Highlights of 2006-07

Promoting Good Health and Preventing Disease

Australian Better Health Initiative

Australia has one of the best health systems in the world and one of the highest life expectancies. Many people, however, suffer from chronic illness, which is an emerging global phenomenon. The development of chronic disease depends on a number of factors, including lifestyle choices and individual behaviours. While some things such as age, gender, background and family history cannot be changed, other factors influencing health such as weight, blood pressure, stress levels and physical fitness can be influenced by the lifestyle of individuals.

This year, the Department worked with the states and territories to coordinate and finalise implementation plans for the COAG Australian Better Health Initiative which seeks to reduce the incidence of avoidable chronic disease by promoting healthier lifestyles. We commenced a number of associated programs which focused on reducing obesity and encouraged physical activity. For example, the Healthy Active Ambassador program engaged well-known Australians who live healthy and active lives to promote the benefits of healthy life choices to the community and especially to young people. The ambassadors included sports people such as Harry Kewell, chef Luke Mangan and children’s entertainment group Hi-5.

The Department also included the 45 year old health check on the Medicare Benefits Schedule, enabling general practitioners to conduct a thorough assessment of patients between the ages of 45 and 49 years to help them avoid chronic disease through planned intervention strategies (Outcomes 1, 3, 5 and 10).

Early Detection and Prevention of Cancer

While cancer remains the leading cause of death in Australia, survival rates for many common cancers have increased greatly in recent years. During the year, the Department continued to implement the Strengthening Cancer Care initiative to reduce the burden of cancer in Australia, including continued support for the National Breast Cancer Centre for the ongoing delivery of breast and ovarian cancer programs. The Department also coordinated the Government’s response to the Senate Community Affairs Committee report Breaking the Silence: a National Voice for Gynaecological Cancers and commenced a major evaluation of the BreastScreening Australia program.

Another major achievement for the Department was the introduction of the National Bowel Cancer Screening Program. Bowel cancer is currently the second most common internal cancer affecting Australians, but the risk of death can be greatly reduced if the disease is detected early. The new national screening program allows eligible Australians to take a simple and non-evasive test in the privacy of their own home at no cost. The Department distributed over 400,000 screening invitations to 55 and 65 year olds in all states and territories in 2006–07 (Outcomes 1 and 10).

Reducing the Risk of Type 2 Diabetes

Many Australians, particularly those over 40, are at risk of developing type 2 diabetes through lifestyle factors relating to nutrition and physical activity. Without effective interventions, it has been estimated that by 2030 around 3.3 million Australians are likely to have this disease.

During the year, the Department played a strong role in the development of COAG initiatives to improve the detection and reduce the risk of type 2 diabetes in Australia (Outcome 10).

Enhancing Access to Mental Health Care

As part of the Government’s contribution to the COAG Mental Health Reform Package, the Department introduced a range of new
initiatives. This included funding for more than 55 community-based and national projects to enhance community capacity in suicide prevention and funding to enable greater access to mental health services for people living in rural and remote Australia. In addition, funding of over $23 million was committed over five years to expand Lifeline and Kids Help Line and funding of $19 million for the non-government sector to deliver new day program places for people with severe mental illness.

Significantly, new Medicare Benefit Schedule items were introduced in November 2006 to increase access to mental health care. The items encourage private psychiatrists to see more new patients. They also allow people with mental disorders to access Medicare rebates for treatment by psychologists and other allied mental health professionals, on referral from their general practitioner under a mental health care plan, or from a psychiatrist or paediatrician. Uptake of the new items has been positive, with more than 1.2 million Medicare items claimed in the period to 30 June 2007 (Outcomes 3, 5 and 11).

Commitment to Aboriginal and Torres Strait Islander Health

Addressing the health needs of Aboriginal and Torres Strait Islander people continued to be a priority in 2006–07. Our focus was on improving access to mainstream health services and listing medicines with specific benefits for Indigenous people on the Pharmaceutical Benefits Scheme. The Department provided funding for the five urban brokerage services to link Indigenous people with networks of mainstream health service providers. We also conducted workshops for Indigenous health services about Medicare, and promoted the Aboriginal and Torres Strait Islander Child Health Check using a travelling roadshow led by Nova Peris and other prominent Indigenous advocates.

Towards the end of 2006–07, the Department established a Northern Territory Emergency Coordination Centre to support the Government’s response to the Ampe Akelyernemane Meke Mekarle Little Children are Sacred report on the sexual abuse of Indigenous children in the Northern Territory. The Department set up the centre to manage the conduct of health checks for Indigenous children aged under 16 years in the 73 affected Aboriginal communities in the Northern Territory, to identify significant health issues and to plan follow-up treatment. With bases in Canberra, Alice Springs and Darwin, the centre is responsible for the recruitment, assembly, training and deployment of health care teams to carry out these health checks (Outcome 8).

Caring for Older Australians

Changes to the Aged Care Sector

Reforming the aged care sector based on the recommendations put forward in Professor Warren Hogan’s 2004 Review of Pricing Arrangements in Residential Aged Care was a key activity during 2006–07. The Department provided advice to the Government on options which informed the resulting Securing the Future of Aged Care for Australians package that focuses on increasing community care places and encouraging investment in quality residential aged care. The reforms also aim to ensure that people get the right level of care at a fair price.

The Department implemented new compulsory reporting and complaints investigation arrangements to protect people from physical and sexual assault when receiving government-subsidised aged care, and to enforce quality standards. This included establishing a new Aged Care Commissioner to hear complaints about action taken by the Department in relation to investigations, or about the conduct of the Aged Care Standards and Accreditation Agency (Outcome 4).

Improving the Care of Older Patients in Public Hospitals

Another focus during the year was on addressing the needs of older patients who no longer need acute hospital care but experience delays in accessing more appropriate forms of care. In rural areas this may be due to fewer aged care options, while in urban areas people with high complexity and/or high cost care needs may have difficulty accessing residential aged care places.

Following a commitment from COAG, the Department worked with the states and territories to put programs in place to assist older people experiencing these problems in rural and urban areas. As of 30 June 2007, all states and territories had Memoranda of Understanding and implementation plans in place and received their first year funding (Outcome 13).

Improving Access to Medicines and Medical Treatments

The Pharmaceutical Benefits Scheme continued to provide access to a wide range of medicines, including new and expensive drugs, in a way that was affordable for individuals and the community. Newly listed drugs included Herceptin® for early breast cancers, Lantus® and Levemir® for the management of diabetes, and Protos® for the treatment of established osteoporosis.

Pharmaceutical Benefits Scheme Reform

A priority for the Department this year was developing a package of reforms to support the long-term sustainability of the Pharmaceutical Benefits Scheme. These reforms will result in the Australian community paying less for certain medicines and potentially saving more than $580 million over the next four years. Reducing cost pressures will make it easier for the Pharmaceutical Benefits Scheme to include new expensive drug treatments as they become available through medical research and clinical trials, and to meet the needs of the ageing population. Implemented from 1 July 2007, the reforms comprise changes to the pricing arrangements for listed medicines, a pharmacy and wholesaler adjustment package, and streamlined authority approvals for some medicines to increase the time prescribers can spend with patients (Outcome 2).

Amendments to the Medicare Benefits Schedule

Revisions were also made to the Medicare Benefits Schedule to ensure that medical services remain clinically relevant and financially sustainable. Some of these changes include new items to fund antenatal checks for women in rural and remote Australia which are undertaken by nurses, midwives and registered Aboriginal Health Workers on behalf of medical practitioners. Other new items will also assist in the treatment of paediatric patients with fractures and provide for the placement of catheters for administering high dose rate brachytherapy to treat prostate cancer (Outcome 3).

Expanding Private Health Insurance

Following an extensive consultation process with the private health sector, the Department implemented a comprehensive package of reforms aimed at making private health insurance better value for consumers and more relevant to current medical practices. The reforms include a policy and legislative framework to enable and encourage health insurers to pay benefits for a broader range of health care services. They allow health funds to extend hospital cover to include medical treatments that are done without the patient having to go into hospital, for instance, dialysis or chemotherapy undertaken in a patient’s home; and programs to manage and prevent heart disease, diabetes and other chronic diseases.

Standard product information requirements were put in place which make it compulsory for all health funds to describe each of their products, including the price, in a common format. The Department also assisted the Private Health Insurance Ombudsman to develop a new consumer website, <www.PrivateHealth.gov.au>, which provides information about private health insurance and helps consumers to search for, and compare, private health insurance products (Outcome 9).

Combating Drugs and Alcohol Misuse

Illicit drug use and high risk alcohol consumption create significant health, economic and social costs to individuals, families and the community. During 2006–07, the Department worked towards reducing the problems caused by illicit drugs through prevention, treatment and diversion components of the Government’s Tough on Drugs Initiative. The Department administered funding to numerous community-based organisations to implement a broad range of drug prevention activities.

The Department finalised and disseminated national guidelines for emergency departments and ambulance services on the management of acute behavioural disturbances associated with psychostimulants (such as ‘ecstasy’, ‘Ice’, cocaine or ‘speed’) and supported approximately 120 non-government organisations to operate a range of alcohol and drug treatment services. We also introduced a range of education initiatives promoting the responsible consumption of alcohol (Outcome 1).

Building the Health Workforce to Meet Community Needs

Developing and expanding the health workforce to meet the nation’s needs now, and into the future, is another issue which has been given attention by COAG. Throughout the year, the Department worked closely with the states and territories on a range of initiatives aimed at ensuring the health workforce is able to respond to the evolving health care needs of the Australian community.

The Department worked in consultation with states and territories, medical colleges and private hospitals to expand medical specialist training beyond traditional public teaching schools, into regional, rural and ambulatory settings, private hospitals and community settings. This led to funding for 10 new pathology training positions from July 2007 and identification of 16 other specialist training positions across Australia for agreement with jurisdictions and specialist colleges to commence in January 2008. The Department also contributed to the COAG agreement for national arrangement for the registration of practitioners and accreditation of training courses, starting with the nine health professions currently registered in all jurisdictions. These arrangements will aid workforce mobility, improve safety and quality, and reduce red tape (Outcome 12).

Progressing National Health Systems

Establishment of the National Health Call Centre Network

The Department played a lead role in implementing COAG’s February 2006 commitment to a National Health Call Centre Network. The network will provide callers with round-the-clock phone access to nurses who can consider symptoms and advise callers on how urgently they may need to be seen by a health professional. If treatment is necessary, nurses can also advise the type of treatment that callers should seek – whether in a hospital or from a general practitioner.

The Department worked collaboratively with all jurisdictions to develop the overarching framework for the establishment of the National Health Call Centre Network company. The company has responsibility for ensuring the roll-out of the service with full national coverage to be achieved by July 2011. Currently, the Commonwealth, the Australian Capital Territory, New South Wales, the Northern Territory, South Australia and Western Australia have formally joined the network, with Queensland, Victoria and Tasmania signalling their intent to join in the future. Calls are currently being taken in the Australian Capital Territory, Western Australia, the Northern Territory, and South Australia. It is expected that calls will be taken in New South Wales in mid–2008, with other states following after that (Outcome 5).

e-Health

The Department continued to provide national leadership in the electronic management of health information through a range of e-Health initiatives to improve the accuracy of patient records and other information available to doctors. For example, with our support, a Shared Electronic Health Record is being rolled out across the Northern Territory. Currently, over 12,000 people have a shared record, with their essential health information available, with their permission, to around 320 health care providers in hospitals, general practice and community care. Registered health care providers can create health profiles for their patients which can be viewed online, as well as medical event summaries and pathology results. They will also be able to access participating patients’ hospital inpatient discharge and emergency event summaries (Outcome 10).

Knowledge Growing, Knowledge Sharing

Support for Medical Research

Investment in health and medical research into new ways to treat and prevent disease has more than doubled in recent years, with a significant portion of these funds provided by the Department. In 2006–07, this included funding for research into serious childhood diseases and conditions, and support for the establishment of a research and development facility which will develop and test life-saving biopharmaceuticals. The Department provided funding to support the National Adult Stem Cell Centre, which will enable researchers to apply stem cell research to diseases such as Schizophrenia, Parkinson’s disease and Motor Neurone Disease (Outcome 10).

APEC Health Ministers’ Meeting

The Asia-Pacific Economic Cooperation (APEC) Health Ministers’ Meeting from 6 to 8 June 2007 provided policy and logistical challenges for the Department which was responsible for the event. The Department worked closely with other agencies such as the Department of the Prime Minister and Cabinet, the Department of Foreign Affairs and Trade, and AusAID to ensure that the event was successful. The meeting provided a unique setting for an open dialogue between economies in the region about emerging health threats, such as avian influenza, and agreed collaborative measures to reduce the risk of these threats and their impact should they occur (Outcome 10).

World Health Assembly

This year I had the honour of being elected as President of the World Health Assembly – the supreme decision making body of the World Health Organization. The Assembly met in Geneva in May to discuss issues relating to avian and pandemic influenza, and the application of the International Health Regulations, smallpox eradication, and non-communicable diseases. Attention was also given to the need for better medicines for children and progress in the rational use of medicines. Information on World Health Assembly achievements in 2007 can be found at <www.who.int> (Outcome 10).

New Portfolio and Organisational Arrangements

On 21 March 2007, the Department welcomed the Hon Christopher Pyne MP as Minister for Ageing and Senator the Hon Brett Mason as Parliamentary Secretary to the Minister for Health and Ageing.

We implemented a new divisional structure on 1 August 2006 to more effectively manage new and expanded responsibilities and to improve the alignment of related functions under the leadership of the Executive team. This followed the move of the National Health and Medical Research Council from a departmental business unit to an independent statutory authority within
the Health portfolio on 1 July 2006. Full details on the new divisional structure can be found in the following ‘Departmental Overview’.

Our People

The continuing strong performance of the Department could not have been achieved without our dedicated and professional staff.

2006 Staff Survey

A record 90 per cent of staff at work on 22 November 2006 participated in our 2006 Staff Survey. I believe this reflects broad recognition that the survey is an important activity and a way for staff to make their views known.

I was pleased to see from the results that we have made improvements since last year. More staff consider that they have real opportunities to participate in decision making. An increasing number of staff also feel that the Department appreciates the skills and knowledge of mature age workers, and the cultural diversity of our workforce in general. While great progress has been made, there are still some areas where we will strive to do better. I will continue to focus our collective energies on these areas.

Staff Generosity

No matter how busy their lives, our staff remain willing to give time, effort and donations to support others. In 2006–07, staff made a wonderful contribution of $53,050 to 15 chosen charities under our voluntary Workplace Giving Program. The Department’s long-standing support for Hartley Lifecare, which supports children and adults living with a physical disability to maximise their potential, also continued with a passion, with over $119,000 raised by staff in this year’s cycle challenge. I am extremely proud of our participation in this event, which gets better each year. In addition, staff made 382 donations to the 2006 Annual Red Cross Canberra Sunday Times Corporate and Community Blood Donor Challenge, placing us third for the number of donations made by a public sector agency.

Collective Agreement Five

In 2006–07, the Department negotiated with staff and union representatives on the development of a new collective agreement. The aim of the negotiations was to settle an employment package of salary and flexible conditions that is both affordable and as competitive as possible, and to continue to build a supportive work environment. An in-principle agreement was reached providing competitive pay increases and a four year agreement which was subsequently put to a staff vote and accepted by 91% of respondents in August 2007.

The Year Ahead

During the coming year, the Department will continue to help Australians to adopt healthier lifestyles and reduce their risk of preventable disease through new public information and education campaigns on nutrition, physical activity, skin cancer and breastfeeding. We will expand the Medicare Benefits Schedule to include items that encourage new medical graduates to train in non-procedural specialties and enable families to access after-hours general practice services. We will also deliver initiatives aimed at addressing the shortage of general practitioners in rural and remote Australia.

Improving the health of Aboriginal and Torres Strait Islander people will continue to be a priority. Better health outcomes are expected from initiatives such as Health@Home Plus – a nurse-led home visiting program for mothers and babies, and other ongoing activities.

We will focus on the roll-out of child health checks as part of the Northern Territory Emergency Response and necessary follow-up services, including for oral health and ear, nose and throat conditions.

In addition, the Department will work with the sector to deliver the additional services to be funded by the $100 million injection for 2008–09 to 2009–10. This will include further adult health checks, primary care and allied health, and specialist services delivered from regional centres, and the establishment of the Remote Area Health Corps to help recruit, deploy and support the necessary health workforce.

Implementation of the mental health, health workforce, Pharmaceutical Benefits Scheme and aged care reforms will continue to produce not only short-term, but medium and long-term benefits for the nation as a whole.

Finally, we will continue to focus on the delivery of high quality policy advice and program administration in order to ensure our objective of better health, better care and better life for all Australians.

For a comprehensive discussion of the Department’s key objectives and priorities for the next reporting year, please refer to the 2007–08 Health and Ageing Portfolio Budget Statements.

Jane Halton PSM
Secretary
Department of Health and Ageing