A Company That Enables Much Of Digital Health Is Growing Like Crazy It Seems.

 This appeared last week:

NextDC feeds the ducks while they’re hungry

NextDC has played the capital markets game superbly to be on the cusp of the top-50 stocks. To stay there, it has to deliver.

Apr 11, 2024 – 11.26am

Data centre owner NextDC has hit the big leagues – its first $1 billion-plus equity raising that should help catapult it into Australia’s top-50 listed companies.

Fourteen years after floating as an $80 million micro cap, NextDC is riding a wave of customer demand for data centre space and investor appetite for AI’s picks and shovels, to fill its boots, accelerate development at new sites in Sydney and Melbourne and buy more land.

Whether you like NextDC or not – and it is a divisive stock – you have to admire its willingness to launch the “Project Blue” raising and feed the ducks while they’re hungry.

The board and management team have a capital intensive business (buying land and building data centres), a large development pipeline and a forward order book that is through the roof.

So, blessed with a share price up 52 per cent in the past year and an earnings multiple that has exploded to 44 times, it is capitalising on that support and raising $1.32 billion in growth capital – nearly double its previous biggest deal.

While NextDC still needs to spend its $1.32 billion wisely, this is what we want to see from ASX-listed companies. Boards need to be smart enough to realise when investors are willing to throw money at them, bank it in the good times, and use it to progress those growth plans.

That’s how we can have a healthy and thriving listed equity capital market, and get new names like NextDC knocking on the ASX 50’s door and growing into globally relevant public companies.

To be clear, we are not saying NextDC is perfect. It is not; but it is in the right place at the right time.

Here is the link:

https://www.afr.com/chanticleer/nextdc-feeds-the-ducks-while-they-re-hungry-20240411-p5fixx

Also we have this:

NextDC goes high-performance with $1.3b raise for new data centres

Tess Bennett Technology reporter

Apr 11, 2024 – 10.44am

NextDC, the country’s largest listed developer and operator of data centres, is raising $1.32 billion to expand in Sydney and Melbourne amid record demand for cloud computing services and an artificial intelligence boom.

Shares in NextDC have surged 51.6 per cent over the past year, as investors clamour for exposure to data centres, one of the hottest assets given their key role in AI and other products that require massive computing capacity.

NextDC boss says nuclear should be on table as AI sucks up energyNextDC shares were halted on Thursday morning as the company launched a one-for-six entitlement offer at $15.40 a share, a 7.8 per cent discount to its last closing price. Chief executive Craig Scroggie said a surge in demand had prompted NextDC to bring forward its capital investment.

“NextDC continues to see significant growth in demand for its data centre services underpinned by powerful structural tailwinds,” he said.

“Amid this backdrop, we have decided to bring forward the development and fitout of key assets in Sydney and Melbourne to ensure we are able to meet this growth in demand, continue to support our customers.”

NextDC is not the only data centre operator benefiting from a jump in demand for cloud computing. AirTrunk – privately owned by Macquarie Asset Management, PSP Investments and its founder, Robin Khuda – has soared to a valuation of more than $15 billion, from just $3 billion four years ago. Its owners are entertaining bids, The Australian Financial Review’s Street Talk column has reported, with plenty of interested parties.

NextDC operates 13 data centres and is developing another nine centres, including new builds in Malaysia and New Zealand.

In February, the Brisbane-headquartered company revealed plans to open its first so-called AI factories – data centres specifically designed to house the processing units sold by chipmakers like NVIDIA.

Mr Scroggie said the facilities were likely to require 10 times the amount of energy used to power the current generation of data centres as well as new cooling methods.

“We’re going from general purpose computing to high-performance computing. That will see a generational change both in the scale and the density of computers,” he said.

Mr Scroggie said the demand for the higher-performance computing services would need to be supported by new energy infrastructure.

“We need power, we need transmission networks, we need green energy, we need more solar, we need more wind and, frankly, we need nuclear,” he said. “We have to find net zero power options that are capable of supporting energy needs when the sun is not shining and the wind is not blowing and batteries [are] not going to cut it.”

The company has not disclosed where its first AI factory would be built. Wilsons analyst Ross Barrows said he had hoped to see more colour on NextDC’s AI facilities in Thursday’s announcement.

“The capital being raised today goes a considerable way to materially expediting built capacity at its existing assets and accelerating the delivery of its development assets, but further insights into new AI-dedicated assets would have added to our understanding of NXT’s medium term growth plans,” Mr Barrows said.

E&P Capital’s Paul Mason said NextDC’s fundraising would find plenty of support among investors. “The raising is probably not a big surprise for many. We have been forecasting another raising in the next two years in our modelling of the company as a result of the very high levels of demand and associated very large build program the company is pursuing,” he said.

More here:

https://www.afr.com/technology/nextdc-raising-1-3b-for-record-data-centre-demand-20240411-p5fiz9

And lastly we have this:

NextDC boss says nuclear should be on

table as AI

Tess Bennett Technology reporter Updated Apr 11, 2024 – 5.16pm, first published at 10.44am 

The chief executive of NextDC says nuclear energy should be considered to feed the need for computing power as the company, a major data centre developer, prepares to spend more than $1 billion thanks to record demand for its services in an artificial intelligence boom.

NextDC, the country’s largest listed developer and operator of data centres, is raising $1.32 billion to expand its operations in Sydney and Melbourne.

“We need power, we need transmission networks, we need green energy, we need more solar, we need more wind and, frankly, we need nuclear,” said Craig Scroggie, NextDC’s chief executive. “We have to find net zero power options that are capable of supporting energy needs when the sun is not shining and the wind is not blowing and batteries [are] not going to cut it.” Shares in NextDC have surged 51.6 per cent over the past year, as investors clamour for exposure to data centres, one of the hottest assets due to their key role in AI and other products that require vast computing capacity.

But, as that demand increases, data centres will have to become more sophisticated, and in turn, will need more energy. In February, NextDC revealed plans to open its first so-called AI factories – data centres specifically designed to house the processing units sold by chipmakers such as Nvidia. Mr Scroggie said the facilities were likely to require 10 times the amount of energy used to power the current generation of data centres, as well as new cooling methods. “We’re going from general purpose computing to high-performance computing. That will see a generational change both in the scale and the density of computers.”

JP Morgan analyst Bob Chen said power availability was the “biggest roadblock for data centre construction” and developers would need to find green energy sources to meet their customer’s net zero emissions goals.

“One thing that is also important here is the customers of these data centres, typically your global cloud service providers like Microsoft, Amazon, Google, also have an ESG mandate and are increasingly preferring operators that can source green energy,” Mr Chen said.
Renewable hubs

Patrick Gibbons, a corporate adviser at Orizontas, wrote in The Australian Financial Review earlier this week that the energy demand from data centres could even prolong the life of coal power stations. He noted Amazon had recently acquired a nuclear-powered data centre for $US650 million ($988 million) as the industry looked for reliable power.

Andrew Richards, chief executive of the Energy Users Association of Australia, said data centres required a large, mostly flat load with strong environmental credentials and would be a growing source of demand. “I am not sure that means they automatically jump to nuclear,” he added.

“If it fits into their ESG framework then I assume they would consider it, but it’s clearly not something they could consider here for at least 15 years.”

AGL Energy plans to service data centres from renewable energy hubs based at old generation sites with plenty of network capacity, firmed by a growing fleet of batteries and pumped hydro storage.

Travis Hughes, AGL’s general manager of energy hubs, said while some data centres – such as those servicing banks – required energy all day, others had the flexibility to reduce the amount of firming power required by reducing their substantial loads via demand response.

“This is the energy system becoming smarter,” Mr Hughes said.

NextDC shares were halted on Thursday as the company launched a one-for-six entitlement offer at $15.40 a share, a 7.8 per cent discount to its last closing price. Mr Scroggie said a surge in demand had prompted NextDC to bring forward planned capital investment.

“NextDC continues to see significant growth in demand for its data centre services underpinned by powerful structural tailwinds,” he said.

“Amid this backdrop, we have decided to bring forward the development and fitout of key assets in Sydney and Melbourne to ensure we are able to meet this growth in demand, [and] continue to support our customers.”

NextDC is not the only data centre operator benefiting from a jump in demand for cloud computing. AirTrunk – privately owned by Macquarie Asset Management, PSP Investments and its founder, Robin Khuda – has soared to a valuation of more than $15 billion, from just $3 billion four years ago. Its owners are entertaining bids, The Australian Financial Review’s Street Talk column has reported, with plenty of interested parties.

NextDC operates 13 data centres and is developing another nine centres, including new builds in Malaysia and New Zealand. Wilsons analyst Ross Barrows said he had hoped for more detail on NextDC’s AI facilities on Thursday. “The capital being raised today goes a considerable way to materially expediting built capacity at its existing assets and accelerating the delivery of its development assets, but further insights into new AI-dedicated assets would have added to our understanding of NextDC’s medium-term growth plans,” Mr Barrows said.

E&P Capital’s Paul Mason said improving battery technology would help meet the sector’s growing demand for power, but other sources of energy production would also need to be considered. “The data centre industry wants to decarbonise, but it also really needs stable, reliable power which is presently difficult with renewables on numerous fronts, particularly around grid inertia and intermittency,” Mr Mason said.

Here is the link:

https://www.afr.com/technology/nextdc-raising-1-3b-for-record-data-centre-demand-20240411-p5fiz9

I have to say that with the power consumption of all these data-centres (and all the ones to follow) it is not so silly to think about the use of nuclear power – as our current grud would have to be at some risk of being overwhelmed.

He need for water (for cooling) and the level of power consumption that is likely makes it hjard to be sure renewables could cope!

David.

This Is Really Not Good Enough I Believe! We Have Regulatory Blindness In Full Flight I Fear.

This appeared last week:

Health

‘What we’re seeing is not telehealth’: alarm over doctors using AI and prescribing without seeing patients

Consumers Health Forum calls on Australian government to address ‘significant safety concerns’ about prescribing without any conversation with patient

Melissa Davey Medical editor

Thu 11 Apr 2024 01.00 AEST Last modified on Thu 11 Apr 2024 08.22 AEST

Australia’s health regulator is fielding complaints about the use of artificial intelligence during telehealth prescribing, and patients being issued with prescriptions without speaking with a doctor.

A spokesperson for the Australian Health Practitioner Regulation Agency told Guardian Australia the agency had received 550 notifications about telehealth consults and prescribing across health professions since July 2020. Of those, 30% related to complaints about a practitioner not adequately assessing a patient, they said.

In 45 cases Ahpra identified poor telehealth prescribing practices, prompting the regulator to take action against practitioners.

“In some cases this has led to restrictions preventing practitioners from prescribing or conducting appointments via telehealth,” the spokesperson said.

Concerns raised with health regulators about telehealth included not having to consult or see a prescriber before a prescription was given; prescribing processes that felt managed by an algorithm, or artificial intelligence process; and medications costing more when dispensed on a prescription provided online or via telehealth.

Dr Elizabeth Deveny, the head of the Consumers Health Forum of Australia, called on the government to address “significant safety concerns” she had about such practices, saying a conversation between a doctor and a patient should occur, “particularly when they’re a new patient”.

“This loophole needs to be closed through better regulation … because there are significant safety concerns,” she said. “Particularly what happens if a person has a bad reaction to this new medication or product, or perhaps the health practitioner who’s doing the prescribing doesn’t have their full history and understand the other medications they’re taking.”

Deveny said she had heard of telehealth platforms prescribing products such as weight-loss drugs without live consults.

“This model of online, no-consumer-contact prescribing doesn’t meet a lot of the safety features we would normally see,” she said.

“Telehealth is a great model that helps consumers access a health practitioner using a phone or computer, allowing them to have important conversations in a way that better suits them. What we’re seeing [when live consultations do not occur] is not telehealth, and we think it has potential for significant harm.”

‘I do not provide tick-box prescribing’

Guardian Australia has reported being able to access a prescription for vapes from an online telehealth platform, despite having never been a patient of that GP and never having previously been prescribed vapes.

The prescription was sent via email almost immediately after a $40 fee was paid and an online questionnaire filled in, with no live phone or video consult required.

The doctor, Dr Carolyn Beaumont, states that her website, medicalnicotine.com.au, “utilises innovative proprietary AI to effectively achieve its aims”.

But Beaumont told Guardian Australia that AI was not used by the platform in prescription generation. She did not clarify how the platform used AI.

“Scripts are individually reviewed and actioned as appropriate,” she said.

She said her online questionnaire “covers all the requirements of taking a medical history and there is plenty of scope for ongoing follow-up as needed”.

Guidelines from Ahpra and the Medical Board of Australia, which came into effect in September 2023, state that “asynchronous, online tick-box prescribing without a real-time patient-doctor consultation is not good medical practice”.

But the guidelines do not explicitly ban the practice. “Real-time doctor-patient consultations remain key to safe prescribing,” the guidelines state.

“I do not provide tick-box prescribing,” Beaumont said. “There is scope for individualised responses and follow-up is available, including in the form of longer-term telehealth that offers preventive care for smokers.”

Ahpra does not disclose the names of doctors who are the subject of complaints and there is no suggestion that Beaumont is among them.

Beaumont has also commented about her method of prescribing without a live consult on an article about vaping on the Medical Republic website.

“It is worth addressing why I choose mostly written communication with my patients, rather than conventional phone or video consults,” she wrote.

“Firstly, timezones. I’m in Victoria, and many patients are from WA. There’s a 3 hour gap, so realistically I can’t make calls until midday. Consider also that as a whole, heavy smokers are more likely to work jobs such as construction, mining or hospitality. These jobs don’t lend themselves to taking time out for a phone consult.”

Deveny told Guardian Australia that in her view time zone differences did not justify a lack of a live consult via phone or video call.

“What happens if something goes wrong with the medication?” she said. “Is the timezone going to mean that they can’t be helped by that doctor? Who’s responsible for that person’s aftercare if the timing doesn’t work?” She said a live consultation also allowed for a more comprehensive medical history than a questionnaire.

Beaumont told Guardian Australia that ideally patients would have a regular GP, but that was rarely a reality for remote workers.

“I manage their aftercare in relation to my prescribing,” she said. “To circumvent timezone difficulties, written communication has proven the most effective modality.”

A spokesperson for the Medical Board of Australia said any practitioner who prescribed in a way not consistent with the board’s guidelines “must be able to explain how the prescribing and the management of the patient was appropriate and necessary in the circumstances”.

More here:

https://www.theguardian.com/australia-news/2024/apr/11/doctors-ai-prescriptions-australia-concerns-consumers-health-forum

It is rather a shame our medical regulator is just so stuporous at the wheel. Harm will be done and only then will they seriously wake up and enforce the regulations which are designed to keep us all safe!

I think they should worry about the basics before getting het up about AI etc. The bottom line is that the present regulatory system is not for for purpose in this century!

David.

The Pace Of Change In The AI Space Is Really Becoming Dizzying!

 

This appeared last week:

Google’s Gemini AI can now write your emails and create spreadsheets

It turns out Google’s new AI isn’t only good for generating images of black Nazis. Soon you’ll be able to generate spreadsheets and emails with it, too.

John Davidson Columnist

Apr 10, 2024 – 2.52pm

Google’s Gemini AI may have gotten off to the worst imaginable start in its race against OpenAI’s ChatGPT, but it’s getting back on track now.

Four months after Google infamously launched Gemini with a fake demo showing the new AI model to have near-human intelligence, and only a month after Alphabet CEO Sundar Pichai was forced to email Google staff telling them Gemini’s bizarre image generation was “unacceptable”, the company has announced a slew of business-oriented Gemini applications that, it must be hoping, will offend no-one.

At its Google Cloud Next 24 convention in Las Vegas, the world’s largest advertising company said it was bringing Gemini to Google Workspace, to help workers write emails and documents, and design spreadsheet tables more easily.

Coders will also get to benefit from Gemini, through a new feature called Gemini Code Assist that the company says will help speed up programming by 30 per cent or more. The assistance will help with autocompletion of lines of code, find bugs, and help coders with “navigating security challenges”, Google Cloud vice president Brad Calder said in a statement.

But not everyone is a coder, and there’s plenty in Google’s announcements for non-coders, too.

Google Sheets, the company’s cloud-based answer to Excel, will get tables where Gemini “formats and organises data in a sleek, updated design”, Aparna Pappu, the VP and GM of Google Workspace, said in a blog post.

“Select a template from our new set of building blocks – featuring everything from project management to event planning and inventory management – so you never have to build a spreadsheet from scratch again,” she said, adding the feature will appear “in the coming weeks”.

Meanwhile, Gmail users will get Gemini in Gmail, which “helps you transform notes into a more complete email draft in a single click”, she said.

“These new experiences will be available to Gemini Enterprise and Gemini Business customers, as well as Google One AI Premium subscribers,” she said.

Here is the link:

https://www.afr.com/technology/google-s-gemini-ai-can-now-write-your-emails-and-create-spreadsheets-20240410-p5fipu

Just read this slowly to get a real sense of the pace of change we are experiencing!

I have little to add.

David.

It Looks Like Some Big Changes Are Afoot In The Privacy Space.

This appeared a few days ago:

7 steps to prepare your organisation for changes to Australia’s privacy legislation

Opinion

02 Apr 2024 5 mins

Michael Fagan, former chief transformation officer at Village Roadshow, examines the proposed changes to the Privacy Act and how CIOs in Australia can prepare for them.

Australian privacy legislation is about to undergo a major overhaul with more than 100 proposals under consideration, you can see the detail here.  While the exact details of changes to the law remain unknown, there is much that organisations can do to prepare.

1. Take inventory of what data you do hold

Do you know what information you currently hold?  Where it is held?  Why it was collected and what the future usage of that data will be?  Have you clearly identified owners of that data? Hint, it’s not someone in your IT department (or shouldn’t be – this is usually a red flag for CEOs).  What are some use cases that might need that data?  If you don’t know where your data is then you will struggle to be compliant.

2.  Be open and transparent about what data you collect and how you use it

Australian Privacy Principle #1 (APP 1) requires organisations to have a clearly defined and contemporary policy describing how they manage personal information.  Is yours readable? Have you run it through ChatGPT and determined the Flesch-Kincaid readability score? It should be readable by a 14-year-old, Year 8 student.  The good news is that you can ask any of the large language models (LLMs) like ChatGPT to rewrite paragraphs or sections for improved comprehension or make it more concise.

3.  Delete old data

I lived in Hong Kong 2008-2013 and one of my most pleasurable weekends was a trip to see an incredible band at the MGM hotel in Macau.  Twelve years later, in September 2023, some of my details were compromised in the MGM Resorts hack in the USA.  Luckily it was just my name and a now-defunct email address – but it had been expired for at least 10 of those years.  I cannot remember ever receiving a single piece of marketing from MGM, but they kept my old data on file – and may have been getting “return to sender” messages for years.

How much old data are you keeping? Deleting obsolete information provides several benefits.   Firstly, it tests your ability to destroy data.  This is not a trivial matter – backups, archives, deeply linked data present challenges. It also gives executives a clear picture of how much customer data you really have.  I helped an organisation clean up their Customer Data Platform (CDP) last year and removed more than a million records, about 15% less than they thought they had.

Another benefit is that it saves money.  Not on disk space which can nearly be considered free at this stage, but many CDPs and other SaaS applications have a charging model based on the amount of data (customer records) that you hold.  That company I helped had a significant reduction in their CDP licensing cost post clean-up.

4. Develop and manage a consent framework for new data, and de-identify where you can

Rely more on first-party data that you collect yourself.  Inform customers when you collect that data, and what you will use it for.  Inform them of this collection, prior to gathering it.  If you have new uses for the data, seek further consent or de-identify the data. 

For the latter, one such technique involves encryption of identifiers which allows different datasets to be linked together for analysis, but still obscure the original data. Another technique is homomorphic encryption, where a data owner encrypts a dataset, sends to the cloud (or another server) for processing, the server processes the data without decrypting, and sends the encrypted results back to the owner – who is the only party able to decrypt the results.

5.  Drive partner accountability

Who are you sharing data with, and what do they do with it?  Are they always using your customers data in a way that is consistent with the promises you made?  Review your contracts and agreements in your partner ecosystem and hold them accountable.  “It is a condition of doing business with us that you have a mutually acceptable attitude to privacy (and modern slavery, and ethical sourcing, and ….).

6. Ensure your breach notification plan exists, and is up to date

Have you conducted a boardroom wargame, simulating a data breach?  Have you repeated it in the last 12 months?

7. Educate your teams, and support people who raise issues

More here:

https://www.cio.com/article/2078080/7-steps-to-prepare-your-organisation-for-changes-to-australias-privacy-legislation.html

As mentioned above you can follow up here:

Why CIOs need to pay attention to the most significant overhaul of Australian privacy law in 40 years

Opinion

27 Mar 2024 4 mins

Michael Fagan, former chief transformation officer at Village Roadshow, examines the proposed changes to the Privacy Act and what CIOs in Australia need to be aware of.

I received 7 unsolicited CVs and resumes in the last 12 months, from well-educated and qualified people, seeking to join the organisation where I was working.  Unbeknownst to the senders, they put me at risk of breaching one of the 13 Australian Privacy Principles (APP), despite me not really knowing these people, and never asking them for information.  The jobseekers included a varying amount of personal information, including email address, phone numbers, home address, work and education history, and more.  One applicant even included a photograph and, no lie, their weight. (Although I suppose if I only weighed 47kg I’d put it on my CV too).  By giving me this personal information, they placed an obligation on me and my organisation to use it wisely, or risk penalties up to $1.8m.

In 2024, the government has committed to strengthening privacy law, including equipping the regulator with more powers and more options to enforce – meaning that those penalties could be even harsher.  The Attorney General’s department spent three years reviewing the 1988 Privacy Act, and released a report in February 2023 outlining 116 proposals for change.  The Australian Government published its response in September 2023 agreeing to 38 proposals, “agrees in principle” to 68 proposals (i.e. further consultation required to understand impact and alignment with other reviews like Digital ID, and the Australian Cyber Security Strategy before implementation), and notes the remaining 10.  The report is available here, and the response here, and the government’s current round of consultation ends 28 March 2024.

Much more here:

https://www.cio.com/article/2075325/why-cios-need-to-pay-attention-to-the-most-significant-overhaul-of-australian-privacy-law-in-40-years.html

It looks like the time to get ready is now – as these things always sneak up on you!

David.

The CSIRO Looks At AI And Health Care – A Useful Review.

This appeared a little while ago.

AI trends for healthcare

27 Mar 2024

Publisher

Commonwealth Scientific and Industrial Research Organisation

Resources

AI trends for healthcare

 Description

In 2023 artificial intelligence (AI) technologies have started to move into mainstream use. Tools such as ChatGPT have provided a way that almost everyone can start to interact with AI technologies – and many people are finding new and novel ways of using the technology. In many ways this stage of the use of AI in society mirrors the arrival of Google in the late 1990s, which really marked the beginning of widespread use of the internet.

A key difference between the use of AI in healthcare and the use of AI in other industries is where AI provides decision-making for diagnosis, prevention, prediction, prognosis, monitoring or treatment. In these cases, the AI is considered a medical device and is currently regulated as such – ‘software as a medical device (SaMD)’. This feeds into a bigger discussion of the use of AI across healthcare, for clinical and non-clinical purposes, and ensuring Australia is ready for its use. The healthcare consequences of the rise of generative models are rapidly unfolding and the national discussion about how to regulate AI is gaining pace.

Publication Details Copyright:  Commonwealth Scientific and Industrial Research Organisation 2024

License type: All Rights Reserved

Access Rights Type:  Open

Post date:  9 Apr 2024

Here is the link:

https://apo.org.au/node/326297

This 48 page document provides insight into what the CSIRO is up to in the “AI and Healthcare” field and is well worth a browse. I am sure any of the authors would be happy to respond to any queries people have! It is good to know there is practically aimed research happening.

Worth a browse and follow up where desired.

David.

 

Forces Are Moving In Ways Which Might Severely Damage Our GP Led Health System.

This appeared last week

11 April 2024

Are we heading for a physician associate moment?

By Holly Payne

The AMA and GP colleges have warned that scope-of-practice reforms could result in the kind of implosion seen in the UK health system.

The UK and Canada are valuable case studies for allied health scope of practice – but not for the reason that the scope of practice review commissioners seem to think, the RACGP says.

Commissioned by the Department of Health and Aged Care last year, the Unleashing the Potential of our Health Workforce scope of practice review is set to release its second issues paper in the coming weeks.

The first issues paper was released in January. It was ostensibly a literature review of sorts and only intended to be “a starting point for further discussions”.

Still, it made two key findings: that health professionals working top of scope make for a stronger primary healthcare system and that Australia has a range of barriers to achieving that.

The reviewers specifically noted that “policy and practice examples from the UK and Canada [in particular] were … found to be highly relevant to the Australian context”.

Responding to the issues paper this week, the RACGP said that “Australia should learn from the UK … on what not to do”.

The number of UK doctors working in Australia has doubled over the past decade, and the government’s commitment to expanding the non-doctor physician associate workforce has created a fallout so large it has threatened one of the oldest medical colleges in the world.

“Australia is in the top three health systems in the world, and the NHS is a basket case,” RACGP president Dr Nicole Higgins told The Medical Republic.

“We’ve got NHS doctor refugees and patients who are leaving in droves because it’s a broken system, and Australia can’t afford to go down that pathway.”

The college submission also pointed out that the Canadian province of Alberta, where pharmacists are allowed to prescribe for a variety of conditions, is experiencing an acute doctor shortage.

One board member of the Alberta College of Family Physicians has publicly blamed the workforce issues on a lack of governmental support for primary care.

The RACGP also homed in on something it felt was missing from the first issues paper: recognition of general practice.

“Issues Paper 1 is deafeningly silent on the large body of high-quality evidence for general practice,” it said.

“The review is overlooking the existing broad scope of general practice and the benefits for patients when GPs and their teams are enabled to work at their top of scope.

“Focusing only on increasing the number of access points will not have the same impact.”

Instead of responding to the individual consultation questions put out by the review, the RACGP chose to present lists of recommendations and risks.

High up on its list of recommendations were facilitating general practice-based dispensing, recognising GP advanced skills and increasing funding to support multidisciplinary team care.

This last includes opening MBS rebates for services delivered by practice nurses without direct GP supervision.

The lists of potential risks were equally voluminous. Chief among the college’s concerns were waitlist blowouts should allied health professionals be allowed to refer to specialists, patient confusion about who was a doctor and the increased administrative burden when relying on tools like My Health Record.

“My Health Record is not a clinical record; it is a summary of patient encounters,” the RACGP said.

“It is not sufficient to provide good patient care … [and] is also reliant on patients choosing not to opt out, which many did when the tool was first launched.”

The GP college also took issue with several of the definitions used by the review team, including one reference to the “acute health system”.

“Does ‘acute health system’ translate only to hospitals?” the RACGP wrote.

“GPs provide care of acute problems, such as lacerations or pneumonia, and should therefore be considered part of the acute care system.”

Although the AMA has not publicly released its submission yet, it told TMR that it would not be supporting “shortcuts” to tackling GP shortages.

“Our members have raised a number of concerns and it’s critical the scope of practice review provides a process to genuinely address the AMA’s concerns,” a spokesman said. 

“The AMA also rejects suggestions that all identified ‘barriers’ are obstacles that should be removed, because some of the so-called barriers provided safeguards.”

ACRRM’s submission to the consultation, while acknowledging the opportunity it presented for rural generalists, was similarly scathing.

“We are disappointed that the initial analysis and evidence review appears to have concluded that broadening of scope of practice would have virtually universal positive outcomes without any reference to potential risks or unintended costs,” the rural college said.

More here:

https://www.medicalrepublic.com.au/are-we-heading-for-a-physician-associate-moment/106634

There is some nonsense being sprouted by Government here!

First it is important to see clearly, as identified above, that the myHealth Record is basically an administrative tool that has little intention or capability to actually support clinical care delivery.

The second is the ongoing bureaucratic attempt from the Department of Health to blur the distinction between medical practitioners and ancillary care providers, and to claim some equivalence between these roles – where there is none. Carers are either doctors or they are not!

We have a very good health system and part of its quality is due to the GP-led nature of the way it is organized. Mess with that at your peril is my view!

David.

AusHealthIT Poll Number 742 – Results – 14 April, 2024.

Here are the results of the poll.

Do You Believe The Cost Of Comprehensive Private Health Insurance Has Become Essentially Unaffordable?

Yes                                                                             21 (81%)

No                                                                                4 (15%)

I Have No Idea                                                            1 (4%)

Total No. Of Votes: 26

People seem to think that Private Health Insurance has really gone over the top!

Any insights on the poll are welcome, as a comment, as usual!

A fair number of votes. But also a very clear outcome! 

1 of 26 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.