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A rolling wrap of reaction to the Wellbeing Budget

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