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Editorial
More on My HR
Good afternoon readers. Today is 8 November. The My Health Record opt-out date is 15 November. Parliament next sits, as a whole, on 26 November.
Minister for Health Greg Hunt has just announced more protections for individuals holding a My Health Record—it’s our ‘Top story’ today.
While welcoming the changes, as many people have, the AMA says MyHR needs more work—but it can work if supported by the public and the health professions.
The Opposition, the Consumers Health Forum and Dr Kerryn Phelps say the opt-out date should be extended. They are saying let’s all agree on this before legislating. The legislating cannot start until 26 November anyway.
The Minister’s Office says no more extensions. After 15 November a My HR will be created for people if they haven’t opted out, but they can opt out any time—before, on, or after 15 November.
‘Oh what a tangled web we weave’ comes to mind—but as a reflection on the business of government rather than the government itself.
To totally mangle our metaphors, in the My Health Record game of musical chairs, we know the music is scheduled to stop on 15 November. Hopefully by then, or as soon as possible afterwards, everyone will have a chair to go to, that they are happy to go to, and which will not be the same as the old one.
See 'My Health Record' for more.
Up the humanities!
…Or words to that effect.
It seems the humanities are making a comeback in today’s employment world, with humanities graduates having the inside running on the critical-thinking skills needed to solve complex public policy issues such as climate change, obesity and entrenched Indigenous disadvantage.
See our ‘Workforce’ section for more on this.
Yes to peanut butter
Was that music I just heard? Or was it the sound of someone saying that two tablespoons of peanut butter a day may help prevent ‘that slow, gradual weight gain after you enter adulthood, and reduce the risk of obesity-related cardiovascular diseases’. See our ‘Obesity’ section for the reason it may well be so.
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Top story
A stronger My Health Record
We have examined the recommendations from the Senate Inquiry, we have listened to concerns raised by a range of groups and My Health Record users, and will move the following amendments to Labor’s original legislation to further strengthen the My Health Record Act:
- Increase penalties for improper use of a My Health Record: maximum criminal penalty increasing from 2 years to 5 years jail; increase of maximum fines for individuals from $126,000 to $315,000.
- Strengthening provisions to safeguard against domestic violence. [Click on title above to get more detail]
- Prohibiting an employer from requesting and using health information in an individual’s My Health Record and protecting employees and potential employees from discriminatory use of their My Health Record. Importantly, employers or insurers cannot simply avoid the prohibition by asking the individuals to share their My Health Record information with them.
- No health information or de-identified data to be released to private health insurers, and other types of insurers for research or public health purposes.
- The proposed amendments also reinforce that the My Health Record system is a critical piece of national health infrastructure operating for the benefit of all Australians, by removing the ability of the System Operator to delegate functions to organisations other than the Department of Health and the Chief Executive of Medicare.
Furthermore, the Government will conduct a review looking into whether it is appropriate that parents have default access to the records of 14–17-year-olds.
Currently a young person aged 14 and over can take control of their My Health Record at any time by removing their parents access to their record.
These proposed amendments are in addition to the amendments announced in July, which have already passed the lower house.
(Source: Department of Health)
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Events and workshops
Third Women in Pharma and Medical Leadership Summit
28 November 2018, Sydney
Liquid Learning’s 3rd Women in Pharma and Medical Leadership Summit once again brings together many of the region’s most influential leaders who champion or embody women's leadership excellence in the industry.
Liquid Learning is excited to partner with the AHHA and offer all AHHA subscribers a 10% discount on standard booking rates. Click here to book now and reserve your seat!
#NextCare Health Conference
30–31 May 2019, Brisbane
Hear from global and world-class experts in leadership from a range of industries, connect with fellow health leaders at all levels, and inspired to leadership excellence.
Our engaging speakers include world-renowned futurist Phill Nosworthy, cultural change coach Amanda Gore, Chief Executive of Australia’s largest public health service Shaun Drummond, health digital transformation enthusiast Dr Clair Sullivan, and healthcare leadership expert Jan Phillips.
Register now to connect, inspire and transform at the inaugural #NextCare Health Conference 2019.
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Aboriginal and Torres Strait Islander health
RANZCO urged to apologise to first Indigenous ophthalmologist
As to what happens when you call out racism, the conference furnished a clear example of the kinds of retribution that follows. The second keynote was given by Dr Kristopher Rallah-Baker, Australia’s first Indigenous ophthalmologist and President of the Australian Indigenous Doctor’s Association. Rallah-Baker, whilst exhorting more Indigenous people to study medicine, tempered his message with reference to his own experiences. It is not necessary to repeat all that Dr Rallah-Baker has had to contend with as an Indigenous medical professional, save one example that he described: the rebarbative response he received from his professional association after writing an article pointing out the poor representation of Indigenous people in ophthalmology.
This was not a polemical piece, but one that stated fact, and yet the response was swift and damning. Here racism is more than a distraction—it is one that one that leaves you feeling threatened and menaced. It leaves you feeling unsafe. Here professional status counts for very little. The racism may be more genteel, but the message is the same—‘know your place.’
(Source: Croakey)
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Alcohol and other drugs
Alcohol misuse by over-50s on rise in Australia and New Zealand, study finds
Adults over 50 in Australia and New Zealand are increasingly drinking at hazardous levels requiring hospitalisation, research presented at an international alcohol conference on Tuesday has found.
Researchers from Massey University, the University of Auckland and the University of New South Wales concluded it was now critical for aged-care workers and doctors to identify alcohol misuse in older people, as well as the possible long-term impacts on cognition.
(Source: Guardian)
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Digital health
How patient demand is set to become an overwhelming driver of digital health
The digitisation of healthcare systems has so far been driven mainly by governments and providers but that is set to swiftly shift as patients begin demanding more responsive care, a panel of digital health leaders have predicted. Global digital health heavyweights gathered in Brisbane last Tuesday morning to help launch HIMSS AsiaPac18 with a broad-ranging panel discussion on the challenges and opportunities confronting healthcare globally.
HIMSS Board of Directors Chair Dr Manish Kohli said these were the same across the globe, albeit with different regulatory drivers. ‘We are all struggling with the same challenges and opportunities’, he said. ‘They are quality, access, cost and now, increasingly, the nursing and physician experience and the patient experience’.
HIMSS President and CEO Hal Wolf said the silver tsunami of an ageing population was increasing the pressure of those challenges, while also lessening the capacity of working populations to fund healthcare. Without a change in strategy, Wolf said, ‘You will not be able to build enough hospitals fast enough. And if you did, you do not have the workforce to fill them.’
(Source: Healthcare IT News)
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Health policy
More medical practitioners in parliament? Just what the doctor ordered
Suddenly doctors, that is medical practitioners, seem to be everywhere in politics. The attention given to the success of Dr Kerryn Phelps in the Wentworth by-election has been followed by the pre-selection of Dr Brian Owler by Labor to contest the seat of Bennelong at the next federal election. Furthermore, at the centre of the centenary of WW1 celebrations and the controversy over the development of the Australian War Memorial is another doctor, Dr Brendan Nelson, the former Coalition minister and opposition leader.
These three are not just any doctors, as each is a former president of the ‘doctors’ union’, the Australian Medical Association, a position that is a conveyor belt into political life for medical practitioners. Nelson was association president in 1993–95 before entering the federal parliament in the seat of Bradfield in 1996. Phelps was president from 2000 to 2003 and is also an elected member of Sydney City Council. Owler, known for his road safety campaign advertisements, was president more recently, from 2014 to 2016.
(Source: Sydney Morning Herald)
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Industrial relations and workforce
Why we should all care about bullying in healthcare
(Article may be paywalled)
Passive cultures are driven by fear—fear of failure and avoidance of blame. Procedures take precedence over compassion and the staff are more focused on protecting themselves than they are on responding to your concerns.
Aggressive cultures are driven by power—power of the position and a sense of superiority over others. Arrogance and bullying are more prevalent than care and understanding, and staff are more focused on pleasing their superiors than they are on ensuring that you get the help you feel you need. And of course, aggression at the top drives passivity at the bottom.
Such cultures thrive in hierarchical organisations where knowledge is power, and decisions are made on the basis of levels of expertise. In hospitals the hierarchy is very clear.
Hierarchy does not necessarily demand aggressive behaviour. Teamwork and empowerment can happen within a hierarchy. If the culture supports bullying, then bullying will happen. If the culture expects collaboration and respect, then collaboration and respect will happen. It all comes down to leadership within the organisation.
(Source: Courier-Mail)
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Mental health
Mental health review must achieve ‘radical reform’: Patrick McGorry
Psychiatrist and youth mental health advocate Patrick McGorry has called for ‘a radical reform of the structure and culture’ of mental health services, as the Productivity Commission prepares to look at the economic cost of mental illness. The former Australian of the Year said previous reviews had resulted in no more than ‘Band-Aids and confetti’, calling for a significant funding boost to bring mental health treatment in line with that directed at illnesses such as cancer and heart disease.
Allan Fels, former chairman of the ACCC and the National Mental Health Commission and who lobbied for the Productivity Commission inquiry, said mental health reform could boost the economy by a massive $18.4 billion a year. Among the benefits would be a marked improvement in workforce participation by Australians with a mental illness.
(Source: Sydney Morning Herald)
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My Health Record
My Health Record: Technical issue crashes phone helpline just days before opt-out deadline
(Article paywalled)
A call centre operator confirmed to News Corp Australia this morning [Tuesday 6 November] the system had crashed.
A spokeswoman for Health Minister Greg Hunt rejected reports the outage was due to a rush of calls as Australians flocked to opt-out before November 15. ‘The call centre is currently experiencing technical issues identifying people through the DHS system. This is not due to an influx of calls. It is a technical issue’, she said.
‘There is no problem with the My Health Record portal. People can log in and opt out online if they wish.’
(Source: Daily Telegraph)
Hunt bows to pressure over MHR safeguards
After bowing to demands for tighter safeguards in the My Health Record legislation, Health Minister Greg Hunt still faces calls to postpone the opt-out deadline that falls due next week.
AMA President Dr Tony Bartone welcomed the announcement, especially the provisions around privacy, confidentiality, and access by insurers. However, he acknowledged more work would need to be done. ‘The My Health Record may not yet be perfect, but it will get there with the support of the public and the health professions’, he said.
The Consumers Health Forum said bipartisan support was essential for the My Health Record to succeed, backing the call to put off the deadline.
Former AMA president Dr Kerryn Phelps, the independent who won the blue-ribbon seat of Wentworth vacated by former prime minister Malcolm Turnbull saying she stood for the ‘sensible centre’, said Mr Hunt should act swiftly to extend the opt-out period.
(Source: Medical Republic)
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Obesity
A daily handful of nuts, or two spoonfuls of nut butter, may keep your weight down
If nuts are so energy-dense—a 30g handful of walnuts or almonds has about the same calories as two Tim Tams—why are they associated with less weight gain? It could be because if you're eating nuts, you're less likely to be eating something not-so-nutritious.
‘Adding one ounce [about 30g] of nuts to your diet in place of less healthy foods—such as red or processed meat, French fries or sugary snacks—may help prevent that slow, gradual weight gain after you enter adulthood and reduce the risk of obesity-related cardiovascular diseases’, Liu said [Dr Xiaoran Liu, Harvard School of Public Health].
Other research has suggested you don't actually absorb all the calories in nuts when they're digested, so they're not as energy-dense in reality as they appear on paper. The Australian Dietary Guidelines, which prescribe regular nut and nut paste consumption, advise opting for ones with no added salt.
(Source: nine.com.au)
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Out-of-pocket costs
Health care is getting cheaper (unless you need a specialist, or a dentist)
Over the five years from 2011-12, real out-of-pocket payments per person climbed only 5%, a big improvement from the five years to 2011-12 when they climbed 29%. Does this new good news contradict all those claims that out-of-pocket costs are one of the most important issues in the health sector, and ‘that among wealthy countries we have the third-highest reliance on out-of-pocket payments’?
Not at all. Australia has one of the highest ratios of out-of-pocket recurrent health spending among wealthy countries, although it has fallen slightly from 17.9% to 17.7% since 2011–12. The data help us focus on where we most need to reduce out-of-pocket expenses. For specialists, they are high and growing; an average of A$155 per person, up 43% since 2011-12. In contrast, out-of-pocket payments for general practitioners were only A$31 per person, up just 4% since 2011-12.
But averages don’t tell us much. The Institute of Health and Welfare says the typical out-of-pocket cost of out-of-hospital medical services varies from A$80 per person to A$255 per person, according to where you live. Many of these high out-of-pocket payments are in high-income regions where most people can afford to pay, but not everyone in those regions can pay.
(Source: The Conversation)
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Research
Nothing lost in translation as Medical Research FF priorities announced
The Medical Research Future Fund Advisory Board has announced MRFF priorities the next financial year through to 2021–22. The board estimates $700m will be available to fund them. The priorities include translational research infrastructure, to make Australian research ‘more investable’.
The other priorities are; antimicrobial resistance, global health and health security, Aboriginal and Torres Strait Islander health, ageing and aged care, digital health intel, comparative effectiveness research, primary care research, clinical researcher capacity, consumer driven research, drug repurposing and public health interventions.
(Source: Campus Morning Mail)
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Workforce
What's an arts degree really worth?
You’ve heard the joke before. ‘What do you say to an arts graduate with a job?’ Answer: ‘I’ll have a Quarter Pounder, with fries.’ The study of humanities—once the cornerstone of our universities—has developed an image problem. But this could be about to change. Increasingly, the business world is realising that the skills of most value in the new economy will be those of critical and analytical thinking, communication and interpersonal skills—skills that humanities subjects deliver in spades.
Indeed, in a world where students today can expect to hold as many as 17 different jobs, the demand for ‘transferable skills’ has never been greater…Humanities subjects are more likely to equip graduates with the critical-thinking skills needed to solve the increasing array of complex public policy issues—so-called ‘wicked problems’—such as climate change, obesity or entrenched Indigenous disadvantage.
(Source: Sydney Morning Herald)
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Announcements
Have your say! Get involved in the global survey focused on improving cancer care
Australians who have been diagnosed and treated for cancer have the opportunity to share their experiences with the world as part of a global research project spearheaded by All.Can, an initiative committed to improving cancer care.
The All.Can survey is open to all Australians who have experienced cancer care and are willing to share their thoughts on their care and the efficiency of the Australian health system. The insights gathered from the survey will be used to shape recommendations to improve cancer care in Australia.
To participate in the survey, visit http://www.myonlinesurvey.co.uk/allcan_ENAU/
(Source: All.Can)
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Jobs
To advertise vacancies in the Healthcare in Brief, please contact the AHHA at admin@ahha.asn.au.
AHHA's online jobs section provides up-to-date information about vacancies across the health sector.
To visit the AHHA online jobs section, click here.
Project Director (Choosing Wisely) (Hervey Bay), Wide Bay Hospital and Health Service; PhD Scholarships, annual stipend of $27,596 per year for three years full-time study, Faculty of Business and Australian Health Services Research Institute (AHSRI) at the University of Wollongong; and Clinical/Physician Executive at Intersystems, Sydney.
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Australian Health Review
The AHHA is pleased to offer you early access to articles in our peer reviewed journal The Australian Health Review. If you have trouble viewing these in your browser, they can be accessed via the AHHA homepage.
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Volume 42(5) 2018
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Healthcare in Brief is brought to you by the Australian Healthcare and Hospitals Association, the independent peak membership body and advocate for the Australian healthcare system and a national voice for universally accessible, high quality healthcare in Australia.
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