Lesley Russell

Five years in the making, the Final Report of the Medicare Benefits Schedule (MBS) Review Task Force was quietly released last week. Associate Professor Lesley Russell outlines the wide-ranging findings and how they are likely to shape the future of the MBS.

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We urgently needed healthcare reforms :better workforce planning: more equitable workforce distribution,more efficient workforce utilisation,improved workforce productivity and financing reforms to sustain these changes. We call for the restoration of an independent health workforce agency to drive this essential work.

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Social prescribing acknowledges that the provision of holistic, patient-centred healthcare must move beyond a medical model and consider the wider social determinants of health. Link workers can provide personalised support to help patients identify and achieve health and wellness goals and linkage into appropriate community services.

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The social and economic impacts of the coronavirus pandemic are driving more people to substance abuse while also limiting access to prevention, treatment, support and rehabilitation – services already in short supply. Without immediate actions, the consequences will be felt for years to come.

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What have we learned from the coronavirus pandemic that can inform and drive reforms to Australia’s health care system?

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In normal, pre-coronavirus pandemic times, we would have expected to see the details and funding for the 7th Community Pharmacy Agreement announced in the May federal budget. But the new agreement, expected to cost some $20 billion over five years, is being negotiated behind closed doors and out of public view.

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In the United States there are serious problems with the adequacy and appropriateness of the health measures to control coronavirus and its impact. (more…)

The crisis in Emergency Departments is causing harm to patients and staff, and transformative health system re-design is urgently needed. (more…)

Medibank has announced that it will become Australia’s first private health insurer to make potential out-of-pocket (OOP) costs publicly available in a move to shore up public trust, after winning a ‘Shonky’ award from consumer group Choice for “junk” policies that “cost more and deliver less”. (more…)

The impacts of drought and climate change on health and wellbeing are threatening to increase the growing gap in health status between Australians who live in metropolitan and rural areas. Yet the Morrison Government and its National Party partners have lost focus on rural health, they have failed to focus on a national drought strategy and are international laggards in climate change action. Rural families and communities are suffering as a result.

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It is unfair and poor public policy that mortality and morbidity rates in rural Australia are significantly worse than those in metropolitan areas. There is an urgent need for a National Rural Health Strategy, accompanied by a sustained increase in funding, workforce and other resources, to address this growing health and healthcare disparity.

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Reducing patients’ out of pocket (OOP) costs is a major issue for the health policy agenda. But what are the chances that solutions to provide real relief for patients will emerge?

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The past week has seen a series of media articles about how some people must fund raise to cover the cost of expensive brain cancer surgery and a paper released from the Actuaries Institute, How to Make Private Health Insurance Healthier, that highlights (yet again) the needed reforms to Australia’s private and publicly funded healthcare. Together they highlight the need to reign in the free marketplace that is specialist medicine in Australia and that is costly to both Medicare and private health insurance.

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This year’s Government budget documents and the Opposition’s response are budgetary in name only – they should be seen as election campaign commitments. As such, they provide a telling story about the parties’ focus on health and healthcare and the underlying political ideologies.   (more…)

LESLEY RUSSELL. Can Primary Health Networks (PHNs) Drive Needed Primary Care Reforms?

A strong primary care system is essential to the equity, efficiency and effectiveness of the healthcare system and for improvements in health outcomes. However, the structure and funding of primary care has not kept pace with changes to disease patterns, the economic pressures on the healthcare system, workforce needs and evidence about the impact of social factors on health. In a paper recently published with my colleague Dr Paresh Dawda, we analyse the current operations and funding of Primary Health Networks and explore whether they are fit-for-purpose to drive and foster primary care reforms.

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Hidden in a pack of draft reports from the Medicare Benefits Schedule (MBS) Review Taskforce that were released by the Morrison Government without fanfare just before Christmas are a series of recommendations that, if effectively funded and implemented, could begin the long and difficult task of reforming Australia’s primary care system. (more…)

The 2018 version of the Australian Atlas of Healthcare Variation was released on December 11.  This is the third such annual atlas, which examines differences in healthcare use according to where people live within Australia and is produced by the Australian Commission on Safety and Quality in Health Care in partnership with the Australian Institute of Health and Welfare. This year it looks at healthcare use in four selected clinical areas: paediatric and neonatal health; cardiac tests; thyroid investigations and treatments; gastrointestinal investigations and treatment. Specific recommendations for improvements are made. There are interactive features available.  (more…)

The Victorian Government’s election commitment to a $395.8 million program to provide free dental care to schoolchildren will be welcome in a state where affordable and timely access to dental care is increasingly difficult. It’s time for a concerted campaign to ensure that improved access to dental care and better prevention initiatives are on the agenda for the upcoming New South Wales and federal elections. Governments must be persuaded that their failure to see oral health, dental services and caries prevention as essential components of health care is a false economy. (more…)

None of the “wicked’ problems in health – obesity, mental illness and suicide, chronic illness, ageing – will be solved with just hospitals, doctors, nurses and prescription pads. They all require resources beyond those provided by the health care system. That’s not news; there are very few health professionals who deny the impact of the social determinants of health on health outcomes and health care costs and the importance of linking into social services. The challenge is how to achieve this. In essence – how do we move the focus from general practice and primary care to primary health care? (There is a difference: see Primary care vs Primary health care: and who cares?)  (more…)

The noisy public debate about patients’ out-of-pocket costs and their consequences reaches a crescendo when it comes to oral health and dental care. (more…)

In a piece published in the Medical Journal of Australia in December 2014, I called for an end to the artificial medical/dental divide. At the same time, writing in The Conversation, I outlined six first steps towards the better integration of dental and medical care to improve health outcomes and contain overall health care spending. My thoughts then are applicable today, especially in light of additional data and information that has emerged over the past three years. (more…)

Governments have yet to create a coherent strategy to help the almost three million Australians providing informal care. (more…)