On 15 June 2012, The Minister for Health, the Hon Tanya Plibersek MP, announced a $325 million assistance package for Tasmania’s health system, outlining a number of significant investments to equip Tasmania’s health system to meet future challenges. For the full media release please visit Getting Tasmania's Health System Back on Track.
The $325m Package is designed to benefit all Tasmanians. Commonwealth funding is being provided for a range of initiatives across the Tasmanian health system, with the aim of enhancing timely access to primary health care, acute care, palliative care and mental health services. These service improvement initiatives are being underpinned by investment in the adoption of eHealth, and in building the capacity of a locally trained and appropriate workforce.
The Commonwealth recognises the importance of ensuring that experts and key stakeholders have an opportunity for input into the design and implementation of these initiatives. It is also recognised that many of these initiatives are interlinking and must be developed and implemented with this in mind, in order to get the best outcomes and benefits for Tasmanians.
The Package represents new investment by the Commonwealth in Tasmania’s health system on top of existing funding commitments since 2007 of more than $4.5 billion.
The Package is not a bailout nor a takeover of the public health system. The four year, finite funding Package is Commonwealth controlled and is aimed at making Tasmania’s health system more sustainable in the long term.
Facts and FiguresThe total funding for the Package, across Tasmania, is $325.2m over four years (which includes small administrative overheads):
|Addressing social determinants of health and health risk factors|
|Improving care coordination for people with chronic disease and aged-care clients|
|Trialling streamlined care pathways – Medicare Locals using flexible funds to better meet the post-hospital care needs of patients|
|Clinical redesign of Tasmania’s hospitals and health system|
|Innovating care in emergency departments (formerly walk-in centres)|
|Funding an elective surgery blitz on overdue patients on Tasmanian waiting lists|
|Providing innovative flexible funding for mental health|
|Investments in eHealth initiatives|
|Strengthening palliative care services|
|Strategies to build workforce capacity|
Stakeholder consultationThe composition and design of the Package was informed by the views and suggestions of local clinicians and health professionals, along with advice provided by a broad range of other local stakeholders, to ensure that the money delivers real and sustainable health benefits for Tasmanians over the next four years.
The Commission has convened a number of stakeholder forums. Summaries of the issues raised during these forums, and outcomes of each of the Commission meetings, are available on the Commission’s website. Stakeholder feedback is being used to inform this ongoing work.
In addition to the work of the Commission, meetings with relevant stakeholders including expert reference group meetings, have been held to inform the implementation of the Package.
The Commonwealth is continuing to work with the Tasmanian Government and other stakeholders on the implementation of the Package to maximise benefits across the Tasmanian health system.
Commission on Delivery of Health Services in TasmaniaOn 13 September 2012, Minister Plibersek also announced the establishment of the Commission on Delivery of Health Services in Tasmania. For the full media release please visit Agreement signed for extra elective surgery in Tasmania.
The Commission has an important advisory and oversight role on the implementation of the Package. It is pursuing system-wide improvements to ensure that real and sustained reform to Tasmania’s health system is achieved.
The Commission consists of three highly qualified health experts with the local experience and significant expertise in system reform - Mr Alan Bansemer, Dr Alasdair MacDonald and Dr Heather Wellington:
- Mr Alan Bansemer, former Health Commissioner of Western Australia, will chair the Commission. Mr Bansemer has played a key role in several national health bodies including the Australian Health Ministers’ Advisory Council, Health Insurance Commission, Australian Institute of Health and Welfare, General Practice Consultative Committee, Casemix Implementation Project Board, Medicare Schedule Review Board and the Australian Medical Workforce Advisory Committee.
- Tasmanian physician Alasdair MacDonald who has played a key role on many state health committees. Dr MacDonald is the Director of Medicine at Launceston General Hospital, President of Adult Division Royal Australasian College of Physicians, Clinical Associate Professor at the University of Tasmania, and a member of the National Lead Clinicians Group.
- Medical practitioner and lawyer Dr Heather Wellington, who was born and spent her early years in Tasmania. Dr Wellington is a member of the Expert Panel under the National Partnership Agreement on Improving Public Hospital Services and is a former member of the Australian Council for Safety and Quality in Health Care. She has held the senior clinical role of Director of Medical Services at the Geelong Hospital and has broad experience in a number of jurisdictions including in developing the Tasmania Health Plan.
To enable effective stakeholder engagement and facilitate the flow of information on the work of the Commission, a website for the Commission has been established: Tasmania Health Commission.
On 21 December 2012 the Commission submitted its Preliminary Report on Tasmania’s health system to the Australian and Tasmanian Ministers for Health. The Report identified potential opportunities for system improvement, including:
- Building capacity to undertake clinical redesign;
- Improving patient pathways, with a particular focus on subacute care and sustainable reform to the management of elective surgery; and
- Improved information systems to support clinical practice.
The Commission's Preliminary Report, along with its Terms of Reference are available on the Commission's website.
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National Partnership Agreement on Improving Health Services in TasmaniaThe Tasmanian Health Assistance Package is being implemented through the public, private and non-government sectors. Payment for those elements of the Package to be implemented by the Tasmanian Government will, subject to the requirements of the Intergovernmental Agreement on Federal Financial Relations, be made under the National Partnership Agreement on Improving Health Services in Tasmania (NPA IHST).
The NPA IHST was signed in September 2012 by Acting Prime Minister, Wayne Swan and Tasmanian Premier Lara Giddings. It is an over-arching agreement between the Commonwealth and Tasmania, to provide funding to the Tasmanian Government for delivery of some components of the Package, including elective surgery. Other elements of the Package involving payment to the Tasmanian Government for delivery include mental health, palliative care, Innovating Care in Emergency Departments, and eHealth. Schedules to the NPA IHST are published on the Standing Council on Federal Financial Relations website.
Elective Surgery - Schedule AOn 13 September 2012, Minister Plibersek announced that the Commonwealth and Tasmanian Governments had signed an Agreement that will deliver at least 2,600 additional elective surgery operations in Tasmania. For the full media release please visit Agreement signed for extra elective surgery in Tasmania
Under this Agreement, $30.5 million is available to the Tasmanian Government over four years to target those patients who have been waiting longest for their surgery, across a range of agreed surgical categories. For more information please visit the PDF printable version of National Partnership Agreement on Improving Health Services in Tasmania - including Schedule A: Reducing Elective Surgery Waiting Lists in Tasmania
Innovating Care in Emergency Departments - Schedule EThe Package was originally intended to establish two walk-in centres: one in Hobart and one in Launceston.
In December 2012, the Department of Health and Ageing commissioned targeted consultation with consumers to inform the development and implementation of the proposed walk-in centres initiative in Hobart and Launceston.
Following further consideration of how best to implement the walk-in centre concept in each of the proposed sites of Launceston and Hobart, it was concluded that a more tailored approach was required to respond to the needs of those communities, taking into account existing services in each location.
The Tasmanian Government has worked with the Australian Government to ensure the initiatives represent the best use of resources and complement existing hospital, primary health care, and after-hours health care services. As a result, Australian Government funding of $10.3 million over four years will be used to fund the Emergency Medical Unit and psychiatric emergency nurses at the Royal Hobart Hospital, and $11.6 million over four years will be used to fund the fast track clinic and the specialist hot clinic at the Launceston General Hospital.
For Launceston, it has become apparent that some patients are experiencing difficulties in gaining access to medical specialists following referral by a GP, and that delays in this regard can be accompanied by a deterioration in their condition resulting in their presentation to the emergency department (ED) for urgent care. Funding will be provided to establish a specialist hot clinic at Launceston General Hospital to provide timely access to a specialist physician consulting service aimed at preventing avoidable hospital admissions.
This clinic will be complemented by enhancing the current fast track clinic service already provided by the Launceston General Hospital. This clinic treats patients presenting to the ED with minor illnesses and injuries and is free of charge.
Royal Hobart Hospital is under significant and constant pressure arising from the volume of patients presenting annually to its ED (around 50,000 patients per year). This is similar to the ED demand experienced by the Prince of Wales Hospital in Sydney and the Princess Alexandra Hospital in Brisbane.
Funding will be provided to help manage ED demand and assist in addressing the consequent pressure on other hospital services by establishing an Emergency Medical Unit alongside the ED for treatment of selected patients presenting to the ED. The Emergency Medical Unit will treat patients requiring short term evaluation, investigation and treatment (for up to 24 hours) which can be provided by ED clinicians. These patients include those with gastroenteritis, renal colic, chest pain, cellulitis or who have procedures performed in the ED, such as shoulder reductions, cardioversion and other procedures requiring a short period of sedation. This will also include elderly patients with limited social support overnight and patients who might otherwise require admission to a ward.
These projects in Launceston and Hobart will provide appropriate care between the primary and acute sectors, allow for improved patient flow through the EDs, avoid unnecessary ED presentations and reduce unnecessary/avoidable hospital admissions.
The Australian Government is funding an evaluation of these initiatives that will be conducted in parallel to service provision. This evaluation seeks to assess the cost benefit of this investment and the impact on patient outcomes.
Formal evaluation of the impact of the services will be critical to determine whether these initiatives improve the efficiency, effectiveness and sustainability of emergency departments in Tasmania.
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Better Access to Palliative Care - Schedule DUnder the strategy of strengthening palliative care services, funding of up to $50 million over four years from 2012-13 to 2015-16 is available to enhance community based palliative and end of life care services through the Better Access to Palliative Care (BAPC) element of the Package.
The Commonwealth recognises that Tasmania has both an ageing population and high incidences of chronic disease and cancer, and a highly decentralised population. For these reasons, the need for palliative care services in the Tasmanian community continues to grow.
By expanding the existing capacity of the Tasmanian health system to deliver multi-disciplinary, home based palliative care services, people with life limiting illnesses who are nearing the end of their lives will have greater choice regarding how and where palliative care services are accessed.
Support for health professionals to improve their palliative care skills, and support for advance care planning are also recognised as playing an important role in strengthening the sustainability of community based palliative care services in the long term.
The intended outcomes of the BAPC program are:
- an increase in the number of Tasmanians who are able to access multi-disciplinary palliative and end of life care in their own home;
- increased understanding and use of advance care planning by health professionals, patients and their families and carers;
- improved access to high quality information for patients, their families and carers regarding palliative and end of life care;
- an increase in the number of health professionals who have received education and training in palliative and end of life care.
The BAPC program will include:
- a) $35.75 million (GST exclusive) to deliver customised packages of “wrap around” care in the home for people requiring palliative care;
b) $3.2 million (GST exclusive) to provide vital infrastructure support services including (but not limited to) health promotion, volunteer training, professional development; and
c) $11 million to the Tasmanian Department of Health and Human Services (DHHS) to enhance support for existing service models in Tasmania.
Service delivery under the BAPC program is expected to commence in the first quarter of 2013-14.
Enquiries about the BAPC program can be made by emailing email@example.com.
Patients, families, carers and interested parties who would like to learn more about the Tasmanian Department of Health and Human Services Palliative Care Services can visit:
Palliative Care Service – North
Palliative Care Service - South
Palliative Care Service – North West
For further information, please read the Frequently Asked Questions in both PDF (247 KB) and accessible format (Word 46 KB)
Media EnquiriesMedia enquiries in relation to Australian Government's Tasmanian Health Assistance Package should be directed to the Media Unit by phone on (02) 6289 7400 or by email to News
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