Australian Institute of Policy and Science, Post Budget Health Briefing
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10 May 2012
Professor Rick McLean, Chair of the Australian Institute of Policy and Science
My colleagues Mark Butler, Julie Owens, Senator Claire Moore and Shayne Neumann.
Thank you for the opportunity to be here this morning.
On Tuesday night, the Treasurer brought down the 2012-13 Budget - a budget that will deliver the country a surplus next year and each year after that.
There is no clearer sign of a strong economy than a surplus.
And in delivering a surplus we will also stay true to the things we have always stood for – front-line services for working Australians, jobs and help for those who need it most.
This budget has Labor values – it will improve the health and wellbeing of Australians regardless of where they live and regardless of what they earn.
It should not be seen in isolation but rather as the next instalment in our investment in health reform.
Health reform that has already delivered massive investments in the health workforce.
$1.8 billion in training more GPs and medical specialists, and providing better support to nurses and allied health professionals.
Over the next ten years, we will deliver an additional 5,500 new or training GPs, 680 medical specialists, and 5,400 training places.
I am very pleased to be able to say that more doctors and medical graduates are training to be GPs than ever before.
All the funded training places available this year have been filled – which is a record takeup. The Government is delivering on its commitment to expand General Practice Training to provide 1,200 places a year by 2014 - more than doubling the number of training places available in 2008.
623 trainee doctors will participate in the federally-funded Specialist Training Program and the More Doctors and Nurses for Emergency Departments initiative in 2012.
The Government is also investing $390 million to support nurses in general practices. This will mean that practices are able to employ nurses to the full scope of their ability, and as an integral part of the team managing patient care.
We are reforming primary care so that more patients can get better care in the community.
A total of $650.4 million has been committed to the improvement of primary health care infrastructure, through GP Super Clinic initiatives.
Of this, $117 million is provided for Primary Care Infrastructure Grants to upgrade around 425 general practices, primary care and community health services, and Aboriginal Medical Services.
These provide expanded accommodation for general practitioners and other health professionals, improve access to integrated GP and primary health care services, offer extended opening hours and clinical training facilities.
Another great example of health reform delivering is this Government's Health and Hospitals Fund - a massive $5 billion investment in health infrastructure – the second part of the regional round was included in this year’s budget.
Take the first two funding rounds - 85 projects with a total value of around $3.2 billion. A third of these projects are now complete - I have visited several and can confirm that these projects are making a real difference to communities all over Australia.
These are great projects ranging from the Tumby Bay Primary Health Centre in SA, which we know from the Mayor has made a real difference to the local community, to the Blacktown Clinical School in Sydney - which is training our medical professionals of the future – or the Nepean Clinical School, the opening of which I attended last week.
And, under the 2010 Regional Priority Round a further $1.3 billion has been allocated to 63 projects which will be of real benefit to regional, rural and remote communities all over Australia - like the Bloomhill Cancer Help Community Therapy House in Buderim QLD, which has just been completed.
So that is the backdrop for this year’s budget – strategic investments across the country making a real difference to patients.
This year’s Budget deals with today’s challenges while laying the foundations to realise tomorrow’s opportunities. I want to run through a representative sample of the health measures this morning.
In drafting the 2012-13 health and ageing Budget, our guiding principles have been –
to build health, hospitals and aged care systems for a modern Australia that are truly centred on the patient and individual
to get maximum value for the taxpayers’ dollars
to advance the health and wellbeing of all Australians; and
to ensure that those least able to look after themselves are, in fact, looked after.
I believe we have delivered on all counts.
If you are among the 400,000 people on public dental waiting lists, you’ll be better able to get dental care with this Budget.
If you want health services closer to home, particularly if you live in regional or rural Australia, this Budget makes it easier for you.
If you want more regular screening for bowel cancer that could save your life, this Budget provides it.
If you want a personal e-health record that will help you to better manage your health and that of your kids, this Budget brings it a step closer.
And if you want government to implement targeted and responsible savings that reduce waste, achieve greater efficiency and direct precious dollars to where they have the greatest health and wellbeing benefit, this Budget delivers.
This Budget is about sustainability.
It is about efficiency, value for money and fairness and fundamentally, it is about people.
Let’s have a look at some of the measures announced by Treasurer Swan on Tuesday night.
Dental health reform
Dental health reform is a priority for this Government – we need to ensure that funds are spent efficiently – and on the people that need services most. The Government is committing $515.3 million to start building a dental care system for those in greatest need.
It is a fact – sad but demonstrably true – that the around 400,000 people on public waiting lists, together with a range of people with limited means – including concession card holders, Indigenous Australians and women and children in shelters – have poorer dental health than their fellow Australians.
We will deliver more affordable oral health and improve access to dental services.
New spending in this Budget will see a blitz on public waiting lists to help meet the treatment and prevention needs of people who are eligible for public dental care.
We will direct vital health dollars to additional training to help boost the dental workforce, and improve dental services in regional, rural and remote areas.
We will expand the Voluntary Dental Graduate Year Program so that additional dental graduates receive practical experience and professional development opportunities, including in underserviced areas.
We will introduce an Oral Health Therapist graduate year program, providing placements that will enable graduates to provide additional preventative dental care and health advocacy to adults and children in areas of need.
A new grants program will help dentists to relocate to regional, rural and remote areas – great news for the bush.
We have made strategic investments in dental facilities through the Health and Hospitals fund that will deliver new and upgraded facilities to boost dental services in regional Australia. Oral health promotion activities will be funded right around the country – a key recommendation from the National Advisory Council on Dental Health.
Previous rounds of the Health and Hospitals Fund have already funded 220 additional dental chairs like the one that I saw at Ballan last week and this round will provide more chairs and even more mobile services.
Finally the dental package will also fund an NGO to support dental practitioners who provide pro bono dental health services, to assist people in greatest need – many dentists tell me that they want to do pro bono work but administrative support with making and confirming bookings would make it easier and more effective for them to do so.
These are the first steps – the foundational steps – towards a better system of dental care for this nation – and it is Labor that is taking them.
Bowel cancer screening
Bowel cancer is the second most common cause of cancer-related death in Australia. Each week, 80 people, most of them over 50, lose the fight against this disease.
The good news is that bowel cancer is preventable if detected early – and that’s why the Government is allocating $49.3 million to expand its free National Bowel Cancer Screening Program so that –
people turning 60 from 2013, and 70 from 2015 will be invited to participate in the Bowel Cancer screening program. This means that all Australians between 50 and 70 will be able to receive free bowel screening every five years; and
will progressively implement biennial screening, starting with people turning 72 in 2017. When our program is fully implemented all Australians aged between 50 and 74 will be offered screening every two years.
Bowel screening saves lives – screening at regular intervals will pick up around 12,000 positive tests and save between 300 and 500 lives annually.
Funding of $233 million will continue the rollout of a national, secure eHealth system that will deliver safer and better health services.
From July 2012, Australians who wish to will be able to register to create a personal eHealth record. This will give them the means to manage their own health care and help ensure they can receive the care they need, where and when they need it.
eHealth will deliver practical benefits to Australian families by reducing medication errors and allowing parents to keep better track of their children’s immunisation records.
If they opt in, it will be much easier for Australians with complex and chronic health conditions to ensure that all their health practitioners get easy access to their medical history, making diagnosis quicker and more accurate.
We have made good progress in the past two years in the development of Australia’s eHealth system. This budget provides certainty as we move from its development to operation.
For the profession, we have clarified that GP’s will be able to factor in the creation of or addition to a shared health summary when making a judgement which Medicare item to bill.
We have raised the bar on the use of ePIP.
The Government has provided more than $160 million to general practices (up to $50,000 per practice) over the last two years across Australia to upgrade their computer systems for eHealth.
Government support has helped more than 96% of practices to get the IT they need for eHealth - Australia's GP workforce is now the fifth most computerised in the world.
Now many practices have most of the IT in place, we want to make sure Government focuses its support on the roll-out and take up of the eHealth record. We've supported GPs to develop their IT systems, and now through changes to the ePractice Incentive Payment, we're supporting them to deliver eHealth to their patients through adopting the Personally Controlled Electronic Health Record.
Health and Hospitals Fund (HHF)
The Health and Hospitals Fund, set up by the Labor Government as a cornerstone of National Health Reform, continues to transform the delivery of health care, allocating funding to areas of greatest need, particularly in regional Australia.
A total of $475 million for 76 projects is being funded by the HHF’s 2011 Regional Priority Round through this year’s Budget. These projects will give patients living in rural, regional and remote communities greater access to a range of health services – things like –
Redeveloping and continuing hospital and multi-purpose health services in regional centres such as Broken Hill, Bundaberg, Griffith, Hillston, Kempsey, Lismore, Peak Hill and Warracknabeal;
New and upgraded facilities to support additional dental services in areas such as Cranbrook, Murray Bridge, Narrogin, the Pilbara and Kimberley regions, and Yamba;
Additional funding for the Royal Flying Doctor Service – an aircraft, patient transfer facility, mobile oral health facilities and staff accommodation; and
Increasing the numbers of doctors, nurses and other health professionals who can be trained in areas including Broken Hill, Ulverstone and Katherine.
These are real projects, responsive to local need, that will mean a real, practical difference to people.
And, on top of helping to bridge the city-country gap in health services delivery, these projects will be a boon for regional Australia, creating jobs and strengthening local economies.
This year’s $475 million investment brings the total Commonwealth commitment under the Health and Hospitals Fund to $5 billion. That’s $5 billion for hospitals, community health services, training facilities for medical staff, operating theatres, paediatric wards, rehabilitation programs, inpatient beds, day therapy facilities, pathology services – all those things that make a real, on-the-ground difference for patients and the dedicated people who look after them.
Getting maximum bang for the health buck, particular in the current economic environment, is a real priority – and this Budget delivers in this area.
Substantial savings are achieved through new efficiencies in services and programs – tackling waste, emphasising quality, redirecting funding and better targeting priorities.
Fundamentally, the Government believes strongly that programs need to be effective and evidence-based. This ensures their sustainability and their quality – which in turn ensures they are delivering value for money for the taxpayer.
For instance, the Government will better target the Private Health Insurance Rebate so that it is paid for insurance products that cover ‘natural therapy’ services only where it is deemed they are clinically effective. The Government’s view is that there must be credible evidence that medicines and treatments are effective if they are to attract the rebate and we’ll also work with insurers and organisations to remove prostheses with high revision rates, thus saving unnecessary surgery.
The Government will also discourage health providers who are using the Extended Medicare Safety Net inappropriately. We will put a cap on selected Medicare items from 1 November this year where excessive fees are being charged or where Medicare may be being used inappropriately for cosmetic purposes.
The Safety Net is there to help patients with serious medical conditions who may have high out-of-pocket medical costs.
Again, this measure will save the taxpayer money – some $95.2 million over four years.
The Government will also tighten regulations around diagnostic radiology services so that those taking the images hold minimum qualifications services such as X-rays. This measure is about safety. It’s about quality – and it will produce savings of $45.8 million over four years.
We have continued to work with the pharmaceutical industry to get the best possible prices for medicines.
This budget included important new investments and also savings that are based on clinical and economic evidence of what’s good for patients and what’s good for the long term sustainability of our health system.
This Budget is further illustration that economic responsibility and social reform do not need to be mutually exclusive.
While maintaining the economic rigour that is essential at this time and returning to surplus, the Government has remained true to its reform roots in this Budget. We have achieved both our economic and social imperatives – and Australia and Australians will be the beneficiaries.
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