Budget Review 2022–23 Index
Rebecca Storen
This article provides a brief overview of several public
health, women’s health and bereavement measures announced in the 2022–23
Budget. The most financially significant announcement is the COVID-19 response
package, which provides ongoing funding for many existing COVID-19 response
measures, including through the National
Partnership on COVID-19 Response (National Partnership) with the states and
territories, primary care, vaccines and treatments.
The Budget also provides 2 specific preventive health measures
and includes dedicated funding of the National
Preventive Health Strategy 2021–2030 (preventive health strategy) and
funding for other initiatives, such as increased cancer screening and alcohol
and other drug (AOD) activities.
In addition, the women’s health package includes measures to
support and implement the National
Women’s Health Strategy 2020–2030 (women’s health strategy) and the new National
Plan to End Violence against Women and Children (this plan is further discussed
in the ‘Women’s
safety’ article elsewhere in this Budget review). The
Budget also provides funding for activities to support the implementation of
the National
Stillbirth Action and Implementation Plan (stillbirth action plan) with bereavement
support and improved access to stillbirth autopsy services.
The Royal
Australian College of General Practitioners (RACGP) has welcomed several of
these budget announcements, but flagged that the endometriosis support measures
announced will need careful implementation to avoid care fragmentation. In
addition, the RACGP notes that the National Ice Action Strategy funding through
the Primary Health Networks (PHN) only indirectly supports the role of general
practitioners (GP), and it continues to call for increased recognition of the
role of GPs in treating AOD use and the extension of funding for GP education
in this area.
COVID-19 response package
The Government has committed $4.2 billion to continue the COVID-19
pandemic health response and the anticipated influenza season across a range of
activities (Portfolio
budget statements 2022–23: budget related paper no. 1.7: health portfolio,
p. 35).
Agreements with the state and
territories
The Budget provides $984.0 million to extend the activities
of the National
Partnership through the supporting hospitals measures and an additional
$69.3 million (from 2021–22) for vaccines (Budget
measures: budget paper no. 2, pp. 91–92). In addition, an estimated
$934.1 million in 2022–23 will be provided to the states and territories
through the National
Health Reform Agreement (NHRA) for the COVID-19 public health response (Federal
financial relations: budget paper no. 3: 2022–23, p. 19). There is some
interaction between the funding provided under the NHRA and that provided under
the National Partnership, including some hospital activities that would
normally be funded under the NHRA instead of being funded under the National
Partnership (Budget paper no. 3, p. 20).
The additional funding to extend the National Partnership
until 30 September 2022 includes:
- $597.2 million for work to minimise the spread of COVID-19
- $311.8 million for state and territory hospital services to
support the diagnosis and treatment of COVID-19
-
$54.2 million through the Private
Hospital Viability Guarantee
- $38 million to support the delivery of COVID-19 vaccines
- $19.3 million to support infection prevention and control
training for residential aged care (Health
portfolio 2022–23 budget stakeholder pack, pp. 161–162).
Primary care
The Budget provides funding to extend several primary care
activities, including:
-
$248.1 million to extend the General
Practitioner-led respiratory clinic (GPRC) program until 30 September
2022 (Health
portfolio budget statement, p. 38)
- $43.3 million in 2022–23 to continue the Remote and Indigenous
Response to COVID-19 and the transition to living with COVID-19; this includes:
- support
for the Royal Flying Doctor Service to respond to outbreaks and deliver
vaccines
- testing
and vaccination support for Aboriginal Community Controlled Health Services
(ACCHS)
- the
remote point-of-care testing program, which is provided in 150 communities (Health
stakeholder pack, p. 161).
- $23.4 million to extend healthdirect’s triage, assessment and
referral service
- $13.6 million in 2022–23 for the purchase of pulse oximeters, and
the distribution of Personal Protective Equipment (PPE) and the pulse oximeters
through the National Medical Stockpile (NMS) to general practices, GPRCs, ACCHS
and community pharmacies providing COVID-19 vaccines (Budget paper no. 2, p. 91)
- $6 million to extend activities through the PHNs to coordinate
care of COVID-19 patients in the community (Health stakeholder pack, p. 161).
COVID-19 specific measures for aged
care
The Budget provides $458.2 million over 5 years from 2021–22
for aged care, including:
- an additional $215.3 million over 2 years from 2021–22 for a
bonus of up to $800 for aged care workers (Health stakeholder pack, p. 157)
- $124.9 million to expand the Aged Care Preparedness Measure,
which includes continuing the Aged
Care Support Program until 31 December 2022 and expanding it for services
directly affected by the floods
-
$50.4 million for 400 training places for registered nurses working
in residential aged care to become Authorised Nurse Immunisers
-
$37.6 million to establish infection control and prevention
training grants for an estimated 2,900 nurses in residential aged care.
Alongside these measures is funding for the addition of PPE
to the NMS for distribution to residential aged care, which is estimated to be
over $1.09 billion (noting that this figure includes PPE for ‘other frontline
health service sites’) (Health portfolio budget statement, p. 36).
COVID-19 testing
The Budget provides:
-
$22.1 million in additional funding to extend in-reach COVID-19 pathology
testing into residential aged care
-
$546.0 million to extend the temporary Medicare Benefits Schedule
(MBS) pathology items for testing for COVID-19 (Budget paper no. 2, pp. 88–89).
While a breakdown of the financial implications for rapid
antigen tests (RAT) is not provided, the Government will invest approximately
$1.6 billion for RATs over 2 years from 2021–22, which includes the following
measures:
- an extension of the COVID-19
Rapid Test Concessional Access Program until 31 July 2022, which is jointly
funded with state and territory governments under the National Partnership
-
purchase and distribution of RATs to residential aged care,
National Disability Insurance Scheme Supported Independent Living, GPRCs,
ACCHS, remote communities and to the states and territories (Budget paper no. 2,
p. 90)
- 50% reimbursement for state and territory government costs
incurred to provide 2 RATs per week for 4 weeks for COVID-19 testing for
children and staff in schools and early childhood education (Health portfolio
budget statement, p. 37).
COVID-19 vaccines and treatment
Commercial sensitivities limit the available information on
the financial implications of COVID-19 vaccination and treatment (medicines);
however, some information on vaccine distribution is available.
The Budget provides additional funding to extend the
COVID-19 vaccination program until the end of 2022 for vaccine administration through
primary care and community settings (including through the MBS), which include
targeted programs for people who may be more vulnerable, such as people living
in aged and disability care services. The exact figure is uncertain, with
different sources provided different numbers with figures range from $690.4
million in the Health portfolio budget statement (p. 35) to $839.3 million
in the Health stakeholder pack (p. 164), with little information available is
it unclear why these figures may differ.
The operation of the National COVID Taskforce has been
extended until 31 December 2022 with the provision of $70.9 million, along with
$66.7 million to continue data and digital systems required for the vaccine
rollout (Health stakeholder pack, p. 164).
The Government has also extended the COVID-19
Vaccine Claims Scheme to include children aged 0 to 4 years and a fourth
dose for priority cohorts to enable access to compensation for COVID-19 vaccines
approved by the Therapeutic Goods Administration.
Preventive health
The
Budget has 2 main preventive health measures:
-
$30.1 million for the National Preventive Health Strategy
2021–2030 over 4 years from 2022–23
-
$170.2 million for preventive health over 5 years from 2021–22.
These measures will be partially funded through existing Department
of Health resources (pp. 105–107).
The Public
Health Association of Australia has welcomed some of the initiatives but has
stated that ‘when we put that lens of public and preventive health as outlined
in the National Preventive Health Strategy across the 2022 Federal Budget, I’m
sorry, but the Budget is an F minus’.
National Preventive Health Strategy
In December 2021, the
Government released the preventive
health strategy, a move welcomed
by stakeholders, although questions remain concerning its implementation.
The strategy has 4 aims, including increasing investment in prevention,
underpinned by the commitment to increase the investment in preventive health
to 5% of total health expenditure for the Commonwealth, state and territory
governments by 2030 (p. 9).
The
Budget provides $30.1 million over 4 years from 2022–23 for initiatives
under the strategy, which is partially covered by existing resources in the
Department of Health (p. 107). Initiatives include:
Alcohol and other drugs
Building on its earlier
commitment to the National
Ice Action Strategy, the Government
has allocated an additional $31.6 million over 4 years from 2022–23 to
extend 19 projects under this strategy (p. 105).
The
Budget provides $19.6 million over 4 years from 2022–23 (and $4.9 million per
year thereafter) to roll out a national take-home naloxone program. The
national rollout was ‘very strongly recommended’ by researchers, based on
findings from an evaluation of the pilot
program (p. xix). The program enables people who may be at risk of, or likely
to witness, an opioid overdose to access naloxone (which temporarily reverses
the effects of an opioid overdose) without a prescription and free of charge from
approved sites, such as pharmacies. It is estimated that the national program
will potentially avert over 4,000 overdose medical events each year (Health
portfolio budget statement, p. 29).
The
Budget also provides $9.2 million in 2022–23 to extend 4 existing programs:
2 through the Alcohol and Drug Foundation,
one through Hello Sunday Morning
and another through SMART
recovery (p. 106).
Screening programs and other preventive
health measures
In response to the recent
decline in cancer screening and early diagnostic testing rates, $55.7
million has been allocated to increase the availability of screening services,
including:
-
$10.2 million to promote cervical screening self-collection tests
and another $4.1 million to increase test distribution
- $15 million for a communication campaign about staying up to date
with health checks and promoting digital services, such as electronic
prescriptions (Health
stakeholder pack, p. 113).
Funding has also been provided for other preventive health
activities including:
- $26.9 million over 4 years to establish a National Allergy Centre
of Excellence, a National Allergy Council and a national register for
anaphylaxis
-
$10.6 million over 2 years for a preventive health communication
campaign for culturally and linguistically diverse communities (Budget
paper no. 2, pp. 105–106).
Women’s health
The
Women’s health package provides funding to improve health services for
women and support the implementation of the women’s
health strategy including $1.6 million to establish a National Women’s
Health Advisory Council to monitor and report on implementation of the strategy.
Funding for this measure will be partially met by existing
resources of the Department of Health and Services Australia (pp. 113–115).
Endometriosis
The Government has
allocated $58.1 million for supports for women living with endometriosis,
which includes:
- $25.2 million over 4 years for a new MBS item for pelvic magnetic
resonance imaging for the investigation of infertility, including for people
with endometriosis
-
$16.4 million to establish 16 endometriosis and pelvic pain
clinics in general practices
-
$5.1 million for the development of an Endometriosis Management
Plan
-
$5.1 million for the National Endometriosis
Clinical and Scientific Trials (NECST) Network for research and the NECST
registry (pp. 113–114).
National Plan to End Violence
against Women and Children – health measures
The Budget provides $137.6 million for health care and
support for women who have experienced intimate partner violence and/or sexual
violence, including:
- $67.2 million to pilot a national model of trauma-informed
recovery care through the PHNs
-
$48.7 million to enhance and expand primary care models to assist
people who have experienced family, domestic and sexual violence to navigate and
access health services across Australia
-
$20.0 million over 4 years ($25.0 million over 5 years) to the
Illawarra Women’s Centre to support the establishment of a women’s trauma
recovery centre
-
$1.7 million to address the impacts of female genital mutilation
or cutting (Health
Portfolio Budget Statement, p. 29).
Ovarian and breast cancer support
The
Budget provides $39.8 million over 3 years from 2023–24 to the McGrath Foundation to continue
its Breast Cancer Nurses Program and $4.0 million over 4 years to Ovarian Cancer Australia’s Teal
Support Program (p. 115).
Bereavement support
The Government has allocated $23 million for bereavement
support and stillbirth autopsy services, supporting the implementation of the stillbirth
action plan, including:
- $5.1 million over 4 years to establish a grant program for
stillbirth and miscarriage support services
- $4.2 million to extend the Hospital to Home program,
which supports parents leaving hospital after stillbirth, sudden infant death
or neonatal death
-
$13.7 million over 3 years to the states and territories to
increase stillbirth autopsies, including creating a dedicated Perinatal
Pathologist position in each state and territory (Budget
paper no. 2, p. 115).
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