The Federal Budget and health: what’s on the table (or not)

Below is a short summary of items related to tonight’s Federal Budget and health: what is promised/likely; what has been asked for; and what seems to be missing.

What is promised/likely in the federal budget

• Expansion of the national bowel cancer screening program
(Some reaction to this will follow in the next post.)

• Funding for public dental waiting lists, oral health promotion.

• Department of Health and Ageing secretary Jane Halton has hinted the tobacco tax may rise, and there have been some suggestions the Government may have been receptive to calls for the abolition of duty free cigarette sales.

• Cuts to the Medicare Safety Net are foreshadowed – see here and here.

• Cuts to private health insurance subsidies for natural therapies are expected.

• Funding for Indigenous suicide prevention (although there are concerns about how this has been organised).

• Funding for personal helpers and mentors intiative for those with severe mental illness.

• Aged care reforms.

• National Disability Insurance Scheme.

***

What some health and related groups have been asking for

• Reform of alcohol taxation.

• ACOSS has called for cuts to wasteful spending (including in health) to fund social reforms. ACOSS is also concerned by reports of cuts to single parents entitlements.

***

Rural health

The National Rural Health Alliance has created a hub for all budget news related to rural and remote health matters.

***

What’s likely to go missing? 

A far cry from last year’s focus on mental health

Sebastian Rosenberg, Senior Lecturer, Brain and Mind Research Institute, Sydney Medical School, University of Sydney
Associate, ConNetica Consulting Pty Ltd, writes:

Like the eye of Sauron, the Gillard Government’s attention remains firmly fixed on a surplus. Twelve months ago, its gaze was fixed briefly on mental health. Treasurer Swan went as far as to call the $2.2bn 5 year package the ‘centrepiece’ of last year’s budget.

The recent leak of a further $51m for Personal Helpers and Mentors called last year’s mental health package ‘unprecedented’ (I am not sure how this claim can be justified given that $1.6bn was spent on the top three Better Access Program items alone between November 2006 and November 2011, under the $5bn National Action Plan on Mental Health initiated by the Howard and Iemma governments).

Leaving aside the spin and maths, the politics suggest that between the surplus, the National Disability Insurance Scheme, ageing and some other matters, it is just not mental health’s turn.

We had our turn last year and despite the fact that the investment made struggles to maintain mental health’s share of the overall health budget, we must simply wait till the wheel turns again.

The new mental health commissions, both state and federal will have to think creatively about which services are really needed. National funding arrangements, including Activity Based Funding and the new lines of demarcation between the feds and the states in health have left responsibility for community mental health care most unclear and future funding for this area imperiled.

The governments have not agreed to any new National Action Plan but have signed a partnership agreement under CoAG worth $200m over 5 years.

There have been only two surveys specifically about mental health in the Australian community conducted by the Australian Bureau of Statistics.  In 1997 it showed that of people with a mental illness in the last 12 months, only 38% received any care for their illness.  In 2007 that figure was a disappointing 35%.

While the success or otherwise of the Better Access Program has been the subject of considerable debate, what is not in question is the Program’s capacity to highlight the massive latent community demand for mental health care.  Well over 15m services have been provided to Australians since the Program began.

The level of damage caused by mental illness, together with the level of unmet need in the community, mean that as far the budget goes, every year should be mental health’s year, at least until the community feels confident it has a service system on which it can rely.

Note from Croakey: Readers may be interested in this account of a new national mental health strategy for Canada. It proposes six strategic directions:

Promoting mental health and prevention of mental illness; Fostering recovery and upholding rights; Providing access to the right services, treatments and supports; Reducing disparity and addressing diversity and those suffering mental-health problems; Working with first nations, Inuit and Métis, communities where addictions and suicide are major problems; Mobilizing leadership and fostering collaboration.