What’s in it for health? Federal Election policy debate, p3 INSIDE Public hospitals, p5 6 Climate change and health Indigenous health, p7 Queensland pharmacy inquiry 7 Campaigning docs, p8 8 Aged Care Royal Commission Health Star Rating, p16 10 Mandatory reporting Electric vehicles, p17 14 Asthma deaths Codeine vindication, p20 Surgical assistants 17 ISSUE 31.08 MAY 6 2019 AUSTRALIAN MEDICINE - 31.08 MAY 6 2019 1 In this issue Managing Editor: John Flannery National News 3-24 Editor: Chris Johnson Contributors: Maria Hawthorne Virginia DeCourcy Research 25-29 Georgia Morris Graphic Design: Streamline Creative, Canberra World News 30-33 Advertising enquiries 34 Streamline Creative Music Tel: (02) 6260 5100 35 Australian Medicine is the na tion al news publication of the Book Review Australian Medical Association Limited. 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The AMA, its servants and agents will not be liable for any claim, loss or damage arising out of reliance on the information in Australian Medicine. AMA LEADERSHIP TEAM Cover pic: Shadow Health Minister Catherine King and Health Minister Greg Hunt shake hands before debating health policy at the National Press Club. President Vice President (Photo by Odette Visser) Dr Tony Bartone Dr Chris Zappala 2 AUSTRALIAN MEDICINE - 31.08 MAY 6 2019 NEWS Contenders debate health policy at press club National Press Club debate on health policy. AMA policy positions have been applauded by both major “However, there was no mention of aged care and still no great political parties, during a live broadcast of the Federal Election detail around mental health. We need them to connect the dots. campaign’s health debate at the National Press Club of Australia. “The AMA will compare and contrast these policies and publicly rate them accordingly before election day. Health Minister Greg Hunt and Shadow Health Minister Catherine King each delivered their pitches and were in turn “But we need to see the major parties announcing the missing grilled by political journalists during the hour-long telecast from pieces from their healthcare vision over the next two-and-a-half Canberra. weeks. Mid-way through the campaign, health policy maintains a high “As the population ages and more people are living longer priority of the election as the parties fight for the all-important with multiple complex and chronic conditions, it is vital that health vote. Australia has a robust, connected, and holistic strategy to ensure improved health outcomes for patients throughout life. AMA President Dr Tony Bartone described the debate as informative and positive, with sound messages from each side – “The Australian health system is one of the best in the world, but with some glaring omissions on the policy front. if not the best. But it will take strong leadership, hard work, good policy with long-term strategic vision, and significant well- “It was a good strong debate, with lots of commitments to long- targeted funding to keep it working efficiently to meet growing held AMA policy, and commitments to strongly resource these community demand. policies,” Dr Bartone said. “The health system has many parts, and they are all linked. “There was important attention to recognised medicines and to Governments cannot concentrate on a few, and neglect the supporting general practice. others. Otherwise, patients will be the ultimate losers. Whole patient care cannot be done in silos, in parts, or in isolation.” “And each party delivered anti-vaping messages, which is very important. Under questioning from the reporters in the room, Mr Hunt and AUSTRALIAN MEDICINE - 31.08 MAY 6 2019 3 NEWS Contenders debate health policy at press club ...continued from p3 Dr Bartone with Catherine King. Dr Bartone with Greg Hunt. Ms King both described the uptake of vaping by teenagers in the “It’s a choice between a Labor Party with an ambitious health United States as a “public health disaster” and said they would agenda, and a Liberal Party with no agenda at all.” not support policies that could see Australia go down the same Mr Hunt said Labor had not “done the work” on its cancer plan path. and had offered Australians few details and incorrect costings on This view is supported by the AMA. the plan. Other health issues canvassed included out-of-pocket Ms King rejected that statement. medical expenses, public hospital funding, cancer care, the But the Minister said he had a long-term vision for the nation’s Pharmaceutical Benefits Scheme, and primary care, with both health, and repeated his four-pillar plan of primary health, sides detailing their spending commitments and obviously hospitals, mental health and medical research claiming superior healthcare visions for the nation. On Medicare and bulk-billing rates, Mr Hunt said the Coalition On public hospitals, Ms King said Labor would invest an extra Government had a good record of increasing funding and rates $2.8 billion and pointed to the AMA’s own advocacy on the issue. since it has been in office. “Just two weeks ago the Australian Medical Association declared “Looking forward … what we are doing across all of the our hospitals are chronically under-funded, our doctors and conditions in relation to diagnostic imaging, an investment of nurses are at breaking point, and patients are waiting longer $600 million for new MRIs across the country,” he said, while than ever before for emergency treatment and… surgery,” she praising the work of the AMA in primary care initiatives. said. “But perhaps most importantly, working the AMA and College “The AMA’s Public Hospital Report Card was a damning of GPs transforming what we are doing in primary health care indictment of the six years of cuts and chaos from the Liberals.” by giving older patients the capacity to have their doctor in the home,” Mr Hunt said. Ms King repeated Labor’s proposal to spend $2.3 billion over “Over the telephone, over teleconference, over the way they four years to improve Medicare coverage of cancer services. prescribe, through email and text – transforming access.” “This election offers a stark choice, and nowhere is that choice more stark than when it comes to health policy,” she said. CHRIS JOHNSON 4 AUSTRALIAN MEDICINE - 31.08 MAY 6 2019 AUSTRALIA DECIDES: ELECTION 2019 Election must result in better funding for public hospitals Dr Bartone talking to Sky News about hospital funding. The AMA has used the backdrop of the Federal Election campaign to promise significant new long-term funding. campaign to release its 2019 Public Hospital Report Card and He said whichever party forms government after the May 18 call for greater funding for struggling hospitals. election, it should immediately fix the funding shortfall for the The Report Card was released over the Easter long weekend and nation’s public hospitals. highlights the plight of many public hospitals having to deal with Dr Bartone said the Report Card painted a depressing picture of inadequate funding. overstretched hospitals and patients waiting longer for their care. In releasing the document, AMA President Dr Tony Bartone said The ability of the hospitals to cope with ever-increasing patient it demonstrated the need for the sector be better resourced, demand continues to decline, he said, and it is a trend that will and he called on all major political parties to use the election only accelerate unless something is done. AUSTRALIAN MEDICINE - 31.08 MAY 6 2019 5 AUSTRALIA DECIDES: ELECTION 2019 Election must result in better funding for public hospitals ...continued from p5 “Public hospitals are a vital pillar of our world-class health But he said there were significant consequences of system, but neglect and underfunding are dooming them to underfunding public hospitals. failure,” Dr Bartone said. “Every year, the Australian population gets older and sicker,” Dr “All our governments have to lift their game, but the leadership Bartone said and the funding priorities and strategies must come from the Federal Government. “It’s no surprise then that public hospitals are treating more patients each year. Between 2012-13 and 2016-17, public “Our public hospitals need clear and transparent long-term hospital separations rose on average 4.5 per cent per annum. funding arrangements, above and beyond the current formulas.” “The number of emergency presentations also rose on average Key findings of the Report Card include: static bed ratios for by 2.6 per cent each year over the same period. the general population and a 24-year low of hospital beds per 1000 people aged 65 years and older; longer waiting times for “Across all types of public hospital service, the rate of increased patients in emergency departments, with only 64 per cent of demand is outstripping the 1.6 per cent, per annum, rate of urgent presentations seen within the recommended 30-minute population growth. timeframe in 2017-18; nationally, more than a third of the “Underfunding can lead to increased numbers of deaths for almost three million patients who presented to an emergency admitted patients, higher levels complications, delayed care, department in need of urgent treatment waited longer than delayed pain relief, and longer length of stay for patients.