RANZCR: Our Advocacy: A Good News Story for Breast Cancer Patients

The Royal Australian and New Zealand College of Radiologists (RANZCR) Inside News June 2020

A Message from the Dean

The quick decision-making and speed of implementation by government is appropriate to the circumstances but very different from the regular process of progressing change in policy, which involves a great deal of work from a large number of people. Our experience of advocating change to governments is one of many meetings and a very long lead time in achieving change. Advocacy is one of the strategic pillars of our College strategy and we work hard to improve safety, quality and access for our patients in both Australia and New Zealand.

The current human biosecurity emergency has rightfully seen our governments be agile and act very quickly to implement legislation and strategies to minimise the spread of the virus and provide economic support to the peoples of Australia and New Zealand.

Amid the turmoil of the pandemic it is easy to overlook the positive.

“I would like to share with you a good news story about the changes that have been achieved though the collective effort of many members advocating for better access to imaging for women with breast cancer symptoms.”

In 2016, the International Day of Radiology’s theme was breast imaging. We used the opportunity to conduct a roundtable in Canberra with other stakeholders who are similarly committed to improving outcomes for patients with breast cancer. From the roundtable a Statement of Principles was developed and presented to the Federal Government. There were three cogent asks:

1. Unfreeze and increase Medicare patient rebates

2. Remove the multiple services rule for breast ultrasound & biopsy

3. Expand access to breast MRI.

It is very gratifying to see that our advocacy has borne fruit with each of these asks achieved, or set to be achieved, in the period from November 2019 through to July 2020. This is a long overdue advance and recognises the critical role that diagnostic imaging plays in improving health outcomes for Australian women. From 1 July 2020, indexation will be introduced for CT, X-ray and ultrasound which includes mammography so patient rebates will be increased

From 1 May 2020, a new item has been introduced to Medicare which allows for a diagnostic breast ultrasound and a biopsy to be done at the same time, removing the multiple services restriction that has caused such difficulty for patients From 1 November 2019, a new rebate for breast MRI was introduced into Medicare.

We were successful in achieving our goals due to a number of key factors. Firstly, we identified and documented the issues. Our message was clear, concise and easy to follow. We had very specific asks of what action we wanted the government to take. The actions we sought of the government were measured and showed a clear benefit to patients. We also had support of other stakeholders with similar interests including key consumer groups to carry the same messages to government. One meeting rarely brings results. These asks for breast imaging have been advocated for through many channels, in addition to the abovementioned roundtable, we have pressed for these changes via the Diagnostic Imaging Advisory Committee of the Medical Benefits Schedule Review Taskforce, through many meetings with several Health Ministers, politicians and Department of Health public servants.

The College is bi-national and we are working just as hard in New Zealand to achieve improvements for patient care. The College is a very actively participating in the New Zealand Health and Disability Review. Our submission highlights a number of key issues including:

* The critical workforce shortfall of clinical radiologists

* The need for investment in digital technology

The pivotal role of clinical radiology and radiation oncology in all aspects of healthcar e delivery: prevention, diagnosis, treatment and monitoring. These issues will be a key focus for our election strategy for the upcoming New Zealand election. I look forward to providing an update about similar positive results from our advocacy activities in New Zealand in the future.

Advocacy requires relentless determination from both members and staff at the College, but if we work hard and stay focused, we will reap the reward for our patients.

Clin A/Prof Sanjay Jeganathan

Dean of the Faculty of Clinical Radiology

If you have any questions or comments about this article please contact Kirsten Fitzpatrick, Project Officer, on fcr@ranzcr.edu.au