks facing the Australian economy although it notes that house prices have begun to ease.
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Superannuation report lays out flaws in system

  • The Australian
  • 12:00AM May 30, 2018

Paul Kelly

The great super rip-off is exposed and documented. Millions of working people, the young, the low-paid, those who change jobs, are the victims. If you have any concern for justice, inequality, transparency and fairness, then you will be alarmed.
Yet what do we find? The great rip-off is being denied, the millions being exploited and hurt financially are being treated with contempt, dismissed as mugs who can be endlessly sacrificed as the defenders of a flawed system promote their collective interests generated by our compulsory superannuation model.
Yesterday morning, before most people had even absorbed the scale of the financial atrocity, the self-interested champions of the system trundled out their contemptible defences — witness the ACTU, the Institute of Superannuation Trustees and, sadly, ­Industry Super Australia, representing the industry funds.
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Tougher foreign interference laws can't come soon enough

By David Crowe
31 May 2018 — 4:05pm
Imagine the scenario at the next federal election when a foreign power seeks to wield its influence to help a friend or punish an enemy in the Australian parliament.
An Australian politician could easily collect donations from a wealthy patron close to a foreign government in exchange for influence over policy. A foreign government could use its muscle with ethnic media to wage a vendetta against an elected MP. A donor to a political party could shape its policy while hiding his or her link to a foreign agency.
What would have sounded alarmist a few years ago is now a humdrum prediction. The spectre of Chinese and Russian influence is everywhere. The Russian meddling in the last United States election is a sign of things to come, while the Russian cyber attacks on Britain in April showed just how blatant the tactics are getting.
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Melbourne house prices book worst quarter in six years

  • The Australian
  • 10:00AM June 1, 2018

Turi Condon

Melbourne’s housing market has recorded its worst quarterly result in more than six years with prices falling 1.2 per cent for the three months to the end of May, helping to drag national housing values down 0.3 per cent for the period, according to researcher CoreLogic.
Melbourne’s housing prices dropped 0.5 per cent for the month outstripping Sydney’s 0.2 per cent fall in May.
Hobart and a number of regional areas led by Geelong and southeast Tasmania helped arrest the national decline, turning in healthy price growth.
CoreLogic labelled the housing market downturn as “more entrenched”.
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Home borrowing contracts sharply, new figures confirm

  • The Australian
  • 1:24PM May 31, 2018

Michael Roddan

Lending in Australia is starting to display signs of a potential credit crunch as official statistics show borrowing for the housing market fell to its slowest rate in five years, giving more fodder to doomsayer analysts.
Official data from the prudential regulator today showed total lending for mortgages rose 0.2 per cent in April, leaving annual growth at just 2.3 per cent — a sharp contraction on the rate in recent months of an annual 5 per cent growth.
Separate data from the Reserve Bank of Australia showed housing credit rising 0.4 per cent in the month of April. CoreLogic researcher Cameron Kusher said it was the slowest monthly expansion in housing credit since June 2013.
Over the year, the RBA data, which includes lending from unregulated shadow lenders outside of the prudential statistics, showed housing data had risen 6 per cent — still three times as fast as wages growth. However, that was below the prior year’s 6.5 per cent growth in housing credit.
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Global business alarm over US steel, aluminium tariffs

  • Patrick Mcgroarty
  • The Wall Street Journal
  • 12:19PM June 1, 2018
Many businesses around the globe have expressed alarm over new US tariffs on steel and aluminium, saying they will disrupt long-established supply chains, drive up consumer costs and harm US exporters hit with retaliatory duties.
The Trump administration’s tariffs could raise prices on consumer products from beer cans to car parts, executives said, and inject new unpredictability into manufacturing, agriculture and consumer businesses.
The head of the US Chamber of Commerce, in a memo to the organisation’s board of directors, said the administration’s overall trade policies, including the possibility of pulling out of the North American Free Trade Agreement, will hamstring the US’s robust economic growth and threaten as many as 2.6 million US jobs.
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  • Jun 1 2018 at 2:53 PM

Trade wars, shadow banking, Euro crisis: How to tip the next big crisis

Wherever you look there are economic dangers that could escalate. Australia needs to get our house in order.
While much of the federal political focus is on the latest kindergarten-grade dysfunction of a minor party, the rest of the world has delivered a masterclass in how things can really go off the rails.
In Italy, the on-again, off-again spectre of a populist Greece-on-steroids euro crisis sent markets whipsawing.
Almost simultaneously China's massive shadow banking risks were again in the news, with the Organisation for Economic Cooperation and Development becoming the latest to warn that Australia wouldn't be immune to a debt disaster in its biggest trade partner.
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The Labor Party's China problem

By Nick O'Malley
2 June 2018 — 12:00am
When Australia’s chief spy, ASIO boss Duncan Lewis, told a Senate estimates hearing last week that Australia faced a greater  threat from espionage today than at any time since the Cold War he was careful not to specify which countries might be targeting us.
No one doubts that he was talking about China. The senators who were questioning him were undoubtedly talking about China.
As evidence of Chinese efforts to influence Australian institutions mounts, both major parties have reason for self-reflection.
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Portrait of a sick system gives us a chance to put things right

By Peter Martin
1 June 2018 — 10:22pm
We’re apathetic about super, until we’re not.
On Tuesday phone lines to Australia’s biggest bank-run super funds buckled under a deluge of calls from customers wanting to close multiple accounts. Traffic to the Australian Securities and Investments Commission’s website for consolidating your super jumped 500 per cent.
Recommendations from the Productivity Commission will boost your super and simplify the system. Economics editor Peter Martin explains.
And in at least one school, Year 12 students were shown two videos; one produced by the Productivity Commission depicting super funds as pigs, and the other prepared by this newspaper, making the point that multiple and poorly chosen accounts can cost members in excess of $400,000 over their working lives.
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We have debts to pay before we give ourselves tax cuts

By ROSS GITTINS
2 June 2018 — 12:15am
How much should we worry about leaving government debt to our children and grandchildren? A fair bit, though not as much as some people imagine.
The central claim of this year’s budget is that we can have our cake and eat it.
We can award ourselves personal income tax cuts worth $144 billion over 10 years, but still halt the growth in the federal government’s net debt at $350 billion by the end of June next year, and then have it fall away as the proceeds from successive, ever-growing annual budget surpluses are used to pay off the debt.
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  • Updated Jun 1 2018 at 11:00 PM

Could the GFC happen again? These guys should know

Conservative bank lending, low interest rates, and tighter access to credit have carved a very different debt landscape to that of the global financial crisis 10 years ago, but there is a risk of complacency around the rise in interest rates, former key Babcock & Brown executives say.
Speaking 10 years after the collapse of the company, former Babcock & Brown chief executive Phil Green says all three factors should work together to prevent a major crash, although he says that there are pockets of the Brisbane and Melbourne CBD residential markets that are already experiencing housing settlement defaults.
Importantly, there are fewer dubious loans such as "low-doc" loans that raged a decade ago, Mr Green says.
"The Australian debt market is not that leveraged," Mr Green said.
"In 2007 when we bought Alinta, there was all that bridge finance, and the purchase was almost 100 per cent geared.
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The alleged bank criminal cartel that will send industry shockwaves

By Elizabeth Knight
2 June 2018 — 12:05am
The bombshell criminal cartel action involving the ANZ and two investment banks is set to cause an industry explosion. After a protracted investigation by the Australian Competition and Consumer Commission, charges will be laid soon that will send shockwaves around the financial securities industry.
It breaks new ground for the ACCC which has alleged criminal cartel behaviour only three times - none of which have involved trading in securities.
The move will undoubtedly open a can of worms around the legality of aspects of share placements, underwriting agreements and share trading practices.
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'Transformative': the Turnbull reform that should happen but never will

By Peter Hartcher
2 June 2018 — 12:03am
Australia's system of compulsory super is a tremendous national asset, a Keating creation that's proved so successful that the Coalition has given up trying to surreptitiously strangle it or wish it away.
But that doesn't mean that the subterranean struggle for political control and advantage has ended. Oh no. The prize is too big and the pickings too rich. The parties are talking reform for the benefit of the ordinary Australian, but they also are thinking reward for their cronies.
The system started as a way of giving ordinary workers a painless way of saving for retirement by requiring bosses to pay a fixed percentage of wages into a tax-advantaged super fund, but it's become much more.
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Government fund would put a stop to the gravy train

  • The Australian
  • 12:00AM June 2, 2018

Adam Creighton

Machiavelli wrote “nothing is more difficult than to initiate a new order of things, for the reformer has enemies in all those who profit from the old order and only lukewarm defenders in those who would benefit from the new”.
Forget lukewarm, try clueless. Whatever the impediments to 16th-century reform in Florence, they were nothing compared with what Financial Services Minister Kelly O’Dwyer faces if she tries to improve the efficiency and competitiveness of superannuation. Abysmal standards of financial literacy are endemic. Almost a third of Australians would rather be given $200 in cash than receive $2000 in superannuation, according to a 2014 Westpac survey. O’Dwyer will have the two most powerful vested interests in the country — finance and unions — arrayed against her.
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Revealed: Live exports review recommended an immediate ban

By Latika Bourke
3 June 2018 — 12:15am
It was the only recommendation of the live exports review that the government did not agree to implement immediately. Now Fairfax Media can reveal why.
Hidden behind confusing jargon and acronyms, recommendation four of Michael McCarthy's snap review into the live export trade called for what would have constituted an effective ban on the summer live trade effective July 1 this year. It required such drastic changes to animal welfare standards that exporters would have been left with no other choice than to close down.
The review was commissioned after footage filmed by a whistleblower onboard the Awassi Express, operated by the Perth-based Emanuel Exports, showed sheep boiling to death during a heatwave on their way to the Middle East in August last year. A total of 2400 sheep died.
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Financial Royal Commission Issues.

Royal commission spreads housing fears

As the royal commission ground through another day of worthy but unspectacular revelations about small business lending, the broader impacts of the commission's work are setting off some rather shrill – and perhaps overly pessimistic – alarms in federal politics, the property industry and the consumer sector.
In Canberra, Treasury secretary John Fraser amplified a warning from ratings agency Moody's, which argued that the royal commission could threaten economic growth if tighter lending standards start to hit the availability of credit.
"There is also the risk that there is an unanticipated tightening in financial conditions through reactions to the royal commission into the financial services industry," Mr Fraser told a Senate estimates hearing on Tuesday.
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Credit crunch risk rising: UBS

  • The Australian
  • 12:54PM May 30, 2018

Michael Roddan

The risk of a sharp credit crunch is rising, according to analysts at investment bank UBS, which is warning of a “disorderly” housing correction.
It comes on top of dire cautions from Treasury secretary John Fraser, who yesterday told a Senate committee that a dramatic tightening in lending standards by the nation’s banks could result in a surprise shortage of credit in the economy.
In his opening remarks to the Senate economics committee, Mr Fraser, himself a former UBS banker, said it was “early days yet to make an informed judgment”, but added: “There is a risk that there is an unanticipated tightening in financial conditions through reactions to the royal commission.”
In a note today, UBS analyst Jonathan Mott said the housing market was already slowing, with house prices falling and credit conditions tightening.
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‘Why not just say 'Do it!'?’ ASIC under fire for its inaction on banks

By Cara Waters
1 June 2018 — 11:48am
Commissioner Kenneth Hayne lost patience with the corporate regulator for its lack of action on unfair contracts for small business.
“Why work with the lender? Why not just say ‘Do it!’?”, he asked after the banking royal commission heard on Friday morning the Australian Securities and Investment Commission (ASIC) had not taken any enforcement action against the banks.
All banks failed to comply with unfair contracts legislation protecting small business when the legislation came into effect in November 2016 and some banks are still not compliant.
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National Budget Issues.

Fortunately, Turnbull’s tax cap is just political window-dressing

By ROSS GITTINS
28 May 2018 — 12:00am
The Turnbull government’s solemn pledge to cap the growth in tax receipts at 23.9 per cent of gross domestic product is a political gimmick to which no government committed to economic responsibility would bind itself.
So it’s good we can be confident that, should the Coalition remain in power in the years to come, it will ditch its solemn pledge the moment it becomes politically inconvenient.
Why can we be confident? Because this very budget ditches two earlier solemn pledges to “bank” any unexpected improvements in tax collections or government spending and to get the budget balance back to a surplus of at least 1 per cent of GDP “as soon as possible”.
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  • Updated Jun 1 2018 at 1:45 PM

Scott Morrison on track to deliver shock surplus

Australia's shrinking professional media appears to have once again completely missed the fact that the government reported a huge $9 billion budget surplus in April, which means it is theoretically possible Treasurer Scott Morrison will deliver voters a shock surplus in the current 2017-18 financial year (on either the net operating balance or fiscal balance measure).
The cumulative net operating deficit this financial year peaked at $18.8 billion in October 2017 and has since shrunk to just $8.6 billion. This is because Morrison has managed to run a budget surplus over the last seven published months to April 2018.
Since the government updated its budget projections at the December mid-year mark, the actual results have been almost $12 billion better than expected care of superior export revenues and reduced welfare payments.
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Health Budget Issues.

Victorian GP Tony Bartone is AMA’s new president

DR Tony Bartone, who has flagged allowing health funds to pay for GP care for the first time ever, is the new president of the powerful Australian Medical Association.
Sue Dunlevy
News Corp Australia Network May 27, 20181:28pm
VICTORIAN GP Dr Tony Bartone, who has flagged allowing health funds to pay for GP care for the first time ever, is the new president of the powerful Australian Medical Association.
The doctors union is so powerful it’s previous president Dr Michael Gannon revealed Prime Minister Malcolm Turnbull rang him to ask him who he should appoint as health minister.
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'Our health system is ailing': New AMA boss speaks out

27 May 2018 — 2:45pm
Dr Tony Bartone has been elected the new president of the Australian Medical Association as the peak doctors' group prepares to wield its political influence ahead of a federal election and shore up its waning membership.
The Victorian GP and outgoing AMA vice president beat two other candidates: former AMA NSW branch president and Sydney immunologist Dr Brad Frankum, and former AMA Queensland  president, obstetrician Dr Gino Pecoraro.
“I am ready to lead the AMA at this critical time,” Dr Bartone told delegates at their national conference in Canberra on Sunday.
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New AMA chief takes shot at Greg Hunt

AAP
May 27, 2018 5:19PM
The newly elected Australian Medical Association president says the country's health system is ailing and doctors' patience with Health Minister Greg Hunt is "wearing thin".
Melbourne GP Tony Bartone was elected AMA president on Sunday, replacing Dr Michael Gannon who has served in the role for two years.
In a speech to the AMA National Conference in Canberra, Dr Bartone painted a bleak picture of the health system and said it was up to the association to improve it.
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Flu vaccine rationed as national shortage hits over 65s hardest

By Kate Aubusson
25 May 2018 — 12:00pm

Talking points

  • Flu vaccines are being rationed to prioritise most at risk group 
  • The Australian government has supplied more than 5.1 million doses of the 2018 seasonal vaccine through the National Immunisation Program
  • The TGA has released an additional 4.5 million to state programs and the private market
  • Every state and territory reported a 25-30 per cent increase in demand for the vaccine.
  • National supply has only increased by 10 per cent so far.
Influenza vaccine rationing is set to continue into early winter as health authorities restrict supplies to GP clinics amid a national shortage.
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Aged care in crisis: who will look after you when you're old?

By Debby Blakey
27 May 2018 — 11:43pm
It’s confronting to think that Australia may find itself in a position where it won’t have enough aged care employees to adequately look after our ageing population.
Government forecasts show we’ll need almost a million aged care employees by 2050.
Research by health industry super fund HESTA reveals the challenge of addressing this future shortfall is greater than we thought, with up to 23 per cent of the workforce planning to leave aged care in the next five years. That’s about 84,000 people who, if they leave, will take their valuable skills and experience with them.
Urgent action is needed to keep these employees and attract new ones.
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AMA chief pain for Greg Hunt

  • The Australian
  • 12:00AM May 28, 2018

Sean Parnell

A general practitioner has again taken charge at the Australian Medical Association, ensuring primary care will be on the agenda ahead of the federal election.
Melbourne GP Tony Bartone was yesterday elected president of the AMA, succeeding specialist Michael Gannon, to whom he was vice-president for two years.
Dr Gannon had lamented not being able to do more for GPs, ­despite the Medicare freeze starting to thaw, and Dr Barton made it clear he would take up the fight.
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Coalition, Labor in brawl over aged-care funding

  • The Australian
  • 12:00AM May 29, 2018

Rick Morton

The Coalition’s $5 billion aged-care budget, described as a hoax by the opposition, used the same method of reallocating residential care places to home care as Labor did when it was in government, with one crucial difference.
While both redistributed funding from the more expensive residential care sector due to lack of demand, Labor used the difference in value between that and home care to book $220 million as a saving in two budgets.
An analysis of budget ­papers under the Gillard government in 2010, 2011 and 2012 shows Labor used the same methodology to save money, starting with $9m in 2010 and booking $211m the next year. In 2012, it allocated $955.4m to its aged-care reforms but almost half of this — $454m — was found by swapping funding from residential aged care to home care, the high-demand support program which helps keep elderly Australians at home for longer.
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Pharmacist pollie slams budget in Parliament

Patients are avoiding or delaying filling a prescription because of cost, says MP Emma McBride

Labor has slammed the government’s health budget, with Central Coast MP Emma McBride (Dobell, New South Wales) criticising healthcare costs for patients in a recent House of Representatives sitting.
Ms McBride works as Deputy Director of Pharmacy for Central Coast Local Health District, and prior to this role was Chief Pharmacist at Wyong Hospital from 2008-16.
“As a hospital pharmacist who worked at my local hospital in Wyong for 10 years before I was elected and who worked in mental health units for most of my life Labor has a strong tradition in health and hospitals,” said Ms McBride in her speech.
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Warning over 'heroic', 'futile' surgery when the patient has no hope

By Aisha Dow
29 May 2018 — 5:48pm
People are suffering after being subjected to “futile” or “heroic” procedures that are unnecessary because they're likely to die anyway, the  Royal Australasian College of Surgeons warns.
According to the latest Victorian Audit of Surgical Mortality, about 0.3 per cent of the more than 632,000 surgeries in the state’s public and private system last financial year resulted in a death.
Most of those who died were elderly patients with underlying health problems, admitted as emergency patients.
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Rumours on Health Care Homes are true, health department confirms

Minister disagrees with PM's 'biggest reform since Medicare' claim
30th May 2018
Health department officials have confirmed fewer than 2000 patients have signed up to the Health Care Homes trial ─ far short of the 65,000 patients targeted.
Last week, Australian Doctor reported on rumours of the 2000 figure circulating at the AMA conference, where the Minister for Health, Greg Hunt, described the reforms as just an “interim step”.
Officials fronting Senate estimates in Canberra on Tuesday confirmed the number and admitted that although 180 practices had signed up for the initiative, uptake was “slower than expected”.
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Health insurance reform passes lower house

Health Minister Greg Hunt has promised more affordable and simpler private health cover under legislation which has passed the lower house.
Matt Coughlan
Australian Associated Press May 31, 201811:00am
People under 30 could be the biggest winners from the Turnbull government's push to make private health insurance more affordable.
The package, which passed parliament's lower house on Thursday, will allow insurers to offer young people a two per cent discount on their premiums every year up to a maximum of 10 per cent.
But Labor argues the measure could drive premiums higher for other policy holders, while giving young people a saving of about 70 cents a week.
-----

Stress-tests not tough enough as health insurers face challenges

  • The Australian
  • 12:00AM June 1, 2018

Sarah-Jane Tasker

The financial regulator has warned that emerging challenges could affect the sustainability of the health insurance industry, and signalled that stress-testing practices in the sector fall “well short” of other industries.
Peter Kohlhagen, senior manager of policy development at the Australian Prudential Regulation Authority, said the health insurance industry was under “some duress” at present.
He said the sector was emerging from a long period of relative stability, but challenges that once appeared to be some distance away were getting closer.
“We observe that some insurers have been slow to react to this changing reality,” Mr Kohlhagen told a health insurance summit in Sydney.
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Bill Shorten’s claim of health ‘gouge’ hits snag

  • The Australian
  • 12:00AM June 1, 2018

Sean Parnell

Labor’s bid to cast health insurers as villains in the battle over rising health costs has been dealt a blow by the industry regulator, which warns the sector is coming under increasing pressure.
In January, Labor leader Bill Shorten promised to cap premium increases at 2 per cent — about half the current increase — for two years and to hold a Productivity Commission inquiry. He said insurers were “treating Australians like mugs, gouging people on the basis of a con” and had massive capital reserves despite being propped up by a $6 billion government rebate.
But Peter Kohlhagen, senior manager of policy development at the Australian Prudential Regulation Authority, told a conference yesterday that it “does not think that capital levels in the industry are too high or should be reduced”.
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Health funds HCF and HBF scrap planned $4 billion merger

By Esther Han
Updated 2 June 2018 — 8:45amfirst published at 8:02am

In numbers

·         A combined HCF-HBF entity would have billions of dollars in total assets. $4 billion
·         Total number of members. 2.5 million
·         Potential market share. 18.4%
Not-for-profit health funds HCF and HBF have scotched their plans to merge, saying as details were nutted out it became clear joining forces would not have been in their members' best interests.
The pair announced in February their aim to merge by August and signed a heads of agreement for the $4 billion deal, which would have seen them become Australia's third largest health insurance provider, behind Bupa and Medibank.
-----

International Issues.

China challenges US Navy ships in South China Sea

By Steven Lee Myers
28 May 2018 — 5:22am
Beijing: China's military announced on Sunday that it had dispatched warships to challenge two US Navy vessels that sailed through waters in the South China Sea that China claims as its own.
The Chinese confronted the US ships and warned them to leave, the Ministry of National Defence said in a statement posted on its website, but other details of the encounter were not immediately clear.
The US vessels — the Higgins, a destroyer, and the Antietam, a cruiser — passed within 12 nautical miles of the Paracel Islands, an archipelago in the northern part of the disputed waters of the South China Sea off the coast of Vietnam.
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South China Sea battle already lost: Jim Molan

  • The Australian
  • 12:00AM May 28, 2018

Paul Maley

The battle for control over the South China Seas has been lost, with nothing short of all-out war capable of dislodging Chinese forces from a string of heavily fortified ­islands, ­Liberal senator and former senior army officer Jim Molan says.
Speaking one week after Beijing landed a long-range strat­egic bomber on Woody Island in the South China Sea, a move analysts agreed extended China’s reach into Southeast Asia, Senator Molan said the West’s failure to move quickly and decisively against Chinese encroachment in the Pacific had permanently altered the balance of power in Beijing’s favour.
Senator Molan, who in 2014 was appointed as chief of coalition oper­ations in Iraq, said there was no point debating whether or not the Australian navy should conduct freedom-of-navigation operations through the South China Sea — the issue had effectively been settled by the West’s inaction.
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Wine trade corked as China retaliates in spat over meddling

  • Rob Taylor
  • The Australian
  • 7:18AM May 28, 2018
A deepening spat over allegations of Chinese meddling in Australian politics has led to cases of wine piling up at Chinese ports and nationalists calling for tougher trade retaliations.
The episode shows how China is willing to use its economic leverage to force foreign governments to reverse positions it views as antagonistic. It has deployed similar tactics in its trade fight with President Donald Trump, stepping up customs inspections of US cars and soybeans.
Treasury Wine Estates, one of the world’s biggest winemakers, says its products are being stalled because of new Chinese customs rules apparently targeting Australia-made wines.
-----

Britain's May refuses to relax Northern Ireland abortion rules

By Andrew MacAskill
28 May 2018 — 6:23pm
London: British Prime Minister Theresa May faces a showdown with ministers and lawmakers in her Conservative party after refusing to back reform of Northern Ireland's highly restrictive abortion rules after neighbouring Ireland's vote to liberalise its laws.
Voters in Ireland, a once deeply Catholic nation, backed the change by two-to-one, a far higher margin than any opinion poll in the run up to the vote had predicted.
The Prime Minister is facing calls from within her cabinet and from opposition parties to scrap the strict rules on abortion in Northern Ireland, bringing the law in the province in line with the rest of the United Kingdom.
Penny Mordaunt, Britain's women and equalities minister, said the victory to legalise abortion should now bring change north of the Irish border.
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If Italy exits the euro, it could be the end of the single currency

By Roger Bootle
29 May 2018 — 10:01am
You might think that it would be fitting if the European Union were to come to a sticky end because of Italy. After all, the agreement that established the entity that we now call the European Union was signed in Rome.
For several decades after that 1957 treaty, Italy was one of the strongest supporters of the European project.
Italy's president set the country on a path back to fresh elections on Monday, appointing a former International Monetary Fund official as interim prime minister with the task of planning for snap polls and to pass the next budget.
-----

Trump says he wishes he didn't appoint Jeff Sessions attorney general

By David Jackson
31 May 2018 — 5:16am
Washington: President Trump acknowledged again on Wednesday that he wishes he had not appointed Attorney General Jeff Sessions, though he did not address reports that his treatment of Sessions may be part of an obstruction of justice investigation in the Russia probe.
In a series of tweets, Trump quoted Representative Trey Gowdy as expressing sympathy for the president's frustration at Sessions' decision to recuse himself from the investigation into Russian efforts to influence the 2016 presidential campaign.
Citing Gowdy's comment that "there are lots of really good lawyers in the country, he could have picked somebody else!" Trump added: "And I wish I did!"
  • Updated Jun 1 2018 at 6:30 AM

Italy's anti-establishment party leaders agree to terms for government

Italy's two anti-establishment parties revived their coalition plans, promising to end three months of political turmoil with a government that aims to ramp up spending, challenge European Union fiscal rules and crack down on immigration.
The coalition deal, following inconclusive elections in March, removes the risk of a repeat vote, a prospect that had sparked a big selloff in Italian financial markets this week.
The leaders of the right-wing League and the 5-Star Movement patched up their alliance after agreeing to substitute a eurosceptic they had initially proposed as economy minister, a nomination that had been rejected by the head of state.
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Australian government 'complicit' in Malaysia's corruption, Anwar Ibrahim says

By Fergus Hunter
1 June 2018 — 9:32am
Former Malaysian opposition leader Anwar Ibrahim, now making his political comeback after being freed from prison, has accused the Australian government of being "complicit" in the corruption of his country's recently ousted leader Najib Razak.
The reformist Anwar has been granted a royal pardon for politically-motivated sodomy charges after his unlikely alliance with former nemesis Mahathir Mohamad helped defeat Najib in Malaysia's elections last month.
Najib is accused of plundering billions of dollars from Malaysia's 1MDB state investment fund.
-----

Spain's new leader takes aim at corruption, austerity

2 June 2018 — 9:44am
Madrid: Prime Minister-elect Pedro Sanchez vowed Friday to root out the corruption that helped bring down Spain's outgoing conservative government and pledged to help people affected by years of public spending cuts under his predecessor, Mariano Rajoy.
Socialist Pedro Sanchez took over as Spain's prime minister, after outgoing leader Mariano Rajoy lost a parliamentary confidence vote triggered by a long-running corruption trial involving members of his centre-right party.
Minutes after narrowly winning a no-confidence vote in parliament, the Socialist party leader signaled a change in tone and priorities from Rajoy's unbending commitment to reducing the national debt during his more than six years as prime minister.
-----

Populist Italian parties reach deal on new government

By Stefano Pitrelli and Griff Witte
1 June 2018 — 9:27am
Rome: Italy appeared on Thursday to step back from the brink of a continent-rattling political crisis, with officials agreeing to a deal that averts the threat of fresh elections and puts two populist parties in charge of the euro zone's third-largest economy.
Italy's anti-establishment parties revived coalition plans, ending three months of political turmoil by announcing a government that promises to increase spending, challenge European Union fiscal rules and crack down on immigration.
The agreement was the latest twist in a topsy-turvy week for Italian politics, one that on Tuesday had sent global markets tumbling amid jitters that the country was careening toward a new vote and a possible euro exit. Investors feared an even greater populist surge if a new election were held.
-----

Trump's jobs tweet shatters decades of protocol, jolts markets

By Damian Paletta
2 June 2018 — 10:44am
President Trump on Friday shattered several decades of protocol — and possibly violated a federal directive — by hinting strongly that the monthly US jobs report would be a rosy one 69 minutes before its release.
In an 11-word Twitter post, Trump jolted financial markets and provided the latest example of how he is reshaping the presidency to fit his freewheeling impulses, pushing aside years of tight controls on the public release of sensitive material that were put in place by Republicans and Democrats.
The president was reacting to data that showed that US employers extended a streak of solid hiring in May, helping lower the unemployment rate to an 18-year low.
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I look forward to comments on all this!
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David.

The ADHA Just Thumbs Its Nose At Proper Disclosure!

Checked at 11.00am today:

Australian Digital Health Agency Board

So they are happy to go 1/2 a year with no Board disclosure.

As with the Digital Baby Initiative - more disclosure would likely foster more support and the secrecy makes one wonder what they have to hide?

Clearly they don't give a fig about their stakeholders. Just hopeless.

David.

This Has Me Rather Scratching My Head - I Wonder Where It Actually Fits?

This appeared last week.

Digital Baby Book Budget boost for parents

Investments in digital technologies and children’s health will have long term benefits for Australians.
29 May 2018
The 2018 Federal Budget, announced on 8 May, is notable for its emphasis on long--term investments in the health of Australians, particularly in children’s health and digital health technologies.

Better health from day one

New parents currently receive a hard copy “blue book” to record and track their children’s health and immunisation milestones, but this will be phased out in favour of a digital record next year. The Budget allocated $5 million to the development of a Digital Baby Book, which will let parents compile a complete medical history for their children from the very start of life, ensuring that their children need never be without the medical information they need to ensure optimal health.
$77.9 million has also been allocated to programs targeted at improving infant and maternal health, such as diet and exercise recommendations for expectant mothers, as well as free whooping cough vaccines. Together, these initiatives are expected to save money over the longer term by reducing reliance on the healthcare system in later life.

Digital health investments

$1.3 billion will be invested over 10 years in a new National Health and Medical Industry Growth Plan, which will cement Australia’s status as a global centre for medical research and innovation. This will include a $500 million investment in genomics research to develop the use of precision medicine.
Other investments include $92 million to the Digital Transformation Agency for the GovPass system, which enables unified digital identification across government services to improve access and reduce duplication. The Australian Health Institute of Health and Welfare received $30 million for technology upgrades and better data sharing capabilities.
Pharmacy gets a boost with $15.3 million allocated to introduce a national electronic prescribing system for the PBS, due to begin in October 2019. This measure will improve medicines safety and compliance, as well as overall efficiency.
Here is the link:
A bit of googling came up with this:

Digital tools set to improve child health

05/03/2018
Home » News Hub » Digital tools set to improve child health
New South Wales and Victoria are leading a new national collaboration to leverage ehealth digital tools to capture child health and developmental information electronically, as part of a new child digital health record scheme.
Led by the National Collaborative for Child Health Informatics, the initiative is set to look at the potential of offering a digital health record for every child in Australia from conception through to adolescence. Both parents and healthcare professionals will be able to access the records.
Traditionally, child health and development data has been recorded in baby books ‘coloured’ for each jurisdiction. NSW, which piloted an electronic version of its Blue Book during in 2012, will lead the digital baby book project.
The digital rollout forms part of four initiatives that aim to build a ‘longitudinal’ child health record for all Australian children moving forward. The other three initiatives, set to launch in 2019, will involve moves to see how to upload school immunisation records digitally to the Australian Immunisation Register (AIR), led by the ACT in association with Tasmania; a new national Digital Pregnancy Health Record, led by Queensland in association with South Australia; and digitising child health checks so the information can be shared electronically, led by the NT with the help of Western Australia.
The National Collaborative Network for Child Health Informatics was formed last year by eHealth NSW in partnership with the Sydney Children's Hospitals Network with support from the Australian Digital Health Agency.
The aim of the Network is to bring together Australia's leading experts in children’s health to identify nationally focused, child-centred and clinician-friendly digital health projects to positively impact the health and social outcomes of Australia’s children and their families.
“This is a unique opportunity to make a real and lasting difference to the health and wellbeing of the children – and indeed the future – of Australia,” eHealth NSW’s Chief Executive, Dr Zoran Bolevich, said. “NSW Health has a significant program of work underway to enhance our health services through effective use of digital technologies.”
Here is the link:
So we seem to have had the technology for years!
In the Budget we have this:

Infant Health – Digital Baby Book

Page last updated: 08 May 2018
Infant Health – Digital Baby Book - PDF 117 KB

The Government will invest $77.9 million in infant and maternal health. The Government will develop a national Digital Baby Book for children as an update to the traditional state and territory hard copy paediatric baby books.

Why is this important?

Most Australian families have paper records of a child’s health, development and childhood vaccinations. However, for many people, paper records are inconvenient and are often lost or not brought to appointments, which can result in delayed and potentially substandard care.

The Government will develop a national digital platform to enable families to replace the hard copy books with a digital book, which will be easier to keep track of key health information when they need it.

Who will benefit?

The Digital Baby Book will give every newborn Australian the opportunity to maintain a lifelong digital health record. The ability to have access to the baby’s records anytime, anywhere and be able to build a complete medical history from birth is an important benefit to support families.

How much will this cost?

This measure will cost $5 million from 2018–19 to 2019–20.
Here is the link:
So it seems we are getting a baby myHR, in app form I imagine, for each nipper.
What is interesting it that it is by no means clear if this is the myHR or something else and how the two hang together.
$5M seems almost ‘chump change’ for the ADHA – I wonder is it them, or someone else, developing the project and where the data is held.
Maybe someone who  knows and can explain how it all hangs together as this seems like a very useful and worthwhile initiative?
David.

Wednesday, June 06, 2018

These ADHA Test Beds Are Interesting But Sadly May Be Focused On The Narrow myHR Mindset.

A week or so ago an EOI appeared from the ADHA. (16 May, 2018

Media release - Digital test beds to drive change in healthcare

Health technology organisations, clinicians, patients and health service managers are driving innovation and developing creative solutions to improve how health services are delivered. These ideas often give life to the next solution, which can improve safety, drive health efficiency, and enable choice and control for patients.
The Australian Digital Health Agency is calling for proposals for innovative test beds that can be rigorously reviewed and then scaled nationally.
These pioneering initiatives will be co-produced by consumers, governments, healthcare providers, and entrepreneurs and will test evidence-based digital empowerment of key health priorities.
Agency CEO Tim Kelsey said digitally enabled models of care are an important priority in Australia's National Digital Health Strategy – Safe, Seamless, and Secure and the test beds demonstrate the Agency’s commitment to work collaboratively with stakeholders.
“Our global peers are increasingly recognising that Australia is in a unique position to test and trial digital health solutions that can be implemented in a diverse and sometimes fragmented system, and have the ability to scale nationally.
“During my time as CEO, I have witnessed some incredible innovations that involve consumers, providers, and healthcare organisations tackling critical priorities such as managing chronic disease in completely new ways. The Agency wants to support these types of initiatives, to assist in their evaluation, and to develop an evidence base of sustainable, scalable initiatives to support further investment,” said Mr Kelsey.
The Agency is seeking expressions of interest that build on areas of high level of digital maturity, with evidence of integrated governance arrangements between the participants. Test beds should involve new approaches to addressing a health challenge rather than pilots that have no plan or capacity to scale across a population.
“These projects will require exemplar regions and sectors with a strong existing capability to deliver outcomes. It is essential to demonstrate feasibility and efficacy for a potential test bed to proceed,” said Mr Kelsey.
MSIA President Emma Hossack has welcomed the Agency’s approach to market.
“Australia’s health software industry has remarkable capability. These test beds will give our members the ability to showcase this capacity in worthwhile settings. Prerequisites of maturity and scalability together with transparent evaluation mean these exemplars will have real value for Australian healthcare,” Ms Hossack said.
Patient and consumer advocate Harry Iles-Mann has had frequent contact with the health system over the past 20 years and welcomes improved digital services to better support patients.
“As more people like me suffer from serious complex chronic health issues, we are reliant on multiple care providers to support our own care management. It’s crucial that we find better ways to provide digitised, highly coordinated health and wellbeing services so that patients can be supported, empowered, and enabled in care and in life,” said Mr Iles-Mann.
Further information
Projects can run for up to four years depending on the test bed however, baseline measures will be required by October 2018, and interim results at 12-18 months. Up to $600,000 is available per test bed.
The Agency has also responded to industry calls to minimise the regulatory burden for respondents, and is requesting submissions of no more than 3-5 pages. The tender closes at 2pm on Wednesday 6 June 2018. Further information available on AusTender.
Here is the link:
On 22 May, the ADHA held an industry briefing and a number of questions were put on notice and the ADHA’s response was published on Wednesday. (30 May, 2018)
In their response the ADHA released details of the six evaluation projects already underway:
1.  Evaluating how GPs in primary care use My Health Record to improve their patients’ health through improved medicines management, sharing information, and reducing unnecessary duplication of diagnostic services, this is with the National Prescribing Service (NPS) MedicineWise and the University of Melbourne;
2.  Evaluating how GPs and hospitals use My Health Record to improve their patients’ health through improved medicines management, reducing unnecessary duplication of diagnostic services, and reducing hospital admissions and length of stay, this is with PenCS, Western Sydney PHN, the University of Western Sydney, and NSW Health;
3.  Educating GPs how to use My Health Record to improve their management of patients’ medicines (specifically deprescribing inappropriate medicines) and reduce unnecessary duplication of diagnostic services, this project is a specific multifaceted education intervention with MedCast and the University of Wollongong;
4.  Quarterly tracking of healthcare providers to investigate awareness, readiness, attitudes, and experience regarding the My Health Record system through to early 2019, this is with McNair YellowSquares and Rodika Research Services;
5.  Changing clinical behaviour in primary care using My Health Record to improve uploading and viewing of documents, sharing of useful and accurate information, and informed clinical decision making, this project involves the discipline of behavioural economics and is with the Behavioural Insights Team; and
6  Evaluating the performance of the My Health Record system by conducting data analytics on de-identified, administrative, non-clinical My Health Record data to investigate the impact on medicine management, ordering diagnostic services, adherence to evidence based care, patterns
of healthcare utilization, and associated costs.
----- End Extract.
It seems these projects are very limited and focused on showing some clinicians are getting some use out of the myHR. Now we know they exist it will be important to follow up and to understand just what they are finding over I imagine the next 6 months to one year. It will also be interesting to see just how rigorous the studies are in terms of real clinical impact of the myHR, evidence for which since 2012 has been pretty thin on the ground. This is a useful list of things that apparently the ADHA thinks will show positive benefits. Reducing various interventions on a pretty large – and safe - scale will be necessary to make the myHR offer any value for money given all the costs!
I would also hope the actual test-bed projects are projects both maybe to optimize, perfect and make clinically useful the myHR and I would also have thought there would have been some useful myHR free innovation projects that actually have a chance of real success and national adoption. Sadly I fear it’s the myHR or nothing or so it seems whereas I reckon the myHR is already obsolete and it would be better to plan for useful myHR free interventions.  We will know when the winners are announced!
Another $3.6M down the drain is likely if the totality focusses on the myHR? One also wonders just how far $600,000 can go in conducting a 1-2 year pilot of a major intervention?
David.

-----

As a coda I have to say if I was the ADHA I would be hoping someone would come up with a plan and a migration path the render the myHR into something people would be keen to have, would maintain and would be heavily used by clinicians. Dream on David.

D.
 

Some Fun myHR Statistics To Make You Think!

As at May 29 the following are what we are being told.
Here is the link to the latest one:
A few numbers:
Consumers registered       5,821,864
Clinical Document Uploads          5,864,519
So that means that each consumer has on average just 1 clinical document on their record.
About 30% only actually have a Shared Health Summary. This means that since 2012 at best 7% of the population have a Shared Health Summary uploaded and some could be 3 or 4 years old!!
What is compelling in the statistics is that anything that is automatically uploaded with so called continuing or standing consent has huge numbers of records and those that need effort on some-one’s part no so much!
The system is basically a Hoover of automated documents which as we know can sometimes go to the wrong place.

MyHealth bungle: Dozens of patient records mixed up

15th November 2016
Federal bureaucrats have inadvertently filled the MyHealth Records of almost 100 people with Medicare data from other patients, it has emerged.
These included five patients whose newly-created My Health Records were populated with somebody else’s MBS and PBS history because the other person had similar identifying details, such as the same name or birthdate.
Another 86 patients had somebody else’s Medicare claims added to their record.
Mistakes by the Department of Human Services affected 96 patients in the last financial year, compared with only 12 patients in the year before, according to a new report from the Office of the Australian Information Commissioner.
The information commissioner is still conducting five investigations into MyHealth Record data breaches, all related to the Department of Human Services.
 More here:
Automated uploads now total over 700,000,000 while all the clinical document uploads are under 6,000,000. (less than 1%) showing this is a admin rather than clinical system.
I note that 349 organisations have cancelled their myHR registration – wonder why?
Lastly there are just NO stats on how often the system is referred to for clinical information – just none.
Enough said. This is a clinically unused white-elephant that is represented as clinically useful but mostly simply isn’t.
David.

Tuesday, June 05, 2018

Here Is The Proof That When You Do Things Right You Don’t Need Compulsion and Opt-out.

This appeared last week:

More than 1.3 million GP appointments booked online

Monday, 28 May 2018  
eHealthNews editor Rebecca McBeth
More than 1.3 million GP appointments have been booked online via a patient portal in New Zealand.
More than 400,000 repeat prescriptions have also been ordered electronically, saving patients a phone call or visit to their GP.
Figures gathered by eHealthNews from New Zealand’s three main patient portal providers reveal that patients are increasingly using digital services to communicate with their GP practice.
Around 550,000 of New Zealand’s 4.5 million patients (12 per cent) are registered with a patient portal and 545 practices offer one. A patient portal is a secure online site where patients can access their health information and interact with their GP.
ConnectMed provides a patient portal to 125 practices and says more than one million patient appointments have been booked electronically via the service.
ConnectMed co-founder Ryan Thatcher says use of the booking function grew from 130,000 in 2015 to 450,000 appointments booked last year and figures are expected to jump again in 2018.
Ryan says most clinics have turned on the ability for patients to order repeat prescriptions – nearly 100,000 have been ordered online – and about half are now offering access to lab results.
The company has also recently added video consultation functionality via the patient portal and has a few practices using it.
ManageMyHealth patient portal, provided by Medtech, has more than 330,000 registered users and more than 120,000 users of its mobile app.
The company says patient numbers are always on the rise and grew by 70 per cent last year.
More here:
What you have here are New Zealanders having what patients need and want, provided by a commercial portals and subscriber GPs etc. delivering the Digital Health goods on an absolute shoe-string while Australia wastes billions on a system that will never offer prescription repeats, booking and so on! And no need for opt-out – those who need the service can get it simply and easily and the rest of us can get on with our lives!
The whole myHR effort needs to be re-cast to be patient and clinically centric and voluntary – not administratively centric and almost compulsory as it presently is!
David.

An Article From The Information Age of the Aust. Computer Society Reveals Some Concerns With The myHR.

This well researched and referenced article appeared last week.

You have 3 months to opt out of electronic health record

Otherwise, the government will simply create one for you.

By David Braue on May 29 2018 11:16 AM
After years of trying carrots, the federal government is getting out the stick by controversially forcing all Australians to opt out of the My Health Record (MHR) program or have one automatically created for them by year’s end.
Some 5.7 million Australians have so far joined MHR, which was created in 2016 in a realignment of the Personally Controlled Electronic Health Record (PCEHR) project – which progressed in fits and starts after being favoured by government policy at the beginning of the decade.
The My Health Records Act 2012 laid out the goals of a voluntary electronic healthcare system that would overcome fragmentation; improve the availability and quality of health information; reduce the occurrence of adverse medical events and the duplication of treatment; and improve the coordination and quality of healthcare provided to healthcare recipients by different healthcare providers.
Voluntary take-up was well below expectations, however, and national expansion of MHR was flagged as a key healthcare priority in the National Digital Health Strategy – which was approved by COAG last year and backed with a $374.2 million Budget allocation over two years.
With registrations stagnant, the Australian Digital Health Agency (ADHA) has set a three-month period – from 16 July to 15 October – during which Australians will need to opt out of participation or have a record automatically created for them.
Australians will be able to cancel their MHR or create one at any time, if they opted out during the set period.
Helping providers work together
Australia was an early adopter of paperless electronic health record (EHR) systems within hospitals and medical practices – largely thanks to financial incentives given to clinic operators for years – but efforts to improve interoperability through ubiquitous health information exchange (HIE) systems have historically struggled to gain traction.
That’s why the latest move has pleased medical bodies, which continue to wrestle with a plethora of data standards and often rely on paper as the lowest common denominator method of exchanging information about patients.
The Australian Medical Association was pushing the federal government to shift the system to an opt-out model as early as 2011, with then-president Dr Steve Hambleton arguing that low take-up would compromise practitioners’ interest in the system.
“We predict it will be many years before the PCEHR becomes ubiquitous in health care,” he wrote at the time.
Kickstarting the MHR program has required a massive alignment of healthcare providers around the country, and the government rolled out a barrage of testimonials – from bodies representing arthritis care, nursing, emergency medicine, aged services, rural health practitioners, public health officials and even the National Farmers’ Federation – to back its efforts.
A pilot program in the Riverina town of Berrigan, NSW is being used as evidence that an integrated HIE can improve multi-channel healthcare delivery.
More than half of Berrigan’s 950 residents were set up with MHR and the town’s local GP clinic, pharmacy, aged care centres, and local hospital were interconnected to allow patients’ medical records to follow them through the various stages of the healthcare system.
Patients report easier transfer of patient treatment and medication histories had proven much easier than having to track their own interactions with multiple providers on paper.
Privacy and security concerns
Such positive results are helping paint the picture of MHR as a tool for healthcare efficiency – and overcoming common barriers to adoption that, according to one recent study, included user resistance and lack of skills, concern for return on investment, and lack of administrative and policy support.
More here:
This article provides a useful historical perspective and makes very sensible comments suggesting what is going on is rather a change from the original conception of the PCEHR, that there are lots of issues still to be addressed and that the changing privacy (GDPR) and security perspectives are important.
I can but agree these are all good points.
David.

The ADHA Is Telling Those Who Asked To Opt-out Where To Next!

I was forwarded this e-mail just now - so the process seems to have started.
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My Health Record Opt-out Dates

My Health Record opt-out dates
Hello,

You are receiving this email because you registered your email address at myhealthrecord.gov.au to find out more information about how to opt-out of the My Health Record system.

If you do not want a My Health Record, you must register your choice between 16 July and 15 October 2018 during the opt-out period. It is not possible to opt-out of having a record before the opt-out period starts.

The opt-out period will not apply to individuals who have previously chosen to have a My Health Record, or were included in the Nepean Blue Mountains or North Queensland opt-out trials in 2016. Individuals who have an existing My Health Record can cancel their record at any time. Instructions on cancelling a record can be found on the
My Health Record website.

Once the opt-out period starts you will receive another email letting you know that the opt-out period has started and what to do if you still want to opt-out.

A My Health Record is a secure online summary of an individual’s key health information. 1 in 5 Australians already have one. It’s an individual’s choice who sees their My Health Record, what’s in it and who it is shared with. My Health Record has safeguards in place to protect an individuals’ information including encryption, firewalls and secure login.

For further information about the My Health Record, please visit the
My Health Record website.

Thank you,

The My Health Record System Operator

www.digitalhealth.gov.au
 
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David.