Australian Health Care Reform Alliance

24/07/2025

A threat to our health - climate inaction clarified by the ICJ

While some politicians continue to downplay the urgency of responding to climate change, the International Court of Justice (ICJ) has just delivered a landmark ruling.

Countries may now be sued for failing to act on climate change. This isn’t just about polar bears or rising seas—it’s about human lives. AHCRA has long recognised that climate change is an integral determinant of health and advocated for 'health in all policies'.

Why does this matter for health?
The ICJ has carried out extensive research in reaching its decisions, informed by voluminous evidence of the growing risks to health posed by climate change:
- More extreme heatwaves - deadly heat stress, especially for the elderly and vulnerable.
- Worsening air pollution - impacting those with asthma, heart disease, and lung damage.
- Expanding disease zones - vector-borne illnesses like dengue and malaria reaching new areas.
- Food and water insecurity - malnutrition, displacement, and conflict.

The ICJ has ruled that a "clean, healthy, and stable environment" is a human right, meaning governments that drag their feet on climate action could be breaking international law.

Key takeaways from the ~500-page ruling:
- Countries must cut emissions and protect people from climate harm.
- Wealthier nations must lead the way in reducing pollution.
- Failure to act has legal consequences, including compensation for harmed nations.

This is a wake-up call for climate deniers and delayers. Our health—and our future—depends on real action.

ABC News Coverage: https://tinyurl.com/4hjms2kp
ICJ Latest Developments: https://www.icj-cij.org/case/187
Full Ruling: https://tinyurl.com/hzs2v9dd
Summary: https://tinyurl.com/3f9bdyp5

The science is clear. The law is now clear. It leaves no option.
It's time for our leaders of all political persuasions to act accordingly if they value our future.

The opinion of the International Court of Justice is seen by some as a turning point in international climate law, with judges finding that states affected by global warming could be eligible for reparations.

11/07/2025

Time to put Oral Health in Medicare!

The Deeble Institute issues an important new report on oral health. https://tinyurl.com/4tn3xxe3

Cost should never be a barrier to good oral health. Yet, right now, oral healthcare is the second-highest out-of-pocket health expense in Australia, forcing 1 in 5 adults to delay or skip treatment because they can’t afford it. https://tinyurl.com/78kdc7up

As AHCRA has highlighted before, Medicare must evolve to include dental care, because your mouth is part of your body, and your health shouldn’t stop at your teeth. https://tinyurl.com/mezz9bc4

While targeted programs help some, we need a fairer, universal approach that defines essential oral healthcare (as the WHO recommends) and integrates it into our public health system. https://tinyurl.com/3t2d37hy

The solution according to Deeble?
- Reform payment models to slash out-of-pocket costs.
- Expand Medicare with staged, evidence-based funding—starting with priority groups and moving toward universal coverage.
- Use health technology assessments (HTA) to ensure public funding goes where it’s needed most. https://tinyurl.com/4c967u4c

The new federal government has a mandate and an opportunity to do better. Let’s continue to push all parties to support Medicare-funded dental care, because equity in health starts with access. Oral health IS health!

06/07/2025

Vaccines save lives

Australia released a National Immunisation Strategy 2025–2030 in June 2025. https://tinyurl.com/32jw7s2k

Immunisation saves lives - it’s one of the greatest public health achievements in history. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the U.S.

They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papillomaviruses.

Recent scientific advancements enabled the accelerated development, production, and evaluation of COVID-19 vaccines, estimated to have prevented approximately 1.6 million hospitalisations and 235,000 deaths in the U.S. alone.

Australia’s National Immunisation Program (NIP) is a global leader, providing free, life-saving vaccines to those most at risk—from infants to older Australians, Aboriginal and Torres Strait Islander communities, and people with medical vulnerabilities.

Thanks to strong policies, we’ve also contributed to the elimination of diseases like polio, measles, and rubella.

But while Australia is expanding access, equity, and trust in vaccines, the U.S. appears to be moving in the opposite direction. Recent court rulings and state policies have weakened childhood vaccine requirements, risking outbreaks of preventable diseases. https://tinyurl.com/6resavbb

Where Australia invests in community co-design, data-driven strategies, and workforce strengthening, some U.S. states are rolling back decades of progress, putting politics over public health. https://tinyurl.com/3af855ar

Australia’s plan for 2025–2030 focuses on:
- Equity: Closing gaps in access for First Nations and vulnerable groups
- Trust: Combatting misinformation with community-led strategies
- Innovation: Harnessing new vaccine technology and better data use
- Leadership: Aligning with WHO goals for pandemic preparedness

The contrast is stark: Australia is building herd immunity as parts of the U.S. are losing it. As Australia launches this new strategy, AHCRA urges strong support for science, equity, and smart policy that protects the health of everyone.

02/07/2025

Aotearoa NZ Rural Urgent Care Review Report – Key recommendations unveiled

The long-awaited Rural Unplanned Urgent Care (RUUC) review report has been released, outlining key recommendations to improve urgent and after-hours care for rural communities in Aotearoa.

Led by Health NZ and ACC, with input from rural clinicians, Māori health providers, and sector experts, the RUUC report highlights the stark inequities rural whānau face in accessing timely healthcare.

Key findings include:
- Urgent Care Clinics (UCCs) are overwhelmingly urban-based, leaving rural areas underserved.
- Rural communities often rely on a single provider for primary, urgent, and emergency care – requiring more tailored support.
- Uneven access to medicines, point-of-care testing, and essential equipment puts rural patients at a disadvantage.

Major recommendations include:
- Setting minimum service standards for rural urgent care.
- "Rural-proofing" national health contracts to better meet rural needs.
- Improving ambulance response times and integrating PRIME services.
- Expanding access to critical medicines and diagnostics (like point-of-care testing).
- Better patient data sharing and transport pathways to ease pressure on ambulance services.

While the report has been criticised because it doesn’t include costings, the intention is for most recommendations to be rolled out under the New and Improved Urgent & After-Hours Care Framework over the next two years.

Read the full report here: https://tinyurl.com/y7wa3jv2
Recommendations as a Flipbook: https://online.fliphtml5.com/eeyoy/ykfl/

This is a big step toward fairer healthcare for rural NZ, with significant implications for practitioners, the ambulance services, rural clinics and PRIME providers.

The RUUC recommendations could have implications for Australian medical, nursing, allied health and paramedic practitioners, given the Trans-Tasman Mutual Recognition Arrangement and workforce mobility between the two countries.

The RUUC's emphasis on integrating PRIME services and expanding paramedic roles in rural communities may inspire similar innovations like the Sandpiper and Rural Emergency Responder Network (RERN) in Australia:
Australian rural health services could adopt modified versions of NZ's integrated urgent care
The success of extended care paramedics in NZ general practices may prompt Australian health clinics to consider similar team expansions
Shared learning opportunities may emerge regarding point-of-care testing and access to medicines in rural settings.

Policy and funding considerations
While the RUUC report lacks detailed costings, its recommendations around "rural-proofing" health contracts and setting minimum service standards could:
Influence Australian rural health policy
Provide evidence for funding models in Australia's rural health system
Encourage collaboration on rural health service benchmarks

Indigenous health parallels
The RUUC's engagement with Māori health providers offers potential lessons for:
Improving urgent care for Australia's First Nations communities
Developing culturally safe models of rural emergency care
Enhancing Indigenous workforce development strategies.

Overall, these developments mean Australian observers should monitor which elements prove most effective, assess how workforce shortages in NZ rural practices impact the reforms, and consider whether the models that emerge are financially sustainable and enhance patient care.

These recommendations may indirectly shape rural health discussions in Australia. However, geographical, population density, and health systems differences mean any Australian adaptation would require careful local modification.

26/06/2025

The Dawson Review: Fixing Australia’s health regulation system

Australia’s health practitioner regulation system is set for major reforms, with the Dawson Review final report due in July 2025.

Led by former NSW Health Care Complaints Commissioner Sue Dawson, the review tackles long-standing inefficiencies, delays, and inconsistencies in the National Registration and Accreditation Scheme (NRAS).

Following extensive consultations, key issues identified include:
Bureaucratic inefficiencies – Slow, outdated processes frustrate practitioners and patients alike.
Fragmented oversight – National Boards work in silos, creating inconsistent processes and variable standards.
Broken complaints system – 85% of notifications go nowhere, yet can significantly damage careers.
No clear strategy – Ad-hoc responses to challenges like telehealth and AI.

Proposed Dawson reforms:
- Single-entry complaints system – faster resolutions with strict timelines.
- Unified regulation for all health workers – less duplication, clearer accountability.
- Modernised governance – balancing profession-specific expertise with efficiency.
- Stewardship model – centralised oversight to improve transparency.

Medical groups like the AMA and RACGP have backed the reforms, citing excessive delays and the harm to practitioners.
Ahpra's new CEO Justin Untersteiner has welcomed the proposed Dawson recommendations, stating they align with the agency’s reform agenda. https://tinyurl.com/4y8xdan7

He acknowledged the need for faster, fairer complaints resolution and pledged to:
- Review all notifications older than 12 months.
- Invest in a complaints navigator service.

What’s Next?
Health ministers will decide on implementation and prioritisation, with the challenges including funding, legislation, and balancing the speed of resolution with patient and practitioner safety.

This is an opportunity to improve a system that at times has been found to fail both health workers and patients.

Dawson Review Consultation Paper 2: tinyurl.com/5h87xw3c
Ahpra’s Reform Agenda: tinyurl.com/4zx3vevm

15/06/2025

Australia’s specialist care crisis – high costs or long waits?

Millions of Australians are forced to make an impossible choice: pay hundreds of dollars for a specialist appointment or wait months—even years—for urgent care.

A new report by the Grattan Institute reveals the dire state of specialist healthcare, with fees skyrocketing by 73% since 2010. Individual visits can cost hundreds of dollars which quickly adds up if you need to see many specialists for a chronic disease, such as complex diabetes, or to visit the same psychiatrist many times.

On average, patients who pay a fee are charged $300 a year. Even poor people can face huge costs. One in 10 low-income patients who are billed pay almost $500 a year.

Key findings from the report include:
- 1 in 5 patients face "extreme fees" (3x the Medicare rate), with psychiatrists charging up to $670 for a first visit.
- Nearly 1 million people delay or skip care due to costs, risking worse health outcomes and putting pressure on hospitals.
- Public clinics, which provide only 1/3 of specialist care, have wait times exceeding clinical guidelines, especially in underserved areas.

The report suggests several solutions:
1. Train more specialists, especially in high-demand fields and to service rural regions.
2. Invest $500M/year in public clinics to reduce the "postcode lottery" of care.
3. Crack down on extreme fees by stripping Medicare rebates from overcharging doctors.

The ABC media highlights that experts warn the system is "broken" and needs better transparency to protect patients. Without action, fees and waits will only grow as our population ages.

The full Grattan Institute report: https://tinyurl.com/uwn4c8t7
ABC coverage: https://tinyurl.com/6kwmkh5k

15/06/2025

The hidden cost of cancelled science grants

In a must-read investigation, ProPublica exposes how the Trump administration’s sweeping cuts to the National Institutes of Health (NIH) funding are derailing critical medical research, impacting treatments for Alzheimer’s, HIV, COVID-19, and more.

The NIH is responsible for over 80% of the world’s grant investment in biomedical research. Its funding has sparked countless medical breakthroughs — on cancer, diabetes, strokes — and plays a fundamental role in developing pharmaceutical drugs.

Nearly every FDA-approved drug in the last decade relied on NIH-backed science. Now, lifesaving studies are being abruptly shut down, leaving patients in limbo and wasting millions in taxpayer dollars.

The human toll is dramatic and concerning. Researchers describe the anguish of losing decades of work. One expert calls it "state-sanctioned dehumanisation."

Read the full story to understand what’s at stake, and how these cuts could affect you or someone you love even here in Australia. Shattered Science: The Research Lost as Trump Targets NIH Funding https://tinyurl.com/bddtb9d8

Share your story and observations on the potential impacts in the comments or reach out to policymakers as needed.

The Trump administration cut research funding that sought cures for future pandemics, examined the causes of dementia and tried to prevent HIV transmission. More than 150 researchers shared with ProPublica what is being lost.

13/06/2025

Climate-related risks to health

With 2024 confirmed as the hottest year on record, the World Health Organisation (WHO) has issued a stark warning: the climate crisis is also a health crisis, and it’s already claiming lives. https://www.who.int/europe/groups/pan-european-commission-on-climate-and-health

These documents summarise key evidence relevant to the climate change threats to human health in the WHO European Region. They provide key messages about the converging and interconnected climate-induced health risks, the implications of reaching climate tipping points and the health implications of inaction.
https://www.who.int/docs/librariesprovider2/default-document-library/pecch-background-paper-web.pdf
https://www.who.int/docs/librariesprovider2/default-document-library/pecch-brochure-rev_pub.pdf

They are the first of a series of short thematic briefs developed for the Pan-European Commission on Climate and Health (PECCH), which has been convened by the WHO Regional Office for Europe to accelerate decisive climate action that protects and promotes health.

The technical issues raised apply across the board and Australians will be affected in a similar way by the effects of climate change.

07/06/2025

Private health insurers are failing both patients and hospitals

The private health insurance (PHI) industry is playing a dangerous game, spinning numbers to make it look like they’re doing the right thing, while hospitals close and patients suffer writes Brett Heffernan, CEO of the Australian Private Hospitals Association. https://tinyurl.com/ysx9hhty

The Reality?

Insurers are paying a shrinking share of premiums to hospitals – now just 80.7%, down from the traditional 88% benchmark.

20 private hospitals have already shut down, with 8 more at risk. Vital services like maternity and mental health units are being axed.

Meanwhile, insurers are raking in $2 billion a year in profits and $3.5 billion in "management fees" – all while underpaying hospitals by over $1 billion annually.

Toowong Private Hospital is the latest casualty – a leading mental health facility closing its doors amid a mental health crisis, thanks to insurers refusing to pay fair rates. https://tinyurl.com/mjzfcmsp

Enough is enough. Health Minister Mark Butler gave insurers 3 months to fix this – but nothing has changed. It’s time for the government to step in and force insurers to pay their fair share.

Australians deserve better than a system where insurers profit while patients lose access to care. It’s time to hold them accountable.

Toowong — a 58-bed acute private psychiatric hospital, treating more than 3000 patients a year and employing 154 specialist staff — will close from 11 June.

05/06/2025

Systems thinking for real change

A recent Victorian Ministerial review reinforces the need to move beyond isolated pilot projects and ad-hoc workforce fixes. The report identifying critical themes impacting the healthcare workforce, was released with little fanfare but has implications for all health workers including Allied Health Professionals (AHPs).

Healthcare systems worldwide are under immense pressure. The COVID-19 pandemic exposed critical gaps in primary healthcare (PHC) and multiple Parliamentary Inquiries across Australia have underscored the need for resilient, adaptable models of care.

The Australian Government Unleashing the Potential of our Health Workforce study of the Health Workforce Scope of Practice drew attention to the impediments to practice and the opportunities for reform. https://tinyurl.com/59kd6twr

These reports, including the OECDS's Realising the Potential of Primary Health Care, highlight that strengthening PHC is one of the most effective ways to improve patient outcomes and system sustainability—reducing hospitalisations, addressing inequities, and better managing chronic diseases and longer-term care. https://tinyurl.com/49nrzwy6

Yet, workforce shortages and care bottlenecks persist. Rural and regional areas struggle with recruitment and retention of staff while the opportunities for mobilising AHPs and paramedics throughout the health system are commonly overlooked.

The Victorian panel review identified 14 key challenges, including:
- Overreliance on locum and international medical graduates
- Burnout from excessive overtime and poor rostering
- Bullying, discrimination, and lack of job security
- Inflexible training pathways and workforce maldistribution.

These issues aren’t isolated to medicine and nursing - they affect allied health where workforce potential remains underutilised and embedded barriers remain.

This latest report offers 15 recommendations for better mobilising AHPs within a modernised system of health. It's a holistic view of the workforce that AHCRA supports.

The Victorian review proposals include:
- Expanding Roles in Primary and Multidisciplinary Care.
The CSIRO’s Our Future World report (2022) identified megatrends such as aging populations, digital disruption, and climate change, that demand a shift toward preventive, community-based care.

AHPs are well-positioned to fill gaps in chronic disease management and rural and remote healthcare (e.g., community paramedics and AHPs delivering telehealth and rehabilitation).

Other opportunities are palliative care and emergency-to-community care transitions (e.g., social workers coordinating post-discharge support).

Yet, systemic barriers and regulations from an earlier era restrict these developments with rigid funding models, fragmented digital systems, and professional silos that limit their impact.

- Workforce flexibility and policy reform
The Victorian review’s Recommendation 6 calls for greater use of nurse practitioners, AHPs, and new roles like "Assistants in Medicine" to reduce physician workload. Similarly, Recommendation 14 urges a 10-year workforce plan integrating new models of care, technology, and multidisciplinary teams.

This aligns with widespread calls for: harmonised scopes of practice (letting AHPs work to their full potential), better pay and conditions to retain rural staff and embedding them in PHC funding structures.

- Preparing for Future Shocks
Alvin Toffler’s Future Shock warned that rapid change leads to systemic breakdown if institutions don’t adapt. Healthcare is no exception. Australia’s Intergenerational Report is clear in forecasting an aging population with a higher chronic disease burden, climate-related health crises (heatwaves, floods, infectious diseases); and digital health disruption (AI diagnostics, telehealth, and remote monitoring).

AHCRA welcomes the Victorian Ministerial Review as a step towards better integration of national health workforce strategies. We must move beyond isolated pilot projects and ad-hoc workforce fixes.

Lasting reform requires policy Integration that embeds paramedics/AHPs in PHC funding and planning; workforce modernisation that acknowledges more flexible roles, better rural care incentives, and career pathways; and seamless digital systems enabling team-based care.

As the Victorian review shows, small fixes (like fractional pay parity) matter, but only if aligned with a bigger vision. As the Victorian recommendations suggest, let’s build a system where all health professionals work at full scope, in sustainable models, for the patients who need them the most.

Access the Victorian Medical Workforce Reform Report 2024 here: https://www.health.vic.gov.au/publications/victorian-public-sector-medical-staff-workplace-systems-employment-arrangements

04/06/2025

Australia’s Mental Health Crisis: It’s Time for Change 🚨

This week, ABC’s 4 Corners program exposed the dire state of NSW’s mental health system. But Sebastian Rosenberg, Associate Professor, Health Research Institute, University of Canberra, and Brain and Mind Centre, University of Sydney outlines that the crisis is national.

Patients in severe distress wait days in emergency departments, while underfunding and misplaced resources leave thousands without proper care.

Decades ago, Australia moved away from institutional mental health care, promising community-based support. Instead, patients have been funneled into overcrowded hospitals and EDs, which are expensive, traumatic, and ill-equipped for long-term recovery.

That also leads to the very public bottleneck of ambulance ramping which has seen parliamentary inquiries across several states.

The result? Half a million Australians with moderate to severe mental health needs can’t access the requisite help. Recovery isn’t just about medication—it’s about housing, stability, and dignity.

Solutions exist, but we’re not using them:
- Community-based care (like Adelaide’s 24/7 Urgent Mental Health Centre) reduces ED reliance.
- Psychosocial support (housing, employment aid) is critical—yet receives just 6% of mental health funding.
- Multidisciplinary teams (doctors, nurses, community paramedics, peer workers) can provide holistic care—if properly funded.

Sebastian suggests we need:
- Governments to prioritise community care over hospitals.
- Funding for early intervention and alternatives to EDs.
- Accountability to ensure resources reach those who need them most.

Mental health care shouldn’t be a crisis - and in the coming parliamentary term we look forward to Minister Butler and his team taking more resolute action for systemic change.https://theconversation.com/people-with-severe-mental-illness-are-waiting-for-days-in-hospital-eds-heres-how-we-can-do-better-257971

28/05/2025

Delivering quality care – have your say on care reforms

In November 2024, the Australian Treasurer spoke to Australian Business Economists about plans to boost productivity and build a stronger economy. The Treasurer outlined objectives to tackle long-term challenges with five productivity pillars, including Pillar 4: Delivering Quality Care More Efficiently. https://tinyurl.com/3huz3tcm

Under Pillar 4, the Productivity Commission (PC) is now exploring three key reforms and wants your feedback in these areas:
- Streamlining care regulations – aligning quality & safety rules across aged care, disability & health
- Better integrated care – removing barriers to "collaborative commissioning" so services work together
- Investing in prevention – creating a national framework to reduce future service demand.

These changes aim to deliver higher-quality care, make systems less fragmented and save costs in the long term. They overlap or mirror similar exercises conducted by the Australian Department of Health, Disability and Ageing.

Over recent months, the PC has collated and reviewed ideas from their Productivity Pitch, conducted research, and consulted with stakeholders to identify these policy reform areas under Pillar 4.

For each reform area, they intend to:
- Recommend specific reforms
- Quantify the benefits (where possible)
- Suggest how the reforms can be implemented.

Your insights would assist the PC in this work to ensure these reforms deliver real improvements. The responses through online questionnaires close on Friday 6 June 2025.
https://engage.pc.gov.au/projects/quality-care