The Murder of Medicare in Australia

Labor’s Medicare Locals integrated health care scheme ceased operations on 30 June 2015 when the Abbott Government replaced it with the Primary Health Networks scheme.

The Abbott and Turnbull governments’ grand plan for further ‘reforming’ Medicare service delivery swam into view on News.com.au and other media platforms on 30 March 2016:

SEVEN MILLION people in the country with chronic diseases like diabetes, heart disease and cancer will have to enrol with a single medical practice under a revolution in GP care to be announced by the Prime Minister today.

Patients will get to choose the GP practice that will co-ordinate all of the medical, allied health and out-of-hospital services they need.

And those with multiple chronic illnesses will get a care plan individually tailored to meet their needs.

Instead of paying their doctor a fee for service every time they receive treatment for their chronic illness, the government will give doctors a quarterly lump sum payment to care for the patient.

A fee for service will still be paid when the patient sees the doctor for other illnesses such as the flu or broken bones or other acute illnesses.

And the performance of doctors will be checked by the government via a new information bank that will measure patient outcomes at a local level and highlight areas for improvement.

Malcolm Turnbull says enrolling patients in a single medical home will help keep people with chronic diseases out of hospital by giving them evidence-based treatment.

This it turns out was merely announcing stage one in the introduction of the Health Care Homes model, which in October 2016 saw Prime Minister Turnbull and Health Minister Ley officially announcing the selected regions, based on Primary Health Network boundaries, for Stage One implementation of Health Care Homes. These include: Perth North, Adelaide, Country South Australia, South Eastern Melbourne, Western Sydney, Tasmania, Nepean Blue Mountains, Northern Territory, Brisbane North, as well as Hunter, New England and Central Coast in New South Wales.

The Hunter New England and Central Coast Primary Health Network includes, but is not limited to, the following locations: Armidale ,Bulahdelah, Cessnock, Forster, Glen Innes, Gosford, Gunnedah, Inverell, Moree, Muswellbrook, Narrabri, Nelson Bay, Newcastle, Quirindi, Tamworth, Taree and Tenterfield.

Therefore in NSW the scheme will be initially implemented in three primary health care networks which stretch from western Sydney through to the NSW-Qld border.

By 4 November 2016 this scheme had quietly morphed in right-wing political backrooms into this according to the Herald Sun:

THE nation’s sickest cancer patients and people with diabetes and other chronic illnesses will get a maximum of $1795 worth of GP care a year funded by Medicare under a revolution in the way doctors are paid.

And Medicare will fund just five extra visits to the doctor if these people need medical attention for issues aside from their chronic illness under the Turnbull Government’s Health Care Homes model.

Doctors were expressing deep concern about the adequacy of the payment levels that were released without consultation with medical groups on November 4.

“The modelling is concerning and potentially leaves the whole program at risk of falling over because of being underfunded from the beginning,” AMA vice president Dr Tony Bartone said.

The Health Care Homes policy is a signature government policy which it claims will solve the woes of the Medicare system by providing comprehensive care for one in five Australians who have a chronic illness, keep them out of hospital and save the health system money.

Patients will have to enrol with a single GP practice to get a new form of wrap around health care under the model but Doctors are worried they’ll get less money than they receive now to care for the sickest patients.

Currently doctors are paid on a fee for service model and get paid $37 by Medicare every time they see a patient for a standard 20 minute visit, they get paid more for longer visits.

There are no limits on how many times a patient can see a doctor and get a Medicare rebate.

Under the new model patients with the least complex chronic conditions will get $591 a year worth of GP care, those with a slightly higher level of complexity will get $1,267 worth of GP care and the most complex patients will receive $1795 worth of care.

The sickest 12 per cent of patients account for 40 per cent of Medicare benefits and on average they receive 51 services a year, Dr Seidel said.

The maximum funding under the government’s health care homes model is only enough to cover 48 GP visits a year, or less than one per week.

Dr Seidel says a patient with diabetes and an infected leg would need to visit the GP at least three times per week to get it dressed.

The RACGP had asked the government to provide doctors with an extra $300 per patient per year on top of existing funding to make the new Medicare model work.

The current funding suggests doctors will be receiving less than they currently get.

Dr Bartone said the Health Care Homes model was based on a long standing method of paying GPs for caring for war veterans.

So now we all have a slightly clearer picture of how multi-millionaire Malcolm Bligh Turnbull and his fellow travellers intend to further pervert Medicare’s aim of providing universal health care.

Those with a chronic or complex medical condition will be tied to one general practitioner or medical practice and be restricted as to how many times a year they can see their doctor. Bulk billing is not guaranteed if that is not the policy of the medical practice/GP with which they are enrolled and, if they require more than 48 standard GP visits a year they may possibly be forced to pay the full cost of any additional ‘chronic illness’ visits . As for any other type of illness or injury they might experience – only five extra GP visits a year will be covered by a Medicare rebate [See update below].

At the moment participation on the patient’s part is allegedly voluntary, however if they agree to enter the Health Care Homes scheme they are forced deeper into the Abbott and Turnbull Governments’ insecure national database and ongoing government data retention scheme.

According to the Australian Dept. of Health, enrolment of up to 65,000 patients begins in 2017 and implementation of services delivery begins on 1 July that same year and continues through to the end of stage one on 30 June 2019. During this initial stage, Health Care Homes services will be limited to Medicare-eligible patients with two or more complex or chronic conditions.

Ongoing evaluation and refinement of Health Care Homes is also promised which probably means that, like e-Health aka My Health, the scheme will cease to be opt-in and become opt-out - or possibly even mandatory.

The Turnbull Government intends to fund Stage One of Health Care Homes by redirecting $93 million in MBS funding between 2017-18 and 2018-19 and providing an additional $21.3 million over the next three years to establish the design principles, IT systems and provide the training needed to assist health care providers to transition to the new system.

Thus far, this new scheme appears to offer no enhanced or additional health services to the chronically ill or those with complex medical conditions - it presents as nothing more than another federal government cost-cutting measure wrapped up in a public relation bow.

Stay tuned for the next instalment in the ongoing saga, “The Murder of Medicare”.

UPDATE

Turnbull Government backs down on capping number of extra GP visits for illness or injury not related to patient's chronic or complex medical condition. However, all other Medicare 
limits impacting on health services delivery to chronically ill patients appear to remain.

News.com.au, 9:35pm 8 November 2016:

The cap on doctor’s visits was revealed on Friday when the government announced details of its keystone Health Care Homes trial.

The trial will see 65,000 chronically ill patients in 200 GP practices enrol with a single GP practice for all their health care.

The Health Department revealed doctors would be given an annual budget of between $591 and $1795 a year to care for these patients, a budget doctors say amounts to a pay cut.

And in a fact sheet the Department of Health said:

“Enrolled patients can still access fee-for-service billing for a small number (up to five) of episodes of care not related to a patient’s chronic conditions”.

On Monday, in a tweet, Health Minister Sussan Ley denied there was a cap of five visits.

“No limit to Medicare fee for service under health care homes. 5 appts departmental guide only. Opt in not capitation. Co-designed with docs!”

Mysteriously, and without a new press statement, wording of the department’s fact sheet on Health Care Homes was changed on Monday to remove the five visit rule:

“Enrolled patients can still access fee-for service episodes of care not related to a patient’s chronic condition”.

Yesterday Ms Ley tweeted “Capped visits were never on the table”.

In response to an inquiry a spokesman for Health Minister Sussan Ley said the Department of Health said it had “changed its fact sheet on payment information”.

“The Department amended it to make it clear that there is no hard cap or limit on the capability of GPs to bill MBS services not related to an enrolled patient’s chronic conditions. The Department says it had nominated five as a notional number for planning purposes for these services and that it was based on clinical advice. The number of fee-for-service episodes of care will not be capped or restricted and will be monitored during stage one of Health Care Homes,” he said.

Medicare: what a difference two years, two unpopular budgets and a close run federal election make to ministerial attitudes

THEN it was a bad, bad thing….

The Sydney Morning Herald, 4 January 2014:

Health Minister Peter Dutton has predicted an overhaul of Medicare, saying spiralling costs will make the system ''unmanageable'' without change.

In an interview with Fairfax Media, Mr Dutton gave the strongest signal yet that the Abbott government may adopt a politically explosive proposal to charge a $6 fee to visit the doctor…..

Annual spending on Medicare climbed from $8.1 billion in 2002-03 to $17.8 billion, an increase of 120 per cent. Growth in Medicare spending was faster than growth in the total health budget of 104 per cent over the decade, and Pharmaceutical Benefits Schedule spending, which rose 79 per cent over the same period.

News.com,au, 18 March 2015:

A NEW report has found 880,000 Australians see their GP more than 20 times a year and account for 17.1 per cent or $2.8 billion of the nation’s non hospital Medicare spend.

These people receive more than $3,200 a year each in non hospital Medicare payments and nearly half of them were also admitted to hospital, the National Health Performance Authority says.

There are 2.3 million Australians who see their doctor more than 12 times a year and they are eating up forty one per cent (16 billion) of the Medicare budget.

These patients received on average $1,850 in non hospital Medicare payments.

NOW it is something to celebrate….

Liberal MP for Farrer and Australian Minister for Health and Aging, Sussan Ley, media release, 28 August 2016:

An extra 17 million GP services were bulk billed under the Coalition last year compared with Labor following another year of record Medicare investment by the Turnbull Government, as Bill Shorten’s Mediscare lies “crumble around him” and leave the credibility of his leadership in tatters.

Minister for Health and Aged Care Sussan Ley today revealed a record 123 million out of 145 million GP services were fully-funded by the Turnbull Government at no cost to patients through Medicare during 2015-16.

This saw GP bulk billing hit a historic high of 85.1 per cent under the Turnbull Government – up from 84.3 per cent in 2014-15 – and follows the Coalition’s record $7.1 billion investment in general practice via Medicare last year.

The number of Australians accessing Medicare-funded GP services was also up by nearly half-a-million to 20.9 million last year, while the average number of services and spend per GP patient grew to 6.9 and $344 respectively…..

Overall, the number of Medicare services increased to 384 million in 2015-16 – more than one million per day – at a total cost of $21,107,750,246 – an increase of nearly $1 billion on 2014-15 – with the overall Medicare bulk billing rate also increasing to 78.2 per cent in 2015-16 from 77.6 per cent the year before.

I suspect that  a number of government MPs will be making appointments with their local chiropractor after repeating this spectacular backflip.

The casual cruelty of the Turnbull Government can leave one speechless

@bamboozled3 tweeted this snapshot on 24 July 2016 from Sue Robinson's Facebook page entry of 21 July:

The Australian Health Minister is reported as stating that we are now working through her situation in a bid to address her concerns.

A statement which does not deny that Ms. Robinson was refused this diagnostic test on the basis that she had no money to pay upfront.

News.com.au reported on 25 July 2015:

On Monday afternoon, Ms Robinson posted an update to say thank you for the support and revealed Ms Ley had made contact.

“It looks as if there might be some action on it, and that is a direct result of your response,” she wrote.

“As a result of the number of ‘shares’ and responses, the office of the Federal Health minister, Sussan Ley posted with contact details asking me to call.

“I did and was put through to a young man called Alex. We established two things. Alex assures me that the guidelines for bone scans haven’t changed since the election (I didn’t think they had, but I thought they might have since the last budget).

“He says there should have been no recent changes at all, and if I was eligible, for example, last year, I should still be eligible as I am still on the meds that compromise my bone density.

“However, according to the Medicare website I was shown this weekend my meds are on the list of those for which a bone scan is recommended, but not one for which it is reimbursed.

“There doesn’t seem to be any justification for this and it does specifically exclude cancer patients because the meds concerned are for cancer.

“I also asked Alex why are there guidelines at all? Surely if a cancer specialist regards such a test as necessary for a patient, that should be enough? After all, every case is different and the referring doctors are the only ones who can really know what is required in each case. Alex said that was a good question, but didn’t answer it, though he did tell me that these exclusions are worked out by a medical services advisory committee.

“We agreed that he would investigate further and I am sending him a link to the Medicare website so he may check the guidelines for himself.

“I also have a little more information on the charging system being used for these tests. I called other local practices who do such scans here and asked about bulk billing. They all had the same reply ... It’s complicated. It seems they can’t tell if you are eligible until you go in and then fill in a form.

“It is your answers in this form, and not the referral, which determine if you are eligible, so they say. They can’t tell you before you arrive whether or not you will be asked to pay. But if you are, the charges vary from practice to practice.

“For those of you who posted saying you are in the same boat, here are the costs you might have to pay if you are excluded from bulk billing. PRP will charge a $60 fee, Erina Radiology charges $85. Medical Imaging at Erina charges $50 for pensioners and $100 for the employed, but also states that they do whatever they can to bulk bill you. This practice was also recommended by one of my Facebook friends Maryellen Golden who said she had been bulk billed for a bone scan there herself. (Thank you Maryellen)

“I guess this isn’t unaffordable (unless you are on a limited income like a pension), and as long as you know it, you can save up. But I can’t help but wonder why it should be costed at all. I’m hoping this will be treated by the government as an unfortunate oversight that will be corrected.

And if it is, it will be your overwhelming response that brought it to their attention. Thank you again.”

For all low-income patients there are other pitfalls awaiting the unwary no matter what the diagnosis.

The Medicare website states; If you have more than one service during the same visit you may not be bulk billed for every service.

What it does not state is that the Medicare treats a patient’s claim involving multiple services differently from a claim involving a single health item and therefore the dollar amount a patient is reimbursed can be much lower.

As much as $65 lower in the instance of which I am aware, leaving the pensioner $125 out-of-pocket in total.

One of the more bizarre positions that the federal government takes is that the patient (or presumably the patient's estate if they left one) is responsible for the cost of the death certificate issued by an attending doctor - Medicare specifically includes this certificate in items not eligible for a rebate.

"Although Medicare benefits are not payable for the issue of a death certificate, an attendance on a patient at which it is determined that life is extinct can be claimed under the appropriate attendance item. The outcome of the attendance may be that a death certificate is issued, however, Medicare benefits are only payable for the attendance component of the service."

Medicare Benefits Schedules (Complete MBS and MBS by Category) operating from 1 July 2016 can be found here.

Turnbull Government in 2016: stupid is as stupid does

In the financial year ending June 2015 the Australian Government processed  a total of 192.25 million PBS concessional prescriptions (including Safety Net prescriptions) for a population of over 23 million – a 2.6 per cent volume increase representing a -3.9 per cent cost-to-government decrease on the previous financial year.

So it is hard to imagine why Malcolm Turnbull & Co or the government appointed Pharmaceutical Benefits Advisory Committee thought this additional cost cutting measure which would be well-received.

The Sydney Morning Herald reporting on 16 July 2016:

Hospitals faced a surge of type two diabetes patients over the past three years, alarming health insurance companies about their growing medical bills.

NSW recorded the biggest increase, with 20 per cent more patients admitted to hospital due to type two diabetes in 2015 compared to 2013, according to statistics collected by Medibank on its members.

The growth in admissions was as high as 42 per cent in Sydney's central suburbs, compared to a national average increase of 15 per cent.

Medibank chief medical officer Linda Swan said the figures sent a clear signal to the health fund that it needed to staunch the spiralling cost of type two diabetes.

"We've been hearing about the epidemic of diabetes for years, but it's not until you see the stark reality that you see this is growing at an extraordinary rate and clearly we're not doing enough," Dr Swan said.

One day later in The Age:

Diabetics will pay 50 times more for strips that help them monitor their blood sugar levels after the government removed the subsidy, raising concerns about more health complications as the condition of those patients spins out of control.

The federal government removed the subsidy on blood glucose test strips for people with type two diabetes who are not insulin dependent effective July 1, though there will be a six-month transition period…..

About 900,000 people with type two diabetes are registered with the National Diabetes Services Scheme and more than two-thirds of them are not insulin dependent.

Saffin promises Labor will establish a headspace centre in the Clarence Valley

Shadow Minister For Families And Payments, Shadow Minister For Disability Reform & Member for Jagajaga Jenny Macklin and Labor Candidate For Page Janelle Saffin (pictured above), joint media release, 14 June 2016:

LABOR WILL ESTABLISH A HEADSPACE CENTRE IN THE CLARENCE VALLEY

Shadow Minister for Families and Payments, Jenny Macklin and Labor candidate for Page, Janelle Saffin today announced that a Shorten Labor Government will provide funding for the development of a Headspace Centre in the Clarence Valley which will provide assistance to young people experiencing mental health issues.

“There is a clear gap in mental health services in the Clarence Valley, and this $1.8 million in funding will address that gap by ensuring local young people can access the help they need,” Ms Saffin said.

“Establishing a Headspace Centre will give young people in Grafton and the Clarence Valley the same support as people in Coffs Harbour and Lismore.”

Ms Saffin said the Clarence Valley community had been rocked by the death of 11 young people from suicide in just 12 months.

“There are a number of factors behind the high levels of youth suicide and mental health problems on the North Coast. These include high levels of unemployment, cuts to other youth services, and substance abuse.

“We cannot turn a blind eye to this reality and pretend it’s not happening. Ignoring the mental health needs of young people is effectively casting them adrift.

“That’s why I am so passionate about this issue, and so determined to make sure all young people in the Northern Rivers and North Coast have access to services such as Headspace.

“I have fought for the Headspace service for our region, and secured the Lismore Headspace. I have since argued that the Clarence Valley needs one as well, and if I am elected I will deliver it.”

Shadow Minister for Families and Payments, Jenny Macklin, said regionally delivered and funded services were vital to preventing mental illness and building stronger, more resilient communities.

____________________________________

And Nationals MP for Page for the last three years, Kevin Hogan scrambles to catch up……

The Daily Examiner, 15 June 2016, page 6:

Federal Member for Page Kevin Hogan said an array of extra mental health services were about to be provided in the Clarence Valley due to extra resourcing.

"Mental health is a very serious issue, every suicide in our community a tragedy," he said.

"Following a community meeting in December last year I organised a Consultation Workshop on May 23. This brought together local agencies to decide how the extra resources should be allocated in the Valley.

"There will be an outreach of Headspace from Coffs operating in the Clarence before the end of the year. There will also be more resources allocated at the acute care level.

"Many good mental health services exist in the Clarence Valley. It was identified that many people were not aware of the current services."

Australian Federal Election 2016: recalling better times in the Page electorate

The public hospital system in the NSW Northern Rivers region has been attempting to deal with state and federal health funding cuts by Coalition governments for years now (including est.$730 million over ten years from the Northern NSW Local Hospital District) and the strain is beginning to show.

So it’s only natural that a good many regional voters look back fondly on the hard work then Labor MP for Page Janelle Saffin put in to securing health funding between 2007 to 2013.

This effort on the electorate’s behalf included:

$4 million for a community health centre in Yamba

$20 million for the upgrade of Grafton Base Hospital and 114,000 for new equipment for the Emergency Department

$487,000 to refurbish 10 student nurse accommodation rooms at Grafton Base Hospital

Federal grant to establish the Grafton Super Clinic

$60.25 million to redevelop Lismore Base Hospital, including new emergency department, an express community care clinic and a new renal dialysis unit

$7 million on top of the $8 million already committed for Lismore Base Hospital radiology services

Magnetic resonance Imaging (MRI) services for Lismore Base Hospital and North Coast radiology’s Clarence Valley Imaging in Grafton

$15 million to fast track the Lismore Integrated Cancer Centre

$2.7 million for a second linear accelerator at the Lismore Base Hospital Integrated Cancer Centre, providing cancer treatment for an extra 30 patients a day

$7 million for Lismore GP Super Clinic

$2.6 million for Our House Cancer Patient Accommodation in Lismore for cancer patients and families -150 construction jobs 

$2.53 million to St Vincent’s Private Hospital Lismore for two new operation theatres, $884,414for state-of-the-art teaching centre and $157,000 to purchase equipment to develop aUrological Centre of Excellence 

$7.9 million to establish the University of Western Sydney's new Rural Clinical School in Lismore and Bathurst

$407,000 to expand McKid Medical Private General Practice in Kyogle under the Primary Care Infrastructure Grants Program and $295,455 to upgrade the Urbenville Medical Centre

$9.22 million to North Coast Medicare Local to establish its headquarters in Ballina and for operational funding

$1.45 million investment in dental funding for the Northern Rivers, announced this year as part of the Commonwealth Dental Health Program

Five new GP registrars to train in Lismore, Goonellabah, Ballina and Alstonville and four specialist doctors in Lismore area

$1.6million to Interrelate to boost mental health services in Ballina and Kyogle shires and the Richmond Valley

$640,000 to Local HACC services Home and Community Care Program funding

$1.45 million investment in dental funding for the Northern Rivers announced in 2013  as part of the Commonwealth Dental Health Program

Five new GP registrars to train in Lismore, Goonellabah, Ballina and Alstonville and four specialist doctors in Lismore area

$1.6million to Interrelate to boost mental health services in Ballina and Kyogle shires and the Richmond Valley

$700,000 to Clarence Valley Council under the Healthy Communities Initiative to combat obesity

A total of $522,000 to Bulgarr Ngaru Aboriginal Medical Service to expand its health service with new premises and practice manager

$1.9 million for local crisis intervention services.

A list of funding for a range of services within the Page electorate between August 2010 and September 2013:

Janelle Saffin Federal Labor MP for Page - Achievements since 2010 by clarencegirl

Ms. Saffin is standing as Labor's candidate in Page on 2 July 2016.

Major parties accused of ignoring radiology in rebate freeze debate as patient gaps hit $100 on average

Medianet Release

31 May 2016 2:29 PM AEST

Rebate freeze debate ignores radiology as patient gaps hit $100

 Radiologists have accused both sides of politics of ignoring a looming health emergency, with patient gaps for scans such as X-rays, Ultrasounds, CTs and MRIs now averaging $100.

 While election debates focus on rebates for GP visits and pathology tests, the Australian Diagnostic Imaging Association (ADIA) says vital diagnostic imaging services are becoming more unaffordable for everyday Australians.

 "We've hit a regrettable milestone in Australia, with gap payments for diagnostic imaging services now averaging $100," said ADIA CEO Pattie Beerens.

 "People are rightly upset about the three year freeze on Medicare payments to GPs, but no-one is discussing the fact that patient rebates for diagnostic imaging have been frozen since 1998.

 "Bill Shorten is now on record saying that the Liberals' plan will jeopardise Medicare, bulk billing and the ability for people not to have to pay up front fees when they need a mammogram or x-ray - and that Labor will put people first.

 "That is encouraging in theory, but in practice neither side of politics has made a commitment that addresses the enormous squeeze on millions of patients needing scans."

 Ms Beerens said practices across Australia remained extremely concerned that the freeze on patient rebates for diagnostic imaging – which have been stagnant for 18 years and are scheduled to continue past 2020 – will continue to drive more patients away from essential diagnosis and treatment.

 "The fact is that most radiology practices are local businesses operating on thin margins. This squeeze has been going on for two decades, and it has to end," Ms Beerens said.

 "Patients don't just decide to have a scan, they have to be referred, but governments have cut so much money from the system that average Australians are being priced out of health care.

 "Sick people will avoid getting diagnosed, and that will create huge long-term problems for our health system."

Federal Election 2016: don't have a heart attack on Fridays

Live in a small coastal village or larger town on the NSW Far North Coast or on a Northern Rivers farm 100 km inland from the sea?

Then you have been living this situation for years.

The Northern Star, online editorial, 30 April 2016:

We live in two of the most marginal seats in Australia in the upcoming federal election and that puts us in the box seat as voters.

Our vote is crucial, what ever way you look at it.

If the Coalition wants to hang on to power it wouldn't want to lose Page, while Richmond is held by Labor's Justine Elliot by a margin of just 1%.

The past two state elections in Queensland and NSW have shown voters are swinging wildly and any form of comfortable political loyalty has flown out the window.

To be completely mercenary about it, neither major party can afford to take the people of the Northern Rivers for granted.

We live in a wonderful part of the world, that's why we are all here. But it's time for voters to rise up and demand the same sort of lifestyle someone living in the city can expect.

That's what our current Fair Go campaign is all about - closing the gap between city and country.

Health figures we've highlighted today paint a stark contrast…..

It suggests to me that our fair share of programs and support services in suicide and cancer are aimed at the wrong part of the country.

And we should demand to know from every candidate standing in Page and Richmond, what they are going to do about it?

The Daily Examiner, online, 30 April 2016, p. 1:

If you're going to collapse from a heart attack in the Clarence Valley, don't do it on a Friday says local doctor Allan Tyson.

Dr Tyson, who is a specialist anaesthetist and emergency doctor at Grafton Base Hospital, said having a heart attack on Friday was not a wise move because the cardiac unit at Coffs Harbour was only available three days a week and Friday was not one of those days.

"The standard of treatment you would get here is a standard lower than you would get if you lived in the metropolitan area," Dr Tyson said.

"Here they would give you blood thinners and hope that the problem didn't reappear

"If it was a real emergency you could be flown to John Flynn (on the Gold Coast) for treatment."

He said in contrast a patient in a metropolitan scenario would have access to the latest cardio services almost instantly…..

The Daily Examiner, 30 April 2016, p. 4:

Clarence Valley residents are more likely to die of avoidable diseases caused by smoking, drinking and obesity than Aussies living in capital city suburbs.

A special ARM Newsdesk analysis of public health data shows the long-term outlook for our region's residents is dire.

The Daily Examiner today reveals a set of shocking statistics as we ramp up our Fair Go for Clarence Valley campaign in the lead-up to the mooted July 2 double dissolution election.

We are calling for iron-clad federal guarantees on a range of issues including health, education and employment so we can have the same advantages and outcomes as metropolitan Australia.

An in-depth analysis of data from the Social Health Atlas of Australia reveals the following alarming health trends for our region.

At least 22.8% of Clarence Valley residents smoke compared to 14.5% in the region's closest capital city, Brisbane.

About 5.4% of our residents drink alcohol to excess. This figure is higher than Brisbane on 4.9%.

Almost one third of the Clarence Valley population is obese. At 31.9%, our obesity rate is higher than Brisbane's 25.2%.

Our avoidable cancer death rate of 121.5 per 100,000 residents from 2009 to 2012 was significantly higher than Brisbane's 93.6.

Deaths from avoidable heart disease in the same period hit 26.9 per 100,000 people in Clarence Valley. This was higher than Brisbane's rate of 25 per 100,000 residents.

The recent Medical Research and Rural Health -- Garvan Report 2015 confirms that death rates from chronic and avoidable diseases increase the further you get from capital cities.

The Garvan Research Foundation found regional areas also had steeper rates of high blood pressure, diabetes and mental health problems.

The report reveals many reasons for the health disparities, but most of them revolve around a set of social factors that include smaller household incomes, higher risk jobs such as mining and farming, a lack of similar specialist medical services compared to metropolitan Australia and the higher cost of transporting healthy foods such as fresh fruit and vegies to our region.

"The foundation of all good policy is a solid information base and a good understanding of the realities facing any sector of the population," Garvan chief executive Andrew Giles said.

Australian Medical Association vice-president Dr Stephen Parnis agreed, saying it would take long-term commitments from successive governments to reverse the Clarence Valley's negative health trends.

Dr Parnis said the first step towards bridging the gaps was ensuring our region had the same health services as those available to capital city residents…..

The Northern Star, 30 April 2016, pp.1 & 6:

The suicide rate per 100,000 in Sydney is 5.3%. In the Northern Rivers it's 12.5% Avoidable cancer deaths per 100,000 people in the Northern Rivers is 103.7. In Sydney it's 95.1…..

"I need to keep across the readings. But as a pensioner I won't be able to afford the 29 tests per year."

Pathology companies are threatening to introduce a $30 co-payment for all medical tests, including pap smears, MRIs and blood tests, if the government goes ahead with the cut.

Mr McPherson's cluster headaches -- much more significant than migraines -- usually take 10 to 12 years to diagnose.

"The lithium reduces the pressure in the nerves. I will need lithium monitoring for the rest of my life," he said.

"I'm about to go on my second program of lithium which is only used in extreme cases of this condition.

"Everything I do has to be inside because light is a trigger for this condition."

"When I saw the Federal Government had made a decision to stop bulk billing of blood tests and pap tests and MRIs, I realised the situation was going to be quite awkward on a pension," he said.

This week doctors at 5500 private collection centres began approaching their patients to sign a petition asking the Senate to block the cuts.

However, according to a new report from the Grattan Institute, taxpayers could save over $240 million a year if the government made pathology companies tender to provide testing services. According to the report, pathology companies now benefit from cheaper, automated testing.

Far from calling for an exemption for his specific case, Mr McPherson has instead called the cuts a war on women.

"Women will die because they will not get regular pap smears which can detect and prevent cancer. It's false economy," he said.

"At cabinet level, did they have a document, which explored the impact of this policy in term of rates of mortality for women?

"And did they say we can accept that?

"Someone has made a decision here, without thinking of the broader impact of the community."

News Mail, 30 April 2016:

Getting good doctors to commit to the bush long-term is a huge struggle so two of the country's key health lobby groups have prescribed a simple remedy - more money.

The Rural Doctors Association of Australia and the Australia Medical Association say there is room in the multi-million dollar Commonwealth-funded Service Incentive Payment program to apply higher remoteness loadings for GPs happy to relocate from the city.

In releasing the RDAA and AMA's Rural Rescue Package, Dr Ewen McPhee said extra financial support aimed at "revitalising and sustaining" rural medical services could be the key to closing health gaps.

The RDAA president said financial incentives based on the remoteness of the area in which GPs worked was the way to go.

"Over the past two decades, many rural and remote communities have found it increasingly difficult to attract and retain doctors with the right mix of skills to meet their health and medical needs, including GPs with advanced skills training who can provide acute services in the hospital setting," Dr McPhee said.

"The Rural Rescue Package would make a huge difference."

The Daily Examiner, 30 April 2016, p. 5:

Maclean Hospital has a constant wish-list of equipment that government cannot fund, so a dedicated group of women and men take it on themselves to do something about it.

The Maclean Hospital Auxiliary have been raising money for the past 70 years and in the past year have raised about $75,000 for the hospital.

Add this to another $107,000 of equipment on order, and that's a lot of cakes and biscuits being sold at stalls.

"They give us a wish list, the articles they need, and then we go down through the list and supply them with whatever monies we have at the time," president Sandra Bradbury said.

"We do various fundraisers, we have four stalls a year, street stalls and we bake cakes."

Without the help of donations, Mrs Bradbury said the hospital would not be nearly as well off.

"It used to be a full running hospital and now it's not... years ago it used to have a children's ward and a birthing place," she said.

The Daily Examiner, online, 29 April 2016:

This is a tale of two babies.

They were born 600km apart, but statistics suggest their prospects are worlds apart.

Data shows Clarence Valley newborn Charlotte Billett, pictured above with parents Stacey and Jeremy, is at risk of dying 4.9 years earlier than Sophia Milosevic, pictured right with her mum Kate.

For both children, their distance from capital cities makes all the difference.

Sophia's home is in the Federal seat of Bennelong in the north of Sydney, a seat long held by former prime minister John Howard.

Charlotte was born in Grafton, 310km from Brisbane and 890km from Canberra.

A special Daily Examiner investigation reveals how regional Australia has been let down, with health, education and infrastructure funding failing to help those who need it most.

In Grafton, the life expectancy for a baby born in 2014 is 80.4 compared to 85.3 where three-month-old Sophia lives in the Sydney suburb of Ryde.

Australian Bureau of Statistics figures reveal the median age of death for locals is 80 compared to 84 in the Ryde council area…..

Public health policy expert Dr Rob Moodie said Grafton's life expectancy rates and median age of death would not improve until the Clarence Valley matched its metropolitan cousins on income, education, employment and access to more top-quality health services…..

The Norther Star, 28 April 2016, p.6:

Over 420,000 Australians have banded together to back up pathology centres in their fight against cuts to bulk billing incentive payments.

Local collection centres advertised their Don't Kill Bulk Bill petition for patients to sign and health centres to get on board.

Natarsha Wotherspoon of Lismore chemist, Blooms, wanted to help.

"It's hard to come up with money for all your health needs ... How many people can't afford to eat, let alone pay for a blood test?" She said.

"If you're very ill and you're getting blood tests two or three times a week, the last thing you need to be thinking about is how you are going to pay for all these tests."

Ms Wotherspoon and the other chemist staff collectively gathered over 2000 signatures.

The Turnbull Government announced on December 17 it would scrap payments to pathologists and diagnostic imaging services when they bulk billed patients, saving $650 million over four years.

Health Minister Sussan Ley said the sector could absorb the losses, but pathologists disagreed.

President of Pathology Australia Nick Musgrave said pathologists would have to charge patients a co-payment…..

The Northern Star, 23 April 2016, p.8:

They were born 730km apart, but statistics suggest their prospects are worlds apart.

Data shows Frankie Lindsay is at risk of dying four years earlier than Sophia Milosevic, pictured right with her mum Kate.

For both children their distance from capital cities makes all the difference.

Sophia's home is in the Federal seat of Bennelong in the north of Sydney, a seat long held by former prime minister John Howard.

Frankie was born in Casino, 195km from Brisbane and 1000km from Canberra.

A special Northern Star investigation reveals how regional Australia has been let down, with health, education and infrastructure funding failing to help those who need it most.

In Lismore, the life expectancy for a baby born in 2014 is 81.2 years compar- ed with 85.3 where three- month-old Sophia lives in the Sydney suburb of Ryde…..

Meanwhile, Ms Milosevic said there was no better place to raise a child in Australia than Ryde.

"It is a Liberal seat so it seems to do very well for itself," she said.

"There are constantly things happening, new playgrounds and projects with new funding.

"It's brought a different demographic of people and the area has become quite affluent."…..

The Northern Star, editorial, 23 April 2016, p.9:

…..Prime Minister Malcolm Turnbull will take the country to the polls within months.

Getting a Fair Go for our region will be our priority through the election campaign.

Mr Turnbull and Bill Shorten have questions to answer. Their parties must prove we are a priority.

Our sister papers across Queensland and northern New South Wales - and those of NewsCorp - will fight for the same thing.

Together, we represent the more than 6 million Australians who don't live in the big cities. Combined we reach 3.3 million readers a month.

Politicians beware: That's a lot of voters.

One in three Australians live in the regions - and they deserve the same access to health care, education, and employment prospects as those in our capital cities.

They're not getting it now, and that has to end.

Living in the bush, or at the beach, should not be a life sentence.

Little Frankie deserves better.

In his 2017-17 Budget speech last night Treasurer Scott Morrision announced an estimated additional $2.9 billion over three years for public hospital services.

With this sum having to be cut seven ways between the states and territories, I think one may safely say that Far North Coast health services will continue to lag behind those in the metropolitan areas across Australia and our life expectancy and health outcomes will continue to be lower under this federal government.