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1999-2000

Outcome 1: Population Health and Safety

The 1999-2000 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.

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

Outcome Summary - The Year Ahead

The 1999-2000 Budget builds on the direction of previous years by funding activities aimed at understanding and controlling the determinants of disease, promoting good health, and reducing public exposure to lifestyle and environmental risks. This work is characterised by a focus on the health of the population and particular at-risk groups in the population and complements the clinical or individual provision of health care services. The Population Health Division, the Therapeutic Goods Administration (TGA), the Australia New Zealand Food Authority (ANZFA) and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) all work towards achieving Outcome 1.

Population Health Division

Population health focuses on the determinants of health - that is those factors that cause illness or improve health. It covers prevention of illness and promotion of health across the whole population and/or in particular population groups. A population health focus can improve efficiencies of the health system and overall health outcomes. This focus requires strong Commonwealth leadership, consultation and collaboration to address the complex nature of population health and safety.

The key priority areas for the Division in achieving the population health and safety outcome for 1999-2000 include:

• continuing to pursue a stronger infrastructure and response capacity for evidence-based national population health action. This will involve:
  • making improvements to the information base for policy and program decisions, especially through strategic information planning and research and development;
  • collaborative action with States, Territories, the Australian Institute of Health and Welfare (AIHW) and the National Health and Medical Research Council. This is to be achieved mainly through the National Public Health Partnership;
  • coordination of legislation and population health policy and program activities which will improve the response capacity to threats to population health;
  • improved health in the region and globally, for example through international partnerships with New Zealand, Canada, the Western Pacific and organisations such as the World Health Organisation, the Organisation for Economic Cooperation and Development and the World Bank;
  • effective integration of a population health approach within the wider Australian health system, for example, coordination between primary health care and general practice initiatives;
  • effective working relationships with other sectors that have an important population health contribution in priority areas, for example, family and children's services, transport, environment, employment, education and primary industry; and
  • national preparedness to respond to disease outbreaks.
• developing and implementing population health action. There are eleven major areas where Outcome   1 can maximise promotion and protection of health. These include the national strategic action to reduce the adverse health impact of illicit and licit drug use, HIV/AIDS, hepatitis C, vaccine preventable diseases as well as strategies to increase physical activity and improve nutrition. Each of these major areas covers a range of activities from the community level to national activities. The Population Health Division will seek to:
  • reduce the incidence and severity of preventable diseases for population groups in priority areas, for example HIV/AIDS and vaccine preventable diseases such as measles; and
  • improved access to a range of preventive and primary health care services, particularly for populations of highest need (such as illicit drug users), in cooperation with State and Territory governments.
• developing and progressing communication and social marketing strategies in the key population health areas. This will result in a population that is better informed and aware about public health risks, opportunities for better health and the benefits of a population health approach.

For the Population Health Division the 1999-2000 Budget includes new directions to strengthen disease control and take a collaborative approach to addressing the underlying causes of ill health.
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Therapeutic Goods Administration

The objective of the regulation of therapeutic goods is to ensure the timely availability of medicinal products and medical devices in Australia. These products and devices must meet standards of safety, quality and efficacy at least equal to that of comparable countries, while at the same time the regulatory impact for business needs to be kept to a minimum. This is achieved through a risk management approach to pre-market evaluation and approval of therapeutic products intended for supply in Australia, licensing of manufacturers, and post market surveillance.

In addition to its primary responsibility for therapeutic goods, the Department aims to minimise potential public health risks posed by chemicals used in the community. This is achieved by providing advice to other regulatory authorities on toxicology, pre-market assessment and public health issues relating to agricultural, veterinary and industrial chemicals.

During 1999-2000, regulation of therapeutic goods will continue to be managed cohesively and strategically with a focus on public health and safety. Over this period, there will be an additional emphasis on:

• international co-operation and exchange of regulatory information, including implementation of mutual recognition arrangements for medical devices with the European Union and harmonisation of requirements with countries with comparable standards where appropriate;
• implementation of a new regulatory framework for complementary medicines;
• review of national drugs and poisons legislation; and
• contribution to the development and adoption of world's best practice in chemicals risk assessment and chemicals management practice.

Regulation of therapeutic goods and chemicals contributes to the protection and promotion of the health of Australians. Public health and safety will remain paramount in striking the balance needed to improve health outcomes whilst reducing regulatory burdens where possible. Changes in the regulation of medicines will take into account consumer demands for faster availability of a wider range of medicinal products and industry requirements for increased flexibility in regulatory processes without compromising consumer confidence in, or Australia's international reputation for, high standards of quality and safety for medicinal products.

Australia New Zealand Food Authority

The Australia New Zealand Food Authority (ANZFA), in cooperation with the Australian Commonwealth, State, and Territory governments and the New Zealand Government, develops food standards and other food regulatory measures for Australia and New Zealand. Once the Australia New Zealand Food Standards Council (ANZFSC) approves a food standard they are published in the 'Food Standards Code' and are adopted by reference in State and Territory law. Food standards are gazetted in New Zealand by the New Zealand Minister of Health.

In Australia, ANZFA also:

• coordinates the surveillance of food;
• coordinates food product recalls in cooperation with the States and Territories;
• conducts research on matters that may be included in a food standard;
• undertakes food safety education initiatives in cooperation with the States and Territories;
• develops codes of practice for industry on any matter that may be included in a food standard; and
• develops risk assessment policies for foods imported into Australia.

During 1999-2000, the Australia New Zealand Food Authority will focus on:

• finalising the Review of the Food Standards Code to allow Australia and New Zealand to adopt a new joint Food Standards Code which encourages industry innovation whilst protecting the health and safety of consumers;
• an agreed food safety system involving coordinated trans-Tasman surveillance, monitoring and compliance;
• development and implementation of new food regulatory arrangements resulting from future decisions of government on the Blair Review recommendations;
• implementation of new arrangements with New Zealand following decisions of the Australian and New Zealand governments to improve trans-Tasman food regulation; and
• specific industry applications for product by product approval for genetically modified foods and possibly for other classes of food requiring individual product assessment for safety.

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Australian Radiation Protection and Nuclear Safety Agency

Activities of the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) during 1999-2000 reflect the functions of the Chief Executive Officer (CEO) as expressed in the Australian Radiation Protection and Nuclear Safety Act 1998.

During 1999-2000 the Agency will continue to implement new regulatory controls in respect of all Commonwealth radiation and nuclear activities. Other priorities include: regulating the siting, construction, commissioning and operation of the proposed replacement research reactor; promotion of uniformity in radiation protection law in Australia; the clean-up of Maralinga; participation in the Comprehensive Test Ban Treaty; and informing and educating in relation to the safe use of medical radiation and UV and other non-ionising radiation.

Budget Measures Affecting Outcome 1

National Illicit Drug Strategy - early intervention and diversion

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Attorney-General's Department	3.5	0.4	0.4	0.4
Australian Transactions Reports and Analysis Centre	3.0	2.2	2.1	2.1
National Crime Authority	1.8	1.8	1.9	1.9
Australian Federal Police	5.5	5.5	5.7	5.6
Department of Education, Training and Youth Affairs	2.9	2.9	1.3	3.2
Department of Family and Community Services	2.0	2.1	3.1	3.2
Department of Finance and Administration	0.2	0.1	0.2	0.3
Department of Health and Aged Care	21.7	22.0	42.96	60.6
Total	33.6	49.9	58.0	74.7

Explanation

The Government's package of measures to fight illicit drug use provides funding for the diversion of illicit drug users from the criminal justice system into treatment. The package also includes funding for prevention, early intervention, education (including school based drug education), and supply control measures. The package was agreed at the Council of Australian Governments on 9 April 1999 and will cost $221   million over four years. This is in addition to:

• $215 million provided for the National Illicit Drug Strategy (NIDS) in the 1997-98 Mid-Year Economic and Fiscal Outlook and the 1998-99 Budget; and
• $80 million for other illicit drug related measures in this Budget.

Tough on Drugs in the Community

This initiative will support the diversion of illicit drug users into counselling or treatment by creating an increased assessment and referral capacity; providing additional funding for a range of community-based education, assessment and treatment services; and increasing capacity for education and training of health workers in the assessment and management of people with drug problems.
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Supporting measures

These include initiatives which focus on improving community awareness of the harm caused by illicit drugs, for example, by building on the existing education and information campaign on illicit drugs. Also included are initiatives to expand community involvement in strategies to respond to the harm caused by illicit drugs and strengthen and support community capacity to cope with illicit drug problems.

Tough on Drugs in Schools

Tough on Drugs in Schools supports the efforts of principals, teachers, parents and school communities in strengthening the attack on drug pushers and rejecting illicit drugs in schools. This will be achieved through the development of enhanced protocols, education and resource materials, and local summits to help school communities develop better ways of handling drug use in the school environment on a national basis. The Government has described this as a zero tolerance approach.

Tough on the Supply of Drugs

The Commonwealth will build on the National Illicit Drug Strategy to expand Australia's capacity to intercept drugs before they reach Australia and to attack distribution networks in Australia. Initiatives include expanding the Law Enforcement Cooperation Programme and the overseas liaison network of the Australian Federal Police, research on the links between drugs and crime, and enhancement of law enforcement agencies' technological capacity and their capacity to use financial intelligence. A further $0.4   million is also provided for related equipment purchases.

The measure also includes resourcing for an evaluation of this phase of the National Illicit Drug Strategy, which will be undertaken by the Department of Finance and Administration. The evaluation will examine the effectiveness of each of the above initiatives in achieving their intended objectives and outcomes, and assess the overall effectiveness of the strategy in addressing the problem of illicit drugs.

Further Information

See also the following related NIDS expense measures:

• National Illicit Drug Strategy - Additional funding for drug treatment services under the Health and Aged Care portfolio;
• Enhancement of the National School Drug Education Strategy under the Education, Training and Youth Affairs portfolio;
• Tough on drugs - four mobile search teams under the Attorney-General's portfolio;
• Tough on drugs - increased search capacity and purchase of x-ray technology to enhance capacity for drug detection at the nation's borders under the Attorney-General's portfolio, and the following related capital measures:
• National Illicit Drug Strategy - early intervention and diversion under the Attorney-General's portfolio; and
• Tough on drugs - increased search capacity and purchase of x-ray technology to enhance capacity for drug detection at the nation's borders under the Attorney-General's portfolio.

National Illicit Drug Strategy - additional funding for drug treatment services

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Department of Health and Aged Care	2.5	2.5	2.5	2.6

Explanation

The Government will provide additional funding for drug treatment services under the Government's National Illicit Drug Strategy (NIDS) to establish new non-government organisation treatment services for illicit drug users and to allow the expansion of existing services. The funding is in addition to the $51 million provided in 1997-98 for treatment services under NIDS.
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Further Information

This programme builds on the National Illicit Drug Strategy announced by the Prime Minister in 1997-98, providing additional funding for the expansion of drug treatment services.

The additional funding will be complemented by an expansion of school-based drug education (to be implemented by the Department of Education, Training and Youth Affairs) and by law enforcement initiatives, continuing the Government's balanced and integrated approach to reducing the supply of, and demand for, illicit drugs and minimising the harm they cause.

See also the previous related NIDS - Early intervention and diversion package.

Helping people with chronic disease manage their illness

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Department of Health and Aged Care	1.5	2.4	4.3	5.1

Explanation

The Government will promote education and support for people with chronic diseases to help themselves by assisting them to gain a better understanding of their conditions and how to manage them. This measure will seed the development of community based self-help groups for chronic disease sufferers, using skilled trainers to educate sufferers in proven self management techniques. The groups will complement and enhance professional care and rehabilitation.

The aim is to improve quality of life for those with chronic conditions which in turn reduces demand on the health care system and reduces the incidence of costly re-hospitalisation.

This measure forms part of a package of initiatives to enhance primary care in particular for older Australians, people with chronic illnesses and those who require a range of different services to support them in the community.

Further Information

More than three million Australians suffer from chronic, disabling conditions such as diabetes, arthritis, high blood pressure, heart disease, asthma and emphysema. These conditions are on the increase in the community, due in part to the ageing of the population and to improvements in life saving treatments.

Preventing falls in older people

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Department of Health and Aged Care	1.1	1.1	2.2	2.2

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Explanation

This measure to prevent falls among older people forms part of the Government's package of initiatives to enhance primary care, in particular, for older Australians, people with chronic illnesses and those who require a range of different services to support them in the community. The Government programme will provide funding for:

• the development of appropriate interventions to reduce the incidence, severity and mortality associated with falls in both community and residential care settings;
• piloting of programs to minimise the risk of injury including promotion of the benefits of appropriate exercise levels in active older people, better methods of medication management, environmental modifications and the use of devices which provide protection from injury in falls;
• research into the areas of identification of risk factors, burden/cost of injuries and evidence on effectiveness and cost benefit analysis of interventions; and
• development of workforce education in community, acute care and residential settings.

Hepatitis C education and prevention

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Department of Health and Aged Care	1.5	2.6	3.5	3.7

Explanation

The Government will provide improved education, prevention and health maintenance initiatives for those currently infected and those at risk of becoming infected to lower the current rate of transmission of Hepatitis C in Australia. Building on proven strategies, research will be commissioned to inform the design of elements of the national response in key areas, including epidemiology; social and behavioural factors; and education and prevention programmes. This initiative will be managed by the National Centre for Disease Control in the Department of Health and Aged Care.

Further Information

Hepatitis C is a blood borne virus that can lead to cirrhosis, liver failure and liver cancer. Recent estimates indicate that over 200,000 Australians (just over 1   per   cent of the total population) have already been infected with the Hepatitis C virus, with around 11,000 new infections occurring each year.

Population Health Evidence Base Advisory Mechanism

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Department of Health and Aged Care	-	-	-	-

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Explanation

The Government will fund the establishment of a Population Health Evidence Base Advisory Mechanism to facilitate the adoption of more cost-effective health promotion and disease prevention strategies.

This measure will also provide a flexible funding mechanism to identify more effective ways of achieving improved population outcomes. A significant consideration will be the extent to which interventions will not only result in improvements to health outcomes, but will also be likely to achieve savings to Commonwealth expenses.

Funding of around $5 million from existing portfolio resources will be spent on the programme over the next four years.

Reforms to food hygiene and safety standards

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Australia New Zealand Food Authority	1.0	-	-	-

Explanation

The Government will implement a range of initiatives to improve the efficiency and effectiveness of Australia's food hygiene standards. This will include implementation of model umbrella legislation and evaluation of the safety of individual products. This measure is in response to community health and safety concerns.

Cross-Portfolio Budget Measures affecting this Portfolio

Industry, Science and Resources

Establish biotechnology strategy

Expense ($m)

	1999-00	2000-01	2001-02	2002-03
Department of Health and Aged Care	3.8	3.8	-	-
Department of Industry, Science and Resources	6	4	-	-
Total	9.8	7.8	-	-

Explanation

The Government will fund the establishment of:

• Biotechnology Australia in the Department of Industry, Science and Resources; and
• A statutory office in the Health and Aged Care portfolio to regulate gene technology and its application on a consistent basis.

Biotechnology Australia will develop a national strategy for biotechnology, a public awareness programme to provide information about biotechnology and gene technology, provide training in the effective management of intellectual property and secure better access to genetic resources and gene collections. It will also support a new Council of Ministers on Biotechnology.

The regulation of gene technology and its applications will operate in close collaboration with existing systems for the regulation of food, agricultural and veterinary chemicals, industrial chemicals and therapeutic goods.
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Further Information

A new Council of Ministers on Biotechnology will be established, consisting of the Ministers for Agriculture, Fisheries and Forestry, Education, Training and Youth Affairs, the Environment and Heritage, Health and Aged Care, and Industry, Science and Resources.

Negotiations with the States and Territories will be continued to secure their support and active involvement in the establishment of the statutory office on gene technology and its operations.

Funding for the statutory Gene Technology Office is provided for a two year establishment phase, with cost recovery to be applied once the system is fully operational.

Performance Information and Resource Allocation

The following indicators are designed to measure how effectively this outcome has been achieved.

Population Health Division

Indicator 1:	Incidence, prevalence and mortality rates in diseases or conditions in the eleven main program areas covered by national strategies where national data exists, for example, vaccine preventable diseases and HIV/AIDS.
Target:	Reduction in incidence, prevalence and mortality in areas covered by nationally agreed programs. SFor ome example, the continuing decline in the incidence of measles and pertussis and Haemophilias influenzae type b infections compared to previous years, and the continuing decline in the number of HIV and AIDS diagnoses and mortality rates following HIV/AIDS.
Info source/rept freq:	Incidence Annual reporting of selected diseases and injuries from National Notifiable Diseases Surveillance System; National Injury Surveillance Unit; AIHW; State and Territory data registries; hospital separations. Prevalence Household surveys; self-reported surveys; selected small-sample surveys. All annual information for selected diseases and conditions. Mortality Australian Bureau of Statistics; State and Territory data registries; National Coronial Information Service. (annual reporting)

Indicator 2:	Increased knowledge and skills, and changes in attitudes (where possible) and behaviours of specified target groups as a consequence of health promotion and disease prevention strategies such as the National Youth Alcohol campaign and the National Tobacco campaign.
Target:	Improvements in knowledge, skills, attitudes and behaviours to promote health and prevent illness over time (2-5 years). For example, increased knowledge of the risks of smoking and alcohol consumption, and a reduction in the uptake of smoking in response to the National Tobacco Campaign.
Info source/rept freq:	Commissioned surveys of knowledge, attitudes and behaviour; commissioned campaign tracking surveys.

Indicator 3:	The adoption and effective use of nationally recommended screening and immunisation policies, best practice guidelines and targets. For example, immunisation protocols for general practitioners, breast and cervical cancer screening best-practice guidelines.
Target:	Progress towards agreed targets and use of best practice guidelines. Some examples are: BreastScreen Australia has a target (for 1999) of 70% participation among women aged 50-69 in early detection screening programs; a target of 80% participation among women aged 16-69 in cervical cancer screening by 1999; and the National Immunisation Strategy has a target of 90% coverage of recommended immunisation for all children at two years of age by 2000.
Info source/rept freq:	State and Territory data registries; Australian Childhood Immunisation Register.

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Indicator 4:	Proportion of national public health strategies which target specified high need groups (for example injecting drug users, homosexually active men, low socio-economic groups and Indigenous Australians).
Target:	100% of strategies take account of the needs of specified high need groups and provide information where available.
Info source/rept freq:	Analysis of national public health strategy documents (annual); HIV/AIDS strategy; feedback from the Minister's office (Some figures may be reported by Aboriginality).

Therapeutic Goods Administration

Indicator 5:	Number of approved products withdrawn from the market or requiring a change to conditions of approval for safety related reasons.
Target:	No withdrawals for safety related reasons.
Info source/rept freq:	Therapeutic Goods Administration Quarterly Performance Reports

Indicator 6:	Level of participation in international cooperation and exchange of regulatory information, including the degree of harmonisation of Australian therapeutic goods regulation with countries with comparable standards.
Target:	Continued progress with on-going and new harmonisation initiatives, including with the European Union and New Zealand. Continued progress with on-going mutual recognition agreements with the European Union for medical devices.
Info source/rept freq:	Annual report.

Indicator 7:	Performance against cost recovery targets, which is adequate to cover the cost of activities falling under the Therapeutic Goods Act 1989.
Target:	Adequate cost recovery.
Info source/rept freq:	Therapeutic Goods Administration (TGA) Quarterly Performance Reports

Australia New Zealand Food Authority

Indicator 8:	Proportion of Review proposals to vary the Food Standards Code completed.
Target:	100% of Review proposals completed.
Info source/rept freq:	ANZFA Standards Review data. ANZFA Annual Report.

Indicator 9:	Timely assessment of applications and proposals to vary the Food Standards Code.
Target:	Applications processed within statutory time limits.
Info source/rept freq:	ANZFA Standards Review data. ANZFA Annual Report.

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Indicator 10:	Acceptance of Food Safety Standards by key stakeholders and Australia New Zealand Foods Standards Council.
Target:	Agreement in 1999 of proposed Food Safety Standards.
Info source/rept freq:	ANZFA Annual report.

Indicator 11:	Adoption of Food Safety Standards by State and Territory Authorities and high priority industry sectors.
Target:	100% adoption of Food Safety Standards by State and Territory Authorities and high priority industry sectors.
Info source/rept freq:	ANZFA Annual report.

Indicator 12:	Efficient implementation of Government decisions on Blair Review recommendations.
Target:	Implementation within time frame set.
Info source/rept freq:	ANZFA Annual Report.

Indicator 13:	Efficient implementation of Government decisions on the review of the Australia New Zealand Treaty.
Target:	Implementation within time frames set.
Info source/rept freq:	ANZFA Annual Report.

Indicator 14:	Timely and completed implementation of food recalls.
Target:	All food recalls initiated within 24 hours of formal notification and 100% of recall reports obtained from industry.
Info source/rept freq:	ANZFA log of recalls. ANZFA Annual Report.

Australian Radiation Protection and Nuclear Safety Agency

Indicator 15:	Level of radiation exposure.
Target:	Exposure to radiation limited in keeping with international standards.
Info source/rept freq:	Chief Executive Officer of ARPANSA Annual Report; National Radiation Dose Registry data; National Surveys of Patient Dose.

Resource Allocation

The allocation of resources for Outcome 1 is described in the following two Tables:

• Table C1.1 describes the relationship between the appropriation structure for Outcome 1 and the 1998-99 appropriation structure; and
• Table C1.2 sets out the allocation of resources across administered items and output groups for the Department and the Portfolio agencies that contribute to Outcome 1.

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Table C1.1: Relationship between old appropriation structure and new Outcome structure for Outcome 1

Outcome	Programs
1. Protection and promotion of the health of all Australians and minimisation of the incidence and severity of preventable mortality, illness, injury and disability.	1.1 Public Health Development and Programs (part) 1.2 Health Regulation
Appropriations Department Special Appropriations National Health Act 1953 - Essential vaccines Appropriation Bill 1 Departmental outputs Administered expenses Appropriation Bill 2 Specific payments to the States and Territories Australia New Zealand Food Authority Appropriation Bill 1 Departmental outputs Australian Radiation Protection and Nuclear Safety Agency Appropriation Bill 1 Departmental outputs	Appropriations Sub-program 1.1 Special Appropriations National Health Act 1953 - Essential vaccines Appropriation Bill 1 National public health (including expenditure under the Human Quarantine Act 1908 and payments to the Human Pituitary Hormones Reserve) (340.3.01)(p) Health Insurance Commission - for expenditure under the Health Insurance Commission Act 1973 (343.1) (p) Running Costs, including Section 31 receipts (340.1) (p) Appropriation Bill 2 National public health (891.1.01) Sub-program 1.2 Special Appropriations Therapeutic Goods Act 1989 Appropriation Bill 1 Australia New Zealand Food Authority - for expenditure under the Australia New Zealand Food Authority Act 1991 (342.1) Nuclear Safety Bureau - for expenditure under the Australian Nuclear Science and Technology Organisation Act 1987 (346.1) Running Costs, including Section 31 receipts (340.1) (p) Other Appropriation Bill 1 Compensation and Legal Expenses (340.2.01) (p)

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Table C1.2: Resource summary for Outcome 1

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Contribution of Administered Items and Departmental/Agency Outputs to Outcome 1

Population Health Division

The Division's outputs reflect the Government's decision to strengthen population health. In order to achieve this outcome the Government has decided to spend $275m on administered items.

The administered expenses will be used in the three main areas of:

• pursuing a stronger infrastructure and response capacity for evidence-based national population health action;
• strategic actions in eleven targeted population health areas; and
• developing and progressing communication and social marketing strategies in the key population health areas.

The Population Health Division has a one-line appropriation for administered items, however, the approximate ratio of funds in the three areas is 9:3:2.

The Departmental outputs link with the administered items to achieve the outcome especially in relation to national leadership (particularly through the National Public Health Partnership) and policy advice on areas including population health issues, national strategies and legislation.

Leadership will be incorporated as a central planning and operating principle in all activities. Consultation and collaboration with stakeholders are essential components to achieving the overall outcome in an appropriate manner. For example, progressing nationally agreed strategic responses linked with the National Health Priority Areas will require high level community involvement and agreement by key partners especially States and Territories.

The Divisions' main departmental output items related to the implementation of the administered funds are national leadership, policy advice, contract and fund management, information and services to the Minister; and regulatory activities also play a small part in the Division's activities. These activities will result in a stronger and more effective national population health approach, infrastructure and response capacity, which will enable the outcome to be achieved.

Therapeutic Goods Administration

The Department carries out regulatory activities determined by the Therapeutic Goods Act 1989. The provision of high quality, timely and cost effective regulation of therapeutic goods and input to systems for the regulation of chemicals contribute to the Department of Health and Aged Care's protection and promotion of health.

Policy advice provided to Ministers covers the operations of the current regulatory systems for therapeutic goods and chemicals as well as possible changes to these systems to meet the future needs of the Australian population. Other outputs provided to the Ministers and Parliament include drafting responses to Ministerial correspondence and the preparation of question time briefs.

The Department plays an important national leadership role in ensuring that different stakeholders work together to achieve the outcome. To support the national leadership and administration role the Department also provides an information service to service providers and clients.
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Australia New Zealand Food Authority

ANZFA carries out functions determined by the Australia New Zealand Food Authority Act 1991.

ANZFA reviews and develops food standards for Australia and New Zealand: to help protect the health and safety of consumers; to protect food consumers from deceptive conduct; to facilitate fair trading in food; to facilitate the development of domestic food industries; and to maximise trading opportunities through promoting consistency with international standards.

ANZFA also develops Food Safety Standards to protect consumers from food borne illness. It also gathers data on the Australian food system to facilitate the above functions and to support other public health and nutrition objectives.

ANZFA provides a range of outputs to the Minister and Parliament such as drafting responses to Ministerial correspondence, the preparation of question time briefs and briefing note requests.

ANZFA plays an important national leadership role in ensuring that different stakeholders work together to achieve this outcome. To support the national leadership and administration role ANZFA also provides an information service to stakeholders.

Australian Radiation Protection and Nuclear Safety Agency

As a part of the Portfolio of Health and Aged Care, ARPANSA provides one output to contribute to the outcome of population health and safety.

The activities of the Agency contribute to the achievement of this outcome by focusing on the Agency's statutory objective under the Australian Radiation Protection and Nuclear Safety Act 1998 - 9to protect the health and safety of people, and to protect the environment, from the harmful effects of radiation'.

The Agency has a regulatory role in respect of all Commonwealth radiation and nuclear activities. The Act prohibits Commonwealth agencies from dealing with radioactive materials or apparatus, or any aspect of a nuclear facility, unless licensed to do so.

In addition to this regulatory role, and in support of the Chief Executive Officer's statutory obligations, the Agency:

• promotes uniformity of radiation protection and nuclear safety policy and practices across jurisdictions of the Commonwealth, States and the Territories;
• provides advice on radiation protection, nuclear safety and related issues; and
• undertakes research and provides services in relation to radiation protection, nuclear safety and medical exposures to radiation.

The following performance information provides a comprehensive overview of the administered and departmental items alongside measures mainly related to quantity, quality and price.

Table C1.3: Performance Information for Administered Items

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Population Health Division

1. Population Health: a strong infrastructure to support evidence-based national population health action progressed in collaboration through the National Public Health Partnership and its Advisory Group in the following 6 major areas: research and development such as targeted research and development on drugs (illicit and licit) and HIV/AIDS; information coordination and planning; legislative coordination; national strategies coordination; planning and practice improvement; and workforce development.	Quantity: Research funding provided to 5 national research centres and 2 research foundations. Quality: Targeted research and development, for example, on drugs and HIV/AIDS, is conducted through internationally recognised peer review selectionp processes. Publication of first National Public Health Indicators Report by August 1999. Implementation of the first stage of a national Public Health Information Plan by June 2000.
a strong infrastructure to support evidence-based national population health action progressed through a focus on the 6   major areas under the National Public Health Partnerships in consultation with the Advisory Group including strategic national population health action (including development, implementation, monitoring and evaluation of programs) particularly in the following 11 areas: illicit drugs; tobacco and alcohol; environmental health; HIV/AIDS and Hep C; Cancer screening; Immunisation; Communicable diseases; Injury prevention; Chronic diseases; Physical activity; and Nutrition.	Quality: Finalisation of discussion papers on public health activity, core public heath functions and capacity drawing on international experience by June 2000. Development of new strategy for the Public Health Education and Research Program based on the review's findings by June 2000. Quantity: Action plans are operational for these 11 areas. Quality: Findings from program evaluations and reviews are used to improve strategies. For example: evaluation of the Measles Control Campaign and the Evaluation of the Australian Childhood Immunisation Register to be completed during 1999; and evaluation of the National Influenza Vaccine Program for Over 65's to commence in 1999. Strategies implemented on time. Some examples include: the development of the Chronic Diseases Strategy with a framework finalised by February 2000; setting up a monitoring and surveillance system for food and nutrition in Australia by March 2000; implementation of the National Environmental Health Strategy from 1999 onwards; implementation of Commonwealth responsibilities under the National Tobacco Strategy will commence in 1999-00; and the National Youth Alcohol Campaign to be launched in 1999.
Develop, implement and evaluate social marketing programs in key population health areas, based on optimum practice models.	Quantity: Develop, implement and/or evaluate 5 to 7 social marketing programs in key population health areas including tobacco, alcohol, illicit drugs, breast and cervical cancer screening and immunisation. Quality: Minister and key stakeholders satisfied with campaign and marketing products; Evaluations show that initiatives have impacted positively against objectives.

Table C1.4: Performance Information for Departmental/Agency Outputs

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Population Health Division

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.	Quality: A high level of satisfaction of the Minister and Parliamentary Secretary with the relevance, quality and timeliness of policy advice provided. Quantity: Policy, research and advice service commensurate with the funds allocated. Price: $8.343m.
2. Services to the Ministers and Parliament.	Quality: A high level of satisfaction of the Ministers and Parliament with the relevance, quality and timeliness of services provided. Agreed time frames met for responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing. Quantity: Number of responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing will be recorded during 1999-00 and used as a future benchmark. Price: $4.925m.
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.	Quality: A high level of satisfaction of stakeholders with the quality and timeliness of Commonwealth inputs to national policy, planning and strategy development and implementation. Timely response to disease outbreaks and effective national response. Quantity: National leadership service commensurate with the funds allocated. Price: $11.392m.
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.	Quality: A high level of satisfaction with relevance, quality and timeliness of information. Quantity: Twelve issues of the Communicable Diseases Intelligence published. The number of web-site hits will be recorded in 99-00 to establish base-line data. Price: $7.723m. Quality: Timely provision of accurate monthly statements and quarterly reports to interest parties. Price: $7.8m.
5. Contract administration and funds management.	Quality: Budget predictions are met and actual cash flows vary by less than 10% from predicted cash flows. 100% of payments are made accurately and on time. Quantity: In the order of 400-500 grants and contracts administered. Price: $7.864m.
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.	Quality: Applications for exemption from the prohibition of tobacco advertising processed within statutory time frames. Public inquiries on the administration of the Act to be dealt with promptly. Possible breaches of the Act investigated and appropriate action taken. Quantity: Respond to 100-150 enquires on the Act. Quality: A high level of compliance with the elements of the Government's regulation reform agenda, and their particular reporting requirements. Price: $0.353m.

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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.	Quality: A high level of satisfaction of the Minister and Parliamentary Secretary with the relevance, quality and timeliness of policy advice provided. Quantity: Policy, research and advice service commensurate with the funds allocated. Price: $1.218m.
2. Services to the Ministers and Parliament.	Quality: A high level of satisfaction of the Ministers and Parliament with the relevance, quality and timeliness of services provided. Agreed timeframes met for responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefings Quantity: Number of responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing will be recorded during 1999-00 as a benchmark. Price: $0.716m.
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.	Quality: Departmental input is taken into account in the setting of national and international standards for therapeutic goods and chemicals, and the adoption of such standards where appropriate. Review of state and national drugs, poisons and controlled substances regulation by end 2000. Quantity: National leadership service commensurate with the funds allocated. Price: $3.951m.
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.	Quality: A high level of satisfaction of industry and consumers with the relevance, quality and timeliness of information services. Quantity: Number of publications circulated, including the number of issues published per year of the following: TGA News - 3 issues; ADRAC Bulletin - 4 issues; and Medical Devices Bulletin - 3 issues. Internet site - the number of hits will be recorded for the first time in 1999-00 and used as a benchmark. Price: $3.027m.
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.	Quality: All applications for entry of products onto the Australian Register of Therapeutic Goods processed within statutory or other agreed timeframes and evaluated at a level appropriate to assessed risk. 80% of problems reported or identified in relation to therapeutic goods resolved satisfactorily within six months of reporting or identification. All public health recommendations in relation to agricultural, veterinary and industrial chemicals provided within agreed timeframes and accepted or adopted by relevant regulatory bodies. All complaints received regarding customer service responded to or resolved within timeframes identified in the Customer Service Charter. Quantity: Number of applications processed for inclusion of products on the Australian Register of Therapeutic Goods. (Previously in the vicinity of 10,000 per year.) Number of public health recommendations made in relation to agricultural, veterinary, and industrial assessments of chemicals. (Previously in the vicinity of 300 per year.) Number of therapeutic products tested as part of post-marketing surveillance. (Previously in the vicinity of 2,000 tests per year.) Quantity: Number of permits and licences issued to meet international obligations relating to controlled drugs and other substances covered under international treaties. (Figures not reported on previously.) Quality:A high level of compliance with the elements of the Government's regulation reform agenda, and their particular reporting requirements. Price: $45.735m.

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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.	Quality: A high level of satisfaction of the Minister and Parliament with the relevance, quality and timeliness of policy advice provided. Quantity: Policy, research and advice service commensurate with the funds allocated. Price: $0.172m.
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.	Quality: A high level of satisfaction of the Minister and Parliament with the relevance, quality and timeliness of services provided. Agreed time frames met for ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing. Submission of annual report on the operations of the ANZFA Act 1991 by 30 September 1999. Quantity: Number of responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing will be collected in 1999-00 and used as a future benchmark. Price: $0.318m.
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.	Quality: Acceptance by authoritative sources of the new standards as achieving desired outcomes. Steady decline in the national estimates of food borne illness. Improved data collection, safety and other characteristics of the food supply. Quantity: National leadership service commensurate with the funds allocated. Price: $6.563m.
4. Information to government and other stakeholders.	Quality:A high level of satisfaction of industry, consumers and stakeholders with the relevance, quality and timeliness of information services. Quantity: Enhancement of ANZFA Internet site. 11 editions of ANZFA News. Information papers and advertising food standards matters. Food Standards Code amendments. Stakeholder consultative forums. Price: $1.321m.

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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.

Quality: A high level of satisfaction of the Minister with the relevance, quality and timeliness of policy advice, research and other services. 100% of States and Territories adopt national radiation protection guidelines and recommendations. 100% compliance by Commonwealth agencies and installations with authorised safety requirements. Quantity: All licence applications processed for Commonwealth installations and facilities (baseline data on numbers will be collected during 1999-2000 as ARPANSA was established in February 1999). Establish baseline data on radiation source licence application numbers. Conduct 15 inspections of Commonwealth installations and facilities. Review the status of 20 Codes of Practice and Safety Guides and develop action plans. Price: $13.984m.

Performance Assessment: Evaluations and Reviews

Population Health Division

Evaluations or reviews planned for this outcome are outlined below. Some of these evaluations will only be initiated during 1999-2000 and it is therefore premature to be explicit about the aim of the evaluation and whether they would be investigating process and/or impacts of the activities. The evaluations include:

1. Breastscreen Australia - a program to increase women's awareness of, and participation in, breast cancer screening with the aim of reducing mortality and morbidity. This program also provides free breast cancer screening for women aged between 50 and 69. An evaluation plan is to be finalised by 1999, and the evaluation is expected to be complete by 2003.

2. National Drugs Strategy - The National Drugs Strategy is a partnership between the Commonwealth and the States and Territories as well as law enforcement. A five-year drug strategy was introduced in 1998. It is expected that evaluations of both the licit and the illicit drug strategies will be complete by 2003.

3. National Public Health Partnership - The National Public Health Partnership (NPHP) was established in 1996 to provide a framework for the Commonwealth and the States and Territories to coordinate and progress population health strategies, research and evaluation. The NPHP will be monitored annually with an evaluation at years three and five. The first stage evaluation is expected to be completed in 2001.

4. Immunisation Strategy - There are two aspects of the Immunisation Strategy that are relevant. Firstly, the final report of the Evaluation of the Measles Campaign is due to be completed in 1999. Secondly, the Australian Childhood Immunisation Register will be evaluated during 1999.

5. National Communicable Diseases Surveillance Strategy - A monitoring and evaluation strategy for this plan will be developed by June 2000, with implementation by the end of 2000.

6. National Indigenous Australians' Sexual Health Strategy - This strategy is a preventative primary health care strategy that was developed in collaboration with indigenous communities in 1996. An evaluation of this strategy is to be initiated from 1999 onwards.

7. National Injury Prevention Strategic Framework - A strategy for injury prevention and control will be completed and implemented in 1999. Evaluation is planned for 2002.

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