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Daily Mail
7 days ago
- Business
- Daily Mail
Embattled GP reveals the biggest losers of Albo's Medicare overhaul
Labor's plans to reform chronic health funding will cripple community medical practices and put Australia's most vulnerable at risk, a leading doctor has warned. From July 1, the federal government will overhaul its approach to funding treatment for patients with chronic diseases like cancer, cardiovascular disease and diabetes as part of its reforms to Medicare The government hopes the changes would 'simplify, streamline and modernise' the treatment of long-term diseases for both patients and doctors. But health experts warn they will remove the incentives in place for publicly-funded GPs to deliver quality care to their patients. Dr Kenneth McCroary, who chairs a prominent advocacy group for GPs in south-west Sydney, said the changes will halve the payments his doctors receive from the government for chronic disease treatment. 'We had these things called chronic health plans and chronic management plans and team-based care plans and mental health plans, which gave us a little bit more funding to spend more time with the patients and help look after them better,' he told Daily Mail Australia. 'And so on July 1, what they're going to do is going to cut the funding for those plans... so it means that instead of being funded to spend some actual quality time working with our patients... we're going to take a 50 per cent cut in the payments for that quality care.' While he insisted the gutting of primary health was a bipartisan failure and not the fault of a single side of politics, he said former Labor champions of universal health care like Bob Hawke and Gough Whitlam would be 'rolling in their graves' over the way their party is managing Medicare. The changes will reduce the list of chronic health services through practices can bulk-bill through Medicare and substitute a shortened list of eligible services, including the preparation and review of chronic condition management plans. Royal Australian College of General Practitioners president Dr Michael Wright also recognised the risks of the changes when they were first flagged last year. 'We know these chronic condition item numbers are crucial to support the financial viability of many practices, and they are the most commonly bulk billed items,' he told NewsGP. 'We were worried that these changes would reduce funding for these important services. When we surveyed our members last year 69 per cent said they would have to start charging a fee rather than bulk bill patients.' Dr McCroary estimated doctors at his practice would be lose out on funding to the equivalent of $40,000 to $45,000 per year. He believes the changes will benefit only those clinics that make a business out of quick, superficial chronic disease treatments. 'How the hell am I going to keep my doors open now, unless I turn into one of the bulk-billing medical centers that sees ten people an hour in-and-out my door every six minutes?' he asked. 'It's not the kind of medicine I want to practice; it's not the kind of medicine my colleagues want to practice; it's not the kind of medicine that community needs to keep them well and healthy and alive and out of hospital; but it's what the government continues to incentivize as it continues to bludgeon away at the core of primary care.' According to Victoria University, more than half of the Australian population lives with a chronic condition, a problem felt most acutely in less economically advantaged communities. Dr McCroary observes the effects of chronic diseases on a daily basis as practice principal at Macarthur General Practice in Campbelltown. 'Just yesterday, a couple came in, he's got heart disease, diabetes, osteoporosis, osteoarthritis. She's got epilepsy and osteoporosis and diabetes and asthma and that's just off the top of my head,' he said. 'And they'll tell me: 'Please bulk bill us, otherwise, you know we can't afford to come here. We're only alive because of the care we get from you guys.'' 'They're our normal patient, they're the normal kind of people we see every day and now we're supposed to be looking after them at half the Medicare income. When asked how he plans to keep his Campbelltown practice open, Dr McCroary expected to work two full time jobs: one with his patients and another advocating for change. 'We're just going to keep trying. But, yeah, it gets hard,' he said.
Japan Times
28-05-2025
- Business
- Japan Times
WHO restructures and cuts budget after U.S. withdrawal
The World Health Organization tried to stabilize its finances at its annual assembly which ended on Tuesday, but still remains well short of reaching its already reduced target. Hit by the withdrawal of its biggest donor, the United States, the WHO trimmed its already smaller 2026-2027 budget from $5.3 billion to $4.2 billion. The U.N. health agency's program budget for 2024-2025 was $6.8 billion. The slimmer budget plan was approved during the World Health Assembly, which serves as the WHO's decision-making body. But a funding gap of some $1.7 billion remains. How WHO funding works WHO budgets run in two-year cycles. Founded in 1948, the agency initially received all its funding through "assessed contributions": nations' membership fees calculated according to wealth and population. However, the WHO became increasingly reliant on "voluntary contributions," which only go toward outcomes specified by the donor. By the 2020-2021 cycle, assessed contributions represented only 16% of the approved program budget. And the organization had long been over-reliant on voluntary funding from a few major donors. 2026-2027 budget In 2022, member states agreed to increase their assessed contributions to represent 50% of the WHO's core budget by the 2030-2031 cycle at the latest — giving the WHO more stable, flexible and predictable income streams. They increased membership fees by 20% as part of the 2024-2025 budget. At this year's assembly, countries approved another 20% increase in membership fees, which should represent an additional $90 million in revenue per year. They also endorsed the WHO's 2026-2027 budget of $4.2 billion. "Your approval of the next increase in assessed contributions was a strong vote of confidence in your WHO at this critical time," the organization's chief Tedros Adhanom Ghebreyesus said Tuesday in closing the assembly. Most of that money is already assured. "We have now secured 60% of our base budget for 2026-2027; a remarkable result in today's financial climate," said Hanan Balkhy, the WHO's Eastern Mediterranean regional director. But that means the agency is still $1.7 billion short, despite the reduced budget. Pledges At a pledging event last week, donors put in an additional $210 million for the 2025-2028 investment round, supporting the WHO's base budget. That included $80 million from Switzerland, $57 million from the Novo Nordisk Foundation, $13.5 million from Sweden and $6 million from Qatar. "In a challenging climate for global health, these funds will help us to preserve and extend our life-saving work," said Tedros. United States Upon returning to office in January, U.S. President Donald Trump started the one-year process for leaving the WHO, and had frozen virtually all U.S. foreign aid. The United States was traditionally the WHO's largest donor. Washington's departure, and its refusal to pay its membership fees for 2024 and 2025, has left the WHO reeling financially. Washington did not attend the World Health Assembly. However, U.S. Health Secretary Robert F. Kennedy Jr. sent a video message in which he branded the organization as bloated and moribund, and urged other countries to "consider joining us" in creating new institutions instead. Kennedy said the U.N. agency was under undue influence from China, gender ideology and the pharmaceutical industry. Reorganization The budget cuts have forced the WHO to reorganize. It is reducing its executive management team from 14 to seven due to the dramatic U.S. funding cuts. The number of departments is being reduced from 76 to 34. The WHO has not yet announced any large-scale layoffs, unlike other U.N. agencies.
Medscape
26-05-2025
- Health
- Medscape
GP Practice Finance: Can You Boost Your Budget?
BIRMINGHAM — Primary care practices could boost income by reviewing list sizes and performance on key indicators, according to experts at The Primary Care Show 2025. Speaking at the event, Katy Drew, a chartered accountant and head of primary care development at specialist medical accountancy firm Sandison Easson, and Claire Houston, a primary care management consultant for Practice Index, explained the impact of funding changes in the 2025-2026 General Practice (GP) contract. They also offered strategies to practice managers for maximising income. Understanding the Global Sum Drew explained that the General Medical Services Statement of Financial Entitlements details the various ways that primary care practices receive funding. Key components include the global sum Quality and Outcomes Framework (QOF) targets, provision of direct enhanced services (DES), and reimbursements for services such as vaccinations. Katy Drew Drew, a former practice and business manager, said: 'If you want to maximise your global sum, you need to be looking at your list size.' However, she cautioned those new to practice management finance that they could not simply multiply the number of patients on their list by the sum allocated per patient (£121.79 for 2025-2026). This is because the money needs to be weighted according to the global sum allocation formula, also known as the Car-Hill formula. This takes into account factors such as the age and sex of the patient population; any additional needs relating to morbidity or mortality, such as the presence of a chronic condition requiring regular care; the number of patients being added to or removed from the list (i.e., list turnover); the nursing and residential homes index (NARHI); and unavoidable costs of running the practice, such as market forces and the rurality index. While fixed factors such as patients' age and sex cannot be influenced, others like list turnover and the NARHI can. Managing List Size and Turnover 'If you are being proactive with your list size, or you've got a list dispersal happening in your area, that will give you an additional weighting on your global sum,' said Drew. She gave the example of gaining 2000-3000 patients from a new local housing development. For the first 12 months, these patients would carry an additional rating of 1.46, boosting funding. However, that uplift falls the following year, which could lower the global sum. 'So, it's something to log away at the back of your mind if you're ever in that situation', Drew advised. She also urged practices to check NARHI coding regularly and update patient registers ahead of quarterly reporting deadlines. Accurate coding can improve global sum payments. 'Month-by-month, you're benefiting from that,' Drew said. She advised checking lists every few months and not to miss any patients when registering them. 'Do it a couple of weeks before your quarter end, so that you've done your coding, it's all set, and then you benefit from that for the next quarter,' she added. Financial Pressures Persist Houston said that financial planning had become challenging for many practices recently. 'I don't think that anything there has changed, but I think it feels much, much harder now than it has done in years gone by.' Claire Houston Houston noted some optimistic signs. 'This is first time in quite a few years that we haven't had an imposed contract, which I think is great news,' she said. However, she noted that rising staff costs, including for parental leave, sick leave, prolonged study leave, and suspensions, continued to stretch budgets. Staffing typically accounted for at least 44% of practice spending but 'doesn't go anywhere near touching the sides of what your actual staff costs are'. QOF Points: More Value, Fewer Available In 2025-2026, the value of a QOF point has risen by 2.2% to £225.49. However, the maximum number of available points for achieving QOF targets has been reduced from 635 points in the previous financial year to 564 points this year. Houston said this change could reduce a practice income by up to £13,000 annually. 'If you've got an expert in your practice, that is really helpful,' added Drew. Some QOF funds have been redirected into the global sum and to raise the Item of Service payment for childhood vaccinations. But Houston warned that shifting funds between streams could have unpredictable effects. Some QOF funds have been redirected into the global sum and to raise the Item of Service (IoS) payment for childhood vaccinations. Houston noted: 'One of the problems that we're seeing is when we move money from one pot to another. Sometimes it works out well for us in practice; other times not so much.' Focus on Cardiovascular QOFs Houston advised practices to carefully examine their disease prevalence before modelling QOF income. She noted that QOF points were only valuable if they could be obtained. The cost per QOF 'being bandied about' is based on an average practice with a list size of 10,184 patients and 'an average prevalence' of the QOF in question, according to NHS England estimates. 'If your practice is smaller, or you have less disease prevalence, you aren't looking at £225 per QOF point at all,' she said. 'So, when you're looking at your modelling, that's a really important thing to think about'. Houston said there were 141 QOF points achievable from meeting cardiovascular disease (CVD)-related targets, worth an estimated £198 million across the UK overall. 'If you are hoping to achieve QOF this time round, go home, look at your practice prevalence versus the national average in terms of your cardiovascular disease [indicators], because the amount of money you will get at the end of the year from QOF is going to be the most singularly affected by that,' Houston advised. She also recommended checking related QOF indicators, such as diabetes, as 'there is significant shifting in terms of pointing at cardiovascular disease within other disease areas'. Practice Managers Share Experiences Kay Keane, a practice manager for Urban Village Medical Practice in Manchester, said that general practices operated on fixed budgets. 'We're given an envelope of money, and that's what we have to work with,' she told Medscape News UK . However, she acknowledged that while the money available varied across practices based on the age and likely medical needs of the patient population and the services offered, there were ways in which more money could be leveraged. Keane observed: 'General practice is the most cost-effective part of the NHS' as it is run by the GPs themselves. Robyn Clark, a practice manager and managing partner for Kingswood Health Centre in Bristol, also highlighted the value of general practice, telling Medscape News UK that it generates £14 for every £1 spent that can be reinvested back into the health system. However, it receives only 7% of the NHS budget. Clark questioned the relevance of the Car-Hill formula, saying it is 'almost irrelevant' to modern patient needs. For example, 'there isn't an extra level of weighting for people whose English isn't their first language. We often find inner city practices with a higher level of non-white British population really struggle because the weighting doesn't meet the actual needs of the patients', Clark said. To address funding gaps, Clark recommended making use of DES, including vaccination services and diagnostics like ECGs. Drew is an employee of specialist medical accountancy firm Sandison Easson, and Houston is an employee for Primary Care Management company Practice Index. Keane and Clark are directors of the Institute of General Practice Management, an independent body for practice managers in the UK.
RNZ News
18-05-2025
- Health
- RNZ News
Budget 2025: New funding for after-hours care 'not going to go very far' - GP and urgent care doctor
New health funding has been welcomed, but there are still concerns over the lack of a trained workforce. File photo. Photo: Photo /123RF General practice doctors are grateful for the government's new funding for after-hours urgent health care , but there are major concerns about how it will be staffed. The GPs say the funding acknowledges urgent care has been under pressure, but the funding is "reasonably light" for what the government is trying to achieve. The government has committed to greater accessibility to urgent and after-hours healthcare in the regions, with several new 24-hour services planned around the country. New funding of $164 million has been allocated over the next four years, with 24-hour urgent care clinics "identified" for Counties Manukau, Whangārei, Palmerston North, Tauranga and Dunedin. The funding boost also covers "new and extended" daytime services for other centres, including Lower Hutt, Invercargill and Timaru. In a pre-Budget announcement on Sunday, Health Minister Simeon Brown said the funding boost would mean 98 percent of New Zealanders would have access to in-person urgent care within an hour's drive. "Strengthening urgent and after-hours care is an important part of our government's plan to ensure all New Zealanders have access to timely, quality healthcare," Brown said. There are currently 48 urgent care clinics across New Zealand, most of which are jointly funded by Health New Zealand and ACC. On top of that are many other after-hours services that provide similar levels of care, but are not considered to be urgent care clinics. Dr Angus Chambers is the chair of GenPro - an organisation that represents the people who own general practices and urgent care centres. He said it was "definitely positive" to have some investment in the after hour urgent care space. "It's clearly a critical area for patient care and and it's under quite a lot of stress, so it's definitely good to see some thoughts into trying to support it." His two main concerns were around the amount of funding and the lack of a trained workforce available to staff the clinics. "The funding seems reasonably light for what they're trying to achieve." He said when the allocated funding is divided between the hundreds of services across the country, the "money's not going to go very far". Chambers also compared it to funding for telehealth services, saying the "complexity of providing an in person after hours service is so much greater". After-hours involved doctors, nurses, a receptionist and facilities, he said. "It's just a little bit hard to see how they've come up with a figure." The other issue he said was going to be "staffing the services" because "the general practice workforce has never been weaker than it is at the moment". He said some of the money will need to be used to make these roles more attractive and keep people working in New Zealand. Chambers said there were a lot of GPs working around the country at "far lower than market rates" to keep those services going, "because they're part of a community". "They see the need for some meaningful work, but we shouldn't have to expect GPs to work with altruism." Overall, Chambers said the "fix" for decreasing demand on hospitals, emergency departments and the after-hours problem was "high functioning general practice care" so that people can get appointments in a timely manner. "If we could manage chronic disease so it doesn't deteriorate, that is what will lead to far less demand." Chambers said involving people who provide these services in decision-making would result in better outcomes. "I think would get greater efficiency and greater effectiveness by trusting the people who actually deliver this work, rather than bureaucrats who are very well meaning, but have really very little idea how to deliver these kind of health services which are very complex and require a lot of experience to get right." Brown told Morning Report the government's investments in primary care will ensure new urgent care clinics are adequately staffed with doctors. "That's why we've announced another range of investments into primary care earlier this year." Funding had been allocated to train 50 more GPs a year, 100 overseas doctors already in NZ, and for 120 nurse practitioners per year, he said. "[The government] is putting a lot of effort not just into extending services or supporting services but also that workforce piece which we know is critically important." He confirmed existing providers would be central to the new services. "Generally they'll be working with current providers and looking to extend hours rather than building new clinics. For instance in Counties Manukau, where it's been identified the need for a new 24/7 provider, there's already a number of providers who provide after-hours care, Health NZ will go through a procurement process to identify a partner there to provide the overnight service in Counties Manukau," he said. Dr Luke Bradford is the medical director at the Royal New Zealand College of General Practitioners. The college looks after the education and standards, advocacy and policy work for the country's general practitioners, and has about 6500 members. Bradford cautiously welcomed the announcement, saying it acknowledged urgent care had been under pressure and an unsustainable model. "It's a vital part in the delivery of the healthcare system, so to acknowledge that it needs increased support was really important." Bradford said the core issues for urgent care come from the financial viability of the model. He wants to make sure the funding supports the model. Bradford said he understood the actual cost to see a patient was about $170 per person. Chambers added the cost to attend an after-hours clinic can range from $0-$260, which was highest he had heard. It varied based on age, ACC status and whether someone had a Community Services Card. "Without funding going in, it's user pays," Bradford said, "there's no way the fees being charged were covering that." Bradford said the other big issue was staff. Clinics are usually staffed - in large part - by GPs working "after hours and on top of their normal work," he said. Rural "on-call hours" and those in the smaller centres often were not paid so you were getting "tired GPs, GPs being underpaid to do it, and therefore you were struggling to staff them." He hoped that would level out due to this funding. As to whether what the government has proposed was possible, Bradford said the "devil's in the detail". He explained the 24/7 clinics were unlikely to be staffed by doctors overnight because there was not enough doctors. "I suspect that it'll be a combination of nurses and paramedics with telehealth support." But he did believe if conditions improved for clinicians working in urgent care, and if the clinics themselves were financially viable, "then a good service can be set up." The majority of the funding would have to go toward staffing, because "you have to pay a premium to the staff who are going to be working overnight". Staff safety was also a priority so people were not alone in buildings through the night, he said. He was also unsure how extra nurses would be attracted to the roles, given the current pay disparity between primary care nurses and their hospital counterparts. The New Zealand Nurses Organisation was also worried about staffing. Primary Health Care Nurses College chair Tracey Morgan said: "Our biggest concern is where will the staff come from. "We welcome the focus on primary and community care but it ignores the main issue. "The pressure on urgent care can't be fixed without solving the chronic under-staffing issues the sector faces." She said until the government gave primary and community health care nurses pay parity with their Te Whatu Ora counterparts, "the sector will continue to lose nurses and health care workers to better paid jobs in hospitals and to better paid jobs overseas". Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Arab News
18-05-2025
- Health
- Arab News
As old powers retreat, the Gulf steps up in global health
As the 78th World Health Assembly gathers this week in Geneva, global health funding and governance are at an inflection point. For decades, Western donors — particularly the US — have dominated the agenda. That era is ending. In the opening days of President Donald Trump's second term, executive orders again withdrew US support for the World Health Organization's core budget, slashed funding for pandemic preparedness and prohibited federal agencies from collaborating on climate-linked health research. These reversals reopen vulnerabilities exposed by COVID-19, even as new global threats — such as pandemics, antimicrobial resistance and climate-driven illness — grow more urgent. The retrenchment runs deeper. The UN's AIDS program recently announced cuts of up to 50 percent in staffing and country coverage. Memos circulating within donor circles hint at a larger reshuffling of global governance — including in health. And yet, for all the institutional uncertainty, global health remains indispensable. Strong health systems are not just a moral imperative — they underpin sustainable development, economic stability and geopolitical resilience. Health spending already represents about 10 percent of global gross domestic product. But more than half the world's population — about 4.5 billion people — lack access to basic services. For pandemic preparedness alone, the funding gap remains at an estimated $10.5 billion annually, much of it in low- and middle-income countries. Amid this leadership vacuum, a new axis of influence is emerging from an unexpected quarter: the Gulf. Gulf Cooperation Council countries are not merely stepping into a donor role — they are reshaping what global health leadership looks like in a multipolar world. With capital, coordination and strategic clarity, nations like the UAE and Saudi Arabia are moving from the margins to the center of the global health architecture. In March, the Mohamed Bin Zayed Foundation for Humanity launched in Abu Dhabi with the goal of reaching 500 million people across Asia, Africa and the Middle East. The foundation, building on the UAE's earlier work through the Reaching the Last Mile initiative, focuses on system strengthening, innovation and measurable impact. Its benchmark for success is lives saved — not dollars pledged. That same mindset underpins the Beginnings Fund, an initiative backed by the UAE, the Gates Foundation, Delta Philanthropies and others, which aims to prevent 300,000 maternal and newborn deaths across 10 low-income countries by 2030. These are not abstract commitments. They represent a deliberate shift away from bureaucratic, process-heavy aid toward outcomes-based, data-driven investment in health systems. The Gulf is also establishing itself as a convening force in global health diplomacy. GCC countries are not merely stepping into a donor role — they are reshaping what global health leadership looks like in a multipolar world. Matthew Miller Saudi Arabia has quietly become one of the WHO's most important contributors. Since 2018, it has donated more than $385 million, supporting health operations in conflict-affected regions including Palestine, Ukraine, Somalia, Syria and Yemen. The Kingdom ranked among the WHO's top 20 donors over the past six years and was the fourth-largest contributor to thematic funds in 2022-23. In February, Riyadh hosted the International Humanitarian Forum, where Saudi Arabia reaffirmed a $500 million commitment to UNICEF and the Global Polio Eradication Initiative. This was more than symbolic. It was a signal of strategic intent. Abu Dhabi, too, has become a focal point for global health discussion. Its annual Global Health Week convenes government officials, health ministers, CEOs and scientists to discuss topics ranging from artificial intelligence to antimicrobial resistance and sustainable life sciences investment. This year's event featured 13 health ministers, several major pharmaceutical firms and the visible presence of UAE sovereign wealth funds — all aligned around a vision of preventive, precision-based and tech-enabled health systems. The WHO will this week debate revisions to the International Health Regulations and new rules on pandemic preparedness. What the moment calls for is not just more funding — it is a different kind of leadership. The GCC countries are not alone in seeking a more inclusive, representative global health order. But their model — rooted in delivery, backed by capital and framed by a pragmatic, forward-looking vision — is gaining traction, particularly among countries that have long felt marginalized by legacy institutions. These nations could host a WHO collaborating center or convene a permanent South-South forum to help redistribute governance power. They are already taking action. Through the G20, Saudi Arabia has supported the WHO's digital health strategy, workforce development programs, vaccine certification systems and campaigns to combat health misinformation — many of them shaped by lessons from the COVID-19 response. The UAE, meanwhile, played a leading role during COP28, hosting the first-ever Health Day and advancing a joint declaration linking climate and health policy. The country is investing in early-warning systems, genomics and the training of a new generation of global health diplomats. These are not vanity projects. They are the building blocks of a new system — one oriented around results, not rhetoric. The retreat of traditional donors leaves not only a gap, but a chance to build better. The Gulf model — regional capital, measurable outcomes and an openness to innovation — offers a new template, one that could be adapted well beyond the region. As ministers and delegates meet in Geneva this week, they will debate how to future-proof global health. But in many ways, that future is already unfolding — in Abu Dhabi, Riyadh and beyond. The question is no longer whether the Gulf is rising in global health. It is whether the rest of the world is ready to keep pace.
