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Health infrastructure
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 projects.[1] Although subject to final budget outcomes, when the HHF was first announced the
expected allocation was $10 billion.[2] The first allocation to the HHF was $5 billion from the 2008–09 Budget.[3]
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 billion dollars.[4] In terms of hospital infrastructure, the Budget announced 17 major projects which
total $1.5 billion.[5] 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.[6]
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 equipment
- 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.[7]
Other infrastructure funds have been criticised for a lack
of transparency and for the failure to conduct a cost-benefit analysis.[8] The principles and evaluation criteria underpinning the HFF were made public at
the time of application.[9] 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.[10] A complete list of projects funded by the HHF was not included in the budget
papers or in the accompanying media briefing.[11]
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 $10 billion, but that this would be dependent on future Budget
surpluses. Given the current economic climate, it is unlikely that there will
be a budget surplus in the near future. This makes critical evaluation regarding
expenditure of the HHF essential.
[1]. W Swan, (Treasurer), Budget
Speech 2008–09, 13 May 2008, viewed 15 May 2009, http://www.budget.gov.au/2008-09/content/speech/download/speech.pdf
[2]. Swan.
[3]. R Webb, C Dow
and R de Boer, Nation building fund 2008, Bills digest, no. 67, 2008–09,
Parliamentary Library, Canberra, 2008, viewed 21 May 2009, http://www.aph.gov.au/library/pubs/bd/2008-09/09bd067.pdf
[4]. N Roxon (Minister for Health
and Ageing), ‘Keynote address’, Generic Medicines Australia Conference 2009, Sydney, 19 May 2009.
[5]. N Roxon,
(Minister for Health and Ageing), Nation-building a hospital system for the
future, media release, 12 May 2009, viewed 14 May 2009, http://www.health.gov.au/internet/budget/publishing.nsf/Content/33CC111799F2D03CCA2575B2003CBA5E/$File/hmedia07.pdf
[6]. Australian
Government, Budget measures: budget paper 2:2009–10, Commonwealth of
Australia, Canberra, 2009, p. 279.
[7]. Refer to
‘Health and Hospitals Fund’ on the Department of Health and Ageing website,
viewed online 18 May 2009, http://www.health.gov.au/internet/main/publishing.nsf/Content/HHF
[8]. G Milne, ‘Missing numbers
from nation building plans’, The Australian, 18 May 2009, p. 8.
[9]. Health and Hospitals Fund:
funding application and guidelines’, viewed 18 May 2009, http://www.health.gov.au/internet/main/publishing.nsf/Content/HHF/$file/Guidelines%20for%20Applicants%20final%20approved%2019%20Dec%202008.pdf
[10]. Budget paper 2, pp 280-282
[11]. However, 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.
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