YambaCAN is hosting a meeting for all members and Yamba residents to attend.
When: Tuesday, 21 February 2023
Time: 6.30pm
Where: Wooli Street Hall, Yamba
Yamba CAN will be providing an outline of achievements since its inception on 28 September 2022.
Those attending will be able to voice their suggestions about what they would like Yamba CAN to focus on.
A short video will also be provided with updates on a number of matters.
In its last published annual report (2021-22) the NSW Ombudsman’s office received a total of 5,746 complaints concerning government departments/agencies including further education facilities, local health districts and icare.
Service NSW had the highest number of complaints (959), followed DCJ Housing (956), Land and Housing Corporation (374), Roads and Maritime (364) and Ministry of Health (100).
In addition the Ombudsman also received 2,405 actionable complaints about local government councils, including 2 complaints about county councils.
With Clarence Valley Council being first in the Top 10 councils with the most finalised actionable complaints per 100,00 head of population (89) even though it tied for last place on that same chart for the actual number of finalised actionable complaints (46). Central Coast Council was the dubious Top 10 winner on the basis of actual number of finalised actionable complaints received which reached 158.
Actionable complaints about these 10 councils - Central Coast Council, Canterbury-Bankstown Council, Northern Beaches Council, Georges River Council, Sutherland Shire Council, Mid-Coast Council, Blacktown City Council, Lake Macquarie City Council, Clarence Valley Council, Inner West Council - represent 29% of all the local government actionable complaints the Ombudsman finalised in 2021-22.
The most frequently raised issues in actionable
complaints about councils were:
What that paragraph appears to be indicating that complaints about development applications and in Chamber decisions concerning development still feature prominently in the annual complaints profile as they have for at least the last two decades.
The Clarence Valley Independent was told by a Local Government NSW spokesperson that despite serving the same population, the state’s 128 councils recorded fewer than half the number of complaints made about the state government.
713 Robodebt mentions in parliament, a Centrelink whistleblower in 2016, protests directly to the Member for Aston’s office and tens of thousands of news pieces. But between the 4 Liberals on the Robodebt Royal Commission they’ve said they ‘don’t recall’ anything 140 times. How? pic.twitter.com/UQ78MYQa3P
— Bill Shorten (@billshortenmp) February 8, 2023
On the 7 February 2023 the Reserve Bank of Australia (RBA) increased the official cash rate by 0.25%. The current official cash rate as determined the RBA is now 3.35%.
As we reach the ninth official cash rate rise since 4 May 2022, the Reserve Bank Governor’s words set out below are less and less reassuring.
According to the Australian Stock Exchange (ASX) RBA Rate Tracker:
As at 8 February, the ASX 30 Day Interbank Cash Rate Futures March 2023 contract was trading at 96.525, indicating a 65% expectation of an interest rate increase to 3.60% at the next RBA Board meeting.
The next RBA Board meeting and Official Cash Rate announcement will be on the 7th March 2023.
Reserve Bank of Australia
Statement by Philip Lowe, Governor: Monetary Policy Decision
Number 2023-04
Date 7 February 2023
At its meeting today, the Board decided to increase the cash rate target by 25 basis points to 3.35 per cent. It also increased the interest rate on Exchange Settlement balances by 25 basis points to 3.25 per cent.
Global inflation remains very high. It is, however, moderating in response to lower energy prices, the resolution of supply-chain problems and the tightening of monetary policy. It will be some time, though, before inflation is back to target rates. The outlook for the global economy remains subdued, with below average growth expected this year and next.
In Australia, CPI inflation over the year to the December quarter was 7.8 per cent, the highest since 1990. In underlying terms, inflation was 6.9 per cent, which was higher than expected. Global factors explain much of this high inflation, but strong domestic demand is adding to the inflationary pressures in a number of areas of the economy.
Inflation is expected to decline this year due to both global factors and slower growth in domestic demand. The central forecast is for CPI inflation to decline to 4¾ per cent this year and to around 3 per cent by mid-2025. Medium-term inflation expectations remain well anchored, and it is important that this remains the case.
The Australian economy grew strongly over 2022. The central forecast is little changed from three months ago, with GDP growth expected to slow to around 1½ per cent over 2023 and 2024. The recovery in spending on services following the lifting of COVID restrictions has largely run its course and the tighter financial conditions will constrain spending more broadly.
The labour market remains very tight. The unemployment rate has been steady at around 3½ per cent over recent months, the lowest rate since 1974. Job vacancies and job ads are both at very high levels, but have declined a little recently. Many firms continue to experience difficulty hiring workers, although some report a recent easing in labour shortages. As economic growth slows, unemployment is expected to increase. The central forecast is for the unemployment rate to increase to 3¾ per cent by the end of this year and 4½ per cent by mid-2025.
Wages growth is continuing to pick up from the low rates of recent years and a further pick-up is expected due to the tight labour market and higher inflation. Given the importance of avoiding a prices-wages spiral, the Board will continue to pay close attention to both the evolution of labour costs and the price-setting behaviour of firms in the period ahead.
The Board recognises that monetary policy operates with a lag and that the full effect of the cumulative increase in interest rates is yet to be felt in mortgage payments. There is uncertainty around the timing and extent of the expected slowdown in household spending. Some households have substantial savings buffers, but others are experiencing a painful squeeze on their budgets due to higher interest rates and the increase in the cost of living. Household balance sheets are also being affected by the decline in housing prices. Another source of uncertainty is how the global economy responds to the large and rapid increase in interest rates around the world. These uncertainties mean that there are a range of potential scenarios for the Australian economy.
The Board’s priority is to return inflation to target. High inflation makes life difficult for people and damages the functioning of the economy. And if high inflation were to become entrenched in people’s expectations, it would be very costly to reduce later. The Board is seeking to return inflation to the 2–3 per cent range while keeping the economy on an even keel, but the path to achieving a soft landing remains a narrow one.
The Board expects that further increases in interest rates will be needed over the months ahead to ensure that inflation returns to target and that this period of high inflation is only temporary. In assessing how much further interest rates need to increase, the Board will be paying close attention to developments in the global economy, trends in household spending and the outlook for inflation and the labour market. The Board remains resolute in its determination to return inflation to target and will do what is necessary to achieve that.
[my yellow highlighting]
The Sydney Morning Herald, 9 February 2023:
There is a better than 50-50 chance Australia could fall into recession due to the Reserve Bank’s aggressive increases in interest rates, economists believe, as a growing group of Labor MPs suggest the seven-year term of RBA governor Philip Lowe should not be extended.
Macroeconomics Advisory chief economist Stephen Anthony said the chance of a recession next year could be as high as 70 per cent due to the impact of the RBA’s high interest rates, coupled with a slowdown in key markets such as China.
Pressure on Lowe has intensified after the RBA pushed interest rates to a 10-year high this week and signalling more than one further increase in coming months. Lowe, whose seven-year term ends on September 17, had signalled in late 2021 that rates would remain on hold until 2024.
The previous two governors, Glenn Stevens and Ian Macfarlane, both had their terms extended by three years. But with a sweeping review of the central bank due to be finalised and handed to Treasurer Jim Chalmers in late March, there is a growing expectation that Lowe will not stay on beyond September.
Within the government, there are now open questions about Lowe’s long-term tenure at the bank.....
"Australians enjoy access to a world class health system with primary care at its centre. Our vital and valued primary care workforce includes Australia’s hard working general practitioners, allied health professionals, primary care nurses, nurse practitioners and midwives, pharmacists, Aboriginal health workers, practice managers and other practice staff. Primary care provides the foundation for universal health care, working hard to keep all Australians healthy and well in the community, and to deliver care that meets the needs of people and communities at all stages of life, no matter where they live.....
Modernising primary care
Recommendations
• Modernise My Health Record to significantly increase the health information available to individuals and their health care professionals, including by requiring ‘sharing by default’ for private and public practitioners and services, and make it easier for people and their health care teams to use at the point of care.
• Better connect health data across all parts of the health system, underpinned by robust national governance and legislative frameworks, regulation of clinical software and improved technology.
• Invest in better health data for research and evaluation of models of care and to support health system planning. This includes ensuring patients can give informed consent and withdraw it, and ensuring sensitive health information is protected from breach or misuse.
• Provide an uplift in primary care IT infrastructure, and education and support to primary care practices including comparative feedback on their practice, so that they can maximise the benefits of data and digital reforms, mitigate risks and undertake continuous quality improvement.
• Make it easier for all Australians to access, manage, understand and share their own health information and find the right care to keep them healthy for longer through strengthened digital health literacy and navigation."
[Strengthening Medicare Taskforce Report December 2022, Introduction opening sentences, p.2 & Modernising primary care, one of four recommendation clusters, p.9]
Last week I 'phoned the GP practice I normally attend when I am unwell seeking an appointment.
Rather than the expected two to three week wait for an appointment I was given a choice of appointment dates that week.
When I entered the four-doctor practice it only had two patients sitting in the waiting room and I made a third.
The situation was almost self-explanatory when I read the signs at reception. The practice was now charging fees payable at time of visit.
A Standard Consultation is $84 (which includes a $10 medical centre facility fee). There is a federal government rebate of $39.75 for patients with a Medicare Card – payable electronically after the $84 is handed over.
The Facility Tax For Professional Services also includes as or when required – a medical centre treatment room fee of $20 and a medical centre consumables fee of $20. There may also possibly be a surcharge applied for public holidays.
There is no bulkbilling of DVA Gold Card Holders and Pension Card Holders until they are over 75 years of age.
As the The Australian Government Actuary is currently not expecting the average 67 year-old to live more than somewhere in the vicinity of another 20.1 years, it would appear that a number of GPs are now willing to lock a significant number older patients out of bulk billing for all but the last 12 years of their remaining lifespans.
So is it any wonder that everyone from the prime minister & state premiers to patients are wondering just how far this corporatisation of primary health care will go and, what workable solutions might be found to correct a dysfunctional primary care system.
An excerpt from The Sydney Morning Herald Economics Editor Ross Gittens’ perspective on the recently updated final report of the Strengthening Medicare Taskforce, 8 February 2023:
According to the doctors’ union, the AMA, the reason GPs have become so hard to find is that the federal government isn’t paying them enough. Whereas in the old days half of all medical graduates became GPs, now it’s down to about 15 per cent.
So, pay them more. Problem solved.
What the report’s saying is: sorry, not that simple. It’s true the Coalition government inherited a temporary freeze in Medicare rebates – the amount of a doctor’s bill that’s paid by the feds – in 2013, and continued it until 2018. And although the schedule of rebate payments has been increased annually since then, the increases have been much smaller than inflation.
Why? Partly because the Liberals were trying to prove they could cut taxes without damaging “essential services” such as Medicare.
But also because they knew something was wrong with the way general practice works. They needed to pay GPs differently to do different things. Rather than pay more and more the old way, they’d hold back until they – or some future government – worked up the courage to make changes.
Over the almost 40 years of Medicare, there’s been a big change in the problems people bring to their GPs. Because we’re living longer, healthier lives, much more of our problems are chronic – someone with heart trouble or diabetes has to wrestle with it for the rest of their lives – rather than acute: something that’s easily and quickly fixed.
But the present (subsidised) fee-for-service way of remunerating doctors is designed to suit acute problems, not chronic conditions. It involves waiting for problems to arise, not early diagnosis or stopping chronic conditions getting worse.
It encourages GPs to keep consultations short, avoiding long discussions of multiple problems.
A change no one wants to talk about is the way sole practitioners or partnerships of doctors are giving way to companies owning chains of practices staffed by doctors they employ.
When you separate the person delivering the care from the person watching the bottom line, you increase the likelihood doctors are pressured to keep consultations short and order many tests – a further reason to be cautious about reinforcing GPs’ dependence on fee-for-service.
The report wants to move to “blended” funding, with acute consultations continuing to be fee-for-service, but GPs paid lump sums for developing and managing “care plans” for particular patients with chronic conditions.
While it’s true fewer medical graduates are becoming GPs, it’s not the whole truth. As the Grattan Institute reveals, “Australia has more GPs per person than ever before, more GPs than most wealthy countries, and record numbers of GPs in training”.
How do other countries with good healthcare get by with fewer GPs? By making sure their GPs can’t insist on doing things that could be done by other health workers – nurses, nurse practitioners (nurses trained to do some of the more routine things doctors do), pharmacists and physios.
This is what “co-ordinated, multidisciplinary team-based care” means. Changing GPs’ surgeries into more wide-ranging “primary care clinics” is also about making it easier for patients to move between different kinds of care, with GPs taking more responsibility for the total package, and all the various doctors and paraprofessionals having access to a patient’s medical history.
There’s nothing new about this. Federal governments have been trying to improve the performance of primary care for decades – with little success. Why? Because they’ve had so little co-operation from the premiers and the GPs themselves.
The true message of the latest report is: Medicare reform must not just be about more money to do the same things the same way.
The full 10-page plus cover sheets Strengthening Medicare Taskforce Report can be found at:
https://www.health.gov.au/sites/default/files/2023-02/strengthening-medicare-taskforce-report_0.pdf
The taskforce was formed by the Albanese Labor Government and has 17 members. Its first meeting was held on 29 July 2022 and the taskforce has issued 6 communiques containing meeting minutes.
Fool us once, shame on you; fool us twice, shame on us. Try to fool us a third time, then your vote count drops on Saturday 25 March 2023.
Clarence Valley Independent, 1 February 2023, excerpt:
The unveiling of the master plan for the $264 million redevelopment of Grafton Base Hospital (GBH) has been described by Des Harvey of the Grafton Base Hospital Community Committee (GBHCC) as a miniscule step forward.
“The Minister and others might think it’s a major step, but in our opinion, there is still no funding other than just a mention of funding,” he said.
“There is a promise of $263.8 million, but that has been around for too many years.
“We’ve also had a promise that construction will commence before March 2023, and we know that’s not going to happen.
“We’re still talking about planning.
“In my opinion, and that of many people I speak to in the community, the planning really was completed back in 2015, and that’s the reason that the government was able to come up with a figure of $263.8 million, so they knew specifically how many nails, screws and alike were involved in the job…..
“But as far as I can see, there is no money in the budget for it, and until there is money in the budget, nothing happens,” he recalled.
