Australia Really Needs To Get A Move-On in AI I Reckon.

This appeared last week:

It’s not too late to move from AI laggard to leader

---

Simon Bush
Contributor

14 February 2025

The announcement by French President Emmanuel Macron this week that France will make major investments of $180 billion to support AI adoption across its economy and Europe marked a significant change in approach by the Europeans to technology, moving from regulation to innovation.

In his speech to the AI Summit in Paris, President Macron made clear that France, and Europe more broadly, need to develop its own AI capabilities and infrastructure and that its governance should align to global standards to “simplify regulations”.

Of course, France is following the United States, United Kingdom, Singapore, Japan and many other countries in embarking on an AI strategy and investment program that ensures its economy doesn’t miss out on the economic benefits.

Australia is an outlier. We are one of the slowest adopters of AI in the world. Australia has decided to focus on regulation, with the Albanese government committed to introducing an Australian AI Act, presumably later this year should it return to government.

Our AIIA membership is telling me directly that the more than 18-month process of talking about risk and the pending AI regulations is slowing the adoption of AI solutions by Australian businesses at a time when productivity is at record lows.

The United States’ US$500 billion Stargate and French AI announcements share common traits. They demonstrate the need for positive signaling by governments, a supportive regulatory environment and strategic investment in AI infrastructure and data centres.

Indeed, President Macron cited land availability (having identified 35 sites) and low carbon energy as reasons why France is a good place to invest and grow the data centre infrastructure to power the AI economy.

These should be Australian strengths, too. Yet the messaging from parts of the federal government has caused concern within the sector as to whether it wants the billions being invested in data centre capacity in this country.

Australia has a great opportunity to be the place where Asia Pacific’s data is hosted in local cloud and date centres, leveraging the power of AI and providing Australia with both economic and soft power benefits.

Despite the slow start, there are positive signs of change from the Australian government. In the last several weeks, industry has noted a subtle but welcome change in positive comments coming from both the Treasurer Jim Chalmers and the Prime Minister.

Both of these leaders have said that Australia should embrace the benefits of AI and be a good place for data centre expansion and investment. This signaling to the market is important.

The AIIA supports the federal government developing a National AI Capability Plan, which was announced in December 2024 that will surely consider these issues and others including bolstering our AI research sector which we have called for in our pre-budget submission.

But the world is moving quickly, and waiting for a report to government by the end of this year is too slow. We need to move faster to join other economies in what is a global AI race.

Australia can be a place for AI skills, research, innovation and the hosting of regional data centres and local AI compute capability.

As President Macron has said, his plan is to accelerate adoption and simplify regulations. We look forward to the Australian government announcing the sensible AI guardrails as soon as possible and its support of the AI revolution.

Simon Bush is the CEO of the Australian Information Industry Association (AIIA)

Here is the link:

https://www.innovationaus.com/its-not-too-late-to-move-from-ai-laggard-to-leader/

It seems to French know just how important all this is. A major announcement from our Government would seem to be needed!

I wonder how long we will wait?

David.

This Seems Like A Huge Merger In The Health Sector With Little Anti-Trust Controls!

This appeared last week:

Chemist Warehouse merges with Sigma Healthcare to form $32 billion ASX giant

Company News

by Finance News Network February 14, 2025 10:08 AM

Chemist Warehouse and Sigma Healthcare have officially merged, creating a $32 billion pharmacy giant that debuted on the Australian Securities Exchange (ASX) on 13 February 2025. The merger establishes one of the country’s largest pharmacy networks, with Chemist Warehouse becoming a wholly owned subsidiary of Sigma Healthcare.

Chemist Warehouse co-founders Jack Gance, Sam Gance, and Mario Verrocchi were present at the ASX for the market debut, ringing the opening bell to mark the occasion. Addressing the crowd, Verrocchi described the listing as a milestone achieved through decades of perseverance.

“After 50 years of toil, 50 years of grind, a bit of blood, sweat, and tears, we’ve established ourselves as the leaders of this industry,” Verrocchi said.

Chemist Warehouse, founded in 1972, has built its success on high-volume, low-cost retail sales, offering competitive pricing on a wide range of skincare, beauty, vitamin, and over-the-counter products.

The company also operates MyChemist, Ultra Beauty, My Beauty Spot, and Optometrist Warehouse, expanding its presence beyond traditional pharmacies.

Leadership Structure Post-Merger

In the merged entity, Sigma Healthcare’s CEO and Managing Director, Vikesh Ramsunder, will continue in his role, overseeing the combined operations. Mario Verrocchi, co-founder and CEO of Chemist Warehouse, will manage the retail pharmacy chains under the merged group, including Chemist Warehouse, Amcal, and Discount Drug Stores. Additionally, Chemist Warehouse co-founders Jack Gance and Mario Verrocchi have been appointed to the board of the merged company, contributing their extensive industry experience to the strategic direction of the new entity.

A Dominant Force in the Pharmacy Sector

The newly merged entity brings together Chemist Warehouse’s nearly 600 stores with Sigma’s network of 340 Amcal and Discount Drug Stores outlets, creating a business that now controls 16 percent of Australia’s pharmacies.

Under the deal, Chemist Warehouse shareholders own 85.75 percent of the merged company, while Sigma shareholders hold 14.25 percent. The three Chemist Warehouse co-founders now collectively hold approximately $15 billion in shares, which are locked in escrow until at least August 2025.

The company’s first day of trading saw Sigma’s stock rise 5.4 percent to close at $2.91, reflecting strong investor enthusiasm for the pharmacy giant’s market debut.

Expansion Plans and Future Growth

Verrocchi has outlined an ambitious plan for growth, with the merged business aiming to add at least 400 more stores over the next five years. He also likened the merger to a marriage, stating that discussions on rebranding Sigma’s pharmacy brands under the Chemist Warehouse banner were still in the early stages.

“We’re saying it’s like we’re getting married. But we can’t ask, ‘Where do you live, how much money do you have in the bank?’ We can’t ask anything. So we’ll open up the suitcase tomorrow,” he said.

Industry Concerns and Regulatory Scrutiny

The merger has raised concerns within the pharmacy sector, particularly from the Pharmacy Guild of Australia, which fears reduced competition and potential price increases for consumers.

“Such consolidation has led to non-competitive duopolies and an unequal distribution of healthcare services, ultimately reducing the presence of smaller, local businesses,” the Guild said in a statement.

Despite these concerns, the Australian Competition and Consumer Commission approved the deal, paving the way for the creation of one of the largest pharmacy groups in the country.

A Long-Term Vision for Industry Leadership

With its ASX listing complete, the company is positioning itself as a vertically integrated retail and pharmaceutical giant, taking inspiration from UK health and beauty retailer Boots.

“For the next five years, I’ve chained myself to my desk,” Verrocchi said, reaffirming his commitment to leading the company’s growth strategy.

Here is the link:

https://www.finnewsnetwork.com.au/archives/finance_news_network932088.html

Only one question. How is this not a monopoly creating merger?

The ACCC thinks it is all OK:

Sigma and Chemist Warehouse proposed merger not opposed, subject to undertaking

Date

7 November 2024

Topics

Mergers

The ACCC will not oppose the Sigma Healthcare Limited (ASX: SIG) and CW Group Holdings Limited (Chemist Warehouse) merger after accepting a court-enforceable undertaking from Sigma.

Sigma is a pharmacy wholesaler of prescription medicines, over the counter and front of store products. Sigma is also a franchisor of pharmacies under banners including ‘Amcal +’ and ‘Discount Drug Store’.

Chemist Warehouse is a pharmacy franchisor and distributor to its own pharmacies and retail stores under the brands ‘Chemist Warehouse’, ‘MyChemist’, ‘Ultra Beauty’, ‘My Beauty Spot’ and ‘Optometrist Warehouse’.

“The ACCC found that, with the undertaking, the proposed merger is unlikely to substantially lessen competition. There is and will continue to be effective competition at all levels of the pharmacy supply chain, capable of constraining a combined Sigma Chemist Warehouse,” ACCC Chair Gina Cass-Gottlieb said.

“The ACCC’s analysis found that the proposed merger is unlikely to substantially lessen competition nationally or locally because other pharmacies and non-pharmacy retailers will continue to compete to the same extent they compete now.”

“Consumers value different aspects of Sigma’s and Chemist Warehouse’s banner pharmacies’ offerings. Importantly, consumers will continue to have choice between smaller format stores offering personalised services to consumers and the Chemist Warehouse offering, focussed on larger format discount stores and front-of-store offerings,” Ms Cass-Gottlieb said.

For reasons including changes to the pharmacy regulatory environment, the ACCC also found that a combined Sigma Chemist Warehouse is unlikely able to influence Sigma banner pharmacies to the same extent Chemist Warehouse influences its current franchisees. Sigma franchisees are expected to continue to make their own individual commercial decisions.

“Critical to our conclusion that a substantial lessening of competition is unlikely is the competitive constraint provided by competing wholesalers including API, EBOS, and CH2,” Ms Cass-Gottlieb said.

EBOS and API are large national wholesalers supplying full product lines, and CH2 is a smaller wholesaler that supplies both community pharmacies and the hospital sector. Each of these wholesalers has agreements with the Commonwealth Government to distribute PBS medicines as well as spare capacity to supply new retail pharmacy customers.

The ACCC’s investigation found that these wholesalers have actively competed for new pharmacy customers and retail pharmacies have switched between wholesalers. The undertaking given by Sigma will ensure that pharmacies currently engaged in longer term contracts with Sigma will also be able to readily switch wholesalers should they choose to do so, strengthening the competitive constraint of these alternative wholesale supply options.

The ACCC therefore formed the view that a combined Sigma Chemist Warehouse will be unable to foreclose downstream pharmacies that compete with Chemist Warehouse franchisees.

“We also gave careful focus to the question of overall competition in pharmacy retailing and concluded that the transaction is unlikely to result in a substantial lessening of competition in any market,” Ms Cass-Gottlieb said.

“There are numerous pharmacy retailers that will continue to provide meaningful and ongoing competition to Chemist Warehouse and Sigma’s banner pharmacies as well as non-pharmacy retailers that sell front-of-store products and some over-the-counter products. The leading supermarkets are key providers of such products and will continue to provide strong competition.”

For prescription medicines, pricing will also continue to be regulated by the Australian Government’s Pharmaceutical Benefits Scheme.

As part of its review, the ACCC also considered whether the acquisition would impact the supply of pharmacy retail products, including generic medicines.

The ACCC found that there were multiple channels available to suppliers and manufacturers of these products to reach consumers, including through alternative wholesalers and direct to pharmacy arrangements. For products other than PBS medicines, non-pharmacy retailers were also key alternatives.

“We received many submissions from pharmacists and other market participants expressing concerns about this transaction,” Ms Cass-Gottlieb said.

“We reviewed the transaction very closely to test these concerns and conducted detailed analysis of Chemist Warehouse and Sigma’s internal documents.”

“The evidence gathered, augmented by the undertaking given by Sigma, led us to conclude that a substantial lessening of competition is unlikely,” Ms Cass-Gottlieb said. 

Evidence shows that retail pharmacies do not face significant barriers to switching and pharmacy customers do switch wholesalers, although concerns remained for pharmacy customers in longer term wholesale and/or franchise agreements with Sigma.

“To help ensure those pharmacies in longer term contracts are able to switch easily to a new wholesaler or banner group, we accepted an undertaking that requires Sigma not to enforce contractual restrictions on exit and ensures payments under contracts do not make it costly for a pharmacy to switch,” Ms Cass-Gottlieb said.

The enforceable undertaking also requires Sigma to safeguard and delete the data of those pharmacies that choose to switch and to require the merged Sigma Chemist Warehouse to continue as a pharmaceutical wholesaler under the Commonwealth Government’s Community Service Obligation (CSO) arrangements for five years.

“The ability of pharmacies to readily exit their existing agreements with Sigma will maintain and enhance the ability of alternative wholesalers to constrain the merged entity,” Ms Cass-Gottlieb said. 

More information, including the undertaking can be found on the ACCC’s public register here: Sigma Healthcare - Chemist Warehouse Group

Notes to editors

In considering the proposed merger, the ACCC applies the legal test set out in section 50 of the Competition and Consumer Act.

In general terms, section 50 prohibits acquisitions that would have the effect, or be likely to have the effect, of substantially lessening competition in any market.

Here is the link (with lots of details):

https://www.accc.gov.au/media-release/sigma-and-chemist-warehouse-proposed-merger-not-opposed-subject-to-undertaking

I guess we watch and wait and see!

David.

 

I Have To Say If Someone Came To See Me With This I Would Be Totally Stumped!

This appeared last week:

Centuries ago, doctors may have said Rachael had ‘hysteria’. They still aren’t sure what causes her condition

By Kate Aubusson

February 16, 2025 — 5.00am

Rachael Dodd sat at her desk, staring at her computer screen as random letters in the body of an email vanished from sight.

Tiny blank spaces populated the text like a reverse join-the-dots. Dissecting words, severing messages in a crude facsimile of what was happening within her malfunctioning brain.

“How is this happening?!” the 31-year-old thought in disbelief during this strange occurrence in 2021 that she would come to call her first “episode”.

Dodd started “going in and out of memory”, having no recollection of conversations or interactions.

She must have had a stroke, her horrified family thought. But at the hospital, a neurologist told her it was an aural migraine. She was fine. Go home.

“I said I don’t feel fine. I feel uncoordinated. Things aren’t working well,” Dodd said she told the doctor.

Her “big episode” came two months later. As Dodd sat on her couch, she felt her right side grow heavy and called for her husband, who found her slumped over. The right side of her face drooping. Dodd couldn’t move her right arm or leg. She was slurring and stuttering, unable to form sentences.

Staff at Sydney Adventist Hospital performed the pin-prick test: she felt nothing. But her CT scan, MRI and echocardiogram were all clear.

This time, a neurologist dug deeper.

“He didn’t dismiss me,” Dodd said. “He took the time to listen and investigate.”

Dodd has functional neurological disorder (FND): a modern “hysteria” at the centre of a medical misogyny Venn diagram.

FND is predominantly diagnosed in women (about 70 per cent of all cases). It manifests as alarming, unexplained physical symptoms and doesn’t appear on the usual scans. It is under-researched, poorly understood, and patients report being humiliated and dismissed as hysterical hypochondriacs, liars and malingerers.

FND can manifest as spontaneous seizures, movement disorders, pain, tremors, speech, vision and hearing problems, extreme slowness and fatigue, and loss of the sense of touch. Symptoms can seem to emerge suddenly, disappear and return with no warning.

A review by international brain science and psychiatry experts found what would be described as FND today had been depicted as “moral failing, demonic possession, hysteria or witchcraft” up to the 19th century, with “uterine repositioning” a proposed treatment historically.

“There is so much stigma for people with FND,” said UNSW senior neuropsychiatrist Dr Adith Mohan, who leads the Mindgardens FND clinic at Prince of Wales Hospital.

“This is a real condition. It is not feigned or imagined. People have real symptoms that they have no control over.”

Unlike many neurological conditions that are a disorder of brain structure, FND is a disorder of brain networks: the way these networks process information.

Research studies using functional neuroimaging have shown changes in the connections between different brain regions in FND patients.

It is the second most common diagnosis neurologists encounter – after headaches or migraine – and affects between four and 12 people per 100,000 each year nationally.

The exact cause of FND is a mystery.

Childhood trauma is a major risk factor. About 70 per cent of people with FND have a history of childhood sexual abuse or developmental violence.

The median delay in diagnosis is eight years, and more than half of FND patients can’t access treatment.

“There is a huge unmet need, and a lack of investment in services and research,” Mohan said.

After every episode, Dodd must relearn basic skills: using a knife and fork, throwing a ball, and writing. It took her six weeks to relearn to walk.

“One moment I’m fine, and the next I’ve lost function down my right side and have to sit there,” she said.

“I think of my brain like a computer that overheats, shuts itself down and then has to reboot. When my brain is overworked, it stops sending messages to parts of my body that it thinks are not required.”

She learnt how to conceptualise FND and reroute these errant messages at Mindgardens FND Clinic, which was a finalist in the 2024 Premier’s Awards.

Mohan leads the team of a physiotherapist, occupational therapist, and clinical psychologist who adapt a six-week intervention tailored to each patient’s symptoms and goals, whether it’s being physically active or caring for their children.

“Some people will get completely well, but many will continue to have some symptoms,” Mohan said.

Of its 100 patients, 41 per cent couldn’t work due to their symptoms at referral. After intervention, 65 per cent of these patients could go back to work, Mohan said.

Dodd said she will never fully recover, but she can recognise the signs, have fewer episodes, and is back to walking her dog, Lenny, and teaching martial arts.

“You can manage a new normal, and you realise life is what you make it,” she said.

Here is the link:

https://www.smh.com.au/national/centuries-ago-doctors-may-have-said-rachael-had-hysteria-they-still-aren-t-sure-what-causes-her-condition-20250214-p5lccb.html

You really have to wonder what is going on here. I believe this good lady is handling the whole thing very sensibly, but if I were her I would be really wondering why no-one, so far, seems to be clear just what is going wrong and what is the cause.

I suspect there is no fix, so any diagnosis would be pretty useless as it would not lead to a fix.

Seems we are just left with the old truism that the brain is a complex and difficult to understand thing that has its own set of rules!

A good reason not to become a neurologist is guess – as one would have a pretty frustrating time explaining the inexplicable to so many patients!

Pity about that! All that learning leading no-where for these patients! Of course, sadly, much of medicine is like this!

David.

This Looks Like Pretty Impressive Capacity For A Vital Resource In Victoria...

This appeared last week:

Motorola nabs $500m deal for Victorian emergency comms

Joseph Lam

9:30AM February 14, 2025

The Australian Business Network

Motorola Solutions has landed a $500m contract with the Victorian Government.

The Victorian Government has spent $500m on the extension of a critical communications service with Motorola Solutions, in a deal which will give the state’s emergency services a boost which will rival state-of-the-art technology in the US.

The 10-year extension will for the first time bring Marine, Search & Rescue onto the network via purpose-built radios that use artificial intelligence and voice commands to communicate.

The new radios, called Project 25, arrive with a suite of new AI-powered features and applications allowing the location of the device and responder to be found on maps in the most rural parts of the country.

Motorola Solutions has provided network capabilities for the state for the past 20 years, with Victoria Police, Ambulance Victoria, Fire Rescue Victoria, Victoria State Emergency Service and Life Saving Victoria all using the network.

Motorola Solutions managing director Con Balaskas said the new smart radios could automatically switch between networks to ensure they maintained a constant line of communication.

The radios typically leverage the Telstra or Optus network, depending on a customer’s location and preference, and when not in range of land mobile radio (LMR) and broadband could leverage a satellite network.

Motorola Solutions has provided network capabilities for Victorian emergency services for the past 20 years.

The Victorian Country Fire Authority purchased 16,000 radios in 2024 and has begun pushing them out to its stations across the state. The radios typically last between seven to 10 years before becoming obsolete.

Since the Black Summer Bushfire in 2019 Australia has upped its investment in communications for emergency services operators as satellite connectivity has become increasingly popular for state emergency services, particularly for areas prone to flooding and other natural disasters.

“Places where it’s difficult to propagate any form of coverage, that’s the primary use case for satellites that we’re seeing from the agencies,” Mr Balaskas said.

“Just from an agency perspective, there has been, probably over the last two years, a lot of investment in remote connectivity and partnerships with Starlink. It’s becoming more prevalent in terms of what they are trying to achieve where they have previously had no connectivity at all.”

Motorola Solutions has deals with every state and territory in Australia to provide communications networks for emergency services personnel.

Across Victoria there were 32,000 radios using its Metropolitan Mobile Radio (MMR) network. Ambulance Victoria has around 1600 smart radios and 750 radios fitted inside vehicles.

The MMR network has been used across several of the state’s major disasters including the 2023 flood crisis and the 2009 Black Saturday bushfires.

In 2024, some 48.5 million calls were made to the MMR network.

Here is the link:

https://www.theaustralian.com.au/business/technology/motorola-nabs-500m-deal-for-victorian-emergency-comms/news-story/5aa685f9fb604e6cd53191279e3ed6cd

I have to say this all sounds like a pretty useful purchase of important capability for Victorian Emergency Services that has also been properly tested in action.

I wonder how this kit compares with that used in the other States and indeed globally. I also wonder why we don’t have a nationally spread solution to ensure coverage where-ever needed?.

With needs happening all over the wide brown land a national system might make some good sense! The scope of capability might also bear review?

Does anyone know how much national co-ordination there is in this area?

David.

AusHealthIT Poll Number 781 – Results – 16 February 2025.

Here are the results of the poll.

Is Australia Investing Enough In Women's Health Initiatives?

Yes                                                                    9 (35%)

No                                                                   18 (62%)

I Have No Idea                                                 1 (4%)

Total No. Of Votes: 26

An interesting outcome with a fair majority not confident we are investing enough in the health of our beloved women!

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

Reasonable voter turnout. 

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.

Looks Like We Have A Doctor Distribution Problem! Too Many Docors, Just Not In The Right Places!

This appeared last week:

Health

No bulk billing GPs found in 10% of federal electorates for standard consultations, survey says

Cleanbill report also reveals four out of five Australian GPs will charge a gap fee for new adult patients without concessions

Natasha May and Nick Evershed

Sun 9 Feb 2025 06.00 AEDT

An adult without concessions would not be able to find a bulk billing GP in 10% of electorates, according to a new report.

The online healthcare directory Cleanbill on Sunday released an electorate breakdown of its third annual Blue Report based on a survey of 6,925 general practices carried out during October 2024.

The Blue Report, published in January, found that for new adult patients without a concession card, four out of five GPs will charge a gap fee.

Cleanbill collects its information, according to its founder, James Gillespie, by compiling a list of general practices nationally, which they call to ensure they are an operating GP clinic, ask if they bulk bill adult patients and, if not, what out-of-pocket fees they charge.

Data managers then check that information against what is stated on clinics’ websites and repeat calls until they can ensure consistent information.

When it comes to what is happening across the 151 commonwealth electoral divisions, Cleanbill was unable to find any available bulk billing clinics for adult patients in 15 electorates, compared with four in its first report in 2023.

Those 15 electorates were Bass (Tasmania), Boothby (South Australia), Braddon (Tasmania), Brisbane (Queensland), Clark (Tasmania), Fairfax (Queensland), Franklin (Tasmania), Jagajaga (Victoria), Kingston (SA), Lyne (New South Wales), Lyons (Tasmania), Mayo (SA), Newcastle (NSW), Shortland (NSW) and Swan (Western Australia).

The report found there were still 12 electorates with bulk billing rates exceeding 50%, of which nine were located in western Sydney.

While some electorates have gained bulk billing clinics since 2023, Cleanbill found the majority (86.7%) had fewer with an average drop of 13.7% in the two-year period.

The electorate of Burt in WA experienced the greatest decrease in bulk billing rates from 61% in 2022-23, dropping to 6.5% in 2024-25, followed by Gorton in Victoria, dropping from 64% to 15% in the same period.

Gilmore in NSW experienced the largest increase in bulk billing clinics, from 10.9% in 2022-23 to 23.5% in 2024-25, followed by Cowper (NSW), which rose from 2.6% to 13.5%, in the same period.

Cleanbill found the electorate of Chifley in NSW had the greatest decrease in average out-of-pocket costs, from $50.25 in 2022-23 to $22.92 in 2024-25, followed by Parramatta in NSW, from $56.85 to $35.70 in the same period.

Meanwhile, Watson (NSW) experienced the largest increase in average out-of-pocket costs, going from $24.54 in 2022-23 to $36.52 in 2024-25, followed by Wide Bay in Queensland, rising from $39.67 to $49.71 in the same period.

Dr Christopher Harrison from the Menzies Centre for Health Policy and Economics at the University of Sydney said Cleanbill’s results were based on patients not covered by the incentives the government introduced in 2023, which increased the amount that GPs receive when they bulk bill children and concession card holders.

“This likely explains why the government can point to a well-documented increase in bulk billing rates overall, while at the same time Cleanbill finds that it has become increasingly difficult for an adult who does not have a concession card to find a GP practice that will bulk bill them,” Harrison said. “These two results are not contradictory.”

There are likely to be existing patients already on a practice’s books who are and will continue to be bulk billed, as well as cases where a patient with financial difficulties could be bulk billed based on GP discretion, he pointed out.

“These data do highlight a growing issue within our healthcare system,” Harrison said. “A sustainable way to incentivise GPs to bulk bill this patient group needs to be found.”

The health minister, Mark Butler, said: “Official data shows our record investment to strengthen Medicare has stopped the freefall in bulk billing that was created under the Coalition Government.

“After we tripled the bulk billing incentive for GPs, bulk billing has started rising again in every state and territory – delivering an additional 5.8m free visits to the GP in just 13 months.”

Nationally, 77.2% of all GP visits were bulk billed in November 2024, he said, an increase of 1.6% from October, before the investment took effect.

The president of the Australian Medical Association, Dr Danielle McMullen, said the Cleanbill report provided a “limited” snapshot of GP billing practice.

“The Productivity Commission’s authoritative report on government services tells a much clearer story – commonwealth spending per person on general practice has declined since 2018/19, and more patients are delaying GP visits due to cost.”

The president of the peak body for general practitioners, Dr Michael Wright, said: “All Australians need affordable access to a GP who knows them. With a federal election fast approaching, we should be seeing bold commitments from all political parties to achieve this.”

Here is the link:

https://www.theguardian.com/australia-news/2025/feb/09/no-bulk-billing-gps-found-in-10-of-federal-electorates-for-standard-consultations-survey-says

Anyone who thinks we will ever see much change in all this – leave your comments below!

For myself I am not holding my breath!

David.

It Really Is A Bit Silly That We Are Having So Many Medicine Shortages

This appeared last week:

Why can’t I pick up my prescription? Australia’s medicine chaos explained

ADHD drug shortages wreak havoc on patients returning to work and school. It is just one symptom of Australia’s ailing medicine access systems, explained here.

James Dowling

9 February, 2025

Just in time for the return of children to school last week, federal health authorities advised of yet another shortage of a medication for those with ADHD.

This time the drug Concerta – a brand of methylphenidate – has “limited availability” across eight dosages, with half of the dosage shortages set to resolved by the end of May, while the other dosages will remain scarce until at least the end of the year.

Adults with ADHD and parents of children with the condition will now need to go pharmacy-hopping in search of supplies, or get a new prescription from their doctor.

It’s a familiar scenario: there were shortages of Vyvanse from August 30 to October 21 last year, and Ritalin was scarce until just a few weeks ago, until more became available on January 24.

Of course drug shortages are not unique to ADHD medications.

Australia is in the midst of drug shortages for a range of conditions, coupled with a subsidy system that is almost unanimously deemed flawed.

Delving into the details of why the supply of ADHD medication is so disrupted shows why so many other Australians cannot get the treatment they need at the time and the price they should.

In the case of Concerta, the Therapeutic Goods Administration cited “manufacturing errors” for causing the shortage.

But ADHD drugs are one of the most chronically inaccessible categories of medicine, with worldwide shortages attributed to spikes in demand.

Until 2021, there were no government-subsidised ADHD medications available in Australia for adults, which meant patients could be paying anywhere from tens to hundreds of dollars for near-identical drugs.

Australasian ADHD Professionals Association president David Coghill said between past subsidy delays and the present rolling shortages, affordable and accessible ADHD prescriptions had never been a reality for Australian adults.

“It’s not just about access to medication, because there are workarounds for these shortages of medication, but for many people, it’s really hard to access their healthcare providers because healthcare providers are (in) short (supply) and waiting times are long,” Professor Coghill said.

“If people’s ADHD medication is not optimal, then they struggle. Kids struggle at school, they struggle in out-of-school activities, so sport or music, and they struggle at home and then out with their peers. There are really big issues for kids, and for adults it’s the same. They don’t just struggle at work.”

Australian supply is reliant on foreign drug companies, which also work under mandates from the US Drug Enforcement Agency, which sets production caps on controlled substances, namely the active ingredients in stimulant-based ADHD drugs.

It means many companies cannot scale up production to meet demand even if they wish to, leaving access “patchy”.

“ADHD medication shortages are disruptive at any time, but they can be particularly stressful when people rely on them for school or work,” said Royal Australian and New Zealand College of Psychiatrists president Elizabeth Moore.

“When there are shortages, we see people feeling they need to ration or save up their medication to avoid running out. They might have exams coming up and are worried they won’t be able to get their prescription filled.

“It’s possible for people to switch to an alternative medication, and for some people this may be necessary. But this means additional appointments with their prescriber and possibly facing long wait lists and out-of-pocket costs due to a shortage of psychiatrists. With many people facing cost-of-living pressures, this is another source of stress for them.”

The systemic flaws that have caused the supply disruption for ADHD apply equally to other medications.

Medicine in Australia

Medicine access infrastructure in Australia is divided among a web of agencies independent of government, each with a siloed assessment process. To enter the country however, all drugs must go through the TGA, which is tasked with determining the safety, quality and viability of a drug.

Any number of stakeholders may have a role in supplying a drug or treatment once it has TGA approval, namely pharmacist wholesalers, hospitals, state health authorities and the Health Department if it is providing a federal access program. Despite the TGA having no direct role in supplying medicines to these stakeholders, it is the appointed body for managing access during a supply shortage.

While a drug will technically be available nationally after TGA approval, it will retail at the price set by its producer, often costing hundreds or thousands of dollars per dose, and is often geographically constrained. In order for the federal government to consider subsidising a drug, it must be rubber-stamped by the Pharmaceutical Benefits Scheme.

The PBS is also an independent evaluator, though its task is to find the cost-effectiveness and public necessity of certain drugs. For vaccines and immunisations, after TGA approval they go to the Australian Technical Advisory Group on Immunisation before potential listing on the National Immunisation Program

The NIP and PBS sit along with the Medicare Benefits Schedule, which lists all the treatments and medical services covered by the government. Collectively they make up the government’s Health Technology Assessments

Compared to the TGA, the approval process of the PBS – managed by another assessment body called the Pharmaceutical Benefits Advisory Committee – faces far harsher criticism. It has fewer mechanisms to scale up in line with demand, meets less frequently and faces longer delays on its decisions.

It is a system that even the government concedes is unfit for purpose, having commissioned three different assessments in recent years. The most recent was the Health Technology Assessment review, which provided 50 possible reforms, including a potential bridging fund to drive affordability during protracted evaluation periods.

Subsidy delays

From November last year, an investigative series by The Australian found PBAC was teetering on the brink of an administrative meltdown. A series of private communications between the PBS, the Health Department and drug companies whose products were affected showed 45 drug decisions had been pushed from the agenda of a thrice-yearly PBS meeting. Of those delayed, 24 were deemed “major” submissions.

The moment this was made public knowledge, Health Minister Mark Butler intervened to organise a special meeting to take on extra submissions and mitigate delays.

In the months since, stakeholders have been left fearing a future policy that caps the number of submissions considered each year. While plans for such a policy are stringently denied by the Health Department and PBS, both agencies have acknowledged the practical limitations of their assessors in private documents, and the PBS advised it would institute a “maximum total number” of drugs considered at each meeting since its mass deferral in late October.

While some subsidy decision delays may only hold back access to drugs with plentiful alternatives, or impact alterations to existing subsidies, it has previously affected cancer treatments, chronic-disease medications and drugs for conditions with no readily available alternative.

The Health Department estimates the PBAC will require years of work to reform, all the while being battered by a rising rate of submissions routinely beyond capacity.

Medicine shortages

Independent to the struggles of the PBS and PBAC, major medical groups have lobbied for reform to the TGA’s medicine shortages strategies, hoping to get one step ahead of an increasingly unpredictable international market.

Australia has a very limited local drug production industry, leaving it reliant on global supply chains that the Covid pandemic proved to be fraught.

There are currently more than 400 ongoing drug shortages, according to the TGA’s shortage database, while the Royal Australasian College of Physicians estimates 27 per cent of Australians are experiencing a shortage in a prescription drug they rely on.

With a consultation process under way to seek remedies to the chronic shortage, a slew of criticisms generally relegated to discussion within the medical community have made their way into public view.

Ongoing medicine delays

417 ongoing shortages (38 critical) with 68 more projected (8 critical)

Ozempic		April 15, 2022	December 31, 2025	1356 days
Morphine Juno (painkiller)		March 22, 2024	April 1, 2025	375 days
Saline IV fluid		July 26, 2024	Indefinite	N/A
Methylphenidate/Ritalin (ADHD)		November 28, 2024	31 December, 2025	398 days
Naxolone (overdose)		December 10, 2024	31 December, 2025	386 days
Insulin		December 20, 2024	January 31, 2025	42 days

 

Source: Therapeutic Goods Administration medicine shortage reports database (non-exhaustive)

The Australian Medical Association, Pharmacy Guild and RACP all called for more transparent information sharing and a dedicated authority for pre-empting and mitigating access droughts.

Currently ad hoc working groups are formed to respond to specific shortages as they arise, though a dedicated Medicine Shortage Work Party was formed during the pandemic and disbanded in 2021.

The AMA made its pitch for a single regulator, which the Guild echoed, having seen its prior appeals for the return of the Medicine Shortage Work Party denied.

Beyond shortages of ADHD medicine, drugs also regularly affected include hormone replacement therapies, weight loss drugs and opioid painkillers. In the recent past, federal access schemes, like the Take Home Naloxone program, have been undermined by rocky access.

Here is the link:

https://www.theaustralian.com.au/health/why-cant-i-pick-up-my-prescription-australias-medicine-chaos-explained/news-story/4482896fd4a957cf71664ceea7154dac

As an outsider it seems to me we are faced with a political and bureaucratic ‘stuff up’ where no one feels responsible to fix what are obviously long lasting, dangerous and annoying problems.

Maybe we could see the bureaucrats earn their pay and actually get on top of these issues or is that too much to ask?

Knowing there is a major issue and just abandoning a working party tasked with fixing the problems is just typical….

As some are often prompted to say – “God give us strength”

Worrying about vapes etc. when life saving drugs are hard to obtain talks to some distorted priorities I believe!!!

David.

Clearly The Systems That Approve Individuals To Be Employed In NSW Health Are Failing!

This report appeared today:

This appeared this morning

NSW Health nurses suspended over antisemitic video

Paul Karp NSW political correspondent

Feb 12, 2025 – 11.48am

Two nurses at Sydney’s Bankstown hospital have been stood down by NSW Health after an antisemitic video emerged online of them claiming they would refuse to treat and would kill Israeli patients.

State Health Minister Ryan Park said the video was the most “vile, shocking and appalling video” he had ever seen, and would be investigated by both NSW Health and the NSW Police, including for potential breach of hate speech laws. Police confirmed that Strike Force Pearl was investigating.

The NSW Health Department has called in police after footage surfaced appearing to show Bankstown Hospital workers bragging about killing Israeli patients.

In the video, a woman in a NSW Health uniform claims that she “won’t treat” Israeli patients and would “kill them”, while a man who falsely identified himself as a doctor said he had “literally sent” Israel patients to “jahannam” (hell).

Mr Park said the two had been identified and stood down just hours after the video – believed to have been taken during a night shift on Tuesday evening or Wednesday morning – was shown to the government.

At a media conference at NSW parliament, Mr Park addressed the Jewish community, saying he was “very sorry” and promising the two nurses “will not ever be working for NSW Health again”.

“There is no place in our hospitals or health system for this sort of view to ever take place.”

The investigation includes a referral to the Health Care Complaints Commission, to include the standard of care the hospital and nurses have given patients.

But Mr Park said that after an initial rapid review of patient incidents, the hospital appeared to be operating with the proper level of safety and care of patients.

NSW Health Minister Ryan Park says two hospital workers filmed making antisemitic comments and bragging about killing Israeli patients have been stood down, with a police investigation now under way.

The video was published by a Jewish influencer who encouraged followers to share it to ensure the nurses he interviewed were fired. “There’s no way such people should work in medicine,” he said in the video.

In the video the woman tells the influencer, “It’s Palestine’s country, not your country you piece of shit.” The man says: “I’m a doctor, my man, in a hospital. You’re going to get killed and you’re going to go to jahannam, inshallah [God willing].”

Premier Chris Minns said the video was “hugely distressing” and would be met with a full response from NSW Health and NSW Police.

He told 2GB Radio the pair “will not be back in the NSW Health system” but a full investigation was required to make sure “there’s not a glimmer of hope of some kind of administrative turnback”.

NSW Health secretary Susan Pearce condemned “in the strongest possible terms” the behaviour of the two nurses. “Never in my wildest dreams did I think I would be standing here with two staff members of NSW Health system having said such horrendous things about our community, particularly our Jewish community.”

Federal Health Minister Mark Butler, said the video “makes me sick to my stomach”.

“The idea that you would single out a particular group in our community and indicate you wouldn’t care for them runs against every single principle in our healthcare system,” Mr Butler said in a statement.

“At a time of unprecedented antisemitism in our country, this is a particularly sickening video.”

– with Tom McIlroy

 Here is the link:

https://www.afr.com/policy/foreign-affairs/nsw-health-nurses-suspended-over-antisemitic-video-20250212-p5lbh1

What a lovely pair! I am amazed to see such hate-filled material from health professionals in Australia. Pretty sad to say the least!

This pair really should go back to where they came from! They are not worthy of living here IMVHO!

David.