Rebecca de Boer
The Health and Hospitals Fund (HHF) was announced in the
2008–09 Budget to finance health infrastructure such as
hospitals, medical technology, medical research facilities and
subject to final budget outcomes, when the HHF was first announced
the expected allocation was $10 billion. The first allocation to the HHF was $5
billion from the 2008–09 Budget.
The 2009–10 Budget announced a range of health
infrastructure projects. These range from hospitals to support
cancer services and medical research and amount to around $3.2
In terms of hospital infrastructure, the Budget announced 17 major
projects which total $1.5 billion. This funding will be spent over seven
years, with $104.1 million to be spent in 2013–14, and $10.0
million in 2014–15.
Projects funded by the HHF were evaluated by the HHF Board,
appointed by the Minister for Health and Ageing, Nicola Roxon, in
November 2008. Applications opened on 19 December 2008 and closed
on 19 January 2009. Preference was to be given to:
- projects that improved acute care facilities, including
hospitals, paediatric and specialised mental health facilities and
- health service infrastructure—primary and community
care—focusing on facilities or equipment to support a more
integrated approach. A balanced program including rural, Indigenous
services and outer-metropolitan will be important
- workforce training infrastructure—to support innovative
approaches to improve the health and medical workforce, to deal
with the increase in numbers of people training to be health
professionals and to assist in improving distribution
- specialised cancer care—development of integrated cancer
care facilities, and
- research facilities that are integrated with improving clinical
care and/or health workforce training.
Other infrastructure funds have been criticised for a lack of
transparency and for the failure to conduct a cost-benefit
principles and evaluation criteria underpinning the HFF were made
public at the time of application. However, the absence of further relevant
information means that it is not possible at this stage to evaluate
the decisions made by the HHF Board .
The HHF will also fund $1.3 billion over six years to deliver a
‘world class cancer system’ in Australia and $430.3
million over six years to translate research into clinical practice
in areas such as mental health and neurological disorders, child
health, Indigenous health and medical bionics. A complete list of projects
funded by the HHF was not included in the budget papers or in the
accompanying media briefing.
Over the Forward Estimates period (until 2012–13), close
to $3 billion of the HHF will be spent. It is important to
note that the HHF was funded from the surplus of the 2008–09
Budget and, although there is provision for additional money to be
allocated to the HHF, this has not yet occurred. When the HHF was
first announced, the Government indicated that the Fund could be
worth up to $10 billion, but that this would be dependent on
future Budget surpluses. Given the current economic climate, it is
unlikely that there will be a budget surplus in the near future.
This makes critical evaluation regarding expenditure of the HHF
W Swan, (Treasurer), Budget Speech 2008–09, 13 May
2008, viewed 15 May 2009,
. R Webb, C Dow and R de Boer,
Nation building fund 2008, Bills digest, no. 67,
2008–09, Parliamentary Library, Canberra, 2008, viewed 21 May
N Roxon (Minister for Health and Ageing), ‘Keynote
address’, Generic Medicines Australia Conference
2009, Sydney, 19 May 2009.
. N Roxon, (Minister for
Health and Ageing), Nation-building a hospital system for the
future, media release, 12 May 2009, viewed 14 May 2009,
. Australian Government,
Budget measures: budget paper 2:2009–10,
Commonwealth of Australia, Canberra, 2009, p. 279.
. Refer to ‘Health and
Hospitals Fund’ on the Department of Health and Ageing
website, viewed online 18 May 2009,
G Milne, ‘Missing numbers from nation building plans’,
The Australian, 18 May 2009, p. 8.
Health and Hospitals Fund: funding application and
guidelines’, viewed 18 May 2009,
paper 2, pp 280-282
in a speech made the Minister for Health and Ageing, she noted that
$3.2 billion for health infrastructure had been allocated from the
HHF – for 32 iconic projects. See See N.Roxon (Minister for
Health and Ageing), ‘Keynote address’, Generic
Medicines Australia Conference 2009, Sydney, 19 May 2009.