The 'Dispatched' Podcast

Australia's election is two weeks in, and we're having trouble engaging. How positional power and 'expertism' can be confused and the value of a transparent and open forum.

The industry's 'Faustian bargain' on the 'sanctity' of the PBS, the challenge so many have in being clear about the problem, and why Pathology Australia provides an important lesson. Another wrong political message on newborns, why dentists might be worried, positive news on a critical medicines reform, and kudos to a pharmacy chain for promoting flu vaccines.

US criticism of the PBS is like catnip for some people, they can't resist it, even if it's the same criticism articulated by multiple Australian stakeholders and the health minister. The strange secrecy over the government's review of arrangements for blood supply products and the terrible treatment of a female academic leader.

A total victory for pharmacy with the prime minister's appearance at their showcase annual event. We discuss the confected outrage over US interest in the PBS, which is hardly new, and why the industry needs to lead this debate because its reputation and change agenda are being trashed. Much of what PhRMA is arguing reflects what Health Minister Mark Butler said on Sunday when he announced ne...

Medicines Australia will be appointing a new chair. To what extent does it matter? The participation model means that the industry might be effectively shackled to the 'change' table rather than having a seat at it. The government has worked it out, constantly increasing the price of participation and limiting exclusionary discussions about change. How does that need to change?

A review of Senate Estimates, with irritating warnings, too much passivity, and passive-aggressive responses (0.00-4.50). Revelations on how oral contraceptives navigated the funding process and the drivers of that outcome (4.51-14.10). We disagree on the role of advisory committees in policymaking (14.10-25.00). The impact of individuals in health policy, how change can have a significant effect,...

A serious discussion about reforming Australia's use of health technology assessment should start with patient rights and the imposition of new obligations on advisory committees and decision-makers. The signs of institutional capture and the dangers of concessions as the price for participation. Once again, pharmacy sets the standard for advocacy with its consistent argument that out-of-pock...

A major structural shift in the PBS with the government moving to break a long-held article of faith (00:10-9:30). Why can't we debate HTA using some plain language and straight talking (9:30-20:20)? Research grants about patients that patients can't apply for (20:20-28:30), pathology pushing for more funding (28:30-37:00), essential questions for our public health system (37:00-47:00),...

Genetics and genomics are the focus of this week's episode. It was a significant week with the release of one organisation's pre-budget submission and a new national framework. Not everyone is happy, but is the criticism fair?

Although the pandemic ended over two years ago, the more we learn about what happened, the more we need the promised Royal Commission.

We return in 2025 with a discussion about our recently published special series on achieving change, arguing for it in a system that treats patients as servile to the government's focus on securing the best deal for itself, moral hazards, and bad excuses.

A government review's six-year-old recommendations led to the decision to fund an unapproved and unapprovable product over an approved medicine. The document is the first in a series that ended with an unprecedented workaround on patient safety and confirms the truism that 'everything happens for a reason'.

International comparisons can work both ways, the incredibly disrespectful and dismissive 'let them eat cake' attitudes of two key advisory committees and a welcome ministerial intervention that should be more broadly applied. We also answer some questions from the audience. 

There was quite a bit of eminence this week in the public discussion about access to health technologies. Some personal and wider reflections on the role of prejudice in funding and reimbursement decisions.

We draw a line between some very careful use of language by small 'g' government officials that clearly connects some recent processes and events. It could be a coincidence, but it's remarkable and very convenient. Everything happens for a reason, and words matter. 

It's another week of debate over PBS deferrals. Unfortunately, there appears to be an effort to limit public discussion. Given the obvious risk to patients and the implications for the access agenda, which is flailing against the backdrop of deferrals, how does that make sense? It also stands in stark contrast to when cost recovery was introduced.

The health department calls them 'holdover' submissions, but they're deferrals. Its strange language does not change the fact that this situation, decided without consultation, could have negative and long-lasting consequences for the world's second-oldest public health program and, more importantly, patients.

A special edition focused on the disappointing and unacceptable outcome on the proposed simplified and faster process for immunotherapies. The institution has revealed a disturbing attitude to patients shrouded in an ability to deliver change.

After a short break, we are back, and there is a lot to discuss. Recommendations to fund unapproved and unapprovable therapeutic interventions, continued disappointment on newborn screening, and a proposed misinformation law that is significantly based on misinformation and an assumption that the government knows best.

A significant structural change in the PBS, which the Government attempted to blunt with 60-day dispensed quantities, is arguably the main growth driver in spending on the program. We discuss the change, which along with others, represents a major reversal in a decades-long approach to medicines access.

The two-sided coin that is the access debate. The competing narratives that might be confusing Health Minister Mark Butler. Governance is an arcane issue, but it matters, and a different approach could mean a better approach to decision-making and improved outcomes.

It has been a week of red flags on the HTA Review, with the occasional green shoot. We investigate each and discuss how unconscious bias impacts decision-making. The way forward as the process progresses to an implementation phase requires some thought, a different approach and a willingness on behalf of stakeholders to do something that makes them very uncomfortable.

No guessing the focus of this week's discussion, but we have worked to focus on a way forward to manage the many challenges presented by the HTA Review, including the importance of injecting some caution in the public response and understanding that the 'celebratory' tone is a very bad way to start a negotiation.

The health debate is increasingly shifting ahead of the election, mainly to challenging issues, including the fierce debate impacting the private health sector. What does it mean for stakeholders wanting attention in other areas? A welcome decision to widen access to a vaccine, but the postcode lottery remains a reality for patients, including babies.

The Albanese Government used moral suasion to resolve the IV fluid shortage caused by other jurisdictions' poor procurement practices. Health Minister Mark Butler used cautious language on the HTA Review. It was what you would expect, but what does it mean in practice?