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Part three of wrapping reaction to Federal Budget; it fails so many health tests

The Federal Budget represents so many missed opportunities to improve the health and wellbeing of Australians, and is likely to increase health inequities because of its focus on short-term ‘fixes’ rather than system reform, and its failure to address critical determinants of health, such as climate change, housing insecurity and poverty. It also fails to address many concerns about aged care.

This post compiles statements from: Public Health Association of Australia; National Shelter; Jesuit Social Services; LGBTIQ+ Health Australia; Australasian College for Emergency Medicine; Catholic Health Australia; Palliative Care Australia; Royal Australian and New Zealand College of Psychiatrists; Australian College of Nursing; Dr Louise Ellis, Australian Institute of Health Innovation; Allied Health Professions Australia; Australian Physiotherapy Association; The Australian College of Rural and Remote Medicine; Australian Lawyers for Human Rights.

Also see part one and part two in this series compiling reaction to the Budget.


Budget deserves an F-minus

Statement by Public Health Association of Australia

The 2022-23 Australian Budget is a major disappointment and represents another missed opportunity to invest in Public Health and prevention in multiple ways that would have improved the lives of everyone in Australia.

There are some initiatives, such as $40.7 m over three years for bowel, breast and cervical cancer screening, money for alcohol and drug services, and other Public Health issues like a study on the effects of junk food advertising on children.

There’s $9.7 million over three years to “extend community driven initiatives to improve levels of physical activity.” But the Budget cuts fuel excise for six months to encourage people to drive more, which will increase air pollution in our neighbourhoods, and exacerbate the worsening effects of climate change.

We welcome $700,000 over four years to develop a National Nutrition Policy Framework. It could have been complemented by lifting levies on alcohol, tobacco, and sugar-sweetened beverages – all of which make people in Australia sicker, and exacerbate chronic diseases.

Furthermore, after testing the Budget against the National Preventive Health Strategy 2021‑2030 – to which the PHAA contributed and helped launch last December – it’s clear Public Health has again been ignored, PHAA CEO, Adjunct Professor Terry Slevin said.

“Last December that Strategy set a target of raising prevention to 5 per cent of health spending, but this Budget’s continued focus on treatment, expensive drugs, and tertiary health care must mean that the current rating of 1.7 per cent will actually be even less,” he said.

“This is a Budget about treatment of people who have been allowed to develop preventable diseases, and about enormously expensive pharmaceuticals.

“When we put that lens of public and preventive health as outlined in the National Preventive Health Strategy across the 2022 Federal Budget, I’m sorry, but the Budget is an F minus.

“Messages about workforce funding are starting to get through – such as in mental health and primary care and other areas.

“But across the broader public health workforce, there’s not a zack for the long-term investment in the people who are essential for their expertise and leadership to tackle the next challenges, be they communicable disease, chronic disease prevention, and others.

“This government failed on public and preventive health. Every year, we are promised ‘next year, it’ll come next year’. It still hasn’t come.

“We’ve got to do better to protect the long-term health of everyone in Australia. Whoever forms the next government, they need to do better at prevention than we have been doing.”

Watch this video featuring Terry Slevin as he gives the Budget an F-minus rating.


Missed opportunity to invest in the security of low-income Australians

Statement by National Shelter

The national peak body representing the housing interest of low-income households says that the 2022/23 federal budget continues to ignore the needs of low-income and vulnerable Australians and again fails to invest in social and affordable housing.

Ms Emma Greenhalgh, Chief Executive Officer, said that ‘at a time of a national housing emergency, there is nothing on offer from the federal government to address the housing circumstances of households in greatest need’.

The housing measures in the budget this year include the continuation of the Home Builder Scheme, and the enhancement of the Home Guarantee Scheme, including the expansion of the scheme in regional areas, and changes to the First Home Super Saver Scheme.

‘We are concerned that the only focus in this budget is on measures that provide fuel to an already inflated market. We need a suite of responses to address this housing emergency, not just one response. The government has spent more in the past 12 months supporting people to renovate housing than on providing funding for people who urgently need housing’, Emma continued.

This year’s federal budget does not provide any new funding for social and affordable housing and does not match the enhanced contributions from state governments in recent years. We cannot find any recommended increase to Commonwealth Rent Assistance, which leaves low-income private rental households at the mercy of inflated rental markets. The tax offsets and one-off payments to households to assist with cost-of-living expenses are insufficient to the scale of the problem for households to meet their increasing costs.

The raising of the NHFIC liability cap by $2billion to $5.5billion will assist community housing providers deliver some more social and affordable housing. However, this is not a grant provided directly to community housing providers. Providers will still be required to source funding to building housing.

National Shelter continues to call for a national housing strategy with additional investment in social and affordable housing.

People tonight who are in housing distress or experiencing homelessness have been forgotten by this budget.


Unambitious and missed opportunities

Statement by Jesuit Social Services

The Federal Budget 2022-23, handed down last night, contains a range of spending measures to provide temporary relief around the current cost of living pressures being experienced by millions of Australians, but is ultimately a missed opportunity to make a sustainable difference to issues such as inequality, affordable housing and climate change, says Jesuit Social Services.

“This Federal Budget has been handed down only weeks away from a Federal Election, resulting in an unambitious Budget packed with short-term spending at a time when the nation needs long-term strategies and investments to tackle serious problems such as rising levels of poverty and inequality, climate change and housing affordability,” says Jesuit Social Services CEO Julie Edwards.

“These are key issues that will shape Australia for decades to come. Real action now would make a tangible positive difference for future generations, instead of just short-term investments such as a temporary cut to the fuel excise and a $420 cost of living tax offset.”

Ms Edwards says that $250 bonus payments to pensioners and people on income support allowances will not adequately address current cost of living pressures.

“People receiving income support are already living below the poverty line, and these one-off payments may help for a week or two, but will not support people to lead dignified lives. What we need to see from our Government is a commitment to create a fair social safety net that ensures recipients can afford an adequate standard of living,” she says.

“Concession card holders will again get access to a limited number of free Rapid Antigen Tests when they should be free and available to all Australians. Additionally, an end to the Pandemic Leave Disaster Payment will hurt low-income workers particularly when Australia is still recording tens of thousands of COVID-19 cases a day.

“We are also extremely disappointed that there is no real plan to tackle housing affordability, increase social housing or address climate change, at a time when we are seeing the devastating impact of the floods across New South Wales and Queensland.”

Ms Edwards says there are some welcome inclusions in the Budget, including a commitment to take in an additional 16,500 Afghan refugees, $1.3 billion to implement recommendations made by the National Plan to End Violence against Women and Children, $540.7 million in new mental health initiatives including regional initiatives to reduce suicides and a reduction in the safety net threshold for the Pharmaceutical Benefit Scheme, which will help income support recipients.

“Ultimately, this Budget a missed opportunity to address some of the most serious issues confronting Australia, such as poverty and inequality, climate change and affordable housing. With the Federal Election around the corner, we call on all political leaders to deliver plans to improve positive outcomes for all Australians, both now and for future generations.”


LGBTIQ+ communities left behind

Statement by LGBTIQ+ Health Australia

LGBTIQ+ Health Australia (LHA) welcomes the investment in the 2022-23 Federal budget that will improve the health and wellbeing of all Australians and continues to call for specific funding measures to directly address LGBTIQ+ health priorities.

The budget includes broad investments in key health disparities such as mental health and suicide prevention, domestic, family and sexual violence prevention, and ageing and aged care. Other than the announcement of the 6-month extension of emergency COVID-19 funding for digital mental health services which will see continued investment in QLife, these announcements are not targeted, and it is unclear how LGBTIQ+ people and communities will benefit.

LHA welcomes investments in the National Preventive Health Strategy 2021-2030 where LGBTIQ+ people are recognised as a priority population and the $104.4 million investment to expand the reach of national domestic, family, and sexual violence prevention organisation Our Watch to improve its reach in diverse communities including LGBTIQ+ people.

Despite being identified as a priority population in a range of existing national strategies, LGBTIQ+ health remains without direct funding to LGBTIQ+ community-controlled organisations. underfunded. Of the recommendations made in LHA’s pre-budget submission, none were funded in the 2022-23 Budget.

LGBTIQ+ people are more likely than the general population to experience poor health outcomes, and these are linked to experiences of discrimination, stigma, and exclusion. Current research shows that LGBTQA+ young people aged 16 to 17 were almost five times more likely to have attempted suicide in their lifetime.

Nicky Bath, (she/her) CEO of LGBTIQ+ Health Australia said, “LGBTIQ+ community-controlled organisations are unable to meet the demand for their services and we need urgent investment to address the health disparities LGBTIQ+ people and communities continue to live with.”

Investment into generalist services does not necessarily translate into a direct health benefit for LGBTIQ+ people and there needs to be an urgent reassessment of funding processes when engaging generalist organisations to provide services and programs to LGBTIQ+ communities.”

LHA is calling on all parties and independent candidates in the upcoming Federal election to commit to its Election Priorities, which support the health and wellbeing of LGBTIQ+ people.

Ms Bath said, “LGBTIQ+ community-controlled organisations across Australia undertake incredible work to support our communities. These organisations urgently need funding to build their stability, sustainability, and capacity to meet the needs of LGBTIQ+ communities. Without this investment, the health disparities we see in available data will only continue.”


More must be done

Statement by Australasian College for Emergency Medicine

The Australasian College for Emergency Medicine (ACEM) acknowledges the commitments in the 2022 federal budget aimed at delivering improvements to Australia’s healthcare system, but says greater investment is urgently needed to solve the widespread hospital and healthcare crisis and deliver Australians the healthcare they need, when and where they need it.

In particular, the College urges urgent attention and investment in healthcare workforce, with a key focus on bolstering and retaining senior nursing workforce staff who form the backbone of the health system and have left the sector in droves, leading to a significant loss of vital skills.

In this initial analysis of, and response to, the Budget, ACEM will be focussing on commitments and investments in areas of federal responsibility that impact on dangerous emergency department (ED) overcrowding, acute hospital access block and ambulance ramping: aged care, mental health, the NDIS and rural, regional and remote healthcare.

Aged Care

Australians deserve safe housing and healthcare where and when they need it – whatever their age.

Acknowledging the significant investment announced in last year’s budget, ACEM welcomes the $468.3 million commitment to further implement the Government’s response to the Royal Commission into Aged Care Quality and Safety, including the $22m investment for new models of multidisciplinary outreach into residential aged care facilities (RACFs) and $7.5 million for the Palliative Care Service Navigation Pilot to trial models for improved coordination of palliative care.

Despite the announcement of $49.5 million over two years to provide an additional 15,000 low and fee-free training places in aged care courses, ACEM remains concerned that the aged care workforce remains under significant strain and believes that longer term investment is required to build and retain a high-quality workforce of clinical and care staff.

It is a national shame that Australia’s aged care system is producing such inconsistent levels of care. To amend this requires massive commitment and investment to ensure aged persons receive the support they deserve.

Mental health

ACEM welcomes the federal budget investments towards improvements in mental health. An initial analysis indicates an emphasis on important community-based services for mental illnesses like depression and anxiety. However, there is a notable absence of significant investment in services and treatments for severe, recurrent, or ongoing mental illness that require higher levels of care in clinical settings – and therefore have a greater impact on emergency departments.

Australia’s mental health system is in dire need of reform and investment across the entire spectrum of illness to ensure timely access to services for all community members.

NDIS

People with disability have the right to a place to live that meets their specific needs. However, too often across Australia, people with disability are stuck living in hospital wards because it takes an unacceptably long time to receive a NDIS plan, and once they have an approved NDIS plan, there is no suitable place for them live, or appropriate services available. Being stuck in hospital beds and simply waiting is terrible for the individual and it means that other people in the ED who need one get stuck in the ED, leading to access block and ambulance ramping.

While ACEM welcomes the statement that the Australian Government aimed to “fully fund the NDIS”, the College is greatly concerned at the lack of concrete commitments and urges the government to release details that ensure clarity regarding these commitments.

Rural, regional and remote healthcare

The Australian public health system should offer the same healthcare to all Australians, wherever they live. However, this doesn’t happen, and there are well established examples of a lack of equity in rural, regional and remote healthcare.

ACEM believes that the 2022 federal budget has not delivered the urgently required, impactful solutions for RRR healthcare.

ACEM welcomes the $224.4 million investment towards improving access to health services, to support doctors delivering primary care in rural and remote Australia, and to improve training opportunities in regional settings. Unfortunately, though, these investments will not solve the urgent problems in RRR healthcare workforce.

The College will continue to advocate for federal investment that allows for genuine health equity for rural, regional and remote areas.

ACEM’s federal healthcare priorities

The funding model for healthcare in Australia is complex and divides healthcare into areas that are funded either by state governments, areas that are paid for by the federal government, or a combination of both.

For the 2022 Federal Election, ACEM will be advocating for parties to commit to policies and investments in areas of federal responsibility that impact on dangerous emergency department overcrowding, acute hospital access block and ambulance ramping: aged care, mental health, the NDIS and rural, regional and remote healthcare.

ACEM’s three key areas of focus are:

  • Better healthcare for older persons in residential aged care.
  • ​Better access to specialist accommodation and services through the National Disability Insurance Scheme (NDIS) for people with disability.
  • Better regional, rural and remote healthcare.

Systemic issues and shortcomings in these areas significantly impact the abilities of hospital emergency departments, and the staff who work in them, to treat people in a timely and effective manner and leads to poorer outcomes – including death.

ACEM President Dr Clare Skinner said, “ACEM welcomes the commitments aimed at improving the healthcare system. However, more must be done to make sure we have a health system that is safe and fair and accessible for all Australians.”

“Because what we are experiencing in public hospitals and healthcare systems across our country isn’t normal, it isn’t safe, and it can be fixed.”


Much more needed to address unmet demand

Statement by Palliative Care Australia

Palliative Care Australia (PCA) has cautiously welcomed the Government’s palliative care funding announcements contained in last night’s Budget but warns the modest $29.6 million funding announcements alone will not be enough to address the chronic underinvestment in palliative care.

The 2022–23 Budget included funding of $7.5 million over three years to implement a palliative care patient navigator and care coordinator pilot to strengthen access to palliative care and end-of-life care service pathways.

It was announced that a further $22.1 million will be invested in Multidisciplinary Outreach Service trials in RACFs to provide more comprehensive health care with hospital-led access to specialists, allied health professionals, geriatricians and palliative care specialists.

PCA CEO Camilla Rowland says those initiatives are worthy, and indeed aligned with the recommendations contained in the recently released Palliative Care Australia Roadmap 2022-2027, but believes governments must invest more if we are to secure high-quality palliative care for all Australians who need it.

“Access to quality palliative care is everyone’s right, and people living with a life-limiting illness deserve high-quality care. The budget papers correctly reference that between 50% and 90% of the 160,000 people who die in Australia each year would benefit from access to palliative care, but the Budget fails to deliver the investment required to ensure that this access happens.

“To guarantee access to quality palliative care, the Government needed to invest an additional $427.5 million for palliative care each year starting with the 2022-23 Budget. Disappointingly, this Budget is almost $400 million short of that target,” Ms Rowland said.

PCA Chair, Professor Meera Agar says that the demand for palliative care is currently unmet, and with the population growing and ageing, it will only worsen without adequate investment.

“The demand for palliative care services in Australia is expected to increase by 50 per cent between now and 2035, and double by 2050. It is not enough for the Government to simply acknowledge the numbers of Australians requiring palliative care. The Government needed to plan and invest significantly more to ensure high-quality palliative care for all who need it, where and when they need it,” Professor Agar said.

PCA remains cautiously optimistic that as the Government rolls out reforms in aged care including the implementation of the Australian National Aged Care Classification (AN-ACC) funding instrument and increased investment in training for aged care workers that the palliative care needs of aged care residents will be a priority.

PCA is also hopeful that all sides of politics will prioritise palliative care for the upcoming Federal election, and the Palliative Care Australia Roadmap 2022-2027 will be used to form priorities and commitment for the next five years.


Aged care workforce crisis ignored

Statement by Catholic Health Australia

Australia’s not-for-profit Catholic aged care providers are disappointed that there is nothing of substance in last night’s Budget to address the workforce crisis that is gripping current and future aged care services.

Peak advisory body Catholic Health Australia says the failure to address workforce remuneration is a bitter blow to the sector and its workforce which is struggling with fatigue, spiralling living costs, low morale, and a growing shortage of carers and nurses.

The $49.5 million aged care training places and clinical placements for nurses in the Budget is, at best, a Band Aid, and underscores a tin ear to the risk that workforce pressures pose for the quality and safety of aged care services.

CHA CEO Pat Garcia said: “Additional training places are all very well, but the sector is struggling to attract and retain aged care workers because they are simply not paid enough for the essential and demanding caring role they perform for the Australian community.

“When unemployment has the figure three in front of it then it makes the job of attracting people to the industry and to training places that much harder.

“Last night’s Budget should have been an opportunity to deliver real reform to ensure a sufficient and qualified workforce to care for the increasing number of older Australians needing care and support, but disappointingly it didn’t do that.

“The Government has previously announced that minimum staffing levels will be mandatory in residential aged care, but it is far from certain whether there will be the workforce available to meet these standards, let alone the additional workforce required for the significant increase in the number of home care packages and the needs of the ageing cohort of baby boomers.

“The Government could not even bring itself to support the Royal Commission’s recommendation for a change to the indexation formula for personal and nursing care funding that could have prevented further wage erosion. Sadly, that is not in last night’s Budget.

“It is vital therefore that once the Fair Work Commission hands down its decision on the current minimum award rates claim for aged care workers whoever is in government commits to fully fund the wage increases. Failure to fully fund a wage rise will mean that Australia will be unable to attract, retain and grow the skilled aged care workforce that is so desperately  needed.”


Aged care residents to continue missing out on allied healthcare

Statement by Allied Health Professions Australia

People in residential aged care have been ignored in the Federal Budget yet again, despite the Royal Commission’s shocking revelations and calls for funding commitments to allied health.

While there were miniscule allocations for allied health in last night’s budget, including small provisions to digital health and interpreter services, which are welcome, most people in need of allied health services have once again been ignored – particularly those in residential aged care.

Access to a broad range of allied health services that help diagnose and manage a range of conditions and support wellness and reablement is especially important for people with chronic, multiple and progressive conditions and end of life needs. Many of these people are older Australians. The Aged Care Royal Commission found that an important cause of poor quality residential aged care is inadequate access to allied health services. The Commissioners said there is ‘a wealth of evidence on the importance of various allied health interventions in maintaining or enhancing people’s mobility, dexterity, and cognitive function.’

The Royal Commission therefore recommended that both care at home and residential care should include a level of allied health care appropriate to each older person’s needs. This requires clinical assessment of each person, and then managing their care so that they can obtain the allied health services that meet those needs. That in turn requires targeted aged care funding.

The Federal Government accepted the Royal Commission recommendations but provided no clear commitments to funding allied health in residential care, including in last year’s Budget. Older people, their advocates and allied health practitioners were therefore looking to this year’s Budget for those commitments, but this desperate need has been ignored.

AHPA CEO Claire Hewat says ‘We had a Royal Commission reveal the shocking state of aged care for many older people, and there was much public hand wringing about it. We all know now that older people are often in distress, at risk of falls and have difficulties swallowing. The current average of three minutes per day of allied health care in aged care facilities is simply not good enough. But the Government’s attitude in this Budget prioritises many things over addressing suffering and quality of life in aged care.’

‘The constant Government reference to the new funding model, AN-ACC, as somehow magically providing better access to allied health is flawed. The AN-ACC funding at best maintains the status quo of approximately 4% of the budget which will not achieve the outcomes required. It’s time to make allied health services accessible for all, and this requires urgent government funding and action. ‘

Our ‘Fair Access to Allied Health for All’ campaign is pushing for change and calling on the public to make their vote count at the upcoming election to help stop the suffering caused by lack of access to allied health services across Australia.

AHPA have developed a range of resources at their website ahpa.com.au/electioncampaign, including information to inform voting choices, a digital kit for sharing on social media and an opportunity for those impacted by lack of access to allied health to tell their story.


Where’s health reform?

Statement by Australian Physiotherapy Association

“The APA’s pre-Budget submission provided the Morrison Government with evidence-based initiatives that would improve patient outcomes, reduce costs and enhance health care. We are disappointed the Government chose to ignore our submission,” APA National President Scott Willis said.

“The Budget has failed to set the fair foundations we needed for health equity and access.

“This was also an opportunity to advance Primary Care by investing in physiotherapy. It was an opportunity to lay the groundwork for the systemic reform needed to reorientate the health system towards primary care encompassing physiotherapy.

“Instead, the Morrison Government has abandoned health for their own political survival — at this critical time in health care reform we see implementation measures against the Primary Care 10 Year Plan that sets aside just $3.9 million to improve access to allied health services.

“This Budget again overlooks the value and impact that allied health professionals have on communities. Significant investment was needed to strengthen care and reduce disparities and this Budget in no way achieves reform which requires sustained investment towards integrated team-based care.

“The APA provided our most detailed and expansive ever pre-Budget submission, offering solutions and options that we know offer substantial improvements to patient care and improved referral pathways. None of these were adopted.

“We called on the Government to initiate fundamental reform to provide a way forward to overcome the barriers to integrated multidisciplinary team-based care.

“It is frustrating that our evidence-based proposals have been ignored.

“There are many welcome measures in the Budget, however, the Primary Care and Rural Health measures ignore the vital role of physiotherapy in health care. Millions of Australians rely on physiotherapists for diagnosis, treatment and services.

“For the almost 40,000 physiotherapists in Australia and the millions of people they diagnose and treat, this Budget offers no substantial reforms, investments or measures,” Mr Willis said.

In aged care, there is no intention to increase allied health services in residential aged care. Additional support for home care packages that may increase access to physiotherapy for some older Australians will depend on the level of package. There is currently no clarity about future assessment tool and other mechanisms in development.

“The APA was assured by the Health Minister’s office that they will be delivering reforms in aged care that increase the scope, funding and engagement of physiotherapists in residential care and care at home.

“The Government hasn’t properly delivered on the Royal Commission into Aged Care Quality and Standards, and while we welcome some initiatives, we are disappointed with the lack of aged care measures announced in the Budget.

The APA welcomes additional funding for a new women’s health package, and increased funding for mental health and suicide prevention. However, we remain concerned that the commitment to ‘fully fund the NDIS’ will not provide participants with the supports they need as we see services being defunded and plans being reduced at a worrying level.

Mr Willis said that health reform starts with bringing fairness back and lifting the barriers to access. We hoped the Government would have used the Budget to deliver structural transformations by supporting integrated care.

“While it is clear this is a pre-election budget packed with spending in an attempt to resuscitate its electoral chances, the 2022-23 Budget has failed to revive the health system or set some solid foundations for the future.

The APA had urged the Federal Government to use this Budget to support innovative models of care, including reform of primary care that allows patient access to physiotherapy as first contact practitioners.

Mr Willis said the Government has chosen not to invest in this advanced model that benefits patients with musculoskeletal problems.

“Reform isn’t just about pumping money into the health system — it’s about redesigning it so that people can have unencumbered access to the care they need.

“Patients are not funded to access physiotherapy services beyond current and very limited MBS chronic disease items. Physiotherapy provides a path to better health and wellbeing but for too many Australians access is denied or inadequately funded.”


Mental health investment welcomed

Statement by Royal Australian and New Zealand College of Psychiatrists

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has welcomed the $648.6 million of new mental health investment outlined in the budget but says key reforms are still required to improve patient care for all Australians.

The RANZCP President, Associate Professor Vinay Lakra, said some well-targeted pockets of investment were announced, but stressed that any strategic recovery from COVID-19 and recent climate-related disasters must also address underlying system gaps made worse by these events.

‘We commend the $89.2 million overall to bolster the mental health workforce and enhance governance in this critical area’, said Associate Professor Lakra.

‘This includes $28.6 million to sustain growth in the psychiatry workforce and build on previous investments by continuing to support up to 30 additional training posts and supervisors each training year from 2023–2026, to address workforce maldistribution and shortages.

‘There is also recognition of the need to encourage more medical graduates to pursue psychiatry through support of the RANZCP’s Psychiatry Interest Forum.

‘It is only through sustained growth in the psychiatry workforce that we will begin to address the critical shortages of specialist services so many people are experiencing.

‘We have strongly advocated for a raft of other specific workforce initiatives to meet current and future demand for psychiatry services, and to ensure public access to affordable and quality care, and we urge the government to revisit these as a matter of priority.’

‘We also applaud the focus on supporting people in suicidal distress and the $46 million allocated for suicide programs and research, as well as new regional initiatives for suicide prevention.’

The RANZCP welcomed the commitment to permanent telehealth and reiterated the need for policy refinements to ensure care is accessible for people with socio-economic disadvantage, in both rural and metropolitan areas.

‘There are easily implementable bulk-billing incentives that would support the provision of affordable services to people with mental illnesses who are unable to get the care they require.

‘For access to mental healthcare to be equitable, services and treatment must be affordable for all and there is a lack of solutions on this front.

‘We would also like to see the Government act on the Select Committee’s recommendation to promote a wider range of best practice options for suicide prevention.

‘The establishment of clinical registries for mental health would provide access to timely, high quality and reliable national data to inform clinical planning and important decisions on policy, programs and funding.

‘The development of clinically appropriate patient outcomes measures would also go a long way to helping mental health and suicide prevention professionals track outcomes of care to ensure the right care is being offered.

‘With so many and varied initiatives announced in the budget, the RANZCP looks forward to working closely with the Government on their implementation and evaluation’, said Associate Professor Lakra.

‘We need to ensure that all Australians have appropriate access to the range of services that they require to fulfil their potential and improve their quality of life, especially in these challenging times.

Other key mental health commitments included:

  • $372.4 million to reduce the impact of alcohol and other drugs
  • $67.2 million for multidisciplinary care teams to deliver trauma-informed therapies for survivors of family, domestic and sexual violence
  • $39 million to ensure all Australians have access to culturally safe and appropriate mental health services
  • $31.2 million in mental health initiatives to support those impacted by recent floods
  • $20 million over four years for specialised eating disorder treatment services
  • $15.1 million for new MBS items to facilitate collaboration between general practitioners and other mental health professional such as psychiatrists
  • $8.5 million to provide culturally safe and appropriate mental health support in remote communities
  • $2.2 million to support the mental health of the health workforce (Hand-n-Hand program), and the extension of the Black Dog Institute’s The Essential Network (TEN).

Telehealth, only part of the answer for mental health support

Statement by Dr Louise Ellis, Senior Research Fellow, Australian Institute of Health Innovation, Macquarie University, Co-author of the Voice of Voice of Australian Consumers Report

In the wake of the pandemic, and as anticipated, the 2022-23 Federal Budget has prioritised mental health, committing close to $3 billion for mental health and suicide prevention. This is welcome news for many Australians, as the mental health impact of successive disasters with droughts, bushfires, the ongoing pandemic and recent floods, is compounding and likely to persist for years to come. Indeed, a recent survey of health consumers, conducted in October 2021 with 5,100 Australians, found that almost a quarter (24%) of adults experienced serious psychological distress during the pandemic.

The Voice of Australian Consumers Report provides a timely and comprehensive look at Australia’s mental health and wellbeing, and interaction with the health system in 2021 – at a time when many Australians were in lockdown, dealing with financial uncertainty, job insecurity and isolation – all contributing factors to rising rates of mental illness.

A key focus of the Federal Budget is on prevention and early intervention, with $63.6 million being committed to continue support for digital mental health services, as a first point of contact for many Australians. The Voice of Australian Consumers Report found 39% of Australians experiencing psychological distress accessed a telephone advice line, such as Lifeline, and 89% were satisfied with the care they received via digital health (telehealth by phone and or video conferencing, help-lines, apps, webchat and websites). This suggests that accessing mental healthcare through telehealth and other digital services is useful and acceptable to people experiencing psychological distress.

But the survey showed that more must be done – particularly for young people, those with a chronic health condition and those experiencing job loss or working fewer paid hours. What is that “more” that is required? We must ensure that Australians can access a mental health professional when they need it. Waiting times, costs, access and issues of supply and demand continue to be critical issues that needs to be addressed.

Although digital mental health services offer a way of providing accessible and affordable support, little is known about their immediate, medium- or long-term clinical value. Importantly, little is known about the healthcare pathways that lead to ongoing psychological health care and treatment after an initial contact through digital health services. Increased emphasis on evaluating digital mental health is a priority to support future policy and practice, as is understanding how patients use, traverse, navigate, and sometimes get lost in, the system.


Some positives for nursing

Statement by Australian College of Nursing

The Australian College of Nursing (ACN) is pleased its calls for greater investment in developing and enhancing nurse leadership skills has been answered in last night’s Federal Budget.

The Budget contained a $1 million matching co-contribution to ACN for the establishment of 21 scholarships focusing on supporting nurses seeking to further their professional development in leadership.

“I welcome the Government’s recognition that an investment in nurse leadership is an investment in shaping the health of all Australians,” ACN CEO Adjunct Professor Kylie Ward FACN said.

“Recipients will be known as the Bullwinkel Scholars in honour of the bravery and courage shown by the 21 Australian nurses who lost their lives in the Bangka Island Massacre 80 years ago. The funding will ensure their legacy lives on not only in the next generation of nurse leaders, but also in the collective memory of our nation.

“As a nurse myself, I understand the challenges my colleagues face when it comes to finding the time and money to invest in education. These scholarships will be pivotal in providing nurses with the financial support and time to upskill their leadership capabilities to ensure our profession continues to lead the way in providing expert care to those who need it most.”

Adjunct Professor Ward also outlined ACN’s support for a number of other measures in the budget including those targeted at education and women.

“I acknowledge the Government’s recognition of the success of the Aged Care Transition to Practice program, of which ACN is one of the main providers, in the Budget,” she said.

We are also looking forward to seeing the rollout of the proposed investment into the training of Registered Nurses in residential aged care facilities to become Authorised Nurse Immunisers and welcome the additional funding for the Puggy Hunter Memorial Scholarship Scheme which ACN has proudly administered for the last 20 years.”

“As a predominately female profession, we support the strong focus on eliminating gender-based violence and funding of the National Plan to End Violence against Women and Children. ACN and I will continue to strongly advocate to eradicate all forms of violence through the work of our Nurses and Violence Taskforce.”

However, Adjunct Professor Ward pointed toward the failure of the Government to invest in advanced practice nurses as a key failing of the Budget.

“I am disappointed to once again see advanced practice nurses neglected from the decision-making table,” she said.

“As ACN outlined in our pre-budget submission, this group of highly educated professionals are crucial to addressing the complex health needs of our most underserviced populations, including those living in rural and remote areas. However, the refusal of Governments to increase their numbers and scope of practice sadly means many barriers to equitable health care remain in place.”


Some welcome news but primary care funding reform still needed

Statement by Australian College of Rural and Remote Medicine

The Australian College of Rural and Remote Medicine (ACRRM) acknowledges the Government’s commitment to improve healthcare in rural and remote communities in the 2022 Federal Budget but continues to call for primary healthcare funding reform to support general practice and primary care.

The College welcomes the government’s commitment to ensure telehealth is permanently accessible, and an investment of $66 million to improve access to life-saving diagnostic imaging by deregulating access to Medicare funded MRI services in rural and remote Australia.

Targeted funding for COVID-19 supports which will strengthen supply chains for testing and protective equipment for the primary care sector, together with additional recognition through the Practice Incentive Program, demonstrates the significant contribution that the primary care sector has made in the COVID response.

The College also notes specific investment in programs which will help close the gap for Aboriginal and Torres Strait Islander peoples.

ACRRM President Dr Sarah Chalmers says the budget addresses some of the issues raised in the College’s pre-budget submission, but more targeted investments in rural-specific solutions are needed.

“We are encouraged to see the 10-year Stronger Rural Health Strategy remains a focus for the government and that funding announced in the Federal Budget supports those programs,” Dr Chalmers says.

“An investment of $99.3 million to build training and education opportunities in the regions gives more rural and remote Australians the opportunity to study and train as health professionals in the communities in which they live.

“These are initiatives the College has advocated for over a number of years.

“We will continue to call for funding to progress the implementation of the National Rural Generalist Pathway and support Rural Generalist training programs across the nation, as well as for significant primary health care reform more broadly.

“Rural General Practitioners and Rural Generalists play a vital role in the holistic care of rural and remote communities. However, rural general practices in particular are finding it increasingly difficult to remain economically viable.

“This needs to be addressed through the reform of primary care funding models, with special consideration of the needs of rural and remote practices and the importance of the services they provide.

“ACRRM looks forward to working with the Commonwealth to deliver a skilled medical workforce, supported by sustainable practice funding models, to increase access to healthcare in our rural and remote communities and ultimately improve health outcomes, and will now take the time to more thoroughly review the details of the announcements made today,” Dr Chalmers says.


Funding cuts undermine human rights

Statement by Australian Lawyers for Human Rights

Australian Lawyers for Human Rights (ALHR) has described the 2022-2023 Federal Budget as reflecting a Federal Government that does not have a vision of Australia as a modern democracy that values human rights.

ALHR President Kerry Weste said, “ALHR is alarmed that the budget reflects a clear disregard for Australia’s need to develop improved national human rights frameworks. We condemn cuts to the Australian Human Rights Commission that will see its budget reduced by over one third over the next four years, from $32.6 million in 2021–2022 to $20 million in 2025–2026.”

Ms Weste explained, “National human rights institutions play a crucial role in promoting and monitoring the effective implementation of international human rights standards at the national level, particularly in a country such as Australia with the unenviable status as the only developed Western Democracy without a federal Human Rights Act or Bill of Rights.”

ALHR has also called out nearly $6 million in cuts to the Office of the Commonwealth Ombudsman whose funding has been reduced from $47.7 million in 2022–2023 to $41.9 million in 2025–2026.

Ms Weste said, “This is highly concerning given the Federal Government has designated the Commonwealth Ombudsman as the National Preventative Mechanism under its 2017 commitment to implement the United Nations Optional Protocol to the Convention against Torture (OPCAT). These cuts bring into question how seriously the current Government is taking its international commitment to embed a coordinated and independent inspection system for all places of detention in Australia. If we are to live up to this commitment and ensure that people in prison, juvenile detention, immigration detention, quarantine and other detention facilities are not subject to torture or degrading treatment or punishment then additional funding and an overarching national framework for OPCAT implementation is required. Instead this budget cuts the resources available to achieve this.”

“A Federal Government that takes people’s basic rights and freedoms seriously, and recognises the importance of treating everyone fairly and equally, would increase funding for institutions that help protect and uphold people’s fundamental human rights. It would also include funding within the budget for the introduction of a Federal Human Rights Act. It’s long past time to finally bring Australia into line with like democracies and ensure everyone in our community enjoys the same protections as people in comparable countries across the world.”

“Sadly, this budget does nothing to progress a human rights culture in Australia.”


Also see this previous wrap for reaction from: People with Disability Australia; the Australian Aged Care Collaboration; the Change the Record coalition; community health services provider cohealth; the Australian Medical Association; the Australian Nursing and Midwifery Federation; the Rural Doctors Association of Australia; Australian Primary Health Care Nurses Association; the Australian Academy of Science; the Refugee Council of Australia.

And see this wrap of reaction from: National Aboriginal Community Controlled Health Organisation; SNAICC, the national voice for Aboriginal and Torres Strait Islander children; Australian Education Union; Australian Healthcare and Hospitals Association; Australian Dental Association; Oxfam; End COVID For All; Consumers Health Forum; Youth Health Forum; Royal Australian College of General Practitioners; Royal Australian and New Zealand College of Obstetricians and Gynaecologists;  Foundation for Alcohol Research and Education; Australian College of Mental Health Nurses; Society of Hospital Pharmacists of Australia; Country Women’s Association (CWA) of NSW; Dementia Australia; Hepatitis Australia; Australian Federation of AIDS Organisations; Professionals Australia; Australian Psychological Society; Medicines Australia; Australian Medical Students’ Association; Community Foundations Australia and Philanthropy Australia.


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