Quote of the Month

 “..we’ve all had our lived experiences of floods of varying intensities. Now as intelligent human beings I think we can do better than what we’ve been doing.

We continue to build on floodplains and expect somehow some sort of different result. 

We talk about flood resilience and flood resilience is not living with its fingers crossed-type mentality.

Fingers crossed that it doesn’t rain too hard, too much. Fingers crossed that when it does the supermarket shelves are not stripped out. Fingers crossed that we can evacuate ourselves and if we can’t, fingers crossed the SES is going to come and look after us. And fingers crossed that if I do need medical help or to get out of Yamba, that road is not broken by flood water.”

[Cr. Jeff Smith, speaking in support of a motion to rezone undeveloped land in West Yamba Urban Release Area within the town’s natural flood storage area, Clarence Valley Council Ordinary Monthly Meeting,18 April 2023] 

Tweets of the Week

 

Interest on student debts generates more money for the Federal Gov than royalties from coal and gas 😱

— Sue Higginson (@SueHigginson_) April 26, 2023

 

STATUS: political comment.

To make your Sunday better.😇 pic.twitter.com/brF4v7MpHP

— Perorationer- A Recovering Copyright Delinquent 🤭 (@Perorationer) April 22, 2023

 

STATUS: humour.

Turn on sound

Government-owned Forestry Corporation NSW forced to remap active logging area of Doubleduke State Forest to protect giant trees

 

Doubleduke is the state forest outlined in darker green
IMAGE: via @CloudsCreek

NSW Environment Protection Authority, News, 16 April 2023:

Protecting giant trees in Doubleduke State Forest

The EPA has acted on community concerns about giant trees in Doubleduke State Forest on Bundjalung Country near Grafton, leading the Forestry Corporation of NSW (FCNSW) to voluntarily suspend tree harvesting there.

Update: 20 April 2023

 

FCNSW has completed a remap of active harvest areas as requested by the EPA on 14 April 2023.

The additional mapping provides assurance to the EPA and the community that all retained trees in active harvest areas have been identified and mapped.

Having regard to remapping works undertaken by FCNSW, a voluntarily suspension of operations is no longer requested by the EPA.

The EPA will continue to monitor and enforce compliance with the CIFOA at the Forest.

The decision and timing to recommence operations in the Forest is a matter for FCNSW.

 

The EPA actively monitors and enforces compliance at crown forestry operations conducted by FCNSW.

On 11 April a complaint was lodged with the EPA alleging breaches in the forest.

EPA officers conducted a site inspection in the forest on 13 April. The inspection identified that FCNSW had not mapped two giant trees in accordance with the Coastal Integrated Forestry Operations Approval (CIFOA) and Protocols.

“A giant tree is defined as one whose diameter is greater than 140cm when measured at 30cm above ground height," EPA’s Director Regulatory Operations, Steve Orr said.

“Under the forestry laws all giant trees must be retained.

“While these two giant trees have not been harvested, they were not mapped.

“We’re extremely concerned that there is a risk that other giant trees may not have been mapped in accordance with the CIFOA."

After the inspection the EPA asked FCNSW to immediately suspend operations in Doubleduke State Forest and remap the active harvest areas.

FCNSW confirmed it had voluntarily stopped harvesting trees in the forest.

FCNSW will continue to maintain tracks and process timber already harvested in the forest.

A number of other alleged breaches were not substantiated.

FCNSW is fully cooperating with the EPA.

The EPA’s investigation is ongoing.

Doubleduke State Forest protestors
IMAGE: via @CloudsCreek

The 60 day script for medication treating chronic stable medical conditions was first recommended in August 2018 - it finally arrives in September 2023

 

RACGP: 60-day dispensing a win for Aussie patients

Royal Australian College of GPs

The Royal Australian College of General Practitioners (RACGP) has warmly welcomed the federal Government’s decision to put patients first and make medicines cheaper and easier to access.

It comes following the Minister for Health and Aged Care Mark Butler’s announcement today doubling the amount of medicine a pharmacy can dispense to a patient to up to 60 days’ worth for more than 320 medicines on the Pharmaceutical Benefits Scheme. This effectively halves the dispensing fees for these medicines.

Currently, patients are limited to a 28- or 30-day supply, forcing them to take more trips to the pharmacy for medications for stable conditions. The changes, which will come into effect on 1 September, will save patients up to $180 a year on medications for chronic conditions including heart disease and hypertension.

RACGP President Dr Nicole Higgins said it was a momentous day.

“This is a win for patients,” she said.

“Cost of living pressures are placing tremendous strain on households across Australia, so there has never been a more important time to save patients money and time. Patients with a range of chronic conditions including heart disease will be able to save up to $180 a year and that will make a huge difference for so many households.

“This announcement shows the tide is finally turning. In 2018, the Pharmacy Benefits Advisory Committee recommended increasing the maximum dispensed quantities of common medications from one to two months’ supply. This change has been recommended because it is in the best interests of patients, and I am pleased that the Government has heeded the expert advice.”

Dr Higgins urged the nation’s leaders to remain steadfast.

“Beware of scare campaigns,” she said.

“A recent Westpac report found that pharmacies are reaping record profits, with the total consumer spending in pharmacies rising from $92.5 million in July 2019 to more than $123 million in January this year. Also, despite what you hear from the Pharmacy Guild, there is no evidence of a shortage of the medications that are included in today’s announcement. Some pharmacy owners may be concerned that they will lose retail sales; however, at the end of the day cheaper access to lifesaving medications must come before retail sales, it’s as simple as that.”

The RACGP President said that the was plenty more to be done.

“My aim is for today’s announcement to be just the beginning,” she said.

“Let’s go even further and extend the length of prescriptions for patients with stable chronic conditions. The RACGP also supports further investigation of the benefits to patients in changing the $1 discount rule. It effectively stops pharmacies from discounting medicines that cost more than the current co-payment of $30 by more than $1. When you consider that in New Zealand the patient contribution is as little as $5 for most items, you have to ask whether we can do better here.

“I’m also focussed on reforming the Pharmaceutical Benefits Scheme prescribing system to reduce administration time and free up GPs to do what they do best – care for patients. Right now, the system is too cumbersome and time-consuming. If it was streamlined, GPs would be able to spend more time with patients rather than admin work. As a GP myself in Mackay, that sounds like a winning combination to me.

“It’s also vital that the Government overhauls Australia’s anti-competitive pharmacy ownership and location laws, which inflate costs for patients. The rules appear to be focussed on protecting pharmacy owners rather than increasing patient access to cheaper medicines.

“Today is a great day for Australian patients. The tide is turning, and patient well-being is front and centre – right where it should be. Mark my words, this is just the beginning.”

A recent poll of more than 1,000 GPs who answered the question: “Do you think your patients would benefit from doubling dispensing times to 60 days?” found a staggering 85% said “yes”.

~ ENDS

List of medications possibly being considered for inclusion in 60 day script scheme can be found at:

https://m.pbs.gov.au/industry/listing/elements/pbac-meetings/pbac-outcomes/2022-12/Increased-Dispensing-Quantities-List-of-Medicines.pdf

 

BACKGROUND

AUGUST 2018 PBAC OUTCOMES – OTHER MATTERS, excerpt:

The PBAC considered a list of PBS medicines taken from the Pharmaceutical Benefits Schedule that are indicated for the treatment of chronic conditions. Based on an assessment of clinical safety and ongoing cost-effectiveness, the PBAC recommended that 143 medicines (348 PBS items) were acceptable for listing with increased maximum dispensed quantities (approximately 60 days or two months’ supply per dispensing). The list of medicines accepted by the PBAC as suitable for additional PBS items with increased dispensing quantities (Proposal 2) is available on the PBS website.

Long COVID aka post-acute sequelae of COVID-19 (PASC) in 2023: no you are not imagining it nor being a malingerer. However research is in its infancy with regard to your often debilitating illness

 

First the good news. On 24 April 2023 the Minister For Health & Labor MP for Port Adelaide Mark Butler announced that The Australian Government will provide a further $50 million from the Medical Research Future Fund (MRFF) for research into post-acute sequelae of COVID-19 (PASC) – commonly known as Long COVID.

Bringing the Long COVID research funding pool to a total of $66.6 million and proving that parliamentary committee's can sometimes galvanise government.

The following is a slightly more mixed message, as at this stage prevention of Long COVID seems to rely on the implementation of public health measures the states and territories have long since abandoned in practice.

April 2023
CANBERRA

The 213-page report to the Australian Parliament by the House of Representatives Committee on Health, Aged Care and Sport can be read and downloaded at:

https://parlinfo.aph.gov.au/parlInfo/download/committees/reportrep/RB000006/toc_pdf/SickandtiredCastingalongshadow.pdf

The Committee accepts the World Health Organisation (WHO) definition of Long COVID as being the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. Debilitating symptoms can be wide ranging with over 200 being recorded by WHO.

It further accepts that the number of people in Australia who were diagnosed with COVID-19 and were at risk of or possibly went on to develop Long COVID could be anywhere between 228,039 to 2,280,399 individuals. The difficulty in tying down a more definitive figure when it comes to the number of Long COVID suffers is apparently hampered by the paucity of data which has been collected to date.

The report goes on to inform government that:

At this stage it does seem that specific treatments require more evidence of benefit before being specifically recommended, but this will become clearer over time. Certainly, most of the care needs to be provided by the primary care system, such as by GPs, nurses, and allied health professionals.

We will need to help schools, universities, and workplaces adapt to allow the gradual return of people with long COVID. We will also need to train health professionals in how to diagnose and manage long COVID patients.

Mental health issues are clearly an area of concern too, particularly as many suffering from long COVID are aged between 20 and 50 years old and have many concerns, such as family and/or work responsibilities, which place additional stresses on them.....

It is also of concern that women seem more likely to be affected by long COVID than men.

The Committee is also of the view that when it comes to infectious disease and its aftermath:

the development of a national Centre for Disease Control (CDC) within the Department of Health and Aged Care would be the most appropriate mechanism for data collection and linkage with the states and territories.

Likewise, there is much that we do not understand about the virus, such as the fact that it is likely changing from being an acute pandemic virus to now an endemic form.

Research will be very important in helping us understand the best ways and means of managing its ongoing effects, particularly including long COVID. Research should include individuals from Aboriginal and Torres Strait Islander communities, culturally and linguistically diverse communities and other high-risk groups including those who are immunosuppressed.

A research program should be established to nationally coordinate and fund research into long COVID and COVID-19 generally. This could be led by the Department of Health and Aged Care — ideally the CDC — and should be the for the longer term.

Clearly, there has been a number of issues raised about reducing transmission of COVID19, such as improving air quality to reduce aerosol spread and this also has reference to broader health outcomes and requires investigation. 

In addressing the prevention of Long COVID the report states quite clearly:

The committee received evidence that emphasised that the best way to prevent long COVID is to prevent an initial COVID-19 infection.

For example, Professor Margaret Hellard, Director of Programs at the Burnet Institute, argued that while we don’t have a full understanding of long COVID, the most effective way to avoid it is to ‘try and stop COVID and reduce the number of COVID infections.

This position is supported by the National Clinical Evidence Taskforce on COVID-19 (NCET), which recommended the Australian Government clearly communicate to the public and to health care providers ‘that prevention of COVID-19 is the most-effective method of preventing long term health issues’ resulting from the virus.

However, this is difficult to achieve without access to other preventative methods given the highly infectious nature of current Omicron variants circulating in the community.

The NCET summarised:

With the shift away from mandated mask use and regular reporting of COVID-19 cases, and the recent removal of the requirement for isolation following confirmed infection, people may have the highly inaccurate impression that COVID-19 is “over”. There is a lack of messaging that potential health risks related to COVID19 continue to be relevant and that vaccines, mask use in crowded indoor spaces, testing and isolation are still a valuable way to decrease the transmission of SARS-CoV-2, and mitigate the impact of long COVID.

The importance of mask wearing, physical distancing, hygiene and taking other health precautions when visiting high-risk settings cannot be underestimated.

However, the enforcement of these health measures is largely at state and territory government discretion, and to varying extents, now a matter of individual responsibility.

As for the Committee’s view on COVID-19 vaccination:

Booster doses of the COVID-19 vaccine are important to prevent waning immunity against the rapidly mutating COVID-19 virus.

On 8 February 2023 the Hon Mark Butler MP, Minister for Health and Aged Care, announced that from 20 February 2023 all adults who have not had a COVID-19 booster or a confirmed case in the past six months are eligible for a COVID-19 booster, irrespective of how many doses that person has received. Additional boosters for people under the age of 18 have not yet been announced, except where children aged 5 to 17 have health conditions that would put them at risk of severe illness.

Although COVID-19 vaccines are widely available and accessible, data suggests that many people are not electing to receive additional doses for which they are eligible. Professor Crabb AC suggested that this may be due to people becoming less aware of the risks associated with COVID-19 infections as the pandemic continues and commented on a general lack of motivation experienced by many people who received their first two doses but ‘don’t see the benefit’ in receiving booster doses......

The Committee made 9 recommendations to government which can be found on xxi & xxiv of the report.

Disappointing news for those on Centrelink unemployment benefits

 

The Interim Economic Inclusion Advisory Committee was created by the Albanese Government in December 2022.

Membership of this committee is intended to be up to 14 members, including a Chair, and include a mix of social security academic experts, representatives from key relevant advocacy organisations, unions, business peak bodies, the philanthropic sector and economists.

CHART: Interim Economic Inclusion Advisory Committee, 2023–24 Report to the Australian Government, p.90

Its purpose is to provide non-binding written advice on economic inclusion, including policy settings, systems and structures, and the adequacy, effectiveness and sustainability of income support payments ahead of every Budget.

The Interim Economic Inclusion Advisory Committee’s April 2023 InterimEconomic Inclusion Advisory Committee, 2023–24 Report to theAustralian Government made 37 recommendations in this 97 page document which covers aspects of: adequacy of working age payments; full employment objective; addressing disadvantage in places where it is concentrated; removing barriers to economic inclusion – families with children; and, advice on legislated measures on economic inclusion and poverty reduction.

The first three recommendations are:

Recommendation 1

The Government commit to a substantial increase in the base rates of JobSeeker Payment and related working age payments as a first priority.

Recommendation 2

The Government commit to increase Commonwealth Rent Assistance and reform its indexation to better reflect rent paid.

Recommendation 3

The Government commit to a timeframe for the full increases to be implemented, if increases are to be staged.

In the joint media release of 18 April 2023, Australian Treasurer & Labor MP for Rankin Jim Chalmers and Minister for Social Services & Labor MP for Kingston Amanda Risworth signalled an intention not to support the first recommendation in the 2023-24 financial year and did not give hope that all three of the aforementioned recommendations will become future priorities anytime soon.

BACKGROUND

Interim Economic Inclusion Advisory Committee, 2023–24 Report to the Australian Government, excerpt, pp3-4:

Introduction

Adequacy of income support

The Committee focused first on the adequacy of income support for more than one million people in Australia who receive working age payments like JobSeeker or Youth Allowance. All indicators available to the Committee show current rates of these payments are seriously inadequate, whether measured relative to the National Minimum Wage, in comparison with pensions, or against a range of income poverty measures. People on these payments face the highest levels of financial stress in Australia. Committee members heard from people who live on income support having to choose between paying for their medicine or electricity bills.

The Committee recommends the Government, as a first priority, commit to a substantial increase in the base rates of the JobSeeker Payment and related working age payments. Income support should better value unpaid caring work and support those who cannot be in full-time paid employment, including due to illness, disability or partial capacity to participate.

The Committee also found the current rate of Commonwealth Rent Assistance (CRA) to be inadequate. At a time of rapidly rising rents, the 1.3 million Australian households receiving CRA are at greater risk of financial stress and poverty. The

Committee recommends the Government commit to increase CRA and reform its indexation to better reflect rent paid.....