Online version of the 2012-13 Department of Health and Ageing Annual Report

Outcome 13: Acute Care

Improved access to public hospitals, acute care services and public dental services, including through targeted strategies, and payments to state and territory governments

Page last updated: 29 October 2013

Major Achievements

  • Around 400,000 patients will have better access to public dental services following the establishment of the National Partnership Agreement on Treating More Public Dental Patients, which will provide $344 million to states and territories over three years.
  • Public hospitals will be funded for the services they actually deliver under a new national system of Activity Based Funding for public hospital services, which started on 1 July 2012. The Department provided national leadership for implementation of national health reform. Commonwealth payments for public hospital services of over $13 billion were made through the National Health Funding Pool to Local Hospital Networks and states and territories.
  • Tasmanians will get improved health care under new palliative care and elective surgery measures.

Challenges

  • Enable more people to get life-saving and life-transforming organ and tissue transplants by working with states and territories to develop a nationally consistent policy for the special release of cord blood units for purposes other than bone marrow reconstitution.

Performance

This is a doughnut chart and a table that summarises the results for all deliverables and key performance indicators in outcome 13 during 2012-13. The results show that 89.5% were met compared with 72.2% in 2011-12, 0% were substantially met compared with 13.9% in 2011-12 and 10% were not met compared with 13.9% in 2011-12.

89.5% MET

0% SUBSTANTIALLY MET

10.5% NOT MET

Period Met Substantially met Not met
2012-13 89.5% 0.0% 10.5%
2011-12 72.2% 13.9% 13.9%

Programs contributing to Outcome 13

Outcome Strategy

Outcome 13 aims to improve access to and the efficiency of public hospitals and acute and subacute care services. In 2012-13, the Department worked to achieve this Outcome by managing initiatives under the programs outlined below.

Program 13.1: Blood and organ donation services

Program 13.1 aims to improve Australians’ access to organ and tissue transplants, and support access to blood and blood products.

Improve Australians’ access to organ and tissue transplants

In 2012-13, the Department continued to help implement organ and tissue transplant reforms by providing advice and governance support to the Australian Organ and Tissue Donation and Transplantation Authority. The reforms aim to achieve a significant increase in the number of life-saving and life-transforming transplants for Australians by introducing nationally consistent donation processes and systems in hospitals. This will be supported by dedicated donation specialists, together with a nationally coordinated approach to community and professional awareness and education. The Department also implemented the Supporting Leave for Living Organ Donors initiative to help alleviate the financial stress of living organ donation.

The Department continued to fund the Australian Bone Marrow Donor Registry (ABMDR) to maximise the chance of a suitable donor match, either in Australia or overseas, for a patient needing a bone marrow, cord blood or peripheral blood stem cell transplant. In 2012-13, the ABMDR undertook 638 donor searches on behalf of Australian patients, with 288 Australian patients with leukaemia or other life-threatening haematological or immune system diseases receiving a bone marrow, peripheral blood or cord blood transplant. Of these, 116 Australians accessed treatment through the ABMDR and 172 Australians accessed treatment through international registries. Australia provided 77 bone marrow, cord blood or peripheral blood stem cell donations to overseas recipients. Through the Bone Marrow Transplant Program, the Department approved financial assistance for 285 patients in Australia, for the costs of obtaining and transporting bone marrow or stem cells from international donors.

The Department also funded the National Cord Blood Collection Network to collect, process, bank and release high quality umbilical cord blood stem cell units to Australian and international transplant centres for patients needing a transplant. In 2012-13, 44 Australian patients received single or double cord blood unit transplants. The network used 27 cord blood units from the Australian inventory and imported 31 cord blood units from international registries for patients for whom a suitably matched unit was not available from within the Australian inventory. In addition, 49 units were exported to international patients.

Scientific developments in the cord blood sector required collaboration between the Department and state and territory governments to consider the medical, ethical, financial and legal implications for the release of cord blood units for purposes other than bone marrow reconstitution. Work will continue in 2013-14 to develop a robust national policy to guide future operations of the network.

Support access to blood and blood products

The Department ensured access to affordable and quality blood supply by providing governance support to the National Blood Authority (NBA) and delivering the Commonwealth’s contribution of funding to the blood sector. In addition, the Department chaired the Jurisdictional Blood Committee (JBC) and continued to support the development of strategies that support appropriate blood use, a reduction in inventory wastage, and better forecasting and demand management across jurisdictions.

The Department also contributed to the Hepatitis C Litigation Settlement Scheme, which provides a contribution to the out-of-court settlement costs for eligible individuals who contracted hepatitis C as a result of a blood transfusion in Australia between 1985 and 1991.

Program 13.2: Medical indemnity

Program 13.2 aims to ensure the stability of the medical indemnity insurance industry so that insurance products for medical professionals are available and affordable.

Ensure the stability of the medical indemnity insurance industry

Medical indemnity insurance is a specialised form of professional indemnity cover that provides surety to medical practitioners and their patients in the event of an adverse outcome arising from medical negligence. Affordable and stable medical indemnity insurance allows the medical workforce to focus on the delivery of high quality medical services.

By subsidising high cost claims and providing a guarantee to cover exceptional claims, the Government ensures that the medical indemnity insurance industry continues to remain stable and secure.

Ensure that insurance products are affordable for doctors

The Department administers a number of schemes – such as the Premium Support Scheme and the Run-off Cover Scheme – designed to maintain and improve premium affordability for medical practitioners.

Ensure availability of professional indemnity insurance for eligible midwives

Privately practising midwives need insurance to meet the requirements of the Government’s National Registration and Accreditation Scheme. Indemnity insurers are reluctant to offer professional indemnity insurance to midwives, as the small potential premium pool and potentially high risk exposure means it is not commercially viable. The Australian Government contracted an insurer, Medical Insurance Group Australia (MIGA), to provide professional indemnity insurance to eligible midwives, to ensure that women and their families can access midwifery care.

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Program 13.3: Public hospitals and information

Program 13.3 aims to increase efficiency and capacity in public hospitals through National Health Reform, improved access to public dental services, and increase support for health services for the Torres Strait.

Increase efficiency and capacity in public hospitals

The Council of Australian Governments’ National Health Reform Agreement introduced nationally consistent Activity Based Funding (ABF) for public hospital services aimed at improving the efficiency of Australia’s public hospital system. Under ABF, Local Hospital Networks receive Commonwealth payments based on the actual number and type of services they provide.

In 2012-13, the Department made submissions to the Independent Hospital Pricing Authority (IHPA) to help develop the 2013-14 Pricing Framework, National Efficient Price (NEP) and National Efficient Cost Determinations. These determinations have applied to Commonwealth public hospital payments since 1 July 2013.

Subacute Care

Elective Surgery

Elective surgery is surgery that, in the opinion of the treating clinician, is not an emergency and can be delayed for at least 24 hours. The National Partnership Agreement on Improving Public Hospital Services rewards those states and territories that achieve their National Elective Surgery Target (NEST). This increases the percentage of patients who receive their elective surgery within clinically recommended times (NEST Part 1) and at the same time reduces the number of patients who have already waited longer than the clinically recommended time (NEST Part 2). Measurement of the NEST began on 1 January 2012 with the Department monitoring state and territory calendar year progress towards achieving the targets.

Emergency Departments

The National Partnership Agreement on Improving Public Hospital Services rewards states and territories that achieve their National Emergency Access Target (NEAT), requiring by 2015 that 90% of patients leave the emergency department within four hours of presentation, either by admission, transfer to another hospital or discharge. Measurement of the NEAT began on 1 January 2012 with the Department monitoring state and territory calendar year progress towards achieving the targets.

Improve access to public dental services

The 2012-13 Budget included $344 million over three years for states and territories to provide public dental services to around 400,000 patients waiting for public dental services. States and territories will use this funding to provide a range of dental services including preventive and restorative services and dentures by expanding the workforce; extending opening hours; purchasing specialist services; engaging the private sector; and building infrastructure.

The Department also continued to provide funding for mobile Indigenous dental pilot projects that use transportable equipment and mobile staff in rural and regional areas.

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Outcome 13 – Financial Resource Summary

Program (A) Budget Estimate 2012-13
$’000
(B) Actual 2012-13
$’000
Variation (Column B minus Column A)
$’000
Program 13.1: Blood and Organ Donation Services1
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 14,600 14,114 ( 486)
Special appropriations
National Health Act 1953 - Blood Fractionation, Products and Blood Related Products - to National Blood Authority 674,348 674,348 -
Departmental Expenses
Departmental Appropriation 2 3,492 3,222 ( 270)
Expenses not requiring appropriation in the current year 3 90 159 69
Total for Program 13.1 692,530 691,843 ( 687)
Program 13.2: Medical Indemnity
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 175 174 ( 1)
Special appropriations
Medical Indemnity Act 2002 96,589 - ( 96,589)
Midwife Professional Indemnity
(Commonwealth Contribution) Scheme Act 2010 334 - ( 334)
Departmental Expenses
Departmental Appropriation 2 489 450 ( 39)
Expenses not requiring appropriation in the current year 3 13 21 8
Total for Program 13.2 97,600 645 ( 96,955)
Program 13.3: Public Hospitals and Information
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 207,203 197,533 ( 9,670)
to Local Hospital Network Special Account ( 107,000) ( 107,000) -
Special Account
Local Hospital Network Special Account 107,000 105,739 ( 1,261)
Departmental Expenses
Departmental Appropriation 2 49,894 48,856 ( 1,038)
Expenses not requiring appropriation in the current year 3 1,013 16,333 15,320
Total for Program 13.3 258,110 261,461 3,351
Outcome 13 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 221,978 211,821 ( 10,157)
to Special Accounts ( 107,000) ( 107,000) -
Special appropriations 771,271 674,348 ( 96,923)
Special Account 107,000 105,739 ( 1,261)
Departmental Expenses
Departmental Appropriation 2 53,875 52,528 ( 1,347)
Expenses not requiring appropriation in the current year 3 1,116 16,513 15,397
Total expenses for Outcome 13 1,048,240 953,949 ( 94,291)
Average Staffing Level (Number) 211 210 ( 1)
  1. This program includes National Partnerships paid to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.
  2. Departmental appropriation combines 'Ordinary annual services (Appropriation Bill 1)' and 'Revenue from independent sources (s31)'.
  3. 'Expenses not requiring appropriation in the budget year' is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses - please refer to the departmental financial statements for further information.

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