Footnotes

Footnotes

Membership of the Committee[1]

[1] Membership arrangements for previous phases of this inquiry can be found in earlier interim reports.

Hospital funding quotes[1]

[1]        Full citations may be found at the beginning of each chapter.

Chapter 1 - Introduction

[1]        Journals of the Senate, 25 June 2014, pp 996–998.

[2]        Public hearing details can also be accessed via the committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Public_Hearings.

[3]        The submissions received by the committee can be accessed via the committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Submissions.

[4]        The submissions received by the committee can be accessed via the committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Additional_Documents.

[5]        Journals of the Senate, 2 December 2014, p. 1948. The report can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/First_Interim_Report.

[6]        Journals of the Senate, 24 June 2015, p. 2809. The report can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Second_Interim_Report.

[7]        Journals of the Senate, 17 September 2015, p. 3158. The report can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Third_Interim_Report.

[8]        National Commission of Audit, Phase One Report, paragraph 10.1 and recommendation 57.

[9]        Commonwealth of Australia, 2014-15 Budget, Budget Paper No. 2, Budget Measure: Smaller Government—scoping studies for four operations of government, May 2014, p. 117.

[10]      Senator the Hon Mathias Cormann, Minister for Finance, media release, 'Further Consultation on Future Ownership Options for Australian Hearing', 8 May 2015.

[11]      Journals of the Senate, 12 October 2015, p. 3175. The report can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Fourth_Interim_Report.

[12]      Journals of the Senate, 2 May 2016, p. 4165. The report can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Fifth_Interim_Report.

[13]      Journals of the Senate, 4 May 2016, p. 4238. The report can be accessed at: http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Sixth_Interim_Report

[14]      Committee Hansards can be accessed via the committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Public_Hearings.

Chapter 2 - Background to hospital funding reform

[1]        Department of the Prime Minister and Cabinet, Reform of the Federation White Paper 2014: Roles and Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.

[2]        Amanda Biggs, Parliamentary Library, Health in Australia: a quick guide, November 2013, pp 1–2; Council of Australian Governments, National Healthcare Agreement 2012; and Department of the Prime Minister and Cabinet, Reform of the Federation White Paper 2014: Roles and Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.

[3]        Amanda Biggs, Parliamentary Library, Health in Australia: a quick guide, November 2013, pp 1–2; Council of Australian Governments, National Healthcare Agreement 2012; and Department of the Prime Minister and Cabinet, Reform of the Federation White Paper 2014: Roles and Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.

[4]        Amanda Biggs, Parliamentary Library, Health in Australia: a quick guide, November 2013, pp 1–2; Council of Australian Governments, National Healthcare Agreement 2012; and Department of the Prime Minister and Cabinet, Reform of the Federation White Paper 2014: Roles and Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.

[5]        Department of Prime Minister and Cabinet, Reform of the Federation White Paper 2014: Roles and Responsibilities in Health, Issue Paper 3, December 2014, p. 21.

[6]        Greg Lewis, Public Health and Commonwealth-State Relations, Department of the Parliamentary Library Information and Research Services, 1998, p. 1.

[7]        House of Representatives Standing Committee on Health and Aging, The Blame Game: Report on the inquiry into health funding, November 2006.

[8]        Sidney Sax, A Strife of Interests – politics and policies in Australian Health Services, George Allen and Unwin, Sydney, 1984, pp 26, 36, 42 and 58; Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp 15–22.

[9]        This was through SPPs as the Commonwealth had no constitutional power over health services. Although the scheme stopped in 1949, Queensland continued to fund free hospital care; Sidney Sax, A Strife of Interests – politics and policies in Australian Health Services, George Allen and Unwin, Sydney, 1984, p. 52, 56, 58; Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp ix–x and 22–35.

[10]      Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, p. 27.

[11]      This was articulated as Section 51(xxiiiA) of the Constitution.

[12]      The Pharmaceutical Benefits Scheme was enacted under the Pharmaceutical Benefits Act 1948. Another scheme had been already in operation in early 1945 (the Pharmaceutical Benefits Act 1944), but it was declared unconstitutional in 1946. Parts of the 1948 Act would also prove to be unconstitutional in 1949; Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp ix-x, 22–35; Scotton, Richard, B, Medibank: from conception to delivery and beyond, MJA Vol 173, 3 July 2000, pp 9–11.

[13]      Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp ix–x and 22–35.

[14]      Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp ix–x and 22–35.

[15]      Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp 52–63; Amanda Biggs, Medicare Background Brief – E-Brief, October 2004 www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/Publications_Archive/archive/medicare (accessed 1 March 2016).

[16]      Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, p. 56; Amanda Biggs, Medicare Background Brief – E-Brief, October 2004.

[17]      The medical side of Medibank was effective nationally from 1 July 1975;       Richard B, Scotton, Medibank: from conception to delivery and beyond, Medical Journal of Australia ,Vol 173, July 2000, pp 9–11.Amanda Biggs, Medicare Background Brief – E-Brief, October 2004.

[18]      Amanda Biggs, Medicare Background Brief – E-Brief, October 2004; Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp 78–89.

[19]      This inquiry was established in 1979 to find ways of containing hospital costs and improving efficiencies. In doing so it looked at health insurance arrangements and the roles of the Commonwealth and states in the health sector. It reported in December 1980. Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp 78–89.

[20]      Stephen Reynolds, Australian Health Insurance Arrangements 1969-81: the roles of public and private health insurance, Legislative Research Service, Department of Parliamentary Library, Basic Paper No.4, 1981; Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013, p. 89.

[21]      Relevant legislation introduced or amended included the Health Legislation Amendment Act 1983, Health Insurance Act 1973, National Health Act 1953 and the Health Insurance Commission Act 1973; Amanda Biggs, Medicare Background Brief – E-Brief, October 2004.

[22]      Amanda Biggs, Medicare Background Brief – E-Brief, October 2004; Richard B, Scotton, Richard, B, Milestones on the road to Medibank and Medicare, Medical Journal of Australia, Vol 173, July 2000, pp 5–7; Richard B, Scotton, Medibank: from conception to delivery and beyond, Medical Journal of Australia,Vol 173, 3 July 2000.

[23]      Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, July 2000, pp 33–34.

[24]      Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, July 2000, pp 33–34.

[25]      The gap is the amount paid for medical or hospital charges, over and above the rebate from Medicare or private health insurance.

[26]      Amanda Biggs, Medicare Background Brief – E-Brief, October 2004.

[27]      This is a practice that continued with all subsequent Medicare and AHCA agreements; Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, July 2000, pp 34–35.

[28]      'Casemix' is a method of classifying the number and types of patients using hospital systems. Casemix funding is when hospitals are funded on the basis of their output, rather than on the level of funding provided from the previous year. This means that such funding is on the basis of how much each jurisdictions is prepared to pay for the care and treatment the casemix not actually how much it costs to care for and treat a particular mix of patients; Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, 2000, p. 39.

[29]      Subsection 26(2), Medicare Agreements Act 1992.

[30]      Subsection 26(2), Medicare Agreements Act 1992.

[31]      Subsection 26(2), Medicare Agreements Act 1992.

[32]      Bonus Pool A was to be distributed to States and Territories for additional public bed-days above a benchmark proportion of 51.5 per cent of total bed-days. Bonus Pool B was to be distributed to States and Territories that increased their share of public bed-days over the public share in 1990-91; Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, 2000.

[33]      Senate Community Affairs References Committee, First Report: Public Hospital Funding and Options for Reform, 11 July 2000, pp 35–37.

[34]      Senate Community Affairs References Committee, First Report: Public Hospital Funding and Options for Reform, 11 July 2000, pp 35–37.

[35]      Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, July 2000, p. 37; P. Mackey, Health Care (Appropriation) Bill 1998, Bills Digest, 1998 http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;orderBy=customrank;page=0;query=health%20care%20appropriation%20Bill%201998%20mackey;rec=1;resCount=Default (accessed 5 April 2016).

[36]      Senate Community Affairs Committee, First Report: Public Hospital Funding and Options for Reform, 11 July 2000.

[37]      This meant that the funding was no linger compose of only 'direct' funding to the states and territories but also indirect funding; P. Mackey, Health Care (Appropriation) Bill 1998, Bills Digest, 1998.

[38]      P. Mackey, Health Care (Appropriation) Bill 1998, Bills Digest, 1998.

[39]      PM, COAG Walkout – Transcript www.abc.net.au/pm/content/2003/s935154.htm (accessed 6 April 2016); House of Representatives Standing Committee on Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007: Administration of State and Territory Compliance with the Australian Health Care Agreements, August 2007.

[40]      Stephen J Duckett, The Australian Health Care Agreements 2003-2008, Australia and New Zealand Health Policy , 2004, p. 2; House of Representatives Standing Committee on Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007): Administration of State and Territory Compliance with the Australian Health Care Agreements, August 2007.

[41]      House of Representatives Standing Committee on Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007): Administration of State and Territory Compliance with the Australian Health Care Agreements, August 2007, p. 3; House of Representatives Standing Committee on Health and Aging, The Blame Game: Report on the inquiry into health funding, November 2006, p. 20.

[42]      House of Representatives Standing Committee on Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007): Administration of State and Territory Compliance with the Australian Health Care Agreements, August 2007, p. 2.

[43]      House of Representatives Standing Committee on Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007): Administration of State and Territory Compliance with the Australian Health Care Agreements, August 2007, p. 20.

[44]      House of Representatives Standing Committee on Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007) : Administration of State and Territory Compliance with the Australian Health Care Agreements, August 2007, p. 3; see also Minister’s foreword, Department of Health and Ageing, The state of our public hospitals, June 2006 report, Commonwealth of Australia, 2006, p. iii.

[45]      National Health and Hospitals Reform Commission, A Healthier Future For All Australians – Interim Report, December 2008, www.health.gov.au/internet/nhhrc/publishing.nsf/Content/BA7D3EF4EC7A1F2BCA25755B001817EC/$File/NHHRC.pdf , p. 23, (accessed 6 April 2016).

[46]      National Health and Hospitals Reform Commission, A Healthier Future For All Australians – Interim Report, December 2008, p. 23.

[47]      National Health and Hospitals Reform Commission, A Healthier Future For All Australians – Final Report, Introduction, June 2009, www.health.gov.au/internet/nhhrc/publishing.nsf/content/1AFDEAF1FB76A1D8CA257600000B5BE2/$File/INTRODUCTION.pdf  (accessed 6 April 2016).

[48]      National Health and Hospitals Reform Commission, A Healthier Future For All Australians – Final Report, Recommendations, June 2009.

[49]      Council of Australian Governments, Communique, Melbourne, 20 December 2007.

[50]      Council of Australian Governments, The Federal Financial Relations Framework, www.coag.gov.au/the_federal_financial_relations_framework (accessed 6 April 2016).

[51]      Council of Australian Governments, Communique, Melbourne, 20 December 2007.

[52]      Council of Australian Governments, The Federal Financial Relations Framework.

[53]      Council of Australian Governments, The Federal Financial Relations Framework; Council of Australian Governments, National Healthcare Agreement 2012.

[54]      Council of Australian Governments, National Healthcare Agreement 2012.

[55]      Council of Australian Governments, Communique, Canberra, 29 November 2008. 

[56]      Council of Australian Governments, Communique, Canberra, 29 November 2008.

[57]      Council of Australian Governments, Intergovernmental Agreement on Federal Financial Relations, 2008, www.federalfinancialrelations.gov.au/content/intergovernmental_agreements.aspx (accessed 6 April 2016).

[58]      Council of Australian Governments, Intergovernmental Agreement on Federal Financial Relations, 2008.

[59]      Under the Intergovernmental Agreement on Federal Financial Relations, National Partnership payments to the States are facilitated by the following types of agreements:

-   National Partnerships, which support the delivery of specified projects, facilitate reforms or reward those jurisdictions that deliver on nationally significant reforms;

-   Implementation Plans, which are not required for all National Partnerships, but may be required where there are jurisdictional differences in context or approach to implementation, or where information additional to the National Partnership is required to increase accountability and transparency; and

-   Project Agreements, which are a simpler form of National Partnership, used for low value and/or low risk projects.

Council of Federal Financial Relations, Agreements, www.federalfinancialrelations.gov.au/content/npa/default.aspx (accessed 6 April 2016).

[60]      Council of Australian Governments, Communique, Canberra, 29 November 2008.

[61]      R de Boer & J Tomaras, Bills Digest- National Health and Hospitals Network Bill 2010, 2011, p. 4; R deBoer & R.Webb, Bills Digest – Federal Financial Arrangements Amendment (National Health and Hospitals Network) Bill, 2010, p. 3.

[62]      R deBoer & R.Webb, Bills Digest – Federal Financial Arrangements Amendment (National Health and Hospitals Network) Bill, 2010.

[63]      R deBoer & R.Webb, Bills Digest Federal Financial Arrangements Amendment (National Health and Hospitals Network) Bill, 2010.

[64]      Council of Australian Governments, National Healthcare Agreement 2012.

[65]      Administrator, National Health Funding Pool, National Health Reform Agreement summary, www.publichospitalfunding.gov.au/national-health-reform/agreement, (accessed 11 March 2016).

[66]      Council of Australian Governments, National Health Reform Agreement 2011, Schedule D.

[67]      Block funding is for teaching and research and to fund small and regional hospitals.

[68]      Public health funding is paid by the Commonwealth to the states and territories for population health activities.

[69]      Clause A2, National Health Reform Agreement 2011.

[70]      Efficient growth consists of : a) the national efficient price for any changes in the volume of service provided; and b) the growth in the national efficient price of providing the existing volume of services; Council of Australian Governments, National Health Reform Agreement 2011.

[71]      Clause A3, National Health Reform Agreement 2011.

[72]      'Efficient cost will be determined annually by the Independent Hospital Pricing Authority, taking account of changes in utilisation, the scope of service provided and the cost of those services to ensure the LHN has the appropriate capacity to deliver the relevant block funded services and functions', Clause A4, National Health Reform Agreement 2011.

[73]      Clause A4, National Health Reform Agreement 2011.

[74]      Clause A5, National Health Reform Agreement 2011.

[75]      The requirements are articulates in Schedule B of the National Health Reform Agreement 2011; also see Clause A8, National Health Reform Agreement 2011.

[76]      Administrator of the National Health Funding Pool, The Role of the Administrator, www.publichospitalfunding.gov.au/administrator (accessed 8 April 2016).

[77]      National Health Funding Body, Welcome from the CEO, www.nhfb.gov.au/ (accessed 8 April 2016).

[78]      The NEP is a major determinant of the level of Australian Commonwealth Government funding for public hospital services and provides a price signal or benchmark for the efficient cost of providing public hospital services. Independent Hospital Pricing Authority, What we Do, www.ihpa.gov.au/what-we-do (accessed 8 April 2016).

[79]      National Health Performance Authority, About Us, www.nhpa.gov.au/internet/nhpa/publishing.nsf/Content/About-us  (accessed 8 April 2016).

[80]      Australian Commission on Safety and Quality in Health Care, Governance, www.safetyandquality.gov.au/about-us/governance/ (accessed 8 April 2016).

[81]      Administrator, National Health Funding Pool, National Health Reform funding flows, www.publichospitalfunding.gov.au/national-health-reform/funding-flows (accessed 11 March 2016).

[82]      Administrator, National Health Funding Pool, National Health Reform funding flows.

Chapter 3 - Commonwealth hospital funding

[1]        Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee Hansard, 4 November 2015, p. 1.

[2]        Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7.

[3]        See the committee's first and second interim reports for further discussion of these policies.

[4]        AMA, Public Hospital Report Card 2015, April 2015, p. 2.

[5]        AIHW, 25 years of health expenditure in Australia: 1989-90 to 2013-14, 5 February 2015, www.aihw.gov.au/publication-detail/?id=60129554398

[6]        OECD, Country Note: How does health spending in the United States compare?, 7 July 2015, www.oecd.org/unitedstates/Country-Note-UNITED%20STATES-OECD-Health-Statistics-2015.pdf

[7]        OECD, Country Note: How does health spending in Canada compare?, 7 July 2015, www.oecd.org/els/health-systems/Country-Note-CANADA-OECD-Health-Statistics-2015.pdf

[8]        OECD, Country Note: How does health spending in the United Kingdom compare?, 7 July 2015, www.oecd.org/unitedkingdom/Country-Note-UNITED%20KINGDOM-OECD-Health-Statistics-2015.pdf

[9]        OECD, Health at a Glance 2015: How does Australia Compare?, p. 1. www.oecd.org/australia/Health-at-a-Glance-2015-Key-Findings-AUSTRALIA.pdf

[10]      Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7.

[11]      Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7.

[12]      Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7.

[13]      Australian Government, 'Part 2 Expense Measures', Budget measures: budget paper no.2: 2014-15www.budget.gov.au/2014-15/content/bp2/html/bp2_expense-14.htm (accessed 5 April 2016); Administrator, National Health Funding Pool, Basis of Commonwealth NHR Funding, www.publichospitalfunding.gov.au/national-health-reform/reporting-basis-commonwealth (accessed 11 March 2016).

[14]      Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7. The $57 billion figure was used at the Senate Economics Committee Estimates hearings in 2014, while the $56 billion figure was calculated by the PBO, based on information in the NHRA.

[15]      Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7. In the graph, the green line of the 'old spending arrangement' represents the NHRA funding, while the blue line represents the indexed funding arrangements in the 2014-15 Budget.

[16]      Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee Hansard, 4 November 2015, p. 1.

[17]      Commonwealth of Australia, 2014-15 Federal Budget Overview, May 2014, p. 7.

[18]      Source: Parliamentary Budget Office, Submission 191, Table 1, p. 5. Under the previous government, hospital funding was to be provided under the 2011 National Health Reform Agreement. The government policy introduced in the 2014-15 Federal Budget would have indexed funding by CPI and population growth from 2017-18 to 2024-25. Dollar amounts in the above diagram have been rounded.

[19]      Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee Hansard, 4 November 2015, p. 1.

[20]      Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee Hansard, 4 November 2015, p. 1.

[21]      Professor Mike Duabe, Professor of Health Policy and Director, Public Health Advocacy Institute of Western Australia, Curtin University; Director, McCusker Centre for Action on Alcohol and Youth, Committee Hansard, 10 October 2014, p. 27.

[22]      Department of Prime Minister and Cabinet, Reform of Federation White Paper: Terms of Reference, website, https://federation.dpmc.gov.au/terms-reference

[23]      Department of Prime Minister and Cabinet, Reform of Federation White Paper: Terms of Reference.

[24]      Phillip Coorey, Australian Financial Review, Leaked proposal suggests states may lose $18b healthcare funding, 22 June 2015, www.afr.com/news/politics/leaked-proposal-suggests-states-may-lose-18b-healthcare-funding-20150621-ghu001; Dan Conifer, ABC News Online, Federal Government plays down discussion paper's 'secret plan' to strip billions in hospital funding from states and territories, 23 June 2015, www.abc.net.au/news/2015-06-23/states-and-territories-could-lose-billions-in-health-funding-an/6565810

[25]      Department of Prime Minister and Cabinet, Reform of Federation White Paper: Discussion Paper, website, https://federation.dpmc.gov.au/publications/discussion-paper

[26]      COAG, 11 December 2015, Communique, www.coag.gov.au/node/529

[27]      Eliza Borrello, ABC News Online, Malcolm Turnbull scraps federation white paper after $5 million work, 28 April 2016, www.abc.net.au/news/2016-04-28/malcolm-turnbulls-$5-million-tax-white-paper-scrapped/7367204

[28]      Department of Prime Minister and Cabinet, Reform of Federation White Paper, website, https://federation.dpmc.gov.au/

[29]      Liz Jackson, ABC Radio PM Program, Thousands will go untreated in SA public hospitals under current funding: report, 29 March 2016, www.abc.net.au/pm/content/2016/s4433224.htm

[30]      Lenore Taylor, The Guardian Australia, Turnbull looks to income tax-raising powers for states to fix school and hospital funding, 30 March 2016, www.theguardian.com/australia-news/2016/mar/29/states-offered-5bn-hospitals-funding-income-tax-raising-powers

[31]      COAG, 1 April 2016, Communique, www.coag.gov.au/sites/default/files/COAG_Communique.pdf

[32]      COAG, 1 April 2016, Communique.

[33]      Heads of Agreement 1 April 2016, www.coag.gov.au/sites/default/files/Heads%20of%20Agreement%20between%20the%20Commonwealth%20and%20the%20States%20on%20Public%20Hospital%20Funding%20-%201%20April%202016_0.pdf

[34]      COAG, 1 April 2016, Communique.

[35]      Lenore Taylor, The Guardian Australia, Malcolm Turnbull promises states hospital funding in budget after Abbott cuts, 24 February 2016, www.theguardian.com/australia-news/2016/feb/24/malcolm-turnbull-promises-states-hospital-funding-in-budget-after-abbott-cuts

[36]      Parliamentary Budget Office, Submission 191, p. 5.

[37]      Ms Skye Jacobi, Director, Intergovernment Relations and Ageing, Department for Health and Ageing, South Australia, Committee Hansard, 11 June 2015, p. 21.

[38]      Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, p. 39.

[39]      Ms Kathleen Forrester, Deputy Director-General, Strategy, Policy and Planning Division, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[40]      Ms Kathleen Forrester, Deputy Director-General, Strategy, Policy and Planning Division, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 15.

[41]      Ms Kathleen Forrester, Deputy Director-General, Strategy, Policy and Planning Division, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[42]      Chief Minister, the Hon Adam Giles MLA, 'Territory Health and Education Funding Under Threat', media release, May 2014, www.chiefminister.nt.gov.au/media-releases/territory-health-and-education-funding-under-threat

[43]      Oxford English Dictionary

Chapter 4 - Impacts on New South Wales hospitals

[1]        Dr Andrew McDonald, private capacity, Committee Hansard, 23 March 2016, p. 39.

[2]        Parliamentary Budget Office, Submission 191, p. 5.

[3]        Charis Chang and Mal Farr, News.com.au, Federal Budget 2014 cuts to health and education spending sparks talk of GST increases,14 May 2014, www.news.com.au/finance/economy/federal-budget-2014-cuts-to-health-and-education-spending-sparks-talk-of-gst-increases/story-fn84fgcm-1226917445787

[4]        Charis Chang and Mal Farr, News.com.au, Federal Budget 2014 cuts to health and education spending sparks talk of GST increases,14 May 2014.

[5]        Professor Bradley Frankum, Vice President, Australian Medical Association (NSW), Committee Hansard, 27 November 2015, p. 17.

[6]        Professor Bradley Frankum, Vice President, Australian Medical Association (NSW), Committee Hansard, 27 November 2015, p. 17.

[7]        Professor Bradley Frankum, Vice President, Australian Medical Association (NSW), Committee Hansard, 27 November 2015, p. 17.

[8]        Dr Andrew Pesce, and Dr Antony Sara, Councillors, Australian Medical Association (NSW), Committee Hansard, 27 November 2015, p. 19.

[9]        Dr Andrew McDonald, private capacity, and Dr Karuna Keat, private capacity, Committee Hansard, 23 March 2016, pp 33–34.

[10]      Dr Karuna Keat, private capacity, Committee Hansard, 23 March 2016, p. 34.

[11]      Dr Andrew McDonald, private capacity, and Dr Karuna Keat, private capacity, Committee Hansard, 23 March 2016, pp 36–37.

[12]      Dr Andrew McDonald, private capacity, Committee Hansard, 23 March 2016, p. 39.

[13]      Professor Bradley Frankum, Vice President, Australian Medical Association (NSW), Committee Hansard, 27 November 2015, pp 24–25.

[14]      In this context "ramp" refers to an ambulance waiting with a patient until the patient can be received by the Emergency Department.

[15]      Mr Jeff Andrew, Vice President, Australian Paramedics Association, Committee Hansard, 11 March 2015, p. 43.

[16]      Mr Jeff Andrew, Vice President, Australian Paramedics Association, Committee Hansard, 11 March 2015, p. 43.

[17]      Mr Jeff Andrew, Vice President, Australian Paramedics Association, Committee Hansard, 11 March 2015, p. 45.

[18]      Mr Gil Wilson, clinical nurse specialist, private capacity, Committee Hansard, 15 September 2014, p. 7.

[19]      Mr Gil Wilson, clinical nurse specialist, private capacity, Committee Hansard, 15 September 2014, p. 7.

Chapter 5 - Impacts on Victorian hospitals

[1]        Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, p. 38.

[2]        Parliamentary Budget Office, Submission 191, p. 5.

[3]        Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, p. 38.

[4]        Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, 4 November 2015, pp 21–22.

[5]        Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, 4 November 2015, p. 23.

[6]        Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, p. 38.

[7]        Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, p. 40.

[8]        Ms Frances Diver, Deputy Secretary, Health Service Performance and Programs, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, pp 39–40.

[9]        Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human Services, Committee Hansard, 4 November 2015, p. 46. These impacts result from the cessation without review of the National Partnership Agreement on Improving Public Hospital Services and the expectation that ongoing funding would be rolled into the National Health Partnership Agreement (see p. 47).

[10]      Victorian Department of Health and Human Services, Answer to question on notice, 4 November 2015, received 1 December 2015.

[11]      Victorian Department of Health and Human Services, Answer to question on notice, 4 November 2015, received1 December 2015.

[12]      Ms Annie Butler, Assistant Federal Secretary, Australian Nursing and Midwifery Federation, Committee Hansard, 5 November 2015, p. 21.

[13]      Ms Lee Thomas, Federal Secretary, Australian Nursing and Midwifery Federation, Committee Hansard, 5 November 2015, pp. 18–19. See also Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, 4 November 2015, pp 23–24.

[14]      Ms Alison Verhoeven, Chief Executive, Australian Healthcare and Hospitals Association, Committee Hansard, 4 November 2015, p. 58.

Chapter 6 - Impacts on Queensland hospitals

[1]        Ms Bronwyn Nicholson, General Manager, Queensland, I-MED Radiology Network, Committee Hansard, 27 April 2016, p. 8.

[2]        Parliamentary Budget Office, Submission 91, p. 5.

[3]        Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[4]        Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[5]        Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[6]        Mr Paul McGuire, Senior Director, Funding Strategy Unit, Strategy, Policy and Planning Division, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 18.

[7]        Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[8]        Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 16 November 2015, p. 6.

[9]        Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 14.

[10]      Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 16 November 2015, p. 5.

[11]      Mr Paul McGuire, Senior Director, Funding Strategy Unit, Strategy, Policy and Planning Division, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 19.

[12]      Dr Jill Newland, Chief Executive, Torres and Cape Hospital and Health Service, Committee Hansard, 16 November 2015, p. 4.

[13]      Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 16.

[14]      Dr Tash Coventry, President, Rural Doctors Association of Queensland, Committee Hansard, 16 November 2016, p. 48.

[15]      Queensland Health, Projected impact of Commonwealth funding cuts on the public hospital system, p. 2, www.health.qld.gov.au/publications/system-governance/health-system/comm-funding-cuts-impact-budget.pdf (accessed 3 May 2016).

[16]      Ms Robin Saunders, private capacity, Committee Hansard, 27 April 2016, p. 1.

[17]      Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 16.

[18]      Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 15.

[19]      Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 15.

[20]      Ms Robin Saunders, private capacity, Committee Hansard, 27 April 2016, pp 1–2.

[21]      Dr Oscar Whitehead, Director, Medical Services, Queensland Section, Royal Flying Doctor Service, Committee Hansard, 16 November 2015, p. 29.

[22]      Ms Robin Saunders, private capacity, Committee Hansard, 27 April 2016, p. 4.

[23]      Ms Robin Saunders, private capacity, Committee Hansard, 27 April 2016, p. 4.

[24]      Ms Robin Saunders, private capacity, Committee Hansard, 27 April 2016, p. 5.

[25]      Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 16 November 2015, p. 6.

[26]      Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 16 November 2015, p. 6.

[27]      Dr Edward Strivens, Clinical Director, Older Persons Health Services, Committee Hansard, 16 November 2015, p. 3.

[28]      Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 16 November 2015, p. 2.

[29]      Dr Mark Wenitong, Public Health Medical Adviser, Apunipima Cape York Health Council, Committee Hansard, 16 November 2015, p. 39.

[30]      Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland Hospital and Health Service, Committee Hansard, 16 November 2015, p. 2.

[31]      Queensland Nurses' Union, Submission 44, p. 5; Public Hospitals Health and Medicare Alliance of Queensland, Submission 15, p. 4.

[32]      Queensland Nurses' Union, Submission 44, p. 5; Public Hospitals Health and Medicare Alliance of Queensland, Submission 15, p. 4.

[33]      www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2015-ley151.htm

[34]      Ms Bronwyn Nicholson, General Manager, Queensland, I-MED Radiology Network, Committee Hansard, 27 April 2016, p. 8.

[35]      Ms Bronwyn Nicholson, General Manager, Queensland, I-MED Radiology Network, Committee Hansard, 27 April 2016, p. 11.

[36]      The Hon Cameron Dick, Minister for Health and Ambulance Services, Queensland Government, Canberra cuts a sick blow to our health system, Media release, 15 December 2015, http://statements.qld.gov.au/Statement/2015/12/15/canberra-cuts-a-sick-blow-to-our-health-system (accessed 3 May 2016).

[37]      Queensland Government, Managing the Queensland Health System: Budget, www.health.qld.
gov.au/system-governance/health-system/managing/budget/default.asp
(accessed 3 May 2016).

[38]      Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard, 16 November 2015, p. 13.

Chapter 7 - Impacts on Western Australian hospitals

[1]        Dr Stephanie Trust, General Practitioner, Kununurra Medical Centre, Committee Hansard, 28 April 2015, p. 13.

[2]        Parliamentary Budget Office, Submission 191, p. 5.

[3]        Stephanie Dalzell, ABC News Online, WA hospital funding cuts criticised by health minister, 22 May 2014, www.abc.net.au/news/2014-05-21/perth-hospitals-to-lose-24300m-over-four-years/5468844

[4]        Stephanie Dalzell, ABC News Online, WA hospital funding cuts criticised by health minister, 22 May 2014.

[5]        Stephanie Dalzell, ABC News Online, WA hospital funding cuts criticised by health minister, 22 May 2014.

[6]        Australian Medical Association, 'Public Hospital Report Card 2016', January 2016, pp 21–23.

[7]        Charlotte Hamlyn, ABC News Online, WA hospitals cannot afford cuts, Australian Medical Association says, 28 January 2016, www.abc.net.au/news/2016-01-28/wa-public-hospital-system-cannot-afford-cuts-ama-says/7121264

[8]        Australian Associated Press, The Guardian Australia, Western Australia to cut 1,100 jobs in south Perth hospitals, 3 January 2016,  www.theguardian.com/australia-news/2016/jan/03/western-australia-to-cut-1100-jobs-in-south-perth-hospitals

[9]        Professor Mike Daube, Professor of Health Policy and Director, Public Health Advocacy Institute of Western Australia, Curtin University; Director, McCusker Centre for Action on Alcohol and Youth, Committee Hansard, 10 October 2014, p. 21.

[10]      Dr Stephanie Trust, General Practitioner, Kununurra Medical Centre, Committee Hansard, 28 April 2015, p. 13.

Chapter 8 - Impacts on South Australian hospitals

[1]        South Australian Government, Submission 24, p. 6. See also, the Hon. Jay Weatherill, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 1.

[2]        Parliamentary Budget Office, Submission 91, p. 5.

[3]        South Australian Government, Submission 24, p. 6. See also, the Hon. Jay Weatherill, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 1.

[4]        Mr Steven Archer, Deputy Chief Executive, Finance and Business Services, Department for Health and Ageing, South Australia, Committee Hansard, 9 October 2014, p. 1.

[5]        South Australian Government, Submission 24, p. 10.

[6]        South Australian Government, Submission 24, p. 6. See also, the Hon. Jay Weatherill, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 1.

[7]        South Australian Government, Submission 24, p. 9. See also South Australian Government, Federal cuts hurt – the facts, http://www.federalcutshurt.com.au/the-facts/

[8]        South Australian Government, Submission 24, p. 8.

[9]        South Australian Government, Submission 24, p. 2.

[10]      The Hon. Jay Weatherill, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 2.

[11]      The Hon. Jay Weatherill, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 3.

[12]      South Australian Government, Submission 24, p. 8.

[13]      South Australian Government, Submission 24, p. 8.

[14]      South Australian Government, Submission 24, p. 8.

[15]      South Australian Government, Submission 24, p. 7.

[16]      South Australian Government, Submission 24, p. 2.

[17]      South Australian Government, Submission 24, p. 2.

[18]      South Australian Government, Submission 24, p. 2; Australian Workplace Innovation and Social Research Centre (WISeR, University of Adelaide) for the Department of Premier and Cabinet, Impacts of the 2014-15 Federal Budget Measures on South Australia (2014), p. 43, http://federalcutshurt.com.au/wp-content/uploads/2014/08/fed-budget-oct2014-n.pdf (accessed 2 May 2016).

[19]      South Australian Government, Submission 24, p. 15.

[20]      South Australian Government, Submission 24, p. 14.

[21]      Health Consumers Alliance of SA, Submission 92, p. 3.

[22]      Health Consumers Alliance of SA, Submission 92, p. 3.

[23]      South Australian Government, Submission 24, p. 9. See also South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/ (accessed 2 May 2016).

[24]      South Australian Department of the Premier and Cabinet, Public Health Expenditure and Distribution of Benefits – Technical Note (Ernst & Young, 2016), p. 4.

[25]      South Australian Department of the Premier and Cabinet, Public Health Expenditure and Distribution of Benefits – Technical Note (EY), p. 3.

[26]      The Hon Jay Weatherill, Premier, South Australian Government, 'Report highlights dire consequences of Fed health cuts, Media release, 29 March 2016, www.premier.sa.gov.au/index.php/jay-weatherill-news-releases/321-report-highlights-dire-consequences-of-fed-health-cuts, (accessed 6 May 2016).

[27]      South Australian Government, Submission 24, p. 11.

[28]      South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/ (accessed 2 May 2016).

[29]      South Australian Government, Submission 24, p. 11.

[30]      South Australian Government, Submission 24, p. 9. See also South Australian Government, Federal cuts hurt – the facts, http://www.federalcutshurt.com.au/the-facts/

[31]      South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/ (accessed 2 May 2016).

[32]      South Australian Government, Submission 24, p. 11.

[33]      South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/ (accessed 2 May 2016).

[34]      The Hon Jay Weatherill MP, Premier, South Australian Government, 'Report highlights dire consequences of Fed health cuts', Media release, 29 March 2016, www.premier.sa.gov.au/index.php/jay-weatherill-news-releases/321-report-highlights-dire-consequences-of-fed-health-cuts, accessed 6 May 2016.

[35]      Australian Medical Association, Public Hospital Report Card 2016, p. 25.

Chapter 9 - Impacts on Tasmanian hospitals

[1]        Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery Federation, Tasmanian Branch, Committee Hansard, 29 April 2016, p. 21.

[2]        Parliamentary Budget Office, Submission 191, p. 5.

[3]        Emma Hope, The Tasmanian Mercury, Premier Will Hodgman hits out at Federal Government's health cuts,19 May 2014, www.themercury.com.au/news/tasmania/premier-will-hodgman-hits-out-at-federal-governments-health-cuts/story-fnj4f7k1-1226922051939

[4]        Emma Hope, The Tasmanian Mercury, Premier Will Hodgman hits out at Federal Government's health cuts,19 May 2014.

[5]        Lucy Shannon, ABC News Online, Tasmania's health sector to bear brunt of 'tough love' federal budget, 19 May 2014, www.abc.net.au/news/2014-05-19/tasmania27s-health-sector-to-bear-brunt-of-27tough-love27-fe/5461224

[6]        Dr Pauline Marsh, Policy Officer, TasCOSS, Committee Hansard, 3 November 2014, p. 29.

[7]        Professor Tim Greenaway, President, AMA Tasmania, Committee Hansard, 3 November 2014, p. 37.

[8]        Professor Tim Greenaway, President, AMA Tasmania, Committee Hansard, 29 April 2016, p. 1.

[9]        Professor Tim Greenaway, President, AMA Tasmania, Committee Hansard, 29 April 2016, p. 2.

[10]      Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery Federation, Tasmanian Branch, Committee Hansard, 4 November 2014, p. 14.

[11]      Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery Federation, Tasmanian Branch, Committee Hansard, 29 April 2016, p. 21.

[12]      Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery Federation, Tasmanian Branch, Committee Hansard, 29 April 2016, p. 22.

[13]      Mr Stephen Hayes, Social Worker, Tasmanian Health Service, Committee Hansard, 29 April 2016, pp 16–17.

Chapter 10 - Impacts on ACT and NT hospitals

[1]        ACT Treasurer, Mr Andrew Barr MLA, Australian Capital Territory Budget 2014-15 Budget in Brief, pp 2–3, http://apps.treasury.act.gov.au/__data/assets/pdf_file/0014/601115/Budget-Paper-2-Budget-in-Brief.pdf (accessed 30 April 2016).

[2]        Mr John Paterson, Chief Executive Officer, Aboriginal Medical Services Alliance Northern Territory, Committee Hansard, 27 April 2015, p. 25.

[3]        Parliamentary Budget Office, Submissions 191, p. 5.

[4]        Australian Medical Association, Public Hospital Report Card 2016, January 2016, p. 32.

[5]        ACT Treasurer, Mr Andrew Barr MLA, Australian Capital Territory Budget 2014-15 Budget in Brief, pp 2–3, http://apps.treasury.act.gov.au/__data/assets/pdf_file/0014/601115/Budget-Paper-2-Budget-in-Brief.pdf (accessed 30 April 2016).

[6]        National Hospitals Performance Authority, 'Costs of acute admitted patients in public hospitals from 2011-12 to 2012-14', April 2016, p. 4, www.myhospitals.gov.au/docs/default-source/our-report-pdfs/cost-of-acute-admitted-patients/april-2016/hp_costsofacuteadmittedpatients_2011-12_to_2013_14_rpt.pdf?sfvrsn=8 (accessed 1 May 2016).

[7]        Parliamentary Budget Office, Submission 191, p. 5.

[8]        Chief Minister, the Hon Adam Giles MLA, 'Territory Health and Education Funding Under Threat', media release, May 2014, www.chiefminister.nt.gov.au/media-releases/territory-health-and-education-funding-under-threat

[9]        Chief Minister, the Hon Adam Giles MLA, 'Territory Health and Education Funding Under Threat', media release, May 2014 http://www.chiefminister.nt.gov.au/media-releases/territory-health-and-education-funding-under-threat

[10]      Australian Medical Association, 'Public Hospital Report Card 2016', January 2016, p. 11. See also Harriet Alexander, The Sydney Morning Herald, Hospital Performance getting worse and now facing budgetary 'black hole', says AMA, 28 January 2016, www.smh.com.au/national/health/hospital-performance-getting-worse-and-now-facing-budgetary-black-hole-says-ama-20160127-gmf8xg.html

[11]      Northern Territory Government, Submission 148, p. 14.

[12]      Mr Michael Kalimnios, Chief Operating Officer, Top End Health Service, Northern Territory Department of Health, Committee Hansard, 8 October 2015, p. 10.

[13]      Mr Michael Kalimnios, Chief Operating Officer, Top End Health Service, Northern Territory Department of Health, Committee Hansard, 8 October 2015, p. 13.

[14]      Ms Joy McLaughlin, Senior Project Officer, Danila Dilba Health Service, Committee Hansard, 27 April 2015, p. 18.

[15]      Mr John Paterson, Chief Executive Officer, Aboriginal Medical Services Alliance Northern Territory, Committee Hansard, 27 April 2015, p. 25.

Appendix 1 - Witnesses who appeared before the committee[1]

[1]   www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Public_Hearings.

Appendix 2 - Submissions received by the committee[1]

[1]         www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Submissions.

Appendix 3 - Tabled documents, additional information, correspondence and answers to questions on notice[1]

[1]        Tabled documents, additional information, correspondence and answers to questions on notice can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Additional_Documents

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