Australian Government, 2009‑10 Budget
Budget

Part 2: Expense Measures

Health and Ageing

Aged care viability supplements — increase

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 2.4 11.0 - -
Department of Veterans' Affairs - 0.3 1.2 - -
Total - 2.6 12.2 - -

The Government will provide $14.8 million over two years to increase the viability supplement paid to eligible aged care providers in regional, rural and remote areas. This increase will enable efficient providers in these areas to earn returns on investment more in line with those achieved by efficient providers in metropolitan areas and major cities. Under this measure, increased viability supplements will be paid to eligible aged care providers who provide Residential Care, Multi‑Purpose Services and Aboriginal and Torres Strait Islander Flexible Services.

The Government recognises that population ageing will place increasing demands on the aged care system in coming years. The Government will continue to consider the longer term needs of the aged care system, taking into account relevant recommendations in the final report of the National Health and Hospitals Reform Commission.

Assistive Technology in Community Care program — discontinuation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -6.6 -6.3 -6.4 -6.5

The Government will cease the Assistive Technology in Community Care program. This program was introduced in 2007 to encourage the use of assistive technology among community care providers. This technology can include home safety devices, medication dispensers and communication technology to reduce isolation.

Funding will cease for this program as the aged care industry is now aware of the availability and benefits of such technology.

This measure will provide savings of $25.8 million over four years.

Australian Better Health Initiative — cease promotional activities for 45 Year Old Health Check

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.9 -0.8 -0.9 -0.9

The Government will cease funding for the promotion of the 45 Year Old Health Check program, provided as part of the Australian Better Health Initiative. The 45 Year Old Health Check provides eligible people aged between 45 and 49 years access to a health examination through their general practitioner and will continue to be funded through the Medicare Benefits Schedule. The uptake rate of the 45 Year Old Health Check has been above original estimates, indicating that further promotional activities are no longer necessary.

This measure will provide savings of $3.5 million over four years.

Australian Better Health Initiative — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - -26.2 -27.1 -27.6

The Government will reduce duplication in health funding by ceasing three components of the Australian Better Health Initiative from 30 June 2010. The components that will cease relate to supporting lifestyle and risk modification, encouraging active self‑management of chronic disease, and the Primary Care Incentive Fund. There will be no change to any existing contracts.

Funding for similar outcomes is now provided through other Government initiatives such as the Australian Primary Care Collaboratives Program. The Government also has a number of major reform processes in train, such as the National Preventative Health Taskforce and the development of a National Primary Health Care Strategy, which will embed the outcomes of these small targeted initiatives into the mainstream health system.

This measure will provide savings of $80.9 million over three years.

Australian Better Health Initiative — promoting healthy lifestyles — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - -12.4 -12.6 -12.9

The Government will reduce duplication in the health system by reducing funding for the promoting healthy lifestyles component of the Australian Better Health Initiative beyond 30 June 2010.

Similar nationwide activities intended to deliver the same health outcomes will be funded as part of the new Council of Australian Governments National Partnership Agreement on Preventive Health, which provides $872.1 million over six years. This includes an extension of the Measure Up campaign, which conducts national marketing to raise awareness on healthy lifestyle choices. The measure Health and Hospitals Reform — Preventative Health — Osborne Division of General Practice's Obesity Program in the 2008‑09 Budget will continue to be funded until 30 June 2012.

This measure will provide savings of $37.9 million over three years.

Australian Institute of Health and Welfare — improving access to data and analysis

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Australian Institute of Health and Welfare - 0.6 0.7 0.7 0.7
Australian Institute of Health and Welfare - 0.3 - - -

The Government will provide $2.9 million over four years (including $0.3 million in capital funding in 2009‑10) to allow the Australian Institute of Health and Welfare to meet the demand for expanded content and analysis in its flagship publications, and to increase the accessibility of data.

The publications supported by this funding are the biennial Australia's Health and Australia's Welfare, and The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, which is co‑published with the Australian Bureau of Statistics.

Data accessibility will be enhanced by producing some publications in formats suitable for the visually impaired, and by publishing health and welfare expenditure data in online tables.

Australian Red Cross Society — additional funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 5.0 5.0 - -

The Government will provide an additional $10.0 million over two years to the Australian Red Cross Society. These funds will assist the Australian Red Cross Society to perform its health‑related work in humanitarian relief and community support in Australia and the region. This funding will be subject to agreement on the high‑level priority areas for the use of the funds, and is in addition to the $5.0 million provided to the Australian Red Cross Society announced in February 2009 in the Updated Economic and Fiscal Outlook.

Australian Sports Anti‑Doping Authority — continued funding for Australia's anti‑doping framework

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Australian Sports Anti-Doping Authority - 5.2 5.2 5.2 5.3
Australian Sports Anti-Doping Authority - 0.2 - - -

The Government will provide $21.1 million over four years (including $0.2 million in capital funding in 2009‑10) to continue funding for the Australian Sports Anti‑Doping Authority's education programs, athlete testing regime, investigation and prosecution framework. These programs will facilitate Australia's compliance with the revised World Anti‑Doping Code.

This measure will help reduce the use of performance enhancing drugs in sport.

Breast cancer treatment — continuation of funding for the Herceptin® program

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -
Medicare Australia - - - - -
Total - - - - -

The Government will provide $168.0 million over four years from 2009‑10 to continue funding for the Herceptin® program. The program provides free access to Herceptin® for patients affected by late‑stage metastatic breast cancer.

This measure involves funding of $42.0 million per year, including funding of $0.5 million per year for Medicare Australia to administer the program. Provision for this funding has already been included in the forward estimates.

Further information can be found in the press release of 3 May 2009 issued by the Minister for Health and Ageing.

Cancer Australia — improved lung cancer data and treatment guidelines

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Cancer Australia - 0.9 2.4 1.7 1.7

The Government will provide $6.8 million over four years to Cancer Australia to improve the treatment of people affected by lung cancer. This funding will support the collection of data to better measure clinical outcomes of patients. It will also fund priority lung cancer research and support the development of best practice guidelines to assist healthcare professionals to treat lung cancer patients.

Continence Aids Payment Scheme — more choice for users

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 3.2 -7.8 -5.4 -4.6
Medicare Australia - 0.9 0.6 0.7 0.8
Total - 4.1 -7.1 -4.7 -3.9
Medicare Australia - 0.8 - - -

The Government will replace the Continence Aids Assistance Scheme, which provides subsidised continence products to eligible individuals, with a Continence Aids Payment Scheme. The Continence Aids Payment Scheme will allow greater freedom in the choice of products and suppliers for users of continence aids. The existing scheme provides subsidised continence products purchased through a sole provider up to the value of $479.40. The new payment starting from 1 July 2010 will be equivalent to the current subsidy, will be indexed annually, and eligibility will be determined in the same way as under the current scheme.

This measure will provide savings of $10.7 million over four years as the Government will no longer pay administrative overheads for the provision and delivery of continence products through a sole provider.

Divisions of General Practice program — new funding formula

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 1.9 3.1 2.6 -

The Government will provide $7.6 million over three years to implement a new funding formula for the Divisions of General Practice program. The program delivers a range of health programs that support local general practices and the community.

The new formula is based on the new classification system, Australian Standard Geographical Classification — Remoteness Areas. This system is outlined in the expense measure titled Rural Health Workforce Strategy in the Health and Ageing portfolio. The new formula will boost funding for some Divisions, particularly where there has been significant population growth.

The Divisions of General Practice deliver community services including: improving patient access to general practitioners, particularly in regional and remote areas; prevention and early intervention of disease; supporting multidisciplinary care; and better management of chronic disease.

Longer term funding arrangements will be considered prior to the expiry of the new funding agreements on 30 June 2012.

e‑Health — electronic clinical information and communication network for north‑west Tasmania

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.3 0.7 0.2 -

The Government will provide $1.2 million over four years for the development of a virtual network that will link data from health care providers in the north‑west of Tasmania into a single integrated electronic clinical information and communication system. This network will allow for improved communications between general practitioners and other health professionals which will support the provision of coordinated health care to patients in the region.

See also the related expense measures titled Magnetic Resonance Imaging unit in north‑west Tasmania — redirection of funding and Health Infrastructure Projects in Tasmania in the Health and Ageing portfolio.

e‑Health programs — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -9.7 -12.1 -13.0 -

The Government will refocus funding for the e‑Health Implementation program following an external review of the National E‑Health Transition Authority. Savings will be achieved from the completion of HealthConnect on 30 June 2009 and the identification of further efficiencies within the e‑Health Implementation program. HealthConnect originally funded State and Territory governments to implement needs‑based projects to improve the safety and quality of clinical communications. This measure does not impact on the Government's funding commitment to the National E‑Health Transition Authority agreed through the Council of Australian Governments on 29 November 2008.

This measure will provide savings of $34.8 million over three years.

Epidermolysis bullosa — national dressing scheme

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 2.0 4.6 4.8 5.0

The Government will provide $16.4 million over four years to establish a national Epidermolysis bullosa dressing scheme to support eligible patients in meeting the high costs of treatment and ensure a nationally consistent level of care.

Epidermolysis bullosa is a rare genetic disease primarily affecting children, and is characterised by extremely fragile and blister prone skin. Management of this disease requires frequent application of specialised dressing and bandages to reduce skin damage and the risk of infection. There are approximately 250 patients requiring specialised dressing, which may cost more than $5,000 per month for the most severe form of the disease.

Access to the scheme will be restricted to those patients meeting certain eligibility criteria. These criteria will be based on the severity of the condition and the clinical requirements for specific dressings, and will be developed in consultation with clinical experts.

European training base for Australian athletes — continuation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Australian Sports Commission - - - - -

The Government will provide $10.9 million over four years from 2009‑10. This measure will enable the continued operation of a European training base for Australian athletes in Gavirate, Northern Italy. The training facility provides athlete accommodation, recovery facilities, sports medicine and drugs testing amenities and access to state of the art training facilities.

Provision for this funding has already been included in the forward estimates.

Fairer income testing in residential aged care — ending the 28‑day income test exemption

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 0.3 - - -
Department of Veterans' Affairs - -0.8 -1.7 -1.8 -2.0
Department of Health and Ageing - -4.0 -9.2 -10.0 -10.9
Total - -4.5 -10.9 -11.8 -12.9

The Government will apply the income test for residential aged care from the day of entry, removing the current 28‑day delay. This will align the residential income‑tested fee with other aged care fees payable from the day of entry into the aged care facility and will ensure an equitable sharing of costs of residential care where the resident has the capacity to pay. The income test itself will not change.

This measure will provide savings of $40.0 million over four years.

Food Standards Australia New Zealand — funding for upgrading computer systems

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Food Standards Australia New Zealand - 1.4 1.1 - -
Food Standards Australia New Zealand - 0.1 0.3 - -

The Government will provide $2.9 million over two years (including $0.4 million in capital funding for hardware and software items) to Food Standards Australia New Zealand to fund the development and implementation of two data management and modelling systems to replace the existing systems. The upgrade of the information technology systems will allow Food Standards Australia New Zealand to continue to meet its obligations in assessing the safety of proposed changes to the Australian and New Zealand food supply as well as assessing the risk to the population in food emergencies.

General practice training — consolidating regional training providers — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -1.5 -3.0 -3.0 -3.0

The Government will consolidate the number of regional training providers to improve the efficiency of the Australian General Practice Training program.

Regional training providers organise the placement of trainee general practitioners, and assist in their continued education, in accordance with the Australian General Practice Training program. This measure will consolidate and restructure elements of the regional training provider program to better reflect factors such as hospital and health services within each training provider's catchment area and the training and financial performance of existing providers.

This consolidation and restructure will result in a reduced number of training providers and deliver savings of $10.4 million over four years.

General practice training — expanding the role of General Practice Education and Training Ltd

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.2 -0.8 -0.8 -0.8

The Government will expand the role of General Practice Education and Training Ltd to include administering the Prevocational General Practice Placements Program. This will better integrate and align educational and workforce programs for general practitioners.

The Prevocational General Practice Placements Program aims to increase the number of postgraduate medical students who choose to become general practitioners by providing them with the opportunity to experience the general practice environment prior to determining their area of speciality. Greater integration of the delivery of vocational and pre‑vocational education and training programs in general practice will be achieved by streamlining the administration of various training programs under the single auspice of General Practice Education and Training Ltd.

This measure will provide savings of $2.6 million over four years.

General practice training — extension of time for rural placements

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - -0.2 -0.3 -0.3

The Government will modify the rules of the Australian General Practice Training Program to allow medical registrars to remain in training practice locations for longer periods of time.

The measure will extend the time of a rural placement for trainee GP specialists from six months to 12 months. This will ensure greater medical continuity in the community and provide trainees with a broader exposure to the rural medical environment. It will also reduce the number of relocation subsidies paid under this program.

This measure will provide savings of $0.8 million over four years.

Grants for physical activity projects in the community — discontinuation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.1 .. -1.6 -1.6

The Government will cease funding for the Healthy Active Australia — grants for physical activity projects in the community program. This program has provided grants to organisations to conduct local and national initiatives that promote increased levels of physical activity. Existing commitments will continue to be met and the objectives of the program will now be pursued through the National Partnership Agreement on Preventive Health, which was agreed by the Council of Australian Governments on 29 November 2008 to address the rising prevalence of lifestyle‑related chronic diseases. The Government has committed $872.1 million over six years to the agreement.

This measure will provide savings of $3.3 million over four years.

Health and hospital reform — establishment of the National Institute for Virology

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $20.0 million over three years towards the establishment of the new National Institute for Virology at St Vincent's Hospital in Sydney.

The National Institute for Virology will support the National Centre in HIV Epidemiology and Clinical Research, which is recognised internationally as a research leader in the field of HIV/AIDS.

The cost of this measure will be met from funding provided as part of the 2008‑09 Budget measure Health and Hospitals Reform — Better Outcomes for Hospitals and Community Health.

Health and Hospitals Fund — hospital infrastructure and other projects of national significance

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 100.0 383.7 273.5 307.2 287.0
Total 100.0 383.7 273.5 307.2 287.0

The Government will provide $1.5 billion over seven years (including $104.1 million in 2013‑14 and $10.0 million in 2014‑15) from the Health and Hospitals Fund to support the development of health infrastructure projects of national significance. The Commonwealth will collaborate with the States and Territories to expand and modernise key public hospitals across Australia to improve hospital care. This will increase elective surgery capacity, enhance sub‑acute care services, improve emergency department facilities and improve access to hospital services. This package builds on the investment in Australia's health and hospital system under the National Healthcare SPP and National Partnerships announced in the Council of Australian Governments' Communiqu of 29 November 2008. The following projects will be funded:

  • Australian Red Cross Blood Service principal site development (Victoria) — $120.0 million;
  • Donor Tissue Bank of Victoria — $13.0 million;
  • expansion of Townsville Hospital (Queensland) — $250.0 million;
  • expansion of Rockhampton Hospital (Queensland) — $76.0 million;
  • Health and Medical Research Institute (South Australia) — $200.0 million;
  • replacement of the rehabilitation unit at the Fiona Stanley Hospital (Western Australia) — $255.7 million;
  • Midland Health Campus (Western Australia) — $180.1 million;
  • Kimberley Renal Service (Western Australia) — $8.6 million;
  • replacement of the paediatrics unit in Broome (Western Australia) — $7.9 million;
  • hospital emergency department in Alice Springs (Northern Territory) — $13.6 million;
  • Northern Territory Medical Program through Charles Darwin and Flinders Universities — $27.8 million;
  • short‑term patient accommodation at Royal Darwin Hospital (Northern Territory) — $18.6 million;
  • acute medical and surgical service unit in Launceston (Tasmania) — $40.0 million;
  • Narrabri District Health Service Centre in Griffith (New South Wales) — $27.0 million;
  • Clinical School and Research Centre at Blacktown (New South Wales) — $17.6 million;
  • Nepean Health Services Redevelopment (New South Wales) — $96.4 million;
  • Oral Health Centre at the University of Queensland — $104.0 million; and
  • Health Care Infrastructure in Rural Australia — $9.2 million.

See also the related expense measures titled Health and Hospitals Fund — better cancer care and Health and Hospitals Fund — translational research and workforce training in the Health and Ageing portfolio.

Health and Hospitals Fund — national cancer statement

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 40.0 42.0 415.0 336.0 342.0
Total 40.0 42.0 415.0 336.0 342.0

The Government will provide $1.3 billion over six years (including $101.1 million in 2013‑14) from the Health and Hospitals Fund to support infrastructure to deliver a world‑class cancer care system in Australia. This funding will help modernise cancer services and improve detection, survival and treatment outcomes. The Government's investment in nationally‑significant cancer projects will improve access to cancer care, particularly for patients in regional and rural Australia.

This investment will fund:

  • two integrated cancer centres focused especially on treating rare and complex cancers: Lifehouse at the Royal Prince Alfred Hospital (New South Wales) will receive $100 million, and the Parkville Comprehensive Cancer Centre (Victoria) will receive $426.1 million;
  • $560 million to build a network of up to 11 regional cancer centres across Australia, including the Australian Capital Territory Integrated Cancer Centre ($27.9 million);
  • state‑of‑the‑art digital mammography equipment for BreastScreen Australia, replacing 205 existing analogue machines around Australia ($120 million); and
  • the Garvan St Vincent's Campus Cancer Centre (New South Wales) ($70 million).

See also the related expense measures titled Health and Hospitals Fund — hospitals infrastructure and other projects of national importance and Health and Hospitals Fund — translational research and workforce training in the Health and Ageing portfolio.

Health and Hospitals Fund — translational research and workforce training

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 46.0 40.0 159.0 170.0 14.0
Total 46.0 40.0 159.0 170.0 14.0

The Government will provide $430.3 million over six years (including $1.3 million in 2013‑14) from the Health and Hospitals Fund to support translational medical research infrastructure. This translational research investment will provide new medical research infrastructure in the areas of mental health and neurological disorders, child health, Indigenous health and medical bionics. The funding has been targeted at projects that will focus on translating research into clinical practice to deliver better health outcomes for all Australians.

It is anticipated that, subject to meeting the requirements of the Health and Hospitals Fund Advisory Board, the following translational research projects will receive funding:

  • Monash Health Research Precinct Translation Facility in Clayton, Victoria — $71.0 million;
  • Eccles Institute — John Curtin School of Medical Research in Canberra, Australian Capital Territory — $60 million;
  • Ingham Health Research Institute Facilities in Sydney, New South Wales — $46.9 million;
  • Stage two of the Menzies Research Institute in Hobart, Tasmania — $44.7 million;
  • Smart Therapies Institute in Brisbane, Queensland — $40.0 million;
  • The Melbourne Neuroscience Project in Melbourne, Victoria — $39.8 million;
  • Hunter Medical Research Institute in Newcastle, New South Wales — $35.0 million;
  • New Research and Training Facility in Darwin, Northern Territory — $34.2 million;
  • Clinical medical teaching and research facilities through the University of Notre Dame in Melbourne, Victoria, and Sydney, New South Wales— $22.8 million;
  • Nepean Clinical School in Kingswood, New South Wales— $17.2 million;
  • Academic and Research Precinct for Melbourne's North in Epping, Victoria — $14.0 million; and
  • Children's Bioresource Centre in Melbourne, Victoria — $4.7 million.

See also the related expense measures titled Health and Hospitals Fund — hospitals infrastructure and other projects of national significance and Health and Hospitals Fund — better cancer care.

Health Infrastructure Projects in Tasmania

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of the Treasury - 0.9 0.9 0.6 -

The Government will provide $2.4 million over three years to fund health infrastructure projects in Tasmania.

This measure will provide $1.4 million to upgrade chemotherapy and cancer facilities in north‑west Tasmania, with a focus on the North West Regional Hospital at Burnie. The upgrade will support such projects as extending the chemotherapy unit, and purchasing chemotherapy chairs. Funding will also be provided to upgrade the Mersey Community Hospital chemotherapy unit and the provision of a mobile chemotherapy/day procedure unit for the west coast of north‑west Tasmania.

This measure will provide $1.0 million to upgrade a portion of the additional patient accommodation proposed for Launceston to establish six 'family‑style' units. The upgraded accommodation will benefit the families of patients from across the region requiring treatment at Launceston General Hospital.

See also the related measures titled Magnetic Resonance Imaging unit in north‑west Tasmania — redirection of funding and e‑Health — electronic clinical information and communication network for north‑west Tasmania in the Health and Ageing portfolio.

Under the new framework for federal financial relations, commencing 1 January 2009, payments to the States, with a few exceptions, will be made by the Australian Treasury to state treasuries.

Hearing services — introduction of hearing threshold

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 0.2 .. .. ..
Department of Health and Ageing - .. -9.7 -12.0 -12.8
Total - 0.2 -9.7 -12.0 -12.8
Medicare Australia - 0.4 - - -

The Government will introduce a minimum hearing loss threshold to determine eligibility for hearing devices through the Australian Government Hearing Services program, with effect from 1 January 2010.

Establishing this threshold will ensure that priority is given to fitting hearing devices for people who will gain a substantial improvement to their level of hearing. A level of hearing loss of less than 23 decibels is regarded to be within the acceptable normal hearing range and would no longer entail automatic eligibility for a hearing device through the Hearing Services program.

Eligible people whose hearing loss is below the fitting threshold, but who have a demonstrated clinical need for a hearing device, will still be able to be fitted with a free hearing device.

This measure will provide savings of $33.9 million over four years.

Hospital Accountability and Performance Program — continuation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $39.6 million over four years to continue funding for the Hospital Accountability and Performance Program (formerly known as the Hospital Information, Performance Information Program). This funding will continue and expand work to enhance hospital‑related patient classification systems on diagnoses and treatments, costing methods and national minimum data sets. Enhanced information will enable nationally consistent measurement and monitoring of hospital‑provided services and associated costs.

This work will contribute to the Government's commitment to develop comparable performance measures across the public and private sectors and provide necessary information to inform the Activity Based Funding model for hospitals, which was supported by the Council of Australian Governments in November 2008.

Provision for this funding has already been included in the forward estimates.

Improving Maternity Services Package

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 8.8 24.7 29.7 49.5
Medicare Australia - 2.4 0.7 0.8 0.9
Total - 11.2 25.4 30.5 50.4
Medicare Australia - 3.1 - - -

The Government will provide $120.5 million over four years for the introduction of Medicare‑supported midwifery services to provide greater choice for women during pregnancy, birthing and postnatal maternity care. This measure includes $3.1 million in capital funding in 2009‑10 for Medicare Australia.

The new arrangements will allow midwives to work as private practitioners, provide services subsidised by the Medical Benefits Schedule and prescribe medications subsidised under the Pharmaceutical Benefits Schedule. The Government will also provide subsidised medical indemnity for eligible midwives working in collaborative arrangements in hospitals and healthcare settings. To ensure that Australia maintains its strong record of safety and quality in maternity care, a safety and quality framework, including professional guidance and an advanced midwifery credentialing framework, will be developed. A new 24‑hour, seven‑days‑a‑week helpline will also be established to provide antenatal, birthing and postnatal maternity advice and information to women, partners and families during the ante‑natal period and up to 12 months following the birth of a child.

The measure will also assist women in rural and remote areas by expanding the Medical Specialist Outreach Assistance Program to provide integrated outreach maternity service teams for women in under serviced areas. The expanded teams will include midwives, obstetricians, general practitioners and other health professionals, such as paediatricians and Aboriginal health workers. Additionally, funding will be provided for the professional development of midwives and for general practitioners to undertake additional training to become GP obstetricians or GP anaesthetists. The package will be implemented progressively from 1 July 2009.

Indigenous access to health care services — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -2.8 -2.7 -2.4 -2.4

The Government will not proceed with funding for two further urban brokerage sites that were to be selected as part of the Improving Indigenous access to health care services measure included in the 2006‑07 Budget.

Activities to increase Aboriginal and Torres Strait Islander people's access to mainstream primary health care services will continue to be funded through the National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes announced in the Council of Australian Governments' Communiqu of 29 November 2008. The Commonwealth has committed $805.5 million over four years to this Agreement.

Existing funding commitments for the three brokerage services already selected will continue.

This measure will provide savings of $10.3 million over four years.

Investment in Preventive Health (Environmental Health) program — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.2 -0.2 -0.2 -0.2

The Government will reduce funding for the Investment in Preventive Health (Environmental Health) program by ceasing the component of the program that supports the development of environmental protection measures. This will address an existing duplication of responsibilities with the National Health and Medical Research Council.

The Investment in Preventive Health (Environmental Health) program will continue to support the implementation of the National Environmental Health Strategy 2007‑2012, environmental health activities in Aboriginal and Torres Strait Islander communities, and environmental health policy advice to the Australian Government and its agencies.

This measure will provide savings of $0.9 million over four years.

Leadership in mental health reform — continuation and further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -5.0 -5.0 -5.0 -5.0

The Government will continue its leadership role in progressing ongoing national mental health reform and improved national evaluation, accountability and reporting mechanisms, at a cost of $46.6 million over four years. This program funding will refocus aspects of mental health service delivery to new areas needed to meet community expectations and continue innovation and best practice in mental health.

Provision of $66.6 million over four years was previously included in the forward estimates. This measure will provide savings of $20.0 million over four years as less funding over the forward estimates will be required, reflecting the revised focus on key priorities.

Magnetic Resonance Imaging — transitional funding for Gippsland and South Eastern NSW mobile unit

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.6 0.9 - -

The Government will provide $1.5 million over two years to extend funding for the mobile magnetic resonance imaging machine, currently operating in Gippsland and South Eastern New South Wales, until 30 June 2011. Funding for this service was previously provided as part of a trial, which was due to cease on 31 October 2009. The funding will allow uninterrupted delivery of magnetic resonance imaging services to residents in Gippsland and South Eastern New South Wales.

Magnetic Resonance Imaging unit in north‑west Tasmania — redirection of funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - - - - -
Department of Health and Ageing - -1.2 -1.2 -1.2 -1.2
Total - -1.2 -1.2 -1.2 -1.2

The Government is redirecting funding of $4.8 million over four years previously allocated to a proposed additional Magnetic Resonance Imaging (MRI) unit in north‑west Tasmania to projects to improve health infrastructure in the region, and will therefore discontinue the Invitation to Apply process for the MRI unit.

The establishment of a Medicare‑eligible MRI unit at Launceston General Hospital has resulted in it no longer being viable for an additional Medicare‑eligible MRI unit to be located in north‑west Tasmania.

See also the related expense measures e‑Health — electronic clinical information and communication network for north‑west Tasmania in the Health and Ageing portfolio and Health Infrastructure Projects in Tasmania in the Treasury portfolio.

Medicare Benefits Schedule — a quality framework for reviewing services

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 3.3 6.0 - -

The Government will provide $9.3 million over two years to put in place a new evidence‑based framework for reviewing services listed on the Medicare Benefits Schedule. The new framework will take effect from 1 January 2010.

Under the new arrangements, services will be evaluated and aligned with contemporary evidence to ensure clinical relevance and appropriate pricing. New services will be evaluated three years after being listed. This will improve health outcomes for patients and help maintain the financial sustainability of the Medicare Benefits Schedule.

Medicare Benefits Schedule — access to positron emission tomography services provided at Westmead and Royal North Shore Hospitals and Austin Health Services

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $6.8 million over four years to give access to the Medicare Benefits Schedule for positron emission tomography services provided at Westmead Hospital and the Royal North Shore Hospital in New South Wales and Austin Health Services in Victoria.

Positron emission tomography is a nuclear medicine technique that produces a three‑dimensional image of functional processes in the body, and is used in the monitoring and treatment of cancer.

The cost of the measure will be met from existing funding provided as part of the measure Health and Hospital Reform — better outcomes for hospitals and community health announced in the 2008‑09 Budget.

Medicare Benefits Schedule — Better Access Initiative — continuing professional development

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.2 0.3 -19.9 -2.3
Medicare Australia - - 0.3 .. 0.1
Total - 0.2 0.6 -20.0 -2.2

The Government will introduce additional mandatory mental health training requirements for general psychologists, social workers and occupational therapists, under the Better Access to Psychiatrists, Psychologists and GPs through the MBS initiative. In addition, one‑off support payments of $200 will be provided to allied health professionals providing mental health services in rural areas to assist them in undertaking the new training requirements.

Allied mental health professionals who do not undertake the required professional development will not be able to access Medicare items after 30 June 2011. This will help ensure high‑quality services to patients as providers will be required to maintain their skills in order to continue to provide services eligible for the Medicare rebate. It is estimated that 80 per cent of all allied health professionals who currently access these items have already completed the required training.

This measure is expected to result in savings of $21.4 million over four years.

Medicare Benefits Schedule — Better Access Initiative — improved targeting for the most in need and better quality of services

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 0.4 .. .. 0.1
Department of Veterans' Affairs - -0.1 -0.1 -0.1 -0.1
Department of Health and Ageing - -7.7 -17.1 -6.1 9.1
Total - -7.4 -17.2 -6.1 9.1

The Government will introduce a new Medicare Benefits Schedule item for General Practice Mental Health Care Plans, with effect from 1 July 2009.

Under the new arrangements a lower fee Medicare Benefits Schedule item for General Practice Mental Health Care Plans will be established for general practitioners who have not completed level 1 mental health training. Services provided by general practitioners who have completed this training will attract the current higher Medicare rebate. This will provide an incentive for general practitioners who have not completed level 1 mental health training to update their skills and also recognises the higher level of expertise of those general practitioners who have completed the training.

This measure will result in savings of $21.7 million over four years.

Medicare Benefits Schedule — capping Extended Medicare Safety Net benefits for items with excessive fees

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 1.6 0.4 0.2 0.1
Department of Health and Ageing - -21.5 -62.8 -79.4 -97.4
Total - -19.9 -62.4 -79.2 -97.3
Medicare Australia - 0.9 - - -

The Government will introduce a cap on Medicare benefits payable under the Extended Medicare Safety Net for a range of items with excessive fees, including to all assisted reproductive technology items and items for treatment of varicose veins, the injection of a therapeutic substance into the eye, hair transplants and a cataract surgery item. The caps will take effect from 1 January 2010.

In 2008, expenditure on the Extended Medicare Safety Net was $414.1 million, an increase of 29.7 per cent from the previous year. The items to be capped accounted for around 28 per cent of all expenditure on the Extended Medicare Safety Net in 2008 and the expenditure on these items has grown at an average rate of approximately 50 per cent per year for the past two years.

There is evidence that the Extended Medicare Safety Net has enabled some doctors to charge excessive fees resulting in windfalls being paid by taxpayers through Medicare. The cap will encourage patients whose doctors charge excessive fees to seek other providers who charge more reasonable fees. The Extended Medicare Safety Net was introduced in the 2003‑04 Budget.

This measure will provide savings of $257.9 million over four years.

Medicare Benefits Schedule — capping Extended Medicare Safety Net benefits for items with excessive fees — obstetrics services

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 2.4 0.4 0.2 0.2
Department of Health and Ageing - -3.8 -49.1 -63.1 -82.5
Total - -1.5 -48.7 -62.9 -82.3
Medicare Australia - 1.7 - - -

The Government will introduce a cap on Medicare benefits payable under the Extended Medicare Safety Net for a range of items with excessive fees including all obstetric items and some ultrasound items related to pregnancy. At the same time, the scheduled fees for the obstetrics items will also be increased from 1 January 2010, benefiting patients particularly in rural and regional areas.

The Extended Medicare Safety Net was introduced in the 2003‑04 Budget. In 2008, expenditure on the Extended Medicare Safety Net was $414.1 million, an increase of 29.7 per cent from the previous year, with obstetrics‑related items accounting for 30 per cent of all expenditure.

There is evidence that the Extended Medicare Safety Net has enabled some doctors to charge excessive fees, resulting in windfalls being paid by taxpayers through Medicare. The cap will encourage patients whose doctors charge excessive fees to seek other providers who charge more reasonable fees.

The capping of the obstetric items will achieve savings of $351.3 million over four years and the increase in schedule fees will cost the Government $157.6 million over four years. The measure will provide net savings of $193.7 million over four years.

See also the related savings measure titled Medicare Benefits Schedule — capping Extended Medicare Safety Net benefits for items with excessive fees and Improving Maternity Services Package in the Health and Aging portfolio.

Medicare Benefits Schedule — diagnostic imaging and pathology services — bulk‑billing incentives and rationalisation of patient episode initiation fees

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 34.7 50.7 54.1 57.5
Medicare Australia - 0.5 0.1 0.2 0.2
Department of Veterans' Affairs - -2.4 -3.7 -3.5 -3.4
Total - 32.9 47.1 50.8 54.3
Medicare Australia - 0.4 - - -

The Government will provide $948.4 million over four years for bulk‑billing incentives for diagnostic imaging services and pathology collection services, to further protect public access to services and address out‑of‑pocket expenses. This additional funding will be offset by savings of $763.4 million over four years from rationalising pathology Patient Episode Initiation fees.

In the diagnostic imaging sector, out‑of‑hospital providers that provide bulk‑billed services for ultrasound, computed tomography, diagnostic radiology, nuclear medicine imaging, or magnetic resonance imaging will be paid an incentive payment of 10 per cent of the Medicare Benefit Schedule fee, commencing on 1 November 2009. This will cost $600.4 million over four years.

In the pathology sector, bulk‑billing incentives will be introduced for Medicare Benefit Schedule items for all Patient Episode Initiation fees. These are Medicare benefits paid to pathologists for the collection of samples. The bulk‑billing incentive will be an additional $1.60 for collections by public providers, and between $2.00 and $4.00 for collections by private pathology providers. This will cost $348.0 million over four years.

At the same time, fees for pathology collections will be adjusted to reflect efficiencies in the pathology sector, and to support the financial sustainability of Medicare. This is expected to save $763.4 million over four years. Collection fees for aged care homes, cancer specimens, and patients unable to leave their homes, will remain unchanged and will increase where the services are bulk‑billed.

This measure will provide net additional funding of $185.4 million over four years, including capital funding of $0.4 million in 2009‑10 for Medicare Australia.

Medicare Benefits Schedule — diagnostic imaging and pathology services — changes to fees for fully depreciated diagnostic imaging equipment

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.1 0.1 -64.7 -68.7
Medicare Australia - 0.1 0.4 .. -
Department of Veterans' Affairs - - - - -1.9
Total - 0.2 0.5 -64.7 -70.6
Medicare Australia - .. .. - -

The Government will modify Medicare Benefits Schedule (MBS) fees for certain diagnostic imaging items to provide greater incentives for diagnostic imaging service providers to update capital equipment. In particular, existing arrangements for 'capital sensitive' items that provide a lower schedule fee for services provided using older machines and technologies will be extended to a wider range of diagnostic imaging modalities, namely ultrasound, diagnostic radiology, nuclear medicine imaging and magnetic resonance imaging. This measure will improve patient access to newer, better quality equipment, reducing exposure to unnecessary radiation.

Where a service is rendered by a piece of capital equipment that is fully depreciated, the MBS fee for that service will be reduced by 50 per cent. These arrangements have been in place for computed tomography since 1997 and for angiography since 2001.

Capital equipment located in remote areas and eligible for a Remote Area Exemption will not be affected by these new arrangements.

This measure will take effect on 1 July 2011 and is expected to save $134.5 million over four years.

Medicare Benefits Schedule — diagnostic imaging and pathology services — improving competition

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 0.5 0.1 0.1 0.1
Department of Health and Ageing - 0.1 .. - -
Total - 0.6 0.1 0.1 0.1
Medicare Australia - 2.4 - - -

The Government will provide $3.4 million over four years to improve competition in the diagnostic imaging and pathology sectors.

Currently, under the Health Insurance (Eligible Collection Centres) Approval Principles 2008 licensing scheme, the number of collection centres a pathology services provider (approved pathology authority) may operate is highly regulated according to a formula that takes account of annual population growth. Under the new arrangements, providers will have greater freedom to choose the number of collection centres they operate. This will cost $3.2 million over four years.

Funding of $0.1 million will be provided to amend request forms for diagnostic services to both inform parents and allow them to use the forms to obtain services from any provider.

Medicare Benefits Schedule — diagnostic imaging and pathology services — improving the quality of services and addressing workforce shortages

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 5.4 7.9 0.3 -8.8
Medicare Australia - 0.1 0.3 -0.1 -0.4
Department of Veterans' Affairs - - -0.1 -0.4 -0.8
Total - 5.5 8.2 -0.3 -10.0
Medicare Australia - 0.1 - - -

The Government will provide net additional funding of $3.5 million over four years to improve the quality of diagnostic imaging and pathology services and address workforce shortages.

The number of specialist pathologist training places will increase to 50 and offer financial support of $100,000 per specialist per year. To help recruit and retain pathologists in rural locations, a rural loading of $20,000 per year will be available for 20 of the new places and a mentoring and academic support program will be introduced. This will cost $17.3 million over four years.

Funding will also be provided to continue and implement a range of initiatives to improve the quality of pathology services, including the development of guidelines for reporting cancer, at a cost of $1.5 million over four years.

To address the workforce shortages in the diagnostic imaging industry, 15 additional training places, at a cost of approximately $100,000 per specialist per year, will be funded at a total cost of $5.4 million over four years.

To help support sustainability of the Medicare Benefits Schedule, the Government will conduct a trial allowing doctors to request certain x‑ray images without a specialist radiologist report. Funding will also be provided for a campaign to assist doctors to adopt best practice for pathology and diagnostic imaging referrals. This will result in net savings of $20.7 million over four years.

Medicare Benefits Schedule — diagnostic imaging and pathology services — rebalancing of pathology fees

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Veterans' Affairs - 0.1 .. .. ..
Department of Health and Ageing - -0.7 -0.9 -1.2 -1.5
Total - -0.6 -0.9 -1.2 -1.5

The Government will modify the Medicare Benefits Schedule for certain pathology items to better align the fees with the level of professional expertise required to analyse specimens, and to better reflect changes in the cost of providing the services as the result of improved technologies.

There will be increases in the schedule fees for eight anatomical pathology items which require specialised manual processes and highly skilled analysis. On average, the fee increases for these items will be $53.00.

Schedule fees will be reduced by an average of $0.56 for 259 items that require less complex testing, mainly done on an automated basis.

This is expected to result in a net saving of $4.1 million over four years.

Medicare Benefits Schedule — diagnostic imaging and pathology services — reviews of pathology and diagnostic imaging items

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 2.4 3.6 - -

The Government will provide $6.0 million over two years for detailed reviews of diagnostic imaging and pathology items listed on the Medicare Benefits Schedule. The reviews will be undertaken by the Department of Heath and Ageing in consultation with industry stakeholders. They will investigate whether fee levels in the Medicare Benefits Schedule reflect current and best medical practice.

Medicare Benefits Schedule — ensuring the appropriate use of clinical procedures and adjusting to modern technologies

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -23.2 -37.9 -40.8 -43.7
Medicare Australia - -0.2 -0.3 -0.3 -0.4
Department of Veterans' Affairs - -1.2 -1.9 -1.7 -1.7
Total - -24.7 -40.1 -42.9 -45.7

The Government will amend the Medicare Benefits Schedule (MBS) fees for a number of procedural items that are able to be performed more quickly and safely due to improvements in technology or where the service can be delivered as a standard consultation or a less complex procedure. This measure will take effect from 1 November 2009.

Examples of items where MBS fees will be amended include certain cataract surgery procedures, and certain coronary angiography procedures.

This measure will provide savings of $153.4 million over four years.

Medicare Benefits Schedule — new and revised listings

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing .. 0.2 0.3 0.4 0.4
Department of Veterans' Affairs .. .. .. .. ..
Medicare Australia 0.1 .. .. .. ..
Total 0.1 0.2 0.3 0.4 0.4

The Government will provide $1.4 million over five years for new and revised listings on the Medicare Benefits Schedule and Veterans' Benefits added since the Updated Economic and Fiscal Outlook released in February 2009.

The amendments to the Medicare Benefits Schedule include:

  • a new item for capsule endoscopy for the surveillance of Peutz‑Jeghers syndrome;
  • new items for the implantation of a device for the management of faecal incontinence; and
  • revision of an item for the treatment of clavicle fracture to permit an assistant surgeon to be present during surgery.

Further information can be found in the summary of changes included in the regular updates to the Medicare Benefits Schedule located in the downloads section of the MBS Online home page (www.health.gov.au/mbsonline).

Medicare Benefits Schedule — nurse practitioner workforce — expansion

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 8.9 2.1 0.6 0.6
Department of Health and Ageing - 1.5 10.8 16.8 16.9
Total - 10.5 12.9 17.4 17.6
Medicare Australia - 1.0 0.3 - -

The Government will provide $59.7 million over four years to expand the role of nurse practitioners, including by providing Medicare Benefits Schedule and Pharmaceutical Benefits Scheme support from November 2010. This measure will provide for the development of a long‑term and sustainable model for nurse practitioners, helping to improve the flexibility and capacity of Australia's health workforce.

Nurse practitioners must be registered nurses with at least five years experience who hold a higher degree in nursing, such as a Masters of Nursing (Nursing Practitioner). Nurse practitioners undertake a range of medical procedures that do not currently attract Medicare rebates. This measure will allow nurse practitioners to provide certain services subsidised by the Medicare Benefits Schedule and prescribe medications subsidised under the Pharmaceutical Benefits Scheme. Expanding the role of nurse practitioners will assist in addressing the challenges facing Australia's health workforce, particularly in regional and remote areas.

Medicare Benefits Schedule — reversal of proposal to fund magnetic resonance imaging scans of the knee or brain — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia .. .. .. .. ..
Department of Health and Ageing - -4.0 -3.9 -3.7 -3.6
Total 0.0 -4.0 -3.9 -3.8 -3.6

The Government will not proceed with the proposal to fund Medicare‑eligible magnetic resonance imaging scans of the knee or brain requested by general practitioners.

This measure was first announced in the 2007 Pre‑Election Economic and Fiscal Outlook but is yet to commence. Implementing the measure would have allowed general practitioners to refer patients directly for Medicare‑eligible magnetic resonance imaging scans of the knee or brain without a referral to, or assesment by, a specialist.

Magnetic resonance imaging scans of the knee or brain that are requested by specialists will remain eligible for Medicare benefits and this measure will not affect the current arrangements for other requests for Medicare‑eligible magnetic resonance imaging scans.

This measure will provide savings of $15.3 million over four years.

Mental health — continuation of existing services in rural and remote areas

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 2.7 1.5 1.2 1.3

The Government will provide $6.7 million over four years to extend the Mental Health Services in Rural and Remote Areas program. The program provides funding to non‑government organisations to deliver mental health services to people living in rural and remote areas of Australia.

This additional funding will maintain access to mental health services in rural and remote areas of high need, including areas affected by drought.

Mental health— continuation of Mental Health Support for Drought‑Affected Communities program

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 5.2 - - -

The Government will provide an additional $5.2 million in 2009‑10 to continue the mental health component of the Mental Health — increased mental health services for drought‑affected communities measure announced in the 2007‑08 Budget. This component funds individual Divisions of General Practice to support mental health professionals and community leaders to respond to the psychological impact of drought.

See also the related measure Drought assistance — Exceptional Circumstances for primary producers in the Department of Agriculture, Fisheries and Forestry portfolio.

National Illicit Drug Strategy — a more strategic approach

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -3.3 -5.7 -6.1 -9.6

The Government will consolidate funding under the National Illicit Drug Strategy to improve efficiency and outcomes through a more strategic approach.

The savings under this measure will be from research projects and funding for drug‑related services will be preserved. The Government will continue to provide funding of $733.5 million over the forward estimates period for anti‑drug activities.

Existing commitments under the National Psycho‑stimulants and Illicit Drug Diversion Initiatives will be met. Funding will also be redirected to provide $0.3 million per annum in additional funding for the Australian National Council on Drugs to support its ongoing work, and to provide $2.9 million in additional funding for the component of the Government's current National Drug Strategy Campaign relating to the use of ice.

This measure will provide savings of $24.7 million over four years.

National Joint Replacement Registry — cost recovery

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.6 0.3 0.4 0.4
Department of Health and Ageing - 1.6 1.6 1.7 1.7

The Government will meet the future costs of the National Joint Replacement Registry through a levy on suppliers of joint replacement prostheses. This is consistent with the Government's cost recovery guidelines.

The registry provides information on the post‑operative performance of joint replacement products. While the registry has been funded by the Government since 1998, the Government considers it appropriate for significant stakeholders in this sector to meet the costs of the registry.

This measure will provide savings of $5.0 million over four years.

National Palliative Care Strategy — continuation of funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $14.4 million over four years to continue the National Palliative Care Strategy, which provides a coordinated national approach for quality palliative care. The key objective of the strategy is to reduce inappropriate palliative patient admissions to hospitals, which will be achieved by way of developing an evidence‑based approach to delivering quality care for patients. This funding will also support initiatives that improve workforce development, access to clinical and performance information, and data collection.

Provision for this funding has already been included in the forward estimates.

National Partnership Agreement — Queensland compensation for health care treatment provided to Papua New Guinean nationals

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of the Treasury - - - - -

The Government will provide $16.2 million over four years to the Queensland Government to continue to provide health care to Papua New Guinean nationals in Queensland's public hospitals under the Torres Strait Treaty. The treaty, between the Australian and Papua New Guinean governments, allows for free movement in the Torres Strait for Papua New Guinean coastal people who live in and keep the traditions of the region. This funding was previously provided under the Australian Health Care Agreement between the Australian and Queensland governments.

Provision for this funding has already been included in the forward estimates.

Under the new framework for federal financial relations, commencing 1 January 2009, payments to the States, with a few exceptions, will be made by the Australian Treasury to state treasuries.

National Return and Disposal of Unwanted Medicines program — additional funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.5 0.6 0.7 0.8

The Government will provide an additional $2.9 million over five years for the National Return and Disposal of Unwanted Medicines program to meet an increase in demand for this service.

This measure increases funding for the service to an average of $2.1 million per year. The National Return and Disposal of Unwanted Medicines program enables consumers to return unwanted or out‑of‑date medicines to any pharmacy. The program provides for the safe disposal of unused and expired medicines to minimise accidental poisoning (especially of children), medication misuse and toxic releases into the environment.

Funding for 2008‑09 of $0.3 million will be met from within the existing resourcing for the Fourth Community Pharmacy Agreement.

National Serology Reference Laboratory — additional funding for regulatory operations

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 1.5 1.5 0.9 1.0

The Government will provide $4.8 million over four years to the National Serology Reference Laboratory to continue and extend existing regulatory operations currently undertaken for the Australian Red Cross Blood Service and the Therapeutic Goods Administration. These regulatory operations include additional testing for Hepatitis B, serological and nucleic acid testing and other testing essential to the ongoing integrity of Australia's blood supply. This funding will also provide for new services in relation to in‑vitro diagnostic device testing and quality assurance undertaken for the Therapeutic Goods Administration.

Northern Territory Medical School

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of the Treasury - - 0.5 1.6 2.2

The Government will contribute $4.4 million over three years from 2010‑11 towards recurrent costs for the Northern Territory Medical School. This recurrent funding will be in addition to the capital grant of $27.8 million over three years provided by the Government for the establishment of the Northern Territory Medical School. This capital grant will be funded from the Health and Hospitals Fund established in 2008‑09.

See also the related expense measure titled Health and Hospital Fund — hospital infrastructure and other projects of national significance in the Health and Ageing portfolio.

Under the new framework for federal financial relations, commencing 1 January 2009, payments to the States, with a few exceptions, will be made by the Australian Treasury to state treasuries.

Nursing education and recruitment — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.6 -0.6 -0.6 -0.6

The Government will consolidate a number of nursing education and recruitment initiatives into a single program. The programs to be consolidated are:

  • the Bringing Nurses Back into the Workforce program;
  • the Rural Nurse Initiative (Nurse Scholarship program);
  • Retraining Scholarships for More Practice Nurses and Allied Workers in Metropolitan Areas;
  • Additional Practice Nurses for Rural Australia; and
  • the Mental Health Postgraduate Scholarships scheme.

These programs support nursing education, and professional training, and provide incentives to encourage nurses back into the workforce: consolidating them means that funding to areas of high priority can be better targeted. The Government will maintain the same number of scholarships.

This measure will result in savings of $2.3 million over four years as a result of administrative efficiencies.

Pharmaceutical Benefits Scheme — chemotherapy drugs — delayed implementation of more efficient arrangements

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 5.3 - - -
Department of Veterans' Affairs - 0.5 - - -
Total - 5.9 - - -

The Government has delayed the implementation of the 2008‑09 Budget measure Responsible Economic Management — Chemotherapy Drugs — more efficient arrangements until 1 September 2009. The delay is to allow further consultation with stakeholders, including industry stakeholders, to ensure the safe, efficient and effective implementation of this measure.

The delay will reduce the savings from this measure by $5.9 million in 2009‑10.

Further information can be found in the press release of 27 April 2009 issued by the Minister for Health and Ageing.

Pharmaceutical Benefits Scheme — enhancements to the National Prescribing Service

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Veterans' Affairs - -1.1 -1.1 -1.2 -1.3
Department of Health and Ageing - -9.1 -12.1 -13.6 -16.2
Total - -10.2 -13.2 -14.8 -17.5

The Government will provide an additional $21.0 million over four years to the National Prescribing Service to enhance the scope and reach of the assistance the service provides to medical practitioners. This is expected to result in savings of $76.6 million over four years to the Pharmaceutical Benefits Scheme and the Repatriation Pharmaceutical Benefits Scheme through improvements in the quality and appropriateness of prescribing.

The National Prescribing Service provides support to health practitioners to improve prescribing practices through education and feedback. The service focuses on therapeutic areas where it has been shown that changes to prescribing can lead to better health outcomes for patients.

This measure is expected to provide net savings of $55.6 million over four years.

Pharmaceutical Benefits Scheme — extending the Pharmaceutical Benefits Scheme reference pricing policies to all non‑exempt pharmaceutical items

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 0.6 0.8 0.9 0.9
Department of Veterans' Affairs - -0.7 -1.4 -1.3 -1.2
Department of Health and Ageing - -8.8 -18.0 -16.7 -16.3
Total - -9.0 -18.6 -17.0 -16.6

The Government will extend the Pharmaceutical Benefits Scheme reference pricing policies to all non‑exempt pharmaceutical items in a therapeutic group. Currently there is an anomaly whereby some medicines within some therapeutic groups are not currently included in the reference pricing methodology. This measure will result in a lower price to the Government for some medicines as, under therapeutic group pricing policy, the cheapest medicines in the group are used as the basis for the price paid for the other medicines in the group. The Government will maintain current arrangements for individuals who, for clinical reasons, require a specific brand.

This measure is expected to provide savings of $61.2 million over four years.

Pharmaceutical Benefits Scheme — extending the therapeutic group premium policy

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 0.5 0.8 0.8 0.9
Department of Veterans' Affairs - -0.7 -1.5 -1.5 -1.5
Department of Health and Ageing - -12.5 -28.5 -29.7 -40.9
Total - -12.7 -29.3 -30.4 -41.5

The Government will establish an additional therapeutic group covering statin drugs on the Pharmaceutical Benefits Scheme. This will result in the Government paying a lower price for some medicines within the new therapeutic group, as the price of the cheapest medicine in the group will be used as the basis for the price paid for the other medicines within the group. The Government will maintain current arrangements for individuals who, for clinical reasons, require a specific brand.

The creation of the new therapeutic group is expected to deliver savings of $113.8 million over four years.

Pharmaceutical Benefits Scheme — extension to the listing of Plavix® and Iscover® (clopidogrel)

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -
Department of Veterans' Affairs - - - - -
Medicare Australia - - - - -
Total - - - - -

The Government has extended the listing of Plavix® and Iscover® (clopidogrel) on the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme from 1 February 2009, at an estimated cost of $101.3 million over five years (including $7.7 million in 2008‑09). This includes funding for administering payments through Medicare Australia.

The extension of the listing will provide subsidised access in combination with aspirin for adults who suffer from Acute Coronary Syndrome. Previously only patients who were clinically unable to take aspirin were provided with subsidised access through the Pharmaceutical Benefits Scheme.

The average cost to the Pharmaceutical Benefits Scheme of providing Plavix® and Iscover® will be approximately $585 per course of treatment. Each course of treatment requires eight prescriptions. General consumers will pay a $32.90 co‑payment per prescription and concession card holders will pay a $5.30 co‑payment per prescription.

Provision for this funding has already been included in the forward estimates.

Further information can be found in the press release of 1 February 2009 issued by the Minister for Health and Ageing.

Pharmaceutical Benefits Scheme — increased uptake of Pharmaceutical Benefits Scheme online

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $6.8 million over five years to fund the increased uptake of the Pharmaceutical Benefits Scheme (PBS) Online processing system.

There has been a higher than anticipated uptake of the PBS Online processing system by community pharmacies. To support this demand the Government will provide $3.5 million over five years to assist with the installation of online processing software in community pharmacies. The Government will also provide $0.6 million over three years to assist with the installation of online processing software in public hospitals.

In addition, $2.6 million over five years will be provided for public hospitals that submit claims directly to Medicare Australia through PBS Online. Public hospitals will be entitled to a $0.40 script incentive for each script they process through PBS Online.

Funding for this measure will be met from within the existing resourcing for the Fourth Community Pharmacy Agreement.

Pharmaceutical Benefits Scheme — Interim increase in the handling fee under the section 100 Remote Aboriginal Health Service Program

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $3.1 million over two years from 2008‑09 to provide an interim increase of $1.55 in the handling fee paid to pharmacists per prescription under the Remote Aboriginal Health Service Program under section 100 of the National Health Act 1953. The increase will take the handling fee to $2.69. It will be back‑dated to 1 January 2009 and will continue until 30 June 2010. The ongoing level of the handling fee will be determined following a review of the program due to be completed by mid‑2009.

The section 100 Remote Aboriginal Health Service Program improves access to essential medicines for clients of remote Aboriginal health services.

Funding for this measure will be met from within the existing resourcing for the Fourth Community Pharmacy Agreement.

Pharmaceutical Benefits Scheme — listing of Avastin® (bevacizumab)

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 63.9 80.5 82.0 81.1
Department of Veterans' Affairs - 1.5 1.8 1.6 1.4
Medicare Australia - 0.1 0.1 0.1 0.1
Total - 65.4 82.4 83.7 82.6
Department of Health and Ageing - nfp nfp nfp nfp

The Government will list Avastin® (bevacizumab) on the Pharmaceutical Benefits Scheme and the Repatriation Pharmaceutical Benefits Scheme, from 1 July 2009, at an estimated cost of $314.1 million over four years. This includes funding for administering payments through Medicare Australia. A pricing agreement negotiated between the Government and the drug manufacturer allows for offsets to the gross cost of Avastin®.

Avastin® will be listed for the treatment of metastatic colorectal cancer (bowel cancer).

Each patient requires approximately 13.5 prescriptions per year, resulting in an average annual cost to the Pharmaceutical Benefits Scheme of approximately $31,500 per patient. General consumers will pay a $32.90 co‑payment per prescription and concession card holders will pay a $5.30 co‑payment per prescription.

Further information can be found in the press release of 3 May 2009 issued by the Minister for Health and Ageing.

Pharmaceutical Benefits Scheme — listing of Sutent® (sunitinib)

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 6.3 34.3 29.5 27.6 26.9
Department of Veterans' Affairs 0.3 1.8 1.5 1.4 1.4
Medicare Australia .. .. .. .. ..
Total 6.6 36.1 31.0 29.0 28.3
Department of Health and Ageing - nfp nfp nfp nfp

The Government has listed Sutent® (sunitinib) on the Pharmaceutical Benefits Scheme and the Repatriation Pharmaceutical Benefits Scheme, from 1 May 2009, at an estimated cost of $131.1 million over five years. This includes funding for administering payments through Medicare Australia. A pricing agreement negotiated between the Government and the drug manufacturer allows for offsets to the gross cost of Sutent®.

Sutent® is used for the treatment of renal cell carcinoma, a form of kidney cancer.

Each patient requires approximately nine prescriptions per year, resulting in an average annual cost to the Pharmaceutical Benefits Scheme of approximately $59,800 per patient. General consumers will pay a $32.90 co‑payment per prescription and concession card holders will pay a $5.30 co‑payment per prescription.

Further information can be found in the press releases of 1 May 2009 and 3 May 2009 issued by the Minister for Health and Ageing.

Pharmaceutical Benefits Scheme — minor new listings

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 18.8 48.3 54.5 57.1 54.6
Department of Veterans' Affairs 1.7 4.7 5.3 5.3 5.2
Medicare Australia .. 0.1 0.1 0.2 0.2
Total 20.5 53.0 60.0 62.7 60.0
Department of Health and Ageing nfp nfp nfp nfp nfp

The Government has agreed to a number of minor new listings on the Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme since the Mid‑Year Economic and Fiscal Outlook 2008‑09, at a cost of $256.2 million over five years. This includes funding for administering payments through Medicare Australia.

The minor new listings (including extensions to Pharmaceutical Benefits Scheme listings) are medicines that have been listed at either no additional cost to the Budget (because they replace existing listings) or at an estimated cost each of less than $10.0 million per annum.

The Government has negotiated a discount that is not included for commercial reasons and consequently is not disclosed.

Minor new listings include:

  • Aclasta®, for the treatment of osteoporosis;
  • Vfend®, for the treatment of specific fungal infections;
  • Nexavar®, for the treatment of primary liver cancer; and
  • Pegatron®, for the treatment of hepatitis C.

Further information can be found in the press releases of 1 November 2008, 1 December 2008, 1 February 2009, 1 March 2009, 1 April 2009 and 1 May 2009 issued by the Minister for Health and Ageing and the updates to the Schedule of Pharmaceutical Benefits issued by the Department of Health and Ageing.

Practice incentive payments — quality and administrative improvements — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 2.3 0.7 0.4 0.3
Department of Health and Ageing - -4.9 -1.3 -14.1 -15.2
Total - -2.6 -0.6 -13.7 -14.8
Medicare Australia - 4.7 1.2 - -

The Government will introduce improvements to the Practice Incentives Program and the General Practice Immunisation Incentive, to improve quality and safety, and simplify administrative processes.

This measure will introduce a requirement for around 750 non‑accredited general practices to adhere to proper vaccine storage and handling processes in order to remain eligible to claim incentives under the General Practice Immunisation Incentive program. This requirement will be implemented in August 2010 and will improve the quality and safety of child immunisation.

The Procedural GP, Practice Nurse, Domestic Violence and After Hours Practice Incentives Program incentives will now be paid retrospectively instead of in advance, which will lower the cost of recovering overpayments for these services. The Government will also introduce a Practice Incentives Program online administration system and update Practice Incentives Program practice records annually to ensure the accuracy of payments. In addition, for those Practice Incentives Program payments that continue to be paid on a prospective basis, recalculations which are undertaken to ensure accuracy of payments will now be made bi‑annually rather than quarterly.

This measure will provide savings of $25.8 million over four years.

Prevocational training for doctors in general practice

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 8.9 10.4 10.4 11.4
Medicare Australia - .. .. .. ..
Total - 8.9 10.4 10.5 11.4

The Government will provide $41.2 million over four years for additional places in the Prevocational General Practice Placement Program. The program provides opportunities for junior doctors to gain clinical experience in primary care with the aim of encouraging them to take up general practice as a career. This measure will enable approximately 160 additional places per year to be offered over the next four years, bringing the total number of annual places up to 410 in 2012‑13.

Primary care — Sharing Health Care Initiative — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -2.7 -0.7 - -

The Government will better target the Sharing Health Care Initiative by refocussing research and targeting projects on chronic disease self‑management in hard‑to‑reach groups such as Indigenous populations and people from culturally and linguistically diverse backgrounds.

The Sharing Health Care Initiative supports improvements in self‑management of chronic disease by encouraging more effective use of health care systems, enhancing collaboration between patients and health professionals, and funding research into chronic disease interventions.

This measure will provide savings of $3.3 million over two years.

Priority Health and Medical Research program — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -4.1 -4.3 -4.4 -4.5

The Government will reduce funding for the Priority Health and Medical Research program. The program provided $5 million a year for the Minister for Health and Ageing to fund health and medical research projects outside the National Health and Medical Research Council's competitive grants process. Terminating this program will ensure all health and medical research project proposals are assessed under the expert scrutiny of the National Health and Medical Research Council's panel review process.

Existing projects that have already been approved for funding will continue. Funding for health and medical research projects will continue to be made available through the National Health and Medical Research Council.

This measure will provide savings of $17.2 million over four years to 2012‑13.

Private health insurance — fair and sustainable support for the future

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 119.3 -713.5 -613.8 -614.9
Australian Taxation Office 1.0 4.8 18.1 33.6 9.1
Medicare Australia - 0.3 - - -
Total 1.0 124.3 -695.4 -580.2 -605.8
Australian Taxation Office - - - 70.0 75.0
Medicare Australia - 0.3 - - -

Effective 1 July 2010, the Government will introduce three new 'Private Health Insurance Incentive Tiers' to better balance the mix of incentives for people to take out private health insurance. Existing arrangements will remain unchanged for singles with income of less than $75,000 per annum and families with incomes of less than $150,000 per annum. Income in this context refers to income for Medicare levy surcharge (the surcharge) purposes.

  • Tier 1 will apply to singles with income of more than $75,000 (more than $150,000 for families), based on current projections. The private health insurance rebate will be 20 per cent, increasing to 25 per cent at 65 years of age, and to 30 per cent at 70 years. The private health insurance surcharge for not taking out complying private health insurance will remain at 1 per cent.
  • Tier 2 will apply to singles with income of more than $90,000 (more than $180,000 for families). The private health insurance rebate will be 10 per cent, increasing to 15 per cent at 65 years of age, and to 20 per cent at 70 years. The surcharge for not taking out complying private health insurance will be increased to 1.25 per cent.
  • Tier 3 will apply to singles with income of more than $120,000 (more than $240,000 for families). No private health insurance rebate will be provided. The surcharge for not taking out complying private health insurance will be increased to 1.5 per cent.

All income thresholds will continue to be indexed to wages, keeping these changes fair and sustainable into the future. The income thresholds will also be adjusted for families with more than one child in the same manner as existing arrangements for the surcharge.

The measure will result in net savings of $1.9 billion over five years. It will reduce Government expenditure on the private health insurance rebate by $1.8 billion over four years and will increase revenue through the surcharge by $145.0 million over the same period. The total cost to implement this measure will be $69.0 million over five years, which includes $66.6 million for the Australian Taxation Office (including $963,000 in 2008‑09), $1.9 million for the Department of Health and Ageing, and $540,000 for Medicare Australia.

The financial impact of premium growth on the forward estimates for the private health insurance rebate is currently allocated to the Contingency Reserve. The savings from this measure relating to projected premium growth have also been allocated to the Contingency Reserve.

This measure will help reduce the long term cost to the budget of a substantial and growing expenditure, contributing to the return of the budget to surplus and the reduction of net debt.

  Current surcharge
thresdholds
(projected 2010-11)
Tier 1 Tier 2 Tier 3
Singles $0 - $75,000 $75,001 - $90,000 $90,001 - $120,000 $120,001+
Families $0 - $150,000 $150,001 - $180,000 $180,001 - $240,000 $240,001+
Medicare levy surcharge nil 1.00% 1.25% 1.50%
Private health insurance        
   rebate        
     Less than 65 years 30% 20% 10% nil
     65 to 69 years 35% 25% 15% nil
     70 years or over 40% 30% 20% nil

Private health insurance — transparent premium setting

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will publish individual insurers' average private health insurance premium increases at the conclusion of each annual premium approval round. This will include details of the reasons provided by insurers for the increases in premiums. Currently, the Government publishes only the average premium increases across all insurers. This measure, to be implemented as part of the 2010 premium round, will enhance the transparency of the premium‑setting process by providing consumers with a better understanding of the Government's role in the proposed premium increases.

The cost of this measure will be met from within the existing resourcing of the Department of Health and Ageing.

Prudential regulation of aged care providers — not to proceed with cost recovery

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 2.1 2.2 2.1 2.2

The Government will not proceed with cost‑recovery of aged care prudential regulation activities as previously announced as part of the 2005‑06 Health and Ageing Portfolio Additional Estimates Statements.

The Government currently oversees the prudential regulation of approved aged care providers who charge accommodation bonds for residents entering their aged care facility. In undertaking this activity, the Government reduces the risk of the aged care provider defaulting on the refund of the bond. The cost to the Government of continuing to fund prudential regulation is $8.6 million over four years.

Public Health Education and Research Program — discontinuation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - -6.6 -11.3 -11.5

The Government will discontinue the Public Health Education and Research Program. The program has led to improvements in public health education and research capacity in Australia, and the development and delivery of post‑graduate awards and certificates in public health. As a result, post‑graduate Master of Public Health programs are now well established in universities. In addition, the most recent review of the program concluded that successive government investments have increased the public health workforce capacity to address population health issues.

This measure will provide savings of $29.5 million over three years, while funding provided in 2009‑10 will meet existing commitments.

Radiation oncology — national radiotherapy single machine trial — discontinuation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -1.3 -1.3 -1.4 -1.4

The Government will cease funding for the National Radiotherapy Single Machine Unit Trial program announced in the 2000‑01 Budget. The trial was carried out in Victoria to evaluate the viability of single radiotherapy machine centres in providing radiotherapy services to rural and regional patients. The trial concluded in 2006‑07 and no further trials are proposed at this stage. The results of the trial are currently being assessed.

This measure will provide savings of $5.4 million over four years.

Reduction of the business management training initiative — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -1.0 -1.2 -1.3 -1.3

The Government will not proceed with funding for the business management training component of the measure A Better Future for Indigenous Australians — family‑centred primary health care announced in the 2007‑08 Budget. This initiative provided funding for the upskilling and training of 100 business managers in order to enhance the business management capacity of Aboriginal Community Controlled Health Organisations through higher education, training and on‑line resources.

Existing commitments to train the 100 Aboriginal Medical Service business managers will be maintained under this measure. Successful aspects of this initiative will be incorporated into a broader program focused on continuous quality improvement and accreditation.

This measure will provide savings of $4.7 million over four years.

Regulation of research involving human embryos and the prohibition of human cloning — continuation of funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
National Health and Medical Research Council - - - - -

The Government will provide $12.7 million over four years from 2009‑10 to continue to fund regulatory activities related to research involving human embryos and the prohibition of human cloning.

This funding will enable the administration, licensing, monitoring and compliance, and inspection activities required to support the Research Involving Human Embryos Act 2002 and the Prohibition of Human Cloning Act 2002. This will continue to assure governments and the community that human cloning and other practices, such as the misuse of human embryos for research purposes, will not occur in Australia.

Provision for this funding has already been included in the forward estimates.

Review of the National Blood Arrangements

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 0.7 0.7 - -

The Government will provide an additional $1.5 million over two years to expand the scope of the planned review of the national blood arrangements. This funding will provide for an independent assessment of potential financial efficiencies, including alternative funding options, and develop recommendations for changes to the National Blood Agreement arrangements to ensure the sustainability of the sector. The agreement sets out the commitment among the Australian, state and territory governments to a coordinated national approach to policy setting, governance and management of the Australian blood sector.

Rural Health Workforce — maintaining rural multidisciplinary training

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 2.7 2.7 2.8 2.8

The Government will provide $10.9 million over four years to increase funding for two existing rural training programs.

Additional funding of $6.8 million over four years will be provided under the University Departments of Rural Health program to encourage students of medicine, nursing and other health professions to pursue a career in rural practice by providing opportunities for students to practise their clinical skills in a rural environment.

In addition, $4.1 million over four years will allow 30 full‑time equivalent annual placements for dental students to undertake clinical training in rural areas with the aim of encouraging those students to practise in rural areas upon graduation. This funding will be provided through the Dental Training Expanding Rural Placements program.

Rural Health Workforce Strategy

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Medicare Australia - 6.5 1.9 0.9 1.0
Department of Health and Ageing - 4.7 28.6 34.0 39.0
Total - 11.2 30.5 35.0 39.9
Medicare Australia - 14.3 2.1 - -
Department of Health and Ageing - 1.3 0.1 .. ..
Total - 15.6 2.2 0.0 0.0

The Government will provide $134.4 million over four years to support regional and remote communities facing health workforce shortages. New programs and changes to existing programs will ensure that health professionals will be further encouraged to work in rural and remote areas and those who choose to remain in these areas will receive greater support. Changes to the geographic classification system will result in more than 2,400 doctors and about 500 communities becoming eligible for support for the first time.

The Registrars Rural Incentive Payments Scheme and Rural Retention Program will be consolidated into a new program, the General Practice Rural Incentives Program, and a rural relocation payment will be introduced. The new program will provide relocation and retention incentive payments for general practitioners in rural areas with incentives varying according to both remoteness and time spent working in a specified area. These payments will assist in recruiting and retaining general practitioners in regional and remote areas at a cost of $64.3 million over four years including $5.2 million in capital funding for Medicare Australia.

Return of service obligations on bonded and overseas trained doctors who work in regional and remote areas will be amended. In addition, the rate of reimbursement of debt under the HECS Reimbursement Scheme will be adjusted according to remoteness. This component will provide greater incentives for doctors to work in regional and remote areas at a cost of $47.5 million over four years including $3.9 million in capital funding for Medicare Australia.

As part of this strategy, the Government will provide $22.6 million over four years, including $7.2 million in capital funding for Medicare Australia, to increase locum relief to doctors in regional and remote areas to allow them to undertake professional development opportunities and take holidays. The existing Training for Rural and Remote General Practitioners Program will be extended to doctors working in urban areas in order to better equip them to undertake a rural locum placement. Urban doctors participating in this program will be required to undertake a rural locum placement. A salary subsidy will also be introduced to assist rural doctors in recruiting locums to their practice.

In addition to the new and amended programs described above, the Government will transition rural health service delivery and rural medical workforce programs to a new geographical classification system to better reflect the current distribution of the population. This new classification system, the Australian Standard Geographical Classification — Remoteness Areas, is based on 2006 Census data and has five area categories: major cities of Australia, inner regional Australia, outer regional Australia, remote Australia and very remote Australia. All areas, other than those in the major cities of Australia category, will be eligible for rural medical workforce programs.

The new and amended programs described above are affected by the new classification system. The new classification system and the additional areas that will be included means that more than 2,400 GPs will become eligible for rural medical workforce support programs.

Secure and sustainable pensions — residential aged care

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 3.4 7.2 7.2 2.9
Medicare Australia 0.1 1.0 - - -
Department of Veterans' Affairs - 0.4 1.3 1.3 0.5
Total 0.1 4.7 8.5 8.5 3.4

The Government will provide $25.3 million over five years for a new funding supplement paid to aged care providers on behalf of self‑funded retirees and some part‑pensioners to support access under changes to arrangements for residents' fees being introduced as part of the increase to the Age Pension.

The Government will ensure that pensioners in aged care retain at least 30 per cent of the $32.49 per week pension increase to help meet their incidental expenses. As a result, pensioners in aged care will benefit from the increased pension, having more money for incidental expenses — $10.09 more per week than they currently have. As the maximum basic daily fee in residential aged care is linked to the rate of the single pension, the remaining 70 per cent of the pension increase will go to aged care homes in the form of an increase in the basic daily fee.

This will see the maximum basic daily fee decrease from 85 per cent to 84 per cent of the total base pension amount. As a result of the $32.49 a week increase in the pension, the maximum basic daily fee will rise from $233.87 per week to $256.27 per week. Once this measure is fully implemented, aged care homes will receive an additional $195 million per year.

In addition, aged care residents who are in care on 19 September 2009, and who do not receive a pension and so do not benefit from the pension increase, or are part‑pensioners who do not benefit significantly from the pension increase, will have their existing fee levels fixed at the current level until they leave care.

Those entering care after 19 September 2009 and who do not receive a pension or do not receive a significant benefit from the pension increase, will initially pay the same level of fees as is currently paid by residents. Over 4 years, their fees will gradually increase until they are paying 84 per cent of the pension, consistent with other residents. To ensure that aged care homes receive the same level of income for all new residents entering care from 20 September 2009, a compensating Government funded aged care supplement will be introduced.

The new basic daily fees and the Government supplement will start from 20 September 2009 in line with the commencement of pension changes.

Shared Responsibility and Regional Partnership Agreements — further efficiency

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -2.0 -2.3 -2.6 -3.1

The Government will redirect funding for the health components of Shared Responsibility Agreements and Regional Partnership Agreements. Since the Strengthening Indigenous Communities package was announced in the 2006‑07 Budget, $21.2 million over four years has been contributed to these agreements. Following a refocusing of priorities, the Government will honour existing commitments, but will not make further investments in the health components of this initiative.

The Government will continue to work in partnership with Indigenous communities and with all levels of government to close the gap in Indigenous disadvantage, as announced by the Council of Australian Governments' communiqu on 29 November 2008, in particular through the National Partnership on Closing the Gap in Indigenous Health Outcomes, to which the Commonwealth will contribute $805.5 million over four years.

This measure will provide savings of $10.0 million over four years.

Sporting facilities in Mackay — contribution

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 1.3 - - -

The Government will provide $1.3 million in 2009‑10 to assist with the redevelopment of the Harrup Park Country Club in Mackay, Queensland as promised during the 2007 election. This funding will contribute to improved facilities for both spectators and players, including a new building with international‑standard change rooms, media facilities, administration offices and improved amenities.

Stoma Appliance Scheme — implementing a new program framework

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.6 -4.0 -4.3 -4.3

The Government will review the Stoma Appliance Scheme and establish a revised program framework that reduces the cost of the program. The review will examine the current schedule of products and the process by which new products are added to the schedule. It is anticipated that implementing the outcomes of the review will deliver a reduction in the current cost of the scheme. Consumers will continue to have access to a range of free products through the scheme.

The Stoma Appliance Scheme provides stoma‑related products, such as pouches, skin protectors, flow filters and creams to help people with a stoma to better manage their condition.

This measure is expected to result in net savings of $13.3 million over four years.

Support for diabetes — remove duplication in research effort

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -7.7 -7.9 -8.0 -8.2

The Government will reduce funding for the Support for Diabetes Research measure announced in the Mid‑Year Economic and Fiscal Outlook 2004‑05. This measure established a research program into islet cell transplantation to treat Type 1 diabetes and promoted the Lift for Life program to control Type 2 diabetes.

New therapies for Type 1 diabetes have emerged as more promising treatment options and research into these will continue to be assessed and funded through the National Health and Medical Research Council. Existing contracts for research into islet cell transplantation will not be affected. The Lift for Life program is now expected to be undertaken by commercial fitness program operators.

This measure will provide savings of $31.9 million over four years.

Support for Specialists to Re‑Enter the Workforce — cessation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.6 -0.6 -0.7 -0.7

The Government will cease funding for the Support for Specialists to Re‑Enter the Workforce program announced in November 2003. The program has assisted medical practitioners to resume clinical practice following a break in their career. The uptake of places has been low and the program is no longer considered a cost‑effective means of encouraging the re‑entry of specialists into clinical practice.

This measure will provide savings of $2.6 million over four years.

Surf Life Saving Australia — contribution to upgrade information and technology systems

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 4.4 - - - -

The Government will provide $4.4 million to Surf Life Saving Australia, as a contribution to help upgrade Surf Life Saving Australia's information and technology system. The new system will provide coordinated data collection and improvements to the administrative and business processes across the organisation to allow it to better plan and deploy services. This will also facilitate better interaction with other emergency services and emergency data systems.

Surf Life Saving Australia includes over 306 local surf life saving clubs, and is a peak body for coastal public safety, surf rescue and lifesaver training.

This funding builds on the 2008‑09 Budget measure Saving lives in the water.

Torres Strait health protection strategy

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - 3.8 3.9 1.2 1.3
Department of the Treasury - 0.9 0.9 0.9 0.9
Total - 4.7 4.8 2.1 2.2

The Government will provide $13.8 million over four years to enhance Australia's capacity to protect the Torres Strait from incursions of communicable disease that may occur through the cross‑border movement of people in the Torres Strait Protected Zone. Disease protection in the Torres Strait will be enhanced through the provision of $9.2 million for the upgrading and extension of the health clinic on Sabai Island to accommodate Papua New Guinean patients seeking medical attention. Funding will also be used to develop and implement a culturally appropriate sexual health education campaign.

Funding of $4.5 million will enable the continuation of mosquito detection, control and eradication in the region and the appointment of a Torres Strait Islands communications officer to undertake additional surveillance and implement communicable disease control activities. Of this funding, $3.6 million will be provided to the Queensland Government to assist in the delivery of the program.

Under the new framework for federal financial relations, commencing 1 January 2009, payments to the States, with a few exceptions, will be made by the Australian Treasury to state treasuries.

Victorian bushfire response — Commonwealth assistance to health services

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing 0.1 4.9 - - -

The Government will provide $7.3 million over two years to assist with the coordination of the health response to the Victorian bushfire in 2009. This contribution will complement the funding provided by the Victorian Government and will be used for mental health, primary care and aged care services to address the health needs of those affected by the bushfires in the short, medium and longer term.

Funding of $2.3 million in 2008‑09 will be met from within the existing resourcing of the Department of Health and Ageing.

Woomera Hospital — continued funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - - - - -

The Government will provide $5.1 million over four years from 2009‑10 to the South Australian Government to meet the terms of the existing Agreement between the Commonwealth of Australia and the State of South Australia for the Administration and Management of the Hospital at Woomera. The Woomera Hospital is owned by the Australian Government and provides services to members of the Australian Defence Force and personnel representing foreign defence forces, civilian residents of Woomera, and other individuals who need to use the hospital services.

Provision for this funding has already been included in the forward estimates.

Workforce program — realising efficiency savings from consolidation

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Department of Health and Ageing - -0.4 -0.4 -0.4 -0.4

The Government will consolidate the 18 elements of the Workforce program into three distinct sub‑programs: Health Workforce Innovation and Reform, Medical Training and Supply, and Nursing and Allied Health Training and Supply. These programs, which have average funding of around $404.4 million per year across the forward estimates, aim to increase the supply and retention of health professionals and influence their decision to choose to work in areas of workforce shortage through recruitment, education and training initiatives.

This measure will provide savings of $1.5 million over four years through administrative efficiencies.

World Class Cancer Care — Building Cancer Support Networks program — continued funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Cancer Australia - - - - -

The Government will provide $2.6 million over four years to continue to support the Building Cancer Support Networks program. This funding will provide grants to improve access to community support for people with cancer and their carers. Projects funded from this program include information resources for Aboriginal and Torres Strait Islander communities, online forums for people living with cancer and support for carers of cancer patients.

Provision for this funding has already been included in the forward estimates.

World Class Cancer Care — cancer data to improve cancer survival

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Australian Institute of Health and Welfare - 0.5 0.5 0.5 0.5
Cancer Australia - 0.5 0.5 0.5 0.6
Total - 1.0 1.1 1.0 1.1

The Government will provide $4.2 million over four years to allow the Australian Institute of Health and Welfare and Cancer Australia to establish a national cancer monitoring centre. The centre will contribute to the fight against cancer through better coordination of and timely access to national data. The monitoring centre will undertake two pilot studies; one study will establish and collect data relating to distance spread of cancer at diagnosis and recurrence, while the other study will benchmark clinical outcomes following cancer treatment using existing and new data sources.

World Class Cancer Care — Mentoring for Regional Hospitals and Cancer Professionals program — continued funding

Expense ($m)
2008‑09 2009‑10 2010‑11 2011‑12 2012‑13
Cancer Australia - - - - -

The Government will provide $15.1 million over four years to continue the Mentoring for Regional Hospitals and Cancer Professionals program. This program promotes effective use of the health workforce by encouraging specialists to spend more time in rural and regional areas and to be available to confer with regional colleagues.

This measure will also continue funding the Cancer Services Network National Demonstration pilot program, which provides a mechanism to link regional and metropolitan cancer services, with a focus on Aboriginal and Torres Strait Islander people and people living in rural and regional areas.

Provision for this funding has already been included in the forward estimates.

If www.budget.gov.au responds slowly or you are having trouble downloading a document, try one of the Budget Website Mirrors

Note: Where possible, Budget documents are available in HTML and for downloading in Portable Document Format(PDF). If you require further information on any of the tables or charts on this website, please contact The Treasury.