Health policy

Analysis and Comment (63)

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Passions run high when it comes to the NHS but despite some unprecedented challenges it will do what it always does – survive. PA

Despite the difficulties, the NHS is not dead yet

By Jon Glasby, University of Birmingham

The NHS in 2013 is facing a series of unprecedented challenges. A rapidly ageing population is just one of a number of factors fuelling a rise in demand for services and hospitals are struggling to cope…
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One-third of rural patients wait 24 hours or longer for an urgent GP appointment. Image from shutterstock.com

Country practice: recruiting doctors to work in the bush

By Anthony Scott, University of Melbourne

If you live far from a city, you are likely to be in poorer health than your urban counterparts; you’re also less likely to use health-care services and if you do, you’ll have to wait longer for care…
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Based on current evidence, expanding these services is the right thing to do. Image from shutterstock.com

A rational expansion of breast cancer screening

By Stephen Duckett, Grattan Institute

In the ninth part of our series Health Rationing, Stephen Duckett examines the government’s decision to extend the breast cancer screening program. As one of many pre-budget teasers, Health Minister…
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Health rationing assessments compare different aspects of health such as pain, anxiety, mobility and social interactions – but what’s more important? Image from shutterstock.com

Comparing apples, pears and hips: health rationing at work

By Richard Norman, University of Technology, Sydney and Rosalie Viney, University of Technology, Sydney

In the seventh part of our series Health Rationing, Richard Norman and Rosalie Viney explain the controversial system governments use to decide what will and won’t be covered under Australia’s universal…
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The health budget isn’t limitless: decisions have to be made about to how to allocate funding between competing choices. AAP/Dave Hunt

Health funding under the microscope – but what should we pay for?

By Mark Mackay, Flinders University

In the sixth part of our series Health Rationing, Mark Mackay examines the latest think tank blueprint to rein in Australia’s rising health costs. But he warns that before funding models are adjusted…
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The current fee-for-service model makes it difficult to contain costs and boost the quality of care. Image from shutterstock.com

Phase out GP consultation fees for a better Medicare

By Peter Sivey, University of Melbourne

In the fourth part of our series Health Rationing, Peter Sivey explains why it might be time to abandon Medicare’s fee-for-service model. Teachers aren’t paid a fee for each lesson they teach, nor are…
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We need a more rational debate about how and where we spend our finite health budget. Image from shutterstock.com

Explainer: what is health rationing?

By Anthony Scott, University of Melbourne

HEALTH RATIONING – a series which examines Australia’s rising health costs and the tough decisions governments must make to rein them it. Any mention of the “R” word in health care immediately brings…
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The biggest and fastest-growing spending category in health is hospitals. Image from shutterstock.com

Tough choices: how to rein in Australia’s rising health bill

By Stephen Duckett, Grattan Institute and Cassie McGannon, Grattan Institute

With health costs rising and costly medical innovations on the horizon, it’s crunch time for health funding. In the lead up to the May budget, The Conversation’s experts will explore the options for reining…
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Research should be routinely performed as part of health-care delivery. Image from shutterstock.com

Don’t bury the benefits of research to improve the health system

By Stephen Leeder

If you missed the release of the McKeon review on Friday you’re not alone. The Commonwealth government released the Strategic Review of Health and Medical Research just before the weekend – a time usually…
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The recent rise in the number of GPs could be welcomed as addressing the shortage. Image from shutterstock.com

Is the national doctor shortage a myth?

By Peter Sivey, University of Melbourne and Anthony Scott, University of Melbourne

Monash University demographer Bob Birrell is quoted in today’s Australian newspaper as saying the national doctor shortage is “a myth”. He points out a large recent increase in the number of GPs, a rise…
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Anaesthetist James Latham Peters transmitted the virus to his patients after he injected himself with the drug fentanyl. Image from shutterstock.com

How was a drug-addicted doctor with hep C able to infect his patients?

By Moira Sim and Eric Khong

Fifty-five women contracted hepatitis C after having abortions in Melbourne between 2008 and 2009. James Latham Peters, an anaesthetist with a drug dependence, has been prosecuted in Victoria for infecting…
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Health Minister Tanya Plibersek (centre) announced the Commonwealth would pay the $107 million directly to hospitals. AAP/Julian Smith

Medi-muddle: hospital funding fight is resolved but the blame game goes on

By Stephen Duckett, Grattan Institute

After months of battle between the Commonwealth and Victorian governments on hospital funding, Federal Health Minister Tanya Plibersek dramatically intervened last Wednesday by announcing a A$107 million…
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Even if the potential donor is registered with the Australian Organ Donor Register, the family may still veto donation. Flickr/cabbit

Organ donation boost requires action, not just talk

By Dominique Martin, University of Melbourne

Yesterday marked the beginning of DonateLife Week, in which Australia’s Organ and Tissue Authority ramps up efforts to promote organ and tissue donation with a week-long media blitz and program of public…
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Key health policy issues that need to be addressed include co-payments, private health insurance and resource allocation. AAP/Alan Porritt

Clear thinking needed on election health priorities

By Ian McAuley, University of Canberra

There was a time when health policy involved intense ideological conflict along partisan lines. In the 1940s, the Chifley government fought all the way to a constitutional referendum to introduce subsidies…
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Taxpayers should get something in return for their investment – good doctors, where they’re needed. UoNottingham

Medical intern crisis won’t be solved with just more hospital places

By Stephen Duckett, Grattan Institute

Almost two hundred medical students from diverse countries have just finished their medical education as full-fee-paying students. They’re now looking for the one year of employment (internship) they need…
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Pathology service providers should be encouraged to adopt a code of conduct similar to that of Medicines Australia. Waiting room image from shutterstock.com

Small step for transparency in medicine but what about pathology?

By Bruce Baer Arnold, University of Canberra

You’ve probably given little thought to the slip of paper your GP hands you when she sends you off for a blood test. After all, you’re likely to have more important things to worry about. But the next…
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It’s time to rethink Australia’s specialist-driven health workforce and rise to the challenge of chronic disease management. Hands image from shutterstock.com

Hike in health costs should prompt workforce rethink

By Peter Brooks, University of Melbourne

Data released recently by the Australian Institute of Health and Welfare shows the nation’s health care bill is rising rapidly, from $77.5 billion in 2000-2001 to $130 billion in 2010-11. The largest increases…
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All available evidence tells us that more investment is needed in preventive health – not cuts. angelsk

Brace yourself for a fatter, unhealthier Queensland after health promotion cuts

By Amanda Lee, Queensland University of Technology

Queensland appears intent on dismantling its public and preventive health services. Health Minister Lawrence Springborg last week outlined the rationale for getting rid of more than 150 jobs in nutrition…
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A new review of international studies shows up to 62% of lab tests and 36% of radiology tests aren’t reviewed by doctors. It is believed the rate may be similar in Australia. Waiting room image from shutterstock.com

Medical test results – why no news doesn’t mean good news

By Joanne Callen

In health care, communication can be a matter of life or death. Take the case of an American woman diagnosed with a blood clot in her leg. She died suddenly of a pulmonary embolism the following day, while…
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Political responses to obesity have been more about creating a spectacle of “doing something” than solving the problem. Bruce A Stockwell

Why we’re losing the battle of the bulge: the politics of obesity prevention

By Phillip Baker

There’s no doubt that obesity has received considerable political attention over the past decade. But data recently released by the Australian Institute of Health and Welfare shows Australians are losing…
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With limited support for public dental care, most Australians bear the open-ended costs of high-expense treatments. massdistraction

Moving beyond patchwork reform for dental health

By Ian McAuley, University of Canberra

The Commonwealth’s government’s $4bn Dental Reform package, announced last week, promises to address many current inequities in access to dental care. It has been praised for its potential to reduce dental…
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Health-care budgets are far from infinite, so how do we decide what’s funded and what’s not? stumayhew

Who deserves more health-care funding? Let’s hear from Australians themselves

By Terry Flynn, University of Technology, Sydney and Joffre Swait, University of Technology, Sydney

Health-care reform in industrialised countries is usually motivated by ageing populations, shaky economic conditions and shifting demographics. Health budgets are finite, so decisions must be made about…
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Relying on FIFO health-care workers is expensive and can end up disempowering local providers. AIA web team

Fly-in, fly-out heath care fails remote Aboriginal communities

By Stephen Duckett, Grattan Institute

This is a story about two small Aboriginal communities in the Gulf region of North Queensland: Mornington Island and Doomadgee. They share two key characteristics with many other remote communities: very…
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The poor suffer the greatest burden of disease but are less able to deal with the costs. Brooks Elliott

Next steps in health care reform

By Tim Usherwood

Australia is facing an epidemic of chronic lifestyle-related diseases, including type 2 diabetes, heart disease, stroke and chronic lung disease. We have many treatments for these that aren’t necessarily…
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New Zealand wants to largely be tobacco free by 2025; Finland has set 2040 as its target date. Iago A R

Should we set a date for a tobacco-free Australia?

By Craig Dalton, University of Newcastle

It’s been 100 years since the first medical textbook identified a link between smoking tobacco and lung cancer. So how strange is it that in 2012 we can walk into Coles and Woolworths and buy cigarettes…
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There are a number of design flaws in the new hospital funding system. xparxy

Why the new way of funding public hospitals won’t work

By Anthony Scott, University of Melbourne and Jongsay Yong, University of Melbourne

The first of July saw the introduction of one of the most important health care reforms for Australia’s public hospitals: national activity-based funding (ABF). Hospitals will now be paid a fixed price…
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Overseas-trained doctors deserve better treatment in Australia but they’re not the solution to rural workforce shortages. syauqee

Overseas-trained doctors can’t fill rural workforce shortages forever

By Peter Brooks, University of Melbourne

The recently released report from the House of Representatives' inquiry into the registration processes and support for overseas-trained doctors highlights some major shortfalls in how Australia’s health…
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We need to rethink our aged care workforce and funding for dementia patients. Alex E Proimos

Improving care for dementia patients in our ailing aged care system

By Steve Macfarlane, Monash University

Last week, Alzheimer’s Australia released a report that was highly critical of the way Australia’s aged care sector responds to the needs of dementia suffers and their families. It’s an issue that demands…
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Current strategies to increase the number of Australian trained medical graduates entering rural practice are not working. Paul Hocksenar

We need new ways to get more doctors into country practice

By John Dwyer

The Australian Medical Association (AMA) is urging the government to consider the establishment of new medical schools in rural and regional areas to boost the number of doctors in the countryside. The…
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Health performance targets can come with unintended consequences. AloneAlbatross

Health targets, indicators and incentives: handle with care

By Jose M Valderas, University of Oxford

The Gillard Government’s health reform legislation passed through parliament without too much fanfare last year, marking the end to the political debates around health reform. Importantly, the legislation…
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A strong health system can balance public and private care – just look at Australia. AAP

Private sector reforms don’t spell the end of the NHS

By Peter Sivey, University of Melbourne and Terence Cheng, University of Melbourne

After a long, painful political and legislative process, the United Kingdom’s Conservative/Liberal Democrat Coalition government has finally been given the green light to proceed with its National Health…
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Almost 90% of the world now has access to drinking water, but there is still a long way to go. barefoot photographers of tilonia/flickr

Is this progress? Watering down the Millennium Development Goals

By Kate Taylor, University of Melbourne

Did you hear about the latest success for the Millennium Development Goals (MDGs)? Don’t be ashamed to say no – most of the world missed it with you. So what happened? You’ll remember that the MDGs are…
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After the election, healthcare reform needs to be a priority for the Queensland government. AAP Image/Dan Peled

Queensland’s top five health priorities this election

By Andrew Wilson

No matter who wins the Queensland election this Saturday, the next premier of Queensland will have to face up to some serious challenges within the state’s health system. There were improvements made…
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Better diets and more exercise could prevent 43,000 cancer diagnoses a year. joshbousel

One in four cancers preventable – but first we need the willpower

By Peter Baade, Cancer Council Queensland; Craig Sinclair, Cancer Council Australia, and Pip Youl, Cancer Council Queensland

Cancer is one of the most common public health threats facing Australians and accounts for nearly one-fifth of the disease burden in this country. The direct cost to the Australian community is approaching…
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Predictions that people will leave private health insurance are unlikely to come true. AAP

Private health insurance means test passes – what now?

By Elizabeth Savage, University of Technology, Sydney

The government finally got its bill on means-testing private health insurance rebates for high-income households through the House of Representatives this morning. Fortunately, the dire predictions about…
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Good dental health is important for overall health – so when will Australia see a national dental scheme? AAP

Healthcare reform in 2012: whose health system is it anyway?

By Peter Brooks, University of Melbourne

As many of us recover from the festive binge of overeating, drinking too much and not exercising enough, spare a thought for the new health minister as she plans for 2012. An exciting agenda looms – will…
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Day 15 of OccupyMN protest that has occupied Minneapolis. Meanwhile corporate greed continues unabated. Fibonacci Blue

Health savings accounts: just another greedy corporate scam

By Thomas Faunce

At a time when the “Occupy Wall Street” protests against corporate greed are proliferating in the United States and around the world, it’s ironic to read the floating of yet another corporate “get-even…
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Current fee-for-service payments for doctors don’t reward quality care. Flickr/larique

Should doctors be paid to keep patients healthy?

By Peter Sivey, University of Melbourne

Going to the doctor is, in many ways, like visiting a car sales yard. The customer has a limited knowledge of the product and the supplier may have a financial incentive to over-service or overcharge…
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Older people are finally being consulted about the type of care they need. EPA/Diego Azubel

Ask the elderly what they need, not the care industry

By Hal Kendig

Australia’s population is ageing, presenting an economic challenge to look after the most vulnerable members of our society. The Productivity Commission released a report last month recommending a complete…
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Bringing research, education and health care delivery together will improve patient care.

Explainer: why Australia needs Advanced Health Research Centres

By Peter Brooks, University of Melbourne

In an attempt to bring Australia’s medical research, education and healthcare sectors into line with world leaders, the National Health and Medical Research Council (NHMRC) is planning to develop a new…
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Four year-old Ayen Chol died after being attacked by a neighbour’s pit bull cross (AFP PHOTO/William WEST)

Breed blame-game: banning Pit Bulls won’t work

By Linda Watson, Monash University

The recent death of four year-old, Ayen Chol from a pit bull attack has again prompted calls to ban the breed. But instead of focusing on a particular breed, or responding to single events as they occur…
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If health and water reform are anything to go by, COAG is in for a challenge.

The rocky road to a national disability insurance scheme

By Alex Collie, Monash University

The stakes are high for today’s Council of Australian Government (COAG) meeting in Canberra, as it decides how to respond to the Productivity Commission’s report into disability care and support in Australia…
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A test case is slated to challenge Myriad’s claim for breast cancer genetic mutations next February. TheAlieness GiselaGiardino²³/Flickr

Patent controversy: don’t let breast cancer gene genie out of the bottle

By Luigi Palombi

The US Court of Appeals for the Federal Circuit has found Myriad Genetics is entitled to patents on two sets human genetic mutations used to predict if women have an increased risk of breast and ovarian…
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Federal governments should fund pharmaceutical research and development. AAP

Patent controversy: it’s time Big Pharma took its medicine

By Philip Soos, Deakin University

Over the last couple of decades, the pharmaceutical industry has come under attack for its perceived shortcomings amid claims that it’s greedy, profiteering nature has caused significant harm. However…
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Preventive health is the the biggest loser in the health deal. AAP

Can we now close the book on health reform? Not quite

By Philip Davies

The deal’s been done and health reform is in the bag. It may not be quite as bold as originally planned by then prime minister Rudd – there’s even been a fair amount of watering down on Julia Gillard’s…
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Home help is much more effective than written instructions from a doctor.

Why home help is the best bang for our health buck

By Janet McCalman, University of Melbourne

The new Victorian Health Plan 2012-22 offers a bleak prognosis: forever rising medical costs, doctors in the wrong places, hospitals overwhelmed. To make matters worse, it claims that patients can’t be…
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The government has made a mistake by not listing pain drug Targin on the PBS. J Hawk

Scrimping on pain drugs is bad medicine and worse economics

By Michael Vagg, Barwon Health

In an attempt to contain growing health costs, the Australian Government has resisted recommendations to subsidise the pain medication Targin on the Pharmaceutical Benefits Schedule. Not only is this…
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Achieving equity is less about grand gestures than meeting the actual needs of Indigenous Australians. Sorry by butupa/Flickr

Playing number games with Indigenous Australians' health

By David Paul, University of Western Australia

The Australian Institute for Health and Welfare (AIHW) has released its latest report on how much money the Commonwealth and State governments spend on the health of Indigenous Australians. Despite being…
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More data on the effects of alcohol and energy drinks is needed to inform policy. loop oh/Flickr

Alcohol and energy drinks: too early to make bleary-eyed policy calls

By Amy Pennay, Monash University

The Australian Medical Association (AMA) has called for a ban on the sale of pre-packaged alcoholic energy drinks based on recent research, echoing a similar call for bottle shops to stop selling pre-packaged…

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