The Albanese Government’s restructuring of health, ageing and disability responsibilities provides “a strategic opportunity for the Minister and his portfolio team to address these complex problems as one system and not simply continue the tradition of passing the buck from one program to another”, according to policy analyst Adjunct Professor Kathy Eagar AM.
However, the disability sector has expressed significant disquiet about the transfer of disability to health, which is a particularly sensitive issue as the NDIS undergoes significant changes and cuts to contain the budget, says Eagar.
Amongst other roles, Eagar is Adjunct Professor, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, and Adjunct Professor, Faculty of Health, Queensland University of Technology.
Kathy Eagar writes:
The 2025 federal election is over and we can all get back to business as usual. Not quite. New “Administrative Arrangements Orders (AAO)” are published after every election and this election was no exception.
Published 10 days after the federal election, the May 2025 Administrative Arrangements Order formally allocates executive responsibility among ministers. Each AAO also specifies the legislation and other matters administered by each department or portfolio.
There are a few important changes to the health portfolio, which come with pros and cons.
The Hon Minister Mark Butler MP has been reappointed but with expanded responsibilities. He is now:
- Minister for Health and Ageing
- Minister for Disability and the National Disability Insurance Scheme
- Deputy Leader of the House.
Minister Butler’s department is now the Department of Health, Disability and Ageing (DHDAA). It was formally the Department of Health and Aged Care. So, as the name implies, “Aged Care” has been replaced with “Ageing” and “Disability” has been added.
Minister Butler represents health, ageing and disability in the Cabinet. His portfolio is responsible for billions of dollars every year and all three programs are projected to face significant increases in demand due to population growth, ageing and disability. These are three areas that every Treasurer worries about because of their capacity to blow the budget.
Minister Butler will be assisted by four Ministers and Assistant Ministers who are part of his portfolio and who have been appointed to the outer Ministry.
These new arrangements give Minister Butler the responsibility for containing significant budgets and for sorting out the interface issues between health, disability and aged care. Good luck with that.
These changes also mean that the Commonwealth can use changes in one stream to lever changes in another.
We have recently seen an example of this.
The Commonwealth has put negotiations with the States and Territories about the 2025 National Health Reform Agreement (NHRA) on hold until States and Territories agree to take responsibility for ‘foundational supports’ for young people with disabilities. The existing agreement has been rolled over for a year and the next NHRA is now expected to commence in July 2026. We can expect to see more of that over the next three years.
The newly named Department of Health, Disability and Ageing will continue to be managed by a Secretary (currently Blair Comley) and maintains all its previous health and ageing functions, except sport. In addition, it becomes responsible for services for carers (both aged care and disability) and for both services and policy for the NDIS and for ‘foundational supports’.
The Ministerial portfolio and the newly expanded Department is responsible for administering 86 Acts of Parliament either in part or in full: 71 Acts related to health, 12 related to aged care and three related to disability.
Health portfolio
Two Assistant Ministers for Health have been appointed to work with Minister Butler.
The Hon Rebecca White MP has been appointed:
- Assistant Minister for Health and Aged Care
- Assistant Minister for Indigenous Health
- Assistant Minister for Women.
The Hon Emma McBride MP has been appointed:
- Assistant Minister for Mental Health and Suicide Prevention
- Assistant Minister for Rural and Regional Health.
The existing health functions of the portfolio remain with one exception. Sport and recreation policy and functions have been transferred to a new Infrastructure, Transport, Regional Development, Communications, Sport and the Arts (ITRDCSA) portfolio. Minister Anika Wells has responsibility for communications and sport in that new portfolio.
Community mental health has been transferred back into health after sitting in the Department of Social Security since 2014.
The new organisational chart for the Department has not been issued but presumably the health divisions will remain unchanged (except that sport has been transferred elsewhere).
Health divisions within the Department
Health Products Regulation Group
Health Strategy, First Nations (and Sport)
Health Resourcing
Primary and Community Care
Interim Australian Centre for Disease Control
Corporate Operations
Portfolio health agencies
Australian Commission on Safety and Quality in Health Care (ACSQHC)
Australian Digital Health Agency
Australian Industrial Chemicals Introduction Scheme (AICIS)
Australian Institute of Health and Welfare (AIHW)
Australian Organ and Tissue Authority (OTA)
Australian Radiation Protection and Nuclear Safety Agency (ARPANSA)
Cancer Australia
Food Standards Australia New Zealand (FSANZ)
Independent Health and Aged Care Pricing Authority (IHACPA)
National Blood Authority (NBA) contact
National Health and Medical Research Council (NHMRC)
National Health Funding Body (NHFB)
Office of the Gene Technology Regulator (OGTR)
Professional Services Review (PSR)
Statutory heath office holders
Gene Technology Regulator
Therapeutic Goods Administration
Office of Drug Control
Executive Director of the Australian Industrial Chemicals Introduction Scheme
National Rural Health Commissioner
Health regulation agencies
Australian Radiation Protection and Nuclear Safety Agency
Office of Gene Technology Regulator
Australian Industrial Chemicals Introduction Scheme
Therapeutic Goods Administration
Office of Drug Control
Aged Care and Ageing
The Hon Sam Rae MP has been appointed Minister for Aged Care and Seniors. Unlike his predecessor, he is in the outer Ministry and is not in the Cabinet. Some aged care stakeholders see this as an aged care demotion.
The only administrative change to aged care arising from the new Ministry and new AAO is that responsibility for carers has been transferred back to health from the Department of Social Services.
This is an excellent decision because it puts carers and care recipients together again. Carers and care recipients need to be seen as a dyad.
Aged care divisions within the Department
Ageing and Aged Care
Portfolio aged care agencies
Aged Care Quality and Safety Commission
Statutory heath office holders
Aged Care Quality and Safety Commissioner
Aged care regulation agencies
Nil
Disability and the National Disability Insurance Scheme
The most significant change is that disability and the NDIS have been transferred to health from the Social Services portfolio. This includes services and policy for the National Disability Insurance Scheme (NDIS) as well as (yet to be established) foundational supports to be delivered by the states and territories.
Senator Jenny McAllister has been appointed as Minister for the National Disability Insurance Scheme.
The disability sector has expressed significant disquiet about the transfer of disability to health. They see disability not as a medical issue, but as a social and rights-based issue. This is a particularly sensitive issue at the moment as the NDIS undergoes significant changes and cuts to contain the budget.
The Department of Social Services, led by Minister Tanya Plibersek, maintains responsibilities for support and services for families with children, adults with disabilities not in the NDIS, income support, employment and housing.
Pending the new organisational chart, it can be assumed for now that the existing disability organisational arrangements will be simply transferred from Social Services to the Health portfolio.
Likely disability division within the Department
Disability
Portfolio disability agencies
National Disability Insurance Agency
NDIS Quality and Safeguards Commission
Statutory disability office holders
Chief Executive Officer, National Disability Insurance Agency (NDIA)
Chair/Board member, NDIA Board
Principal member/Council member, Independent Advisory Council to the National Disability Insurance Scheme (NDIS)
NDIS Quality and Safeguards Commissioner
Disability regulation agencies
Nil
What does it all mean?
At one level this is just another change in the way the bureaucracy is organised, which will have little impact on the ground.
At another, this is a major change that presents some important strategic opportunities. The expanded portfolio and department is responsible for three streams that are all already undergoing significant reform and that are all under significant budget pressure.
On top of that, much of the pressure on health is coming from a failure to manage demand and meet needs in the aged care and disability sectors.
This restructure provides a strategic opportunity for the Minister and his portfolio team to address these complex problems as one system and not simply continue the tradition of passing the buck from one program to another.
Three years to fix these issues is not a long time. But it is time enough to make a very good start. Time will tell.
• Professor Kathy Eagar AM is Adjunct Professor, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales; Adjunct Professor, Faculty of Health, Queensland University of Technology; Director, Consultants in Health Services Development; and Foundation Director, Australian Health Services Research Institute.
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