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1999-2000

Portfolio Additional Estimates Statements 1999-2000 - Part C - Outcome Analysis

Contains the 1999-2000 Portfolio Additional Estimates Statement for the Health and Aged Care Portfolio.

Contents

Outcome 1: Population Health and Safety
Outcome 2: Access to Medicare
Outcome 3: Choice Through Private Health Insurance
Outcome 4: Quality Health Care
Outcome 5: Rural Health
Outcome 6: Hearing Services
Outcome 7: Aboriginal and Torres Strait Islander Health
Outcome 8: Enhanced Quality of Life for Older Australians
Outcome 9: Health Investment
Outcome 10: Portfolio Leadership

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Outcome 1: Population Health and Safety

To promote and protect the health of all Australians and minimise the incidence and severity of preventable mortality, illness, injury and disability.

Post-Budget Measures

Childhood Nutrition Programme

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Childhood Nutrition Programme	0.0

In reaching agreement with the Leader of the Democrats on the Goods and Services Tax reform impact on health and aged care services, the Government announced funding for child nutrition of $15 million over the years 1999-00 to 2001-02. Expenditure in

1999-00 is to be absorbed by the Department.

Further Information

There is evidence that the diet of a child has an impact on health throughout life. Diseases such as late onset diabetes and cardiovascular disease can have their origins in poor nutrition in childhood. Optimum nutrition from conception is also necessary for healthy cognitive, physical and dental development.

Social coalitions involving food suppliers and business, government, non-government and community organisations will be formed to establish projects aimed at improving the diet of young children. The programme targets young children and their parents in selected high need communities such as rural and remote areas, indigenous and lower socio-economic communities.

The initiative will be developed and implemented within the framework of the National Public Health Nutrition Strategy, and will complement the National Breast Feeding Strategy.
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Resource Summary for Outcome 1

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Population Health
Appropriation Bill 1 / 3	265,267	69,483	43,881	0
Appropriation Bill 2 / 4	148,835	142,159	0	-3,251
Administered Capital	0	0	6,830	0
Special Appropriations
National Health Act 1953 - Essential vaccines	34,391	63,601	0	0
Therapeutic Goods Act 1989 *	10,382	10,382	0	0
Revenue
Therapeutic Goods - fees and charges *	-10,382	-10,382	0	0
Total Administered Expenses	448,493	275,243	50,711	-3,251
Departmental Expenses
Department of Health and Aged Care Expenses	97,740	95,495	6,392	0
Variations common across all Outcomes (refer page 21)			6,083
Total Departmental Expenses	97,740	95,495	12,475	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	43,456	52,790	9,971	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	2,711	0
Revenue from other sources	53,870	42,705	-207	0
Total Price of Department's Outputs	97,326	95,495	12,475	0
Agency Expenses
Australian Radiation Protection and Nuclear Safety Agency
Total Australian Radiation Protection and Nuclear Safety Expenses	14,069	13,984	168	0
Revenue from Government (Appropriation Bill No. 3) for Agency Outputs	9,974	8,459	168	0
Revenue from other sources	4,104	5,525	0	0
Total Price of Agency Outputs	14,078	13,984	168	0
Australian New Zealand Food Authority
Total Australian New Zealand Food Authority Expenses	11,047	8,375	3,000	0
Revenue from Government (Appropriation Bill No. 3) for Agency Outputs	8,094	8,375	3,000	0
Revenue from other sources	2,954	0	0	0
Total Price of Agency Outputs	11,048	8,375	3,000	0
Total Outcome 1 Departmental Expenses	122,856	117,854	15,643	0
Revenue from Government (Appropriation Bill No. 3) for Outcome 1 Outputs	61,524	69,624	13,139	0
Revenue from Government (Appropriation Bill No. 4) for Outcome 1 Outputs	n/a	n/a	2,711	0
Revenue from other sources	60,928	48,230	-207	0
Total Price of Outcome 1 Outputs	122,452	117,854	15,643	0
Total for Outcome 1	570,945	393,097	66,354	-3,251

* The Therapeutic Goods Act 1989 Special Appropriation relates to amounts equal to amounts received by the Commonwealth by way of annual registration charge, annual listing charge and annual licensing charge. All money received by the Therapeutic Goods Administration is used for the running of the Agency.
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Explanation of Variations

Departmental Expenses

Australian National Council on AIDS and Related Diseases and advisory committees under the National Drug Strategy framework

376 ($'000)

The increase in funding relates to the provision of in-house support for the Australian National Council on AIDS and Related Diseases (ANCARD) and advisory committees under the National Drug Strategy (NDS) framework. The variation reflects the transfer of funds from the National Public Health program in Appropriation Bill No. 1 to Departmental Expenses to fund the revised Secretariat arrangements. The transfer, although agreed in the 1999-00 Budget context, was not attributed to the Departmental Expenses appropriation.

Variation to Outcome resources common across all Outcomes

6,083 ($'000)

(refer page 21)

Therapeutic Goods Administration - Supplementation pending entering into commercial lease arrangements

6,016 ($'000)

The further commercialisation of the Commonwealth's property portfolio involves the introduction of commercial leases and commercial rents. To offset any rental increases resulting from the commercialisation process, Government agreed that agencies, including the Therapeutic Goods Administration (TGA), would be provided with supplementation to bridge the gap between the higher commercial rental levels and those budgeted for the 1999-00 financial year. Access to supplementation is contingent upon agencies entering into commercial style lease arrangements.

Agency Expense

Australia New Zealand Food Authority (ANZFA)

3,000 ($'000)

Additional funds for ANZFA to meet its statutory responsibilities and stakeholder needs in an environment of new technologies and increased levels of consumer concerns about food.

Australian Radiation Protection and Nuclear Safety Agency (ARPANSA)

168 ($'000)

The further commercialisation of the Commonwealth's property portfolio involves the introduction of commercial leases and commercial rents. To offset any rental increases resulting from the commercialisation process, Government agreed that agencies, would be provided with supplementation to bridge the gap between the higher commercial rental levels and those budgeted for the 1999-00 financial year. Access to supplementation is contingent upon agencies entering into commercial style lease arrangements.
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Administered

Appropriation Bill No. 3

Administered Item 1: Population Health

Movement of Funding Between Population Health Items

5,000 ($'000)

The transfer and bring forward from Appropriation Bill 2 to Appropriation Bill 1 is to assist in meeting various across the board initiatives in 1999-00. The transfer involves re-phasing of funds from 2000-01 into the current year in Appropriation Bill No. 1 and will be directed to Population Health priorities in 1999-00.

National Illicit Drug Strategy

2,387 ($'000)

Carryover funds from 1998-99 due to slippage in the implementation of a component of the Commonwealth's National Illicit Drug Strategy (NIDS) as a consequence of only two States (Victoria and South Australia) being in a position to accept the NIDS funding offer during 1998-99.

Jonathon Mann Memorial Scholarships

250 ($'000)

Funding to pay for Jonathon Mann Memorial scholarships, to undertake research into HIV/AIDS, is provided through the carryover and transfer of Outcome 4 funds from 1998-99.

Supplementation for Superannuation Guarantee Charge

122 ($'000)

Supplementation is provided for increases in the Superannuation Guarantee Charge (SGC) for the Family Planning Program component of Appropriation Bill 1.

Adjustments to the accrual treatment of the estimates

36,122 ($'000)

(refer page 21)
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Appropriation Bill No. 4

Administered Item 1: Population Health

Movement of Funding Between Population Health Items

-3,361 ($'000)

The transfer and bring forward from Appropriation Bill 2 to Appropriation Bill 1 is to assist in meeting various across the board initiatives in 1999-00. The transfer involves re-phasing of funds from 2000-01 into the current year in Appropriation Bill No. 1 and will be directed to Population Health priorities in 1999-00.

Supplementation for Superannuation Guarantee Charge

110 ($'000)

Superannuation Guarantee Charge (SGC) for the Family Planning Program and Women's Health Program components of the Public Health Outcome Funding Agreements in Appropriation Bill 2.

Administered Capital

6,830 ($'000)

Liabilities existing at 30 June 1999 for which no appropriation was made at Budget. This amount represents part of the Administered Capital Injection (refer page 14).

Revised Performance Information and Level of Achievement - 1999-00

Performance Information for Departmental Outputs

1. Policy advice to the Ministers and Government in relation to: population health issues and strategic directions; National Public Health Partnership activities; legislation; progress and impact of the national population health strategies; inequality of health outcomes of vulnerable populations; and national and international trends which pose a challenge to population health and safety.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.065m.
2. Services to the Ministers and Parliament.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.038m.
3. National leadership, including: collaboration with States/Territories through the National Public Health Partnership on information, research, legislation, workforce, planning and national strategy coordination; national coordination of responses to disease outbreaks; definition of the Commonwealth's role in population health; provision of public health expertise to domestic and international agencies; and meeting international public health obligations including those relating to controlled drugs and other substances covered by international treaties.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.088m.
4. Information, including: draw together and disseminate best practice and evidence-based approaches to population health and safety (for example, publication of Communicable Diseases Intelligence); Memorandum of Understanding with the Australian Institute of Health and Welfare is managed to provide quality information for example analysis of burden of disease; increased capacity for research, development and information management in the population health context capable of filling gaps in knowledge (for example, through the establishment of a web-site); and maintenance of the immunisation register by the Health Insurance Commission.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.048m. Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.073m.
5. Contract administration and funds management.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.061m.
6. Regulatory Activity, including: administration of the Tobacco Advertising Prohibition Act 1992 especially in relation to breaches of the Act and compliance of exemptions; and implementation of the Government's regulation and microeconomic reform agenda.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $ 0.003m.

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Therapeutic Goods Administration

1. Policy advice to the Ministers and Government on: the availability and marketing of therapeutic goods in Australia; and public health issues relating to national and international standards and best practice for management of chemicals.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.134m.
2. Services to the Ministers and Parliament.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.079m.
3. National leadership, including: input to setting of international standards for therapeutic goods; and appropriate national policies and controls for medicines, medical devices and chemicals.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.435m.
4. Information, including: publication of bulletins and newsletters on regulation of medicines, medical devices and chemicals; development of an Internet information site; operation of TGA customer service feedback processes; and operation of a TGA information telephone service.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.333m.
6. Regulatory activity, through: pre-market assessment of therapeutic goods at a level appropriate to assessed risk; licensing of manufacturers of therapeutic goods; post-market surveillance and activities relating to problem reports; post-approval monitoring and enforcement of compliance with the therapeutic goods regulations and compliance of manufacturers with the principles of Good Manufacturing Practice; assessment and testing programs based on risk management and targeted testing; pre-market assessment of chemicals and provision of advice to other agencies on the public health impact of agricultural, veterinary and industrial chemicals and which takes into account national and internationally recognised standards; and implementation of the Government's regulation and microeconomic reform agenda.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $5.035m.

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Australian Radiation Protection and Nuclear Safety Agency

1. Protection of the health and safety of people, and of the environment, from the harmful effects of radiation.

Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.168m

Australia New Zealand Food Authority

1. Policy advice to the Ministers and Government in relation to: the development and review of food standards; trends in national food consumption; and emerging threats to and benefits for consumers in the national food supply.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.060m.
2. Services to the Minister and Parliament including the annual report to Parliament in the operation of the Australia New Zealand Food Authority Act 1991.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.120m.
3. National leadership by: achieving a new joint Australia New Zealand Food Standards Code which fully reflects contemporary scientific and clinical knowledge, optimally protects public health and safety, avoids unnecessary costs and impediments to the food industry, ensures adequate consumer information and facilitates international trade; developing new Food Safety Standards to provide more effective protection of consumers from food borne pathogens and other food caused injury; and enhancement of food related surveillance and monitoring arrangements for Australia and New Zealand.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $2.340m.
4. Information to government and other stakeholders.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.480m.

Outcome 2: Access to Medicare

Access through Medicare to cost-effective medical services, medicines and acute health care for all Australians.

Post-Budget Measures

General Practice Memorandum of Understanding (part)

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
General Practice Memorandum of Understanding - Outcome 2	22,085	52,678	75,780	87,388

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The Health and Aged Care component of this measure is attributed across two Outcomes, Outcome 2 and Outcome 4. The above funding represents only the Outcome 2 component of this measure.

The Government entered into a three year Memorandum of Understanding (MoU) with the Royal Australian College of General Practitioners, the Rural Doctors Association of Australia and the Australian Divisions of General Practice on 6 August 1999. The General Practice MoU will be in effect from 1 July 1999 to 30 June 2002.

The MoU will improve financial certainty for Government and general practice, thereby ensuring both the viability of general practice and sustainability of Medicare over the longer term. It will also create a framework within which to modernise the Medicare Benefits Schedule in order to deliver better quality care to patients.

Through the MoU, the Government has guaranteed outlays of $7.7 billion over 3 years on Medicare rebates for patients for general practitioner (GP) consultations. As part of this guaranteed funding, Medicare rebates for GP consultations will increase by approximately 2.3% on 1 November 1999.

Other initiatives of the MoU include:

• an additional $26.5 million in new and existing initiatives to encourage GPs to practise in rural and remote areas;
• implementation of facilities to enable patient paid Medicare claims to be lodged electronically from the GP's surgery;
• continued Government funding for a range of general practice funding programs, which currently includes the Practice Incentives Program, the General Practice Immunisation Incentives scheme, and the GP Links program;
• commitments to increase the intake of Indigenous students to medical courses; and
• a shared commitment by the Government and the general practice profession to develop new initiatives to promote quality general practice over the life of the MoU, including investigating means of:
  • enabling GPs to undertake population health activities;
  • improving access for patients to a range of vaccines in the GPs surgery; and
  • promoting the quality use of pathology, diagnostic imaging and pharmaceuticals.

Provision of Safe Haven to internally displaced persons from East Timor (cross portfolio measure)

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Provision of Safe Haven to internally displaced persons from East Timor (cross portfolio measure)	6,546

The Department of Health and Aged Care has through Operation Safe Haven - East Timor provided temporary safe haven and support services for 1500 East Timorese evacuees in Australia. The 1500 East Timorese are provided with accommodation, food, health, education, and interpreting and counselling services at havens. In addition, they are provided with a small Living Allowance.

The Department requires an additional $6,546 million to be appropriated in administered items in order to implement this measure in 1999-00.

Provision of Safe Haven to displaced Kosovars (cross portfolio measure)

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Provision of safe haven to displaced Kosovars (cross portfolio measure)	17,282

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A decision was made on 1 May 1999 to activate plans to provide a temporary safe haven in Australia for displaced Kosovar evacuees. The Department of Immigration and Multicultural Affairs has through Operation Safe Haven provided temporary safe haven and support services for approximately 3960 Kosovar evacuees in Australia. The Kosovars are provided with accommodation, food, health, education, and interpreting and counselling services at the havens. In addition, the evacuees are provided with a small Living Allowance. Evacuees who returned home between 31 August and

31 October 1999 were provided with a Winter Reconstruction Allowance to assist them to rebuild their lives in Kosovo.

This will require an additional $17,282 million to be appropriated in administered items in 1999-00.

Private Health Insurance - Reduction in Medicare payment lag times for Simplified Billing

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Reduction in lag times	0	0	0	0

The Government has agreed to reduce the minimum Medicare payment lag times for all simplified billing claims from 16 to 10 days. The process of simplified billing incorporates three aspects. Firstly, the number of bills a patient receives for in-hospital care is greatly reduced, ideally to a single bill. The second aspect involves the health fund or approved billing agency making claims from Medicare and the patients' health fund on behalf of the patient. The third aspect is informed financial consent whereby patients, prior to being admitted, are made aware of any possible out-of-pocket costs. Simplified billing is an important element of the Government's initiatives to increase the viability of private health insurance.

There will be a one off cash flow impact for 1999-00 of $0.91m, however this change will not affect expenses or the fiscal balance. Reducing the Medicare payment lag times for all simplified billing claims will have two effects. Firstly, increasing the attractiveness of using simplified billing, and secondly, increasing the attractiveness of providing a service involving no or known medical gaps during an in-hospital episode of care.

Exceptional Circumstances - Batlow Fruit Growers, New South Wales (cross portfolio measure)

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Batlow Fruit Growers	13	14	-	-

The Government agreed to provide $1.6 million (Health component is $0.027 million) for Exceptional Circumstances assistance to fruit growers in the Batlow area in New South Wales, who suffered frost damage and relied on fruit production for at least 65 per cent of their 1997/1998 farm income. Eligible farmers will be able to access income support payments, interest rate subsidies and concessional access to a Health Care Card, Family Payments and the Youth Allowance for twelve months with a twelve month recovery period.

Exceptional Circumstances - Mallee Region, Victoria (cross portfolio measure)

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Mallee Region	113	132	-	-

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The Government agreed to provide $10.4 million (Health component $0.245 million) for Exceptional Circumstances assistance to farmers in the Millewa and eastern and southern Mallee regions in Victoria, who had ineffective rainfall during important stages of crop development, resulting in crop failure. Eligible farmers will be able to access income support payments, interest rate subsidies and concessional access to a Health Care Card, Family Payments and the Youth Allowance for 12 months with a twelve month recovery period.

Resource Summary for Outcome 2

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Access to high quality and cost-effective medical services for all Australians
Appropriation Bill 1 / 3	199,451	251,164	16,337	0
Appropriation Bill 2 / 4	61,782	64,136	19,173	-20
Special Appropriations
Health Insurance Act 1973 - Medical benefits	6,964,953	6,909,585	23,901
Therapeutic Goods Act 1989 *	10,382	10,382	0	0
Administered Item 2: Access to high quality and cost-effective medical services for all Australians
Appropriation Bill 1 / 3	21,303	23,150	4,712	0
Special Appropriations
National Health Act 1953 - Pharmaceutical Benefits	3,213,545	3,357,388	-49,668
National Health Act 1953 - Aids and appliances (p)	71,797	51,624	12
Administered Item 3: Access to public hospital services for public patients
Appropriation Bill 2 / 4	1,007	1,009	0	0
Special Appropriations
Health Insurance Act 1973 - Medicare Agreements - provision of hospital services and other health services (p)	8,282	0	0
Health Care (Appropriation) Act 1998 - National health development - special assistance	6,470	73,530	-9,040
Health Care (Appropriation) Act 1998 - Australian Health Care Agreements - provision of designated health services (p)	5,440,387	5,674,211	32,011
Total Administered Expenses	15,988,977	16,405,797	37,438	-20
Departmental Expenses
Departmental Expenses	354,818	385,979	3,890	0
Variations common across all Outcomes (refer page 21)	0	0	1,182
Total Departmental Expenses	354,818	385,979	3,890	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	348,493	342,132	4,585	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	527	0
Revenue from other sources	4,819	43,847	-40	0
Total Price of Department's Outputs	353,312	385,979	5,072	0
Professional Services Review
Total Professional Services Review Expenses	1,643	3,383	0	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Agency Outputs	1,587	3,330	0	0
Revenue from other sources	55	53	0	0
Total Price of Agency Outputs	1,642	3,383	0	0
Total Outcome 2 Departmental Expenses	356,461	372,179	5,072	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	350,082	345,462	4,585	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	572	0
Revenue from other sources	4,874	23,458	-40	0
Total Price of Outcome 2 Outputs	354,956	368,920	5,072	0
Total for Outcome 21	16,343,936	16,774,716	42,510	-20

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Explanation of Variations

Departmental

Enhanced Primary Care - Voluntary Annual Health Assessments for those aged 75 years and over

256 $'000

Re-allocation of funds within the Departmental Expenses appropriation relating to the Enhanced Primary Care measure for the annual health assessments. The volume impact on the Health Insurance Commission was incorrectly reflected against the Department. Internal adjustment within Departmental.

General Practice Immunisation Incentives

2,023 ($'000)

Correction of attribution of funds from Administered to Departmental incorrectly appropriated at Budget.

General Practice Links Program

498 ($'000)

Correction of attribution of funds from Administered to Departmental incorrectly appropriated at Budget.

Practice Incentive Program

1,113 ($'000)

Correction of attribution of funds from Administered to Departmental incorrectly appropriated at Budget.

Variation to Outcome resources common across all Outcomes (refer page 21)

1,182 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

• Appropriation Bill No. 3: -639 ($'000)
• Appropriation Bill No. 4: -4,170 ($'000)

Administered Item 1: Access to high quality and cost-effective medical services for all Australians

Appropriation Bill No. 3

Alternative Funding for General Practice Services

223 ($'000)

Carryover of funds due to delays in payments to State Based Organisations and Divisions of General Practice for the General Practice Immunisation Incentive Program.
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Education, Accreditation and Review of Diagnostic Services

379 ($'000)

Carryover of funds due to delays in finalising a contract with the Australasian Cochrane Centre ($0.150m) and delays in implementing a study to be undertaken by the National Cancer Control Initiative on removal of pigmented skin lesions ($0.229m).

Practice Incentive Program

20,000 ($'000)

Practice Incentive Program Whilst the program is an annual appropriation it is effectively demand driven. There has been a substantial increase in participation of the program. Participation in the incentive tiers has also been much higher than expected. Funds have been brought forward from 2001-02 and 2002-03.

General Practice Immunisation Incentives

-2,023 ($'000)

Correction of attribution of funds from Administered to Departmental incorrectly appropriated at Budget.

General Practice Links Program

-498 ($'000)

Correction of attribution of funds from Administered to Departmental incorrectly appropriated at Budget.

Practice Incentive Program

-1,113 ($'000)

Correction of attribution of funds from Administered to Departmental to pay the Health Insurance Commission for service delivery under the Output Pricing Agreement.

General Practitioner involvement in coordinated care planning

-3,263 ($'000)

Correction of attribution of funds from Bill 1 to Special Appropriation incorrectly appropriated at Budget.

Multidisciplinary case conferencing

-747 ($'000)

Correction of attribution of funds from Bill 1 to Special Appropriation incorrectly appropriated at Budget.
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Renal Dialysis

-100 ($'000)

Ministerial agreement to transfer funds from item Education, Accreditation and review of Diagnostic Imaging to Australian Health Care Agreements - provision of designated Health Services.

Pathology Quality Incentives

4,630 ($'000)

Correction of attribution of funds from Special Appropriation to Bill 1. This amount is needed for administering program. Only the net saving was attributed to MBS, the amount will be offset against the MBS Special Appropriation.

Operation Safe Haven

506 ($'000)

Payment to Health Services Australia for the provision of health screening and medical escort services for Kosovar evacuees. The Government approved additional funding for the purpose of the Department's role in Operation Safe Haven.

Appropriation Bill No. 4

Operation Safe Haven

16,776 ($'000)

Payment to Health Services Australia for the provision of health screening and medical escort services for Kosovar evacuees, which was approved for the purpose of the Department's role in Operation Safe Haven.

Provision of Safe Haven to internally displaced East Timorese

6,546 ($'000)

Correction of attribution from SPP(+$20,000) to other administered expenses (-$20,000).

0 ($'000)

Administered Item 2: Access to high quality and cost-effective medicines for all Australians

Appropriation Bill No. 3

Pharmacy Restructuring Measures (Better use and disposal of medicines)

3,694 ($'000)

Correction of attribution of funds from Special Appropriation to Bill 1. Only net savings attributed to PBS Concessional. This amount is needed to administer the program and will be offset against the PBS Special Appropriation.
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Revised Performance Information and Level of Achievement - 1999-00

Performance Information for Administered Outputs

1. Access to high quality and cost-effective medical services for all Australians: national insurance for medical services through the Medicare Benefits Schedule; alternative funding for General Practice; and development and support of other medical services related to the Medicare Benefits Schedule.

Quantity: Rebates will be provided for an estimated 209 million medical services. Quantity: Rebates will be provided for an estimated 11 medical services per capita Efficiency: An estimated 67% of MBS expenses will be subject to financing agreements with the medical profession. Quality: Increase in the percentage of practices taking up outcomes based elements of the Practice Incentives Program (PIP). Quantity: Increase in number of practices participating in PIP above current level of 52%. Quality: 100% of new medical services, which are listed on the MBS and for which a financial subsidy is provided, have been assessed for evidence of safety, effectiveness and cost-effectiveness (see also Departmental Output Group 6).

Outcome 3: Choice Throught Private Health Insurance

A viable private health insurance industry to improve the choice of health services for Australians.

Resource Summary for Outcome 3

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Appropriation Bill 1 / 3	302	1,870	0	0
Special Appropriations
Private Health Insurance Incentives Act 1997 - Private Health Insurance Incentives Scheme	158,203	-1,561	0
Private Health Insurance Rebate	544,589	1,291,987	101,666
Total Administered Expenses	703,094	1,292,296	101,666	0
Departmental Expenses
Departmental Expenses	24,689	33,689	0	0
Variations common across all Outcomes (refer page 21)	0	0	3,984	0
Total Departmental Expenses	24,689	33,689	3,984	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	24,106	34,569	2,344	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	1,775	0
Revenue from other sources	479	-880	-135	0
Total Price of Department's Outputs	24,585	33,689	3,984	0
Private Health Insurance Ombudsman
Total Private Health Insurance Ombudsman Expenses	700	950	0	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Agency Outputs	700	950	0	0
Revenue from other sources	0	0	0	0
Total Price of Agency Outputs	700	950	0	0
Total Outcome 3 Departmental Expenses	25,389	31,698	3,984	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	24,806	35,519	2,344	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	1,775	0
Revenue from other sources	479	-880	-135	0
Total Price of Outcome 3 Outputs	25,285	34,639	3,984	0
Total for Outcome 3	728,379	1,326,935	105,650	0

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Explanation of Variations

Departmental

Variation to Outcome resources common across all Outcomes(refer page 21)

3,984 ( $'000)

Revised Performance Information and Level of Achievement - 1999-00

No outcome specific variations have been made to departmental and administered expenses for this outcome. Hence, there is no impact on performance measures as presented in the 1999-00 Portfolio Budget Statement.

Outcome 4: Quality Health Care

Improved quality, integration and effectiveness of health care.

Post-Budget Measures

General Practice Memorandum of Understanding (part)

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
General Practice Memorandum of Understanding - Outcome 4	7,680	9,380	9,390	10,973

The Health and Aged Care component of this measure is attributed across two Outcomes, Outcome 2 and Outcome 4. The above funding represents only the

Outcome 4 component of this measure.

The Government entered into a three year Memorandum of Understanding (MoU) with the Royal Australian College of General Practitioners, the Rural Doctors Association of Australia and the Australian Divisions of General Practice on 6 August 1999. The General Practice MoU will be in effect from 1 July 1999 to 30 June 2002.

The MoU will improve financial certainty for Government and general practice, thereby ensuring both the viability of general practice and sustainability of Medicare over the longer term. It will also create a framework within which to modernise the Medicare Benefits Schedule in order to deliver better quality care to patients.

Through the MoU, the Government has guaranteed outlays of $7.7 billion over 3 years on Medicare rebates for patients for general practitioner (GP) consultations. As part of this guaranteed funding, Medicare rebates for GP consultations will increase by approximately 2.3% on 1 November 1999.
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Other initiatives of the MoU include:

• an additional $26.5 million in new and existing initiatives to encourage GPs to practise in rural and remote areas;
• implementation of facilities to enable patient paid Medicare claims to be lodged electronically from the GP's surgery;
• continued Government funding for a range of general practice funding programs, which currently includes the Practice Incentives Program, the General Practice Immunisation Incentives scheme, and the GP Links program;
• commitments to increase the intake of Indigenous students to medical courses; and
• a shared commitment by the Government and the general practice profession to develop new initiatives to promote quality general practice over the life of the MoU, including investigating means of:
  • enabling GPs to undertake population health activities;
  • improving access for patients to a range of vaccines in the GPs surgery; and
  • promoting the quality use of pathology, diagnostic imaging and pharmaceuticals.

Resource Summary for Outcome 4

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: General Practice Reform
Appropriation Bill 1 / 3	169,081	207,891	-6,474	0
Administered Item 2: Integrated and coordinated care initiatives
Appropriation Bill 1 / 3	47,239	33,555	2,965	0
Administered Item 3: Health systems development
Appropriation Bill 1 / 3	26,874	14,609	3,987	0
Appropriation Bill 2 / 4	64,127	63,856	5,537	0
Special Appropriations
National Health Act 1953 - Aids and appliances (p)	29,200	31,500	0
National Health Act 1953 - Blood fractionation, products and blood related products	134,222	148,951	3,745
Health Insurance Act 1973 - Medicare Agreements - provision of hospital and other health services (p)	1,557	0	235
Health Insurance Act 1973 - Australian Health Care Agreements - provision of designated health services (p)	31,632	40,282	-3,865
Administered Item 4: Strategic action of National Health Priority Areas
Appropriation Bill 1 / 3	9,057	3,396	6,915	0
Administered Item 5: Mental Health strategies
Appropriation Bill 1 / 3	8,142	24,285	-2,019	0
Appropriation Bill 2 / 4	2,625	0	0	0
Special Appropriations
Health Insurance Act 1973 - Medicare Agreements - provision of hospital and other health services (p)	4,062	0	0
Health Insurance Act 1973 - Australian Health Care Agreements - provision of designated health services (p)	51,000	70,407	-8,932
Total Administered Expenses	578,815	638,732	2,094	0
Departmental Expenses
Departmental expenses	22,345	23,803	1,506	0
Variations common across all Outcomes (refer page 21)			2,499
Total Departmental Expenses	22,345	23,803	4,005	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	18,546	21,691	2,976	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	1,114	0
Revenue from other sources	3,704	2,112	-85	0
Total Price of Outcome 4 Outputs	22,250	23,803	4,005	0
Total Expenses for Outcome 4	601,066	662,534	6,099	0

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Explanation of Variations

Departmental

Trials of coordinated care for people with ongoing and complex needs

1,506 ($'000)

The carryover of funds from 1998-99 to 1999-00 to cover the costs of infrastructure payments, national financial evaluation and financial monitoring of the trials, and planning for conclusion of the trials.

Variation to Outcome resources common across all Outcomes (refer page 21)

2,499 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

• Appropriation Bill No. 3: -5,933 ($'000)
• Appropriation Bill No. 4: 537 ($'000)

Administered Item 1: General Practice reform

Appropriation Bill No. 3

General Practice infrastructure, training and support

-494 ($'000)

Funding of $5m was approved as a carryover in the 1999-00 Budget process. The actual expenditure slightly exceeded the 1998-99 revised estimate. The estimates need to adjusted to better reflect the funding requirements in 1999-00.

General Practice Memorandum of Understanding (MoU) - Rural Initiatives component

7,680 ($'000)

The Commonwealth has signed a MoU with various medical organisations aimed at achieving a number of reforms in general and clinical practice. Part of the MoU commits the Government to $26.45m over three years to further encourage the recruitment and retention of doctors in rural and remote areas (see page 51 for detailed explanation of this measure).

Administered Item 2: Integrated and coordinated care initiatives

Appropriation Bill No. 3

Transfer of NPP funding for EPC element: Voluntary Health Assessments for those aged 75 and over to Outcome 2

-926 ($'000)

Funding for this measure was as part of the Enhanced Primary Care package agreed by Government during 1999-00 Budget process. The Administered Expenses funding component was incorrectly appropriated under Outcome 4 (sub-item 2) in lieu of Outcome 2. An adjustment was required to correct this error.
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Trials of coordinated care for people with ongoing and complex needs

3,891 ($'000)

The coordinated care trials were originally due to be completed in June 1999. Delays in the commencement date, led to the trials being extended by six months to December 1999 with a subsequent wind up period. The carryover of funding from 1998-99 to 1999-00 is required to cover the extension and subsequent wind-up. Funds will also contribute to transitional funding where a trial is selected for further development in the second round, rather than wind up.

Administered Item 3: Health systems development

Appropriation Bill No. 3

Acute Health Care - Microeconomic Reform Initiatives

42 ($'000)

The carryover of funds from 1998-99 to 1999-00 is required to meet expenses relating to the ANZICS intensive care central database. Payment was expected to be made to the NSW Department of Health for this purpose prior to the end of the 1998-99 financial year. However due to unforeseen delays with contractual arrangements, the expense will now be incurred in 1999-00.

Appropriation Bill No. 4

Blood Transfusion Services

5,000 ($'000)

Funding for this program was agreed in 1998-99 Additional Estimates. These estimates did not include the funding for litigation costs associated with Hepatitis C settlements.

Administered Item 4: Strategic action on National Health Priority Areas

Appropriation Bill No. 3

Diabetes and cancer funding transferred from PHD

3,926 ($'000)

Transfer of funds from Outcome 1 to Outcome 4 to reflect a more appropriate classification of activities within this program.

Subsequent to the finalisation of the Budget figures it became apparent that the1999-00 Budget estimate for the Administered Expenses under Outcome 4 did not include any provision for Diabetes and Cancer. Investigations have revealed that while there was a reduction in the Outcome 1 estimate, the corresponding entry to increase the Outcome 4 estimates was omitted. Accordingly, the Administered Expenses estimates for Outcome 4 are to be increased.

Administered Item 5: Mental health strategies
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Appropriation Bill No. 3

National youth suicide prevention strategy

-1,200 ($'000)

Funding of $3.3m was approved as a carryover in the 1999-00 Budget process. The actual expenditure slightly exceeded the 1998/99 revised estimate. The estimates need to adjusted to better reflect the funding requirements in 1999-00.

Offset to Australia New Zealand Food Authority supplementation

-1,000 ($'000)

Reduction in funding to particularly offset the supplementation to the Australia New Zealand Food Authority (ANZFA).

National Mental Health Program

-612 ($'000)

Funding of $4m was approved as a carryover in the 1999/00 Budget process. The actual expenditure slightly exceeded the 1998/99 revised estimate. The estimates need to adjusted to better reflect the funding requirements in 1999/00.

Administered transfers to other outcomes not affecting Outcome 4 resources

General practice infrastructure, training and support

Carryover of funds from 1998-99 to 1999-00. These funds are to be transferred from Outcome 4 to Outcome 1 to support funding for the Jonathon Mann Scholarships

-250 ($'000)

Carryover of funds from 1998-99 to 1999-00. These funds are to be transferred from Outcome 4 to Outcome 7 to support funding for the Hoy Kidney Foundation;

-595 ($'000)

Carryover of funds from 1998-99 to 1999-00. These funds are to be transferred from Outcome 4 to Outcome 10 to support funding for tax reform complementary therapies.

-420 ($'000)
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Revised Performance Information and Level of Achievement - 1999-00

Performance Information for Departmental Outputs

3. National leadership, including: promoting continuous quality improvement and evidence-based medicine to foster high quality and cost effective services; providing the health care industry with nationally consistent methods of classifying different forms of health care, and associated costs; expanding and improving partnerships in health reform; increasing consumer and community involvement in health services planning, delivery, monitoring and evaluation in Australia; expanding the National Mental Health Strategy activities to the private sector; coordinating the development of measures to achieve the Prime Minister's commitments on improved care for elderly Australians; managing with States and Territories ongoing coordinated care trials; and supporting the collaborative National Health Priority Areas initiative.

Revised / additional attribution of funds have not affected the performance measures applied to this output. ncrease in price at 1999-00 Additional Estimates: $1.506m

Outcome 5: Rural Health

Improved health outcomes for Australians living in regional, rural and remote locations.

Resource Summary for Outcome 5

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Support, education and training for health workers
Appropriation Bill 1 / 3	98,017	14,058	15,097	0
Appropriation Bill 2 / 4	37,614	184	9,000	0
Administered Item 2: Support for the flexible delivery of rural health services
Appropriation Bill 1 / 3	2,439	9,071	0	0
Total Administered Expenses	138,070	23,313	24,097	0
Departmental Expenses
Departmental expenses	6,927	6,325	0	0
Variations common across all Outcomes (refer page 21)			652
Total Departmental Expenses	6,927	6,325	652	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	5,744	5,655	383	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	291	0
Revenue from other sources	1,154	670	-22	0
Total Price of Outcome 5 Outputs	6,897	6,325	652	0
Total Expenses for Outcome 5	144,968	29,638	24,749	0

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Explanation of Variations

Departmental

Variation to Outcome resources common across all Outcomes (refer page 21)

652 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

• Appropriation Bill No. 3: 15,097 ($'000)
• Appropriation Bill No. 4: 9,000 ($'000)

Revised Performance Information and Level of Achievement - 1999-00

No outcome specific variations have been made to departmental and administered expenses for this outcome. Hence, there is no impact on performance measures as presented in the 1999-00 Portfolio Budget Statement.

Outcome 6: Hearing Services

To reduce the consequence of hearing loss for eligible clients and the incidence of hearing loss in the broader community.

Resource Summary for Outcome 6

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Provision of services for contestable clients
Appropriation Bill 1 / 3	113,790	116,488	4,370	0
Administered Item 2: Provision of Community Service Obligations
Appropriation Bill 1 / 3	23,260	26,440	0	0
Total Administered Expenses	137,050	142,928	4,370	0
Departmental Expenses
Departmental expenses	6,026	10,633	3,769	0
Variations common across all Outcomes (refer page 21)			1,077
Total Departmental Expenses	6,026	10,633	4,846	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	5,227	10,083	4,403	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	480	0
Revenue from other sources	773	550	-37	0
Total Price of Outcome 6 Outputs	6,001	10,633	4,846	0
Total Expenses for Outcome 6	143,051	153,561	9,216	0

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Explanation of Variations

Departmental

Supplementation pending entering into commercial lease arrangements

3,769 ($'000)

The further commercialisation of the Commonwealth's property portfolio involves the introduction of commercial leases and commercial rents. To offset any rental increases resulting from the commercialisation process, Government agreed that agencies, including the Australian Hearing Services (AHS), would be provided with supplementation to bridge the gap between the higher commercial rental levels and those budgeted for in the 1999-00 financial year. Access to supplementation is contingent upon agencies entering into commercial style lease arrangements.

Variation to Outcome resources common across all Outcomes (refer page 21)

1,077 ($'000)

Administered

Administered Item 1: Provision of services for contestable clients

Appropriation Bill No. 3

Provision of services for contestable clients

4,370 ($'000)

Carryover of funds from 1998-99 to 1999-00. Historically, there is a three month lag between the time a voucher is issued and when it is fully claimed. This carryover reflects a longer than anticipated delay between the issuing of vouchers to eligible clients and the lodgement of all claims for payment by contracted service providers.

Revised Performance Information and Level of Achievement - 1999-00

5. Contract administration and funds management, including: the payment of contracted service providers by the Health Insurance Commission (the Department estimates that it will pay the Health Insurance Commission $427 000 in 1999-00 to deliver these services); supplementation to the Australian Hearing Services to offset any rental increases resulting from the introduction of commercial style lease arrangements.

Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $3.769m for the Australian Hearing Services.

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Outcome 7: Aboriginal and Torres Strait Islander Health

Improved health status for Aboriginal and Torres Strait Islander peoples.

Resource Summary for Outcome 7

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Services in Aboriginal and Torres Strait Islander communities
Appropriation Bill 1 / 3	113,062	156,343	1,063	0
Administered Item 2: Infrastructure to support the development and operation of high quality health care services for Aboriginal and Torres Strait Islander people
Appropriation Bill 1 / 3	28,876	25,497	189	0
Total Administered Expenses	141,938	181,840	1,252	0
Departmental Expenses
Departmental expenses	16,846	16,811	107	0
Variations common across all Outcomes (refer page 21)			1,773
Total Departmental Expenses	16,846	16,811	1,880	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	14,189	15,386	1,150	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	790	0
Revenue from other sources	2,586	1,425	-60	0
Total Price of Outcome 7 Outputs	16,775	16,811	1,880	0
Total Expenses for Outcome 7	158,713	198,651	3,132	0

Explanation of Variations

Departmental

Reinstatement of wage increase supplementation

107 ($'000)

Increased funding relates to the reinstatement of the wage increases granted in the second foldback agreement for the 1995-96 Budget measure - Aboriginal and Torres Strait Islander Primary Health Care.
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Variation to Outcome resources common across all Outcomes (refer page 21)

1,773 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

7,992 ($'000)

Appropriation Bill No. 3

Administered Item 1: Services in Aboriginal and Torres Strait Islander communities

Appropriation Bill No. 3

Ophthalmological equipment under the Eye Health Strategy

1,476 ($'000)

Carryover of funds for ophthalmological equipment under the Eye Health Strategy due to delays in finalising implementation arrangements with stakeholders.

Renal Dialysis Unit to be established in Weipa

1,000 ($'000)

Carryover of funds for Renal Dialysis Unit to be established in Weipa due to delays in finalising funding and operational arrangements.

Australian Kidney Foundation

595 ($'000)

Carryover and transfer of funds from Outcome 4, Quality Health Care for the Australian Kidney Foundation's renal disease early intervention project.

Year End Accrual Balances

-10,000 ($'000)

Re-phasing of cash requirements to more accurately reflect payment patterns and year-end accrual balances.

Administered Item 2: Infrastructure to support the development and operation of high quality health care services for Aboriginal and Torres Strait Islander people.
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Appropriation Bill No. 3

Health Infrastructure

189 ($'000)

Carryover of funds from the 1998-99 Health Infrastructure Budget measure due to delays in finalising arrangements with stakeholders and commencing field work.

Revised Performance Information and Level of Achievement - 1999-00

Performance Information for Departmental Outputs

1. Policy advice to the Ministers and Government in relation to: health priorities and appropriate models of health service delivery; structural changes to health financing systems that address barriers to equitable access to health services and pharmaceuticals; and workforce issues and development priorities.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.016m.
2. Services to the Ministers and Parliament.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.013m
3. National leadership, including: a national strategy for improved health of Aboriginal and Torres Strait Islander people; enhanced policy and program responses to the health needs of Aboriginal and Torres Strait Islander people; support for intersectorial partnerships that enhance health service development and delivery, including the Aboriginal and Torres Strait Islander Health Council; and the development and collection of performance information to monitor access to, and effectiveness of health services for Aboriginal and Torres Strait Islander people.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.021m
4. Information to stakeholders and the general community concerning Aboriginal and Torres Strait Islander health.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.008m.
5. Contract administration and funds management: continued development of grant administration framework; community liaison and support for the development and implementation of programs; and effective administration and resource management.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.049m.

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Outcome 8: Enhanced Quality of Life for Older Australians

Support for positive and healthy ageing and high quality and cost-effective services for frail older people, people with disabilities, and their carers.

Post-Budget Measure

	1999-00 ($'000)	2000-01 ($'000)	2001-02 ($'000)	2002-03 ($'000)
Aged Care Residential Care Subsidy Principles 1997 change to definition of "homeowner" to ensure protection for people with low value homes	600	800	800	800

The Government has agreed to an amendment to the residential aged care subordinate legislation which will amend the definition of "homeowner" so that residents of aged care facilities who have low value homes are not considered "homeowners".

The amendment will ensure better protection for residents, and enable providers of residential aged care, particularly in rural areas where many residents are owners of low value housing, to claim an appropriate level of remuneration through concessional and assisted resident supplements.

Further Information

The Residential Care Subsidy Principles 1997 which underlie the Aged Care Act 1997, enable providers of residential aged care to charge a resident an accommodation bond or charge on a sliding scale in circumstances where the resident's total assets are valued at $23,500 or more. For residents whose total assets are valued at less than $23,500 and who are not homeowners, providers can receive a concessional resident supplement, or an assisted resident supplement for those residents whose total assets are valued between $23,500 and $37,500.

The amendment to the Principles corrects an anomaly under which some residents who are homeowners of low value homes, and whose total assets are less than $23,500 cannot be charged an accommodation bond or charge. In addition the provider is precluded from claiming concessional resident supplement due to the residents' "homeowner" status.

Resource Summary for Outcome 8

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Healthy Lifestyles for Older Australians
Appropriation Bill 1 / 3	3,458	2,004	0	0
Administered Item 2: Community care and support for carers
Appropriation Bill 1 / 3	69,351	104,543	0	0
Appropriation Bill 2 / 4	500,200	525,565	0	-3
Special Appropriations
Aged or Disabled Persons Care Act 1954 and Aged Care Act 1997 - Community care subsidies	118,608	116,141	-1
National Health Act 1953 - Domiciliary nursing care benefit	98,383	705	0
Aged Care Act 1997 - Flexible care subsidies (p)	3,414	8,663	0
Administered Item 3: Residential care
Appropriation Bill 1 / 3	138,677	76,459	11,530	0
Administered Capital	0	0	27,653	0
Special Appropriations
Aged Care Act 1997 - Residential care subsidies	2,886,311	3,119,512	277
Aged Care Act 1997 - Flexible care subsidies (p)	16,154	20,076	0
Administered Item 4: Client Assessment by aged care assessment teams (ACAT) and referral to appropriate services
Appropriation Bill 2 / 4	38,584	40,062	0	0
Total Administered Expenses	3,873,140	4,062,730	39,459	-3
Departmental Expenses
Departmental expenses	93,572	89,467	209	0
Variations common across all Outcomes (refer page 21)			9,277	0
Total Departmental Expenses	93,572	89,467	9,486	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	80,599	83,071	5,667	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	4,134	0
Revenue from other sources	12,577	6,396	-315	0
Total Price of Outcome 8 Outputs	93,175	89,467	9,486	0
Total Expenses for Outcome 8	3,966,316	4,152,197	48,945	-3

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Explanation of Variations

Departmental

Additional funding relates to the restoration of Departmental funding omitted from the 1998-99 Additional Estimates.

209 ($'000)

Variation to Outcome resources common across all Outcomes (refer page 21)

9,277 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

-567 ($'000)

Appropriation Bill No. 3

Administered Item 2: Community care and support for carers

Appropriation Bill No. 4

Change to method of calculation of indexation of community care and support

-3 ($'000)

Administered Item 3: Residential care

Appropriation Bill No. 3

Residential care

12,100 ($'000)

Carryover of funds from 1998-99 to 1999-00. The requirement to carryover funds largely reflects the delays in the 1998-99 Additional Estimates Bills receiving Royal Assent. As a result, some projects were forced to run behind schedule because of lack of funds. There were also unavoidable delays in the establishment of construction projects.

Administered capital

Funding to cover liabilities outstanding as at 30 June 1999

27,653 ($'000)

This amount represents part of an administered capital injection to cover liabilities existing as at 30 June 1999 for which no funding has previously been received (refer page 14).
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Revised Performance Information and Level of Achievement - 1999-00

Performance Information for Departmental Outputs

5. Contract administration and funds management, including: monitoring and payments to States/Territories, service providers and clients, Carer Resource and Respite Centres; administer HACC funding agreements; and management of pilot projects, eg, Extended Aged Care at Home packages (EACHs).

Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.209m.

Outcome 9: Health Investment

Knowledge, information and training for developing better strategies to improve the health of Australians.

Resource Summary for Outcome 9

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: Grants
Appropriation Bill 1 / 3	141,977	189,381	118,524	0
Appropriation Bill 2 / 4	8,929	4,771	14,893	0
Total Administered Expenses	150,906	194,152	133,417	0
Departmental Expenses
Departmental expenses	13,397	9,915	0	0
Variations common across all Outcomes (refer page 21)	0	0	1,032	0
Total Departmental Expenses	13,397	9,915	1,032	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	11,380	8,954	607	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	460	0
Revenue from other sources	1,960	961	-335	0
Total Price of Departmental Outputs	13,340	9,915	1,032	0
Australian Institute of Health and Welfare
Total Australian Institute of Health and Welfare Expenses	8,027	8,052	0	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Agency Outputs	8,027	8,052	0	0
Revenue from other sources	8,164	8,215	0	0
Total Price of Agency Outputs	16,191	16,267	0	0
Total Outcome 9 Departmental Expenses	21,424	21,653	1,032	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	19,407	17,006	607	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	460	0
Revenue from other sources	10,124	9,176	-35	0
Total Price of Outcome 9 Outputs	29,531	26,182	1,032	0
Total Expenses for Outcome 9	180,437	220,334	134,449	0

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Explanation of Variations

Departmental

Variation to Outcome resources common across all Outcomes (refer page 21)

1,032 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

• Appropriation Bill No. 3: 117,167 ($'000)
• Appropriation Bill No. 4: 14,893 ($'000)

Administered Item 1: Grants

Appropriation Bill No. 3

The carryover of funds is to cover the Commonwealth's commitment to meet the establishment costs of the Integrated Cancer Program conducted by the Centenary Institute and the Sydney Cancer Centre.

2,357 ($'000)

Carryover and transfer of funding from Outcome 2 for payment to Wagga Clinical School. Existing portfolio allocations are being utilised to partially fund the establishment of the clinical school at Wagga Wagga.

1,000 ($'000)

Offset to Australia New Zealand Food Authority supplementation

-2,000 ($'000)

Reduction in funding to particularly offset the supplementation to the Australia New Zealand Food Authority (ANZFA).

Revised Performance Information and Level of Achievement - 1999-00

No outcome specific variations have been made to departmental and administered expenses for this outcome. Hence, there is no impact on performance measures as presented in the 1999-00 Portfolio Budget Statement.
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Outcome 10: Portfolio Leadership

Leadership and management of the Department to ensure development and implementation of world class policy and practices for health and aged care services for all Australians.

Resource Summary for Outcome 10

Administered Expenses
	1998-99 Estimated Actual $'000	1999-00 Budget $'000	Additional Estimates $'000	Savings $'000
Administered Item 1: International health policies and standard setting
Appropriation Bill 1 / 3	5,340	10,406	979	0
Administered Item 2: Peak community organisations' input into policy and program development and delivery
Appropriation Bill 1 / 3	6,566	3,127	420	0
Appropriation Bill 2 / 4	5,000	0	1,000	0
Total Administered Expenses	16,906	13,533	2,399	0
Departmental Expenses
Departmental expenses	10,401	10,194	6,562	0
Variations common across all Outcomes (refer page 21)			1,102	0
Total Departmental Expenses	10,401	10,194	7,664	0
Revenue from Government (Appropriation Bill No. 1 / 3) for Departmental Outputs	9,041	6,557	1,660	0
Revenue from Government (Appropriation Bill No. 4) for Departmental Outputs	n/a	n/a	6,041	0
Revenue from other sources	1,316	637	-37	0
Total Price of Outcome 10 Outputs	10,357	10,194	7,664	0
Total Expenses for Outcome 10	27,263	23,727	10,063	0

Explanation of Variations

Departmental

Supplementation for Overseas Property Lease

67 ($'000)

Supplementation for the lease on an apartment for use by a departmental officer seconded to the OECD (reflects new charging arrangements for overseas property).
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Loan to purchase corporate system replacement

5,550 ($'000)

The Department is undertaking replacement of its Financial Management and Personnel Management Systems over the next two years. Approval has been given by the Department of Finance and Administration to finance the acquisition of these systems by way of a loan. The variation of $5.550m represents the expected drawdown of the loan in 1999-00.

Adjustment to Agency banking interest

945 ($'000)

Estimates of interest revenue provided to us and factored into the 1999-00 Budget did not take into consideration balances of Special Accounts that had been closed or transferred to agencies as part of the 1998 Administrative Arrangements Order (AAO) changes. The variation of $945,000 represents an adjustment to Departmental Revenues identified by Health and Aged Care and agreed by the Department of Finance and Administration.

Variation to Outcome resources common across all Outcomes (refer page 21)

1,102 ($'000)

Administered

Adjustments to accrual treatment of the estimates (refer page 21)

22 ($'000)

Appropriation Bill No. 3

Administered Item 1: International health policies and standard setting

Appropriation No. 3

International Health

957 ($'000)

The funding provided for grants to the World Health Organisation was based on the exchange rate and price levels in previous years. The additional funding is required to meet subsequent movements in exchange rates.

Administered Item 2: Peak community organisations' input into policy and program development and delivery.

Appropriation No. 3
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Complementary Therapies Project

420 ($'000)

Carryover of funds from 1998-99 to 1999-00. These funds are to be transferred from Outcome 4 to Outcome 10 to assist complementary therapists meet self-regulatory requirements for GST-free status.

Appropriation No. 4

Australian Hearing Services - Capital advance

1,000 ($'000)

Carryover of funds from 1998-99 to 1999-00.

Revised Performance Information and Level of Achievement - 1999-00

Performance Information for Departmental Outputs

1. Policy advice to the Ministers and Government by the Departmental Executive and other senior advisers in relation to: cross portfolio issues; taxation issues; microeconomic reform agenda issues; integrated service delivery; relations with international organisations and other countries concerning health matters; health industry services and products, sector issues, status and potential developments; the development of strategic policy advice on the aged and health financing; development of a national information management infrastructure; the structure and operation of portfolio bodies, including the performance and accountability of those corporate agencies established under Corporations Law; cross portfolio information to support decision making; and Community Sector Support Scheme.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $1.819m.
2. Services to the Ministers and Parliament in relation to: the Budget strategy and related papers; the Portfolio Budget Statements; financial information including estimates management; taxation issues; overseas visits and international meetings; bilateral international projects and cooperation under Memoranda of Understanding; and the Annual Report.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $2.145m.
3. National leadership, including: representing Australia and contributing to international fora; establishment of the National Health Information Management Advisory Council; placement of World Health Organisation fellows; and designation of World Health Organisation collaboration centres.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.758m.
4. Information, including: occasional papers; responding to requests from, and contributing to the work of, international organisations and other countries; provision of information to State and Territory Governments, community groups and industry groups on taxation issues relating to health and aged care; production of profiles of health and aged care funding for each electorate; improving availability of cross-portfolio information through an integrated information framework; and implementation of HealthInsite on the Internet as a national access point to quality health information for consumers.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.919m.
5. Contract Administration and Funds Management in relation to: individual contracts to ensure that each organisation funded under the Community Sector Support Scheme is appropriately focussed on portfolio objectives; contracts for international commercial health projects undertaken jointly with the Asian Development Bank; Australian contributions to international organisations; contracts for grants to Australian bodies under the Australia/Russia Agreement and World Health Organisation Regional Training Centre initiative; and contracts for development of integrated portfolio information.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.565m.
6. Regulatory activity report on a range of microeconomic reform measures to external agencies/Ministers.	Revised / additional attribution of funds have not affected the performance measures applied to this output. Increase in price at 1999-00 Additional Estimates: $0.356m.

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