We Really Could Improve The Gender Balance Of The Research We Undertake and The Work We Do To Address Gender Differences.

This appeared a day or so ago…

Health Minister Mark Butler mum on government’s response to damning menopause report

Health Minister Mark Butler dodged a series of questions in a tense interview after the release of a damning report into women’s healthcare.

Jessica Wang

September 22, 2024 - 11:22AM

NewsWire

Health Minister Mark Butler has declined to say how the government intends to respond to a damning report that found both the health system and workplaces were failing women.

Released on Wednesday, the report made 25 recommendations, including giving menopausal women flexible work arrangements, and giving extra training to GPs and increasing the time medical students spend on menopause and perimenopause - with the current curriculum only allotting for an hour of education during a five to six-year course.

The senate committee also called on the government to consider paid gender-inclusive reproductive leave, plus a national awareness campaign on the condition, and for menopause to be taught in schools as part of the curriculum.

It also said there needed to be urgent action taken to address shortages of menopause hormone therapy, and reforms to the Pharmaceutical Benefits Scheme to make the drug cheaper and more accessible to women who needed it.

While Mr Butler acknowledged it was an “important inquiry,” and said some of the findings were “shocking,” he wouldn’t commit to whether the government would implement the recommendations.

“This is now one of two really important inquiry reports the Senate has delivered to us around women’s health, and together, they tell a pretty shameful story of women not being taken seriously in the health system about their symptoms,” he told ABC Insiders host David Speers.

“Also our treatment regimes, our PBS medicines … the hormone replacement therapy just not keeping pace with best practice.”

Asked if he would specifically consider the recommendations to ensure flexible work arraignments for women, Mr Butler appeared to dodge the question.

“The report was only delivered in recent days, so we’re going to go through it carefully, but it’s been a really important inquiry,” he said.

“They are complex conditions that need really complex support.”

He said he would be working with Minister for Women Katy Gallagher and Assistant Minister for Health and Aged Care Ged Kearney to consider the findings.

Women, on average, go through menopause between the ages of 45 to 55, which can include the rapid onset of symptoms like hot flushes, vertigo, brain fog, headaches, anxiety and depression.

Throughout the committee, multiple women reported being disregarded by medical professionals with one woman telling the committee: “I’ve been gaslit and misdiagnosed, had symptoms ignored and dismissed, told they’re all in my head or it’s stress, told to exercise, take a holiday, have a glass of wine”.

Here is the link:

https://www.news.com.au/lifestyle/health/health-problems/health-minister-mark-butler-mum-on-governments-response-to-damning-menopause-report/news-story/ba00ba50a1cb59edf87c2088cc034601

There are a range of uniquely female illnesses and physiological differences that are not properly considered as often as may be helpful.

These run all the way from various female malignancies to optimum symptom control for menopausal patients and their carers.

There is also to tendency to apply research done exclusively on blokes to females as well. This may be right sometimes but totally inappropriate in other circumstances. For example do cancers of the same organ always behave the same in males and females? I suspect not!

All that is needed is awareness to make sure we get that balance of effort and funds appropriate and not assume all studies done on boys transfer seamlessly to girls!!!!

Pretty obvious but I wonder how often the implications are just ignored or missed? The reason(s) that the balance is not always correct at present could be the subject of many books!

David.

AusHealthIT Poll Number 765 – Results – 22 September 2024.

Here are the results of the poll.

Is It Way Overdue That Universities Are Abandoning Face-To-Face Lectures?

Yes                                                                                    5 (28%)

No                                                                                   10 (56%)

I Have No Idea                                                                 3 (17%)

Total No. Of Votes: 18

A very clear vote, from those who bothered. People seem to like face-to-face teaching!

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

A moderately disconnected voting turnout. 

3 of 18 who answered the poll admitted to not being sure about the answer to the question!

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

David.

I Know Government Moves Slowly, But This Lot Have Raised Taking Your Time To An Art Form!

This appeared last week

More privacy reforms urgently needed but not expected before election

Noah Yim and Alexi Demetriadi

12 August, 2024

The nation’s Privacy Commissioner says further reform in privacy legislation is “urgent” and “much needed” but those changes are unlikely to happen before the next election, due by May next year.

This comes after the Albanese government on Thursday introduced its first tranche of amendments to the Privacy Act.

The introduction of criminal penalties for doxxing – the malicious publication of personal information – has largely been welcomed by members of a WhatsApp group of 600 Jewish creatives who had been victim to doxxing earlier this year and prompted the new criminal ­penalties.

Privacy Commissioner Carly Kind welcomed the government’s first tranche of amendments but stressed the need for more reform.

“We are eagerly awaiting the second tranche of privacy reforms, dealing with much needed reforms including a new positive obligation that personal information handling is fair and reasonable,” Ms Kind said.

“The coverage of Australia’s privacy legislation lags behind the advancing skills of malicious cyber actors.

“Further reform of the Privacy Act is urgent, to ensure all Australian organisations build the highest levels of security into their operations and the community’s personal information is protected to the maximum extent possible.”

Attorney-General Mark Dreyfus has flagged the government will make more amendments. The Australian under­stands this is not expected before the next election.

Coalition legal affairs spokeswoman Michaelia Cash said the opposition would “closely examine” the bill.

She drew attention to a few areas: new costs for businesses, the role of class action law firms, and the bill’s interaction with anti-money laundering and counter-terrorism financing laws.

“The Coalition has only seen the bill for the first time today and we will now examine it in detail,” she said.

“We recognise the need for appropriate reform, but privacy is both highly technical and far-reaching.”

A spokeswoman for the WhatsApp group of 600 Jewish creatives welcomed the “positive” step taken by the government to stop “horrific Jew hatred” that had “swept” Australia. “These attacks against Jewish Australians have often been fanned by online agitators who have so far faced no consequences for their appalling actions,” she said.

In February, the names, mobile numbers, professions and photographs of creatives in the group were exported from the WhatsApp chat by a New York Times reporter who then passed the 900-page document to a person who was the “subject of a story”.

The proposed provisions would not be retrospective and therefore unable to address that incident.

“The lessons of history show that what starts with the Jews rarely ends with the Jews,” the group’s spokeswoman said.

Stuart Cohen, another of those doxxed, said the legislation’s enactment “could not come soon enough” and would protect not just Jewish people but all Australians.

“The impact of my name appearing on the list was limited but this doxxing has had a really terrible impact on many friends, family and associates who have been accused of all sorts of heinous crimes for which none are guilty,” he said.

Here is the link:

https://www.theaustralian.com.au/nation/more-privacy-reforms-urgently-needed-but-not-expected-before-election/news-story/d6a4328a46f07a2141dd80fecd53e89d

As best I can tell the ‘bad guys’ are inventing evil things to do to people faster that they can be legislated against!

A hopeless situation!

David.

Here We See More Signs Of The Stress The Private Health Care System Is Under.

This appeared last week:

Insurers deny caving in to Healthscope demands

Michael Smith Health editor

Sep 13, 2024 – 5.37pm

Private health insurers deny that they caved in to public pressure from hospital operator Healthscope to give it more money, accusing the private equity-owned group of launching an “unethical” advertising campaign that had been a “dismal failure”.

Medibank Private, NIB and HCF have agreed to out-of-cycle funding payments in the “tens of millions of dollars” in the past three weeks following intense lobbying from debt-laden Healthscope, which owns 38 private hospitals.

On Friday, the insurance lobby denied that the payments revealed in The Australian Financial Review were in response to Healthscope’s advertising campaign launched last week singling out three other insurers, including Bupa, which it accused of “bleeding it dry” by underfunding its hospitals.

Healthscope is owned by Canadian investment giant Brookfield.

“Out-of-contract payments have not occurred in response to Brookfield and Healthscope’s heavy-handed US-style campaign,” said Rachel David, the chief executive of Private Healthcare Australia, an industry body representing big insurance companies.

“The Brookfield campaign has been designed to pressure health funds into unsustainable, above-inflation contracts that would drive up the cost of health insurance for millions of Australians working hard to contribute to their own healthcare in a cost-of-living crisis.”

On Friday, Healthscope welcomed the funding injections but accused the insurance lobby of hyperbole and personal attacks.

‘Hyperbole and personal attacks’

“We’ve been in constructive dialogue with a number of health insurers, who have recognised the serious issues at hand for private hospitals and engaged with finding sensible solutions,” Healthscope chief executive Greg Horan said. “The insurers’ lobby group has offered no ideas or solutions, just hyperbole and personal attacks.”

Health funds said they had been making out-of-contract payments to private hospitals to help with financial difficulties for the past two years. Those payments are rarely disclosed, although Medibank said last month that it had contributed $63 million in additional funding across the sector.

On Friday, the insurers were keen to distance their latest payments from Healthscope’s campaign, although they did not say what specifically triggered the funding injection.

Sources said Healthscope had wanted insurers to tip in more than they agreed, demanding indexation gains that would have locked insurers into funding increases in the future. Insurers rejected that request, instead offering one-off payments as a consolation prize.

Even before it launched the campaign on September 4, Healthscope had been aggressively lobbying insurers to give it more money. In negotiations with them, it warned that it would be forced to close hospitals without financial help, something insurers want to avoid as well.

Dr David said the public campaign had caused distress for people planning treatment in Healthscope hospitals, including pregnant women booked to give birth, cancer patients, and people relying on mental health services. If a hospital operator goes out of contract with an insurer, patients often have to pay more for their treatment.

“It’s deeply unethical that they are threatening these vulnerable people with extra fees. There is no need to bring consumers into contract negotiations with health funds,” Dr David said.

“The Healthscope campaign has been a dismal failure, with minimal engagement from consumers. This is undoubtedly an embarrassment for Brookfield and its investors. This is not how we do business in Australia.”

Mr Horan hit back, saying Healthscope’s Protect Your Hospitals campaign focused on the insurers that were refusing to fund patient care fairly. He said thousands of health fund members participated in the campaign, which included advertisements radio and newspaper advertisements and on social media. He said nurses and hospital teams had also supported the campaign.

Bupa declined to comment on Friday, but sources said the insurer was still in talks with Healthscope and had previously made out-of-cycle payments. The Australian Health Service Alliance, which represents not-for-profit insurers being targeted in the Healthscope campaign, said it continued to work with Healthscope.

“The Australian Health Service Alliance (AHSA) and Healthscope entered into a new, two-year agreement earlier this year, which includes more than 20 of the nation’s not-for-profit health funds. The agreement is valid up until 2026,” AHSA chief executive Andrew Sando said.

Unexpected cost inflation

Ramsay Health Care, Australia’s biggest healthcare operator and one of the few profitable private hospital owners, declined to comment when asked if it was seeking similar payments. Although this was unlikely as it was in a better financial position, the company has previously brought health funds back to the table early or out of the normal contract cycle because of unexpected cost inflation.

Relations between hospital operators and insurers are more strained than usual because of cost inflation and a federal government review of the industry that has put the spotlight on the challenges facing the sector.

Last month, the country’s largest non-profit provider with 10 hospitals, St Vincent’s, reached a last-minute agreement with NIB after threatening to walk away and leave the insurer’s customers paying higher prices.

UnitingCare Queensland, which owns and operates four private hospitals, threatened to walk away this week from its contract with the Australian Health Service Alliance, a large buying group representing 22 not-for-profit insurers.

In 2022, Bupa and Ramsay hospitals failed to reach an agreement on how to cover costs. Bupa has more than 4 million customers.

Here is the link:

https://www.afr.com/companies/healthcare-and-fitness/insurers-deny-caving-in-to-healthscope-demands-20240913-p5kact

The bottom line here is that pretty much all health care costs are rising much more quickly than inflation and funding will become increasingly stretched! What this has to mean that both sides will have to give a little or get better and cheaper at what they do.

With the way healthcare is going the pressure can be assumed to be relentless!

David.

The Aged Care System Looks To Be About To Get A Fire-Cracker Up Its Backside To Start Meeting Patient Expectations!

I am afraid cold custard and a 2 hour wait to be taken to the toilet will not cut it anymore.

Aged care concessions cost $5b in revenue

Phillip Coorey Political editor

Sep 13, 2024 – 5.42pm

The Albanese government sacrificed about $5 billion in budget savings in return for securing the Coalition’s support for the aged care reforms announced this week, according to sources in both camps.

The reforms, which will require retirees to pay more for both home and residential care from July 1 next year, increase the use of means-testing and therefore have the greatest impact on part-pensioners and self-funded retirees.

These voters are key to the Coalition’s support base and, from the outset, Opposition Leader Peter Dutton and shadow health minister Anne Ruston told the government the package as originally proposed would never pass muster among Coalition MPs.

Consequently, Senator Ruston and Mr Dutton won a raft of demands, including exempting existing residents in aged care homes and those on the waiting list for home care, from the new fee structures.

Another key concession was to insist on a cumulative lifetime contributions cap for home and residential care of $130,000. The current cap is $79,900, but the initial proposal was to have no cap on home care and a $184,000 cap on residential care.

When the reforms were unveiled on Thursday, the government said the net saving to the aged care budget over the next 11 years would be $12.6 billion. But a government source familiar with the process said the figure would have been about $5 billion more had it not been for the concessions. A Coalition source said it was “billions”.

Nonetheless, over the longer term, the savings will start to increase as no one in the system will be exempt. The annual aged care bill is $36 billion and rising.

The exemptions differ between the two care modes. Anyone in a residential facility before the July 1, 2025 start date will be carved out, and anyone already on a home care waiting list on Thursday – the day the reforms were announced – will come under the old regime.

Under the new funding model, a full-pensioner will pay, at the most, $300 more a year for residential care, a part-pensioner $700 extra, while a self-funded retiree would be on the hook for up to $13,400.

As for home care, a full-pensioner will pay 5 per cent of their independence costs and 17.5 per cent of their everyday living costs.

Depending on their income and assets, part-pensioners and Commonwealth Seniors Health cardholders will pay between 5 per cent and 15 per cent of their independence costs, and between 17.5 per cent and 80 per cent of their everyday living costs.

Self-funded retirees will pay 50 per cent and 80 per cent of the respective costs. Everyday living services include cleaning and gardening. Independence supports could include help with showering, dressing and taking medications.

The reforms have been overwhelmingly welcomed by the aged care sector, but there has been some pushback from self-funded retirees.

Margaret Walsh, the acting national president of Australian Independent Retirees, who was on the aged care taskforce which advised on the reforms, told the ABC: “I felt I was pretty much the lone voice, particularly for independent retirees.

“We had other people representing pensioners. I think that I was the only one, and I was certainly overruled on most things.”

When Mr Dutton sought approval for the deal from his party room on Thursday, about 12 MPs who spoke in protest did so on behalf of self-funded retirees.

Aged Care Minister Anika Wells said asking people to pay a bit more was essentially for their own good.

“When a person arrives at residential aged care, let’s be honest, it’s not something that people look forward to ... in fact, over the past few years, people have been dreading it,” she said.

“Lots of people have said to me, ‘I’d be happy to pay a little bit more if I could get a higher standard of aged care’.

“What I hope is that when that moment comes ... they arrive to an aged care facility that has a new wing being built and that the room they have has an ensuite.”

Here is the link:

https://www.afr.com/politics/federal/aged-care-concessions-cost-5b-in-revenue-20240913-p5kaad

To me the problem with the aged care system has been that even if people were prepared to pay more for something better than cold custard such services were very hard to find and get access to.

The system seems to rely on all the patients being passive and uncomplaining and to be able to just lump them all together out of sight but with pretty pathetic services.

The ‘baby-boomers’ are hot going to wear this and are going to demand much better and more focused care I suspect (know) and will be willing to pay to get it. It will all cost a lot more than at present....

I suspect the next decade will be a period of dramatic change in aged care – see if I am not right!

David.

Interesting To See AI Actually Being Used In Some Clinical Situations. Just Amazing Stuff!

This appeared last week:

AI is just what the overworked, burnt-out doctor ordered

By Angus Delaney and Kayla Olaya

September 14, 2024 — 1.51pm

Shorter wait lists for surgery, more time with patients and reduced burnout for workers are some of the benefits that doctors believe are possible through the use of artificial intelligence in healthcare.

AI tools have been developed to record and document doctors’ consultations with patients, produce formal reports and slash clinicians’ paperwork, and advocates claim the technology could transform a healthcare system in crisis.

But some experts and industry bodies have urged caution when using AI, which remains largely untested.

Melbourne orthopaedic surgeon Ilan Freedman is an early adopter, using AI to save him an extra 90 minutes a day in his practice. Without the distraction of note-taking, he says he is more focused on his patients.

Freedman says the tech could have far-reaching benefits for the health system, by freeing time and effort that would allow more consultations and operations. It could also be transformative on the home front, as the Clayton-based medico spends more time with his family and is no longer stuck in the office after hours.

“Because I don’t need to allocate admin time, I can get the work done in less time,” said Freedman.

“For me, I’m not seeing more patients overall, but I’m seeing … the same number of patients in much less time.

“I think everyone [other surgeons] I showed it to basically has adopted using it.”

Joel Freiberg, the founder of Australian tech start-up Medow Health, was inspired to develop a medically specific AI scribe after watching his father, a respiratory physician, stay late at work completing paperwork.

Currently, Medow Health’s user base is increasing by 50 per cent every month, as word spreads in the medical profession of AI’s possibilities.

Freiberg said clinics commonly had months-long wait lists for patient consultations and his AI tool would help reduce those wait times.

“Doctors are spending 30 per cent of their time on data entry … if you cut that in half you can see three to four more patients a day and cut those wait times,” he said.

“We all sit in the doctor’s office waiting for an hour, many times they’re doing their reporting ’cause they don’t want to forget what they said.”

Freiberg’s AI is currently only used in private clinics, but the developer wants to take the technology into the public system, and believes it could reduce Victoria’s backlogged elective surgery wait list.

In June, 58,722 Victorians were on the waiting list for planned surgery, according to the Victorian Agency for Health Information, and the real figure is larger, as many patients were waiting for an initial consultation.

While advocates are not suggesting the technology replaces a real-person consultation, some in the health system urge caution with how widely AI is used.

“There’s very little research evidence around these scribes,” said Farah Magrabi, a professor of biomedical and health informatics at Macquarie University.

“There are issues where the scribe could be basically summarising it incorrectly.

“This AI has the potential to really solve a lot of problems for doctors, and other health professionals as well, who are burdened by documentation, but they need to clearly understand how it’s working.”

The Royal Australian College of General Practitioners in July released advice on AI scribes, and noted the potential benefits, such as reducing administrative burden, improving patient satisfaction and decreasing doctor burnout.

But the potential for errors in scribes and the risks of a data breach that would expose sensitive medical information are among the drawbacks. Also, there is limited data on how well the scribes work.

The Australian Medical Association’s guidelines on AI support the use of the technology only when there is appropriate ethical oversight and where it is “used to benefit patients’ health and wellbeing”. The association has also raised concerns about a patient’s rights and a doctor’s clinical independence.

Dr Michael Bonning, the association’s chair of public health, said AI that accelerated administration work could reduce surgery wait times, but “we still need more of these doctors available to our system ... and [to] fund our health system effectively”.

More immediately, Bonning said, the value lies in reducing doctor fatigue and staff turnover.

“The level of burnout we are seeing is significant, [AI] does something about that,” he said. “I think about it as being transformative … we are at a time where the demands on the system are overwhelming.”

Everything considered, Bonning is hopeful AI could make a big difference.

“I believe in the value of technology being rolled out … and to ensure it meets all of those practical and ethical standards and recognise this can make our lives easier,” he said.

Here is the link:

https://www.smh.com.au/national/victoria/the-doctor-will-see-you-sooner-ai-could-reduce-healthcare-burnout-20240911-p5k9pv.html

And here is the link to the AI-co-pilot.

https://www.medowhealth.ai/

I have to say I find it just amazing that these technologies have been integrated and packaged in such a way that they can now be made available to clinicians for routine use.

The web-site warrants a close review to see just how fast things are moving. I am reminded of Arthur C. Clarke’s comment about ‘any sufficiently advanced technology seeming like magic’. This sure comes close – and is worth a close review!

I am afraid my Luddite tendencies are beginning to emerge. This is plain scary!

David.

It Looks Like At Least One University Has Decided Packed Lectures Are Pretty Much A Waste Of Time!

This appeared last week -  and is simply a ‘beat-up’. No one is actually furious I am sure!

‘Furious’: Adelaide University becomes first major Aussie uni to ditch face-to-face lectures

Staff have been left outraged by the decision, which will see students having no face-to-face teaching at all.

Brielle Burns

September 14, 2024 - 10:21AM

Labor committed to growing number of Australian university students

Education Minister Jason Clare says the Albanese Labor government will provide extra funding to encourage more Australian students to go to university.

A major Australian university has ditched face-to-face lectures entirely in a move which has reportedly outraged staff.

Adelaide University, which will launch in 2026 as a multimillion-dollar merger between the University of Adelaide and the University of South Australia, announced “most students” will no longer attend face-to-face lectures, which will be gradually replaced “by rich digital learning activities”.

“These activities will deliver an equivalent learning volume to traditional lectures and will form a common baseline for digital learning across courses, providing a consistent experience for students,” a post on the University of Adelaide website reads.

“These asynchronous activities will be self-paced and self-directed, utilising high-quality digital resources that students can engage with anytime and anywhere.”

The university stated courses will have a “common digital baseline”, with the proportion of digital learning expected to increase by 2034.

Other activities such as tutorials and workshops “may be delivered on-campus to create a rich cohort experience, or in instances where digital delivery provides the best outcomes for students, through the online learning space”, it noted.

Dr Andrew Miller, division secretary of the National Tertiary Education Union’s (Nteu’s) South Australia branch demanded the university reverse the decision, revealing staff are “furious”.

“We were promised the new university would be co-created with staff, students and community stakeholders,” he told The Guardian.

“This decision sidestepped that commitment. Co-creation means giving agency and empowerment to collectively build the university.”

Dr Millier, who claimed the decision was made without the proper involvement of staff, said staff should have their own say in learning outcomes.

“Flexibility [between online and face-to-face] ordinarily works both ways – some learners benefit tremendously from face-to-face learning with a specialist academic present while there are other independent learners that benefit from more remote digital engagement.”

Dr Alison Barnes, the national president of the Nteu, further slammed the “outrageous” move, arguing the shift to an online model adds to the “death of campus life”.

“Having lectured most of my adult life … I think about how many students have approached me before or after lectures to raise academic issues, things they haven’t understood about material or want extra help with,” she told the publication.

A spokesperson for Adelaide University said the move away from face-to-face lectures is not new.

“Universities have been increasingly responding to student needs for flexible delivery over the years,” they said in a statement student newspaper Honi Soit.

“Lectures are passive learning activities that can be delivered online to maximise flexibility for students without impacting learning quality.”

News.com.au has contacted the University of Adelaide for comment.

Here is the link:

https://www.news.com.au/finance/work/careers/furious-adelaide-university-becomes-first-major-aussie-uni-to-ditch-facetoface-lectures/news-story/fa62e5dcad7006a2f980df5c5bf027e3

Large lectures are really a very inefficient way passing on knowledge, which has to be the fundamental purpose. Better to be talking with and discuss the information with small groups in interactive formats etc., maybe having watched some form of interactive A/V education prior. I am sure this is what is now actually happening!

This said – there are situations where the public lecture can be a very useful forum – especially when followed by questions and discussion – or when a speaker has a point of view to put, and wants to present an organized argument or set of ideas!

It would be hard to think that these plans are little more than a cost-cutting exercise! What do you reckon ‘flexible delivery’ really means?

All this said, I reckon the idea of ‘staff outrage’ is pretty confected!

Bottom line – there is a time and place for all sorts of pedagogy from one on one up!

David.

 

AusHealthIT Poll Number 764 – Results – 15 September 2024.

Here are the results of the poll.

Have You Seen Ward Based Use Of Computer Terminals For Clinical Information Recording At Your Local Hospital?

Yes                                                                                 21 (75%)

No                                                                                     4 (14%)

I Have No Idea                                                                 3 (11%)

Total No. Of Votes: 28

A very clear vote, many have seen terminals in use at the ward level in hospitals.

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

A moderately disconnected voting turnout. 

3 of 28 who answered the poll admitted to not being sure about the answer to the question!

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

David.