Tuesday, 30 November 2021
Health, Aged Care and Sport Committee; Report
I rise today in recognition that better health for all Australians is key in our development and success as a country. I would like to thank all the members of the House of Representatives Standing Committee on Health, Aged Care and Sport for their report, entitled The new frontier: Delivering better health for all Australians. I extend a special thanks to the member for North Sydney for his work in chairing this inquiry and to the deputy chair—Mr Deputy Speaker, the member for Macarthur—who, as a paediatrician, along with me, is a former brother-in-arms on the front line of health care. Alongside the secretariat supporting the committee, the member for North Sydney and the member for Macarthur have overseen the development of 31 recommendations to ensure the best opportunity for health for everyone in Australia. I am delighted that I was asked to be a supplementary member of the committee. It has been a very bipartisan committee. It has been a great experience for me. It is truly something to be recognised in this parliament as something that is actually progressing outcomes for all Australians. So thank you, Mr Deputy Speaker, for your participation, and thank you for allowing me to participate as well.
We know—indeed, most Australians know—that Australia enjoys one of the best health systems of any country. Medicare sits at the foundation of our health system and, combined with private health insurance and private health networks, forms a strong foundational framework of health care that delivers for the benefit of all Australians as part of a universal healthcare system. Indeed, all levels of government are involved in the running of our system, and it is clear that it is a successful system. In fact, as an outcome, Australia ranks eighth in the world for life expectancy. By and large, metrics of health rank Australia in the top 10 worldwide; in fact, some metrics have us at number two. But, of course, there is always more that we can do. We can never be satisfied; we must always strive for better. It is the least we can do for all Australians.
That is why I am very delighted with this report, which has made numerous recommendations towards ensuring that the system works better for all Australians. Each of these 31 recommendations were considered and developed in light of current challenges in the health sector, with tangible benefits for all coming from the adoption of these recommendations. Some recommendations I would like to highlight include the following.
The first is recommendation 1: the committee calls for the establishment of a centre for precision medicine and rare diseases. As you know, I was a professor at the Murdoch Children's Research Institute, which began life as the Murdoch Birth Defects Institute. It is a pre-eminent medical research institute that specialises in both genetics and stem cell research. So it is with great pleasure that I talk about this recommendation, which, if implemented by the minister, will increase the ability of the Department of Health to provide Australians with access to breakthrough drugs and novel medical technologies, particularly for children with rare diseases, because, as you and I know as paediatricians, there is often very little hope for these children. We are currently in the House debating 'Maeve's law', a very important law reform which may offer new hope to people who have this very rare genetic condition through the mitochondria, so it is great to see there would potentially be a centre to focus on new technologies, precision medicine and rare diseases. On top of this, the proposed centre would provide a comprehensive horizon-scanning unit for the aforementioned drugs and technology to support patients. This centre would be well placed to advise the Department of Health as well as the Medical Research Advisory Board.
Recommendation 3 is another recommendation that I'm particularly proud of—that is, the creation of an office of clinical evaluation within the Department of Health. This office would evaluate both pharmacological and non-pharmacological interventions as well as establish a 'living evidence' function to ensure that health assessments are informed by the most up-to-date and accurate data. We all know, having been through COVID, how important knowing what the most recent tests, diagnostic as well as therapeutic, are for the care of patients. The opportunity for research to be in a 'living evidence' function would be useful to Australia, as would having external horizon scanning so that we can connect with countries overseas.
As an aside, Deputy Speaker Freelander, you and I know that medical types in Australia keep up with what's happening internationally through international medical conferences. Australians are great travellers, but health professionals in Australia, particularly doctors and medical researchers, are fantastic travellers, and they have served us well as a sort of subterranean global health diplomacy in this country. You and I both know, being members of the National COVID-19 Health and Research Advisory Committee, that there is a lot of data gathering across jurisdictions by the health professionals in this country that feeds into this NHMRC supported committee and provides evidence for the government and for policy within this country. But it would be great to have an office of clinical evaluation that does this on a continual basis, not just during periods when we're facing health pandemic, such as we are now. By gathering this information and then sharing it with state and territory governments, the proposed office would ensure continuity of the best quality and most effective treatments.
In my role as co-chair of the newly formed Parliamentary Friends of Medical Technology, I'm particularly pleased by a number of recommendations pertaining to the emergence of new medical technology that will help ensure Australian patients get fast and efficient access to the best available devices and digital products as and when they emerge. Many people watching this will absolutely understand that one medtech that has been of great benefit to all Australians is telehealth, a form of digital interaction with clinicians, which means you don't need to travel to congested inner cities or travel long distances in rural and remote parts of Australia; you can get access to scripts or to review appointments at the drop of a phone call or a videoconference. We want to make sure we can bring these new technologies, which Australia has been at the forefront of developing, to market more quickly and through the regulatory process more efficiently.
To this effect, the committee's recommendation 19 suggests reforms to one part of the medtech sector, the Prostheses List, by firstly addressing the lack of coverage for non-implantable devices under the current arrangements and, secondly, ensuring that there is improved coordination between the Medical Services Advisory Committee and the Prostheses List Advisory Committee to provide faster access for patients. Further, the New Frontier report recommended that the independent health technology assessment review reassess relevant aspects of the health technology assessment process to ensure there are future pathways for treatments and therapies that do not fit neatly into the current system, such as for rare cancers, antimicrobials, orphan drugs and precision medicines.
As a paediatrician, I would emphasise that it's imperative that appropriate clear pathways are considered for inclusion for paediatric medicines and technologies. The committee was of the clear view that precision medicine approval pathways will require a different application assessment process than current approaches designed for treatments for common conditions, with their large datasets and comparative evaluations. Finally with regard to medtech, the committee recommends that the Department of Health introduce an equivalent to the managed access programs for medical devices. The report recommended that the details of this scheme, including the eligibility criteria and duration, should be formulated in consultation with patient groups, clinicians and industry.
I know that recommendation 21 is of particular interest to you, Deputy Speaker, as it is to me. The committee calls for the standardisation of newborn screening across Australia—and about time too, I would say. On top of this, the committee recommended an expansion of the newborn screening program in light of the increased understanding of genomic testing. We know, again from the Murdoch Children's Research Institute but also the Garvan Institute of Medical Research, that genomic research is pre-eminent here in Australia, and we should take advantage of that not just for our patients and for Australians but also for the business opportunities that this provides to Australian businesses. Preventative health care is immensely important to me, considering my background in paediatrics, and accurately screening our youngest Australians is crucial to make sure that we can detect those early conditions as early as possible, to give them the best possible chance for a good start to life.
The committee's recommendation for increased patient voice is something I see as paramount for moving forward. The committee implores the Department of Health to bring patient voice upfront into the health technology assessment system. This includes representation of peak patient bodies in the system, refreshing every three to five years. Particularly importantly, we did as a committee recognise that there was a dearth of Aboriginal and Torres Strait Islander people as voices with regard to, particularly, medicines that may have specialty in their situation. I'm very pleased that we have identified this as a gap in our healthcare system. We know that they experience everything, and we need to make sure that patient voice is pivotal to improving our healthcare services in general.
Australia's health system is oft lauded as one of the best in the world, but complacency and satisfaction will not improve the lives of Australians in the health system. We must continue to deliver better health for all Australians. This indeed is a time for the new frontier, and COVID has focused that more now than ever. Looking at this part of health technology delivery in Australia will help give every Australian the opportunity for better health. I commend this report to the House.