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Health Budget 2016 – the reaction

Budget reactions at a glance

PHAA The Federal Budget was released this evening with the bulk of funding focused on treatment and clinical services instead of prevention initiatives.

AHHA The Government must continue to plan not just for the next electoral cycle, but with a strategic vision for the future of Australian health.

CHF Much more funding is needed to support the substantial changes required to renovate Australia’s health system.

NACCHO The 2016/17 Budget needs to reflect the views of all Indigenous Australians in setting priorities

CHA CHA is concerned that consumers are going to pay more for necessary health care following tonight’s Federal Budget announcements,

NRHA Successive Federal Budgets have missed the opportunity to provide a fair share of health services to Australia’s rural and remote population.”

AMA The 2016-17 Health Budget continues the Government’s stranglehold on Australia’s Medicare system by taking $1 billion out of the pockets of Australian patients and household budgets by extending the Medicare rebate freeze.

RACGP This is an illogical Budget which has taken no heed of the sensible advice from the RACGP

RDAA The overshadowing continuation of the Medicare indexation freeze for a further two years will see more rural and remote patients unable to afford the medical care they need.

Alzheimer’s Australia Tonight’s Federal Budget contains no new major policies or programs that would significantly improve the lives of the more than 353,000 Australians living with dementia and their carers.  

Cancer Council Around 320,000 adult Australian smokers are likely to quit and 40,000 teenagers deterred from taking up smoking as a result of expected tobacco tax increases in the 2016-17 federal budget.

FVPLS Forum  Aboriginal and Torres Strait Islander women are at the epicentre of the national family violence crisis, yet specific initiatives to confront this crisis and invest in services for safety are invisible in the Budget.

World Vision The fresh cuts of $225 million announced as part of the Federal Budget follows three years of brutal cuts that have now slashed more than $1 billion from the Australian aid budget.

Catherine King, Shadow Minister for Health The Budget rips another $2.1 billion out of health spending on top of the $2.1 billion in health cuts in December’s Mid Year Review.

Croakey has collated first responses to the Budget from key health groups and stakeholders (below).  This will be added to as more responses come in from the sector.

An excellent wrap of expert reaction to the Budget can also be found at The Conversation.

[divide style=”dashs” width=”medium”]

Jennifer Doggett writes:

PHAA

The latest budget shows a fundamental misunderstanding of the importance of prevention for the economy and the health of the Australian population says Public Health Association of Australia (PHAA) Vice President David Templeman.

The Federal Budget was released this evening with the bulk of funding focused on treatment and clinical services instead of prevention initiatives.

“After tonight’s budget release, it is clear the Government is not prioritising prevention and has missed a significant opportunity to invest in the health and wellbeing of Australians,” said Mr Templeman.

“This budget is very treatment focussed. We must shift to a model which focuses on prevention rather than waiting for someone to become sick and relying on healthcare and hospital services,” said Mr Templeman.

PHAA’s election priorities identify ways the Federal Government can save lives and help the economy, for every dollar invested in prevention, the Government can save over five dollars in health spending.

“We know prevention works. While we applaud the Government for reinvesting in initiatives such as the Health Star Rating and tobacco consumption rates but we would like to see a greater level of investment in  public health prevention initiatives such as a sugar tax on soft drinks,” said Mr Templeman.

“A sugar tax on soft drinks would not only improve the health of Australians but it would inject money back into the economy. The funds can be reinvested back into prevention initiatives and research,” said Mr Templeman.

“Initiatives such as these have had flow on affects. The Aboriginal and Torres Strait Islander peoples smoking rate is now at 39% the lowest recorded rate which is attributed to prevention and educational programs,” said Mr Templeman.

“People don’t want to be in hospital. A comprehensive approach is vital to keep Australians out of hospital and have the best quality of life. Over the last decade, there has been a significant increase of people living with multiple chronic diseases including type II diabetes and heart disease. This should be a wakeup call to the Government to implement strategies to prevent this from happening,” continued Mr Templeman.

“The Federal Government has missed an opportunity to consider how the pressure could be taken off the health system. There doesn’t have to be a choice – treatment and prevention can both be funded but investment in prevention can stop the problem before it starts,” stated Mr Templeman.

CHF

Consumers face a range of increased out of pocket costs for frontline doctor care and medicines if measures in this and previous budgets pass a future Senate, the Consumers Health Forum says.

Tonight’s Budget will extract another $925 million by freezing Medicare rebates over the next three years, on top of the $1.3 billion already removed in previous years, increasing the pressure on GPs to drop bulk billing and charge gap fees.

The vote of a future Senate could also mean a range of fresh out of pocket costs, including a $5 rise in the co-payment for prescribed medicines and cutting of the $630 million in bulk billing incentives to pathologists and radiologists.

“These measures will discourage the sort of reform we need to support a primary health care system that would improve care for those with chronic and complex illness,” the CEO of the Consumers Health Forum, Leanne Wells said.

“Once again the Government is focusing funding on hospitals when better primary care would reduce demands on hospitals.

“On top of the prospect of rising out of pocket costs are the cuts in oral health funding which pose a backward step for those millions of Australians who can’t afford to see the dentist.

“The Government’s announcement last month of plans to shift dental services back to state governments, and save an estimated $1 billion in forecast spending, is a retrograde step given the many Australian children and adults for whom dental care is unaffordable.

“We welcome the steps by the Health Minister Sussan Levy to reform of primary health care, and reviews of Medicare benefits and of private health insurance.

“But much more funding is needed to support the substantial changes required to renovate Australia’s health system.

“The proposed Health Care Homes is the one shining light where successful implementation involving clinical, consumer and PHN co-design and localised translation must be assured.  Health care homes have the potential to transform the care of those with chronic and complex conditions. But the continued Medicare freeze on payments to doctors poses a disincentive to participate in the roll-out of this reform.

“It sends a signal that the Government is not giving the priority to the setting it relying on in embracing health care homes.

“If Australia is to meet the challenges of modern health care, it requires a 21st century primary health system that will provide the growing numbers of chronically ill with the integrated care they need through a single healthcare destination— and reduce demand for expensive hospital treatment.

“The Minister has announced a promising trial of the “Health Care Homes” plan for care of those with chronic and complex conditions.  But expecting such a development to be cost neutral, besides the $21 million for the trials, with no real extra funding committed, represents a big obstacle to its success.

“The program will need to adequately resource practices with the means to broker gaps in services and extend care into the home and community, to minimise the need for hospital.  The program will also need to ensure that patients are equipped with the knowledge and services they need to maintain a healthy lifestyle,” Ms Wells said.

AHHA

The Australian Healthcare and Hospitals Association (AHHA) says tonight’s Budget is a disappointing result for the health sector. Nearly fifty measures, including some small investments and many cuts, have been disguised as strategy.

“The confirmation of an additional $2.9 billion over three years in public hospital funding is welcome, though this returns less than half of the expected funding that was initially removed by the Government in the 2014 Budget. The AHHA strongly supports the ongoing commitment to activity-based funding, particularly given the National Health Performance Authority’s recent report has shown such funding improves hospital efficiency,” AHHA Chief Executive Alison Verhoeven said.

“However, the Government must continue to plan not just for the next electoral cycle, but with a strategic vision for the future of Australian health.

“Action is needed to align the interfaces between health, aged care and disability services to help coordinate patient care. The limited arrangements proposed for Health Care Homes will only partly serve to address this.

“Primary Health Networks require appropriate and long-term funding to carry out their core functions, with flexible funding to meet community needs. Under-resourcing organisations with ever-increasing responsibilities will compromise their ability to achieve their full potential and to deliver on the government’s health policy objectives.

“Despite much commentary from the Health Minister about the need for private health insurance reforms, the can has been kicked down the road tonight, with a paltry investment in yet another review committee.  And the promised clean up of the Medicare Benefits Schedule has amounted only to minimal savings and some attention to achieving better compliance by providers.

“The Child and Adult Public Dental Scheme is a welcome indication of support for dental care as part of the Australian health system. However, the funding is not sufficient to underpin equitable access to care.

“The increased tobacco tax is a sensible move, and will assist in further reducing smoking. It is pleasing that both major parties are now on board with this public health measure.

“Reform to the healthcare and related systems must be considered as part of a co-ordinated approach to the delivery of care across the primary, acute, aged and disability care sectors. What Australians have been delivered tonight is a hotch potch of spending and cuts, with no clear vision,” says Alison Verhoeven.

CHA

“CHA is concerned that consumers are going to pay more for necessary health care following tonight’s Federal Budget announcements,” said Suzanne Greenwood, CEO of Catholic Health Australia (CHA).

“The cuts to the pathology and diagnostic imaging bulk billing incentives announced last December are likely to see consumers paying higher out of pocket costs for blood tests and diagnostic services as early as 1 July this year.”

The extension of the freeze on MBS rebates for a further two years to 2019-20 will place further pressure on out of pocket costs.    Many private health insurance members will also face higher premium costs from 2018 as a result of a three year freeze in the indexation of the income tiers thresholds.   There are also likely to be further cuts to a range of workforce and other programmes that support services such as drug and alcohol rehabilitation.

On the positive side, CHA was pleased to see public hospital funding largely restored and linked to activity based funding which promotes efficiency.

“The Healthier Medicare Homes Trial has the potential to provide more co-ordinated and appropriate care support to those with multiple chronic illness and we look forward to this programme expanding into the future,” said Mrs Greenwood.

CHA also welcomes initiatives to provide private health insurance members with greater value for money concerning their products, including the purchase of medical devices.

“Catholic Health Australia looks forward to working with the soon to be established Private Health Sector Committee to develop the detail of the new Private health Insurance Package,” concluded Mrs Greenwood.

NRHA

The National Rural Health Alliance is disappointed that the Federal Budget fails to address the under-expenditure on rural health, which is in the order of $2 billion per year. Kim Webber, CEO of the National Rural Health Alliance said,

“The last significant investment in rural health was the half a billion dollar investment in a comprehensive rural health strategy more than 16 years ago.  Since then, successive Federal Budgets have missed the opportunity to provide a fair share of health services to Australia’s rural and remote population.”

“Rural Australia is not requesting MORE money per capita than what is spent in the city, merely the same amount with flexibility to allow us to implement innovative models which work for rural and remote communities.”

The Budget prioritised a Smart Cities Plan that aims to foster partnerships between the Federal Government, state governments and city governments.  The National Rural Health Alliance urges the Government to also include rural and remote areas in its national agenda.

The Smart Cities approach could be used to invest in the health and wellbeing of the almost 7 million people who live in rural and remote Australia.  Economically, our rural and remote communities are the powerhouse of Australia contributing through the mining, agriculture, tourism and energy sectors. We need a clear vision for the growth and development of rural and remote Australia that broadens the employment base, builds in long-term investment in health and education and capitalises on the potential for growth in emerging technologies.

“Attracting people to rural and remote communities for jobs and opportunities will also open up more affordable housing and great lifestyle options.  But people will not come and stay in rural and remote Australia if we do not have accessible health services.  We need to ensure that health funding is flexible enough to enable new models of service delivery in rural and remote Australia” Kim Webber said.

From VACCHO’s perspective there are two related deficiencies in this year’s Federal Budget.

  • The lack of funding to implement the National Aboriginal and Torres Strait Islander Health Plan
  • Failure to reverse all the hidden cuts to Aboriginal Primary Health funding caused by the freezing of Medicare rebates and the establishment of the Indigenous Advancement Strategy (IAS).

Jill Gallagher AO, VACCHO CEO says “We’re not fooled, the end result of all this is that ongoing, unnecessary slashing of health funding has serious implications for Aboriginal peoples.”

VACCHO as a partner of the National Close the Gap Campaign supports the ask of Government to provide details on resourcing for the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

There is no allocation of funds in the Budget Portfolio Statement for the Implementation Plan and yet long term, sustainable funding for Aboriginal and Torres Strait Islander health is what is so desperately needed.

There is no sustainable support for Aboriginal Community Controlled Health Services still reeling from $534 million cuts to funding due to the IAS and continued funding deficits resulting from freezes to Medicare rebates introduced in 2014.

For our Member organisations who have a proven track record of improved health outcomes, this limits service provision to their most vulnerable community members. However, $21.3 million has been allocated to trial “medical homes” funding packages for people with chronic and complex conditions.

“The truth is, the vicious budgetary measures of 2014 still remain. You can’t ‘cut’ your way to Closing the Gap” says Jill Gallagher AO.

There is no attempt in the current budget to repair damage caused by the IAS via funding cuts and the poorly targeted distribution of resources, despite severe criticism recently tabled by the Finance and Public Administration References Committee Inquiry.

VACCHO welcomes continued implementation on Palliative Care and National Blood Borne Virus strategies 2014-17 and the addition of new medications on the PBS including Hepatitis B and cancer drugs.

However, we want to see additional implementation measures and call on the Government to take action that:

  • Allocates increased tobacco tax revenue to preventative health initiatives.
  • Increases hospital investments which are reflective of the amounts cut in the 2014 budget with indexation.
  • Expands the new dental scheme for adults and children beyond publicly funded dental services to increase access by vulnerable communities.
  • Maintains accessibility of medications through the recommendations of the Medicare Review.

Prime Minister Turnbull has failed on his Close the Gap promise of “it is time for Governments to ‘do things with Aboriginal people, not do things to them’.

“We know all too well that you can’t have jobs and growth if you don’t have fundamental investment in health and education” says Jill Gallagher AO.

ACRRM

The Australian College of Rural and Remote Medicine (ACRRM) has strongly welcomed the Federal budget announcement which will provide GP registrars enrolled on the College Independent Pathway with the same access to GP-related Medicare benefits as their other GP registrar colleagues. 

College President, Professor Lucie Walters said the announcement would benefit up to 130 rural GP registrars who were undertaking their training through the ACRRM Independent Pathway, as well as removing a significant impediment for others who were considering enrolling in the program.

The ACRRM Independent Pathway is a user-funded, fully-accredited general practice training pathway which is specifically designed to deliver long-term rural workforce outcomes.

“This announcement will enable these doctors to fully access the relevant Medicare Benefits Schedule (MBS) rebates and remove a significant cost and administrative impost on them, their patients and their practices,” she said.

“The ultimate beneficiaries will be the rural and remote communities in which our Independent Pathway registrars live and work as skilled rural doctors.”

While welcoming this announcement, Professor Walters said it was disappointing the Federal Government had not chosen to support general practice through lifting the current freeze on MBS rebates in the budget.

“The ongoing MBS indexation freeze is threatening the viability of many rural and remote practices and placing unwarranted cost imposts on their patients,” she said.

“If we are to improve health outcomes in rural and remote communities, we need both skilled doctors and sustainable rural practices.

AMA

The AMA tonight condemned the extension of the freeze of the Medicare patient rebate until 2020 – a saving to the Government of almost $1 billion.

AMA President, Professor Brian Owler, said the 2016-17 Health Budget continues the Government’s stranglehold on Australia’s Medicare system by taking $1 billion out of the pockets of Australian patients and household budgets by extending the Medicare rebate freeze.

“The poorest, the sickest and the most vulnerable will be the hardest hit,” Professor Owler said.

Professor Owler said patients will be further disadvantaged by an extension of the pause in the indexation of the Medicare Levy Surcharge and the Private Health Insurance Rebate thresholds – saving the Government a further $370.9 million.

“These measures will be another hit to household budgets, and represent extra disincentives to people accessing health care when they need it.

“The AMA notes that there is inadequate funding for the Health Care Home trials, an important initiative to tackle chronic disease.

“We also have concerns about cuts to Flexible Funds, which will effect important programs in the community.

“This means that the people in the community most in need of support will be paying for the Government’s ‘Budget repair’.

“There are also significant cuts to the aged care sector which require closer examination.”

Professor Owler said that there are some positives in the Budget, but they are overshadowed by the cuts.

“The AMA welcomes confirmation of the almost $2.9 billion in COAG funding for public hospitals, but we see this as a down-payment only.

“The States and Territories will need significant extra funding if they are to build hospital capacity to meet growing demand.

“We also welcome the increase in the tobacco tax, new funding for FASD programs, and continuation of the Health Star scheme.”

The AMA will closely examine the totality of the Health Budget and health initiatives from other portfolios and comment later accordingly.

NACCHO

“Indigenous policy needs to take into account the needs and aspirations of the Indigenous population. This needs to reflect the fact that some Indigenous voices are heard much louder than others. When Indigenous Australians are asked whether they can have a say within their community, the young, females, and those with low levels of education are much less likely to say they can have a meaningful say.

The 2016/17 Budget needs to reflect the views of all Indigenous Australians in setting priorities.”

Nicholas Biddle  (2016), Budget Forum 2016: Indigenous Australians, What Might We Expect, and Where Might the Impact Be?,

Office of Catherine King – Shadow Minister for Health

By our count the Budget rips another $2.1 billion out of health spending on top of the $2.1 billion in health cuts in December’s Mid Year Review.

So, Turnbull has now cut $4.1 billion out of health.

Malcolm Turnbull’s first Budget has:

  • Extended Tony Abbott’s GP Tax to six years, taking it out to 2020, ripping another $925 million out of Medicare and taking total cuts to $2.2 billion
  • Cut another $182.2 million from the health flexible funds, taking the total cuts to these crucial health programs tackling drug and alcohol abuse, chronic disease, communicable diseases and rural health issues to almost $1 billion
  • Ripped millions more out of health through cuts to Medicare items (not reinvested back into health).

These are on top of the Mid Year Budget Review decisions that:

  • Cut $650 million out of Medicare by slashing bulk billing incentives for diagnostic imaging and pathology.
  • Gutted crucial health workforce training programmes by $595 million
  • Ripped another $146 million out of health prevention and eHealth programmes
  • The Budget also continues to pursue two of Tony Abbott’s 2014 Budget measures:
  • The $1.3 billion hike in the price of essential medicines by increasing prescription charges by $5 for general patients and $0.80 for Health Care Card Holders
  • The $267 million attack on the Medicare Safety Net

St Vincent’s Health

The federal budget has delivered little to celebrate in the health portfolio, with not-for-profit service providers collateral damage in the government’s efforts to obtain greater savings, according to hospital and aged care services group, St Vincent’s Health Australia (SVHA).

The not-for-profit organisation – Australia’s largest non-government provider of public hospitals – said it was concerning that the government had also expanded or remained wedded to unfair initiatives from previous years that will affect low income and sick Australians.

“As far as health goes, there’s not much to celebrate in this year’s budget,” said Toby Hall, CEO of St Vincent’s Health Australia.

“There’s a theme developing in the government’s approach to health and aged care: it’s going after for-profit providers, using a some very blunt policy instruments, in attempt to claw back savings.

“The problem is that not-for-profit service providers are being caught in the crossfire – we, and the vulnerable people we support – are at risk of becoming collateral damage.

Removal of bulk-billing incentives for pathology

“We’re disappointed to see the government dig in on removing, or winding back, bulk-billing incentives for pathology and diagnostic imaging services.

“We operate two in-house, not-for-profit pathology services and two diagnostic imaging services at our public hospitals in Sydney and Melbourne.

“The government’s view is that pathology providers will be able to absorb the lost revenue from their profits. For the large for-profit providers – which dominate 80% of the sector – that may be the case, but smaller, not-for-profit providers will either have to increase fees or become unviable.

“Fee increases will disproportionately impact on low income people – who have the least capacity to pay but carry the highest burden of chronic disease. These patients are also at highest risk of poor health outcomes if they delay or avoid necessary tests due to cost. The proposed pathology changes include no protections for concessional patients.

Aged care cuts

“We believe the government’s decision to seek $1.2bn in efficiencies from aged care over four years will have real impacts on not-for-profit service providers and the low income residents we care for.

“Not-for-profit providers have small margins. We – along with other not-for-profit providers – care for a significantly higher proportion of concessional residents than other aged care operators. These changes put services for this vulnerable group under threat as providers seek to stay sustainable.

“People’s care needs are increasing. How are we expected to meet that demand with less funding?

“The aged care sector already has one of the lowest paid workforces in the country. We struggle to attract skilled staff into our industry. How will these cuts make that battle easier?

Extension of Medicare Rebate freeze

“We are concerned that the Government’s decision to extend the freeze on Medicare rebates to doctors and other health professionals for another two years will end up hitting patients in higher out-of-pocket costs.

“In the face of a two-year extension to the freeze, there’s also a risk that GPs and specialists who might previously have provided bulk-billing will now cease doing so. And who will be the hardest hit? The chronically ill and those least likely to be able to afford specialist care.

Aikenhead Centre for Medical Discovery

“Of course, as one of the lead organisations behind the proposed Aikenhead Centre for Medical Discovery (ACMD), we were disappointed by the Prime Minister’s budget-eve letter to the Victorian Premier that the federal government wouldn’t be supporting the project.

“The Victorian Government has made a solid commitment of $60m for the project. The other partners combined – including St Vincent’s Health Australia – have also put $60m on the table.

“We think the federal government’s lack of financial support is short-sighted.

Private health insurance

“We support the government’s direction in private health insurance reform.

“As an operator of eight private hospitals around Australia, anything that addresses that confusion and delivers greater transparency and better value to consumers is welcomed.

“This is especially important given the government has paused indexation on private health insurance thresholds for another two years – which will see more and more people lose their rebate over time as incomes rise.

New funding initiatives

“As an organisation that sees the extreme levels of damage that alcohol causes in our hospitals every day – not just in terms of accidents and injuries, but in terms of chronic disease and illness – we welcome the budget’s extra funding to combat Foetal Alcohol Spectrum Disorder (FASD), with a particular focus on rural and remote Aboriginal and Torres Strait Islander communities.

“We urge the Commonwealth to take a similar leadership role in other areas of responsibility around alcohol, including taxation and advertising and promotion.

“We also welcome the government developing a National Cancer Screening Register to replace current state and territory registers for the National Cervical Screening Program and the current register for the National Bowel Cancer Screening Program,” said Toby Hall

RACGP

The 2016 Federal Budget has done absolutely nothing to reverse the increasing pressure on Australia’s world-class healthcare system according to The Royal Australian College of General Practitioners (RACGP) President Dr Frank R Jones.

“This is an illogical Budget which has taken no heed of the sensible advice from the RACGP.”

By extending the freeze on the Medicare Benefits Scheme (MBS) for a further two years, the Government is threatening the future and quality of general practice patient services, the frontline of Australia’s healthcare,” he said.

“Extending the freeze until 2019-20 is calamitous and will lead to a loss of more $925 million from MBS funding; it may leave general practices unviable – which is just an extraordinary outcome.”

In 2015 the nation’s GPs saw 85 percent of Australia’s population providing 140 million patient services at a fraction of the cost of more expensive hospital and other specialist care.

“Reversing the freeze on the indexation of the MBS is absolutely essential to maintain high quality healthcare services. The RACGP will now step up its campaign for reversal of the freeze, lobbying all parties, informing our patients of our disappointment, and advising them as to how it will affect them as we head into a Federal Election,” Dr Jones said.

A key recommendation made by the RACGP in its pre-budget submission, funding for a pilot for trialing the implementation of the patient-centred medical home, received some support in the budget but not enough.

“The $21.3 million proposed to pilot this crucial program won’t provide patients with enhanced quality services,” Dr Jones said.

“This figure equates approximately $8.93 per patient per month, compared to $45 per call for the My Aged Care Hotline.

“The Federal Government is responsible for the health of the nation, and tonight’s budget fails to recognise cost-effective quality general practice-based patient care.

RDAA

The Rural Doctors Association of Australia (RDAA) has said while there are some welcome piecemeal initiatives for rural patients in tonight’s Federal Budget, the overshadowing continuation of the Medicare indexation freeze for a further two years will see more rural and remote patients unable to afford the medical care they need.

RDAA has warned that the freeze will continue to bite hard on many rural and remote practices that are already struggling financially, and will further increase the barriers for rural and remote Australians in accessing local primary care.   “The continuation of the Medicare freeze is going to send more rural and remote patients to the healthcare equivalent of deepest, darkest Siberia” RDAA President, Dr Ewen McPhee, said.

“Those rural and remote Australians who can least afford to miss out on healthcare are being hurt the most by this irresponsible and unrelenting measure.   “We implore the Turnbull Government to end the freeze urgently in the lead-up to the election.   “We are also concerned at the Government’s announcement to streamline and simplify the Practice Incentives Program, which is a particularly important program in supporting rural practices.

“With this measure announced to save $21.2 million from 2015-16 to 2019-20, we are very concerned that this critical program will be downgraded and that this will have a big impact on the support it provides to general practices. We desperately need to see the fine details around what the Government is proposing here.

“On the positive side, we provisionally welcome a redesigned Rural General Practice Grants Program.  While again we need to see the fine details, the revised program looks to be more flexible in terms of the requirements placed on rural practices in accessing Government funding to undertake extensions of their premises, and also includes fit-outs and renovations of existing practices and equivalent upgrades.

“While there remains a requirement for practices to match the Commonwealth’s funding contribution, and while we see no indication that the grants provided to practices will be made tax-free, having further flexibility in how this funding can be used is welcome and will hopefully help more practices to expand some services like allied healthcare and in-practice training for medical students and young doctors.

“We are also pleased to see that GP registrars training through the Australian College of Rural and Remote Medicine’s (ACRRM) Independent Pathway will be given the same access to GP-related Medicare benefits for the services they provide while training. This will help to level the playing field for GP Registrars training in rural and remote areas, and thus help attract more young doctors to the bush.

“There are a number of other smaller initiatives that will assist rural and remote patients, and Aboriginal and Torres Strait Islander patients, in this Budget and these are welcome in their own right.   “But these are essentially piecemeal in nature, and demonstrate that again in this Budget there is no comprehensive plan to reduce the discrepancy in health outcomes, and access to healthcare, between rural and remote Australians and their urban counterparts.”

Dr McPhee said RDAA still also awaits more details around welcome announcements made by the Federal Government in the Mid-Year Economic and Fiscal Outlook (MYEFO).   These comprised:

  • Up to 30 new Regional Training Hubs to enable medical students to continue rural training past university and into postgraduate medical training. The hubs will be located at existing rural training sites.
  • A Rural Junior Doctor Training Innovation Fund to be targeted at rural-based interns to enable them to spend some of their training year in rural general practice. We have welcomed this initiative as providing an alternative program to the highly-successful Prevocational General Practice Placements Program (PGPPP) that unfortunately was discontinued by the Coalition Government.
  • A targeted expansion to the Specialist Training Programme, to provide up to 100 new training places in rural areas — 50 in 2017 and another 50 in 2018 — enabling the Specialist Training Programme to provide up to 1,000 ongoing places by 2018.

“While we have welcomed these MYEFO initiatives, we still await the fine details around funding and their implementation” Dr McPhee said.

The NAAA (National Association for Action on Alcohol)

The Federal Budget released today shows the Government is taking positive steps to address the Fetal Alcohol Spectrum Disorder (FASD) rates in Australia.

Investing in FASD prevention shows the Government is committed to lowering the FASD rates to improve quality of life for the next generation. A national register would go a long way to further supporting this initiative.

“FASD is a life sentence for those born with it – there is no cure,” said National Alliance for Action on Alcohol (NAAA) co-chair and Chair of the Royal Australasian College of Surgeons Trauma Committee Dr John Crozier.

“FASD devastates families and communities. It can have major impacts on children’s intellectual ability and behaviours, putting pressure on health care services,” said Dr Crozier.

“This initiative is aimed at three key aspects of FASD: clinician education, prevention and research. This support is key to prevent FASD by empowering women with the right information to make educated decisions about the risks of drinking alcohol while pregnant,” says Dr Crozier.

“The clinical network and information resources that will be made available to clinicians are an important step in improving patient outcomes and helping clinicians better understand how FASD affects their patients,” Dr Crozier said.

“Allocation of funds in tonight’s budget is an important step in the right direction, but it won’t solve the FASD problem in Australia,” said Dr Crozier.

NAAA calls on the Government to establish and fund a central register of people diagnosed with fetal alcohol, similar to the Australian Cerebral Palsy Register. Action should also include comprehensive steps to reduce harmful drinking throughout the community.

Alzheimer’s Australia

Tonight’s Federal Budget contains no new major policies or programs that would significantly improve the lives of the more than 353,000 Australians living with dementia and their carers.

“At a time when dementia is the second leading cause of death and is projected to affect almost a million people by 2050 with significant economic and social costs to Australia, we need national investment to drive a co-ordinated approach from prevention through to cure.” Alzheimer’s Australia national CEO, Carol Bennett said.

“Perhaps the most positive outcome of this Budget for people living with dementia is the continued support for dementia specific flexible funding.  This will enable some evidence based improvements in dementia support which is much needed,” Ms Bennett said.

Alzheimer’s Australia also welcomed:

  • Enhancements to the MyAgedCare contact centre ($136.6m over 4 years)  Alzheimer’s Australia has advocated strongly for improvements to the ‘one stop shop’ that provides a gateway to aged care services and support for informed decision making.
  • A commitment to further developing consumer experience and quality of life measures in residential and home care services  One of the most important issues for people living with dementia and their families is the quality of aged care services.  The need for at least one publicly reported measure of quality in aged care is a high priority.  Measures of quality will generate more confidence in the aged care service system and provide information on which consumers can base decisions about their services and providers.  It is essential that these tools are co-designed with consumers and carers to ensure that services are meeting their needs
  • Continued unannounced compliance site visits ($10.1m) Unannounced visits are an important component of generating community confidence that residential aged care services are safe and compliant with the accreditation framework.

The concerning feature of the Budget is the cut of $1.2b over four years to the Aged Care Funding Instrument (ACFI).  “While the Government may have had little choice but to cut ACFI due to projections of unsustainable expenditure in aged care, this budget decision suggests the funding tool is flawed and needs an overhaul to ensure it leads to quality outcomes.  The current model does not reward the very things that promote quality of life especially for people with dementia,” Ms Bennett said.

“While this Budget provides no new funding for dementia, we remain hopeful that initiatives in the pipeline, including the funding of the National Institute for Dementia Research and the Medical Research Future Fund, will provide the hope for those living with dementia and their carers that they so desperately seek.” Ms Bennett concluded.

Cancer Council

Around 320,000 adult Australian smokers are likely to quit and 40,000 teenagers deterred from taking up smoking as a result of expected tobacco tax increases in the 2016-17 federal budget, resulting in a major reduction in the nation’s cancer burden.

Cancer Council Australia CEO, Professor Sanchia Aranda, said the tax increases would translate to tens of thousands of cancer deaths prevented in Australia and a significant improvement in the nation’s health.

“The tobacco tax announcement is great news for Australia’s health,” Professor Aranda said. “Based on analyses of the benefits of previous tobacco tax increases, 320,000 smokers are likely to quit over the longer term as a result of an expected series of 12.5% annual tobacco tax increases.

“In addition, 40,000 teenagers will be deterred from smoking altogether – adding to a continued decline in the number of teenagers in Australia who smoke.

“Two in three Australian smokers die prematurely of smoking-caused disease, with cancer being the most significant cause of death.

“There are 16 cancer types caused by smoking, so a policy intervention with such extraordinary capacity to reduce smoking prevalence will see a major reduction in Australia’s cancer death rates.”

Professor Aranda said the Australian Government should be commended for introducing the increases. The federal Opposition, which had previously announced its commitment to a series of 12.5% increases, should also be commended.

“Both sides of politics in Australia have shown great courage and commitment to anti-smoking policies over the past 40 years, which is the main reason Australia has one of the world’s lowest smoking rates,” she said.

“Yet smoking remains the number one preventable cause of cancer death in Australia by a significant margin. The tobacco tax increases announced will make a significant impact on tobacco-related cancer death rates.

“Tobacco tax increases are particularly effective in deterring smoking among people on lower incomes, who bear a disproportionate burden of tobacco disease burden.”

Professor Aranda said the revenue would also assist governments in funding other tobacco control measures such as hard-hitting media campaigns and support for quit services.

 

The Danii Foundation

Today’s Budget has delivered nothing for 140,000 Type 1 diabetics who suffer from an auto-immune disease that unlike Type 2 Diabetes cannot be reversed through diet and exercise.”said Donna Meads-Barlow, founder of the Danii Foundation.

The Danii Foundation is a national body dedicated to improving the lives of Type 1 Diabetics and their families, founded after the death of Daniella Meads-Barlow aged 17.

Daniella died in her sleep as a result of Nocturnal Hypoglycemia, an unnecessary death that claims at least another young Australian every week.

“The Foundation has stridently advocated for funding to prevent unnecessary deaths and ensure the best management of Type 1 Diabetes through Continuous Glucose Monitoring. Currently detection of blood sugar levels is via an archaic finger pick.”

“The Danii foundation made a compelling argument in its budget submission demonstrating how funding CGM could reduce waste in our public hospital setting, via unnecessary admissions, and horrific morbidity including limb amputation, blindness and kidney failure.”

“Only a reckless and uncaring Government would ignore ongoing waste and deny Australians, many children the best technology to manage such an insidious disease, one that has no cure, with much of its cause also unknown.”

ACOSS

“The tightening of super tax concessions and changes to youth employment programs are welcome, but harsh cuts affecting people on low incomes remain locked in, with more announced and more likely to come. The failure to strengthen revenue is a major problem, and this Budget reveals the ongoing consequences to essential services and the social safety net.”

“The Budget locks in $13 billion in cuts from family payments, income support for young people and paid parental leave, and adds a further $3 billion in cuts to payments and essential services. This includes cuts to Medicare and dental health and income support for people with disability.”

“Alarmingly, the budget delivers a real cut to new recipients of the Newstart Allowance through removing the compensation for carbon pricing, while the related tax cuts remain in place. For people surviving on just $38 a day, this is unconscionable.”

“We are very pleased to see the new approach to helping young people into paid work. This Budget recognises the failure of Work for the Dole, and has instead provided an opportunity for young people to get work experience in real jobs with a wage subsidy, something we have urged for some time and should be used more widely.”

“We also welcome the action on superannuation and multinational tax avoidance. The superannuation reforms take us in the right direction, tackling unfair concessions for people on higher incomes, and providing assistance to people who struggle to secure adequate retirement savings. However, the tax treatment of super remains biased towards higher income earners, a

“The personal and company tax cuts costing $8.8 billion are only partly offset by the $3.3 billion in integrity measures, most of which are assumed to come from more resourcing of the Australian Taxation Office (ATO). By failing to act on shelters and loopholes such as negative gearing, capital gains discounts, private companies and trusts and work-related deductions, our revenue base is at real risk of further erosion. We must be able to afford to properly fund health, education and social security to invest in our capabilities and protect people who are vulnerable.”

ACOSS is concerned that all of the reduction in the deficit over the next four years ($1.7 billion) from this Budget comes on the spending side ($3.3 billion), with revenue declining by $1.3 billion.

“The Budget has failed to take any action to address housing affordability in Australia, or to lift the unemployment payment. Serious gaps remain in essential services including legal assistance, early childhood and homelessness services.”

“We cannot support further cuts to Centrelink staffing, at a time when the system is already under severe strain.”

“This Budget must be the beginning, not the end of tax reform. Any tax cuts – personal or corporate – should wait until enough revenue has been raised to pay for them and restore essential services. Most people are still paying less tax overall than a decade and a half ago, before eight annual tax cuts were given. The proposed personal tax cut will only benefit the top 20% of income taxpayers.”

Welcome measures:

  • Restrictions on retirement tax breaks for people with high incomes and wealth
  • Lowering of the superannuation contributions cap and reintroduction of a scheme to prevent low income earners from being penalised when they contribute to their retirement
  • Curbs on tax avoidance by multinational corporations
  • Shift from the failed Work for the Dole scheme towards work experience in regular jobs for young people

Concerning measures:

  • Harsh cuts from previous budgets carried over to the 2016-17 budget, including cuts to family payments for low income families, reductions in PBS concessions, higher age pension eligibility age, one month waiting period for young people to access income support and lower payments for many young unemployed people
  • The vast majority of the cuts to state health and schools funding remain in place
  • The risk of further harmful spending cuts due to the failure to fully fund personal and company tax cuts, especially over the next four years
  • An effective cut to dental health programs
  • Reassessment of 90,000 people currently receiving the Disability Support Pension, putting them at risk of a $170 per week cut to payments
  • Some increases in superannuation tax breaks for contributions for people on higher incomes who don’t need them (the new tax deduction and carrying forward of the concessional cap)
  • More reductions in Centrelink resources, when the system is already under strain

Missing in action

  • A long overdue increase to the unemployment payment
  • Investment in affordable housing programs and supply, and certainty for homelessness services into the future
  • Changes to the child care package to ensure vulnerable children have 2 days per week of quality education and care
  • Additional funding for struggling community services, including Aboriginal and Torres Strait Islander and legal services.

Action to combat violence against Aboriginal and Torres Strait Islander women invisible in the Budget

National Family Violence Prevention Legal Services (FVPLS) Forum

Targeted action to address the specific needs of Aboriginal and Torres Strait Islander victim/survivors of family violence is invisible in the Federal Budget.

“Aboriginal and Torres Strait Islander women are at the epicentre of the national family violence crisis, yet specific initiatives to confront this crisis and invest in services for safety are invisible in the Budget,” said Antoinette Braybrook, Convenor of the National FVPLS Forum.

“This is yet another missed opportunity for the Government to better resource Family Violence Prevention Legal Services (FVPLS) who provide legal services and supports to Aboriginal and Torres Strait Islander victims/survivors of family violence, with more than 90% of our clients nationally being Aboriginal and Torres Strait Islander women and children.”

Aboriginal and Torres Strait Islander women are 34 times more likely to be hospitalised from family violence and 10 times more likely to die of violent assault than other women. The question must be asked why there is no targeted action to address this crisis.

The Budget includes $100 million over three years on initiatives to reduce violence against women and their children. This is inadequate to meet the needs of women fleeing violence for their safety. It is also silent on a specific allocation of funding on programs for Aboriginal and Torres Strait Islander women.

Without targeted investment in services like FVPLSs the horrific disproportionate impact of violence against Aboriginal and Torres Strait Islander women will only get worse. The Budget also fails to reverse the cuts to Community Legal Centres and Aboriginal and Torrs Strait Islander Legal Services.

“Violence against Aboriginal and Torres Strait Islander women and children is at epidemic levels. It will cost the nation $2.2 billion by 2021-22. Its moral cost – which sees lives lost and communities destroyed – is unquantifiable. Yet tragically a response to this violence is invisible in the Budget Papers.”

“FVPLSs provide essential services for safety of Aboriginal and Torres Strait Islander victims/survivors of family violence and deliver early intervention prevention programs to break the vicious cycle of violence. Further investment is needed to build the capacity of existing services and address service gaps to ensure all Aboriginal and Torres Strait Islander women can access these services for safety.”

“Budgets set out the priorities of Government. Ending the disproportionate impact of violence against Aboriginal and Torres Strait Islander women should have been front and centre of this Budget.”

World Vision

World Vision Chief Executive, Tim Costello has called for an end to the ‘madness of endless aid cuts’ following the Turnbull Government’s decision to further slash the Australian aid budget to its lowest level ever in the nation’s history.

Mr Costello said the continuing cuts were a tragedy of untold consequences that saw the world’s most vulnerable bearing the brunt of budget savings over the past three years.

The fresh cuts of $225 million announced as part of the Federal Budget follows three years of brutal cuts that have now slashed more than $1 billion from the Australian aid budget.

“This latest round of cuts puts lives and futures at risk as well as regional and global security and prosperity; it’s both unwise and unworthy of our nation,” he said.

Tonight marked the commencement of the election campaign, Mr Costello said, but if Malcolm Turnbull is re-elected he will preside over an Australian aid budget that will remain at its lowest level ever for the life of the next parliament.

“The madness of endless aid cuts was launched by Tony Abbott two days before the last federal election, now Mr Turnbull and Mr Shorten have the opportunity to come together to change that.

The head of World Vision called on both the Government and Opposition to stop cutting aid and commit to restoring Australian aid to its pre-cuts level of $5.5 billion.

“All parties have 60 days to commit to restoring the aid budget to the previous level of a $5.5 billion (only 0.3% GNI),” Mr Costello said. “We call on all parties to commit to making this happen over the life of the next parliament.”

He said it was particularly disappointing that aid to support fragile states in our region such as Myanmar, Pakistan and Afghanistan continue to be cut. Despite the near ending of bilateral program even our commitment to multilateral program in Africa continues to decline he said.

World Vision welcomes the government’s strengthened commitment to the Syria crisis. This will bring long term stability to the funding of that crisis and end the practice of pitting funding for cyclones in the Pacific against the Syria crisis.

However a declining aid budget has forced a reduction in the flexibility in funding for emergencies.

Mr Costello welcomed the decision of the Department of Foreign Affairs to respond to the sector’s call for greater transparency with the release of detailed information on the aid budget.

 

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