HEALTH AND AGEING
Rural Medical Infrastructure Fund
The Rural Medical Infrastructure Fund (RMIF) will provide $15 million over three years in small communities to help establish ‘walk-in walk-out’ community medical facilities, making it easier to recruit or retain general practitioners.
The RMIF will provide grants of up to $200,000 to help rural councils set up these medical centres in smaller communities. In some rural areas, the cost of establishing and maintaining suitable premises and facilities has a heavy impact on the viability of general practice. The high cost is a deterrent for doctors to establish private practices in these areas. An increasingly mobile general practitioner workforce also means some doctors are reluctant to make such a significant and long-term investment.
In response, some councils have established community medical clinics that doctors can use for a reasonable charge, but many small councils simply do not have the resources. The Fund can contribute to the costs incurred by councils that purchase and fit-out facilities, providing continuity of practice management regardless of doctor turnover. This means that families in rural Australia can continue to receive care from a general practitioner with access to their medical records and history.
Round the Clock Medicare: Investing in more after-hours GP services
After-hours care by doctors is being increased for patients — as a priority of the Australian Government.
The new Round the Clock Medicare initiatives will extend the reach of general practice around the clock. New funding of $555.8 million over the five years from 2004-05 for Round the Clock Medicare will cover:
- $449.6 million over five years for higher Medicare rebates for after-hours GP services. This began on 1 January this year.
- $106.2 million over five years for three new grants programmes
to support after-hours general practice infrastructure;
- $20.6 million over four years for operating subsidies, to a maximum of $200,000 a year for new and recently established after hours GP services,
- $66.5 million over five years for start-up grants of up to $200,000 over two years and for the Medicare costs for new after-hours GP services, with up to five to be funded this financial year, and
- $19.1 million over four years for supplementary assistance to after-hours services in outer suburban and regional areas to ensure their viability.
The Australian Government will provide recurrent operating subsidies, to a maximum of $200,000 a year for new and recently established after-hours GP clinics and medical deputising services.
These subsidies will be open to ‘standard hour clinics’ that want to extend their operation, deputising services, or new dedicated after-hours services.
These services will be located in local communities or close to hospitals and health care facilities — at well‑located sites, where local communities gain benefit from them.
The Australian Government will also provide one-off start-up grants of up to $200,000 over two years to assist existing general practices, dedicated after-hours clinics and medical deputising services to remain open after hours. Funding for up to 30 services a year over the next four years will be provided.
The Round the Clock Medicare election commitment also included funding in 2004-05 for clinics run by local GPs in five regions: Kallangur (Queensland); Tweed Heads and Ryde (New South Wales); Glenside (South Australia); and Williamstown (Victoria).
In addition, the Australian Government will provide up to 100 competitive grants of up to $50,000 per year to: local practices; medical deputising services and cooperatives of local GPs that are operating a rostered after hours surgery-based or call-out service.
Round the Clock Medicare: Continuing the After Hours Primary Medical Care Programme
This Budget also supports continuation of the existing After Hours Primary Medical Care Programme at a cost of $58.2 million over four years from 2005-06.
Under the programme, the Australian Government has funded:
- Four major trials.
- 54 seeding grants.
- 12 infrastructure or IT grants.
- 19 project grants.
- 12 quality improvement projects (medical deputising services).
Services currently funded under the After Hours Primary Medical Care Programme’s Service Development Grants and Trials components — including GP Assist in Tasmania and GP Access After Hours in the Hunter urban region of NSW — have had their contracts extended to June 2006. Existing services are currently undergoing a thorough evaluation.
Developing and implementing training courses for cancer nurses
The Australian Government will provide $4.1 million in new funding over the four years from 2005-06 to develop and implement a training package for nurses to become specialised in cancer care. This initiative will be managed by the Peter McCallum Cancer Institute, in association with other Australian cancer care institutions and professional colleges and associations.
Continued support for rural and remote nursing workforce
The Australian Government has re-affirmed its support for the rural and remote nursing workforce by providing funding of $20.6 million over three years from 2005-06 to continue the existing Rural and Remote Nurse Scholarship Programme.
The programme provides scholarships and support to nurses, former nurses and nursing students in rural and remote Australia.
The assistance provided allows them to study nursing, update their skills or qualifications, attend conferences, or re-enter the nursing workforce.
This programme contains several initiatives that support, educate or train the rural and remote health workforce and assist in removing major barriers to recruiting and retaining rural and remote health workers.
This programme has funded postgraduate scholarships for rural nursing and allied health professionals, training posts in rural areas for medical specialists, and a variety of training and support initiatives under the Rural Health Support Education and Training Programme.
Reaffirming a commitment to a strong rural and remote health workforce
The Australian Government has reaffirmed its commitment to improving access to high-quality health services for rural and remote communities by committing to continue $17.2 million of funding over three years to 2007-08 for the National Rural and Remote Health Support Services Programme.
Additional practice nurses for rural Australia and other areas of need
The Australian Government has committed to continue providing grants to support employment of practice nurses, to general practices in rural areas and other areas of need. The grants are made available to practices enrolled in the Practice Incentive Programme (PIP), and will total $129.7 million over the four years to 2008-09.
More than 1,000 general practices have directly benefited from the PIP practice nurse payment.
The role of the nurse in general practice will also be enhanced by other programmes being introduced by the Australian Government. This includes a new role for practice nurses as contacts for domestic violence victims, and in providing cervical screening to women in rural and regional areas.
Respite care to assist employed carers
Carers in paid employment and carers re-entering the workforce will benefit from an increase in the number of respite services available through funding of $95.5 million over four years. This will include increasing the funding to Commonwealth Carer Respite Centres, enabling day respite centres for older Australians to extend their hours of operation. This will provide additional respite for up to 5,000 employed carers.
Residential respite funding boost
Funding for residential respite will be boosted by $41.8 million over four years which will enable an extra one million high care respite days in aged care homes. This will allow an estimated 47,000 carers to take a break from their demanding carer role, with the peace of mind that comes with knowing their loved one is receiving high quality care.
Overnight respite in community respite houses
The Australian Government will increase overnight respite in community respite houses by providing $61 million over four years for Commonwealth Carer Respite Centres to purchase more than 55,000 nights of care in the community for 2,000 carers, particularly in areas where such options may be limited.
The funding will also support the development of specific standards and reporting requirements for community respite houses to ensure older people in community respite are receiving the quality care they need.
Increasing rural and regional respite services
Rural and regional respite services’ capacity will be increased to provide access to flexible respite services tailored to meet demand specific to rural and remote areas through $9.3 million funding over four years to Multipurpose Services. This will provide more than 122,000 days of respite care through Multipurpose Services.
Reaffirming a commitment to better outcomes in mental health care
The Australian Government’s Better Outcomes in Mental Health Care Initiative has been providing GPs with education and training to help them deliver quality care to patients with mental health problems and it has allowed access for patients to allied health professional care.
The Australian Government has reaffirmed its commitment to the prevention and early intervention of mental illness in the community by providing continued funding of $102.2 million over four years to 2008‑09 to continue the Better Outcomes in Mental Health Care Initiative. Additional funding will also be available through the Medicare Benefits Schedule for GPs to provide chronic disease management, including care plans and reviews for patients with mental health problems.
The Australian Government will also provide an additional $42.6 million over five years to expand the programme, which assists GPs in managing patients with mental health problems and rewards GPs for providing best-practice, primary mental health care.
These funds will also provide a GP Psychiatric Support Service so that GPs can seek advice from a psychiatrist via phone, fax or e-mail for patient care.
Dementia
The Australian government will provide over $250 million over four years to improve the care of elderly Australians living with dementia and will make dementia a National Health Priority Area. This includes the provision of 2,000 new Extended Aged Care at Home places specifically targeted to people with dementia, and expansion of the Carer Education and Workforce Training project, providing dementia specific training for up to 9,000 aged care workers and up to 7,000 carers and community workers.
Cancer prevention and screening activities
The Australian Government will allocate $43.4 million over four years for a bowel cancer screening pilot programme, which will reduce morbidity from bowel cancer. From the middle of 2006, people turning 55 years or 65 years old across Australia will be invited to complete a simple, yet highly effective test in the privacy of their own home and mail it in for analysis. People in regional Australia will benefit from having ready access to simple early detection services.
Developing and implementing mentoring for regional cancer services
Over the four years from 2005-06, $14.1 million in new funding has been allocated to assist hospitals, providers and support networks to develop and implement cancer care mentoring.
A mentoring system involving major urban teaching hospitals in each state and territory, linked to several regional and bush nursing hospitals in regional centres, will help foster multidisciplinary approaches in regional areas where on-the-ground support is less comprehensive.
The mentoring plan will encourage specialists and other leading health professionals from centres of excellence in cancer to spend more time in rural and regional areas and be available to consult with regional colleagues.
New Medicare rebate for Pap smears taken in rural Australia
Meeting the Australian Government’s 2004 election commitment, a Medicare rebate is now available for Pap smears taken by a practice nurse on behalf of a general practitioner in regional, rural or remote areas.
The Australian Government has committed $17.8 million over five years from 2004-05 to this initiative. The new Pap smear Medicare rebate, which came into effect on 1 January 2005, requires the practice nurse to be qualified and trained to take a Pap smear. The GP retains responsibility for the health, safety and clinical outcomes of the patient.
By supporting the mostly female practice nurses to carry out Pap smear tests, more women will be encouraged to take advantage of this important health service.
Medicare benefits eligibility for two more Magnetic Resonance Imaging units
In February this year, 21 new providers of Medicare-eligible MRI services were announced.
In line with the Australian Government’s election commitment, eligibility for Medicare will be extended to one Magnetic Resonance Imaging (MRI) unit in Dubbo and one mobile MRI unit in the Gippsland region.
With the addition of these units, there will be 101 Medicare-eligible MRI machines in Australia.
The Dubbo unit will improve access to MRI services for people living in rural and remote western New South Wales.
As well as the recurrent Medicare costs for this unit, the Australian Government is providing new funding of $3 million towards purchasing and equipping the mobile MRI unit. Patients who obtain Medicare-eligible services from the mobile MRI unit will not incur out-of-pocket expenses.
MRI is a powerful diagnostic tool that does not use radiation to generate scans. It is especially useful for scans of soft tissue like the brain and for the diagnosis of conditions such as cancer.
New Medicare offices
In 2005-06, the Health Insurance Commission will be opening an additional two new Medicare offices. These are in Tuncurry, NSW and Wynnum, Queensland. This reflects the Australian Government’s focus on and commitment to providing easy access to Medicare services.
Accommodation for visiting health professionals, north east Tasmania
Meeting its 2004 election commitment, the Australian Government will provide one-off funding of $100,000 to the Dorset Shire Council towards the cost of building an accommodation unit for visiting health professionals at Scottsdale Hospital. This money is being provided on a matching basis with the Tasmanian Government.
The accommodation will make it easier to attract health professionals, reducing the need for people in the area to travel far when they require specialist health services.
Gippsland Lakes Community Health Centre
In line with its 2004 election commitment, the Australian Government will provide funding of $500,000 over two years for the building of a new community health centre in Gippsland, Victoria. The new centre will house important health care services for the broader Gippsland Lakes community.