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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 Gover