Evaluation of the Child Health Check Initiative and the Expanding Health Service Delivery Initiative - Final Report

4.1 Progress and status of the CHCI

Evaluation of the Child Health Check Initiative and the Expanding Health Service Delivery Initiative - Final Report

Page last updated: 17 April 2012

4.1.1 Child health checks
4.1.2 Follow-up services
4.1.3 CHCI expenditure

4.1.1 Child health checks

The CHCI was launched on 1 July 2007. The first checks began in Central Australia in the second week of July. By early 2008 intensive efforts to deliver child health checks had slowed and a relatively small number of checks were provided after this time. Some agencies were funded to continue providing checks on an opportunistic basis until late September 2008. AIHW progress reports on the implementation of the program give an estimated overall coverage of 65 per cent of the total eligible population (AIHW and DoHA 2009). In comparison, an analysis of the DHF Client Master Index (CMI) dataset completed as part of this evaluation identified that 57 per cent of eligible children received a check11. The rate of coverage does not take into account health checks that were made available under MBS Item No. 708.


4.1.2 Follow-up services

Approximately 70 per cent of children who had a child health check received at least one referral for a health condition. PHC follow-up services were funded to 30 June 2009. Ear, nose and throat (ENT) follow-up services were funded to 31 December 2010 and hearing (including audiology) and dental follow-up services were funded to 30 June 2012. The most common referral types were for PHC clinic follow-up (39 per cent) and dental (35 per cent), followed by tympanometry and audiology services (14 per cent), paediatrician (12 per cent) and ENT specialist (10 per cent).

Table 6 shows the number of children referred to follow-up services, and the number and proportion who
have been seen at least once by the referred service.Top of page


Table 6: Referrals for follow-up services requested and provided
Type of referralNumber of children who had a referral from CHC(d)Number of children who have been seen at least once by the referred service (number of referrals provided)Percentage of children who have been seen at least once (%)Percentage of children who have not been seen (%)
PHC3,543(a)2,154(c)60.839.2
Paediatrician1,120(a)501(c)44.755.3
Dental3,223(b)1,939(b)60.239.8
ENT specialist1,625(b)1,070(b)65.834.2
Tympanometry and audiometry1,291(b)705(b)54.645.4
Other specialists947(a)308(c)32.567.5

(a) As at 30 June 2009.
(b) As at 19 July 2010.
(c) As at 19 July 2010. Based on the chart review dataset which only includes children who have received a chart review.
(d) For ENT referrals, this includes referrals received at chart review.
Source: AIHW (19 May 2010), NTER CHCI Data Management, Analysis and Reporting Project; AIHW (4 August 2010), NTER CHCI Data Management, Analysis and Reporting Project.


4.1.3 CHCI expenditure

From 1 July 2007 to 30 June 2010 a total of $75.688 million was allocated to the CHCI, of which $54.469 million was spent. Table 7 shows a breakdown of the allocation and expenditure by financial year. This shows that the expenditure on child health checks occurred mainly in 2007–08, with over half of the total follow-up funding also spent in that year. Expenditure on follow-up services decreased from $19.586 million in 2007–08 to $10.027 million the following year and $6.922 million in 2009–10.


Table 7: Annual CHCI funding allocation and expenditure ($ million)
2007-082008-092009-10
AllocationExpenditureAllocationExpenditureAllocationExpenditure
Child health checks
Australian Government provided CHCs-7.371--0.003--
NT Government provided CHCs-3.457----
ACCHO(a) provided CHCs-1.718----
Capital and infrastructure-2.878----
Other (training, data collection)-2.253-0.261--
Total child health checks-17.677-0.258--
Child health check follow-up
Hearing and ENT-7.136-5.200-3.259
Dental-3.414-3.990-3.663
PHC and other follow-up-9.036-0.837--
Total follow-up-19.586-10.027-6.922
Total CHCs and follow-up(b)58.33537.2629.33410.2858.0196.922

(a) Aboriginal Community Controlled Health Organisation.
(b) May not sum to total due to rounding.
Source: DoHA (4 August 2010), NT related health measures—allocation and expenditure 2007–08 to 2011–12.

As shown in Table 8, of the original $75.688 million allocated for the CHCI, a total of $54.469 million has been spent—an underspend of $21.219 million. The time frame from the announcement of the NTER to the allocation of funding by parliament was only a matter of weeks (FaHCSIA 2008), with emphasis placed on rapidly implementing the measures. The short time frame meant that funding allocations were based on projected estimates of expenses and were provided on the basis that any unspent funds would be returned to the Australian Government Budget, or conversely additional funding could be provided if required.Top of page


Table 8: Total CHCI allocation and expenditure to 30 June 2010 ($ million)
Total allocation
Total expenditure(a)
Child health checks
Australian Government provided CHCs-7.368
NT Government provided CHCs-3.457
ACCHO provided CHCs-1.718
Capital and infrastructure-2.878
Other (training, data collection)-2.514
Total child health checks-17.935
Child health check follow-up
Hearing and ENT-15.595
Dental-11.067
PHC and other follow-up-9.873
Total follow-up-36.535
Total CHCs and follow-up75.68854.469

(a) May not sum to total due to rounding.
Source: DoHA (4 August 2010), NT related health measures—allocation and expenditure 2007–08 to 2011–12.

The CHCI also involved costs for OATSIH related to policy, planning and implementation functions, to a total departmental expenditure to 30 June 2010 of $19.711 million. This figure includes expenditure relating to ‘alcohol and other drugs’ and ‘child special services’, which are outside the scope of this evaluation.

The other substantial cost associated with planning and implementing the CHCI is the cost of the Australian Defence Force’s (ADF) role, which was known as Operation OUTREACH. This operation began on 27 June 2007 and provided logistical support for a variety of NTER programs. Support for the CHCI included transporting child health check teams, providing accommodation and meals for people in Darwin and packing and deploying medical supplies. The total cost of Operation OUTREACH was just over $14 million (Department of Defence 2009), though we were unable to determine how much of this was spent on the CHCI.

11 - The CMI is described further in Section 4.2.2.

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