From 1 July 2012, a Rural Health Outreach Fund will be created, which will consolidate the activities of five existing programs:
- Medical Specialist Outreach Assistance Program
- Medical Specialist Outreach Assistance Program – Ophthalmology
- Medical Specialist Outreach Assistance program - Maternity Services Program (part of the Maternity Services Reform Package)
- Rural Women’s GP Service
- National Rural and Remote Health Program which includes the Kimberley Paediatric Outreach Program.
Table 30 – Rural Outreach Fund program allocations 2011-12 to 2014-15
|Kimberley Paediatric Outreach Program||0.83||0.84||0.86||0.87|
|MSOAP Maternity Services||3.39||5.29||5.38||5.47|
|Rural Women’s GP Services||3.48||3.54||3.61||3.67|
MSOAP-ICD will be included in an Indigenous Chronic Disease Fund, but continue to be administered under the MSOAP arrangements. Funding allocations for MSOAP-ICD will be $19.5 million in 2011-12 increasing to $25.7 million in 2012-13. The Indigenous Chronic Disease Fund will consolidate programs related to the COAG Indigenous Chronic Disease initiative including:
- MSOAP - Indigenous Chronic Disease
- Urban Specialist Outreach Assistance Program
- Expanding the Outreach and Service Capacity of Indigenous Health Organisations
- National Action to Reduce Indigenous Smoking Rates
- Subsidising PBS Medicine Co-payments
- Engaging Divisions of General Practice to Improve Indigenous Access to Mainstream Primary Care
- Care Coordination and Supplementary Services Measure
- Improving Indigenous Participation Through Chronic Disease Self-Management
- Attracting More People to Work in Indigenous Health
- Workforce Training and Support
- Clinical Practice Guidelines
- Local Community Campaigns to Promote Better Health
- Improving Eye and Ear Health Services for Indigenous Australians for Better Education and Employment Outcomes - Training of Aboriginal health workers in ear health and hearing monitoring and screening (a specific COAG measure)
- Rheumatic Fever Strategy - National Coordination Unit (not part of ICD).
The consolidation of the programs was an outcome of a strategic review that replaced a total of 159 predominantly grant programs with 18 new or expanded flexible Funds (DoHA 2011d). An additional six programs will be transferred from DoHA to Cancer Australia and the National Health and Medical Research Council.
The Rural Health Outreach Fund is designed to provide a larger more flexible pool of funds aimed at improving access to medical specialists, GPs, and allied and other health providers in regional, rural and remote Australia. The Fund has been created in 2011-12, but through the financial year the Department is developing “comprehensive guidelines to underpin the operation of the fund, which will clearly articulate the fund’s policy objectives, operating parameters, eligibility criteria and compliance requirements” (DoHA 2011d) and will be working with funded organisations to transition them to the new arrangements.
The fund will support the delivery of outreach medical specialties and a range of primary health care services including multi-disciplinary maternity services, eye health services and their coordination, and services by female GPs. Program funding is not being reduced, with all existing program funding to be included in the flexible Funds (DoHA 2011d). One of the aims of the reforms is to increase flexibility within the funds.
Another aim is to reduce ‘red tape’. Across the 159 programs to be consolidated “there are around 2,200 direct funding recipients (not including people or organisations who receive payments through third parties, such as Medicare Australia), and many of these are grant recipients who have multiple funding agreements with the department… with separate program guidelines and reporting requirements” (DoHA 2011d) and multiple contact points within the Department. The Department believed that under the new arrangements “funding recipients will benefit from a significantly streamlined set of arrangements. In many cases the number of funding agreements will be reduced over time to just one, meaning fewer contact points within the Department and a resultant reduced administration and reporting burden” (DoHA 2011d). Streamlined administration is a key objective.
Another feature of the changed arrangements is that the role of fundholders will become contestable. This means that an open tender process will be undertaken to determine the organisation to undertake the fundholder role from 1 July 2012.