The Albanese Government is now “in the home stretch” of completing the Federal Budget, due to be handed down on 9 May, with final decisions to be made “over the next fortnight or so”, Treasurer Jim Chalmers said today.
He was speaking before heading to Washington DC for a series of meetings in the context of a slowing global economy and warnings from the International Monetary Fund that “the global economy is on an increasingly perilous path”.
“The Treasury and the Reserve Bank are not currently expecting a recession here at home, but the economy will slow and that’s why this Budget is so important in a little under four weeks’ time because what we need to do is provide some responsible cost-of-living relief without adding to inflation; we need to lay the foundations for future growth in our economy, at the same time as we try and make ourselves more resilient to these sorts of international shocks,” he told ABC Radio National.
The Australia Institute released a report this week highlighting growing inequity as a critical concern amid pressure on the Government to reconsider the Stage 3 tax cuts, which mostly benefit the top 10 percent of income earners.
The report says that inequality has been “on steroids” in Australia over the last decade, with the bottom 90 percent of Australians receiving just seven percent of economic growth per person since 2009, while the top 10 percent of income earners reap 93 percent of the benefits.
The findings reflect the concentration of Australian businesses into oligopolies, the weakening of unions in the Australian labour market, and a worldwide trend for the benefits of economic growth to go disproportionately to the top 10 percent of income recipients, says the report.
This, then, is the context for wide-ranging asks from the health and social sectors. These will be summarised in a #HealthBudget2023 series at Croakey, with this first article covering pre-budget submissions of the Consumers Health Forum of Australia (CHF) and Allied Health Professions Australia (AHPA), as well as a collective campaign to address poverty through increasing income support payments.
Croakey readers can sign up here to receive budget updates from the Department of Health and Aged Care.
Long COVID
Both the CHF and AHPA submissions highlight concerns about the wide-ranging impacts of long COVID, and call for investment to improve prevention, treatment and support.
The CHF has called for faster and more equitable access to long COVID treatment, including multidisciplinary and person-centred care, a research and development grant program to identify and develop treatment options, and for funding of community supports to meet the needs of those affected as well as their families/carers/dependents.
The CHF says there is growing evidence that long COVID will affect many Australians, “with implications for the health system, the economy, government payments and supports, and the whole community”.
“People are taking long term sick leave, losing their jobs, returning to part time or lower skilled work, and risk permanent disability. Those affected by long COVID may have to rely on government payments and health services, they will need more paid and unpaid care, and they may not be able to fully meet their own responsibilities to provide care for their children and/or others,” says the submission.
The CHF says an effective response to long COVID requires:
- reducing COVID infections in the community
- earlier treatment and multi-disciplinary care for patients, and support for related needs, such as housing, income, and prevention of family violence
- expanding the reach of specialist clinics and other primary care options that provide consistent, evidence-based treatment.
- conducting and supporting Australian based research into the condition, while using Australian and overseas research to educate health providers and update treatment guidelines
- increasing awareness of the condition, particularly in Aboriginal and Torres Strait Islander, culturally and linguistically diverse, and other communities living with health disadvantage, so that people who need it can get advice and treatment
- establishment of the Australian Centre for Disease Control.
Allied Health Professions Australia has also called for improved access to multidisciplinary allied healthcare for people with long COVID-19, and for the Chronic Disease Management Plan eligibility criteria to be amended to explicitly permit access to subsidised allied health sessions for people with long-COVID symptoms three months from their initial illness.
They have also called for Primary Health Networks to be funded to commission integrated, multidisciplinary primary care clinics, especially in rural and remote areas.
“Allied healthcare professionals tell us the system for providing support to people experiencing post- COVID-19 symptoms is fragmented, contingent on location and socioeconomic circumstances, and poorly supported by Medicare, with MBS-funded allied health sessions capped at five allied health sessions per calendar year,” says the AHPA submission.
“A significant proportion of people with long-COVID report reduced workforce participation including limited working hours and reduced ability to perform the same duties. Five subsidised allied health sessions for people with significantly reduced income capacity is woefully insufficient.”
Perhaps the Treasurer will take note, having recently had COVID himself (and not for the first time).
Support consumer voices
Consumers Health Forum of Australia submission
The CHF has asked for $17.8 million over three years so the organisation can fund improved consumer leadership, engagement, research and best practice initiatives.
By not investing enough in consumer engagement, the former Coalition Government allowed the voices of those with vested interests to drown out consumers’ input into health policy and service delivery, says the CHF.
The Forum has launched a petition urging the Treasurer to ensure consumers can “have a real voice in influencing, designing and influencing changes to Medicare and other primary health reforms”.
Its pre-budget submission also includes calls for the Government to:
- increase MBS rebates for GP and specialist consultations
- introduce a General Practice Bulk Billing Incentive Payment to encourage practices to bulk bill a higher proportion of payments, particularly for priority populations
- introduce a General Practice Extra Support Services Payment to encourage practices to offer person centred care, particularly for people living with health disadvantage
- encourage GPs to routinely provide 12-month referrals to specialists, and longer/indefinite referrals for ongoing conditions, enabling follow up where needed
- increase the proportion of health funding committed to preventive health in this Budget and future years
- establish and resource the prevention fund, including an independent governance body to advise government on the direction of the fund
- increase funding for health literacy and self-care initiatives
- increase funding for crisis care that supports people with significant mental health and episodic conditions in the community.
- funding for a social prescribing program to improve consumers’ overall health and wellbeing
- introduce a dental benefits scheme that offers income support recipients and other low-income adults basic dental care with capped funding and choice of provider.
Improving access to allied health
The Allied Health Professions Australia submission
Build a sustainable allied health workforce – nationally consistent allied health workforce data is needed to support quality workforce planning, sustainability and service modelling. planning, sustainability and service modelling. Despite allied health being the second largest health workforce, there remains no national allied health workforce strategy and no clear picture of the various settings, sectors and locations in which allied health professionals work.
Integrate allied health into existing digital infrastructure – interoperable, accessible digital systems are required to enable the efficient and timely sharing of allied health information and the integration of allied health information to My Health Record (MHR) will improve the quality of health care, relieve acute care pressure points, and enable data generation to support patient, practice and community-level planning.
Fund allied health services in residential aged care – repeating recommendations made in other forums for allied health to become an intrinsic part of residential care, provided at a level appropriate to each person’s needs. Allied health services are essential to maintain aged care residents’ wellbeing and facilitate the restoration of function.
The Royal Commission into Aged Care Quality and Safety found that allied health services are underused and undervalued across the aged care system and that this produces morbidity, mortality, and quality of life impacts, including those associated with dementia, mental health, malnutrition and falls. The Royal Commission called for allied health to become an intrinsic part of residential care, provided at a level appropriate to each person’s needs.
Improve participant utilisation of allied health services in the NDIS – reiterating recommendations made in other forums to improve the utilisation of allied health services, which are vital to help NDIS participants maintain and improve function, build their capacity, and access assistive technology. Allied health services are vital to help NDIS participants maintain and improve function, build their capacity, and access assistive technology.
Participants use significantly fewer allied health services than they are entitled to under their plans. NDIS pricing is increasingly out of step with allied health workforce costs, exacerbating challenges in workforce recruitment and retention.
#RaiseTheRate
A longstanding collective campaign to push the Government to increase income support payments has also gathered steam ahead of the budget. These tweets below were shared by Croakey’s rotated Twitter account, @WePublicHealth, during a recent National Day of Action.
Bookmark this link to track Croakey’s coverage of #HealthBudget2023
