The lies Liberals tell on the subject of aged care

The Australian, 7 February 2019:

Aged Care Minister Ken Wyatt was handed a departmental briefing report showing the “winners and losers” from the Coalition’s $2 billion savings drive in the aged-care sector shortly after Scott Morrison announced a royal commission and denied funding cuts.

Documents obtained by The Australian under Freedom of Information laws show the proportion of “losers” almost tripled to 53 per cent following the budget savings revealed in late 2015.

In the three-year period to 2018, aged-care services that had been classified as “winners” almost halved to 47 per cent, according to the brief sent to Mr Wyatt.

A series of “hot issue briefs, question time briefs and general briefs” sent to Mr Wyatt last year acknowledged the budget hit to the Aged Care Funding Instrument — which is the basic taxpayer care subsidy paid to all nursing homes — together with “increasing cost pressures will be putting pressure on the sector”.

Mr Wyatt was also made aware of reports of “cut backs to staffing”. At a press conference announcing the royal commission into aged care in September, the Prime Minister was questioned about two cuts to the ACFI in the 2015 mid-year economic update and the 2016 budget but denied any had been made.

“No, no, the Labor Party said that. I don’t accept that,” he said. Two days later, a question time brief prepared for Mr Wyatt offered advice on what to say if asked about funding cuts to ACFI.

The ministerial brief also contains a breakdown of funding changes by domain, revealing that average annual taxpayer subsidies per resident increased by just $400 between 2016-17 and 2017-18 despite the growing frailty and complexity of Australians as they enter residential aged care older than ever before.

For the first time, funding for the two areas that provide extra boosts for nursing home residents with significant behavioural problems and complex healthcare requirements went backwards by $300 a person.

The peak body for aged-care providers, ahead of the April 2 budget, has urged the Coalition to include an additional payment of almost $700 million each year.

“This estimate reflects a range of factors, including the value of foregone indexation (through ACFI),” Leading Age Services Australia (LASA) says in its pre-budget submission, seen by The Australian. “This is approximately a 5.2 per cent increase in residential care funding in 2019-20, noting that this is difficult to calculate as forward estimates for residential and home care are no longer separately reported.” LASA said it considered the money to be a “down payment” and a notably larger funding boost might be needed following the findings of the royal ­commission.” The commission, which is due to release its interim report in Oct­ober and the final version by the end of April 2020, has already highlighted the widespread industry practice of “doping” nursing home residents, which doctors, nurses and consumer groups attribute to overworked staff. [my yellow highlighting]

OUR ABC: the fate of public broadcasting is in your hands at the 2019 federal election

Use your vote wisely.......

abc.net.au, 23 October 2018:

Statement by David Anderson, Acting Managing Director of the ABC, to the Senate Environment and Communications Legislation Committee 

Thank you Senators. 

I am appearing today as Acting Managing Director of the ABC. It is a privilege to be in this role, overseeing one of Australia’s most loved and respected cultural institutions. 

There is no doubt Senators will have many questions about recent events and strategies. I will do my best to answer them in my acting capacity and from my management position. Accountability is part and parcel of being a national broadcaster. 

So too is independence. I have already stressed in my early conversations with employees that the great faith and trust the community invests in the ABC is built on the foundation of independence. 

The ABC is funded by government and it is ultimately answerable to the people of Australia. They are the ones who expect us to report without fear or favour, to live up to standards of quality and excellence, to shun commercial and other agendas, to hold the national conversations and to reflect the nation back to itself. 

The other absolute I have, as a long-term content manager within the Corporation, is the primacy of content. Across the ABC’s history we have been adept at using technology to improve the ways we bring our programs and services to our audiences. 

Even in my time at the national broadcaster, the distribution platforms and channels we use have changed dramatically. They will need to change even more over the next decade as we seek relevance and reach in a challenging digital media landscape. 

But it is the content that we carry on those platforms that ultimately matters. 

 Vibrant new kids’ programs that delight and educate our children; 

 Agenda-setting journalism that shines a light into dark corners and holds regulators and lawmakers to account; 

 The rich, direct and often lifesaving conversations we have with our regional and rural audiences; 

 The insightful work of Radio National; 

 Our commitment to the promotion and support of cultural endeavours, particularly music, the arts and creative communities; 

 Colourful dramas like Mystery Road that use local actors, local crews, local locations and local stories to entertain us; 

 And our ability to unite the nation, whether it be on Australia Day, the approaching Remembrance Day/Armistice celebrations or through our in-depth coverage of the drought; 

 And this week, of course, the Invictus Games. 

It is the distinctive content that makes the ABC unique and a priceless national asset. 

While the recent weeks have been testing, I am very proud of the passion and energy shown by our 4000 employees. They have not been distracted. They remain committed to serving Australians. 

As the Acting Managing Director, my early objective has been to work with the Board, bring stability to the organisation, demonstrate leadership and to press for the resourcing we need to deliver the Charter remit and the services the community expects. 

I note there has been a lot of talk recently about ABC budgets and future demands. I would like to bring these facts to the table: 

 20 per cent of the ABC Budget is actually fixed costs for transmission – the infrastructure that delivers our programs to audiences across the nation. 

 The $84 million efficiency cut over three years comes on top of the 2014 decision to cut the ABC budget by $250 million over five years. The cumulative impact of these measures is a significant reduction in our operating budget at a time when we are facing rising costs of production and the need to increase our investment in digital products. 

 We have been given no certainty about the future of funding for a program that directly employs 81 journalists, including specialist reporters and outer suburban bureaus such as Geelong, Parramatta and Ipswich. 

As a long-serving content manager and leader, I can personally attest to the financial pressures affecting the Corporation. I can vouch for the efforts of management to maximise every dollar spent on audiences and to plough efficiency savings into content. 

I am making it clear to stakeholders that the next triennial funding round, scheduled for resolution in next year’s Budget, should be used as an opportunity to reposition the ABC for the future. 

If the ABC is important now in bringing diversity to the media landscape, then it will be even more essential over coming years in providing quality, independent, local content to Australians. The ABC will be the innovator. We will provide the creative jobs that are necessary for this new era. We will continue to provide the highest quality independent journalism. 

Thank you. I am happy to take questions.

Twitter, 24 October 2018:

It appears the Australian Government's $487.6 million* grant to the Great Barrier Reef Foundation may end up paying for little more than ‘feel good’ greenwashing exercises

The Guardian, 26 September 2018:

Great Barrier Reef scientists were told they would need to make “trade-offs” to the Great Barrier Reef Foundation, including focusing on projects that would look good for the government and encourage more corporate donations, emails tabled in the Senate reveal.

The documents, including cabinet briefing notes, contain significant new details about the workings of the foundation and the government decision to award it a $443m grant, including:

The executives of mining, gas and chemicals companies – and international financial houses that actively back fossil-fuel projects – were among the guests at a six-star retreat hosted by the foundation less than a month after the grant was announced;

The media companies Foxtel and Fairfax and the tech giant Google are among a tightly held list of donors to the foundation;

The only CSIRO employee contacted about the grant before the announcement in April was in Patagonia, and did not get the email. Documents have previously revealed that the government’s peak science agency was cut out of the decision to award the grant;

In August, as scrutiny of the grant intensified, public servants pushed to block a long-planned meeting between the then science minister, Michaelia Cash, and the head of the foundation, Anna Marsden, because of concern about the “optics”.

Emails sent by staff at the Australian Institute of Marine Science outline how government expectations, the ability to leverage private donations and public perceptions “may drive the [foundation] to prioritise shorter-term research initiatives in order to demonstrate progress and return on investment”.

“Where it becomes challenging is that … interventions with the largest future benefit also take the longest to develop,” the institute’s executive director of strategic policy, David Mead, wrote in an email to colleagues. 

 “Among other trade-offs, we will need to determine to what degree we focus on quick wins or whether we progress longer-term strategic interventions and accept that we will only partially progress them during the next five years (perhaps with little outward visibility of success/progress).”

The emails also reveal an initial state of uncertainty about how a $100m allocation for reef restoration and adaptation would be handled.

Three weeks after the announcement about the money, Mead was trying to get answers about how the grant would be allocated.

“I followed up with the granting agreement, did not really get an answer other than they are working on it over the next month,” Mead wrote on 18 May. “So we will just have to watch this space.

“Once the thing is signed by GBRF we are going to need them to make some definitive statements one way or the other, as everyone is wondering and I don’t want the team to destruct … ”

Emails between staff at the industry, innovation and science department reveal discussion about the “optics” of a long-planned meeting between Cash, Marsden and the chief executive of institute, Paul Hardisty.

Note

* The total Great Barrier Reef Foundation grant was for $487,633,300.

Will the Australian Government continue its policy of harrassment and intimidation in relation to Australia's national public broadcaster?

This was the situation before Malcolm Turnbull was politically beheaded by the hard right of the Liberal Party and Scott Morrison installed as the new Australian Prime Minister.....

Lenore Taylor is Guardian Australia's editor. She has won two Walkley awards and has twice won the Paul Lyneham award for excellence in press gallery journalism.

She has been a journalist for over thirty years and covered federal politics for over twenty-two years. 

Despite being invited onto the ABC "Insiders" program as a political journalist and editor, she found that pressure appeared to have been placed on that program to remove its video of her one of comments from its Twitter feed.

Do not retweet - @JoshFrydenberg and @TurnbullMalcolm don't want this seen and told @InsidersABC to delete this clip. #auspol #reefgate pic.twitter.com/Xf4B0J7p5B

— EBA Truth (@ebatruth) August 13, 2018

I raised a question on #insiders yesterday about how the reef foundation could have been so surprised by the grant if the govt had already done due diligence on it, as Josh Frydenberg revealed in the interview - this from @InsidersABC about why a tweet of my comment was removed https://t.co/VsJ2Swc4HF

— Lenore Taylor (@lenoretaylor) August 13, 2018

“The comments bring into question remarks by the environment and energy minister, Josh Frydenberg, on the ABC’s Insiders program on Sunday, that the government did “extensive due diligence” on the foundation before awarding it close to half a billion d…” https://t.co/LSSn7ixjlw

— Ellie (@elliemail) August 13, 2018

This was my call yesterday and on reflection it was a mistake. I should have quote tweeted the original tweet and provided the new information given to me by government. Apologies to @lenoretaylor. Her comments remain on iview and on the Insiders website. https://t.co/3iJHHxm6hc

— Samuel Clark (@sclark_melbs) August 13, 2018

The Great Barrier Reef Foundation denies there was any prior due diligence conducted concerning the $487,633,300.00 grant.

Marsden told ABC radio on Monday [13 August 2018] the foundation had to submit a retrospective application after learning in April it would receive the money.

“We had to certainly demonstrate value for money and our track record,” she said.

Once this particular cat was out of the bag ABC "Insiders" decided on 360 degree change of direction or suddenly remembered what being an independent public broadcaster actually means - readers can make up their own minds as to motive.

We’ve republished this tweet. It was my call on Sunday to take it down, and that was a mistake. My apologies again to @lenoretaylor. https://t.co/NyivO2sJaL

— Samuel Clark (@sclark_melbs) August 14, 2018

Remembering that as federal treasurer Scott Morrison led the charge to savagely cut ABC funding, the question that needs answering now is "Will he continue to bash the ABC by allowing minsters to apply inappropriate pressure on management and staff to alter editorial decisions?"

The real reason Turnbull gave the Great Barrier Reef Foundation $487.6 million with few strings attached and a short deadline on the spend

The Saturday Paper, 18-24 August 2018:

Picture the scene: three men in a room, two of them offering the third the deal of a lifetime.

The pair say they will give the man’s little outfit – which has assets of only about $3 million, turnover of less than $8 million and just a handful of staff – a $444 million contract, under terms yet to be negotiated. The offer comes out of a clear blue sky, totally unsolicited by the lucky recipient. For this little organisation, it is like winning the lottery, except they didn’t even buy a ticket.

Such a deal would be exceptional, even in the corporate world. It would have been exceptional even if the pair making the offer had been, say, investment bankers, and the third man the head of a tech start-up.

But they weren’t. Two of them were the prime minister of Australia and his environment minister, and the third was the chairman of a charitable organisation called the Great Barrier Reef Foundation. All three do have backgrounds as bankers, however: Malcolm Turnbull, Josh Frydenberg and the foundation’s John Schubert worked with Goldman Sachs, Deutsche Bank and Commonwealth Bank respectively.

The question is why it was done this way. Why solicit this little organisation, of which most people would never have heard, to be the recipient of the biggest such grant ever made in Australia? Why was the money given without tender and without any prior grant proposal? Why, instead of providing the money a bit at a time, subject to satisfactory performance as assessed on an annual or biannual basis, was six years’ worth of funding provided in one lump on June 28, less than three months after that first meeting?

Geoff Cousins thinks he knows the answer.

Cousins is a former president of the Australian Conservation Foundation. Perhaps more importantly, he is a corporate boardroom heavyweight. For 10 years, he was an adviser to John Howard.

“It’s a most cynical piece of accounting trickery,” he says of the Barrier Reef grant. 

“A piece of chicanery. That’s the only way I can describe it.”

To explain why, he traces back several years, to the government’s desperate attempts to persuade UNESCO, the United Nations Educational, Scientific and Cultural Organization, that it was a good steward of the Great Barrier Reef, and that the reef World Heritage area should not be declared to be “in danger”.

To that end, the government had promised, under its Reef 2050 Plan, to invest more than $700 million in measures to protect one of the world’s great natural wonders.

“For the Department of the Environment and Energy to grant over $440 million to a small charity that didn’t even prepare an application form or ask for the grant is inconceivable!”

“They made a commitment, the Australian government, to the World Heritage listing committee, to spend $716 million on the Barrier Reef, prior to 2020,” Cousins says. 

“But they have spent just a fraction of that, and there is no way that in the remaining 18 months or less that they can reach that target, which raises the potential of the reef being put on the endangered list.”

In Cousins’s view, someone must have realised the trouble the government faced in meeting its spending targets on time. His guess is Frydenberg.

“Even if you started now, you couldn’t actually spend that money. There’s not a list, not a pipeline of projects approved and ready to go,” Cousins says.

“So Malcolm, then putting on … his business head, his accounting head, says ‘Well, all we’ve really got to do is make sure the money moves from the government’s accounts to the bank account of some other private or not-for-profit institution, then the money is spent.’ But the money hasn’t really been spent at all. Even the CEO of the foundation says it won’t all be spent for six years.”

If you tried that kind of dodge in the corporate world, Cousins says, “your accounting firm would say … they would have to qualify your accounts”.

Cousins makes a very strong circumstantial case. It is true the federal government has grossly underspent on its UNESCO commitment, and that the money given to the reef foundation will go much of the way to making good on that funding promise.

It is true also that UNESCO has become increasingly critical of the government’s performance protecting the reef. Last year’s meeting of the World Heritage Committee noted in particular that progress on achieving water-quality targets was too slow to meet the agreed time frame. As it happens, the largest single item on the reef foundation’s to-do list is improving water quality, with $201 million allocated to it.

Read the full aticle here.

Waiting for home care in Australia in 2018

There are now 108,000 older Australians on the waiting list for Home Care Packages.

On this list are individuals who have:

* not yet been approved for home care;

* been previously assessed and approved, but who have not yet been assigned a home care package; or

 * are receiving care at an interim level awaiting assignment of a home care package at their approved level.

Waiting time is calculated from the date of a home care package approval and this is not a an ideal situation, given package approval times range from est. 27 to 98 days and the time taken to approve high level home care packages is now than twelve months - with actual delivery dates occurring at least 12 months later on average.

Labor’s Shadow Minister for Ageing and Mental Health issued a statement which pointed out that “With the waiting list growing by almost 4,000 older Australians in just three months, the 3,500 new home care packages a year committed in the Budget won’t come close to keeping pace with demand”.

With more than half the applications for permanent entry into residential aged care taking more than 3 and up to 8 months to be met, this is not going to be a go-to first option in any solution for this lengthy home care waiting list - even if enough older people could be persuaded to give up the last of their independnce and autonomy.

By June 2017 New South Wales had the largest number of persons on the home care waiting lis at 30,685.

Given the high number of residents over 60 years of age in regional areas like the the Northern Rivers, this waiting list gives pause for thought.

Then there is this side effect of the waiting list and home care start dates identified by Leading Age Care Services Australia (LAGSA):

Consumers with unmet needs and unspent funds

LASA has undertaken an extensive review of the disparity that exists in the current release of HCP assignments, noting that there are substantial numbers of consumers on HCPs with either unmet needs or unspent funds . This bimodal distribution of home care package assignments reflects a mismatch between consumer package assignment and a consumer’s current care needs. The mismatch appears to be a function of the extended lapse of time that exists between approval assessments and package assignments. Until this dynamic is sufficiently addressed by Government, LASA expects that providers will be faced with a unique set challenges in 2018 when providing care to HCP consumers. This is likely to increase the need for regular care plan reviews in the context of unmet needs and unspent funds. This dynamic could be considered more closely within the context of developing a single assessment workforce.

Thus far Australian Minister for Aged Care and Liberal MP for Hasluck  Ken Wyatt is offering no insight into federal government thinking on this issue.

Sources:

https://gen-agedcaredata.gov.au/Topics/Admissions-into-aged-care

https://www.aihw.gov.au/reports-statistics/health-welfare-services/aged-care/overview

https://agedcare.health.gov.au/sites/g/files/net1426/f/documents/09_2017/assessor_fact_sheet_-_home_care_package_wait_times_v1.0_0.pdf

https://gen-agedcaredata.gov.au/Resources/Home-care-packages-program-data-report-2017

https://lasa.asn.au/wp-content/uploads/2018/02/270218-Consumer-directed-care-in-home-care-packages.pdf

Federal Labor promises to pursue return of dodgy grant to Great Barrier Reef Foundation

Excerpt from email sent out over Labor Senator Kristine Keneally's signature on 17 August 2017:

On April 29 Mr Turnbull announced the largest donation of taxpayers money to a private foundation in Australian history.

Half a billion dollars was given to the Great Barrier Reef Foundation, a private foundation with only six full-time staff at the time.

That's why we're calling on Mr Turnbull to return the reef money. Here's what we know so far:

• There was no tender process for the donation and the foundation never applied for the money.
   
• The Prime Minister was present at the meeting with the foundation and he personally told the chair, Dr John Schubert about the donation. It appears no public servants were present.
   
• Before receiving the donation the budget for the foundation was only $9 million and it only employed six full time staff.
   
• The negotiations for  the contract that governs the half a billion dollars of taxpayers' money only began after the money had been announced and committed by the government.
   
• The foundation has acknowledged the biggest threats to the reef include climate change and land clearing, yet the foundation has made clear none of its work goes to act against climate change or land clearing.
   
• All the probity checks and balances which ordinarily apply to expenditure by government agencies will not apply to spending decisions made by the foundation.

Effectively, half a billion dollars of taxpayers’ money has been given away without process, probity or policy justification.
 
The future of the reef should not be determined behind closed doors by Mr Turnbull’s mates......

Labor will continue to pursue this through the Senate Inquiry process and all other avenues available to the opposition.

Great Barrier Reef: $487.63 million to do little more than sit by the bedside of a dying reef system?

The Sydney Morning Herald, 7 August 2018:

The Great Barrier Reef Foundation has had some good fortune that few environmental NGOs could count on. The $444 million it was granted by the government earlier this year dwarfs its previous budgets by a large multiple. Having worked in two small environmental charities of a similar operating budget and staffing to the pre-windfall foundation, I can confirm getting so much money without even applying for it is far beyond anyone’s wildest dreams.

Still, the biggest questions about the GBRF windfall don’t relate to its good luck in an opaque government decision, or even its connections to the fossil fuel industry. 

These are entirely valid concerns, but they risk eclipsing the bigger significance of the government’s move.

What we also need to ask is: what does the foundation do? What are its outputs, its activities? And why would the federal government be so keen to direct such a huge chunk of funding to those activities?

At best, the government’s massive funding dump is a long-shot attempt to save a few bits of the reef from inevitable degradation. At worst, it’s a distraction from that fate – and a diversion from addressing its causes.

The foundation has standard governance structures, and the support of credible, dedicated scientists. But what it does it essentially triage.

It’s now clear the government understands that even in the best climate scenario, the Great Barrier Reef will not survive in its recent form. The Department of Environment and Energy acknowledged this just last month. Even the Queensland tourism industry has publicly come to terms with the certainty that the reef will continue to suffer from climate change.

Scientists have been telling us since the 1980s that even modest climate change is a threat to coral reefs. Corals are so sensitive to changes in temperature that even in the best case warming scenario – achieving the 1.5 C stretch goal of the Paris Agreement - it’s now estimated that only 10 per cent of the world’s reefs will survive in their current form. At 2C, none are expected to escape “severe degradation and annihilation”.

The foundation delivers projects focused on “resilience, restoration and innovation”. That means doing its best to protect and restore the reef. It notes climate change is the biggest threat, but it does not address greenhouse gas emissions, at either a local or systemic level.

Its activities are similar to those we’ve seen from several other reef-focused initiatives and programs in recent years: breeding resilient corals, establishing small refuges, developing monitoring tools, and supporting species such as turtles and dugongs.

Projects like these have been allocated hundreds of millions of dollars of federal government funding through various programs over the years, including water quality and run-off management along with contentious projects to removing Crown of Thorns starfish, and more radical measures such as underwater fans to drive cooler water from the depths. The foundation, for its part, reported recently on testing of a polymer “sun shield”, noting that the technology would only scale to smaller, “high value or high risk” parts of the reef.

A good case can be made that these experiments are pragmatic. Even if emissions stop tomorrow, locked-in warming will continue to ravage the reef for the next few decades.

The foundation counts respected research institutions among its partners, and scientists such as Professor Ove Hoegh-Guldberg of the University of Queensland are on its scientific advisory board. For Hoegh-Guldberg, who sounded the alarm on the threat of climate for coral reefs in 1999, the foundation provides an important opportunity to educate corporations on the dire state of the Great Barrier Reef and climate in general. Again, its scientific review processes have not been questioned.

However, it’s important to remember that there's no guarantee these “resilience” activities will succeed against a backdrop of waters reaching temperatures deadly to coral. Whether portions of a complex marine ecosystem can be preserved, and in what form, is still very much unknown. Professor Terry Hughes, a contender for world leading coral reef expert, is dubious; in a Nature paper he found that water quality and fishing pressure – two key ways of improving resilience - made little difference in the face of devastating warm surges.

BACKGROUND

WEDNESDAY, 8 AUGUST 2018, Great Barrier Reef Foundation: waiting for the inevitable crash

Medicare Australia State of Play 2016-2018

The Australian Minister for Health and Liberal MP for Flinders Greg Hunt tweeted this on 16 August 2018:

Here are the facts on Medicare:
✅Today’s Medicare data shows a record bulk-billing rate of 86.1%
✅This is 4% higher than anything Labor could achieve
✅Almost 9 out of 10 trips to the GP are free
✅Funding for Medicare this year alone is $5.5 billion higher than Labor put in

— Greg Hunt (@GregHuntMP) August 16, 2018

So what is all this self-congratulatory chest-beating about?

According to the Department of Human Services in 2016–17 a total of 24.9 million people were enrolled in Medicare.

In 2017-18 Medicare recorded a total 419,852,601 Schedule Items on which Medicare benefits were paid.

This figure represents on average 1,672,091 items per 100,000 people.

According to Heath Minister Hunt the Medicare bulk billing rate in 2017-18 stood at 86.1 per cent of the total number of Medicare benefits claimed, leaving 13.9 per cent of Medicare benefits to be claimed by the patient.

Based on 2016-17 figures this would indicate in excess of 13.3 million of these Medicare benefits were claimed online by the patient.

Medicare also recorded 3,318,396 payments of Schedule Item 3 General Practitioner Attendances To Which No Other Item Applies, which is a medical service for which there is a 100% Medicare benefit.

That’s an average 13,216 items per 100,000 males and females between 0-4 years and 85 years or over.

However, none of these statistics reveal the number of GP or specialist doctor medical practices which charge patients an upfront amount above the scheduled Medicare benefit amount.

According to the Royal Australian College of General Practitioners (RACGP) the real percentage of patients who had all their GP visits bulk billed during 2016–17 was an est. 66 per cent.

Which meant that an estimated 34 per cent of GP patients in that financial year paid an upfront cost that might not have been able to be fully claim from Medicare.

The Australian Medical Association (NSW) in a 2018 statement suggests that these patients are likely to be paying an average of $48.69 in out-of-pocket fees.

The Australian Institute of Health and Welfare states in its Health Services Series Number 80  that in 2016-17 there were 7.8 million attendances at public hospital emergency departments and “at the conclusion of clinical care in the emergency department, 61% of presentations reported an episode end status of Departed without being admitted or referred”, which indicates that this percentage may contain an unspecified number of individuals who attended a public hospital emergency department because a bulk billing GP was not practicing in their local area and they were not able to readily afford an upfront fee or additional out-of-pocket expenses.

ABC News reported* on 17 August 2018 that:

> 1.3 million people delay seeing a doctor because of the cost;
> 1 in 2 Australian patients faced out-of-pocket costs for non-hospital Medicare services, with the median cost sitting at $142 per person;
> almost 35 per cent of out-of-pocket expenses were spent on specialist services, while almost 25 per cent went to GP gap payments; and
> a further 12 per cent was spent on diagnostic imaging services, like radiology.

Greg Hunt's tweet has definitely avoided facing the Medicare elephant in the room. 

* Based on MyHealthyCommunities: Patients' out-of-pocket spending on Medicare services 2016–17 released August 2018.

Great Barrier Reef Foundation: waiting for the inevitable crash

Mainstream media reports that Australian Prime Minister & Liberal MP for Wentworth Malcolm Turnbull (former director Goldman Sachs), Minister for Environment and Energy & Liberal MP for Kooyong Josh Frydenberg (former director Deutsche Bank Australia) and Chair of the Great Barrier Reef Foundation & Member of the Business Council of Australia John Schubert (former chair Commonwealth Bank) met on 9 April 2018 to discuss the allocation of a grant valued at in excess of AU$487.6 million to the foundation.

It was also reported that no officials from the Department of the Environment and Energy were present at that meeting when the grant offer was made and apparently accepted.

Less than ten weeks later the grant was formally approved without meeting all relevant provisions in the Commonwealth Grants Rules and Guidelines 2017.

The Great Barrier Reef Foundation with a staff of only six full-time employees now has no more than 6 financial years to spend this large sum, which represents est. 69.66 per cent of funds held in the federal government operated Reef Trust since 2014 and 97.52 per cent of additional funds received by the trust on 29 April 2018.

Leaving the Reef Trust with an unspecified amount to fulfil other commitments over the next six years.

Due to obvious time constraints, the Great Barrier Reef Foundation’s board and corporate 'advisers' need to have a detailed financial and project action plan for 2018-19 immediately - if not sooner.

I suspect that I am not alone in waiting for waste of resources, duplication of effort, poorly targeted projects, lack of verifiable outcomes and other instances of  mismanagement to emerge over time, given the slapdash way this grant was put together.

Australian Government, GrantConnect:

Grant Award View - GA9190

GA ID: GA9190

Agency: Department of the Environment and Energy

Approval Date: 20-Jun-2018

Publish Date: 12-Jul-2018

Category: Natural Resources - Conservation and Protection

Grant Term: 27-Jun-2018 to 30-Jun-2024

Value (AUD): $487,633,300.00 (GST inclusive where applicable)

---

Ad hoc/One-off: Yes

Aggregate Grant Award: No

---

PBS Program Name: DoTE 17/18 Program 1.1: Sustainable Management of Natural Resources and the Environment

Grant Program: Reef Trust

Grant Activity: Reef Trust grant to the Great Barrier Reef Foundation

Purpose: The project will deliver activities which are consistent with the purposes of the Reef Trust Special Account Determination to achieve the Reef Trust Objectives and assist to protect the Great Barrier Reef World Heritage Area.

---

Internal Reference ID: 100000001841

---

Confidentiality - Contract: Yes

Confidentiality Reason(s) - Contract: Other:  Aspects of the Co-Financing Plan and the Communication and Stakeholder Engagement Plan 

Confidentiality - Outputs: No

---

Grant Recipient Details

Recipient Name: Great Barrier Reef Foundation

Recipient ABN: 82 090 616 443

---

Grant Recipient Location

Suburb: Brisbane

Town/City: Brisbane

Postcode: 4000

State/Territory: QLD

Country: AUSTRALIA

---

Grant Delivery Location

State/Territory: QLD

Country: AUSTRALIA

Australian Government, Department of the Environment and Energy - Marine:

Grant Agreement Between the Reef Trust and Great Barrier Reef Foundation (June 2018)

Third Sector, 7 June 2018:

The Great Barrier Reef Foundation (GBRF) has confirmed one of its board directors will step down as he faces criminal charges for cartel conduct.

Stephen Roberts, an investment banker and GBRF board director, has been charged by the Australian Competition and Consumer Commission (ACCC) for allegedly playing a part of a criminal cartel during a $2.5 billion deal.

ACCC Chairman, Rod Sims, said: “These serious charges are the result of an ACCC investigation that has been running for more than two years.”

The charges, which included other banking chief executives and senior staff, were laid by the Commonwealth Director of Public Prosecutions and will be determined in court.

Criminal charges relating to an alleged cartel by Citigroup, Deutsche Bank and the ANZ have been formally laid in relation to alleged cartel arrangements relating to trading in ANZ shares following a $2.5 billion institutional share placement in August 2015.