Australian Government, 2012‑13 Budget
Budget

Appendix A: Policy Decisions taken since the 2012-13 Budget (Continued)

Expense Measures (Continued)

Health and Ageing

Advertising media campaigns — reduction

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing ‑5.2
Australian National Preventive Health Agency ‑13.5
Total — Expense ‑18.7

The Government will achieve savings of $18.7 million in 2012‑13 by reducing media spending across the Health portfolio. This measure will not impact on frontline services.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012.

Dental health reform — Child Dental Benefits Schedule

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 0.9 191.3 604.7 636.9
Department of Human Services 0.5 12.1 15.5 16.3
Total — Expense 1.4 203.4 620.2 653.2
Department of Human Services .. 1.4 0.2 ..
Department of Health and Ageing
Total — Capital .. 1.4 0.2 ..

The Government will provide $2.9 billion over six years (including $688.2 million in 2016‑17 and $724.9 million in 2017‑18) to establish a Child Dental Benefits Schedule which will provide basic dental services for eligible children aged 2 to 17 years.

From 1 January 2014, around 3.4 million Australian children aged 2 to 17 years, in families receiving Government benefits such as Family Tax Benefit Part A, will be eligible for assistance of up to $1,000 per child over a two year period for basic dental services such as check‑ups, x‑rays, fillings and extractions.

This measure builds on the Government's package of foundational activities to improve the oral health outcomes of low‑income Australians announced in the 2012‑13 Budget.

See also the related measures titled Dental health reform — National Partnership Agreement for adult public dental services, Dental health reform — flexible grants program and Dental health reform — Medicare Teen Dental Plan — redirection of funding.

Further information can be found in the press release of 29 August 2012 issued by the Minister for Health.

Dental health reform — flexible grants program

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 50.5 55.5

The Government will provide $227.0 million over four years from 2014‑15 (including $60.5 million in 2016‑17 and $60.5 million in 2017‑18) to support dental infrastructure and workforce initiatives in outer metropolitan, regional, rural and remote areas.

This measure will improve the oral health outcomes of Australians by addressing gaps in dental service delivery through the provision of grants for purposes including: the purchase of dental equipment and new dental infrastructure; dental workforce initiatives; and practice support activities.

See also the related expense measures titled Dental health reform — Child Dental Benefits Schedule, Dental health reform — Medicare Teen Dental Plan — redirection of funding and Dental health reform — National Partnership Agreement for adult public dental services.

Further information can be found in the press release of 29 August 2012 issued by the Minister for Health.

Dental health reform — Medicare Teen Dental Plan — redirection of funding

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Human Services ‑1.2 ‑5.9 ‑6.0
Department of Health and Ageing ‑35.9 ‑97.7 ‑106.5
Total — Expense ‑37.2 ‑103.7 ‑112.6
Department of Human Services ..
Department of Health and Ageing
Total — Capital ..

The Government will achieve savings of $513.4 million over six years (including $123.8 million in 2016‑17 and $136.2 million in 2017‑18) by closing the Medicare Teen Dental Plan from 1 January 2014.

Savings from this measure will be redirected to partially offset the Government's Dental health reform package.

See also the related expense measures titled Dental health reform — Child Dental Benefits Schedule, Dental health reform — National Partnership Agreement for adult public dental services and Dental health reform — flexible grants program.

Further information can be found in the press release of 29 August 2012 issued by the Minister for Health.

Dental health reform — National Partnership Agreement for adult public dental services

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of the Treasury 200.0 295.0
Department of Health and Ageing 0.8 0.8
Total — Expense 200.8 295.8

The Government will provide $1.3 billion over four years from 2014‑15 (including $390.8 million in 2016‑17 and $390.8 million in 2017‑18) to support the provision of dental health services to adults who rely on the public dental system.

This measure will contribute to long term dental health by providing funding to states and territories to assist more than 1 million low income adults by shifting the focus of public dental services from emergency management to prevention.

Funding will be provided under a National Partnership Agreement with the states and territories and will build on the 2012‑13 Budget measure Dental health — alleviating pressure on public dental waiting lists.

See also the related expense measures titled Dental health reform — flexible grants program, Dental health reform — Child Dental Benefits Schedule and Dental health reform — Medicare Teen Dental Plan — redirection of funding.

Further information can be found in the press release of 29 August 2012 issued by the Minister for Health.

Health and Hospitals Fund — Queensland Regional Acute/Subacute/Extended Inpatient Mental Health Services project — cancellation

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing
Department of the Treasury ‑1.9 ‑2.8 ‑5.4 ‑10.0
Total — Expense ‑1.9 ‑2.8 ‑5.4 ‑10.0

The Government will not proceed with funding for the Queensland Regional Acute/Subacute/Extended Inpatient Mental Health Services project following a decision by the Queensland Government to withdraw its support for the project. This is estimated to save $20.1 million over four years. Funding for the project was announced as part of the Health and Hospitals Fund 2010 Regional Priority Round in the 2011‑12 Budget.

Savings from this measure will be redirected to support a new $21.4 million Cancer Centre in the growth centre of Springfield, Queensland.

See also the related expense measure titled Springfield Cancer Care Centre.

Life Saving Drugs Program — new and amended listings

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing ‑0.5 ‑1.2 ‑1.4 ‑1.5

The Government has agreed to a new listing and an amendment to an existing listing on the Life Saving Drugs Program and these are estimated to result in saving of $25.1 million over four years.

Vpriv® (velaglucerase alfa) will be listed for the treatment of Type 1 Gaucher disease providing an alternative to the existing treatment, Cerezyme® (imiglucerase).

A price reduction will be applied to Fabrazyme® (agalsidase beta), used for the treatment of Fabry disease. The restriction on this medicine will be amended once the price reduction takes place to allow existing Fabry patients, as well as those newly diagnosed, to access this medicine.

The Life Saving Drugs Program provides subsidised access for eligible patients to expensive life saving medicines for very rare life‑threatening conditions.

Further information can be found in the press release of 24 June 2012 issued by the Minister for Health.

Medical Indemnity Insurance — Reduction in subsidies under the Premium Support Scheme

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing

The Government will achieve savings of $22.9 million over four years by reducing the level of subsidy that applies under the Premium Support Scheme (PSS).

The PSS was introduced in 2004 to help doctors with the costs of their medical indemnity insurance. The PSS provides a subsidy to cover the proportion of medical indemnity insurance costs of eligible doctors that exceed 7.5 per cent of their gross medical income. The subsidy will be reduced from 80 to 70 cents in the dollar in 2012‑13, then to 60 cents in the dollar from 2013‑14 onwards, reflecting more affordable premiums for medical indemnity insurance.

This measure was included as a 'decision taken but not yet announced' in the 2011‑12 Budget.

Savings from this measure will be redirected to support other Government priorities.

Medicare Benefits Schedule — amending telehealth geographical eligibility

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Human Services 1.3 ‑0.2 ‑0.3 ‑0.3
Department of Veterans' Affairs ‑0.4 ‑1.4 ‑2.0 ‑2.4
Department of Health and Ageing ‑7.1 ‑28.9 ‑44.8 ‑47.7
Total — Expense ‑6.2 ‑30.6 ‑47.1 ‑50.5

The Government will restrict telehealth services to those patients for whom distance is the most significant barrier to accessing specialist care.

This is estimated to save $134.4 million over four years. This restriction will align eligibility to Medicare Benefits Schedule (MBS) telehealth items with the Australian Standard Geographical Classification Remoteness Area (ASGC‑RA), the standard remoteness classification used by the Australian Bureau of Statistics. From 1 January 2013, geographic eligibility criteria for MBS telehealth services will be amended to exclude patients in outer metropolitan areas and major cities of Australia, in accordance with the ASGC‑RA. The amendment to geographical eligibility will not affect services that are provided to patients of an Aboriginal Medical Service or care recipients of a residential aged care facility.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012.

Medicare Benefits Schedule — new and amended listings

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Human Services 0.2 0.1 .. ..
Department of Veterans' Affairs ‑0.1 ‑0.1 ‑0.1 ‑0.1
Department of Health and Ageing ‑2.3 ‑2.3 ‑2.8 ‑3.2
Total — Expense ‑2.2 ‑2.3 ‑2.9 ‑3.3

The Government will amend the Medicare Benefits Schedule (MBS) and Veterans' Benefits for new and revised listings since the 2012‑13 Budget, saving $10.8 million over four years.

The amendments include:

  • a new item for radiofrequency ablation in the treatment of Barrett's Oesophagus with high grade dysplasia. Radiofrequency ablation destroys potentially pre‑cancerous cells in the lower oesophagus and allows the regrowth of healthy cells;
  • amending an item to include in situ hybridisation (ISH) gene amplification testing to Stage III breast cancer patients prior to surgery. ISH testing assesses whether patients have over expressed human epidermal growth factor receptor 2 genes which result in more aggressive breast cancer;
  • restricting access to liposuction to reduce the potential for services under the MBS to be used for cosmetic purposes;
  • a new item for radiofrequency ablation in the treatment of varicose veins; and
  • restricting access to ultrasound in association with anesthesia, pending assessment of the cost effectiveness of this practice by the Medical Services Advisory Committee.

Further information will be available in the MBS Summary of Changes issued by the Department of Health and Ageing when the amendments take effect.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012.

Medicare Benefits Schedule — telehealth — new items

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Human Services 0.6 0.1 0.1 0.1
Department of Veterans' Affairs .. ‑0.1 ‑0.1 ‑0.1
Department of Health and Ageing ‑0.1 ‑1.1 ‑1.8 ‑1.9
Total — Expense 0.4 ‑1.1 ‑1.8 ‑2.0

The Government will introduce new Medicare Benefits Schedule (MBS) items from 1 January 2013 for short consultant physician and specialist video conferencing attendances where the time and content is less than that usually expected for initial consultations.

This measure is estimated to generate savings of $4.5 million over four years by creating new MBS items such as telehealth triage and short consultations for referrals to screening services. The new MBS items will be restricted to patients located in eligible geographic areas and other eligibility requirements will apply consistent with current telehealth items.

MBS items for specialist video consultations have been in place since 1 July 2011 in line with the 2010 election commitment Connecting Health Services with the Future.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012.

National Immunisation Program — extended listing of Gardasil®

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 19.4 24.5 22.1 25.6
Department of the Treasury ‑17.7 ‑17.7 ‑17.5 ‑17.5
Total — Expense 1.7 6.8 4.6 8.1

The Government will provide $21.1 million over four years to extend the national human papillomavirus (HPV) vaccination program to boys.

The Gardasil® vaccine will be delivered in schools through the National Immunisation Program (NIP) to 12 and 13 year old boys. The Government will also fund a two year catch‑up program for two Year 9 cohorts (14 and 15 year old boys).

Gardasi provides protection against genital warts and certain cancers caused by HPV. Extending the availability of Gardasil® to boys will ensure that the entire target population will be protected against HPV infection. Male immunisation also gives indirect protection to unvaccinated girls against HPV, which is responsible for 70 per cent of all cervical cancers in Australia.

Further information can be found in the press release of 12 July 2012 issued by the Minister for Health.

Pharmaceutical Benefits Scheme — new and amended listings

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 12.8 ‑9.3 ‑48.1 ‑89.7
Department of Human Services 0.2 0.1 0.1 ..
Department of Veterans' Affairs ‑0.7 ‑2.9 ‑6.0 ‑9.0
Total — Expense 12.3 ‑12.1 ‑54.1 ‑98.6
Department of Health and Ageing nfp nfp nfp nfp

The Government has agreed to a number of new and amended listings on the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS) at a net saving of $152.5 million over four years.

Listings and amendments include:

  • Bronchitol® (mannitol), for the treatment of mucus build‑up in the lungs of patients with cystic fibrosis;
  • Eylea® (aflibercept), for the treatment of age‑related macular degeneration;
  • Jevtana® (cabazitaxel), for the treatment of a certain type of metastatic prostate cancer;
  • Firazyr® (icatibant), for the treatment of attacks of hereditary angioedema (unpredictable episodes of swelling that can impede breathing); and
  • Myfortic® (mycophenolate sodium), for the treatment of kidney inflammation caused by lupus (lupus nephritis).

Pricing agreements negotiated between the Government and the pharmaceutical manufacturers reduce the costs to Government of some of these medicines.

General consumers will continue to pay a $35.40 co‑payment per prescription and concession card holders will pay a $5.80 co‑payment per prescription.

Further information can be found in the press release of 24 June 2012 issued by the Minister for Health and on www.pbs.gov.au.

Pharmaceutical Benefits Scheme — price changes

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 2.5 2.8 2.9 3.1
Department of Veterans' Affairs 0.1 0.2 0.2 0.2
Total — Expense 2.6 3.1 3.2 3.3

The Government has agreed to a number of price amendments to medicines currently listed on the Pharmaceutical Benefits Scheme (PBS) and the Repatriation Pharmaceutical Benefits Scheme (RPBS), at a net cost of $12.2 million over four years.

Price reductions have been applied to:

  • Cefazolin® (cephazolin), which is used as a broad‑spectrum antibiotic;
  • Cetrotide® (cetrorelix), for use in in‑vitro fertilisation; and
  • Orgalutran® (ganirelix), for the treatment of infertility in women.

There have been a number of price increases including:

  • Heparin sodium injection, for the prevention and treatment of blood clots;
  • Mirena® (levonorgestrel intrauterine), for use as a contraceptive and treatment of menorrhagia;
  • Vagifem® (oestradiol vaginal tablets), for use as hormone replacement therapy for postmenopausal women;
  • Hydopa® (methyldopa), for the treatment of high blood pressure;
  • Lincocin® (lincomycin), for the treatment of serious bacterial infections; and
  • Macrodantin® (nitrofurantoin), for the treatment of urinary tract infections.

Further information can be found in the press release of 24 June 2012 issued by the Minister for Health and on www.pbs.gov.au.

Pharmaceutical Benefits Scheme — price reduction of high potency cholesterol‑lowering medicines

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing
Department of Veterans' Affairs
Total — Expense

The Government has agreed to a price reduction of 25 per cent on high potency cholesterol‑lowering medicines (statins) listed on the Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS), at a saving of $941.3 million over four years.

Savings from this price reduction were included as a 'decision taken but not yet announced' in the 2012‑13 Budget.

Preventive Health — investing in preventative health initiatives

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing
Australian National Preventive Health Agency
Total — Expense

The Government will provide $74.1 million over four years to support preventive health activities. Of this funding, $29.1 million will support the Australian National Preventive Health Agency's (ANPHA) core activities and research as well as initiatives to combat eating disorders. The remaining $45.0 million will fund social marketing to discourage tobacco use, complementing the plain packaging initiative.

ANPHA was established following the commencement of the Australian National Preventive Health Agency Act 2010 on 1 January 2011. The Government established ANPHA to strengthen Australia's investment and infrastructure in preventive health.

This supports the Government's commitment to the National Partnership Agreement on Preventive Health.

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

Private Health Insurance Rebate — indexing the Government's contribution

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 3.0 ‑36.5 ‑218.9 ‑451.7
Australian Taxation Office 2.2 1.6 0.1 0.1
Department of Human Services 0.2 0.3 ..
Total — Expense 5.3 ‑34.6 ‑218.8 ‑451.6

The Government's contribution to private health insurance will be calculated using commercial premiums as at 1 April 2013 and then indexed annually by the lesser of CPI or the actual increase in commercial premiums. This will be used to determine an individual's private health insurance rebate.

In conjunction with this measure, the Government will streamline arrangements for the 2013 premium setting round. The Government will undertake discussions with industry and consumer groups on options for further simplification of premium setting that will drive competition and continue to deliver strong consumer protection from 2014.

The measure will take effect from 1 April 2014 and will result in savings of $699.7 million over four years.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012.

Private Health Insurance Rebate — removal of rebate on lifetime health cover loading

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Human Services 1.3 1.2 0.7 0.7
Australian Taxation Office 1.2 1.1 2.8 0.1
Department of Health and Ageing 0.3 ‑124.2 ‑133.9 ‑140.6
Total — Expense 2.8 ‑121.8 ‑130.4 ‑139.8
Department of Human Services 2.2 0.8 .. ..

The Government will remove the Private Health Insurance (PHI) Rebate on the Lifetime Health Cover (LHC) loading component of PHI premiums.

The LHC loading is an additional two per cent charge to a person's PHI premium for every year elapsed after their thirty‑first birthday before they take out PHI. LHC loadings are only payable against the hospital component of a person's PHI premium.

The measure will take effect from 1 July 2013 and will result in savings of $386.3 million over four years.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012. This savings measure will improve the effectiveness of the incentive for a person to take out PHI early in their life.

Springfield Cancer Care Centre

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 0.9 10.4 10.1

The Government will contribute $21.4 million towards the construction of the Springfield Cancer Care Centre in Queensland to enable local residents suffering from cancer to access quality care.

The new centre, which will offer day services and radiation oncology, will reduce the need for patients to travel to facilities in Brisbane or Toowoomba for treatment.

Further information can be found in the press release of 10 July 2012 issued by the Prime Minister, the Parliamentary Secretary for Health and Ageing, the Member for Oxley, and the Member for Blair.

Tasmania's Health System — additional funding

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of the Treasury 31.9 46.7 49.6 40.0
Department of Health and Ageing 6.9 41.8 54.1 54.1
Total — Expense 38.8 88.6 103.7 94.1

The Government will provide $325.2 million over four years for the Tasmanian health system to address challenges caused by Tasmania's ageing population, high rates of chronic disease, and constraints in the state health system as well as equip it to meet future challenges.

This measure includes:

  • $63.2 million over four years to ensure Tasmanians receive better palliative care services within the community by expanding‑ the capacity of the private, non‑government, and public health sectors;
  • $60.0 million over four years to develop and implement three programs through the Tasmania Medicare Local including: a new patient care pathways program to better manage patient transitions between acute, primary and aged care services; a coordinated care pilot to improve health outcomes for people with chronic and complex conditions; and initiatives to address the social determinants of health and risk factors for Tasmanians;
  • $54.9 million over four years to promote teaching, training and research excellence among the health workforce in Tasmania, including: the expansion of the Specialist Training Program; the development of the nursing and allied health workforce; and a pilot Virtual Health Sciences Precinct;
  • $40.9 million over four years to support innovation in clinical services that would enable care to be delivered more effectively and efficiently;
  • $36.8 million over four years to accelerate access to the Personally Controlled Electronic Health Record (PCEHR) for Tasmania's public hospitals; support the adoption of electronic pathology requesting and reporting in Tasmania; and support eHealth readines and connection to PCEHR for allied health practitioners;
  • $31.2 million over four years to reduce elective surgery waiting lists in Tasmania by undertaking approximately 2,600 additional elective surgeries from 2012‑13;
  • up to $22.8 million over four years to establish walk‑in health clinics in Hobart and Launceston, to provide primary health care services for people with minor illnesses and injuries; and
  • $15.4 million over four years to establish a flexible funding pool to target existing and emerging mental health service delivery challenges in Tasmania.

Further information can be found in the press release of 15 June 2012 issued by the Minister for Health.

Therapeutic Goods Administration — blueprint reforms

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing 2.3 4.0 4.0 1.3
Department of Health and Ageing 2.3 4.0 4.0 1.3

The Government will provide $11.7 million over four years to implement a package of reforms to the Therapeutic Goods Administration (TGA) that will enhance the TGA's current processes to ensure that the regulatory framework within which it operates remains able to adapt to new scientific developments and emerging community expectations.

These reforms aim to strengthen the regulation of: therapeutic goods advertising, complementary medicines and medical devices. They also aim to improve the current arrangements surrounding the promotion of therapeutic products and enhance TGA's communication and stakeholder engagement practices.

The cost of the measure will be fully recovered through fees charged to industry.

Further information can be found in the press release of 8 December 2011 issued by the Parliamentary Secretary for Health and Ageing.

Video conferencing for the after hours GP helpline — staged implementation

Expense ($m)
  2011-12 2012-13 2013-14 2014-15 2015-16
Department of Health and Ageing ‑20.0

The Government will change its approach to developing the video conferencing capabilities of the after hours GP helpline. A staged approach to the rollout of the video conferencing capabilities will allow the technology to be fully tested and developed in 2012‑13 to ensure appropriate consumer experience before a national rollout in 2013‑14.

The telephone helpline commenced operation in July 2011 to enable people who require after hours medical advice, and who cannot access their usual GP, to speak to a GP over the telephone if necessary.

Video conferencing will continue in selected residential aged care facilities where it has been available since July 2012.

Savings from this measure will be redirected to partially offset the cost of the Dental Health Reform package announced on 29 August 2012.

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