NACCHO 2015 Budget Aboriginal Health News alerts
As the National Rural Health Alliance stated last night this year’s Budget has succeeded in doing what many a Prime Minister in the past has wanted: to take health off the front page of the newspapers and blogs
But for our member services we have provided the following interim news alert
1.Federal budget 2015: Nearly $2 billion in cuts to health system
2.Health Budget night lock up fiasco :
3. Indigenous Advancement Strategy gets $4.9bn commitment
4. National Rural Health Alliance
5. Health experts react in The Conversation
6.AMA was also concerned about the apparent lack of preventive health measures and funding in the Budget.
7.The government’s $485 million e-health package
NACCHO the peak Aboriginal health body welcomes the confirmed announcement by the Federal Government of three-year funding agreements for Aboriginal Community Controlled Health Organisations.
The Government will invest $1.4 billion to continue support for Aboriginal Community Controlled Health Organisations.
National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke said the new agreements meant that crucial primary health care services would be sustained and that Aboriginal health services could now provide job security to their doctors, nurses and health workers who have the important role of improving the health and wellbeing of Aboriginal Australian.
And according to the Ministers press release “The health of regional, rural and Indigenous communities will also continue to be supported through key budget measures such as: $20 million over two years in increased support for the Royal Flying Doctor Service; better targeting of financial incentives for doctors through the General Practice Rural Incentives Programme and the consolidation of workforce scholarships to form a new, more effective programme to encourage health students to take up rural careers.”
PLEASE NOTE : NACCHO is awaiting more details of the Aboriginal Health budget before responding see below
A/Prof Owler said it was evident last night that the health sector was not impressed with the withholding of Budget detail in the Health Budget lock-up. It was insulting to have the leaders of Australia’s health organisations locked in a room with no Budget detail,” A/Prof Owler said. The AMA will also make a more detailed response when full details of the health Budget are made available
1.Federal budget 2015: Nearly $2 billion in cuts to health system Dan Harrison Fairfax
The Abbott government will cut nearly $2 billion from the health system over the next five years, while pushing ahead with controversial changes to the way it funds state-run public hospitals.
After angering voters last year with proposals for a Medicare co-payment, Health Minister Sussan Ley has looked for savings from a range of little-known programs, including grants for preventative health research, chronic disease prevention and rural outreach.
Ms Ley says the budget still represents a “sensible and moderate” increase in funding – to more than $69 billion next financial year. Health spending is projected to increase by 3.2 per cent in real terms over the next four years.
The government is proceeding cautiously on Medicare reform, allocating $34 million to support the work of taskforces which will examine elements of the system and present reform blueprints to the government by the end of the year.
But it has not retreated on its plans to cease funding hospitals based on the services they provide and shift to a new model based on population growth and inflation, which will leave states and territories $57 billion worse off over 10 years.
The Australian Medical Association has said this “will fall well short of the funding needed to position public hospitals to meet the increasing demand”, locking them in to having inadequate capacity to give people the treatment they need.
Patients will welcome $1.6 billion in new drug listings, including medicines for melanoma and bowel cancer.
A number of services will be added to Medicare, including a new treatment for early-stage breast cancer, while a new cervical cancer test will mean women will only need to get a pap smear every five years instead of every two.
The government will move to funding hospitals based on population growth and inflation. Photo: Erin Jonasson
A scheme created by the former Labor government to pay living organ donors the minimum wage while they recover from surgery will be extended from six to nine weeks. This is part of a $10 million push to improve organ and tissue donation rates, which also includes allowing people to register their consent online to donate their organs.
The budget papers restate the government’s commitment to set up a Medical Research Future Fund, which was first announced in last year’s budget. It will be established by August, and despite jettisoning the Medicare co-payment, the government expects the fund’s balance to reach $20 billion by 2020. It will distribute $10 million from the fund in 2015-16, and expects to allocate more than $400 million to projects over the next four years.
The single largest saving in the health budget – about $963 million over five years – will come from what the government calls “rationalising and streamlining” health programs, including “flexible funds” which support initiatives in areas such as infectious and chronic diseases.
The government has committed $485 million to reform the system of electronic health records, which it says was mishandled by the former Labor government. The revised scheme is expected to cost about $200 million less than had been previously allocated. An opt-out model will be trialled to overcome disappointing levels of take up.
Dental care has also taken a hit, with the government extracting savings from dentist workforce programs and child dental programs.
A further $252 million will be saved from reducing the amount the government pays drug companies for medications for common conditions such as asthma and high cholesterol. The government hopes to achieve further savings of about $3 billion over five years through its ongoing negotiations with chemists over a new community pharmacy agreement.
2.Health Budget night lock up fiasco
CLICH THRU to the CROAKEY site for more info
The most frustrating part of Budget Night for many health groups was the lack of information available at the Health Lock-Up. Budget papers were not provided to attendees, as is customary, and Departmental representatives were unable to answer questions about the detail of the Budget measures.
AMA President Brian Owler was so irritated with the disorganisation that he commented to the media that “It was insulting to have the leaders of Australia’s health organisations locked in a room with no Budget detail.” Matthew Cooke, NACCHO Chairperson, attending the lock-up with CEO Lisa Briggs was equally annoyed, questioning via Twitter the value of a lock-up without access to the Budget papers.
Given that the Health Budget held few surprises for anyone in the health sector, let alone the Department who (presumably) had advised the Government on the Budget measures, the lack of preparation for the lock-up is surprising.
Picture above NITV referring to $146.7 million Income Management extended as “WINNER”
3.Budget 2015: Indigenous Advancement Strategy gets $4.9bn commitment
The government has committed $4.9 billion to its troubled Indigenous Advancement Strategy, while maintaining $534 million in cuts from last year’s budget.
The government will index funding for the IAS in 2018-19 to provide funding continuity across five key areas: jobs, land and economy; children and schooling; safety and wellbeing; culture and capability; and remote Australia strategies.
The government said it would continue to pursue its reform program in indigenous affairs, promoting an agenda of employment, school attendance and safety.
While the portfolio has been spared further cuts after last year’s overall 4.5 per cent reduction in spending, almost $1bn will be redirected from the previous Labor government’s 10-year Stronger Futures package for the Northern Territory to a new national partnership agreement.
The redirection of $988.2m over eight years will replace the existing partnership agreement on Stronger Futures in the Territory, and will prioritise schooling, community safety and employment.
An additional $1.4bn already allocated to Stronger Futures will be maintained and administered by Social Services, Health and the Department of Prime Minister and Cabinet outside of the new NPA.
Details of the government’s spending program revealed in yesterday’s budget show the cost of supporting the IAS within the Department of Prime Minister and Cabinet was $311m last year — more than the amount spent on programs dedicated to children and schooling, safety and wellbeing and culture and capability.
The $310m departmental costs for administering the IAS are expected to fall to $279m this financial year.
In other measures announced yesterday, $5.4m will be provided over two years to extend funding to indigenous boarding schools where more than 50 indigenous students from remote areas are housed, or where more than 50 per cent of all boarders are indigenous.
The South Australian government will receive $15m in transition funding as the government withdraws from supporting municipal services in remote communities.
A new remote indigenous housing strategy will replace the $1.1bn national partnership agreement on remote indigenous housing, with a renewed focus on increasing indigenous home ownership and employment.
4.Health Budget: new words for a new period -NRHA
This year’s Budget has succeeded in doing what many a Prime Minister in the past has wanted: to take health off the front page of the newspapers and blogs.
In what can only be described as a muted affair, those concerned with detailed but big picture changes to Australia’s health system will be disappointed.
Those who, on the other hand, would like to see the Coalition deliver on its pre-election promise to have the Commonwealth mimimise its role in health might see some reason to be encouraged.
Driven by the federal government’s fiscal circumstance, much of the content of this year’s health budget is about ‘greater efficiency’, ‘cost saving’ and ‘rationalisation’. Whether this is driven by the Commonwealth’s need for savings or by a redefining of its role in health remains to be seen.
Searching through the limited material available in the health budget lock-up, those who work in and for remote rural health were able to find just a few things to celebrate. The electronic health record is to be resuscitated with trials of an opt-out approach – one of which will hopefully be in a rural area.
The biggest game in town for rural and remote health consumers as for others is the review of the Medicare Benefits Schedule. It is to be hoped that it will not be an exercise in minimising cost but, instead, a means of providing better access to care for people in rural and remote areas. For instance new items with demonstrated effectiveness would include item numbers for a range of health clinicians on either end of a telehealth consultation.
The Royal Flying Doctor Service, one of the NRHA’s 37 member bodies, seems to have been spared penury for a little while longer, although its longer term future – like that of so many other services and agencies, will be in the hands of a ‘review process’.
Following the report from the Mental Health Commission, services for mental health played a leading role – without any firm commitments on how matters will be improved. Aboriginal and Torres Strait Islander health was an extra with very few speaking lines and the Modified Monash Model made a welcome guest appearance.
And there is some welcome new funding for concessional loans for farmers in drought affected areas and, especially welcome, for small businesses in towns affected badly by the drought. (Given the siloed nature of Westminster governance systems, this was not mentioned in the health budget.)
Nine workforce programs including scholarship schemes are to be ‘rationalised’, contributing to $1.7 billion in savings over the next four years. Also contributing to these savings is a further reduction in the funding available to peak bodies in the sector and a range of services currently funded through the flexible funds. Just for now it seems likely that the ‘flexibility’ of these funds is one way only.
Interestingly, the words and phrases not mentioned at all in tonight’s formal budget proceedings include ‘continuity of care’, ‘patient-centred care’, and reform.
5.How the Health experts Reacted –The Conversation
The big surprise about this year’s health budget was what wasn’t there – billions of dollars in expected savings from the Pharmaceutical Benefits Scheme (PBS).
In the past week, pharmacists and drug companies have been widely reported as being “on the brink of war” with the federal government, over well-sourced predictions that the budget would try to save as much as $5 billion from the PBS over the next five years.
Those savings were expected to come in large part through a 5% cut in what the government paid for key prescription drugs, potentially worth billions, along with $400 million in savings from pharmacists.
Both Medicines Australia and the Pharmacy Guild had been preparing public campaigns against the planned cuts. Last week The Australian reported that Medicines Australia chairman Martin Cross had written to the Prime Minister asking him to intervene.
On Tuesday, the budget papers revealed that instead of billions in PBS cost-savings, just $252.2 million over five years would be saved through adjusting the price of a number of PBS-listed drugs. Talks with industry are said to be continuing.
Meanwhile, new drugs to treat melanoma and breast cancer will become more affordable from the middle of this year, under a $1.6 billion boost over five years that is also funding other recently listed PBS treatments for asthma and multiple sclerosis.
Among this year’s health measures, the single biggest cost to the bottom line was a hangover from last year: the federal government’s failure to persuade the Senate and public to support cutting $5 off the rebate it pays GPs for common doctor visits. The budget papers show the reversal of that policy will cost $2.9 billion between 2014-15 and 2018-19.
But there was better news on the big ticket health item of the Coalition’s first budget – the announcement of a Medical Research Future Fund (MRFF). It will receive $400 million over the next four years, starting with $10 million in this financial year. But that’s still a long way short of the government’s stated plan to see the MRRF become a $20 billion fund in 2019-2020.
AMA President Associate Professor Brian Owler (pictured above with NACCHO Chair Matthew Cooke ) said tonight that the modest positive measures in the 2015 Health Budget failed to overcome the lingering profound negative effects of the 2014 Budget.
A/Prof Owler said the AMA was surprised and disappointed that the review of the Medicare Benefits Schedule (MBS) – with the clear inference that this would be a Budget savings exercise – was the centrepiece of the 2015 Health Budget.
“The GP co-payment may be gone, but the health system is still struggling with the impact of the freeze on Medicare patient rebates,” A Prof Owler said.
“There is nothing in tonight’s Health Budget to indicate that the Government will restore public hospital funding, which was savagely cut in last year’s Budget.
“Instead, we were told tonight by the Secretary of the Department of Health that the MBS review would build on considerable savings already made by MBS review processes.
“The MBS exists to provide patient rebates and access to services.
“This move is against the Government’s assurances that the MBS review was not about Budget savings.”
A/Prof Owler said the AMA would be seeking urgent clarification from the Health Minister and Prime Minister about the objectives of the MBS review.
A/Prof Owler said the AMA was also concerned about the apparent lack of preventive health measures and funding in the Budget.
The AMA welcomes a range of other measures, including:
- e-health changes, including the myHealth Record, particularly the opt-out component;
- mental health plan;
- support for the National Critical Care and Trauma Response Centre;
- funding for Aboriginal Community Controlled health organisations;
- organ donation programs; and
- the Ice Action strategy.
A/Prof Owler said it was evident tonight that the health sector was not impressed with the withholding of Budget detail in the Health Budget lock-up.
“It was insulting to have the leaders of Australia’s health organisations locked in a room with no Budget detail,” A/Prof Owler said.
The AMA will make a more detailed response when full details of the health Budget are made available
7.Read David Glance’s analysis of the government’s $485 million e-health package here.
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