A successful government engagement example to follow

One of the best examples of effective government engagement I have seen and been involved with, was the re-establishment of indexation for MBS items in nuclear medicine. Nuclear medicine items within the Medicare system had not had indexation for a staggering 25 years, by the time this all changed. I worked for the Australasian Association of Nuclear Medicine Specialists (AANMS) for a couple of years and we had conversations about what would be one of the key actions that could be taken that would have significant benefits for practitioners and patients, and it was indexation.

Twenty-five years without indexation of MBS rebates had created a significant funding gap in out of pocket costs for patients and unsustainable costs for services. It was

impacting the affordability, accessibility and availability of nuclear medicine services and patient care.

The process of advocating for the reintroduction of indexation started in 2020 up until the 2024-25 Federal Budget when the change was announced. This might seem like a long time, but to achieve a significant change like this in 4 years was not long. It was an indication of the effective and clear advocacy that was undertaken by AANMS.

The process involved gathering data and information by engaging a health economist to undertake a report and bring together the costings, information and research. Ultimately proving the case economically – to Treasury – is central to success.

It involved gaining support from decision makers. Before even commencing advocacy, meetings were held with the Department of Health and Aged Care, the Government of the time and the Opposition. There was no question when the timeframe of over 20 years and the impact was communicated, that the need for indexation to be restored was supported by all sides.

It involved consistent and clear communication by Presidents’ and leadership at AANMS – it didn’t matter if personnel changed, the organisation was clear on the key ask in budget processes and other discussions. Government and decision makers would not be left in doubt about what was being asked and the case was built. This is crucial.

So often you will see organisations continually changing what they are asking for and therefore not building a case, having inconsistent messaging, and leaving decision makers with no clear idea of what is being asked. It is also about having the solution to the issue being identified and in this case it was absolutely clear.

It involved respectful engagement by working with decision makers. When you are a Minister and MP or a government department, you have many, many people and organisations coming to you asking for something happen and often it’s a problem without a solution or an ask that isn’t backed by the work. Decision makers want outcomes just as anyone does, and organisations should be willing to work with rather than fight with them. There were no stunts, not tantrums, just effective, evidence-based engagement.

The eventual announcement in the 2024-25 Federal Budget may have gone under the radar for some, but the reintroduction of indexation along with suite of other changes for nuclear medicine, was such a significant change. But more than that, it was one of the best examples I have seen of sustained, effective, respectful, clear and evidenced based advocacy.

Credit goes to the Dr Geoff Schembri the AANMS President who started this advocacy, and the following President Professor Sze Ting Lee and General Manager Lisa Maddocks who carried it forward and didn’t waiver. It’s an example to follow.