1996-1997
1.1: Public Health Development and Programmes
The 1996-97 Portfolio Budget Statements, informs Senators and Members of Parliament of the proposed allocation of resources to portfolios outcomes and their objectives and targets including the agencies within the Health and Family Services portfolio.
Objective
- Strong national public health capacity and effective national leadership in a more federal public health environment.
Goals
- Better health outcomes for population groups in agreed priority areas.
- Improved access to a range of preventive and primary health care services.
- A national and cooperative approach to public health effort in Australia.
- Strengthened infrastructure to support effective national public health action.
- Recognition of public health as an essential national activity integral to the best use of our wider health and community services system.
- Strong partnerships with other sectors which have an important public health contribution in priority areas, e.g. transport, environment, employment and education, housing and primary industry.
- A population which is better informed about public health risks, disease prevention and management, and opportunities for better health throughout life.
- High quality advice to government on national needs and priorities, related action plans and on specific public health issues.
Strategies
- In partnership with the States, Territories and other stakeholders:
- develop and implement a national public health framework for all health promotion, protection and disease prevention and control activities in Australia;
- build and maintain a strong infrastructure to support national public action, including the health workforce, primary health care system, legislative framework, research and development, information base and continuous improvement programme; and
- extend and apply a population health framework to the whole of health system planning and financing.
- Co-ordinate developing and implementing national public health strategies in agreed priority areas, and which involve other levels of government, non-government organisations, relevant sectors and industry, and consumer groups (as appropriate). Priority areas include:
- diabetes;
- AIDS and other communicable diseases;
- women's health, including breast and cervical cancer;
- nutrition;
- injury prevention; and
- drugs.
- Establish effective mechanisms to ensure intersectoral action in agreed priority areas at the national level.
- Build and maintain an evidence-based national public health policy and planning capacity to guide future investment in national interventions by Australian governments and other stakeholder groups.
- Involve the Australian community in planning, implementing, monitoring and reporting on national public health action.
- Together with States, Territories and other stakeholders, develop and implement effective strategies to increase public awareness of public health risks and the benefits of disease prevention and management to government and the community.
- Monitor and report to government and the community on progress of national public health strategies against key health outcome measures and performance indicators.
- Provide timely and accurate advice to government on public health issues, priorities, action and outcomes.
Performance Indicators and Targets
Effectiveness
- Incidence, prevalence and mortality rates attributable to specific diseases, injuries, environmental hazards and licit and illicit drug use including a comparative analysis of specified target groups.
- Qualitative evidence from key stakeholders and the Australian community that major public health infrastructure initiatives:
- meet the needs of key target groups; and
- have a positive impact on improving public health planning, delivery and monitoring/reporting.
- Multi-lateral and bilateral National Public Health agreements/Memoranda of Understanding negotiated and signed with all States and Territories.
Target: All states signed up to NPH agreements by scheduled dates.
- National public health strategies under way in agreed priority areas.
- Evaluative evidence of change in knowledge, attitudes, skills and behaviours of specific target groups as a consequence of health promotion and disease prevention strategies.
- The adaption and effective use of nationally recommended screening and immunisation policies, best practice guidelines and targets.
Target: 70 per cent participation among women aged 50 to 69 in breast screening, and 80 per cent participation among women aged 16 to 69 in cervical screening, by 1999.
Efficiency
- Per cent and number of activities/initiatives/milestones completed on time and within budget.
- Extent of savings to the Australian health system and Australian society attributable to nationally coordinated health promotion and prevention strategies as measured by case examples.
Quality
- Information from key stakeholders that the Commonwealth's inputs have been of high standard, timely, relevant and contributed to effective results and responses.
Equity
- Per cent and number of public health services and interventions accessed by specified target groups, including Aboriginal and Torres Strait Islanders, and people with a disability compared with the general population, adjusted for differences in need.
Budget Measures
Election Commitments
Funding for Breast Feeding Awareness Campaign
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
1.0 | 1.0 | - | - |
Purpose of measure
To inform women of the benefits of breast feeding, with the aim of increasing the percentage of Australian women who breastfeed their children, particularly in the first six months of life.Expected Implementation Strategies for Measure
Five key action areas are identified:- Family education - increasing awareness among women, their partners and families of the importance of breastfeeding.
- Hospital support - the development of standards for hospitals on ways to encourage and support breastfeeding, for incorporation into the hospital accreditation standards.
- Post-hospital support - the development of standards for community health services on ways to encourage and support breastfeeding women after discharge from hospital; support for the Nursing Mothers' Association of Australia to strengthen their ability to provide support to women from different cultural backgrounds; and the development of guidelines for employers on ways to provide support for women who wish to continue breastfeeding after returning to work, particularly employers with a large blue-collar workforce.
- Health worker education - the development of materials for health workers to ensure that consistent, accurate advice is given to women about infant feeding; and enabling Aboriginal and Torres Strait Islander Health Services to undertake programmes on infant feeding based on locally determined needs and priorities.
- Monitoring - development of national agreed definitions on infant feeding, and development of some standardised questions on infant feeding, to improve the collection and interpretation of breastfeeding data in Australia.
Intended Impacts of Measure
The breastfeeding initiative is expected to lead to:- promotion of the benefits of breastfeeding, particularly in the first six months of life, and the positive correlations between breastfeeding and the health of babies and young children.
- increased rates of breastfeeding, particularly in certain Aboriginal and Torres Strait Islander communities, thereby improving the health of Aboriginal and Torres Strait Islander children.
New Directions in Public Health - Funding the Promotion of Folate Intake
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
0.2 | 0.2 | - | - |
Purpose of measure
To increase the percentage of Australian women of child-bearing age who consume the recommended intake of folate (folic acid), either through diet or dietary supplementation.Expected Implementation Strategies for Measure Development, trialing and implementation of a folate education programme in two States, targeted at:
- women of child-bearing age;
- individuals and organisations involved in providing education, employment and care for women; and
- the food and pharmaceutical industries.
Once evaluated, the programme will be provided as a model for other States and Territories.
Monitoring of the impact on neural tube defects of the National Health and Medical Research Council's recommendations that voluntary fortification of selected foods will be permitted in Australian food regulations.
Intended Impacts of Measure
I ncreased awareness among women of child-bearing age and individuals and organisations involved in providing education, employment and caring for women, of the relationship between folate and neural tube defects, food sources of folate, and supplementary sources of folate.
Increased awareness among the food and pharmaceutical industries of the importance of adding folate to their products at the recommended levels.
Extension of Funding for the HIV/AIDS and Related Issues Programme
Financial Implications
- women of child-bearing age;
- individuals and organisations involved in providing education, employment and care for women; and
- the food and pharmaceutical industries.
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
44.7 | 51.5 | 52.3 | - |
Purpose of measure
To continue the National HIV/AIDS Programme and to expand the focus of the programme to address related communicable disease and sexual health issues. [h5>]Expected Implementation Strategies for Measure The Programme will continue to strengthen core HIV/AIDS activities but with a broader scope to include related communicable diseases and sexual health issues over the period of the strategy.The programme will have two components:
- National activities undertaken by the Commonwealth:
- a continued national research capacity closely linked to a departmental monitoring and evaluation function to enable collection, review and analysis of relevant data in relation to policy objectives;
- national co-ordination and leadership including a ministerial council, advisory structures, funding of activities of peak consumer organisations, the capacity to address emerging national priorities including Aboriginal and Torres Strait Islander sexual health; and
- national education and information activities including co-ordination of education activities and development of national education tools and models to ensure consistency, currency and best practice in education messages.
- State and community based activities implemented through Commonwealth/State performance agreements which include specific outcome measures and levels of service maintenance in relation to HIV/AIDS and related issues linked to Commonwealth funding to States and Territories.
Intended Impacts of Measures
Outcomes will include reduced transmission of HIV, hepatitis C, blood borne viruses and sexually transmissible diseases.New Directions in Public Health - Continue Funding of the National Childhood Immunisation Programme
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
2.5 | 16.2 | 14.3 | - |
Purpose of measure
To increase immunisation levels of Australian children to prevent continuing outbreaks of vaccine-preventable diseases.Expected Implementation Strategies for Measure
The programme will be nationally co-ordinated. The Commonwealth will continue to provide specific purpose payments to States and Territories for the purchase of childhood vaccines recommended by the National Health and Medical Research Council (NHMRC). Funding for the provision of information to the Australian Childhood Immunisation Register will be shared between the Commonwealth and States and Territories.The Commonwealth will undertake further education programmes to increase the knowledge of providers and the community about the importance of immunisation as a disease preventive measure.
Funding will also be allocated for research into immunisation.
Intended Impacts of Measure
National immunisation coverage targets have been set, based on recommendations by the NHMRC. A National Register will allow comprehensive monitoring of immunisation coverage rates. The objective is to increase immunisation coverage rates to such an extent that the transmission of disease is interrupted.New Directions in Public Health - Continue Funding of the National Childhood Immunisation Programme - Health Insurance Commission
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
- | 3.5 | 3.6 | - |
New Direction in Public Health - Funding of Life Education Centres Programme
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
0.3 | 0.3 | 0.3 | - |
Purpose of measure
To develop Life Education Centre Programmes to cater for secondary schools.Expected Implementation Strategies for Measure
To support a national secretariat and enhance drug education aimed at secondary school students.Intended Impacts of Measure
Enhancement of secondary school based drug education programmes.New Directions in Public Health - Funding for the Ministerial Council on Injury Prevention
Financial implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
0.3 | 0.3 | 0.3 | 0.3 |
Purpose of measure
To obtain intersectoral cooperation and action to reduce preventable injuries, and to report on difficulties encountered and possible solutions.Expected Implementation Strategies for Measure
Consultation with Commonwealth and State and Territory Government and non-government stakeholders will be undertaken to develop proposals on the precise role, structure and method of operation of the Council. It is anticipated that the Council will be operational by early 1997.Intended Impacts of Measure
Injury is a key public health issue and an agreed national health priority area, which is amenable to successful interventions. Much of the scope for preventive activity lies in other portfolios, and this initiative will address the lack of coordinated action across various areas of government and sectors of the economy. Considerable benefit will accrue in terms of reduced costs for the health care system and improved health status of the population with reductions in injury incidence.New Directions in Public Health - Funding for the National Non-Insulin Dependent Diabetes Mellitis Action Plan
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
2.4 | 3.1 | 2.2 | - |
Purpose of measure
To reduce the incidence and prevalence, and the impact of complications, of diabetes in Australia, and to reduce the social, economic and health costs of this disease to the community.<h5>]Expected Implementation Strategies for Measure The National Diabetes Action Plan includes:
- raising diabetes mellitus to become the fifth National Health Priority Area under a new national strategy for reporting on changes in the population's health;
- funding research on diabetes;
- a specific focus on migrant communities and on Aboriginal and Torres Strait Islander populations; and
- a training package for general practitioners and allied professionals on early diagnosis, and in identifying and disseminating models of best practice in Non-Insulin Dependent Diabetes Mellitus management to prevent or delay the onset of complications.
Intended Impacts of Measure
Raised awareness of diabetes as a national health priority area and earlier diagnosis through a more skilled workforce, particularly in high risk population groups. Reduced onset of Non-Insulin Dependent Diabetes Mellitus and its complications, resulting in a significant reduction in social, economic and health costs of diabetes to the community.Spending
New Directions in Public Health - Continue National Health Advancement, Innovative Health Services for Homeless Youth, and National Drug Strategy
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
4.5 | 43.9 | 46.6 | - |
Purpose of Measures
These measures reflect a strategy to combine public health funding into a single appropriation so as to provide flexibility to deal with emerging issues and to generate savings through reduction of duplication and simplified administrative requirements under public health agreements with the States. It is intended to negotiate with the States and Territories a single new Public Health Agreement, to 1998-99, that will replace the current numerous separate agreements covering different time frames.This agreement will emphasise the Commonwealth's role in developing and strengthening public health infrastructure, national co-ordination and providing national leadership in public health through strategic initiatives in policy and planning, research, intersectoral activity, education and information, standard setting, monitoring and evaluation, and workforce development. This approach will allow savings to be achieved with minimum adverse impact on public health outputs.
Also to be included in proposed agreements are programmes relating to HIV/AIDS, Childhood Immunisation, and minimising the harm of substance misuse.
Expected Implementation Strategies for Measure
These savings measures can be realised by implementing a structural change which meets both the Government's election commitment for stronger national leadership in Public Health and the COAG agenda. Continuation funding has been approved until 1998-99 for Innovative Health Services for Homeless Youth and for the National Health Advancement Programme in order to place the funding of the components of the public health programme on a common time frame, so that longer term Public Health agreements can be entered into with the States and Territories.The context for these new Public Health Agreements will be the development of a National Public Health Partnership between the Commonwealth, States/Territories, involving key agencies such as the Australian Institute of Health and Welfare and the National Health and Medical Research Council. The Partnership will clarify for the first time Commonwealth and State/Territory roles and responsibilities in the field of public health. It will also be accompanied by a long term collaborative work plan in priority areas such as:
- public health information requirements;
- public health research and development;
- public health workforce development;
- the review, modernisation and harmonisation of public health legislation and regulation; and
- the co-ordination and integration of national public health strategies.
Intended Impacts of Measure
Each programme component has its own intended outcomes. The specific administrative arrangements encompassed by this measure seek outcomes which include rationalisation of the large number of existing agreements between the Commonwealth and States and Territories in the area of public health; and clarification of the roles and responsibilities of the Commonwealth, the States and Territories, with a stronger national leadership role for the Commonwealth while the States and Territories focus on service delivery.Other outcomes expected from this measure include greater flexibility for States/Territories in matching resources to meet locally identified public health priorities while at the same time remaining active partners in national public health strategies in priority areas; and increased reporting against outcome measures and performance indicators.
Savings
Broadbanding of Existing National Public Health Programme
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-3.8 | -6.8 | -5.2 | - |
Savings from Reduced Cash Balances Held by Statutory Bodies
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.1 | - | - | - |
Purpose of Measure
Improved cash management of HIC benefit payments for relevant public health programmes.See the description of the Savings from Reduced Cash Balances Held by Statutory Bodies measure under Sub-Programme 2.1.
Application of Efficiency Dividend to Commonwealth Own Purpose Outlays and Specific Purpose Payments of a Running Costs Nature
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-5.0 | -6.5 | -7.9 | -9.6 |
Across-the-Board Reduction of 2% in Running Costs - Health Insurance Commission
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.1 | -0.1 | -0.1 | -0.1 |
Across-the-Board Reduction of 2% in Running Costs - Department
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.4 | -0.4 | -0.4 | -0.4 |
