Volume 4 • Issue 1 • February 2010

2010-11 Budget Submission calls for better dental care and emphasises consumer participation in achieving major reform CHF Chair, Antonio Russo The Consumers Health Forum of Australia (CHF) has set out a strong health reform agenda in its 2010-11 Budget Submission, delivered to the Federal Government at the end of last year. With an election due before the end of the year, 2010 will see an intense focus on much needed reform of the health sector, with political parties seeking support in a policy area that impacts on the lives of all voters. CHF’s submission places a strong emphasis on increased consumer involvement across the health sector and also advocates funding for an independent national health promotion and prevention agency, broadening the focus of the proposed National Preventative Health Agency. The single biggest request seeks a commitment to over $3 billion to support the establishment of a dental care program in Australia. CHF Chair, Antonio Russo, said better access to affordable dental care should be an urgent priority. 'Dental care is far too expensive and beyond the reach of many Australians who struggle with the cost of their medications and other essentials. And it can have a significant impact on health management and preventative health,' Mr Russo said. CHF 2010-11 Budget Submission 'Pain, stress and infection resulting from not receiving dental care can complicate other health conditions. We all know that good diet is an essential component of better health - how can you maintain good diet if you have trouble eating?' said Mr Russo. Extra funding is also needed for better promotion of healthy lifestyles, prevention, early intervention as well as consistent investment in holistic care for people with chronic conditions. In a wide ranging submission, CHF advocates support for a number of important reforms including: A national framework for health consumer engagement and investment in consumer representation and engagement with under-represented groups; Universal access to dental care; Ongoing support for preventive health measures; Improved health promotion and scoping for health literacy; Support for e-Health infrastructure; Health funding models; Expansion of Medicare to include a broader range of services; Improved multidisciplinary service provision, Improved transport schemes for rural and remote health consumers. The CHF Budget Submission was prepared after extensive member consultation and after consumer consultation late last year co-hosted with the Minister for Health and Ageing, the Hon Nicola Roxon MP. CHF has written to, and is meeting with, all federal political parties and independents seeking a response to the CHF 2010-11 Budget Submission. A summary of responses will be published for our members. View the full CHF budget submission at www.chf.org.au CHF members and consumer representatives share ideas at a forum with the Minister for Health and Ageing, the Hon Nicola Roxon MP, in October 2009 and at an earlier CHF Members' Policy Forum

Consumers inform Fifth Community Pharmacy Agreement

CHF consumer consultations are underway to inform the Australian Government about consumer views on the content and implementation of the Fifth Community Pharmacy Agreement (Fifth CPA).

As reported in the December issue of Consumers Shaping Health, CHF welcomes the opportunity to provide consumer input into the Fifth Community Pharmacy Agreement.

'Community pharmacy services play a critical role in achieving quality use of medicines. The focus of the Fifth CPA, and remuneration for pharmacists, must be on achieving better health outcomes for consumers,' said CHF Chair, Antonio Russo.

Prior to Christmas, media releases from the Pharmacy Guild of Australia (the Guild) and the Minister for Health and Ageing, the Hon Nicola Roxon MP, reported that $1 billion in savings had been agreed to 'in-principle' for the next Agreement

'As the Government drives reform with sustainability of the health system at the top of the agenda, it is critical that consumers have a say in the way limited health dollars are spent. It is a significant step in the right direction to seek consumer perspectives on the content and implementation of the Fifth CPA,' said Mr Russo.

CHF’s consultations are already underway, with two teleconferences held in January and a National Consultative Workshop scheduled for Thursday, 18 February 2010. A Background Information and Consultation Paper is available on CHF’s website.

The Guild released a circular in mid-January outlining some of the programs that are likely to form part of the new Agreement under the areas of Quality and Standards, Patient Services and e-Health. However, CHF understands that these components are yet to be negotiated, and present a good opportunity for CHF’s members to provide input.

TGA National Manager talks with CHF members

As part of CHF's focus on pharmaceuticals policy, CHF Governing Committee, Voting Members and consumer representatives will have an important opportunity to talk with Dr Rohan Hammett, National Manager of the Therapeutic Goods Administration, at a Members' Policy Forum in Canberra on 18 February 2010.

• View details of the CHF Fifth Community Pharmacy Agreement Consumer Consultation Project 2009-10 at www.chf.org.au
• View the CHF Background Information and Consultation Paper at www.chf.org.au
• Raise and discuss consumer issues relevant to the Fifth CPA on the CHF Discussion Forum (members only)

Health Technology Assessment

Consumers provide input into review of HTA

Consumers call for increased transparency, accountability and cost effectiveness.

CHF is pressing hard for greater consumer involvement in the assessment of health technology in Australia, supported by a series of recent consumer consultations as well as a recent supportive industry report.

CHF Executive Director, Carol Bennett, said health consumers and the industry had clearly indicated in two reports published in December that there needed to be a more cost effective, efficient, transparent and accountable system governing this multi-billion dollar industry.

In June 2009, CHF was contracted by the Department of Health and Ageing to consult with consumers and provide consumer input to the Review of Health Technology Assessment.

The current process of Health Technology Assessment generally applies to new medicines, surgical procedures, devices and prostheses, and is an industry with an annual turnover in excess of $6 billion.

A number of Government bodies are involved in a complex evaluation and approval process, including the Therapeutic Goods Administration (TGA), the Medical Services Advisory Committee (MSAC), the Prostheses and Devices Committee (PDC) and the Pharmaceutical Benefits Advisory Committee (PBAC).

Consumers discuss HTA at CHF National Workshop

In CHF’s consultations, consumers provided many examples of a system that is failing to meet their needs.

CHF has made seven key recommendations to the Department of Health and Ageing:

1. Genuine and clearly articulated processes to take account of consumer experiences at all stages of assessment and review;
2. A change in how new applications are assessed to ensure consumers experiences are given due consideration beyond the scientific and cost effectiveness analysis;
3. The capacity for granting interim approval under safeguarded conditions for some important devices, to ensure these devices are available to consumers more quickly;
4. A better system for monitoring and reporting on adverse events (including the consumer experience of these events);
5. More effective ways for reviewing and removing technologies that have been shown to be dangerous or obsolete or have been superseded by superior products;
6. Extensive consumer education to ensure consumers understand medical devices and technologies and the system designed to regulate their use; and
7. An industry-wide Code of Conduct.

An industry comparative study prepared by Deloitte and released by Medicines Australia in December 2009, found that Australian consumers and the community had less involvement in the HTA assessment process than comparable countries like England, Canada and Scotland.

Commenting on the CHF report in media interviews, Ms Bennett said: ‘It is obvious that the current system is broken and we need either a new system or a major overhaul that pays more than lip-service to the involvement of health consumers.'

CHF understands that the Review Report is now with the Minister for consideration.

• View CHF report at www.chf.org.au

Australia needs a single ‘principles-based’ Code of Conduct for therapeutic goods

Parliamentary Secretary for Health, the Hon Mark Butler MP

Australia urgently needs a single Code of Conduct to ensure health consumers know that medicines and other therapeutic goods they buy have been promoted ethically and deliver the claimed health benefits.

CHF is pleased that the Parliamentary Secretary for Health, the Hon Mark Butler MP, is supporting a review of the current system of regulating the advertising, promotion and the complaints procedure covering therapeutic goods.

‘We welcome a serious attempt by government and industry to provide a transparent, accountable and rigorous process that affords protection to Australia’s health consumers,’ says CHF Executive Director, Carol Bennett.

‘The numerous industry codes of conduct - largely self-regulated - have created a perception that the system of review and complaint is closed and secretive and, in some cases, operates in the industry’s interests,’ Ms Bennett said.

‘Some in the pharmaceutical industry would acknowledge that the current system is grossly inefficient and out of date and can be improved, probably with considerable cost savings,’ she said.

Ms Bennett cited as one area of concern, the extraordinary and unregulated growth of online pharmacies which sell a range of medicines and ‘miracle cures’ without normal checks and balances.

‘The need for a single Code of Conduct has been highlighted by consumers within the CHF network, especially in recent consumer consultations around health technology assessment,’ said Ms Bennett.

‘CHF accepts that individual industries have their own issues and requirements, but believes it is quite feasible that an overarching ‘principles-based’ code can be developed to cover the whole of the industry while addressing sectoral issues,’ said Ms Bennett.

CHF calls for:

• A single code covering both complaints and advertising and promotional activities by industry;
• A single and independent complaints mechanism with full public disclosure;
• A single monitoring system; and
• Sanctions for non-compliance which go beyond just simple retraction of claims and impose significant penalties.

The consultative approach led by the Parliamentary Secretary suggests there is an opportunity for consultation and agreement among the various stakeholders, with potential benefits for all.

CHF Executive Director, Carol Bennett, met with other consumer advocates and Parliamentary Secretary, the Hon Mark Butler MP, in mid-January to discuss how a single code might work. CHF eagerly awaits an announcement by the Parliamentary Secretary about a process to support this approach.

Ms Bennett said that key stakeholders must be involved in the further development and design of a single principles-based code. Consumer consultation in this area was called for in the CHF 2010-11 Budget Submission.

• Share your views on the CHF Discussion Forum (Members only) at www.chf.org.au

Cataract rebates - finally a resolution

Cost and time savings from new medical technology should be passed on quickly to health consumers, according to CHF Executive Director, Carol Bennett.

She was commenting on the agreement reached between the Federal Government and the Australian Society for Ophthalmologists announced at the end of January 2010 that will see a reduction in the Medicare rebate for several services including the most common procedure from $831.60 to $731.80 from 1 February 2010.

'The price of consumer electronic devices like mobile phones and computers is declining rapidly as technology advances and competition ensures those savings are being passed on to consumers,' she said.

'Likewise, new advances in medical technology are helping improve procedural techniques and reduce times.'

Ms Bennett said health costs are rising exponentially and it is a continuing challenge for consumers, industry and government to keep costs at a manageable level.

'CHF believes it was unfortunate that rather than work with Government to pass on cost savings, the ophthalmology industry chose instead to increase gap payments for procedures in order to preserve unreasonable profitability,' she said. 'Consumers recognise the value of professional medical services but are also capable of identifying when there are unreasonable charges in the health system,' Ms Bennett said.

Realising Our Broadband Future

CHF Executive Director, Carol Bennett hosted a panel session on e-health at the Realising Our Broadband Future forum in Sydney on 10 December 2009. Opened by the Prime Minister, the Hon Kevin Rudd MP, the forum provided the Government, industry and the community with an opportunity to discuss the possibilities that will arise from a National Broadband Network. Beyond providing an effective foundation for e-health, consumers want to see the National Broadband Network deliver better and more timely access to health services and information that will improve health literacy, service options and health outcomes for consumers.

Consumers talk pathology

Consumer representative, Amy Zelmer and CHF Project Officer, Sarah Watt at the CHF Pathology Workshop in Brisbane

Consumer consultations held around Australia will inform a review of pathology services.

Pathology is an area important to health consumers, with over 100 million services funded under Medicare each year. In 2009, we observed some apparent attempts by industry to encourage providers to reduce bulk-billing, and now the Government is set to review funding arrangements against the broader health agenda of sustainable, cost effective spending.

CHF’s current Quality Use of Pathology project provides timely input and an opportunity for consumers to influence and contribute to strategies to improve pathology services.

‘The recent CHF consumer consultations held in every State and Territory have provided valuable insights from a broad and diverse range of consumers,’ said Carol Bennett, CHF Executive Director.

Consumers highlighted the need for better communication from their practitioner about the costs, risks, benefits and alternatives to pathology testing. Access, (especially for rural and remote consumers), affordability, and safety and quality issues were raised. Many consumers want pathology test results to be made available to their practitioners electronically and thought that this would help eliminate repeat and unnecessary testing. Valuable consumer insights were also gained in the areas of Point of care testing (PoCT), direct access testing (DAT), and genetic testing.

Western Australian consumers talk pathology in December 2009

‘The CHF project is using consumer consultation to establish an evidence base to identify consumer issues, including gaps and opportunities and facilitators and barriers to quality use of pathology, and to suggest strategies that would make the pathology experience more beneficial to consumers,’ said Ms Bennett.

Consumers and stakeholders will have the opportunity to work together to progress strategies to improve consumer health outcomes and quality practice at a National Workshop in Melbourne on 22 March 2010.

• View more details on the CHF Quality Use of Pathology Project at http://www.chf.org.au/pathology-2009-project.php
• Discuss pathology issues on the CHF Discussion Forum (Members’ only)

Keeping Clinical Trials in Australia

CHF Executive Director, Carol Bennett

Consumer perspective valued in bid to improve clinical trials

CHF Chair, Antonio Russo, welcomed a review of Clinical Trials and the establishment of a Clinical Trials Action Group to enhance Australia’s position as a preferred destination for this important work.

‘It is important to Australian health consumers that clinical trials are conducted in Australia. Apart from helping to sustain Australian research and development, it provides consumers with potential access to new treatments and medicines,’ said Mr Russo.

The Group is co-chaired by the Parliamentary Secretary for Health, the Hon Mark Butler MP, and the Parliamentary Secretary for Innovation and Industry, the Hon Richard Marles MP, and will report to Ministers Roxon and Carr.

CHF Executive Director, Carol Bennett, has been appointed Chair of the Expert Reference Group focusing on the development of a Clinical Trials Information and Communications Technology (ICT) Strategic Plan under the review. John Stubbs, Chief Executive Officer of Cancer Voices Australia, chairs the Expert Reference Group looking at strategies to improve patient recruitment. Other strands focus on developing a clinical trials roadmap; developing key performance measures for clinical trials; and ensuring the rapid uptake of streamlined ethics, scientific and governance review processes.

The Review will conclude with a report to the Ministers by the end of April 2010.

• Further background available at http://www.innovation.gov.au/Industry/Pharmaceuticals/Pages/PIWGCLINICALTRIALSSUBGROUP.aspx

Congratulations Professor Patrick McGorry

CHF congratulates mental health researcher, advocate and clinician Professor Patrick McGorry for his award as 2010 Australian of the Year.

Professor McGorry is Executive Director of Orygen Youth Health (OYH), a world-renowned mental health organisation for young people that has put Australia at the forefront of innovation in the prevention and treatment of mental illness. He is also a Director of the National Youth Mental Health Foundation (headspace).

CHF Executive Director, Carol Bennett, said it was heartening to all advocates, workers and researchers in the health field that Professor McGorry’s many years of dedication and hard work in this complex and difficult area had been formally recognised by this high-profile award.

Consumer representative, Alison Marcus, appointed to TGA Advisory Committee on the Safety of Medicines (ACSOM)

Congratulations to CHF nominated consumer representative, Alison Marcus, on her recent appointment by the Parliamentary Secretary for Health, the Hon Mark Butler MP, to the TGA Advisory Committee on the Safety of Medicines (ACSOM).

Alison is respected across the CHF network for her work in the community quality use of medicines area, especially around improving management of the consumer experience of adverse medical events and continuous quality improvement processes.

Alison joins strong consumer representation on key TGA committees. CHF has previously supported nominations for Diane Walsh (Therapeutic Goods Committee), Tricia Greenway (Complementary Medicines Evaluation Committee) and Debra Petrys (Medicines Evaluation Committee).

Alison Marcus	Diane Walsh	Tricia Greenway	Deb Petrys

Peter Logue joins CHF

Peter Logue

CHF welcomes Peter Logue to our team. Peter has a background over the past 30 plus years in journalism and public relations in the UK, Australia and Asia and worked for 14 years in the Parliamentary Press Gallery between 1977 and 1991. He is a former President of the National Press Club and is currently a board member of the National Folk Festival and is a regular musician in a number of Canberra based bands. You can contact him on 02 6162 7504 or by email to p.logue@chf.org.au

CHF views and news

CHF submissions, media releases, project information and consumer representation can be found at www.chf.org.au

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