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New telehealth rules will stop Australians getting healthcare, nurses say
New telehealth rules will stop Australians getting healthcare, nurses say

The Advertiser

time14 hours ago

  • Health
  • The Advertiser

New telehealth rules will stop Australians getting healthcare, nurses say

Regional and remote Australians could lose healthcare access because of new telehealth rules, nurse practitioners say. From November 1, patients of nurse practitioners - nurses with advanced training - will have to see them in person once a year to get Medicare rebates for virtual appointments. These rules, set by the federal government, already apply to general practitioners. Canberra-based Isabel Reeves runs a business helping people manage their Type 1 diabetes. She has 580 patients from every state and territory of Australia, including some living very remotely, such as on stations in Western Australia and the Hayman Islands in Queensland. Simon Rattenbury, 55, is one of these patients. Originally from Yass, he spent two years travelling around Australia and now lives in Darwin. He said his GP does not know much about type 1 diabetes, which impacts about one in 200 Australians. "Over the phone, I can still ask exactly the same questions as what I can ask face to face," Mr Rattenbury said. "[The changes are] making people use practitioners or doctors or educators that they're not real comfortable with." Mr Rattenbury said he would fly from Darwin to Canberra once a year to make sure he can continue seeing Ms Reeves with a Medicare rebate. Charles Darwin University adjunct associate professor Chris Helms, based in Canberra, said that as a primary healthcare nurse practitioner, he "can diagnose and treat just about everything you might see in a typical general practice". He specialises in gender-affirming healthcare and sexual health and can prescribe medication to people with conditions like HIV, hepatitis B and C. Many of his patients live regionally and sought him out because they could not get care in their local area or felt unsafe doing so. "This is a cost-shifting measure by the government, which further marginalises my patients by hitting their pocketbooks during a cost-of-living crisis," he said. Chief executive of the Australian College of Nurse Practitioners, Leanne Boast, said nurse practitioners were filling gaps created by GPs leaving remote areas. "A lot of nurse practitioners ... reach out into rural and remote communities more. We're also more likely to provide mobile services at times, home visiting, and things like that," Ms Boast said. "This rule means that a nurse practitioner or a group of nurse practitioners couldn't take over that practice and set up and provide services to the local community and outreach via telehealth to a region around them." She said nurse practitioners were being singled out, as the rules would not apply to allied health practitioners. A federal health spokesperson said the government wants to discourage online-only health businesses. "Higher quality care is achieved through telehealth [when a] patient has an ongoing relationship with their provider," they said. "There are risks of lower quality and lower value care when telehealth is not used optimally. This can include missed opportunities for early diagnosis and intervention." Telehealth services exempt from this new requirement include care for children under the age of 12 months, homeless people, patients of Aboriginal medical services, people isolating with COVID, impacted by a natural disaster or being treated for blood-borne viruses, sexual or reproductive health issues. The Royal College of General Practitioners said bringing nurse practitioner rules in line with GPs shows respect for the profession. But Ms Boast said nurse practitioners were disadvantaged compared to GPs. "There's no bulk-billing incentives, there's much lower rebates, there's no practice incentives to support nurse practitioners setting up and operating practices," she said. Nurse practitioners cannot enrol in MyMedicare, a new federal government initiative that allows patients to use telehealth for two years, unless they are connected to a GP. Regional and remote Australians could lose healthcare access because of new telehealth rules, nurse practitioners say. From November 1, patients of nurse practitioners - nurses with advanced training - will have to see them in person once a year to get Medicare rebates for virtual appointments. These rules, set by the federal government, already apply to general practitioners. Canberra-based Isabel Reeves runs a business helping people manage their Type 1 diabetes. She has 580 patients from every state and territory of Australia, including some living very remotely, such as on stations in Western Australia and the Hayman Islands in Queensland. Simon Rattenbury, 55, is one of these patients. Originally from Yass, he spent two years travelling around Australia and now lives in Darwin. He said his GP does not know much about type 1 diabetes, which impacts about one in 200 Australians. "Over the phone, I can still ask exactly the same questions as what I can ask face to face," Mr Rattenbury said. "[The changes are] making people use practitioners or doctors or educators that they're not real comfortable with." Mr Rattenbury said he would fly from Darwin to Canberra once a year to make sure he can continue seeing Ms Reeves with a Medicare rebate. Charles Darwin University adjunct associate professor Chris Helms, based in Canberra, said that as a primary healthcare nurse practitioner, he "can diagnose and treat just about everything you might see in a typical general practice". He specialises in gender-affirming healthcare and sexual health and can prescribe medication to people with conditions like HIV, hepatitis B and C. Many of his patients live regionally and sought him out because they could not get care in their local area or felt unsafe doing so. "This is a cost-shifting measure by the government, which further marginalises my patients by hitting their pocketbooks during a cost-of-living crisis," he said. Chief executive of the Australian College of Nurse Practitioners, Leanne Boast, said nurse practitioners were filling gaps created by GPs leaving remote areas. "A lot of nurse practitioners ... reach out into rural and remote communities more. We're also more likely to provide mobile services at times, home visiting, and things like that," Ms Boast said. "This rule means that a nurse practitioner or a group of nurse practitioners couldn't take over that practice and set up and provide services to the local community and outreach via telehealth to a region around them." She said nurse practitioners were being singled out, as the rules would not apply to allied health practitioners. A federal health spokesperson said the government wants to discourage online-only health businesses. "Higher quality care is achieved through telehealth [when a] patient has an ongoing relationship with their provider," they said. "There are risks of lower quality and lower value care when telehealth is not used optimally. This can include missed opportunities for early diagnosis and intervention." Telehealth services exempt from this new requirement include care for children under the age of 12 months, homeless people, patients of Aboriginal medical services, people isolating with COVID, impacted by a natural disaster or being treated for blood-borne viruses, sexual or reproductive health issues. The Royal College of General Practitioners said bringing nurse practitioner rules in line with GPs shows respect for the profession. But Ms Boast said nurse practitioners were disadvantaged compared to GPs. "There's no bulk-billing incentives, there's much lower rebates, there's no practice incentives to support nurse practitioners setting up and operating practices," she said. Nurse practitioners cannot enrol in MyMedicare, a new federal government initiative that allows patients to use telehealth for two years, unless they are connected to a GP. Regional and remote Australians could lose healthcare access because of new telehealth rules, nurse practitioners say. From November 1, patients of nurse practitioners - nurses with advanced training - will have to see them in person once a year to get Medicare rebates for virtual appointments. These rules, set by the federal government, already apply to general practitioners. Canberra-based Isabel Reeves runs a business helping people manage their Type 1 diabetes. She has 580 patients from every state and territory of Australia, including some living very remotely, such as on stations in Western Australia and the Hayman Islands in Queensland. Simon Rattenbury, 55, is one of these patients. Originally from Yass, he spent two years travelling around Australia and now lives in Darwin. He said his GP does not know much about type 1 diabetes, which impacts about one in 200 Australians. "Over the phone, I can still ask exactly the same questions as what I can ask face to face," Mr Rattenbury said. "[The changes are] making people use practitioners or doctors or educators that they're not real comfortable with." Mr Rattenbury said he would fly from Darwin to Canberra once a year to make sure he can continue seeing Ms Reeves with a Medicare rebate. Charles Darwin University adjunct associate professor Chris Helms, based in Canberra, said that as a primary healthcare nurse practitioner, he "can diagnose and treat just about everything you might see in a typical general practice". He specialises in gender-affirming healthcare and sexual health and can prescribe medication to people with conditions like HIV, hepatitis B and C. Many of his patients live regionally and sought him out because they could not get care in their local area or felt unsafe doing so. "This is a cost-shifting measure by the government, which further marginalises my patients by hitting their pocketbooks during a cost-of-living crisis," he said. Chief executive of the Australian College of Nurse Practitioners, Leanne Boast, said nurse practitioners were filling gaps created by GPs leaving remote areas. "A lot of nurse practitioners ... reach out into rural and remote communities more. We're also more likely to provide mobile services at times, home visiting, and things like that," Ms Boast said. "This rule means that a nurse practitioner or a group of nurse practitioners couldn't take over that practice and set up and provide services to the local community and outreach via telehealth to a region around them." She said nurse practitioners were being singled out, as the rules would not apply to allied health practitioners. A federal health spokesperson said the government wants to discourage online-only health businesses. "Higher quality care is achieved through telehealth [when a] patient has an ongoing relationship with their provider," they said. "There are risks of lower quality and lower value care when telehealth is not used optimally. This can include missed opportunities for early diagnosis and intervention." Telehealth services exempt from this new requirement include care for children under the age of 12 months, homeless people, patients of Aboriginal medical services, people isolating with COVID, impacted by a natural disaster or being treated for blood-borne viruses, sexual or reproductive health issues. The Royal College of General Practitioners said bringing nurse practitioner rules in line with GPs shows respect for the profession. But Ms Boast said nurse practitioners were disadvantaged compared to GPs. "There's no bulk-billing incentives, there's much lower rebates, there's no practice incentives to support nurse practitioners setting up and operating practices," she said. Nurse practitioners cannot enrol in MyMedicare, a new federal government initiative that allows patients to use telehealth for two years, unless they are connected to a GP. Regional and remote Australians could lose healthcare access because of new telehealth rules, nurse practitioners say. From November 1, patients of nurse practitioners - nurses with advanced training - will have to see them in person once a year to get Medicare rebates for virtual appointments. These rules, set by the federal government, already apply to general practitioners. Canberra-based Isabel Reeves runs a business helping people manage their Type 1 diabetes. She has 580 patients from every state and territory of Australia, including some living very remotely, such as on stations in Western Australia and the Hayman Islands in Queensland. Simon Rattenbury, 55, is one of these patients. Originally from Yass, he spent two years travelling around Australia and now lives in Darwin. He said his GP does not know much about type 1 diabetes, which impacts about one in 200 Australians. "Over the phone, I can still ask exactly the same questions as what I can ask face to face," Mr Rattenbury said. "[The changes are] making people use practitioners or doctors or educators that they're not real comfortable with." Mr Rattenbury said he would fly from Darwin to Canberra once a year to make sure he can continue seeing Ms Reeves with a Medicare rebate. Charles Darwin University adjunct associate professor Chris Helms, based in Canberra, said that as a primary healthcare nurse practitioner, he "can diagnose and treat just about everything you might see in a typical general practice". He specialises in gender-affirming healthcare and sexual health and can prescribe medication to people with conditions like HIV, hepatitis B and C. Many of his patients live regionally and sought him out because they could not get care in their local area or felt unsafe doing so. "This is a cost-shifting measure by the government, which further marginalises my patients by hitting their pocketbooks during a cost-of-living crisis," he said. Chief executive of the Australian College of Nurse Practitioners, Leanne Boast, said nurse practitioners were filling gaps created by GPs leaving remote areas. "A lot of nurse practitioners ... reach out into rural and remote communities more. We're also more likely to provide mobile services at times, home visiting, and things like that," Ms Boast said. "This rule means that a nurse practitioner or a group of nurse practitioners couldn't take over that practice and set up and provide services to the local community and outreach via telehealth to a region around them." She said nurse practitioners were being singled out, as the rules would not apply to allied health practitioners. A federal health spokesperson said the government wants to discourage online-only health businesses. "Higher quality care is achieved through telehealth [when a] patient has an ongoing relationship with their provider," they said. "There are risks of lower quality and lower value care when telehealth is not used optimally. This can include missed opportunities for early diagnosis and intervention." Telehealth services exempt from this new requirement include care for children under the age of 12 months, homeless people, patients of Aboriginal medical services, people isolating with COVID, impacted by a natural disaster or being treated for blood-borne viruses, sexual or reproductive health issues. The Royal College of General Practitioners said bringing nurse practitioner rules in line with GPs shows respect for the profession. But Ms Boast said nurse practitioners were disadvantaged compared to GPs. "There's no bulk-billing incentives, there's much lower rebates, there's no practice incentives to support nurse practitioners setting up and operating practices," she said. Nurse practitioners cannot enrol in MyMedicare, a new federal government initiative that allows patients to use telehealth for two years, unless they are connected to a GP.

Sovereign tech boost as feds urged to prioritise local IT solutions
Sovereign tech boost as feds urged to prioritise local IT solutions

AU Financial Review

time5 days ago

  • Business
  • AU Financial Review

Sovereign tech boost as feds urged to prioritise local IT solutions

These frameworks are vital, but complex, requiring specialised knowledge and operational discipline. This shift comes as the federal government's Buy Australian Plan (BAP) and Digital Sourcing Framework is laying the foundations for reshaping the way technology partners are selected. The BAP is designed to support local industry and ensure that taxpayer dollars are reinvested in Australia's economy, while the Digital Sourcing Framework encourages agencies to favour providers that meet criteria around sovereignty, value, innovation and responsiveness. In 2022‑23 alone, the Commonwealth spent $74.8 billion on goods and services, with more than $7 billion of that allocated to computing, software and communications services. There is now a compelling case for a growing share of this spend to be directed to Australian providers who can deliver secure services at scale. That's creating opportunities for firms like Brennan, an Australian systems integrator that has long served the enterprise sector and is now expanding its government footprint. Brennan's acquisition of Canberra-based CBR Cyber in March has significantly strengthened its cyber credentials and opened new doors in the public sector. 'By acquiring CBR, we are now far more accessible to government agencies, and have cleared experts on hand to deliver the secure services they require. It's fast-tracked our ability to serve government,' says Peter Soulsby, head of cybersecurity at Brennan. 'We have since accelerated the build of a sovereign SOC that will be able to deliver the highest levels of protection to the government. This investment will also benefit the hundreds of existing customers we service through our hybrid SOC today.' The integration of Brennan's national infrastructure and CBR Cyber's public sector expertise positions the firm as a viable alternative to global systems integrators – offering scale and sophistication, but with boots-on-the-ground service and governance anchored in Australia. But as Soulsby points out, demand for cyber expertise is rapidly outpacing supply. 'The real issue isn't capability gaps, it's volume,' he says. 'Everyone in cyber is working 30 to 40 per cent harder just to keep up. Demand has outstripped the system's ability to deliver. The only way to catch up is by introducing new cleared, capable talent, which is not an easy task.' The security workforce pipeline remains constrained by slow-moving processes, he says, requiring a co-ordinated effort between federal and state governments, and education providers, to build a domestic talent stream. 'But that's a four- to five-year lead time,' Soulsby adds. Shared services models are gaining appeal as organisations adopt frameworks such as the Essential Eight or ISM. However, the user experience has become essential to implementation - if controls hinder day-to-day workflows, users may resort to workarounds, ultimately undermining security rather than enhancing it. 'Shared models help avoid this by bringing in tested IP and learnings from other implementations, so agencies don't repeat past mistakes.' This pragmatic approach also extends to sovereignty itself. 'Sovereign IT isn't just about location, it's about resilience,' Soulsby says. 'In a future geopolitical scenario where we can't rely on foreign partners, we must be able to support ourselves. Investing in sovereign IT is also an investment in Australian roads, education, and jobs, because tax and spending stay onshore.' That cultural and operational alignment is especially crucial when responding to fast-evolving threats. Agencies need real-time agility – not just paper compliance – and access to cybersecurity experts who understand the local context. Delivering that kind of agility increasingly requires more than just technical fixes. This mindset – of embedding security from the outset – is fast becoming the modus operandi for leading local operators. 'We don't sell dreams. We deliver outcomes,' says Andrew Weir, federal manager at CBR Cyber. 'And increasingly, that means designing systems where cybersecurity is built in from the start – not bolted on after the fact.' As Soulsby notes, demand for locally based expertise will only grow as agencies seek tailored, context-aware support that navigates an increasingly complex cyber landscape. 'We may see a further 10 to 20 per cent spike over the next 12 to 18 months. With global supply chains increasingly unreliable, the safest way forward is to do this locally despite the economic complexity.' As agencies continue to modernise, sovereign partnerships offer a pathway that is not only secure and compliant, but also adaptive, resilient and deeply aligned with Australia's national interests.

Kembla Grange stables unveil pair of exciting fillies at Moruya
Kembla Grange stables unveil pair of exciting fillies at Moruya

Sydney Morning Herald

time20-07-2025

  • Sport
  • Sydney Morning Herald

Kembla Grange stables unveil pair of exciting fillies at Moruya

A pair of Kembla-based two-year-old fillies, both on debut, can steal the show when they travel south to tackle the older horses at Monday's Moruya meeting. Spice Baby, an exciting daughter of 2018 Golden Gift winner Tassort in the Joseph Isle stable and drawn the inside, is likely to jump favourite in a Maiden Handicap over 1020m. But drawn just two places further out, the Kerry Parker yard unveils Miss Steffi, a well-bred and aptly named daughter of Group 2-winning Graff. Spice Baby has been strong through the line in two lead-up trials and draws to get a cosy run, while Miss Steffi also starts behind two recent trials, winning the first at home before given a quieter time at Rosehill only six days ago. Named after the tennis great, Miss Steffi is bred to get much further being out of a Carnegie mare, and will be aimed at some feature middle-distance affairs in early spring if she heads in the right direction. Spice Baby, out of a mare by 2005 Golden Slipper winner Stratum and to be ridden by Louise Day, is more the sprinting type and opened about $3.70 in early betting alongside Canberra-based Caravanserai, an ex-Godolphin three-year-old having his first run in six months for the new Natalie Jarvis stable. Miss Steffi, to be ridden by Adrian Layt, was further out about the $7 mark. Meanwhile, the far-reaching success of Canberra stables is set to continue, headed by the Matthew Kelley yard which heads to the South Coast eyeing off a double. Loading

Kembla Grange stables unveil pair of exciting fillies at Moruya
Kembla Grange stables unveil pair of exciting fillies at Moruya

The Age

time20-07-2025

  • Sport
  • The Age

Kembla Grange stables unveil pair of exciting fillies at Moruya

A pair of Kembla-based two-year-old fillies, both on debut, can steal the show when they travel south to tackle the older horses at Monday's Moruya meeting. Spice Baby, an exciting daughter of 2018 Golden Gift winner Tassort in the Joseph Isle stable and drawn the inside, is likely to jump favourite in a Maiden Handicap over 1020m. But drawn just two places further out, the Kerry Parker yard unveils Miss Steffi, a well-bred and aptly named daughter of Group 2-winning Graff. Spice Baby has been strong through the line in two lead-up trials and draws to get a cosy run, while Miss Steffi also starts behind two recent trials, winning the first at home before given a quieter time at Rosehill only six days ago. Named after the tennis great, Miss Steffi is bred to get much further being out of a Carnegie mare, and will be aimed at some feature middle-distance affairs in early spring if she heads in the right direction. Spice Baby, out of a mare by 2005 Golden Slipper winner Stratum and to be ridden by Louise Day, is more the sprinting type and opened about $3.70 in early betting alongside Canberra-based Caravanserai, an ex-Godolphin three-year-old having his first run in six months for the new Natalie Jarvis stable. Miss Steffi, to be ridden by Adrian Layt, was further out about the $7 mark. Meanwhile, the far-reaching success of Canberra stables is set to continue, headed by the Matthew Kelley yard which heads to the South Coast eyeing off a double. Loading

All go for global firm's new NZ chairman
All go for global firm's new NZ chairman

Otago Daily Times

time11-07-2025

  • Business
  • Otago Daily Times

All go for global firm's new NZ chairman

Christchurch will remain home for Ian Fraser who has just taken on the chairmanship of GHD, a company with 12,000 employees and turning over $3-plus billion. PHOTO: SUPPLIED New GHD global chairman Ian Fraser will likely spend 100 days away from his Christchurch home over the next year. That is nothing new for the first Kiwi head of the global design, engineering and environmental services company. Earlier this month, he took over the responsibility of leading the governance for a business with a workforce of 12,000 employees, many of them shareholders, and turning over more than $3 billion. Returning from the Philippines only last Saturday, he accepts long-haul flights come with the territory. "In the last few years, it would be in excess of 100 days away a year. That is the reality of the job and it is important for us to remain connected with the business and the owners across the world so that I can hear what they need and what their clients are needing." From experience, he's learnt to travel lightly, avoiding check-in luggage. Christchurch will continue to remain home for him and his family. Unlike many companies, GHD is without a central headquarters and its staff work in more than 160 offices on five continents, while the executive team and board members live and work around the world. "We have a virtual leadership team and a virtual board and always have had this — so as long as people are prepared to work the clock a little bit for the different time zones you can typically live where it is best for you in one of our major offices around the world. We have 140 people here in Christchurch now, so it's quite a decent-sized office for GHD. It's a good lifestyle here. We see the value in people working together in offices, but our executives are typically very mobile, having to travel a lot as part of our jobs. Hence having a home base where you have got your family and extended friends is a really strong thing for when you come home." GHD can be found operating internationally in water, energy and resources, environment, property and buildings, and transportation. Established in 1928, it delivers advisory, digital, engineering, architecture, environmental and construction services to public and private sector clients. More locally, it is among one of three consortiums shortlisted for the tender design for the next stage of the Ara Tūhono project extending the Northern Motorway (SH1) in the upper north. Other work includes supporting local governments' water and transport infrastructure needs and building projects for Corrections and the Ministry of Education among others. Before the new role, Mr Fraser was chief executive of GHD's Australia, Asia and Pacific operations for three years. He started with the company just over 10 years ago, initially managing its New Zealand business and then joining the executive leadership team. That led to him being a board member for the past two years. The transition from former chairman Canberra-based Rob Knott to him has been in the offing for a year. "I worked closely with Rob for 10 years and he's retired, so it's been a planned succession and I've been in a succession handover period for the last year and have had a great apprenticeship. He was a great leader and left big shoes to fill." Ahead of him is the task of running the board and working with executive leaders to seamlessly develop and drive the long-term strategy of the business. Ultimately, he was accountable to the shareholding to make sure the business continued to thrive, he said. GHD is owned by just over a quarter of its 12,000-odd employees. "There's not many large, privately held professional services companies in the world now. About 27% of our employees are shareholders and they receive a dividend for their investment and are the only people with a stake in the company. It enables the company to be self-determined because there's no third-party investors influencing our strategy and it's really managed by us, for us and for our clients." The breadth of its business was diverse, he said. "We like to call ourselves a professional services company now because we definitely do quite a lot of up-front business advisory work right through to engineering design and construction supervision and we are a full services company. Predominantly, we are involved with the built environment in roads, water, buildings and energy infrastructure." Gross revenue for the 2024 financial year of about $3.1b was up on previous years and another good result was likely. "Continued growth in transport, energy and water infrastructure is needed around the world from continuing urbanisation. The growth has slowed a little bit this year, but those fundamentals of a growing population around the world will need good-quality infrastructure." After graduating from the University of Auckland as a geologist, Mr Fraser spent more than 30 years in environmental and engineering consulting, previously living and working in the United States, and working on projects throughout the Pacific, Southeast Asia, South America and Mexico. In northern Mexico's Saltillo, he worked for several months, on and off, preparing plans for a much-needed upgrade of the drinking water system. Another early project was the Tiwi geothermal field in the Philippines in 1992 and his connection with the nation's development has remained strong following many visits since. Closer to home, he's been involved with the environmental assessment and cleanup of many contaminated sites in New Zealand, including industrial properties and petrol stations. About 20 years ago he moved towards leading teams, challenging himself to keep learning which has evolved to the next governance chapter. He said it was an immense honour to take over as chairman, particularly as the first to hold the position from New Zealand. "We have got a very strong leadership team and a great CEO in Jim Giannopoulos in Melbourne and I am supported by a very experienced board. The company is going to turn 100 years old in 2028, so it will be a privilege to be chair at a time when it is celebrating it centenary", Mr Fraser said. Christchurch-born of Scottish parents who migrated in 1961, he started his schooling years in North Canterbury's Hawarden. Continuing to be based in Christchurch had many advantages. The city was a great place for an international role and the time zones were good to work into the US most of the morning, he said. "And it's got an international airport you can get off to Asia and Australia pretty easily in the morning. New Zealand and New Zealanders are well respected overseas and have a lot to offer." A certain Christchurch symmetry in GHD is also not lost on him. "GHD was formed interestingly by Gordon Gutteridge, Gerald Haskins and Geoffrey Davey and Haskins was a Christchurch man who went to Australia and then joined the other two to form GHD. So it is quite a nice parallel there. Haskins' dad was the town clerk for Christchurch city, so there is a Kiwi in the H of the acronym. I love the fact Haskins was there nearly 100 years ago and now there's another Kiwi in the governance of the business."

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