In this edition: NMHC's National Report, Abortion decriminalised in NSW, Tribunal bans nurse, ARPANSA release 'Radiation Incident Site Preservation' guide, and Health Expenditure in Australia 2017-18.
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AMA: Mental health report calls for combined effort
On 23 September 2019, the National Mental Health Commission released its National Report on Australia’s mental health and suicide prevention system. The report includes recommendations to improve outcomes, including the recommendation of a whole-of-government approach to mental health and suicide prevention.
The Report considers that the present focus on mental health and suicide prevention “marks a significant turning point in Australia’s history, and is building increased awareness of the impacts of mental health from a social and economic perspective as well as a health perspective.”
The whole-of government-approach is recommended to cover the wide range of factors that contribute to people’s wellbeing. Including employment, education, housing and social justice, and the delivery of mental health care and services.
30 recommendations in total are made which focus on “bolstering the mental health system” to create positive sustained change in the sector and meet long term health objectives. The key areas of focus include:
- Key reforms, such as addressing access issues with the National Disability Health Insurance Scheme (NDIS) and supporting Primary Health Networks in mental health activities and suicide prevention;
- Implementing a whole-of government approach to mental health and suicide prevention;
- Investment in early intervention; and
- Planning for service delivery and facilitation of ongoing improvement in outcomes for consumers and carers, to address the need for more services.
The Commission’s Advisory Board Chair Lucy Brogden said that “Current national reforms are key, but complex, interrelated and broad in scope and will take time before their implementation leads to tangible change for consumers and carers.”
The Commission has an ongoing monitoring and reporting role, which includes working with stakeholders to identify how collaboration across the sector to implement the recommendations can be achieved, and how progress can be measured.
Abortion no longer a crime in NSW
On 2 October 2019, the New South Wales legislature decriminalised abortion. New South Wales joins the majority of states which have legalised the procedure. South Australia and Western Australia remain the only states not to have done so.
The NSW legislature has passed the Abortion Law Reform Act 2019 (NSW) (Act). This Act accords with the other regimes in Australia. The Act permits any person to access an abortion:
- up to 22 weeks pregnant, in consultation with a doctor; and
- after 22 weeks, in consultation with two doctors who must determine that an abortion is appropriate.
Consideration must be had to all relevant medical circumstances, the person’s current and future physical, psychological and social circumstances, as well as the professional guidelines and standards that apply to the performance of an abortion.
In addition, doctors are able to conscientiously object to performing an abortion and refer the person seeking an abortion to another practitioner. The pregnant person must be able to give informed consent to their doctor, and failing that, consent must be obtained by a legal guardian. It remains an offence to perform an abortion outside of an approved health facility.
Tribunal bans nurse from aged care for five years
When Mr Lionel Cox, a 92 year old man with no living family members, was placed in respite care, Ms Kumar, the Nurse Unit Manager at the aged care facility, learned that he owned his own home but did not have a will. Acting in contravention of the facility’s policy regarding wills of patients, she quickly arranged for him to prepare and sign will naming her as the executor and sole beneficiary. She also forced a nurse she was responsible for managing to witness the execution despite the nurse’s clear distress at being made to do so.
Only days after signing the will, Mr Cox died. Ms Kumar obtained a grant of probate, transferred the Fitzroy property into her name and later sold it for $1.17 million.
The VCAT Members deciding a case against her brought by the Nursing and Midwifery Board of Australia did not look favourably on her behaviour, and made the following observations:
In any event, character is demonstrated by actions, including what a person does when an opportunity to behave unethically presents itself – when no-one is looking.
The nature and seriousness of the conduct here indicate to us a deeply flawed character and a person who lacks trustworthiness and integrity.
Ms Kumar was disqualified from applying for registration as a registered health practitioner for a period of 5 years. VCAT also made a prohibition order with the result that she is unable to work (including as a volunteer) in residential aged care, home or community based aged care or disability care during that period.
This decision serves as a timely reminder to aged care providers to ensure that registered health practitioners clearly understand their professional and ethical boundaries. You can read the decision in full here.
ARPANSA releases new regulatory guide: Radiation Incident Site Preservation
The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has released a new Radiation Incident Site Preservation guide that sets out the expectations for preserving a site following a radiation safety or security incident.
Part of ARPANSA’s role is the regulation of all Commonwealth entities that use radiation. Regulation ensures compliance with the Australian Radiation Protection and Nuclear Safety Act 1998 and associated Regulations (2018) and is supported by a series of regulatory guides.
The ARPANSA new guide outlines expectations for incident management to ensure safe, secure, effective and efficient operations where radiation exposure or contamination is known or suspected to be present.
Effective incident management is important to effective regulation as collection and preservation of information is integral to post-incident investigation, site clean-up and ensuring learnings from past incidents are understood to avoid future occurrences.
This new guide sets expectations and best practice for site preservation only and does not attempt to inform on recovery or response procedures. Those aspects of incident management are expected to be developed at the local level and be unique to the licence holder’s conduct or dealings.
Health expenditure in Australia 2017-18
The Australian Institute of Health and Welfare (the Institute) has released its report into health expenditure in Australia 2017-18.
It is estimated that $185.4 billion was spent on health goods and services in Australia in the 2017-18 year, an increase of approximately 1.2% on the prior year. This equates to an average of approximately $7,485 per person and constituted 10% of overall economic activity for this period.
Of this, approximately $126.6 billion was funded by the Government, $30.6 billion by individuals and the balance by non-government entities such as private health and compensation insurers.
Private health insurers spent approximately $1,470 per person, an increase of approximately $400 since 2007-08, despite the number of people covered decreasing by almost 2 million during this period. Of the $16.6 billion spent by private health insurers, almost half was spent on private hospitals.
The Institute states:
"Regular reporting of national health expenditure is vital to understanding Australia’s health system and its relationship to the economy as [a] whole. Expenditure estimates also provide information about how spending relates to changes such as the ageing population, increased chronic disease prevalence, and medicinal and technological developments.”
To read the report, click here.