The 'Dispatched' Podcast

The MS medicines controversy continues. Why wouldn’t the minister just deal with it and make it go away? It may not be that easy. Why any resolution will probably deal with symptoms rather than the cause. The realities of ministerial offices and the challenges they face that are not visible to outsiders. Another 'phrase of the week' is dissected to reveal its true meaning.

A small player with no market share and no real prospect of gaining any agreed to an almost 50 per cent price reduction to secure reimbursement. Who would have thought the market leaders would respond negatively? Discussion about the change to nurse prescribing, which has been a feature of the PBS for more than 15 years, and concerns over vaccine hesitancy.

Congratulations to one of Australia's leading health journalists on a highly effective series of stories and commentaries that reveal the true extent of this country's challenge and the problems patients face in accessing medicines. A welcome hardening of the research-based industry's public position on the need for change, a very good report on a needed health technology, and anoth...

The emerging impact of China's use of international reference pricing might pose a significant risk to access to medicines in Australia. The critical importance of detail and getting the basics right when negotiating with the government - its ability to operate so effectively in the detail is how the government succeeds in these negotiations. Phrase of the week!

Why long-term thinking and planning are the key to success. What is the ten-year goal, and how does a new agreement progress that? Plan for policy and government engagement like it's a product launch. Also, is the problem with the HTA Review the process or the expectation? How a different starting point would have made this outcome positive.

Where did these industry agreements come from, and why? In the first episode of a two-part special, we discuss the genesis of the Australian government's agreements with the industry, based on personal experience, why they emerged as a solution to a decade-old challenge, and the problem they were aiming to solve. The opportunities, the risks, the vulnerabilities, and the importance of underst...

Powerful patient stories stand in contrast to a decision-making framework that explicitly dehumanises their lived experience. The need for 'decency and compassion'. Week one of Senate Estimates, the challenge of saying one thing publicly and something else privately, and a Budget that revealed so much about what is coming.

There are enough measures and signals in this week's Budget to suggest medicines, vaccines and other technologies were discussed extensively in the process leading up to Tuesday's announcement. It might also help explain Health Minister Mark Butler's annoyance at one organisation's response. A Government response to a parliamentary inquiry triggered another odd response from st...

In this week's episode, the focus is on the latest example of no progress on reform, the mindset and intransigence it reveals, the repeated pattern, and the early evidence that it would always end this way. Can it be an opportunity? Next week's Budget is upon us, and the discussion focuses on what to look for, that just because it is not in there, does not mean it is not in there, and wh...

In this special episode, the focus is on the official plan to force a 'consensus' on health technology assessment reforms through a process conducted in secrecy under the guise of ethics approval. The problem with running this policy process like a clinical trial is that we do not and will not know the identities of participants, how they were selected, their input, how it is used and we...

Tokenistic characterisations of patient engagement are no substitute for listening and empowering. The risk of government funding for organisations and how it can impact what they do, primarily because the government is just another vested interest. 

Another significant speech for the health portfolio that highlights the reform challenge and the importance of choices. A review announced in 2021 without an official response, and the reform of a major program announced with enabling legislation to be tabled next month. It's all about choices and priorities. Also, official recognition of discussions about managing a more assertive US on medi...

An unhinged reaction to the new pharmacy prescribing initiative in New South Wales, why Australia needs to be humble in any health system comparison with the US, and given that the Government sets and umpires the rules for reimbursing innovative technologies, it can hardly complain when companies say no.

Australia’s health system is overly bureaucratic, opaque, and misaligned, with reforms like the HTA Review slowing access rather than improving it. Decision-making prioritises institutional processes over patients, who remain largely excluded despite bearing the consequences. The system is based on a transactional model, and without genuine patient-led change, core structural problems will continu...

In this week's episode, the discussion focuses on Health Minister Mark Butler's address at an event in Sydney and its invocation of history as the framework for pending negotiations over HTA reforms and PBS pricing. Also, strange comments by one senior official about evidence in healthcare decision-making send a clear signal about some of the thinking that might impact the next one to tw...

A powerful patient story was overshadowed by a mindset that expects patients to simplify their needs and accept delays. Some proposed reforms risk entrenching these problems, while claims of having a 'world-class system' gaslight patients and seek to shut down scrutiny. This is about power. Institutions hold it, and patients are expected to adapt, meaning they must not relent in their pu...

How Australia’s health system is failing patients by prioritising process and cost control over timely access to treatment, forcing more to rely on compassionate access programs. HTA processes are slow, often dehumanising, and used by the government as a delay tactic. Meaningful reform requires shifting away from process-driven decision-making toward real patient needs. The opportunity articulated...

In this episode, we examine funding uncertainty for genomic profiling through OMICO, structural tensions within the PBS and pharmaceutical supply chain, and broader concerns about how political and financial incentives shape health policy and budget decisions. The episode concludes with an uncomfortable discussion of recent public commentary on hostility against some communities (trigger warning).

Australia’s system for deciding whether new health technologies are funded is too focused on contested models and not enough on real people and their needs. The lack of human consideration leads to long delays, avoidable suffering, and sometimes deaths, in a process where patient voices are 'summarised' into oblivion while insiders talk around the problem instead of fixing it quickly, op...

Reflect on  Susan Ley’s legacy as a former health minister, especially the 2015 PBS Access and Sustainability Package. She was treated rudely and unfairly, and that meaningful ecosystem reform has since stalled. Critique Senate Estimates, noting that departmental witnesses were evasive and overly defensive, with patients largely absent from the conversation. The discussion expands to reform and th...

Mark Butler’s four 'pillars' on medicines policy and the argument that Australia prioritises low prices over preventing shortages and ensuring access. Do we need smarter, targeted incentives to address shortages that often reflect global challenges? Is there a risk of 'process creep' that actually slows access? Aged-care reforms that unintentionally removed funding for dose adm...

The Government has announced an additional $25 billion for public hospitals over five years, representing close to two PBSs, while NDIS spending is still rising by $1 billion every few months. Can anyone seriously still argue that there is no new money available to invest in medicines? 

Not for the first time, some Australian politicians are in trouble over their use of very generous travel entitlements. We discuss why it matters for patients and why the claim that they are acting within the rules does not stack up.

A turbulent round of Senate Estimates, highlighted by a heartbreaking exchange about a mother with two children battling Crohn’s disease. Officials suggested that the family seek compassionate access from companies or seek treatment at a public hospital. We also canvass ‘MFN’ pricing risks, FOI controversies, ministerial travel blowouts and looming budget pressures that do not operate according to...