Below we compile rolling reaction to the Federal Budget. Also see this Twitter thread compiling reaction and follow the news at #WellbeingBudget2022.
See links to Budget statements here.
This post includes commentary from Australian Council of Social Service, Public Health Association of Australia, Consumers Health Forum, Australian Nursing and Midwifery Federation (ANMF), Council on the Ageing Australia, Royal Australasian College of Physicians, SNAICC, The Australasian College of Paramedicine, Royal Australian College of General Practitioners, Oxfam Australia, People with Disability Australia, The Climate Council, LGBTIQ+ Health Australia, Refugee Council of Australia, Australian Primary Health Care Nurses Association, Australian Academy of Science, Australian Red Cross, Everybody’s Home, Australian Education Union, Amnesty International Australia, Anti-Poverty Network SA, Australian Medical Association, National Shelter, CBM Australia and the Australian Disability and Development Consortium, Medicines Australia, Allied Health Professions Australia, Australian College of Nursing, Australian College of Rural and Remote Medicine, the Royal Australian and New Zealand College of Psychiatrists, Jesuit Social Services.
Strong measures but deep concern on low income support, future revenue needs
Australian Council of Social Service (ACOSS)
ACOSS CEO Cassandra Goldie said:
“This is a budget that delivers on some of the government’s important election commitments, and we welcome them.
We’re very pleased to see the $560m investment in community services, as well as investment in aged care, paid parental leave and child care.
We now also have a new housing accord, which lays the foundations for increasing the supply of social and affordable housing in Australia to deal with the housing crisis.
Other measures we welcome include provision for at least $3b in disaster payments over the forwards, $100m in solar banks to open up solar power for renters and low-income people, investment in The Voice and an Anti-racism Strategy.
We remain deeply concerned about the lack of action to lift the incomes of people living on payments like JobSeeker, which is just $48 a day. There are over 3 million people living in poverty, with many on JobSeeker and Youth Allowance forced to skip meals and essential medication, and live in their cars.
In a wealthy country like Australia, we should not condemn people to living on such inadequate incomes.
People on the lowest incomes face multiple crises including high inflation, 150,000 more people unemployed in 2023, rents up 10 per cent in just one year, high debt as well as multiple disasters. So, this must be the beginning and not the end of the hard work this government must do. We must see an urgent increase in income support for people on the lowest incomes in Australia.
We’re also very troubled to see that budget spending is forecast to increase by only 0.3 per cent per annum when we know we must deliver critical essential services to meet community need. It’s obvious the government will need more revenue to meet the community’s urgent needs, and for this reason, we cannot afford the $19b a year tax cuts starting in 2024.”
Some small, welcome first steps but where are the $s for prevention?
Public Health Association of Australia
The initial $3.2 million investment in the October Budget for the Centre for Disease Control is important and welcome, the Public Health Association of Australia has said.
The Centre is the most substantial public health decision to come out of a federal Budget in many years.
“At the moment the Centre for Disease Control is not about the money but the process,” PHAA CEO Adj Prof Terry Slevin said.
“The next step is what will be in the May Budget.”
As Health Minister Butler told Mr Slevin in a webinar: “We’ve committed funding to make sure that we work with states and territories, work with the sector, including with organisations like yours, Terry, that have taken such a deep interest in this, and make sure we get this model right for the future.”
We also welcome the initial steps and $3.2m toward creating a National Health Sustainability and Climate Unit and develop Australia’s first National Health and Climate Strategy.
We will continue advocating and working will our allies and partners in the months ahead to influence what we hope will result in greater detail and investment in the May 2023 Budget.
First Nations’ health
We welcome the Budget’s investments in the health of Aboriginal and Torres Strait Islander peoples, which are coupled with efforts to enact the Uluru Statement and hold a referendum within the next 18 months.
Measures include training up to 500 First Nations health workers through a $54.3m investment in the First Nations Health Workers Traineeship Program.
It’s also pleasing to see money to tackle Rheumatic Heart Disease, with $13.5m for the National Aboriginal Community Controlled Health Organisation (NACCHO) to offer prevention, screening and treatment programs.
This Budget also includes funding for areas which fall under the social determinants of health, such as investments in early childhood education and care, community wellbeing, women’s safety programs and funding to improve the health of LGBTQI+ Australians.
Expectations for May 2023 Budget
It is disappointing there was no new investment in actions to fulfil the National Preventive Health Strategy. We will be looking for NPHS-related investments in May, as well as developments in how the government will measure and improve peoples’ wellbeing.
It remains the case that about 2% of total health expenditure is on public and preventive health.
We have great expectations that the Labor Government will shift that, and increase investment over its term to redress the imbalance and reduce the focus on treating health problems which could have been prevented.
One way of funding those investments is to not proceed with the Stage 3 tax cuts.
A ‘no surprises’ budget but true health reform awaits
Consumers Health Forum
Consumers Health Forum, the peak body representing Australian health consumers, acknowledges the Government’s efforts to strengthen Medicare and primary care but says there is a long way to go before true health system transformation.
“This is the budget we were expecting but perhaps not the one we dreamt of,” CHF CEO Dr Elizabeth Deveny said. “It is a ‘no-surprise’ budget that delivers on the government’s election commitments, but the promise of true health system reform is still ahead of us.
“Health consumers will be very pleased about the reduction in the cost of medicines but for those on pensions or very low incomes, it would have been good for the PBS safety net threshold to be reduced further,” Dr Deveny said.
“We applaud the government’s commitment to strengthening Medicare. One of the underlying principles of universal healthcare is that consumers are able to access services, when and where they want them.”
CHF said that the funding of several initiatives to improve system navigation was evidence that the health system makes it too difficult for people to find the service they need without expert guidance.
“What health consumers want is for their health journey to be as seamless as other parts of their life – where services can be accessed via digital channels, face-to-face or a hybrid,” Dr Deveny said.
“We have a long way to go before that is achieved due to fragmentation of services, various models of care and a range of stop-gap measures.”
Dr Deveny said that, as stated in the Wellbeing budget paper, measuring what matters is the ultimate test of system performance.
“What we want to see in the future is that the consumers’ experience of care is measured, and that the consumers’ voice is hard-wired into all policy and healthcare decisions,” she said.
“Sadly, the budget did not include any funding to improve the health literacy of consumers, which empowers them and gives them the tools to share in decision-making around their healthcare.”
Dr Deveny said while CHF applauded the investment in housing and climate change, both of which directly impact health, it would have been good to see a greater focus on preventative health.
CHF’s views on healthcare budget initiatives:
- Mental health – while restoration of psychiatric telehealth services loading in rural and regional areas is welcome, we would like to see the commitment to mental health services extend beyond Headspace and 10 session Better Access.
- The commitment to strengthening First Nations’ health is very welcome. Highlights are the additional 500 workers and traineeships codesigned with NACCHO, 17 new clinics, doubling the funding for rheumatic heart disease and 120 more dialysis chairs
- Rural and Regional – welcome the workforce and training packages and incentive payments to GPs with advanced skills.
- Would like to see models of care and workforce solutions in remote communities
- We called for a CDC in our election platform so good to see this commitment.
- We also welcome the establishment of a National Health Sustainability and Climate Unit.
Welcome investments for health, aged care, child care and more
Australian Nursing and Midwifery Federation (ANMF)
The ANMF has welcomed funding for health and aged care and cost of living relief in the Budget.
ANMF Federal Secretary Annie Butler said the significant investment is the first-step in fixing the troubled aged care sector, by providing support for staff ratios and other measures which will ensure safe, quality care for older Australians living in nursing homes.
“We commend the Government for recognising the need to prioritise funding for health and aged care in the Budget, particularly during these difficult economic times,” Butler said.
“We welcome funding to improve aged care and increase access to healthcare, including reducing the costs of prescriptions, which will ensure that everyday healthcare is more affordable and accessible for all Australians, when and where they need it.
“The Government’s plan for boosting wages in female-dominated industries, improving gender equity and addressing cost-of-living pressures, will provide a platform to finally commence reforming aged care by recruiting and retaining nurses and workers, so desperately needed across the sector.
“Nurses, midwives and carers will also benefit from increased access to childcare subsidies and the extension of paid parental leave to 26 weeks and more affordable housing for these essential workers.
“Furthermore, funding for a new National Nurse and Midwife Health Service will provide much-needed health and well-being support for frontline nurses and midwives across the country.
Strong commitment to aged care, other welcome promises for older Australians
Council on the Ageing (COTA) Australia
COTA Australia CEO Chief Executive Ian Yates welcomed the Budget, saying it has “kept its promises to older Australians and gone further in some areas”.
“Looking at the Budget as a whole, the Government’s focus on reducing inflation as soon as possible, helping get from 7.75 per cent this year to 3.5 per cent in 2023/24, will be a welcome relief to older Australians on fixed incomes and will protect the savings of retirees and people saving for retirement,” he said.
COTA Australia provided comprehensive comments on major funding areas, as outlined below:
Aged Care
The Budget builds on the previous government’s work to implement many of the recommendations of the Aged Care Royal Commission; extends measures that had only been short term funded; and funds the additional commitments Labor made during the federal election including to extend care hours, require 24 hour nursing cover, improve transparency and improve the quality of food and the meals experience in both residential and home care.
COTA particularly welcomed:
- Higher pay for all aged care staff to follow from the work value case currently before the Fair Work Commission, for which the Government has already made a provision.
- At least 15,000 of the free TAFE training places being reserved for aged care to help address workforce pressures.
- The creation of a dedicated Age Care Complaints Commissioner in the Aged Care Quality and Safety Commission.
- More than $310 million for the essential upgrading of IT infrastructure and systems to support the new Support at Home program, greater provider transparency and other reform measures.
- Full funding for 24 hour, 7 day nursing in all residential care services from 1 July 2023.
- Increasing the minutes of care for each aged care resident from the new average of 200 minutes (including 40 of nursing) required from 1 July 2023 to 215 minutes from 1 October 2024.
- Implementing a national personal care worker registration scheme and a Code of Conduct.
- Creating an independent Inspector General of Aged Care as recommended by the Royal Commission and getting the Office of the Inspector General started in 2022/23,
- Providing better food services using a four year funded program to support and train the sector.
- Implementation of the new Support at Home program by 1 July 2024, which will require testing and finalisation of the new single assessment service, design of the new service list and the IT systems needed to support greater choice, self-management, and transparency. In the meantime, the government will be moving to cap home care administration fees until unit pricing is introduced.
- Continuation of the Disability Support for Older Australians program from the end of 2022 to the end of 2023 – an essential but still transitional step to fully implementing the Royal Commission recommendation for older Australians with severe disabilities to be treated in an equivalent way to the NDIS.
- Implementing new measures to establish enhanced financial and care service transparency of providers to both the government and older people seeking and using care
- Supporting the new Independent Hospitals and Aged Care Pricing Authority to be ready to recommend independently determined fair and reasonable service pricing by 1 July 2024
The Government has also extended COVID-19 support to the sector by a substantial $845 million.
Self-evidently much is being done and will be done in aged care reform with the nearly $4 billion committed in this Budget, with aged care wage increases still to come. We congratulate not only Ministers Butler and Wells on their hard work so far, but also the evident commitment of the Prime Minister and Treasurer to this reform process being given priority.
Much more remains to be done to fully implement the Royal Commission recommendations and to achieve a world class aged care system of which all Australians can be proud and have confidence in.
In the lead up to the next Budget COTA will be strongly engaging on matters still under consideration, such as improving services for people with severe disability, and ensuring that the new Support at Home program really delivers for older people and their families.”
Health
This Budget has kept the promises to reduce the PBS co-payment, revamp the primary health system, establish Medicare Urgent Care Clinics, and rural health provision. These initiatives will both improve the health of older people, and also help with the cost of living. COTA Australia will continue to advocate for better dental care for older Australians.
Housing
The government’s commitment to addressing Australia’s housing crisis is welcome. Spiralling rents have been especially difficult for older people on fixed incomes. We look forward to the National Housing Accord delivering affordable housing. That Accord should include measures that promote more accessible housing that is suitable for everyone as we age. As that Accord is negotiated, COTA Australia will be focused on ensuring it fixes Commonwealth Rent Assistance, which currently falls far short of making rental housing affordable for pensioners and other low income people.
Older Workers
Older workers in Australia often face ageism, and sometimes regulated discrimination. Improving the participation rate of older workers should be a priority, both for their wellbeing and so the country can benefit fully from their skills and experience. The one-off $4,000 credit to the Work Bonus scheme until 30 June 2023 announced at the Jobs Summit was welcome but longer term solutions are needed.
Reforms to the workplace relations system that enhance flexibility for older workers are an important step. So too is improving the anti-discrimination framework – flagged in this budget. We look forward to working with the Government to develop longer term solutions to improving the participation rate for older workers.
Women
The commitment to gender equality is clear and welcome in this Budget. Older women face many of the same pressures all women face, but after a lifetime of discrimination, also face an accumulation of financial and social barriers. Initiatives in workforce, housing and education will all be of assistance. COTA Australia is particularly pleased to see the focus on the gender superannuation gap. We look forward to working with Government on future policies in housing and superannuation to solve the poverty trap faced by too many older women.
Paid Paternal Leave and Childcare
Taking care of children is not just a parenting question, it often includes grandparents as well. When childcare is not accessible, grandparents often sacrifice their own later careers to provide childcare so their own children can go back to work. The initiatives to expand Paid Parental Leave to 26 weeks, and to improve the affordability of childcare, will help many older Australians.
Disaster resilience and preparedness
Older people are among the most vulnerable to natural disaster. The longer term focus of the disaster readiness initiative is particularly helpful to older people living in disaster prone communities. We welcome the focus on reducing the cost of insurance, and making insurance more accessible and better understood. It means that when disaster strikes, older Australians on fixed incomes will not be left with nothing.
“This is a Budget that honours election commitments and seeks to steady an economy that at present represents real risks to older people,” Mr Yates said. “We welcome it and look forward to further advancing its initiatives to achieve a just, fair and achieving Australia for all, including older people.”
More work needed
SNAICC
While the Albanese Government’s first Budget has made considerable commitments to reform in the early years, there is still considerable work that needs to be done to close the gap for Aboriginal and Torres Strait Islander children.
SNAICC – National Voice for our Children CEO Catherine Liddle said reforms to make childcare cheaper and lifting parental leave were welcome.
“But specific commitments are needed if barriers are going to be removed for Aboriginal and Torres Strait Islander families,” Ms Liddle said.
“The Budget announcement around specific funding to increase access to playgroups for Aboriginal and Torres Strait Islander children is very welcome.
“We look forward to seeing more detail on the $12.4 million overall funding allocated to playgroups and libraries.
“We were happy to see the Federal Government investing $33.7 million over four years to meet their commitment to changing the activity test so Aboriginal and Torres Strait Islander children will be able to access 36 hours of subsidised childcare a fortnight.
“This increase of 12 hours a fortnight is a significant step forward.
“But all the evidence says what will make a real difference in making sure our children meet developmental milestones and are ready for school is scrapping the activity test.
“This was recommended for Aboriginal and Torres Strait Islander children in the Interim Report of the Senate Select Committee on Work and Care, which also recommends an immediate increase in funding for Aboriginal and Torres Strait Islander early education and care services.”
Ms Liddle said it was reassuring to see the $10.2 million commitment to establishing the Early Childhood Care and Development Policy Partnership in this Budget.
“This partnership under the Closing the Gap Agreement will develop policies on Aboriginal and Torres Strait Islander child protection, family services, and early education and care.”
SNAICC will continue to advocate for evidence-based changes to reduce the numbers of Aboriginal and Torres Strait Islander children in out-of-home care.
“This includes funding actions under the Safe and Supported, the National Framework for Protecting Australia’s Children.
“We are concerned there is no funding in this Budget for Safe and Supported, which has the potential to be a game changer in keeping our children safe and connected to family and culture.
“It also shifts the way Government works with Aboriginal and Torres Strait Islander people, making sure they lead the decisions that impact their lives.
“Unless these commitments are backed up with funding they are just words.”
Welcome start, but falls short
Royal Australasian College of Physicians
The Royal Australasian College of Physicians (RACP) has welcomed key wellbeing measures and the delivery of health election commitments in the October Budget 2022, but says it falls short of what is required to protect public healthcare in the evolving crisis.
RACP President and paediatrician Dr Jacqueline Small said the RACP is pleased to see the delivery of priorities for early childhood including the increase to paid parental leave and a significant boost to early learning and childcare.
“Investing in our children is the best way to improve Australians’ lifelong health and reduce unnecessary burden on our public healthcare system,” Dr Small said.
“These nation-building investments will provide significant benefits to Australia’s wellbeing and the health system for decades to come.”
“We are pleased to see the inclusion of wellbeing measures – this is an important development of budget processes that provides a more holistic view of the impact of the budget on community wellbeing.
The RACP has also welcomed steps forward on several initiatives physicians have been calling for including:
- $314.8 million to help close the gap in First Nations health, including more money for infrastructure, workforce, training, and programs delivered through Aboriginal Community Controlled Health Organisations.
- $200 million for schools’ wellbeing programs and $270 million for updates to schools equipment and ventilation, both related to the RACP Kids Covid Catch Up plan.
- $3.4 million for establishing a National Health Sustainability Unit to drive the development of the Government’s National Strategy on Climate Health and Wellbeing.
- $3.2 million to undertake initial design for establishing an Australian Centre for Disease Control to improve pandemic preparedness and prevent chronic disease.
- Continuation of necessary Covid-19 measures including providing RATs to Aboriginal Community Controlled Health Services, NDIS participants, aged care facilities and supported disability accommodation.
- $2.5 billion for the election commitment to increase residential care staffing minutes and require 24/7 nurse coverage.
- $10.5 million to establish the Office for Youth
- $23.9 million for the establishment of a National Centre of Excellence in Intellectual Disability.
Dr Small said: “While the Budget is a welcome start for many important initiatives, it falls well short of the investment required to halt the crisis we face in public health.
“The Government must take further steps to address workforce challenges because our hospitals are on their knees. This includes training more specialists, especially in rural and regional areas.
“Chronic residual burnout of healthcare workers affects all patients, families, and the wider community. The passionate work of hospital and other health workers is masking a deeper and worsening crisis,” Dr Small said.
Dr Small said prevention measures were another key area where the Budget falls short.
“Until we see our healthcare system as something that prevents illness and invest accordingly to reduce future burden, the situation will continue to worsen. The Government must take a longer view and plan for the system we need in the decades to come,” Dr Small said.
Other areas requiring action to halt the healthcare crisis include:
- Expansion of telehealth and other digital health services so that all Australians can access quality care wherever they live.
- Investment in innovative models of care, including developing care pathways for specialist medicine referrals for chronic and complex diseases.
- Key measures for children’s health that are left unaddressed from the Covid-19 review.
- Action to address the inequitable impacts of the pandemic on children highlighted by the Shergold report.
- More funding will be needed to address the impacts of climate change on health to deliver a climate-ready and climate-friendly health system as per the RACP’s Healthy Climate Future campaign.
We are pleased to see this positive start by the new Government, and we look forward to working closely with them to deliver the health system that Australians need and deserve.
- Some of the key RACP pre-budget asks included:
- Ensure Medicare supports equity of access to care for low income and underserviced patients, particularly in rural and regional areas
- Fund the reinstatement of all telephone-based specialist consultations, including those for complex consultations
- Reduce the negative impacts of the digital divide by funding videoconferencing technology packages to support capacity building for patients, especially those in priority and underserviced groups.
- Increase the number of Specialist Training Program (STP) places to grow access to specialist medicine in rural and regional communities and build a pipeline of specialists
- Invest in bolstering the healthcare workforce through national strategies for flexible training and work hours, parental leave and other support mechanisms.
- Fully fund a Centre for Disease Control and Prevention, including consultation with the RACP in its design
- Fully fund the effective implementation of the National Preventive Health Strategy which commits 5% of health expenditure to prevention over 10 years to 2030.
Some welcome news but lifting income support must be an immediate priority
Jesuit Social Services
The Federal Budget 2022-23, delivered during a time of global economic uncertainty, contains some welcome investments that will make a positive difference to the lives of millions. But, with the Federal Government emphasising the importance of wellbeing for all Australians it also represents a missed opportunity to improve outcomes for some of the country’s most marginalised people by failing to lift income support rates, says Jesuit Social Services.
“This Federal Budget has been delivered at a very challenging time, with rising inflation, soaring fuel and energy prices and increased cost-of-living pressures not only being experienced in Australia but around the word. Many of the key investments in this Budget, such as cheaper child care, extended parental leave and making medication cheaper, will benefit many at a time of unprecedented challenges,” says Jesuit Social Services CEO Julie Edwards.
“We also welcome the cross-Government accord to increase the supply of social and affordable housing across Australia. Through our programs we work every day with people who have experienced homelessness, inappropriate or unsafe housing, housing instability and stress, and we see the impact it has on all aspects of their lives. We hope that this initiative makes a tangible difference to the lives of people who need support,” says Ms Edwards.
Ms Edwards says that it is extremely disappointing there is no commitment to increase the Jobseeker payment and other related income support measures.
“It is concerning that Jobseeker recipients will continue to be forced to live in poverty and have to struggle to pay for everyday essentials. The Federal Budget needs to work for every Australian, not just some, and sadly there is not enough here to address rising inequality which has been exacerbated during the pandemic and natural disasters.”
Ms Edwards says the organisation is pleased to acknowledge the $99 million First Nations Justice package, highlighted by additional funding for Aboriginal and Torres Strait Islander Legal Services and funding for up to 30 community-led justice reinvestment initiatives across Australia.
“Justice reinvestment means investing in communities of need to address the drivers of crime, prevent anti-social behaviour from occurring in the first place and keep people connected with education, employment and culture. Ultimately, this results in less crime, fewer victims and fewer people having contact with costly and ineffective prison systems,” says Ms Edwards.
“Our research into locational disadvantage conducted over more than 20 years including last year’s Dropping off the Edge 2021 report highlights that a small number of communities continue to experience entrenched and complex disadvantage. This research is a roadmap to the communities where justice reinvestment– and other targeted reforms – can make a genuine difference.”
Rural and remote communities to benefit
The Australian College of Rural and Remote Medicine
The Australian College of Rural and Remote Medicine (ACRRM) says the Federal Budget is a step forward for the Albanese Government’s election commitment to improve health outcomes for rural, remote, and Aboriginal and Torres Strait Islander communities
ACRRM President Dr Dan Halliday says this Federal Budget invests in rural and remote-specific healthcare solutions and helps to address the shortage of healthcare staff and resources.
“We note the commitment to innovatively revamp Australia’s primary healthcare system and strengthen Medicare, and expect that this will include flexible, and fit-for-purpose programs to support primary care in rural and remote communities,” Dr Halliday says.
“The government must also focus on addressing barriers to rural and remote general practice training which is essential to attract and retain a skilled specialist Rural Generalist (RG) workforce.
“ACRRM has long advocated for the need to restore the value proposition for rural general practice and direct funding towards comprehensive primary care that is locally based and designed to meet the needs of people living outside the urban footprint.
“Appropriate funding for general practice and primary care is the single greatest measure which can be taken to reduce the impact on our hospital system, and to improve the health of the nation more generally.
‘In particular, the specialist RG model of practice has been shown to be the best model to meet the healthcare needs of rural and remote communities,” Dr Halliday says.
The College welcomes the $185.3 million rural workforce package which aims to attract, support, and retain more health professionals into regional and rural communities. This includes confirmation of funding for previously announced initiatives, including Workforce Incentive Program reforms which will see RGs and General Practitioners (GPs) receive increased loadings to their remuneration in recognition of the extended scope of practice they undertake ($29.4m).
Other initiatives supported by the College include:
- Incentive payments of up to $10,500 to attract RGs and GPs who have advanced clinical skills to practise in rural and remote communities ($74.1m)
- Additional Advanced Specialist Training posts for RGs in recognition of the importance and value of the RG program and its potential to deliver an efficient and effective extended range of healthcare services which meet community need
- Increases training opportunities for junior doctors to experience RG medicine
- 20 new Commonwealth-funded medical training places at the James Cook University ($13.2m), which will ultimately boost the rural health workforce
- More than $300m for health programs that will help close the gap in health and wellbeing outcomes for Aboriginal and Torres Strait Islander peoples
- New funding of $24.7m for the Innovative Models of Care program.
“These budget initiatives pave the way for further consultation with ACRRM and other rural and remote stakeholder organisations, building on their knowledge and vested interest to develop targeted policies to ensure rural and remote communities have equitable access to the high-quality, local-based healthcare services they need and deserve.”
“They are a positive first step towards building strong, resilient and sustainable healthcare services in rural, remote and Aboriginal and Torres Strait Islander communities,” Dr Halliday says.
Federal budget opens door to broadening the scope of paramedic practice
The Australasian College of Paramedicine
The Australasian College of Paramedicine welcomes the $235 million funding allocation towards the roll-out of 50 Medicare Urgent Care Clinics (UCCs) throughout Australia announced in the federal budget and will continue to advocate with the government for the inclusion of paramedics as part of this workforce in pioneering new pathways for paramedicine to improve health care in our communities.
Paramedics are highly skilled health professionals able to work as part of multidisciplinary teams in UCCs, helping to bridge the gap between emergency departments and traditional primary care services.
“Paramedics are uniquely placed to support patients with urgent and acute non-life-threatening conditions before they need to access emergency ambulance or hospital services, resulting in fewer unnecessary emergency department presentations and a commensurate reduction in ambulance ramping,” said College CEO John Bruning. “These patients have a series of conditions that fall within the paramedic scope of practice and capability, and if we are truly committed to Building for the Future, paramedics must be a part of the equation moving forward.”
Not only is placing paramedics in UCCs practical, it’s also cost-effective and has the potential to significantly reduce costs to states, territories and the Commonwealth associated with emergency presentations, the management of chronic health conditions, and early entry into aged care. Australian Institute of Health and Welfare data from 2020-2021 showed 768,716 non-urgent and 2,470,637 semi-urgent emergency department presentations where the consumer was not admitted or referred, equating to 36.7% of all emergency department presentations at a cost of $2.78 billion per year. Providing care to these patients in the community through UCCs and other innovative community paramedicine initiatives as part of multidisciplinary teams would deliver substantial savings to the health system, likely in excess of $1 billion per year.
Innovation is the key to improving our ailing health systems, and the $24.7 million earmarked in the budget to fund an additional three rounds of the Innovative Models of Care Program to trial new primary care models demonstrates the government’s willingness to explore new dimensions of healthcare.
Such investment creates opportunities to address critical gaps in the health system, particularly in rural and regional areas of Australia. The College has been lobbying the government for initiatives that augment Commonwealth-funded primary care capacity through the utilisation of paramedics outside of the scope of state and territory ambulance services through the adoption of innovative community paramedicine models that involve broader domains of practice and models of care that incorporate primary care, community engagement, preventative care, response to unplanned care needs, and integration with medical, allied health, aged and social care services.
We have also been advocating for changes to current policy that provide access to workforce incentive programs, including relocation, training, and remote/rural packages, for paramedics wanting opportunities to fill gaps in the health system and workforce shortages in regional and rural areas across the country.
The opportunity now exists for a new and broader conceptualisation of healthcare provision and the long-awaited recognition of paramedics’ potential as a viable, cost-effective and capable workforce able to complement and bolster health services in communities of need and in turn address the challenges impacting health service provision nationally, borne out in the shortfalls in hospitals’ capacity and resourcing, workforce shortages, and ambulance ramping that are evident across the country.
“The initiatives the College is proposing will help to deliver a safer and more accessible health system with significant cost savings and improved patient-centred care. Paramedics are part of the solution, and it is important that they are recognised as such and given the scope to expand their roles for the benefit of all Australians.”
Delivers on election promises but “fails to recognise GP crisis”
Royal Australian College of GPs
The RACGP has warned that although Budget October 2022-23 delivers on key election promises, significant funding for general practice care is urgently needed to address the GP crisis.
The Budget includes a re-commitment to $250 million per year in GP funding over three years following the Strengthening Medicare Taskforce Report which is due later this year, as well as $143.3 million for rural and remote healthcare, and $229.7 million in general practice support grants to build better infrastructure.
However, the RACGP said it does not address the immediate challenges facing general practice care, including a lack of funding following years of Medicare freezes and inadequate indexation of patient rebates.
“The pandemic has exposed cracks in our health system, including general practice care, that require urgent repairs,” RACGP President Adj. Professor Karen Price said.
Price said the RACGP holds grave concerns that without major investment into general practice care by the federal Government the current shortage of GPs being felt by communities throughout Australia will intensify, waiting times to see a doctor will increase, and the health and wellbeing of Australians will suffer.
The RACGP has called for a series of reforms including an increase Medicare rebates for longer consultations, the creation of a new Medicare item for GP consultations longer than 60 minutes, as well as support for longer telehealth phone consultations lasting more than 20 minutes, and increased investment in rural healthcare.
Price said the provision of $229.7 million in general practice grants “is also welcome and we look forward to more comprehensive information regarding the number of $25,000 and $50,000 grants available for each identified area, including grants to support for general practices to achieve accreditation”.
“We also welcome confirmation of the $143.3 million in funding for healthcare in rural and remote areas, including $74.1 million over 4 years for tiered incentives, recognising doctors with additional skills practising in rural and remote areas, and $29.4 million to expand the list of eligible health professionals and increase the rural loading in the practice stream, via the Workforce Incentive Program.”
Other initiatives encompassing remote, rural and regional health, like support for further trials of Single Employer Models, are welcomed levers to address the GP crisis in rural areas.
“The RACGP also very much welcomes the federal Government’s commitment to the Uluru Statement from the Heart and the initiatives aimed at boosting the Aboriginal and Torres Strait Islander workforce in the health sector.
“As anticipated, the Budget confirms funding for 50 Urgent Care Clinics, which will be developed and piloted in consultation with the profession. While the RACGP notes that these will be GP-led, we require further information, including the funding model, workforce requirements, where the workforce will come from, and the impact on existing health infrastructure. So, that is something that we will work through with the Government because the devil really is in the detail.”
“Finally, it’s disappointing that there was no investment in general practice mental health services.”
First step to getting aid budget back on track but we must do better
Oxfam Australia
Oxfam Australia Chief Executive Lyn Morgain said:
“In a world wracked by increasing inequality exacerbated by conflict, COVID-19 and climate change, this budget is a promising first step towards re-engaging with our global community.
“After years of cuts and neglect, we are heartened to see this government revive our ailing aid budget, with an additional $1.4 billion over four years. We also welcome the announcement of $30 million to go towards the Australian NGO Cooperation Program over the next four years. This funding allows organisations like Oxfam to deliver real long-term development gains – and in the wake of the pandemic we have a lot of ground to make up.
“The government’s refocusing of the development program around gender is also a positive shift made in response to calls from the sector to target those most in need. This includes the reinstatement of the 80% target for gender-targeted programming and a new requirement that design of programs worth over $3 million must include gender equality as a significant objective.
“Despite these announcements, Australia’s aid budget still remains stubbornly at just 0.2% of GNI – well below the recommended 0.7% target. We can and must do better. What’s more, while the slightly widened footprint of our aid program to include significantly more funds for South-East Asia is pleasing, we must recognise the responsibilities we hold beyond the region, as well.
“That’s why it’s unfortunate to see the government fail to increase humanitarian spending at a time when the needs across the globe have never been greater. While the government announced $15 million in September to support a response to the deadly hunger crisis spreading through communities in the Horn of Africa and Yemen, it’s distressing to see nothing further committed in the budget. Our sector is calling on the government to contribute $150 million to tackle the looming famine and hunger crises threatening millions of lives. Their current contribution falls well short of what is required to avert a catastrophe.
“The budget showed the Australian Government is serious about rebuilding our reputation when it comes to funding climate action, but there is still much work to do. Committed funding included $500 million in concessional loans towards infrastructure projects in the Pacific, which was counted as part of our climate financing commitments – this is not what we hoped to see. Our climate finance should not be plunging the countries least responsible for the climate crisis into further debt. Australia has a good record as a donor that prioritises grants and adaptation funding for climate and we would like to see this continue.
“Developing countries, including our Pacific family, are now calling on high emitting countries like Australia to account for the damage our carbon emissions have already caused by providing loss and damage funding for changes the globe cannot adapt to or mitigate. This government must show we are serious about getting our relationships in the region back on track by backing in this call at the upcoming COP27 meetings in Egypt. This should be in addition to an extra $1 billion in climate finance – we did the sums and found we are currently contributing just one-tenth of our fair share in this space.
“Domestically, there have been some positive steps but more can be done to improve outcomes for Australia’s First Peoples. The overrepresentation of Aboriginal and Torres Strait Islander peoples in prisons is this country’s great shame. The government’s injection of significant funding to combat this is a positive step, however now leadership on law reform and work with the states and territories to raise the age of criminal responsibility to 14 is critical.”
Some positives but also many concerns to address
People with Disability Australia (PWDA)
PWDA welcomes tonight’s budget as thoughtful overall — recognising the attention to NDIS and other targeted reforms, including education and skills measures, housing and women’s safety.
PWDA praises a renewed attention to the NDIS. “The 17 per cent rise to support costs and an increase in individual supports will see benefits flow to NDIS participants,” said PWDA President Samantha Connor.
PWDA also welcomes the announcement of $12.4 million to reduce the number of appeals and an additional $21.2 million to support participants and their families with appeals. Along with funding to appoint 380 additional permanent frontline NDIS staff, this Budget has the potential to reduce some key stressors for people with disability who are NDIS participants.
Other positive announcements include 480,000 fee-free spots in vocational education and training, targeted to priority groups, including people with disability, First Nations people and job seekers.
“Fee-free vocational education places are a step toward removing the affordability barrier people with disability face when training for meaningful careers,” Connor said.
Additional funding of $485.5 million to fund an additional 20,000 university places for students from under-represented and low socio-economic backgrounds will also help offset barriers for students with disability and other disadvantaged groups.
PWDA also welcomes the cost of living/health announcement that will see the decrease of the maximum co-payment under the Pharmaceutical Benefits Scheme (PBS) from $42.50 to $30 per script. “People with disability not only face rising cost of living pressures but also costs of disability, so relief in the form of lower medication costs is welcome,” said Carolyn Hodge, PWDA Deputy CEO.
However, PWDA is concerned about other health announcements. “While we welcome the provision of $808.2 million in 2022-23 to extend elements of the Government’s response to COVID-19 until 31 December 2022, we hold concerns about the lack of targeted measures for people with disability and the cessation of the response. COVID is not over!”
The Housing Australia Future Fund will provide a welcome $10 billion investment across State and Territories, including 20,000 new social housing dwelling and 4,000 for women and children impacted by family and domestic violence and older women at risk of homelessness. “With housing the number one issue in our disability advocacy services, we encourage all governments to ensure a continued focus on providing accessible social housing for people with disability – including safe, secure and accessible homes for women with disability escaping violence,” said Hodge.
One area of concern is the absence of serious reforms around income support for people with disability, especially those affected by the COVID pandemic. “Those already living in poverty will be disproportionately affected by higher interest rates, housing and energy costs,” said Connor.
PWDA holds concerns that those most disproportionately affected by poverty will be further impacted by any impending economic crisis. “We welcome a small $1,000 increase in the annual rate of the Totally and Permanently Incapacitated Payment for eligible disabled veterans to help with cost-of-living pressures, but recognise that this is not enough,” Ms Connor said. “We will be looking for more from the next budget.”
While the Government will provide $630.4 million over four years from 2022–23 to strengthen Australia’s resilience to disasters, there is no dedicated measure to ensure people with disability will be safe in climate emergencies and other disasters.
PWDA calls upon government to ensure that targeted emergency preparedness measures are developed and implemented urgently. “We are facing an increasing number of emergencies and disasters each year and it is imperative that our responses are planned and tailored to the needs of people with disability,” Ms Connor said.
Climate features big but need to hasten renewables transition
The Climate Council
The Budget has delivered more cash for climate initiatives than any other in the last decade, but Australia must ramp up its renewables transition to ease the pain of rapidly rising bills.
“This really is the first budget in a decade to take climate seriously as both an opportunity and a threat,” said the Climate Council’s Nicki Hutley.
“From a climate perspective, this Budget is a refreshing change from what we have had to endure for many years now. Climate change was mentioned 220 times — it’s not front and centre —but it’s a vast improvement on recent years.
“For a start, there is a detailed discussion around the fiscal and economic risks of climate change, with confronting figures such as the potential 7 per cent drop in GDP over the remainder of this century if we fail to act.
“Reassuringly, the Government is living up to its pre-election climate commitments with investment in renewable energy, the grid, electric vehicles and charging infrastructure, and a cornucopia of other measures, which all add up.
“There are state and federal partnerships and there’s also funding to help our Pacific neighbours in the fight against climate change. Plus more much-needed measures for disaster resilience.
“This is a most welcome step forward, but far more still needs to be done. We need to land a detailed, workable Safeguard Mechanism. We need to go harder and faster on the energy transition. And, we need to stop subsidising fossil fuels and approving new developments.”
Carbon pricing must be on the agenda
Professor Frank Jotzo
Jotzo, Director of the Centre for Climate Economics & Policy at the Australian National University’s Crawford School of Public Policy, said:
“On climate change and energy this budget makes useful commitments. The new expenditure items are not large, especially in comparison with the United States and Europe where many billions are flowing to support zero-emissions industries. But there is sound budgetary support for many underpinnings of future action, including for energy infrastructure, and importantly for institutions and initiatives that help guide climate policy and energy transition.
There is money for a national energy transformation partnership, for the Climate Change Authority to do its job better, and for international climate partnerships and better engagement with the UN. The main effects on emissions will come from policy that is budget neutral, first and foremost the Safeguard Mechanism which will be geared to bring an emissions price signal to Australia’s industry sector without raising revenue nor subsidies.
In future budgets, the question will be whether there aren’t opportunities for the federal government to provide on-budget support for stronger climate policy – and why Australia is not using carbon pricing to bring in revenue to pay for it.”
We need a new vision for LGBTIQ+ health
LGBTIQ+ Health Australia
LGBTIQ+ Health Australia (LHA) welcomes the Budget investment in Australia’s health and wellbeing, and has called on the Government to show a clear vision to address the significant disparities in health outcomes in LGBTIQ+ health.
Fulfilling commitments made at the May election, the Budget includes $1.3 million over two years to support the health and wellbeing of LGBTIQA+ people, including consultations to understand barriers to accessing health services. The funding will also provide additional funding to QLife to recruit volunteer peer support workers.
LHA welcomes the 500 new frontline service and community workers to support people experiencing family, domestic and sexual violence, including an election commitment for 15 specific workers for LGBTIQ+ community-controlled organisations who are vital in implementing the 2022-2032 National Plan to Stop Violence Against Women and Children.
LGBTIQ+ Health Australia CEO Nicky Bath (she/her) said the funding is a step forward for health and wellbeing programs that tackle the disparities experienced by LGBTIQ+ communities. “Congratulations to Treasurer Jim Chalmers and Labor on its first budget this term. The funding is a step in the right direction and future budgets need to demonstrate the Government’s vision for tackling the disparities in health and wellbeing outcomes for LGBTIQ+ people,” she said.
“LHA’s 2022 Federal Election Policy Priorities called for a 10-year National LGBTIQ+ Health Action Plan with key accountability measures and targets, and reviews of how programs and investment is being made. The consultation process is just a first step towards a 10-year action plan that LHA as the peak body in LGBTIQ+ health and wellbeing has tirelessly advocated for,” Bath said.
Despite LGBTIQ+ communities being identified as a priority population in a range of existing national strategies, the LGBTIQ+ community-controlled organisations best placed to provide services and programs lack direct funding to deal with disparities in access and outcomes for the communities they serve. “LHA has long called for investment in community-controlled organisations. The specific funding for LHA and our member organisations is a welcome recognition of the value of community-led responses to health and wellbeing challenges and we need to do more,” Bath said.
LHA has called for future budgets to address broader areas of concern for LGBTIQ+ communities identified in the 2022 Election Priorities, including LGBTI-inclusive aged care, public funding for services for people with intersex variations, investing in gender-affirming care for trans and gender diverse people in the public health system, and properly implementing the ABS 2020 Standard for Sex, Gender, Variations of Sex Characteristics and Sexual Orientation Variables across the health system.
“Swift implementation is needed to address the crisis in the mental health of LGBTIQ+ communities, especially trans and gender diverse people, and build the capacity of community-controlled organisations to provide desperately needed services,” Bath said.
Welcome supports for refugees dwarfed by offshore processing, no boost to humanitarian intake
Refugee Council of Australia (RCOA)
The Refugee Council of Australia has welcomed the Albanese Government’s increased Budget investment in the Adult Migrant English Program (AMEP), faster visa processing and support for temporary entrants from Ukraine but these allocations have been dwarfed by a $150 million increase in funding for the Government’s offshore processing regime.
Key points in the Budget include:
- $20 million for the AMEP to increase case management support for students and access to flexible delivery options.
- $42.2 million over two years (with $40.9 million this year) to increase visa processing in the Department of Home Affairs.
- $18.4 million over 4 years for additional three-year Temporary Humanitarian Concern Visas to Ukrainians and to extend Medicare for 12 months for Ukrainians on Bridging Visas.
- $12.6 million over two years for a pilot program to assist Temporary Visa Holders who are experiencing domestic violence.
- An increase of $150 million in spending this financial year on offshore processing, expanding the 2022-23 allocation to $632.5 million.
- The Government will provide $1.4 billion in additional Official Development Assistance over 4 years from this financial year to rebuild Australia’s international development program, with focus on the Pacific and Southeast Asia.
- $1.0 million over 2 years to conduct a review of Australia’s multicultural policy settings to support efforts to strengthen social cohesion.
- $18.2 million over 4 years to establish a Community Language Schools Grants program to support more young Australians to learn a second language.
There were no no additional places announced for the Refugee and Humanitarian Program, despite Labor’s commitment to increasing the program. The Migration Program will increase to 195,00 places per year, up 35,000 places.
“We are appalled to see yet again that the funds allocated to positive changes in immigration and refugee programs are overshadowed by the increased allocation to the Australian Government’s offshore processing policy,” RCOA chief executive officer Paul Power said.
“Since Australia’s offshore detention centres were reopened by the Gillard Government in 2012-13, successive government have spent $11.654 billion on offshore detention and processing arrangements – $9.547 billion since the current version of offshore processing began in 2013-14.
“The allocation of $20 million for Labor’s pre-election commitment to increase accessibility to English learning for people with caring responsibilities and other barriers to formal classroom learning is an important step towards refocusing the AMEP as a vital settlement program,” Power said.
The $42.2 million additional investment in visa processing, foreshadowed at the recent Jobs and Skills Summit, is a welcome step towards addressing the significant backlog in onshore and offshore visa applications. People seeking safety in Australia have been waiting for an average of two years for an Onshore Protection visa and even longer, in many cases, for refugee resettlement from another country.
“Ensuring that timely and considered decisions are made on protection applications, offshore resettlement and family reunion visas is fundamental to an effective and humane Refugee and Humanitarian Program,” Power said.
RCOA is disappointed that no additional places within the Refugee and Humanitarian Program were announced in the Budget.
“Despite Labor’s pledge in its national platform to expand the Humanitarian Program progressively to 27,000 places per year with 5,000 additional places for community sponsorship, this Budget sees the program remain at the level set up the Morrison Government – 13,750 places in the general program and 4,125 additional places for refugees from Afghanistan.
“With 13,825 previously-budgeted places for refugee and humanitarian arrivals left unfilled over the past two and a half years, we are disappointed that no places were rolled over from previous years and no additional places announced.
“COVID-related border closures and disruption saw refugee resettlement to Australia drop to a 45-year low in 2020-21 but lost places were never restored, despite UNHCR identifying an ever-increasing number of refugees in urgent need of resettlement,” Mr Power said.
“We look forward to the Albanese Government outlining concrete steps for when and how it will increase the Humanitarian Program as well as a quick announcement on the implementation of its pre-election commitment to end temporary protection.
“With five months now passed since the Albanese Government took office, many refugees on temporary visas have now endured more than nine years separated from their spouses and children. The Government must act quickly to bring an end to this agony.”
RCOA will also continue to draw the Government’s attention to the urgent need to restore a basic financial safety for people seeking asylum. Communities across Australia are witnessing the impacts of destitution and homelessness among bridging visa holders as a direct result of changes since 2017 to eligibility for Status Resolution Support Services (SRSS) program support.
Budget fails to address critical nurse shortages in general practice, aged care
Australian Primary Health Care Nurses Association (APNA)
APNA said the Federal Budget has failed to address the growing nurse shortages in general practice and aged care which will lead to a crisis in Australia’s primary health care system.
The profession is still waiting for the Federal Government to recognise how serious the shortage of PHC nurses is. Nothing in tonight’s Budget helps to rebuild the profession, retain talent, or recruit new nurses into the biggest workforce in the primary health care sector.
Australia’s 91,000 primary health care (PHC) nurses work outside of the hospital system and are a vital link in meeting Australia’s health needs by caring for millions of patients in settings such as residential aged care facilities, general practices, correctional facilities and schools.
APNA President Karen Booth welcomed the commitment to spend more on Australia’s health care and aged care systems. She also acknowledged the work done by the Commonwealth Department of Health to implement a commitment in the 2022-23 Budget for 5250 additional placements for nursing students in aged care, disability care and veteran’s care settings.
However, Ms Booth said this was just a down payment and required concerted action to address the workforce shortage. Ms Booth said the profession would look forward to the Government’s response to the Strengthening Medicare Taskforce recommendations to address these issues.
“Australia’s PHC nursing workforce pipeline cannot meet future demand. We are already experiencing nurse shortages and we are at risk of not having enough suitably trained PHC nurses to staff aged care homes, general practices, and other primary health care settings. We need a sustainable pipeline of qualified primary health care nurses now to meet the health care needs of the future,” Booth said.
Ms Booth said that this issue is already starting to bite, with a 2021 scheme by the previous Federal Government to recruit 2000 overseas health professionals to meet chronic nursing workforce shortages, in fact recruiting only 24.
In this light, Australia must focus on locally trained PHC nurses rather than rely on overseas-trained nurses to fill the aged care workforce shortfall. In particular, the Albanese Government must move urgently to set up a national model to attract new nurses into the PHC workforce.
This can only work if state and Federal governments coordinate efforts to reflect areas of responsibility:
- The Commonwealth must commit additional funding to support student nursing placements in general practice, aged care, disability, veteran service settings
- State/Territory governments must commit additional funding to support student nursing placements in school nurses, mental health services, maternal/child health, community health, Aboriginal health and correctional facilities.
This solution will directly benefit hospitals by reducing secondary and tertiary costs This approach will also support nursing career pathways and reduce costs associated with retraining nurses or losing their talents and experience altogether if they leave their principal work setting.
APNA’s existing Student Nurse Placement Program (SNPP) already provides a model which could be scaled up for this purpose.
No real commitment to wellbeing for older people
Allied Health Professions Australia
Contributed by CEO Bronwyn Morris-Donovan and Policy and Advocacy Manager Dr Chris Atmore
Seventeen months ago Allied Health Professions Australia commented that treatment of allied health in the Federal Budget was a litmus test for whether the Federal Government is genuinely committed to a holistic health system, particularly in residential aged care.
We criticised the Coalition Government’s failure to accept the Royal Commission’s view that allied health services are a fundamental and intrinsic component of aged care, and are particularly critical to helping to maintain residents’ wellbeing and facilitating reablement.
The Government has changed, but unfortunately our conclusion has not. Although Labor has continued the aged care reforms begun under the Coalition, including introducing the new AN-ACC funding model for residential aged care, its 5-Point Plan never addressed the parlous state of allied health care.
Consequently, there is no mandatory allied health equivalent of the nursing and personal care minutes now required in residential aged care, no guaranteed clinical multidisciplinary assessment of allied health needs and associated care planning, and no ringfenced funding.
Instead, identification of allied health needs and related necessary spending continues to be left to the discretion of increasingly financially pressured providers drawing on their overall AN-ACC funding allocation.
The Labor Government and the Department of Health and Ageing continue to insist that allied health expenditure will be sufficient, based on past provider expenditure of 4% of total care funding, which translates into between 511 and 700 million, or between 4.6 and 8.8 minutes per day – a far cry from the AN-ACC developers’ recommendation of 22 minutes a day. Past provider spending on allied health has also recently decreased from 4%. Latest data is 5.07 minutes per day, even worse than the 8 minutes identified by research for the Royal Commission.
Even a recent scoping study commissioned by the Department concludes – in somewhat contradiction to the 4% ‘reassurance’ – that the level and breadth of allied health involvement in Australian residential aged care homes is limited.
It is important to remember that mental health services are often provided by allied health professionals, such as psychologists, social workers and occupational therapists. We know that the mental health needs of aged care residents are badly neglected, and this Budget does nothing for them.
Allied health staffing in residential aged care is also continuing to drop, or at best to flatline, with reports of some large providers disbanding their in-house allied health professional teams and allied health professionals leaving the aged care sector, due to the uncertainties around funding for their services. Equally concerning is what appears to be growing substitution of cheaper but lesser qualified – and so inappropriate and even potentially unsafe – workers.
The recent Senate Inquiry into the Aged Care Amendment (Implementing Care Reform) Bill 2022 asked why allied health is not being treated like the two other pillars of aged care. The Department’s response was that providers have obligations under the Aged Care Act and Quality Standards, and the Aged Care Quality and Safety Commission will identify any insufficient allied health provision.
But it is not clear how, other than via audits and responses to individual complaints, the ACQSC will effectively monitor, let alone enforce, the minutes and cost of allied health provided against the Quality Standards. Of particular concern is the fact that both the ACQSC and the Quality Standards were already in place long before the Royal Commission finding of only eight allied health minutes.
To be effective, aged care reforms must embrace – and Budgets must fund – allied health services for all older people who need them.
Strengthening Medicare
On other allied health related issues, the Government has placed great emphasis on the Strengthening Medicare Taskforce with a new, broader membership and greater recognition of professions beyond general practice. We are, therefore, disappointed that the one-off grants of up to $50,000 for innovation, training, equipment and minor capital works to improve patient access will only be available to general practice. This funding measure, designed to recognise the additional pressures of COVID-19, fails to recognize the estimated 200,00 allied health providers also placed under significant strain during the pandemic. Allied health continues to be left on the sidelines, while our medical colleagues receive $250 million in GP funding and $229.7 million in GP Grant Programs.
We are cautious about expansion of the Worforce Incentive Program (WIP) as a means of improving access to multidisciplinary team care. The WIP was originally designed as an incentive mechanism to support employment of primary health care nurses into general practice. Against strong opposition the program was expanded in 2018 to include employment of allied health professions by general practice. There is yet to be formal evaluation of the WIP, so the extent to which it has been successful in incentivising multidisciplinary care remains unclear. The model lacks interaction with peers and clinical supervision, creates preferential referral pathways, lacks career progression, and threatens sustainability of allied health businesses, especially in rural areas.
Government is likely to elaborate on its understanding of ‘wellbeing’ in future Budgets. For this to be a genuine underpinning concept, understanding the holistic and preventative value of allied health must be translated into costings and funding items.
Significant investments in science
Professor Chennupati Jagadish, President of the Australian Academy of Science
The Australian Academy of Science welcomes the release of the Australian Government’s 2022-23 budget.
The Academy will lead a new regional presence coordinating scientific engagement in the Asia-Pacific over the next six years thanks to a $10.3 million investment from the Australian Government.
The Australian Government’s investment will enable Australia to leverage its standing as a science and research leader and engage in strategic science diplomacy in our region and globally.
The Government has also made several other significant investments that rely upon science to advance Australian economic and social prosperity.
These include:
- The establishment of the $15 billion National Reconstruction Fund with seven key priorities in renewables and low emissions, medical science, value-adding resources, enabling capabilities, transport, defence and agriculture, fisheries, food and fibre.
- Confirmation of the Government’s intention to establish an Australian Centre for Disease Control.
- $105.2 million to support First Nations people to respond to climate change in their communities. The Academy’s Future Earth Australia National Strategy for Just Adaptation, published last month, called for the development of a national Indigenous-led climate change mitigation and adaptation strategy.
- Renewal of Australia’s climate policy ambition through greater investment in the Climate Change Authority, the Australian Renewable Energy Agency, net zero and negative emissions, and major investments in Australia’s renewable energy systems.
- $2.9 million for the National Science and Technology Council’s provision of science and technology advice to support evidence-informed decision-making and independent science advice to Government
- A down payment on meeting Australia’s responsibility to protect our natural biodiversity including support for preventing species extinction, protecting the Great Barrier Reef and advancing environmental law reform
- 20,000 new university places for under-represented students, the Startup Year Program and establishing the Australian Universities Accord
- $5.8 million for the Women in STEM and Entrepreneurship program and the independent review into Government programs to ensure they support greater diversity in Australia’s science and technology sectors
- $10 million for Questacon to help inspire the next generation of young people to consider STEM careers
Australians look to science to provide the knowledge, solutions, and advice to guide us through the challenges of our uncertain world. A world now more frequently experiencing climate induced natural disasters and the threat of pandemics.
We recognise a lot of work is in train to revitalise the scientific enterprise and reverse the fourteen-year decline in investment in research and development. It will take time, but it can be done.
We look forward to working with the Australian Government to map a pathway that repositions Australian science to advance national prosperity and global competitiveness.
Positive start for affordable mental health treatment, but more to be done
Royal Australian and New Zealand College of Psychiatrists
The RANZCP welcomes key mental health initiatives to improve affordable access to mental health treatment within the interim Australian Federal budget.
The RANZCP President, Associate Professor Vinay Lakra, welcomes key mental health measures as positive steps forward, including:
The reinstatement of Medical Benefits Schedule (MBS) Item 288 (50% Rural Loading): MBS 288’s removal had compounded existing economic and geographic inequalities by burdening patients with unaffordable gap fees and/or out-of-pocket costs and limiting psychiatrists’ ability to offer services to rural patients. As the only speciality to have their loading returned, the RANZCP commends the Federal Government for responding to our extensive advocacy. In the middle of a cost-of-living crisis, such measures allow psychiatrists to bulk bill people in rural areas and improve affordable access to a psychiatrist.
A commitment to making medicines cheaper by decreasing the maximum co-payment under the Pharmaceutical Benefits Scheme (PBS) from $42.50 to $30 per script. Reducing the cost of essential medicines is welcomed and is key to improving the affordability of treatments for mental health and physical health conditions. As a peak mental health body, the RANZCP offers its expertise to the government to support further improvements to the affordability of non-pharmacological treatments.
“It’s positive to see the Federal Government deliver on key election promises such as making medicines cheaper and addressing the bulk-billing of telehealth psychiatry consultations in regional and rural areas,” Associate Professor Lakra said.
The RANZCP also welcomes the Government’s $5.3 million investment in the National Centre of Excellence in Intellectual Disability Health. The RANZCP has advocated for the collection of data on the needs of people with intellectual disability who are living with mental health conditions to support better service planning and better health outcomes.
The RANZCP’s budget submission included proposals that require Government action. In particular, the RANZCP urges long-term funding to deliver child and adolescent mental health services and investment in the child and adolescent psychiatry workforce.
“The RANZCP is looking forward to continuing our role as an active partner in discussions around other key mental health areas which also need urgent attention, such as addressing child and adolescent mental health.
“The Federal Budget provides some funding for specific projects such as additional youth mental health services. We know that children’s mental health has deteriorated during the COVID-19 pandemic which is why we’re looking forward to working with the Federal Government to ensure long-term national funding models for the sustainable delivery of child and adolescent mental health services are identified and delivered.”
There also remain serious gaps in affordable mental health care access across both rural and metropolitan areas. Every Australian should be able to access the support they need for their mental health and wellbeing.
With the Government’s Strengthening Medicare Taskforce, the RANZCP reiterates our offer of ongoing expertise to reform Medicare, to strengthen multidisciplinary working capacity across the health care system.
We anticipate that the next full budget to be announced in 2023 will fund current successful workforce initiatives. These enhance psychiatrists’ role in improving the quality and timeliness of primary care by providing a greater option of affordable psychiatry services to refer to.
Welcome commitment to resilience
Australian Red Cross
Australian Red Cross welcomed the commitment to national resilience in the budget, with up to $1 billion over 5 years, matched where possible by state and territory government investment.
“This is an important and urgently needed shift in policy and practice,” said Australian Red Cross CEO Kym Pfitzner. “We know that disasters are becoming more frequent, more severe, and more complex to respond to,” he said. “The more resilient our communities, the better they’ll cope with disasters.”
“The infrastructure losses after every disaster are highly visible. What is far more unseen, but equally devastating in magnitude, are the psychological and social impacts,” said Australian Red Cross Director of Australian Programs, Vicki Mau.
“We need to keep strengthening our psychological and social wellbeing support so people and communities can better recover.”
“Disasters do not affect everyone equally. We strongly urge an inclusive approach, so that marginalised people and those at risk can benefit in culturally safe, systemic and meaningful ways,” she said.
“Our staff and volunteers are currently responding to floods in Victoria, New South Wales and Tasmania, and a heatwave across northern Australia,” Mau said.
“It is only the beginning of the summer disaster season. Australian Red Cross knows that disaster preparedness, response and recovery needs to keep up with climate caused emergencies. We commend the commitment to resilience.”
Housing accord could be game changer for rental crisis
Everybody’s Home
A major housing package announced in the federal budget is a landmark step towards tackling Australia’s rental crisis, according to Everybody’s Home, the national campaign for real housing solutions.
The National Housing Accord includes an additional $350 million to build 10,000 affordable homes over five years from 2024, on top of the $10 billion Housing Australia Future Fund which will build 30,000 new social and affordable housing properties.
State and territory governments have also committed to building 10,000 homes under the Accord. It also includes a target to build one million well-located and energy-efficient homes over the same period.
Everybody’s Home national spokesperson Kate Colvin said:
“After almost a decade of the Coalition shirking federal responsibility on desperately needed investment in affordable rentals, the new Federal Government is showing national leadership.
“The Accord has the potential to be a game changer for housing affordability, which has spiralled out of control with devastating consequences for so many Australians.
“Bringing the states and federal government together with local government and super funds unlocks enormous potential. We hope this new collaboration will lead to continued growth in social housing alongside growth in affordable housing, to meet the enormous need from people on the lowest incomes.
“Homelessness is increasing and Australian families with full time breadwinners are living in tents right now. People being able to afford to live near where they want to work is crucial for the economy and society more broadly.
“This shapes as the breakthrough Australians need to break the vicious cycle of soaring rents, high inflation and unaffordable housing.”
Budget sets standard for TAFE funding, but much more needed for public schools
Australian Education Union (AEU)
AEU Federal President Correna Haythorpe welcomed “the beginning of the investment in the public education system Australia desperately needs” in the Budget, saying it was “refreshing to see TAFE made the key priority … after over a decade of cuts”.
The $921 million investment in fee-free TAFE places and TAFE technology fund “has laid the groundwork for TAFE to lead the nation’s skills recovery over the next five years,” she said.
“However, we need to secure the future of TAFE with renewed infrastructure, new and improved workforce and policy settings.”
The AEU has welcomed the $124.5 million investment in strategies to address the ongoing teacher workforce crisis, including the additional 4,036 university places for education and 1,469 for early childhood teachers.
“These additional university places in teaching and early childhood education are an important step to addressing the growing teacher shortages across public schools and preschools.
“It is particularly welcome that these places will be allocated to students from disadvantaged backgrounds and marginalised communities.
“However, this step alone does not solve what is an escalating national crisis.”
The AEU said it was pleased to see the $350 million funding boost for capital work upgrades and student wellbeing in public schools.
“This budget restores the Commonwealth’s responsibility to deliver capital works funding for public schools after the former Coalition Government dismantled it in 2017.
“This is undeniably a good starting point, but public schools need greater funding so students have the most up-to-date resources and facilities they need.
However, there is one election commitment that has not yet been realised — that is the delivery of a pathway to delivery of 100 per cent of the Schooling Resource Standard for all public schools in Australia.
“The upcoming negotiations for a new National Schools Reform Agreement must be a turning point for the Labor Government. They must scrap the 20 per cent funding cap on the Commonwealth’s share of funding to public schools across Australia and lead negotiations with states and territories to deliver the investment students in public schools are entitled to.
“For our society to be truly egalitarian and be able to realise every child’s potential, Australia can no longer turn a blind eye towards the inequitable funding system that plagues our public schools.”
“We are disappointed to see that this Federal Budget has failed to deliver funding for preschool education to three-year-olds so that every child can access the lifelong benefits of two years of early learning in the years before starting school.”
Focus on Justice Reinvestment welcome but small start on over-incarceration
Amnesty International Australia
Amnesty International Australia welcomed the government’s commitment to its election promise to fund First Nations-led diversion programs.
Treasurer Jim Chalmers confirmed in the budget that the Federal Government would fund justice reinvestment programs to help keep kids out of the quicksand of the criminal justice system.
“(This) is a welcome start in addressing the underlying causes that lead to overrepresentation of First Nations People in prison,” Amnesty International Australia Indigenous rights campaign lead Maggie Munn said.
“But it is only a start, a small one at that, and we will continue to demand better for our people in addressing the painful legacy of colonisation.
“All of the experts agree – kids don’t belong in prison. Prisons don’t address the causes of problematic behaviour, and they don’t reduce recidivism.
“Justice reinvestment is led by the community, for the community. Instead of failed punitive approaches, justice reinvestment is evidence-based. It embraces therapeutic and rehabilitative methods like diversion programs that address the underlying causes of problematic behaviour in children, in order to improve it – diverting them away from the criminal justice system.”
Heartbreaking Budget for people on JobSeeker, low-income renters
Anti-Poverty Network SA
The first Albanese Federal Budget is a heartbreaking budget for those with the least, offering no meaningful relief, while those with the most look forward to enormous tax cuts, Anti-Poverty Network SA spokesperson Duncan Bainbridge said.
Despite the unprecedented cost-of-living pressures for people on JobSeeker, renters, and others on low incomes, the Federal Budget contains no desperately-needed raise to JobSeeker and other income support payments, and no additional funds to urgently increase public housing stock.
“JobSeeker is only $48 a day. People on JobSeeker are facing unprecedented, unsustainable rises in rents, and other basic costs. We hear of $30-$50-a-week rent rises, compounded by double-digit percentage increases in utility and fresh food costs. These increases are blowing a low-income person’s budget to pieces”, Bainbridge said.
“The recent $1.83-a-day “rise” to JobSeeker, an automatic, twice-a-year indexation to ensure JobSeeker matches inflation, does not even come close to matching what is happening to people’s lives. Labor should recognise this, and implement an immediate raise to JobSeeker and other payments, lifting them above the poverty-line, something long supported by most of the community.
With massive numbers of low-income renters facing ‘housing crisis’ – spending more than 50% of their income on rent – the refusal to commit additional funds specifically to expanding public housing stock is staggering.
Any housing announcement that does not massively increase the number of new public homes is tinkering around the edges. 1 million new homes is cold comfort indeed, when virtually all of those homes will be out of reach to those on very low incomes.
Labor’s current public housing commitment – an extra 20,000 homes, nationally, over 5 years – is a drop in the ocean, when, in 2021, there were 163,500 on the public housing waiting list, nationally, and 17,000 on the public housing waiting list, just here in SA.
“That Labor is persisting with the Stage 3 Income Tax Cuts – that will cost over $20 billion year, when implemented from July 2024, and will largely benefit very high-income earners – but cannot bring themselves to permanently raise JobSeeker above the poverty-line, or put vastly more funds into public housing, shows a staggering, callous failure to listen and respond to the huge level of hardship in the Australian community.”
Some welcome down payments, but 2023 must be a health budget
Australian Medical Association
The Australian Medical Association (AMA) said the Federal Government’s investment of $980 million for general practice in the budget is a welcome follow through on its election commitments, but it warned that with the health system under so much pressure, the May 2023 budget must be “a genuine health budget”.
“Time is running out for our overstretched health system,” said AMA President Professor Steve Robson in a statement.
“The government needs to use the next six months to prepare a package of measures to deliver additional investments in health that address the crisis in our ramped public hospitals, further support our overworked GPs, and reform the private health system.”
Robson welcomed a number of measures, including the allocation of $750 million for its Strengthening Medicare Fund to support the recommendations of the Strengthening Medicare Taskforce, which are due by the end of this year.
The AMA was also pleased with a planned quick rollout of $229.7 million in GP infrastructure grants of up to $50,000 each, which will support general practices to enhance digital capability, invest in infection control and meet accreditation standards.
It said other positives included extra money for Aboriginal and Torres Strait Islander people’s health, funding to begin scoping a Centre for Disease Control (CDC), as well for the development of a National Health and Climate Strategy and the establishment of a National Health Sustainability and Climate Unit.
The AMA welcomed a $143.3 million commitment to support access to healthcare in rural and regional areas and said a $2.5 billion investment in aged care and commitment to provide funding to support a pay increase for aged care workers would address critical recommendations from the Royal Commission into Aged Care Quality and Safety.
The critical next step would be ensuring aged care residents can continue to see their usual GP, it said, highlighting the AMA’s plan to improve access to GPs.”
Robson said the budget did not address the long-running logjam facing public hospitals, calling for 50/50 funding implemented and the arbitrary 6.5 per cent cap on federal hospital funding growth scrapped (see the AMA’s Clear the Hospital Logjam campaign).
He warned that, with inflation expected to hit 7.75 per cent by the December quarter this year, “any extra federal funding will simply be eaten up by rising healthcare costs before it reaches even a single patient, leaving no funding to provide extra services to meet community health needs”.
With the COVID-19 pandemic not yet over, Robson warned that several key COVID-19 related support measures for public hospitals, aged care and general practice are due to end by 31 December this year “and the virus is unlikely to respect this deadline, which will put more pressure on the health system.”
The AMA said the limited number of urgent care centres funded in this budget are not the solution to the hospital crisis, that reform of the private health system also needed to be addressed in 2023 and that the Federal Government missed the opportunity in this budget to address chronic disease through the AMA’s proposed sugar tax, or other preventative health initiatives.
Housing Accord lays good foundations but housing stress must be addressed
National Shelter
The national peak body representing the housing interests of low-income households commended the announcement of the National Housing Accord, with the Budget set to almost double the delivery of social and affordable housing from 30,000 at the election earlier this year to 55,000.
The announcements by the Government today provide the architecture to respond to the housing crisis in the longer term, however there is no immediate relief for the over 950,000 households experiencing housing stress right now, it said.
“It is heartening to see leadership from the Federal Government to bring together key funding and delivery partners to solve the housing crisis that has gone on for too long in Australia. However, the Government must ensure that the 1 million homes that will be delivered will help those on the lowest incomes and those experiencing housing difficulties.
“Being able to secure housing that people can afford is vital to maintaining the health and wellbeing of individuals and communities. It is disappointing therefore that there has been no review or increase to Commonwealth Rent Assistance or income support payments, when we know housing is unaffordable right now.
“Addressing housing supply is a critical part of the equation but providing lower income households more money in their pockets so that they can afford to pay rent will make a considerable difference to their housing opportunities, and ultimately their health and wellbeing.
“While the Government has recognised that access to secure and affordable housing is a key element of good health and wellbeing for individuals and communities, tonight’s ‘wellbeing budget’, only addresses the long-term problem, when we know that there are people struggling now who also need immediate relief.
Welcome investment for people with disabilities in Australian aid
CBM Australia and the Australian Disability and Development Consortium
Disability-inclusive international development agency, CBM Australia, and peak disability-inclusive development coalition, the Australian Disability and Development Consortium (ADDC), warmly welcome the Federal Government’s $3.3 million increase to the disability central allocation in the Australian aid program.
CBM and ADDC have praised the Federal Government’s recognition of disability inclusion throughout the budget, where it has promised “effectiveness” through prioritisation of “practical support” for people with disabilities in Australia’s aid program, along with the broader increase in development assistance.
CBM, ADDC and other coalitions have lobbied successive governments to reverse the cuts to the disability-inclusive development central allocation, which had fallen to just $9.6million in recent years.
“We know from our partners in the region and beyond that the pandemic has had a catastrophic impact on people with disabilities. The decision to reinstate the central allocation is vital to ensuring the most marginalised are not left further behind,” CBM CEO Jane Edge said.
The government’s recognition of disability inclusion is a critical part of the aid program’s effectiveness, and along with the increase of the allocation to prior levels, is an important step to building a truly inclusive Australian aid program.
ADDC Executive Officer, Kerryn Clarke, highlighted the central disability budget cuts over recent years meant that further year-on-year increases would be needed in future budgets to ensure people with disabilities are given the support they need to partner in Australian aid initiatives.
“Australia is a world leader when it comes to disability inclusion in international aid,” Clarke said. “To ensure that leadership continues we must maintain specific funding to ensure that people with disabilities are consulted and included in all aspects of Australia’s international development and humanitarian response. The increases we see in the budget affirms Australia’s commitment to working in partnership with people with disabilities.”
The central allocation funds critical work in partnerships, capacity development and technical expertise, including for our nearest neighbours in the Pacific and Southeast Asia.
No surprises for health, more investment in innovation, technologies urged for May
Medicines Australia
Medicines Australia, which represents the research-based medicines industry in Australia, welcomed the Budget’s which it said takes steps towards addressing economic pressures and introduces new funding for PBS listings.
“Tackling the budget deficit must go together with strong investment in health. As COVID has shown us – a thriving economy depends on a healthy population who have rapid access to innovative medicines, treatments and vaccines,” said CEO Elizabeth de Somer.
“As expected, this budget is a prelude to the May budget where we would hope to see increased investment in health innovations, medicines and technologies that improve lives and save lives,” she said.
Medicines Australia acknowledges the reduced co-payment announcement and investment into accelerating efforts to close the health gap for First Nations people.
It said significant budget announcements for the medicines sector include:
- COVID-19 vaccines and National Medical Stockpile: $355.8 million in 2022-23 for the distribution and uptake of COVID-19 vaccines and $500.0 million in 2022-23 for the procurement of additional vaccines and treatments on the National Medical Stockpile.
- Australian Centre for Disease Control: $3.2 million in 2022-23 to undertake the initial design for the establishment of an Australian Centre for Disease Control for infectious and chronic disease.
- TGA digital and business transformation: $23.3 million provided over two years from 2022-23 to modernise the Therapeutic Goods Administration’s (TGA) business systems. This will be fully cost recovered over 6 years from 2023-23 through changes to TGA cost recovery arrangements.
- PBS Data Distribution Project: $13.2 million over 4 years from 2022-23 (with $0.7 million per year ongoing) to build data linkages between Services Australia systems and the Health Products Portal.
Health systems at risk
Australian College of Nursing
The Australian College of Nursing (ACN) has welcomed initiatives in the Budget to address health inequalities in our community, but more needs to be done to provide safe and appropriate healthcare now and in the future.
ACN CEO Adjunct Professor Kylie Ward FACN said as nurses, we worry about the impact of the rising cost of living on consumers, so it was pleasing to see the Government announce initiatives to provide cost of living relief, including cheaper medicines, more affordable housing and increasing wages for those in the aged care sector.
“We welcome initiatives presented by the Government at last night’s Budget to improve social determinants of health for those experiencing poverty, disability, and discrimination, but I worry about our health systems,” Adjunct Professor Ward said.
“Nurses are a fundamental part of the social fabric of society, we. We are in every setting and every postcode.
“As a profession, we don’t just worry about the physical health of Australians, but we worry about the mental health and the pressures placed on our communities with increasing costs of living costs.
“We continue to talk, but not act on the increasing burden of disease we’re facing as a nation.
“We continue to talk about improving our primary health and delivering equitable health care, but leave nurses overworked and underfunded.
“We need a sustainable health system for decades to come with high -quality care at its heart.
“All consumers deserve the right to access the highest standards of nursing care irrelevant of their postcode.
“A failure to provide strategic and long-term investment in the nursing profession will have dire consequences for the health of Australians.”
Save the dates
- 5pm AEDT, 8 November: Health policy and the Federal Budget
- 5pm AEDT, 15 November: Health in All Policies and the Federal Budget
More details to come closer to the time.
