Introduction by Croakey: Election-year budgets bring particular opportunities and challenges for policy and advocacy, especially around health equity.
Alison Barrett has been reviewing some of the health sector’s pre-budget submissions. We hope to publish more on this topic, so please send submissions that may be of interest to Croakey readers.
Alison Barrett writes:
The Federal Government is being urged to invest in a National Rural Health Strategy, preventive health initiatives, mental healthcare, and measures to improve air quality and climate resilience.
The calls come in pre-budget submissions from key health organisations aimed at informing development of the 2025-2026 Federal Budget, which is currently scheduled for release on 25 March, ahead of the federal election.
The federal election must be held on or before 17 May. While we await an election date and the official launch of campaigning, the politicking is already in swing, with Health and Aged Care Minister Mark Butler this week reminding listeners of a 2015 survey of doctors, which pronounced Peter Dutton as “the worst health minister in living memory” (no doubt we will be hearing this line again…).
Preparing for electioneering, Prime Minister Anthony Albanese this week announced several ministry changes. Following Bill Shorten’s retirement from parliament next Monday, Amanda Rishworth, Member for Kingston, will become the new Minister for the National Disability Insurance Scheme and Dr Anne Aly, Member for Cowan and Minister for Early Childhood Education Minister, is to become the Minister Assisting the Minister for the NDIS.
Senator Katy Gallagher will also become the Minister for Government Services, and Anika Wells, Member for Lilley and Minister for Aged Care and Minister for Sport, has been promoted to the Cabinet.
Dutton is preparing a pre-election reshuffle of the Coalition’s frontbench following the retirement of Paul Fletcher and Simon Birmingham.
Pre-budget submissions by health organisations, including the Royal Australian and New Zealand College of Psychiatrists (RANZCP), National Rural Health Alliance, Lung Foundation Australia, Asthma Australia and the Stroke Foundation, also urge action on critical health system and workforce issues and research gaps.
The Lung Foundation Australia, Asthma Australia and the Stroke Foundation have called for additional funding for preventive health measures.
“Further work is required in asthma prevention to reduce morbidity and mortality,” Asthma Australia said. “This has become even more important with the impacts of climate change that are increasing the risks for people living with asthma.”
Submissions for the 2025-26 Federal Budget are open until Friday, 31 January.
Improve access to mental health services
The RANZCP calls for immediate and sustainable investment to strengthen and expand the psychiatry workforce in its pre-budget submission for 2025-2026.
In particular, they urge for the implementation of the National Mental Health Workforce Strategy 2022-32.
RANZCP says “little progress has been made” since its pre-budget submission for 2024-2025, which was “anchored” to the recommendations of the National Mental Health Workforce Strategy 2022-2032.
The College emphasises that access to mental healthcare is under strain due to rising cost of living pressures, workforce shortages and a fragmented service system.
The mental healthcare system is buckling under chronic underinvestment: “Workforce is our biggest barrier” – many staff are burnt out, “facing moral injury and rising stress”.
These concerns are acutely felt in NSW, where more than two-thirds of staff specialist psychiatrists are threatening to resign on 21 January, following a pay dispute between the NSW Government and the union representing doctors in the state, the Australian Salaried Medical Officers’ Federation (ASMOF). ABC reports that 29 percent of NSW staff specialist psychiatry positions are vacant.
The RANZCP submission presents 15 calls for action (see here for more detail), including changes to the Medicare Benefits Schedule (MBS) rebate and item numbers, and investment in workforce and training programs.
The College says its recommendations “seek to ease the financial strain on families by lowering out-of-pocket expenses and improving access to mental health services, delivering a more accessible and effective mental health system for all Australians”.
Full submission here: https://www.ranzcp.org/getmedia/eb682b33-a3cf-4865-9bff-66b4093dfec4/ranzcp-federal-pre-budget-submission-2025-26.pdf
Media release on NSW psychiatry resignations: https://www.ranzcp.org/news-analysis/update-on-new-south-wales-workforce-issues
Building a healthier rural Australia
The National Rural Health Alliance calls for the development of a National Rural Health Strategy under the next National Health Reform Agreement (2025-2030) to coordinate Commonwealth, State and Territory investment and service delivery.
“Current approaches are not delivering coordinated, transparent or sustained solutions, and a clear, coordinated and funded plan is needed to ensure the inequity between rural and urban Australia is addressed and benchmarked,” the Alliance writes.
The National Rural Health Strategy should address ways to lessen cost-of-living pressures and underfunding by Government to ensure rural Australians are not foregoing necessary healthcare, the Alliance says.
Detailed components of the proposed National Rural Health Strategy and Implementation Plan can be read here, and include mitigating and adapting to the impact of climate change, telecommunications, digital literacy and connectivity, supporting culturally appropriate healthcare for First Nations people and funding the coordinated delivery of mental health services.
The Alliance proposes that the National Rural Health Strategy be funded through a $1 billion National Rural Health Fund – half for blended or block funding and half for infrastructure – with ongoing funding from the Commonwealth.
The National Rural Health Fund would be supported by rural health capacity and capacity building investment through long-term funding of $6 million over four years and $1.5 million ongoing for the Alliance “to work as the enabler and trusted conduit between communities and Governments”, they write.
The Alliance also proposes funding of $9.7 million over four years and $1.6 million ongoing for a Rural Health Innovation and Evidence Hub to be hosted by the Alliance.
The Hub would support real-time learning from rural health systems innovation across Australia through regular forums in rural communities and a strengthened Australian Journal of Rural Health, supported by an IT platform with artificial intelligence integration.
According to the Alliance, its recommendations seek to address the following three issues:
- Commonwealth and State investments in rural health are not coordinated, transparent or sustained, nor is there a national-level rural health strategy based on population health need.
- There is no sustainable Commonwealth funding to address the “significant shortfall” in rural healthcare funding and services. A “significant proportion” of blended or block funding models would enable augmentation of MBS fee for service, based on population health needs to address equity of access and deliver better health outcomes, they write. Healthcare funding should be flexible and stay in rural and remote communities, not allocated by default to the urban or regional pool of funds because of workforce distribution.
- The Alliance has received triennial peak body funding from the Department of Health and Aged Care for the last seven years without indexation. The current round of funding for the Alliance will cease on 30 June 2026.
Additionally, a national “smart” hub on rural health will facilitate real time information sharing and exchange on the lessons learned from the “many short-term Government grants, pilots, innovative models of care and research in rural communities”, according to the Alliance.
Read full pre-budget submission here: https://www.ruralhealth.org.au/document/improving-access-healthcare-services-and-health-equity-people-living-rural-australia
Addressing chronic health conditions
Lung Foundation Australia, Asthma Australia and Stroke Foundation are calling on the Federal Government to invest in programs and actions that will help improve lung health and prevent stroke.
“The challenges of climate change, unhealthy air and health inequity make it more important than ever for people with asthma to have a voice,” Asthma Australia writes.
The organisation also emphasised the importance of addressing and improving housing conditions.
“Policies and programs should consider the housing features needed to reduce asthma risk and support broader health and wellbeing, be climate-resilient, and energy-efficient,” they write.
In its pre-budget submission, Asthma Australia calls for:
- progress of the National Sustainable Asthma Care Roadmap
- improving air quality by strengthening ambient air quality standards and implementing indoor air quality standards
- Medical Research Future Fund investment of $100 million for the CURE Asthma initiative
- resourcing for the Asthma Australia Consumer Engagement Program.
Lung Foundation Australia has identified seven priorities:
- Reduce pressure on the healthcare system by investing in its Respiratory Care Program
- Address lung cancer inequities by increasing access to specialist lung cancer nurses
- Continue funding for Australia’s best practice lung health education and training program in primary care
- Invest in prevention to safeguard the future health of Australians
- Strategic investment to support implementation of the National Lung Cancer Screening Program
- Improve air quality and climate resilience in Australia
- Reduce the burden of occupational respiratory diseases by investing in research and projects.
Lung Foundation Australia says its recommendations align with several policy documents, including the Department of Health’s National Strategic Action Plan for Lung Conditions and related National Strategic Framework for Chronic Conditions, the National Preventive Health Strategy, the Australian Cancer Plan, the National Tobacco Strategy, and more.
The Stroke Foundation is seeking funding of $13.5 million over four years to support its F.A.S.T. national advertising campaign, enable updating of the living clinical guidelines for stroke management and enhancing the StrokeLine Service.
“Our programs and services are in greater demand than ever before because the health system, the National Disability Insurance Scheme and the aged care system are not adequately meeting the needs of survivors of stroke as they return to the community post-stroke,” says the Foundation.
Bookmark this link to follow Croakey’s coverage of the 2025/2026 Budget