1999-2000
Outcome 5: Rural Health Care
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.
Improved health outcomes for Australians living in regional, rural and remote locations.
Outcome Summary - The Year Ahead
In late 1998, the Department was restructured to accommodate changes to administrative arrangements following the 1998 Federal Election to better address the Government's priorities for its second term agenda. Part of these changes included the establishment of a new Rural Health Branch to coordinate Departmental programs and strategies on rural health.
Activities under all of the Portfolio Outcomes impact on rural areas. Some Outcomes also have specific initiatives designed to improve rural health outcomes, access to services or attraction or retention of the rural health workforce. General practice initiatives in rural areas are reported under Outcome 4 and general medical training and workforce initiatives under Outcome 9. Other initiatives are reported under this Outcome.
During 1999-2000 activities under Outcome 5 will focus on:
- development and implementation of a strategic policy framework for rural health and coordination across Departmental activities;
- partnership arrangements with other Commonwealth agencies, State and Territory government agencies, and non-government stakeholders;
- various rural workforce development strategies supported under the National Rural Health Support Services Program;
- continued support for the University Departments of Rural Health Program; and
- implementation of the 1998 Rural Multipurpose Health and Family Services Network and the 1999 Regional Health Service Centres initiatives.
A new measure will be funding for first line emergency care courses. These courses are designed to provide necessary training to nurses working in remote areas to help them better assist victims of emergencies and trauma who are remote from modern life saving equipment and back-up emergency transport. This activity will be funded on a continuing basis to ensure that a mobile group of emergency medicine specialists, medical practitioners and specially trained emergency care nurses are able to provide courses of instruction to remote area nurses.
The establishment of new multipurpose services under the 1998 Rural Multipurpose Health and Family Services Network initiative will continue to be a key priority in 1999-2000. Locations for seven services had been approved as at the end of March 1999.
A key priority in 1999-2000 will be the development of Regional Health Service Centres in rural Australia. These Centres will build on the successful multipurpose services model by establishing thirty Regional Health Service Centres across Australia. Multipurpose services provide an efficient and cost effective solution to provision of health, aged care and community services in many rural communities which, because of problems related to economies of scale, can not sustain separate services. Through the "cashing" out of Commonwealth and State contributions to aged care and health they have provided flexibility in the way in which funds were spent. Regional Health Service Centres will include a number of services operating from one central location, for example General Practice services, immunisation and other preventative health services, aged care, child care and other community services.
These Centres will be planned in consultation with local communities, including local health professionals, State and Territory Governments and other Commonwealth agencies to ensure effective and coordinated government responses to local needs.
Budget measures affecting Outcome 5 are listed in the next section. Several other Budget measures under other Outcomes will also help to achieve Outcome 5, specifically:
- 'Expanded Medicare easyclaim facilities' (outcome 2, page 81);
- 'Retention payments for general practitioners in rural and remote areas' (Outcome 4, page 125);
- 'Fly-in fly-out female general practitioner services to meet the needs of rural women, (Outcome 4, page 126);
- 'Strengthening support for women with breast cancer' (Outcome 4, page 126);
- 'Aged care capital funding assistance targeted particularly to rural Australia' (Outcome 8, page 192);
- 'Simplifying aged care planning for rural and remote areas' (Outcome 8, page 194); and
- 'Establishing regional medical schools' (Outcome 9, page 217).
Budget Measures Affecting Outcome 5
Top of page30 new Regional Health Service Centres
Expense ($m)
 | 1999-00 | 2000-01 | 2001-02 | 2002-03 |
| Department of Health and Aged Care | 5.9 | 11.8 | 11.7 | 11.4 |
Explanation
The Government will establish 30 Regional Health Service Centres in rural communities across Australia. This will build on the successful Multipurpose Service programme under which the Commonwealth and States jointly fund services through flexible funding arrangements.
Regional Health Service Centres will enable a range of health, aged care and community services to be provided, based on community need, with particular emphasis on primary health care. These services could include rural health promotion, general practitioner services, illness and injury prevention, acute and palliative care, women's health, children's services, community nursing, aged care, mental health, podiatry, radiology and immunisation.
The Commonwealth will work closely with State and Territory Governments and local communities to ensure effective and coordinated services responsive to the needs of local communities. Where necessary, community planning managers will be employed to assist communities in the planning of services to reduce establishment times, assist in transition arrangements and ensure that services are responsive to community needs. Information technology infrastructure will be funded to enhance services and skills by linking Regional Health Service Centres to other services and infrastructure.
Bush Crisis Line upgraded
Expense ($m)
| 1999-00 | 2000-01 | 2001-02 | 2002-03 |
| Department of Health and Aged Care | - | - | - | - |
Explanation
The Government will fund the continuation and expansion of the Bush Crisis Line, a 24-hour telephone crisis debriefing and counselling service which assists isolated rural and remote area health professionals to cope with job related trauma.
This initiative will provide improved services to a wide range of rural and remote health professionals, including those working in the field of Aboriginal and Torres Strait Islander health. This measure will increase the number of psychologist/counsellor positions, including provision for Indigenous co-counselling and access to locum/treatment services.
The cost of the measure is $559,000 over three years and will be funded from within existing portfolio resources.
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Further Information
The Bush Crisis Line is a personal support network which provides crisis debriefing and counselling for job related trauma among isolated rural and remote health practitioners and their families through a 24-hour free call 1800 number.
Further training for remote nurses
Expense ($m)
| 1999-00 | 2000-01 | 2001-02 | 2002-03 |
| Department of Health and Aged Care | - | - | - | - |
Explanation
The Government will fund first line emergency care training for remote area nurses to enable them to better assist victims of emergencies and trauma who are remote from modern life saving equipment and back-up emergency transport. This additional training will enable remote area nurses to treat patients pending the availability of further medical treatment. It will also ensure that a mobile group of emergency medicine specialists, medical practitioners and specially trained emergency care nurses are able to provide courses of instruction in first line emergency care to remote area nurses.
The measure will complement the ongoing emergency aero-medical evacuation services provided to remote areas of Australia by the Royal Flying Doctor Service.
The cost of the measure is $75,000 a year and will be funded from within existing portfolio resources.
Assisting rural medical students through their studies
Expense ($m)
| 1999-00 | 2000-01 | 2001-02 | 2002-03 |
| Department of Health and Aged Care | 1.0 | 1.0 | 1.0 | 1.0 |
Explanation
The Government will establish a Rural Australia Medical Undergraduate Scholarships scheme. The measure will provide financial assistance to undergraduate medical students who have completed their secondary education in a rural area to help meet accommodation, living and travel costs incurred while studying at tertiary level.
This is one of a number of long term strategies that aim to increase the general practice workforce in rural and remote communities. The undersupply of doctors in these areas is well documented. Evidence suggests that medical graduates that have a rural origin are more likely to return to rural areas to practice once they have completed their training. However, there are a number of barriers that prevent rural students from considering tertiary education, particularly the financial burden associated with travelling to, and living, in the city. The Rural Australia Medical Undergraduate Scholarships Scheme aims to reduce these financial barriers. It is envisaged that up to 100 scholarships could be funded each year.
Further Information
The Rural Workforce Agencies located in each State would have responsibility for administering the scholarship scheme.
Performance Information and Resource Allocation
Top of pageThe following indicators are designed to measure how effectively this outcome has been achieved.
| Indicator 1: | Access to health and allied health services for people living in regional, rural and remote locations. |
| Target: | Establish indicators and data collection methods by June 2000 which take account of issues such as the numbers of practitioners, current health status and distance from site of service. |
| Info source/rept freq: | To be established. |
| Indicator 2: | The number of health and allied health professionals practising in regional, rural and remote locations receiving training, education and support. |
| Target: | Establish baseline information and data collection methods by June 2000. |
| Info source/rept freq: | To be established. |
| Indicator 3: | Positive change in health status for people living in regional, rural and remote locations over the longer term. |
| Target: | Establish a set of indicators and data collection methods by June 2000. |
| Info source/rept freq: | To be established. |
Resource Allocation
The allocation of resources for Outcome 5 is described in the following two Tables:
- Table C5.1 describes the relationship between the appropriation structure for Outcome 5 and the 1998-99 appropriation structure; and
- Table C5.2 sets out the allocation of resources across administered items and output groups for the Department for Outcome 5.
Table C5.1: Relationship between old appropriation structure and new Outcome structure for Outcome 5
| Outcome | Program |
| 5. Improved health outcomes for Australians living in regional, rural and remote locations. | 2.3 Acute Care (part)
4.3 Residential Access and Quality (part) |
| Appropriations
Department Appropriation Bill 1 Departmental outputs Administered expenses Appropriation Bill 2 Other administered expenses | Appropriations
Sub-program 2.3 Appropriation Bill 1 National rural and remote health support services (340.4.02) Running Costs, including Section 31 receipts (340.1) (p) Appropriation Bill 2 University Departments of Rural Health (891.2.04) Sub-program 4.3 Appropriation Bill 1 Services to rural, remote and other special needs groups (340.5.020) (p) Appropriation Bill 2 Rural multi-purpose health and family services network (892.00.06) Other Appropriation Bill 1 Compensation and Legal Expenses (340.2.01) |
Table C5.2: Resource summary for Outcome 5
1 The difference between the cash and accrual figures for 1998-99 is largely due to liabilities for multi-year agreements
Contribution of Administered Items and Departmental Outputs to Outcome 5
In order to achieve this Outcome the Government has allocated funds of $23m in administered expenses. To support the Government decision to allocate funds to this area the Department will provide a range of outputs in five output groups.
As the achievement of this Outcome is being pursued in partnership with other Commonwealth agencies, State and Territory Governments and other stakeholders, the Department plays an important national leadership role in facilitating these different stakeholders to work collaboratively to achieve this Outcome.
To ensure that funding allocated to this Outcome is used in the most effective way the Department provides policy advice to Ministers, including issues and recommendations relating to the implementation of current program elements and also recommendations on strategic policy directions. The Department also provides a range of services to the Ministers and Parliament such as drafting responses to Ministerials, providing briefings on various issues, drafting speeches, preparation of Question Time Briefs and Parliamentary Questions on Notice.
The Department also provides a contract administration and funds management service to ensure that the administered funds are used to provide efficient, effective, and quality services.
As part of these activities, the Department will assemble and disseminate information on rural health issues.
The following performance information provides a comprehensive overview of the administered items and Departmental outputs together with performance measures.
Table C5.3: Performance Information for Administered Items
1. Support, education and training for health workers1
| Effectiveness: Increased numbers of participants in rural workforce development and up-skilling programs.
Provision of a range of aeromedical services (emergency evacuation and primary health care). Establishment of rural and remote midwifery up-skilling, first line emergency care and pharmacy workforce development programs. Further development of the Bush Crisis Line. Quantity: Establishment of 37 specialist training posts in rural areas. Support for 7 University Departments of Rural Health. |
2. Support for the flexible delivery of rural health services, including:
| Quantity: 23 remaining identified locations for services under the Rural Multipurpose Health and Family Services Network approved.
30 Regional Health Service Centres approved. Quality: Services established within 4 year period. |
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Table C5.4: Performance Information for Departmental Outputs
| 1. Policy advice to the Ministers and Governmenton a wide range of issues related to rural health. | 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: $1.012m. |
| 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 briefing. Quantity: Numbers of responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing will be collected during 1990-00 and used as a future benchmark. Price: $1.369m. |
3. National leadershiprole in relation to:
| Quality: A high level of satisfaction of key stakeholders with the quality and timeliness of Commonwealth initiatives in national strategic policy formulation and planning.
Quantity: National leadership service commensurate with the funds allocated. Price: $1.096m. |
4. Information, including:
| Quality:A high level of satisfaction of internal and external stakeholders with relevance, timeliness and quality of information.
Quantity: Information service commensurate with the funds allocated. Quantitative information on information activities to be collected and used as a future benchmark. Price: $1.025m. |
5. Contract administration and funds management in relation to:
| 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. High level of satisfaction with the timeliness and accuracy of information. Quantity: Management of between 250 and 300 agreements (grants, consultancies and contracts) in 1999-2000. Price: $3.401m. |
Performance Assessment: Evaluation and Reviews
No major evaluations or reviews are planned for this Outcome in 1999-2000.
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