Footnotes

Executive Summary

[1]        Australian Institute of Health and Welfare, Australia's Health 2014, May 2014, p. 69. 

[2]        Australian Institute of Health and Welfare, Health expenditure Australia 2011-12, September 2013, p. 28.

[3]        The Hon Mr Tony Abbott MP, Opposition Leader, SBS News, 6 September 2013, www.sbs.com.au/news/article/2013/09/06/no-cuts-abc-or-sbs-abbott (accessed 18 November 2014).

[4]        www.abc.net.au/news/2014-05-14/budget-2014-states-react-to-health-and-education-cuts/5452234) (accessed 20 November 2014).

[5]        Australian Government, Budget 2014-15, Overview, p. 7, www.budget.gov.au/2014-15/content/overview/download/Budget_Overview.pdf (accessed 19 November 2014). 

[6]        Australian Medical Association (AMA), Submission 48, p. 5.  

[7]        See Chapter 3 for references.

[8]        Daily Telegraph, NSW emergency fears due to GP co-payment, 8 October 2014 and Mr Steven Archer, Deputy Chief Executive, Finance and Business Services, Department for Health and Ageing, South Australia, Committee Hansard, 9 October 2014, p. 5.

[9]        Australian Medical Association (AMA), Submission 48, p. 5.

[10]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, The Drum, 14 August 2014.

[11]      Mr Martyn Goddard, private capacity, Committee Hansard, 3 November 2014, p. 23.

[12]      Professor Jane Hall, Director, Centre for Health Economics Research and Evaluation, University of Technology, Sydney and Richard De Abreu Lourenco, Research Fellow, University of Technology, Sydney, GP co-payments: why price signals for health don’t work, 10 July 2014.

[13]      Mr Stephen Burgess, Innovation, Policy and Research Officer, Benetas, Committee Hansard, 7 October 2014, p. 8.

[14]      Mr Hill, Ambulance Employees Australia of Victoria, Committee Hansard, 7 October 2014, p. 18.

[15]      Dr Martin Carlson, Moruya General Practitioner, Committee Hansard, 16 September 2014, p. 10.

[16]      Australian Government, Budget 2014-15, Overview, p. 7, www.budget.gov.au/2014-15/content/overview/download/Budget_Overview.pdf.

[17]      Australasian College of Emergency Medicine, Committee Hansard, 8 October 2014.

[18]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, Committee Hansard, 8 October 2014, pp 32–33.

[19]      Mr Andrew Stuart (Deputy Secretary) and Mr Nathan Smyth (First Assistant Secretary, Population Health Division), Department of Health, Senate Community Affairs Legislation Committee, Committee Hansard, 2 July 2014, Canberra, p. 48.

[20]      See for example evidence from Ms Meredith Carter, Spokesperson, VMAG, Committee Hansard, 7 October 2014, p. 2 and Professor Elizabeth Dabars, CEO and Secretary, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, 9 October 2014, p. 29.

[21]      Dr Bruce Bolam, Executive Manager, Programs Group, Victorian Health Promotion Foundation (VicHealth), Committee Hansard, 7 October 2014, p. 22.

[22]      The Hon Tony Abbott MP (Opposition Leader), People’s Forum 2, transcript, ABC News 24, 28 August 2013, www.abc.net.au/news/2013-08-28/medicare-locals/4919936.

[23]      The Coalition's Policy to Support Australia's Health System, Liberal and National Parties, August 2013, http://lpaweb-static.s3.amazonaws.com/13-08-22%20The%20Coalition%E2%80%99s%20Policy%20to%20Support%20Australia%E2%80%99s%20Health%20System.pdf, p. 3.

[24]      Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, Professor John Horvath AO, 4 March 2014, p. 4.

Chapter 1 - Introduction

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

[2]        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.

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

Chapter 2 - The inquiry

[1]        Royal Australian College of General Practitioners, RACGP Overview of the Federal Budget 2014-2015 (Health), 13 May 2014, p. 1.

[2]        See for example, the Hon Peter Dutton MP, Minister for Health, Address to CEDA Conference, 19 February 2014.

[3]        Mr Richard Bartlett, Acting Deputy Secretary, Department of Health, Committee Hansard, 8 October 2014, p. 56.

[4]        See for example Dr Stephen Duckett, Director, Health Program, Grattan Institute, Committee Hansard, 8 October 2014, p. 26. Also see paragraphs 3.10–3.18 below.

[5]        Medicare Benefits Schedule — introducing patient contributions for general practitioner, pathology and diagnostic imaging services, 2014-15 Budget, Budget Paper 2; Budget Measures, pp 133–134.

[6]        Medicare Benefits Schedule—introducing patient contributions for general practitioner, pathology and diagnostic imaging services, 2014-15 Budget, Budget Paper 2; Budget Measures, pp 133–134. The $5 increase to the PBS co-payment will increase the maximum patient contribution from $37.70 to $42.70 from 1 January 2015.

[7]        The abolition, merger, and consolidation of agencies was a recommendation of the National Commission of Audit on the argument that it would create efficiency and remove duplication. The list of agencies to be abolished, merged or consolidated is at Budget Paper No. 2 – Budget Measures, Cross Portfolio, 'Smaller Government – additional reductions in the number of Australian Government bodies', p. 70.

[8]        Journals of the Senate, 25 November 2014, p. 1848.

[9]        Mr Andrew Stuart (Deputy Secretary) and Mr Nathan Smyth (First Assistant Secretary, Population Health Division), Department of Health, Senate Community Affairs Legislation Committee, Committee Hansard, 2 July 2014, p. 48.

[10]      'Smaller Government – Australian National Preventative Health Agency – abolish' Budget Measures 2014-15 – Part 2, p. 145.

[11]      See also paragraphs 2.16–2.18 and 3.50–3.52.

[12]      'Smaller Government – Australian National Preventative Health Agency – abolish' Budget Measures 2014-15 – Part 2, p. 145.

[13]      'Smaller Government – More Efficient Health Workforce Development', Budget Measures 2014-15 – Part 2: Expense Measures, p. 146.

[14]      See both: 'Smaller Government – Australian National Preventative Health Agency – abolish' Budget Measures 2014-15 – Part 2, p. 145; and 'Smaller Government – More Efficient Health Workforce Development', Budget Measures 2014-15 – Part 2: Expense Measures, p. 146.

[15]      See for example evidence from Ms Meredith Carter, Spokesperson, VMAG, Committee Hansard, 7 October 2014, p. 2 and Professor Elizabeth Dabars, CEO and Secretary, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, 9 October 2014, p. 29.

[16]      Australian Government, Budget 2014-15, Overview, p. 7, www.budget.gov.au/2014-15/content/overview/download/Budget_Overview.pdf.

[17]      Australian Government, Budget 2014-15, Overview, p. 7, www.budget.gov.au/2014-15/content/overview/download/Budget_Overview.pdf.

[18]      Australian Government, Budget 2014-15, Overview, p. iv, www.budget.gov.au/2014-15/content/overview/download/Budget_Overview.pdf.

[19]      Department of the Prime Minister and Cabinet, Legislation Proposed for Introduction in the 2014 Spring Sittings, www.dpmc.gov.au/parliamentary/docs/legislation_proposed_2014_spring_sittings.pdf?d=20140821.

[20]      See evidence from Professor Mike Daube, Professor of Health Policy and Director, Public Health Advocacy Institute of Western Australia, Curtin University; and Director, McCusker Centre for Action on Alcohol and Youth, Committee Hansard, 10 October 2014, p. 24; and Professor Judith Walker, Chair, Federation of Rural Australian Medical Educators, Committee Hansard, 7 October 2014, p. 35.

[21]      See for example evidence from Ms Alison Fairleigh, Area Manager Townsville, Mental Illness Fellowship NQ, Committee Hansard, 21 August 2014, p. 12.

[22]      See for example: Australian Diabetes Educators' Association, Submission 49; Victorian Health Promotion Foundation (VicHealth), Submission 80; and Australian Health Promotion Association, Submission 84.

Chapter 3 - Patient co-payments, cuts to hospital funding and preventative health

[1]        Senate Community Affairs References Committee, Out-of-pocket costs in Australian healthcare, August 2014, www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Australian_healthcare (accessed 3 November 2014).

[2]        Much of this section of the report is reproduced directly from the Senate Community Affairs References Committee, Out-of-pocket costs in Australian healthcare, August 2014, pp 25–27.

[3]        Department of Health, Portfolio Budget Statements 2014-15, Budget Related Paper No. 1.10, p. 63.

[4]        The Hon Peter Dutton MP, Minister for Health, Address to CEDA Conference, 19 February 2014.

[5]        The Hon Peter Dutton MP, Minister for Health, Lateline, 8 September 2014.

[6]        Australian Medical Association (AMA), Submission 48, p. 4.

[7]        College of Medicine and Dentistry, James Cook University, Submission 17, p. 5.

[8]        Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, p. 43.

[9]        Associate Professor Sarah Larkins, Director of Research and Postgraduate Education, College of Medicine and Dentistry, James Cook University, Committee Hansard, 21 August 2014, p. 19.

[10]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, Committee Hansard, 8 October 2014, p. 26.

[11]      AIHW, Health expenditure Australia 2012-13, 23 September 2014, www.aihw.gov.au/publication-detail/?id=60129548871.

[12]      Mr Bartlett, Department of Health, Senate Community Affairs References Committee Out-of-pocket costs in Australian healthcare inquiry, Committee Hansard, 29 July 2014, p. 58.

[13]      Mr Bartlett, Department of Health, Senate Community Affairs References Committee Out-of-pocket costs in Australian healthcare inquiry, Committee Hansard, 29 July 2014, p. 59.

[14]      Mr Terry Barnes, Australian Centre for Health Research, Former Abbott adviser flags possible fees to visit hospital emergency wards, ABC website, 30 December 2013, www.abc.net.au/news/2013-12-30/emergency-room-fee-to-match-doctors-fees/5178156 (accessed 3 November 2014).

[15]      Australian Medical Association (AMA), Submission 48, p. 5.

[16]      Queensland Nurses' Union, Submission 44, p. 3.

[17]      Associate Professor Timothy Moore Greenaway, State President, Australian Medical Association Tasmania, Committee Hansard, 3 November 2014, p. 37.

[18]      Dr Bastian Seidel, Deputy Chair, Tasmanian Faculty, Royal Australian College of General Practitioners, Committee Hansard, 3 November 2014, p. 19.

[19]      Professor Nicholas Talley, President, Royal Australasian College of Physicians, Committee Hansard, 8 October 2014, p. 8.

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

[21]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, Committee Hansard, 8 October 2014, p. 35.

[22]      Dr Simon Antony Judkins, Victorian Councillor, Australasian College of Emergency Medicine, Committee Hansard, 8 October 2014, p. 23.

[23]      Ms Pattie Beerens, Chief Executive Officer, Australian Diagnostic Imaging Association, Committee Hansard, 8 October 2014, p. 43.

[24]      Mr Stephen Burgess, Innovation, Policy and Research Officer, Benetas, Committee Hansard, 7 October 2014, p. 11.

[25]      Mr Danny Hill, Assistant Secretary, Ambulance Employees Australia of Victoria, Committee Hansard, 7 October 2014, p. 19.

[26]      Adjunct Associate Professor Elizabeth Dabars, AM, CEO and Secretary, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, 9 October 2014, p. 32.

[27]      Mr Shane Mohor, Acting Chief Executive Officer, Aboriginal Health Council of South Australia, Committee Hansard, 9 October 2014, p. 45.

[28]      Ms Stephanie Miller, Executive Director, Health Consumers Alliance of South Australia, Committee Hansard, 9 October 2014, p. 65.

[29]      Answer to Question on Notice, Senate Community Affairs Legislation Committee, Budget Estimates 2014-15, SQ14-000985, p. 1.

[30]      www.smh.com.au/business/federal-budget/abbott-pledges-no-nasty-surprises-no-lame-excuses-20130516-2jpen.html (accessed 20 November 2014).

[31]      St Vincent de Paul Society, Submission 22, p. 3.

[32]      Public Health Association of Australia, Submission 76, p. 8.

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

[34]      Dieticians Association of Australia, Submission 59, p. 2.

[35]      Australian Council of Social Service, Submission 67, p. 2.

[36]      Benetas, Submission 42, p. 2.

[37]      Benetas, Submission 42, p. 2.

[38]      Youth Affairs Council of South Australia Inc, Submission 38, p. 2.

[39]      National Community Controlled Health Organisation, Submission 86, p. 3.

[40]      National Community Controlled Health Organisation, Submission 86, pp 4–5.

[41]      Mr Shane Mohor, Acting Chief Executive Officer of the Aboriginal Health Council of South Australia, Committee Hansard, 9 October 2014, pp 44–45.

[42]      Aboriginal Health Council of Western Australia, Submission 63, p. 13.

[43]      St Vincent de Paul Society, Submission 22, p. 2.

[44]      St Vincent de Paul Society, Submission 22, p. 4.

[45]      Australian Federation of Aids Organisations, Submission 108, p. 2.

[46]      Mr Rob Bonner, Director, Operations and Strategy, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, 9 October 2014, p. 34.

[47]      Mr Danny Hill, Assistant Secretary, Ambulance Employees Australia of Victoria, Committee Hansard, 7 October 2014, p. 18.

[48]      The Hon Peter Dutton MP, Minister for Health, Address to Australian Medical Association National Conference, 23 May 2014.

[49]      Mr Richard Barlett, Acting Deputy Secretary, Department of Health, Committee Hansard, 8 October 2014, p. 56.

[50]      ABC News, GP co-payment proposal causing a drop in visits to the doctor, AMA says, 23 May 2014, www.abc.net.au/news/2014-05-22/visits-to-gp-fall-after-co-payment-budget-announcement/5469642 (accessed 5 November 2014).

[51]      Professor Jane Hall, Director, Centre for Health Economics Research and Evaluation, University of Technology, Sydney and Richard De Abreu Lourenco, Research Fellow, University of Technology, Sydney, GP co-payments: why price signals for health don’t work, 10 July 2014, http://theconversation.com/gp-co-payments-why-price-signals-for-health-dont-work-28857, (accessed 4 November 2014).

[52]      Ms Jane Carter, Spokesperson, VMAG, Committee Hansard, 7 October 2014, p. 3.

[53]      Adjunct Associate Professor Elizabeth Dabars, AM, CEO and Secretary, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, 9 October 2014, p. 29.

[54]      Professor Mike Daube, Committee Hansard, 10 October 2014, p. 21.

[55]      The NSW assessment was made on the earlier mooted figure of $6 so the 500 000 figure is likely to be a conservative estimate.

[56]      Daily Telegraph, NSW emergency fears due to GP co-payment, 8 October 2014, www.dailytelegraph.com.au/news/breaking-news/nsw-emergency-fears-due-to-gp-co-payment/story-fni0xqi3-1227084184963?nk=1a57d6e6da6b96f6fb43b8fa4a8086c0 (accessed 4 November 2014).

[57]      Mr Steven Archer, Deputy Chief Executive, Finance and Business Services, Department for Health and Ageing, South Australia, Committee Hansard, 9 October 2014, p. 5.

[58]      The Hon Peter Dutton MP, Minister for Health, Address to Australian Medical Association National Conference, 23 May 2014, p. 3.

[59]      For example NSW–ABC News, Jillian Skinner says NSW considering inviting GPs to treat patients in hospital to avoid $7 co-payment, 17 May 2014, www.abc.net.au/news/2014-05-16/ministers-blast-federal-government-over-missing-80-billion/5458614 (accessed 5 November 2014) and South Australia–ABC News, Senate health inquiry: GP co-payment will increase SA hospital visits 'by 290,000 people', 9 October 2014, www.abc.net.au/news/2014-10-09/co-payment-to-increase-sa-hospital-visits-committee-told/5801886 (accessed 5 November 2014).

[60]      AMA, Submission 48, p. 5. With respect to the $1.4 billion figure, the AMA noted that 'as the AMA does not have any information about the Government’s modelling, this is a simple calculation.'

[61]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, Committee Hansard, 8 October 2014, pp 28–29.

[62]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, The Drum, 14 August 2014, http://grattan.edu.au/news/can-the-coalitions-copayment-policy-be-repaired/, (accessed 7 November 2014).

[63]      For instance Ms Julie Leete, Area Manager, Lismore, Interrelate, Committee Hansard, 15 September 2014, p. 34; Mrs Annette Alldrick, Secretary and Delegate, Shoalhaven Branch, NSW Nurses and Midwives' Association, Committee Hansard, 16 September 2014, p. 32; Mr Steven Archer, Deputy Chief Executive, Finance and Business Services, Department for Health and Ageing, South Australia, Committee Hansard, 9 October 2014, p. 2; Mr Darren Carr, Chief Executive Officer, Mental Health Council of Tasmania, Committee Hansard, 3 November 2014, p. 9; Dr Judith Watson, Chair, Tasmanian Medicare Local, Committee Hansard, 4 November 2014, p. 5; and Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery Federation (Tasmanian Branch) Committee Hansard, 4 November 2014, p. 19.

[64]      Mr Vahid Saberi, CEO, Northern NSW Medicare Local, Committee Hansard, 15 September 2104, p. 23.

[65]      Mr Martyn Goddard, private capacity, Committee Hansard, 3 November 2014, p. 23.

[66]      Mr Stephen Burgess, Innovation, Policy and Research Officer, Benetas, Committee Hansard, 7 October 2014, p. 8.

[67]      Ms Jane Carter, Spokesperson, VMAG, Committee Hansard, 7 October 2014, p. 6.

[68]      Mr Hill, Ambulance Employees Australia of Victoria, Committee Hansard, 7 October 2014, p. 18.

[69]      Mr Stephen Burgess, Innovation, Policy and Research Officer, Benetas, Committee Hansard, 7 October 2014, p. 10.

[70]      Dr Martin Carlson, Moruya General Practitioner, Committee Hansard, 16 September 2014, p. 10.

[71]      Mr Steven Archer, Deputy Chief Executive, Finance and Business Services, Department for Health and Ageing, South Australia, Committee Hansard, 9 October 2014, p. 6.

[72]      Ms Amanda Mitchell, Health Development Coordinator, Aboriginal Health Council of South Australia, Committee Hansard, 9 October 2014, p. 47.

[73]      Budget Paper No.2: Budget Measures – Health. www.budget.gov.au/2014-15/content/bp2/html/bp2_expense-14.htm.

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

[75]      Ms Jane Carter, Spokesperson, Victorian Medicare Action Group, Committee Hansard, 7 October 2014, p. 3.

[76]      www.abc.net.au/news/2014-05-14/budget-2014-states-react-to-health-and-education-cuts/5452234 ) (accessed 20 November 2014).

[77]      Hon Jay Weatherill MHA, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 1.

[78]      Hon Jay Weatherill MHA, Premier, South Australian Government, Committee Hansard, 28 August 2014, p. 1.

[79]      Hon Jay Weatherill MHA, Premier, South Australian Government, Committee Hansard, 28 August 2014, p .1.

[80]      Mr Stephen Archer, Deputy Chief Executive, Department of Health and Ageing, South Australia, Committee Hansard, p. 1.

[81]      Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, p. 38.

[82]      Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, p. 41.

[83]      Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, p. 44.

[84]      Ms Alana Killen, Chief Executive Officer, Australasian College of Emergency Medicine, Committee Hansard, 8 October 2014, p. 20.

[85]      Dr Stephen Duckett, Director, Health Program, Grattan Institute, Committee Hansard, 8 October 2014, p. 33.

[86]      Australian Medical Association, Submission 48, p. 3.

[87]      Dr Bruce Bolam, Executive Manager, Programs Group, Victorian Health Promotion Foundation (VicHealth), Committee Hansard, 7 October 2014, p. 22.

[88]      Dr Bruce Bolam, Executive Manager, Programs Group, Victorian Health Promotion Foundation (VicHealth), Committee Hansard, 7 October 2014, p. 22.

[89]      Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee Hansard, 7 October 2014, p. 37.

[90]      Ms Jane Carter, Spokesperson, VMAG, Committee Hansard, 7 October 2014, p. 2.

[91]      Adjunct Associate Professor Elizabeth Dabars AM, CEO and Secretary, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, pp 29–30.

[92]      Adjunct Associate Professor Elizabeth Dabars AM, CEO and Secretary, Australian Nursing and Midwifery Federation (SA Branch), Committee Hansard, p 30.

[93]      AMA, Submission 48, p. 3.

[94]      Journals of the Senate, 25 November 2014, p. 1848.

[95]      Mr Andrew Stuart (Deputy Secretary) and Mr Nathan Smyth (First Assistant Secretary, Population Health Division), Department of Health, Senate Community Affairs Legislation Committee, Committee Hansard, 2 July 2014, Canberra, p. 48.

[96]      'Smaller Government – Australian National Preventative Health Agency – abolish' Budget Measures 2014-15 – Part 2, p. 145.

Chapter 4 - Medicare Locals—history and implementation

[1]        National Health and Hospitals Reform Commission, Terms of Reference, http://nhhrc.org.au/terms-of-reference/.

[2]        A National Health and Hospitals Network for Australia's Future, Government publication, 2010, p. 5.

[3]        Council of Australian Governments, National Health Reform Agreement, 2011, p. 6. http://webarchive.nla.gov.au/gov/20140801015609/http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhra-agreement.

[4]        Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, Professor John Horvath AO, 4 March 2014, p. 2.

[5]        National Health Reform Process and Delivery Publication, Government Publication, September 2011, pp 17–18, http://webarchive.nla.gov.au/gov/20140801015101/http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhr-progress-delivery, (accessed 7 November 2014).

[6]        National Health Reform Process and Delivery Publication, Government Publication, September 2011, pp 17–18.

[7]        National Health Reform Process and Delivery Publication, Government Publication, September 2011, p. 18.

[8]        Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, Professor John Horvath AO, 4 March 2014, pp 2–3.

[9]        National Health Reform Process and Delivery Publication, Government Publication, September 2011, p. 16.

[10]      National Health Reform Process and Delivery Publication, Australian Government, September 2011, p. 16.

[11]      Australian Medicare Local Alliance (In Liquidation), Submission 82, p. 1.

[12]      'A National Health and Hospitals Network for Australia's Future' Government publication, 2010, p. 40.

[13]      Australian Medicare Local Alliance, Submission 82, p. 6.

[14]      Australian Medicare Local Alliance, Submission 82, p. 6.

[15]      The Coalition's Policy to Support Australia's Health System, Liberal and National Parties, August 2013, http://lpaweb-static.s3.amazonaws.com/13-08-22%20The%20Coalition%E2%80%99s%20Policy%20to%20Support%20Australia%E2%80%99s%20Health%20System.pdf, p. 3.

[16]      The Hon Tony Abbott MP (Opposition Leader), People’s Forum 2, transcript, ABC News 24, 28 August 2013.

[17]      Health Minster the Hon Peter Dutton MP, Media release, Medicare Locals review: Australia's former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government's review of Medicare Locals, 16 December 2013, www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2013-dutton025.htm.

[18]      Health Minster the Hon Peter Dutton MP, Media release, Medicare Locals review: Australia's former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government's review of Medicare Locals, 16 December 2013.

[19]      Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, Executive Summary, p. v.

[20]      www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2013-dutton025.htm.

[21]      Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport 4 March 2014, p. 3.

[22]      Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. 3.

[23]      Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. 3.

[24]      Ms Kathryn Stonestreet, CEO Southern NSW Medicare Local, Committee Hansard, 16 September 2014, p. 5.

[25]      Northern Adelaide Medicare Local, www.naml.com.au/about-us.

[26]      Northern Adelaide Medicare Local, www.naml.com.au/about-us.

[27]      Mrs Brenda Ryan, CEO Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, p. 12.

[28]      Mr Paul Hersey, CEO South Coastal Perth Medicare Local, Committee Hansard, 10 October 2014, p. 12.

[29]      Mr Paul Hersey, CEO South Coastal Perth Medicare Local, Committee Hansard, 10 October 2014, p. 12.

[30]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Senate Community Affairs Legislation Committee, Supplementary Estimates, 22 October 2014, p. 34.

[31]      This submission was provided to the committee upon request.

[32]      This submission is available on the AMA website: https://ama.com.au/submission-australian-government-review-medicare-locals

[33]      Northern Adelaide Medicare Local Media Release, Media speculation around Medicare Locals, 23 April 2014, www.naml.com.au/media-centre/latest-news.

[34]      The Hon Tony Abbott MP (Opposition Leader), People’s Forum 2, transcript, ABC News 24, 28 August 2013.

[35]      Northern Adelaide Medicare Local Media Release, Media speculation around Medicare Locals, 23 April 2014, www.naml.com.au/media-centre/latest-news.

[36]      The Horvath Review refers to Primary Health Organisations, but the Government has opted for the alternative name 'Primary Health Networks'.

[37]      2014-15 Budget, Budget Paper No. 2: Budget Measures 'Establishment of Primary Health Networks', p. 129.

[38]      Budget Paper No. 2: Budget Measures – Health. www.budget.gov.au/2014-15/content/bp2/html/bp2_expense-14.htm.

[39]      Mr Phil Edmondson, CEO Tasmanian Medicare Local, Committee Hansard, 4 November 2014, p. 11.

[40]      Mr Phil Edmondson, CEO Tasmanian Medicare Local, Committee Hansard, 4 November 2014, pp 2–3.

[41]      Dr Judith Watson, Chair, Tasmanian Medicare Local, Committee Hansard, 4 November 2014, p. 1.

[42]      Australian Government, A National Health and Hospitals Network for Australia’s Future – Delivering better health and better hospitals, report, 2010, p. 33.

[43]      Answer to question on notice, Kathryn Stonestreet, CEO Southern NSW Medicare Local, 16 September 2014.

[44]      Mr Paul Hersey, CEO, South Coast Perth Medicare Local, Committee Hansard, 10 October 2014, p. 11.

[45]      Mr Darren Carr, CEO, Mental Health Council of Tasmania, Committee Hansard, 3 November 2014, p. 11.

[46]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, pp 35–36.

[47]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Committee Hansard, 8 October 2014, p. 70.

[48]      Department of Health, Answer to Question on Notice 12, 8 October 2014 hearing.

[49]      Ms Alison Fairleigh, Area Manager Townsville, Mental Illness Fellowship NQ, Committee Hansard, 21 August 2014, p. 11.

[50]      Mr Vahid Saberi, Chief Executive Officer Northern NSW Medicare Local, Committee Hansard, 15 September 2014, p. 27.

[51]      Ms Debra Lee, Chief Executive Officer North Adelaide Medicare Local, Committee Hansard, 9 October 2014, p. 12.

[52]      Mr Saberi, North Coast Medicare local, Committee Hansard, 15 September 2014, p. 26; and www.ncml.org.au/index.php/programs-services (accessed 19 November 2014).

[53]      www.snswml.com.au/our-health-programs.html (accessed 19 November 2014).

[54]      www.barwonml.com.au/health-professionals/clinical-services-support (accessed 19 November 2014).

[55]      Mrs Brenda Ryan, CEO Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, pp 10–15.

[56]      Mrs Nancy Piercy, CEO, Murrumbidgee Medicare Local, Committee Hansard, 2 October 2014, p. 27.

[57]      Mrs Brenda Ryan, CEO, Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, p. 10.

[58]      Ms Alison Fairleigh, Area Manager Townsville, Mental Illness Fellowship NQ, Committee Hansard, 21 August 2014, p. 12.

[59]      As some staff work part-time, employee numbers in the following table and footnotes may vary with the staff numbers being higher than the FTE numbers.

[60]      Ms Kathryn Stonestreet, CEO, Southern NSW Medicare Local, Committee Hansard, 16 September 2014, p. 3. The Southern NSW Medicare Local has about 150 employees.

[61]      Mrs Jean McRuvie, CEO Central Queensland Medicare Local, Committee Hansard, 30 September 2014, pp 2–3. The Central Queensland Medicare Local has about 94 employees.

[62]      Mrs Nancye Piercy, CEO Murrumbidgee Medicare Local, Committee Hansard, 2 October 2014, p. 26. The Murrumbidgee Medicare Local has more than 100 private contractors and 120 employees.

[63]      Dr Elizabeth Deveny, CEO Bayside Medicare Local, Committee Hansard, 2 October 2014, p. 27. The FTE count for the Bayside Medicare Local depends on whether both Commonwealth funded services and state funded services are included.

[64]      Mr Jason Trethowan, CEO, Barwon Medicare Local, Committee Hansard, 6 October 2014, p. 2. The Barwon Medicare Local has 85 employees.

[65]      Mr Matthew Jones, CEO, Loddon Mallee Murray Medicare Local, Committee Hansard, 7 October 2014, p. 46. The Loddon Mallee Murray Medicare Local has just over 60 staff, including part time staff. 50 per cent of staff are mental health clinicians.

[66]      Mr Kim Hosking, CEO Country North Medicare Local, Committee Hansard, 9 October 2014, p. 19. The Country North Medicare Local has around 100 employees.

[67]      Ms Debra Lee, CEO North Adelaide Medicare Local, Committee Hansard, 9 October 2014, p. 19. The North Adelaide Medicare Local has about 70 employees.

[68]      Mr Chris Seiboth, CEO, Central Adelaide and Hills Medicare Local, Committee Hansard, 9 October 2014, p. 19.

[69]      Mrs Brenda Ryan, CEO, Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, p. 11. At 30 May 2014, the FTE for the Goldfields-Midwest Medicare Local was 66.6. As at 10 October 2014 the FTE had fallen to 47.8.

[70]      Mr Paul Hersey, CEO, South Coast Perth Medicare Local, Committee Hansard, 10 October 2014, p. 11.

[71]      Mr Phil Edmondson, CEO, Tasmanian Medicare Local, Committee Hansard, 4 November 2014, p. 12. The Tasmanian Medicare Local as 150 staff. Wind up costs are estimated to be higher for this Medicare Local due to it having $60 million of additional work through the federal government's Tasmanian Health Assistance Package.

[72]      Mrs Jean McRuvie, CEO Central Queensland Medicare Local, Committee Hansard, 30 September 2014, pp 2–3.

[73]      Mr Phil Edmondson , CEO Tasmanian Medicare Local, Committee Hansard, 2 October 2014, p. 11.

[74]      Including during hearings of the Senate Community Affairs Legislation Committee for Supplementary Estimates.

[75]      Answer to Question on Notice 4, 2 October 2014 hearing.

[76]      Department of Health website, 'Primary Health Networks – Latest News', www.health.gov.au/internet/main/publishing.nsf/content/primary_health_networks

[77]      Department of Health website, 'Primary Health Networks – Latest News', www.health.gov.au/internet/main/publishing.nsf/content/primary_health_networks

[78]      Department of Health, Establishment of Primary Health Networks – Frequently Asked Questions, Version 1.2, 11 July 2014, p. 3.

[79]      Ms Mary McDonald, Acting Deputy Secretary, Department of Health, Committee Hansard, 2 October 2014, p. 48.

[80]      See appendix 6 for a copy of the 15 October version of the FAQ.

[81]      www.health.gov.au/internet/main/publishing.nsf/Content/phn_presentation

[82]      Mr Vahid Saberi, CEO, Northern NSW Medicare Local, Committee Hansard, 15 September 2104, p. 26.

[83]      www.tasmedicarelocal.com.au/about-us/primary-health-networks.

[84]      Mr Phil Edmondson, CEO Tasmanian Medicare Local, Committee Hansard, 4 November 2014, p. 4.

[85]      Mr Phil Edmondson, CEO Tasmanian Medicare Local, Committee Hansard, 4 November 2014,  p. 12.

[86]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 38.

[87]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 38.

[88]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 39.

[89]      Dr Carlson, Moruya General Practitioner; and Chair, Southern New South Wales Medicare Local, Committee Hansard, 16 September 2014, p. 6.

[90]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 29.

[91]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 29.

[92]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 30.

[93]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 33.

[94]      Senator Dean Smith, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 34.

[95]      Mr Mark Booth, First Assistant Secretary, Primary and Mental Health Care Division, Department of Health, Senate Community Affairs Legislation Committee Supplementary Estimates, 22 October 2014, p. 34.

[96]      Mr Kim Hosking, CEO Country North Medicare Local South Australia, Committee Hansard, 2 October 2014, p. 21.

[97]      Mrs Nancy Piercy, CEO, Murrumbidgee Medicare Local, Committee Hansard, 2 October 2014, p. 21.

[98]      A table of the Parliamentary Library , 

[99]      All population figures are based on 2011 Census data.

[100]    These are the Central and Eastern Sydney PHN; the Hunter New England and Central Coast PHN; the North Western Melbourne PHN; the Eastern Melbourne PHN; the South Eastern Melbourne PHN; and the Adelaide PHN.

[101]    The table is based on an analysis of the Parliamentary Library. All population figures come from 2011 Census data. Medicare Local boundary information comes from www.medicarelocals.gov.au/internet/medicarelocals/publishing.nsf/Content/digital-boundaries#.VGQNKE0cScV and Primary Health Network boundary information comes from www.health.gov.au/internet/main/publishing.nsf/Content/primary_Health_Networks, (accessed 13 November 2014). A Medicare Local is included in the PHN boundary if more than half of its population would be covered by the new boundary.

[102]    Also encompasses significant proportions of the Hume (40 percent); Lower Murray (14 percent) and Loddon-Mallee-Murray (9 percent) Medicare Locals.

[103]    Also encompasses significant proportions of the Northern Melbourne Medicare Local (45 percent).

[104]    Also encompasses significant proportions of the Goulburn Valley Medicare Local (11 percent).

[105]    Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. 3.

[106]    Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. 7.

[107]    Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. v.

[108]    Mrs Brenda Ryan, CEO Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, pp 18–19.

[109]    Mrs Brenda Ryan, CEO Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, p. 18.

[110]    Mrs Brenda Ryan, CEO Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, pp 18–19.

[111]    Mr Kim Hosking, CEO Country North Medicare Local South Australia, Committee Hansard, 2 October 2014, p. 26.

[112]    Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. 14.

[113]    Mr Stankevicius, CEO, Consumer Health Forum Australia, Committee Hansard, 2 October 2014, p. 8.

[114]    Mr Stankevicius, CEO, Consumer Health Forum Australia, Committee Hansard, 2 October 2014, pp 8–9.

[115]    Mr Kim Hosking, CEO Country North Medicare Local South Australia, Committee Hansard, 9 October 2014, p. 17.

[116]    Ms Mary McDonald, Acting Deputy Secretary, Department of Health, Committee Hansard, 2 October 2104, p. 39.

[117]    Ms Mary McDonald, Acting Deputy Secretary, Department of Health, Committee Hansard, 2 October 2104, p. 39.

[118]    Frequently Asked Questions on the Establishment of Primary Health Networks, 15 October 2014, p. 4.

[119]    Professor John Horvath AO, Review of Medicare Locals – Report to the Minister for Health and the Minister for Sport, 4 March 2014, p. ii.

Chapter 5 - Proposed merger of the Organ and Tissue Authority and the National Blood Authority

[1]        Budget 2014-15, Budget Measures, Budget Paper No. 2, p. 70. This two line description is the only reference in the entire budget papers about the merger.

[2]        Organ and Tissue Authority website, About Us > Organ and Tissue Authority, www.donatelife.gov.au/organ-and-tissue-authority-ota.

[3]        Organ and Tissue Authority website, About Us > National Reform Programme, www.donatelife.gov.au/about-us/national-reform-programme. 

[4]        Organ and Tissue Authority website, About Us > National Reform Programme, www.donatelife.gov.au/about-us/national-reform-programme. 

[5]        Organ and Tissue Authority website, About Us > National Reform Programme, www.donatelife.gov.au/about-us/national-reform-programme. 

[6]        Organ and Tissue Authority website, About Us > National Reform Programme, www.donatelife.gov.au/about-us/national-reform-programme#sthash.Txs3lSLi.dpuf.

[7]        Gift of Life Incorporated, Organ and Tissue Reform in Australia, 17 December 2013, www.giftoflife.asn.au/_blog/Main_Blog_%28Home_Page%29/tag/AOTDTA/.

[8]        Transplant Australia, Organ and Tissue Donation and Transplantation Resource: The Benefits, www.transplant.org.au/The-Benefits.html.

[9]        Transplant Australia, Organ and Tissue Donation and Transplantation Resource: The Benefits.

[10]      National Blood Authority website, About Us, www.blood.gov.au/about-nba.

[11]      National Blood Authority website, About Us, www.blood.gov.au/about-nba. 

[12]      National Blood Authority website, About Us, www.blood.gov.au/about-nba.

[13]      National Commission of Audit, Phase One Report, 2014, p. 211. www.ncoa.gov.au/report/docs/phase_one_report.pdf.

[14]      The Department of the Treasury, Budget 2014-15, Budget Paper No. 2, p. 70.

[15]      Minister for Finance, Senator the Hon Mathias Cormann, Media Release, Delivering A Smaller, More Rational Government, MC 36/14, 13 May 2014, www.financeminister.gov.au/media/2014/mr_2014-36.html.

[16]      Mr Leigh McJames, Chief Executive Officer, National Blood Authority, Committee Hansard, 25 September 2014, p. 3.

[17]      Answer to Question on Notice 1, 25 September 2014 Hearing (NBA), www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Additional_Documents (accessed 13 November 2014).

[18]      Answer to Question on Notice 5, 4 September 2014 Hearing (OTA).

[19]      'Monthly Report on Deceased Organ Donation in Australia – October 2014', Australia and New Zealand Organ Donation Registry, Produced 5 November 2014, Data received by ANZOD up to 4 November 2014, http://www.anzdata.org.au/anzod/updates/ANZOD2014summary.pdf

[20]      Organ and Tissue Authority website, About Us > Organ and Tissue Authority, www.donatelife.gov.au/organ-and-tissue-authority-ota.

[21]      National Blood Authority website, About Us, www.blood.gov.au/about-nba.

[22]      Mr Leigh McJames, Chief Executive Officer, National Blood Authority, Committee Hansard, 25 September 2014, p. 8.

[23]      Mr Brad Rossiter, personal capacity, Committee Hansard, 16 September 2014, p. 25.

Government Senators' Dissenting Report

[1]        The committee hearing in Melbourne on 8 October 2014 included witnesses from the federal departments of Health, Treasury, Finance and Human Services; all witness who appeared during Supplementary Estimates hearings in October 2014.

[2]        Commonwealth of Australia, Budget Paper 1, p. 1-1.

[3]        National Commission of Audit, Towards responsible government: The report of the National Commission of Audit, Phase One, pp 99–100; 111–112.

[4]        Senator the Hon Fiona Nash, Senate Community Affairs Legislation Committee, Budget Estimates, Committee Hansard, 2 June 2014, p. 64.

[5]        Department of Health, Submission 101, Senate Community Affairs References Committee, Out‑of-Pocket Expenses Inquiry, p. 25.

[6]        Department of Health, Strengthening Medicare, www.health.gov.au/internet/budget/publishing.nsf/content/budget2014-factsheet-strengthening-medicare, accessed 21 August 2014.

[7]        Department of Health, Budget 2014-15 http://budget.gov.au/2014-15/content/glossy/health/download/Health.pdf, accessed 21 August 2014.

[8]        Department of Health, Strengthening Medicare, www.health.gov.au/internet/budget/publishing.nsf/content/758402BC42DF82DBCA257CEE0020D480/$File/strengthening-medicare.pdf, accessed 21 August 2014.

[9]        Department of Health, Submission 12, Senate Community Affairs Legislation Committee, Inquiry into the National Health Amendment (Pharmaceutical Benefits) Bill 2014, p. 5.

[10]      Department of Health, Submission 12, Senate Community Affairs Legislation Committee, Inquiry into the National Health Amendment (Pharmaceutical Benefits) Bill 2014, p. 11.

[11]      Mr Leigh McJames, Chief Executive Officer, National Blood Authority, Committee Hansard, 25 September 2014, pp. 2-3.

[12]      Ms Yael Cass, Chief Executive Officer, Organ and Tissue Authority, Committee Hansard, 4 September 2014, p. 2.

Appendix 1 - Submissions received by the committee[1]

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

Appendix 2 - Additional information and answers to questions on notice received by the committee[1]

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

Appendix 3 - Witnesses who appeared before the committee[1]

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

Appendix 8 - Medicare Locals—examples of services and programs

[1]        www.mmll.org.au/about-our-services/programs (accessed 19 November 2014)

[2]        Mr Saberi, North Coast Medicare local, Committee Hansard, 15 September 2014, p. 26; and www.ncml.org.au/index.php/programs-services (accessed 19 November 2014).

[3]        www.snswml.com.au/our-health-programs.html (accessed 19 November 2014).

[4]        www.cqmedicarelocal.com/#!resources/cfvg (accessed 19 November 2014).

[5]        Central Adelaide and Hills Medicare Local, Overview of programs, http://cahml.org.au/overview-of-programs.html, (accessed 19 November 2014); and Mr Chris Seiboth, CEO, Central Adelaide and Hills Medicare Local, Committee Hansard, 9 October 2014, pp 14–15.

[6]        www.cnorthhealth.com.au/ (accessed 19 November 2014).

[7]        www.naml.com.au/programs-services (accessed 19 November 2014); further information about the services NAML currently provides and which could be lost in the transition to PHNs, see submission 93 from the NAML.

[8]        Dr Judith Watson, Chair, and Mr Phil Edmondson, CEO, Tasmanian Medicare Local, Committee Hansard, 4 November 2014, pp 2–10.

[9]        www.barwonml.com.au/health-professionals/clinical-services-support (accessed 19 November 2014).

[10]      http://bml.org.au/ (accessed 19 November 2014)

[11]      http://www.lowermurrayml.com.au/#!c_services/c1ger (accessed 19 November 2014)

[12]      Mr Paul Hersey, CEO, South Coast Perth Medicare Local, Committee Hansard, 10 October 2014, p. 11–17.

[13]      Mrs Brenda Ryan, CEO Goldfields-Midwest Medicare Local, Committee Hansard, 10 October 2014, pp 10–15.