Australian Health Care Reform Alliance

06/12/2025

An incentive to work differently in health

A major national shift is underway, focused on how we fundamentally use our health workforce. The goal is to move beyond outdated rules and practice barriers to let highly skilled professionals - like nurses, paramedics and other allied health practitioners, apply their full capabilities in patient care.

To make this happen, the Federal Government is using a powerful lever: $900 million in funding. This money is tied directly to states and territories reforming their models of care and "scope of practice" rules.

The result is that jurisdictional Treasurers and Premiers have a clear, financial incentive to modernise the system. It's about moving from a model that has underutilised talent to one that actively unlocks it.

This reform isn't just about individuals doing more - it's about redesigning how teams and the system operate. The projected outcomes are better support for community-based care, more flexible roles, and smarter ways to keep people well and out of hospital.

Alison Barrett writes: The inclusion of scope of practice reforms in national competition policy arrangements has been welcomed as likely

05/12/2025

The Silver Report

Victorian Treasurer Jaclyn Symes has released (4/12/2025) the final report from Independent Reviewer Helen Silver AO — the former top bureaucrat tasked with streamlining Victoria's public sector by identifying inefficiencies and consolidating government entities - as well as the government's response.
ABC News https://tinyurl.com/48eevdcx
Full 154 page Report: https://tinyurl.com/rd4eanev
Victorian Govt response: https://www.vic.gov.au/vps-review
What Matters Most summaries: https://tinyurl.com/zn6e9wts

The Report is comprehensive within the the Review’s Terms of Reference that excluded integrity bodies and Parliament and other bodies not within scope due to their independent functions.

Frontline workers were considered outside the scope of the Review and thus the Review did not consider schools, hospitals, health services and the police. Individual courts, local government and departments were also excluded. Captured within scope were 90+advisory committees.

The Department of Health is used as a case study - with Victorian health spending increasing over the past 10 years, with real per capita state health expenditure increasing by 39 per cent in Victoria since 2014-15 and contrasted at $4200 in 2023-24 with NSW at $3600.

The Silver Review covers several related issues with reform proposals, including an increased role for preventive health measures, greater use of digital systems, delivery of care closer to home, and transitioning out of areas of Commonwealth responsibilities (p 41).

The Review recommended the Health Complaints Commissioner role be absorbed into Safer Care Victoria so as to realise operational efficiencies and reduce administrative costs.

Another merger proposal was to merge human rights offices and commissioners within the Victorian Equal Opportunity and Human Rights Commission (VEOHRC), bringing together the Commissioner for LGBTIQA+ Communities, Commission for Gender Equality in the Public Sector, Commission for Children and Young People, the Victorian Multicultural Commission and the Office of the Public Advocate within VEOHRC. This initiative is intended to leverages expertise, increase administrative efficiency and provide a one-door approach to human rights services with VEOHRC to become a centre for excellence for human rights.

The Review recommends streamlining the regulatory system to a smaller number of larger, focused regulators that could address common issues and concentrate on core regulatory activities. However, it is noted that too large regulators tend to lose efficiency, subject matter expertise and focus on the sectors they regulate, and knowledge of the sector dynamics and the priority risks of harm.

AHCRA reiterates that patient (community) safety and health practitioner regulation are of paramount importance and a fundamental role of government. www.pc.gov.au/inquiries/current/quality-care

Effective implementation of the various merger proposals is crucial and it is absolutely vital that the health-related input provided by advocacy groups is retained. Some of the strongest reactions and objections to the Review proposals have been those relating to the news that VicHealth will close as a standalone agency and be absorbed into the State Department of Health.
https://www.croakey.org/shock-and-alarm-greet-news-about.../

Among the insights offered by the Review was that Victoria should strengthen its approach to oversee and manage entities (p 149). It should implement best practice governance structures, enhance visibility and monitoring through data, conduct first-principles necessity reviews, and sunset entities by default.

The Victorian Secretaries’ Board will oversee implementation and its monitoring role will be supported by the Department of Premier and Cabinet and the Department of Treasury and Finance. https://tinyurl.com/3rpd7af3

24/11/2025

Beyond the Band-Aid

A plea for the federal health Minister to resolve the structural and funding issues impacting valuable community health centres.

Introduction by Croakey: Communities in Naarm/Melbourne who rely on community health services provider cohealth have been given a short-term reprieve

24/11/2025

Health at a Glance 2025

The OECD has released the latest edition of its regular Health at a Glance report summarising a range of health indicators. Members, Key Partners and accession candidate countries’. The Australian health system compares well on many indicators, but less so in some areas. https://www.oecd.org/en/publications/health-at-a-glance-2025_8f9e3f98-en

Aome findings across the OECD include:
- Health systems account for nearly a tenth of economic output
- The health workforce is growing quickly with cross jurisdictional workers helping to fill the gaps in many nations
- Obesity is placing growing pressure on health systems and economies
- Antimicrobial resistance is one of the fastest-growing threats to global health
- A renewed focus on value-for-money is essential:

For the country note on Australia see https://www.oecd.org/en/publications/health-at-a-glance-2025_15a55280-en/australia_7cad4f74-en.html

17/11/2025

Australia's public mental health system is in crisis.

A new report from the Australian Medical Association reveals that patients in urgent need of mental health care are waiting an average of seven hours in busy emergency departments.

These bright, noisy, and overstimulating environments are the worst possible place for someone in crisis, often worsening their symptoms and leading to increased distress.

Why is this happening? The system is buckling under:
- Record-high demand
- A critical shortage of inpatient beds
- A lack of investment in community mental health
- A severe workforce shortage

As one expert put it, the emergency department has become a "last resort," leading to missed opportunities for early intervention and longer recovery times.

This isn't just a number—it's our friends, family, and neighbours. It's a national issue that demands a national solution.

Get the full story and understand the depth of this crisis here.https://www.ama.com.au/sites/default/files/2025-11/AMA_Public_Hospital_Report_Card_Mental_Health_Edition_2025_0.pdf

11/11/2025

The growing cost of delayed climate action

The Lancet sets out a chilling scenario for climate change but offers glimmers of hope if resolute action is taken.

The Lancet, 8 (2025) . doi:10.1016/S0140-6736(25)01919-1

11/11/2025

Australian CDC legislation passed

This week has seen the passage of a law to create the Australian Centre for Disease Control following the Senate debate and voting on several amendments.

The final law now includes some new rules. The CDC must:
- Report on how prepared Australia is for a pandemic.
- Report on how climate change affects people's health.
- Include a person with a disability on its main advisory board.
- Have a leader who can advise and work with workplace safety and disability groups.

There were disagreements and missed opportunities on the focus to be placed on Aboriginal and Torres Strait Islander Health.

Changes were proposed to make the CDC specifically focus on improving health for Indigenous Australians and addressing the root causes of health inequality. Both the Government and the LNP voted together to reject these changes. This is seen as a major missed opportunity.

Changes were also proposed to make the hiring of the CDC's boss and its advisory board more independent, using expert panels to prevent partisan selection of appointees. The Government and the Greens voted together to reject these changes.

Another proposal was for the CDC's 5-year review to be done by a panel of acknowledged experts (like public health professionals, economists, etc.) and not by politicians or related political party staff. This amendment was also rejected.

The article points out that the debate was rushed. The government limited the speaking time, so many politicians didn't get a proper chance to discuss the proposed changes before voting on them.

In summary, while the new CDC will focus on pandemics and climate change, critics argue it missed the chance to be more independent from political influence and to directly tackle the serious health inequalities faced by Aboriginal and Torres Strait Islander peoples.

Introduction by Croakey: The Federal Government and Opposition voted together to oppose amendments to the Australian Centre for Disease Control

11/11/2025

Why AHCRA supports climate action - it's a significant health issue

A study of 217 tropical cyclones globally to see how people died unearthed findings that might surprise you.

To reduce the health impacts of tropical cyclones, disaster planning must look beyond immediate injuries and infrastructure damage. Governments at all levels need to prepare for a surge in medical needs across a range of diseases.

Tropical cyclones can be even more deadly – and for a wider range of reasons – than we ever thought.

19/10/2025

UTS proposal to disestablish the School of Public Health

Daniel Demant is an Associate Professor of Social Epidemiology with the School of Public Health at UTS and writes about the proposal. https://insightplus.mja.com.au/2025/38/uts-plans-to-cut-public-health-at-the-worst-possible-time/

He opines that the proposed closures are more than a university decision and that they are a public health issue. At a time when Australia urgently needs more expert workers, UTS is proposing to educate fewer. The pandemic taught us, at extraordinary cost, that public health is not expendable.

Australia has just emerged from one of the worst global health crises in living memory.

17/10/2025

Ahpra warns on superannuation access

The inherent accountability embodied in professionalism and health practitioner regulation has been highlighted as Australians continue to access their superannuation on compassionate grounds more than ever before.

63,300 people were approved to withdraw a combined $1.37 billion from their superannuation for medical costs last financial year, according to data from the Australian Taxation Office (ATO).

The tax office and the Australian Health Practitioner Regulation Agency (Ahpra) are concerned that some businesses are "inappropriately supporting" patients to access their super for unnecessary cosmetic procedures. https://tinyurl.com/26dwkszu

Regulators are now sounding the alarm. They warn that some businesses and health practitioners are encouraging people to use their super for "overly expensive or unnecessary treatments," leaving patients out of pocket and with a smaller retirement nest egg.

Read the full Ahpra guidance here: https://www.ahpra.gov.au/News/2025-10-16-Warning-about-extracting-super-early.aspx

Key takeaways:
- Dental procedures are the #1 reason, with $817 million approved.
- People aged 31-55 are the most affected.
- Women, who already retire with less super, are accessing it more than men.
- 30% of applications are rejected for not meeting the requirements.

This isn't just about individual choices – it also highlights a bigger problem. As one expert said, "We have a healthcare system that doesn't cover many dental costs."
AHCRA agrees. https://tinyurl.com/av6euntt

15/10/2025

What is health policy, anyway? KFF launches an updated resource

One of the first challenges for those interested in health policy is that there's no single agreed-upon definition of the field. In Australia we have several policy and advocacy bodies, albeit one is currently being closed. https://tinyurl.com/44ns4yyp

At KFF, their work focuses on the role of government, public programs like Medicare and Medicaid, and the financing and coverage of health care, largely based around the U.S. They have now organised their core materials into a new, living "textbook" to share that perspective.

KFF provides important updates on health policy changes such as Medicaid cuts and new work requirements; major shifts in vaccine policies; the restructuring of the health agencies; reduced federal support and changes to the U.S. public health infrastructure; Supreme Court decisions on access to reproductive health care; the elimination of federal diversity and disparities-related initiatives, and more.

As the health policy landscape changes rapidly, these chapters will be updated in real-time to combat misinformation and provide independent, factual analysis. https://tinyurl.com/3vrxzuk2

10/10/2025

Impending closure of AHHA - what next?

The Australian Health Care Reform Alliance (AHCRA) shares the concern at the loss of another independent national peak body for public and non-profit hospitals and healthcare providers. AHHA has contributed policy and advocacy work for many years across the spectrum of health.

Jason Staines writes: The impending closure of the Australian Healthcare and Hospitals Association (AHHA), the national peak body for public