Report on Budget Estimates 2008-2009
1.1
On 13 May 2008 the Senate referred the
following documents to the Committee for examination and report in relation to
the portfolios of Families, Housing, Community Services and Indigenous Affairs;
and Health and Ageing:
- particulars of proposed expenditure in respect of the year ending
on 30 June 2009
- particulars of certain proposed expenditure in respect of the
year ending on 30 June 2009
- particulars of proposed supplementary expenditure in respect of
the year ending on 30 June 2008
- particulars of certain proposed supplementary expenditure in
respect of the year ending on 30 June 2008.
1.2
The Committee has considered the budget expenditure of the portfolios
set out in their respective Portfolio Budget Statements 2008-2009 (PBS). Explanations
relating to the estimates were received from Senator the Hon Chris Evans,
Minister for Immigration and Citizenship representing the Minister for
Families, Housing, Community Services and Indigenous Affairs and Senator the
Hon Jan McLucas, Parliamentary Secretary to the Minister for Health and Ageing,
and officers from the portfolio Departments at hearings held from 2 to 5 June
2008.
1.3
The Committee expresses its appreciation for the assistance of the Minister;
Parliamentary Secretary; Dr Jeff Harmer, Secretary, Department of
Families, Housing, Community Services and Indigenous Affairs (FaHCSIA); and Ms
Jane Halton, Secretary, Department of Health and Ageing (DoHA); and the
officers who appeared before it.
1.4
In accordance with Standing Order 26, the date for submission to the
Committee of written answers to questions or additional information relating to
the expenditure is 1 August 2008.
1.5
The Committee discussed many of the expenditure proposals and information
contained in the PBS. These discussions are detailed in the Committee’s Hansard
transcripts of 2 to 5 June 2008, copies of which will be tabled in the Senate. Hansard
transcripts of the estimates proceedings are also accessible on the
Committee’s website at http://www.aph.gov.au/senate_ca. Answers to questions
taken on notice and tabled documents relating to the Committee's hearings will
be tabled separately in the Senate. Consolidated volumes of this additional
information may be accessed from the Committee's website.
1.6
At the conclusion of the hearings Senators Moore and Humphries, the
current and former Committee Chairs, and the DoHA Secretary, Ms Halton,
acknowledged the significant contribution made to the Committee over many years
by retiring Senators Patterson, Allison, Stott Despoja and Webber. Senator McLucas,
Parliamentary Secretary for Health and Ageing endorsed the remarks and also
paid tribute to Senators Nettle, Bartlett and Murray who have also contributed
to the work of the Committee in a number of major inquiries.[1]
Procedural matters
Budget issues and Indigenous
Australians
1.7
The Committee asked a considerable number of questions covering a wide
range of Indigenous issues. These are noted later in the report. However,
Senators were again confronted with the difficulty and frustration of knowing
in which portfolio questions might best be asked. While FaHCSIA was
accommodating in directing Senators in this regard, the effect was that
Senators had to again shuffle between committees often to pursue questions with
other portfolios on the same issue. This difficulty was especially prominent during
previous estimates in attempting to question a range of matters relating to the
Northern Territory Emergency Response and in these estimates in questioning the
Closing the Gap budget measures.
1.8
This totally unacceptable situation arises due to the complexity and
cross-over of matters with regard to the whole-of-government coordination of
policy development and service delivery for Indigenous Australians. This issue
is clearly acknowledged by the Government in the Budget Statement 'Closing the
Gap between Indigenous and non-Indigenous Australians':
The Australian Government's commitment to turn around Indigenous
disadvantage is supported by $425.3 million in new funds in the 2008-09 Budget
(see Appendix 2). The funding is provided across eight portfolios, but will
be spent as part of an integrated whole-of-government strategy (emphasis
added).[2]
1.9
For Senators to try and question a budget measure across eight portfolios
is clearly untenable. The Committee considers that as the Government has
acknowledged that this is an integrated whole-of-government strategy, it should
be quite straightforward to arrange during the estimates hearing program
(possibly a spill-over day) a separate time to conduct an estimates hearing on
Indigenous matters that would include all the portfolios with budget
expenditure or responsibility for Indigenous issues.
Recommendation 1
1.10
The Committee recommends that future estimates hearing programs include
a separate time to conduct an estimates hearing on Indigenous matters that
would include all the portfolios with budget expenditure or responsibility for
Indigenous issues.
1.11
Given the similar proposed cross-portfolio nature of the government's
social inclusion agenda, the Committee believes that it would be useful for
departments to consider how best to address this issue.
Appearance of Medibank Private
1.12
Medibank Private Limited, a Government Business Enterprise (GBE) with the
Minister for Finance and Deregulation as their sole shareholder, has appeared
before the Community Affairs Committee at DoHA estimates hearings for many
years during the questioning of private health insurance matters. This has greatly
assisted Senators questioning in this subject area and has been undertaken with
the cooperation and goodwill of all involved.
1.13
However, for these budget estimates Medibank Private was requested by
individual Senators to appear before both the Finance and Public Administration
Committee and the Community Affairs Committee. Medibank Private graciously
acceded to the twin requests, though this is an unsatisfactory procedure. The
Parliamentary Secretary, Senator McLucas, addressed the Committee Chair with
regard to this matter:
On behalf of Medibank Private, ask that you as chair of this
committee discuss with the chair of Finance and Public Administration the
perennial problem of where Medibank Private should appear. They have been
called twice to these estimates. I accept that at this estimates it is an issue
that you want to find out about in the context of both Finance and Public
Administration and this committee. Senator Humphries and I have had this
discussion over a number of years. It probably would be useful if we could
clarify which committee Medibank Private should appear in front of. Personally,
I do not think it is reasonable to have them appear at two into the future. If
that could be clarified, that would be extremely useful for Medibank Private.[3]
1.14
The Chair responded that she agreed Medibank Private should not be
expected to appear twice at estimates and would endeavour to clarify the matter
prior to the supplementary estimates hearings.[4]
Requests for attendance of
portfolio agencies at the hearing but not questioned
1.15
Some agencies had been requested to attend the hearing but were not then
called to the table to answer questions. This situation had also arisen at the
Additional Estimates hearings. Reasons ranged from the Senator who had
requested their appearance unable to be in attendance at the time and other
Senators not having any questions of these agencies and, in one case, because
time constraints resulted in the questions for the agency having to be placed on
notice.
1.16
Some of the agencies that were not questioned had travelled from
interstate and had spent a considerable amount of time at the hearing waiting
to be called. In the case of two agencies this situation had also occurred at
the previous estimates.
1.17
The Committee Chair apologised to representatives of the agencies
concerned, and with the cooperation of the Committee intends to try to prevent
this situation occurring at future hearings. The Committee will trial a
procedure similar to the practice with the supplementary estimates that will list
on the hearing program the name of the Senator/s who requested the attendance
of a particular agency so that if they are not in attendance at the time they
may be contacted.
Provision of
answers relating to Additional Estimates 2007-08
1.18
The Committee is again pleased to acknowledge DoHA's efforts in providing
answers to questions on notice relating to the additional estimates. A
considerable number of answers were provided by the due date 11 April 2008, with the rest being provided throughout April and early May, with the exception
of three remaining answers which were provided to the Committee in late May.
1.19
Similarly to the previous round of estimates FaHCSIA were not able to
provide any answers to questions on notice by the due date. A substantial
number of answers were provided in early May and the remainder provided to the
Committee shortly before the budget estimates hearings, following the same
pattern as the previous estimates round. Senators expressed their
dissatisfaction at the late provision of answers. The Departmental Secretary
offered an apology and explained that best efforts were made by the Department to
provide timely responses, and pointed out that the budgetary period is
traditionally a particularly busy time which also contributed to the delay in a
number of answers not being able to be provided earlier.[5]
Portfolio Budget Statements
1.20
The inclusion of output groups in FaHCSIA's portfolio structure and
outcomes (Figure 1 in the Portfolio Overview) would be an advantage in order to
avoid having to locate the various output groups in each of the Outcomes
performance information in Section 2 of the PBS.[6]
Revisions to Portfolio Structure
and Outcomes 2008-2009 from 2007-08
1.21
Changes to the Families, Housing, Community Services and Indigenous
Affairs Portfolio arising from the Administrative Arrangements Order (AAO)
released 3.12.07, revised 25.01.08 accounted for the following changes to the
FaHCSIA Outcome structure:
|
Revisions to FaHCSIA Outcomes/Output
groups
|
|
2008-09
|
2007-08
|
|
Output Group 2.4 – Addressing Youth Homelessness
|
Formerly Output Group 2.4 – Support for Youth
|
|
|
Output Group 3.3 – Child Care Support
On 3.12.07 AAO transferred all programs and
functions from this output group to DEEWR
|
Issues
Families, Housing, Community Services and Indigenous Affairs portfolio
1.22
During FaHCSIA's hearings information was sought by the Committee on
matters relating to portfolio and corporate matters which included updates on
staff workloads, staffing levels – particularly with regard to SES officers,
and possible staff reductions. It was somewhat difficult for FaHCSIA to provide
comparisons with previous years as to staffing levels because of the
significant AAO transfers of various programs both to and from FaHCSIA. Efficiency dividends, ministerial staff, board appointments,
overseas travel, media monitoring, and community cabinet meetings were included
in discussions.
1.23
FaHCSIA was asked what feedback had been received from the public
regarding adequacy of their pensions and commented that a lot of the issues
discussed were covered in the Committee's inquiry into the cost of living
pressures on older Australians, which is still awaiting a Government response. The
Committee was advised that FaHCSIA would be providing data for the Henry review
of the tax system which will report on the appropriate level of income support
and allowances. Carers and seniors groups will be consulted to allow them to
provide feedback relating to their concerns to assist the review.[7]
1.24
Issues relating to housing support were
debated at length, particularly housing affordability. Detailed information was
sought in relation to the operation of the Housing Affordability Fund and the
National Rental Affordability Scheme.[8] The Committee was informed regarding various programs and
measures to support people who are homeless, particularly homeless youth. 'A
Place to Call Home' initiative to reduce the numbers of homeless people was
explained in detail.[9]
1.25
A number of questions were asked relating
to carers and support for people with disabilities, particularly with regard to
the Commonwealth State/Territory Disability Agreement (CSTDA) which was
discussed in detail, as well as the disability assistance package, supported
accommodation places, carer payments and allowances, including the new
assessment tool and process. Support and improved accommodation arrangements
for young people with a disability and young people in nursing homes, unmet
need, rehabilitation services, special disability trusts, disability support
pensions, and assistance for children with autism spectrum disorders were also amongst
topics discussed.[10]
1.26
Information was sought on matters relating
to aged care support, such as the utilities allowance, telephone allowance,
transport concessions, the use of data from the Household, Income and Labour
Dynamics in Australia (HILDA) Survey, Commonwealth Seniors Health Card,
compliance review, the Henry review with regard to pensioner support.[11] The Minister commented that he considered the Committee's
report into the cost of living pressures on older Australians would be a 'very
useful basis for the [Henry] review'.[12] Senator Evans went on to say:
I would
not be at all dismissive of the role that that committee report will play and
the valuable contribution it makes to shaping the debate. I do not just say
this as a senator. When committees do that work in advance of a sharp political
divide, then they really do contribute substantially, and I think the report
will be one of the landmark reports, so I am sure it will be taken very
seriously.[13]
1.27
FaHCSIA provided Senators with information
on matters relating to women which included support for victims of people
trafficking programs, accommodation for women and children in need, the
National Council to Reduce Violence Against Women and Children, and programs to
help reduce domestic violence. The AppointWomen scheme and opportunities for
the advancement of women were also discussed, as well as the Women's Leadership
and Development Program and the National Rural Women's Summit.[14]
1.28
As in previous hearings a large amount of
FaHCSIA's hearing time (almost 8 hours) was taken up with the Committee
seeking information on a wide range of Indigenous matters. The Closing
the Gap measure was explained to the Committee in detail. The Government's intention
is to achieve the COAG targets of closing gaps within certain timeframes
between Indigenous and non-Indigenous Australians in the areas of life
expectancy, education - including early childhood education, mortality rates of
children under five, gaps in reading, writing and numeracy, and employment
outcomes for Indigenous peoples. Although FaHCSIA is the lead agency, policy
development and service delivery is spread across a number of portfolios which
increases the complexity of coordination and the task of Senators asking
questions of the responsible portfolio department. The Northern Territory
Government also has responsibility for some areas of policy and service
delivery for Indigenous peoples.
1.29
As well as information provided on the above matters FaHCSIA detailed to
the Committee the progress being made to achieve the targets across a wide
range of Indigenous issues. The provision of adequate housing was discussed in
detail, including tender processes, building design, construction costs, contracting
issues, maintenance, and tenancy arrangements.[15]
1.30
Senators sought and were provided with updates on the progress of the
Northern Territory Emergency Response (NTER) to ensure better outcomes for
Indigenous peoples, particularly children. The Committee was informed on a
range of matters including income support and management, income quarantining
and the operation and use of merchant vendor provider cards, police protection,
child protection workers, and pornographic material. The Committee was also
provided with information relating to the proposed review of the NTER. Some
other Indigenous matters included in discussions were petrol sniffing, and the
youth alcohol prevention scheme.[16]
1.31
The Registrar of Indigenous Corporations informed the Committee on the appointment
of an administrator and arrangements, including public consultations, relating
to the Waminda Aboriginal Corporation. Senator Johnston asked if reports
provided by the administrator to ORIC could be released and was advised that if
the documents were made public 'there would be a reluctance by special
administrators to be as open as possible with us'. Senator Johnston expressed
concerns he had regarding possible misappropriation of funds and further
pursued the release of the administrator's report and was advised that advice
would be sought as to whether the report could be released.[17]
1.32
Aboriginal Hostels Limited agency provided the Committee with updates on
their hostels, particularly the renal dialysis specific hostels. Indigenous
Business Australia agency explained their history, progress, developments,
programs and outcomes.[18]
1.33
Matters relating to support for families which were discussed in some
detail included budget changes which required income testing on Family Tax
Benefit A and B, including the impact on and number of people who may be affected
by the measure and the possible effect on rent assistance. Family Relationship
Centres and the review of privacy issues, the FRSP online system, child support
and the baby bonus were also discussed.[19]
1.34
The Committee was informed of the impact of changes to child support systems,
including details of the new arrangements. The financial counselling program,
emergency relief services, pandemic influenza preparedness, disaster recovery
payments, volunteer small equipment grants, were also included in discussions.[20]
Health and Ageing
portfolio
1.35
DoHA was asked a range of questions concerning staffing and other corporate
matters similar to FaHCSIA. The graduate program was discussed, including
details of rotations.[21]
1.36
The Australian Institute of Health and Welfare (AIHW) agency provided
details to the Committee regarding their efficiency dividend, contract staff,
research output and publications. Due to the Committee's current inquiry into
ready-to-drink alcoholic beverages Senators had a particular interest in
obtaining further information from AIHW relating to alcohol consumption and the
numbers of people drinking at harmful levels, data which the agency had
recently released in a survey. The Committee was also informed on data used to
assess unmet need for supported accommodation and respite services and hospital
statistics.[22]
1.37
Private health insurance matters were discussed at some length,
particularly the changes to the Medicare levy surcharge thresholds and how this
might impact on private health insurance coverage. DoHA was asked if they had
provided advice to Treasury to inform the modelling on this measure and the
nature of the advice. The Committee was informed that advice was provided to
Treasury but details of the advice could not be provided because this formed
part of the budget process and is part of advice to ministers. The possible impact
of the Medicare levy surcharge on private health insurance membership and on
public hospitals, Lifetime Health Care cover, the private health insurance
rebate, and increases in private health insurance premiums were discussed, as
well as the reimbursement by private health insurance funds of surgically
implanted prostheses.[23]
1.38
Further questions relating to private health insurance were asked of the
Private Health Insurance Administration Council (PHIAC) covering the role of
the Council, data collected and published, applications for rate changes, and
the prudential safety of health funds.[24]
1.39
With regard to biosecurity and emergency response matters, DoHA informed
the Committee about the shelf life and replacement program of the national
medical stockpile of drugs in case of a pandemic, and preparedness for
emergency situations.[25]
1.40
A wide range of questions were asked on population health matters which
included program funding and expenditure, programs to reduce alcohol
consumption and illicit drug use, identification of people with tuberculosis, including
their treatment and management, and bowel cancer screening and breast screening
programs. Pregnancy counselling services, including the helpline, and the funding
of support services were also discussed. Information was also provided on the
national women's health policy. A number of questions were also asked about monitoring
of the sales of alcohol following the implementation of the new tax on ready-to-drink
beverages. Healthy eating and programs to assist good nutrition were also discussed.[26]
1.41
The Therapeutic Goods Administration was asked about legal proceedings
against employees of Pan Pharmaceuticals; the review being conducted by the
National Coordinating Committee on Therapeutic Goods into extemporaneously
prepared medicines; and labels on medicines for children less than two years of
age.[27]
1.42
The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) provided
information regarding the purchase of a medical linear accelerator to undertake
work to support dosimetry in radiotherapy, problems with the construction of
the OPAL reactor at Lucas Heights and the development of models particularly
for application in the event of a radiological dispersal device.[28]
1.43
Senators sought information from the Food Standards Australia New
Zealand (FSANZ) agency concerning food labelling standards, genetically
modified food safety assessments, research into certain food colours, including
children's behaviours and reactions to food colours, and food additives.[29]
1.44
Cancer Australia informed the Committee with regard to their objective
to improve cancer data and how they were intending to achieve this. Progress
with the National Centre for Gynaecological Cancers, an ongoing issue of
particular interest to the Committee, was also discussed.[30]
1.45
The Committee discussed a number of aged care matters with DoHA,
including the availability of mobile rapid response teams in certain areas,
progress with the ACAT review, the Grant Thornton report into the financial
liquidity of aged care providers and viability of the industry, the Aged Care
Funding Instrument, the timeframe for bed allocation and bed readiness, the non
take-up of aged care places in Western Australia and Tasmania. Compliance
matters, police checks in nursing homes, increasing the aged care nursing
workforce, administration of Bridgewater aged care facility, and the relocation
of Alton Court residents following closure were also discussed. The Committee
was also informed regarding the role of the recently appointed Ambassador for
Ageing and her program of engagements, contract and remuneration.[31]
1.46
In relation to pharmaceutical matters DoHA was asked about funding for the
expensive subsidised drug Varenicline which is prescribed to assist with
quitting smoking, and whether the funding also covered counselling and
follow-up to ensure that the money was effectively spent. DoHA explained that
consultation with a medical practitioner was required to obtain the initial prescription
for the drug, and a revisit to the doctor was necessary to continue treatment
with the drug. The doctor had to be satisfied that the patient genuinely wished
to give up smoking and also that some form of counselling would be undertaken as
well as attendance at a smoking cessation program. Other matters discussed
included subsidies for insulin pumps, and PBAC cost recovery.[32]
1.47
Senators sought detailed information covering access to medical and
dental services including the funding and administration of the teen dental
program. Other matters discussed were progress with the oncology unit at Royal Darwin
Hospital, extension of Medicare funding for Positron Emission Tomography
(PET), Medicare funding for home-based sleep testing, and obstructive sleep apnoea.[33]
1.48
A great deal of time was spent by Senators repeatedly requesting details
of community sports grants which were election commitments and were repeatedly
advised that the commitment would be honoured and details of the projects would
be advised when the appropriate negotiations had been completed.[34]
1.49
The Australian Sports Commission (ASC) was questioned about the status and
future of Taekwondo Australia which had been deregistered by the Australian
Olympic Committee. The ASC advised they were awaiting the international body to
review the situation. Australia's prospects at the Beijing Olympics, the impact
of efficiency dividends, costs to fund an Olympic team, security of the
Australian Institute of Sport (AIS) campus, Australian Sports Foundation
funding and projects were also included in discussions.[35]
1.50
Questions were asked of the Australian Sports Anti-Doping Authority
(ASADA) relating to privacy issues concerning the list of 900 athletes whose
Medicare records were accessed to ascertain if the athletes were illegitimately
using substances for the purposes of doping. The Committee was advised that 'it
was a pilot project after receiving legal advice from the Australian Government
Solicitor to determine whether Medicare records could provide information – not
medical records – of the doping records of athletes'. ASADA was asked whether
the advice of the Privacy Commissioner was sought on the matter but advised that
there had been no consultation. The Privacy Commissioner has launched an own
motion investigation into the matter and ASADA is fully assisting the Privacy
Commissioner in that regard.[36]
1.51
Primary health care matters discussed included detailed information on
GP superclinics, GP training, the Healthy Kids Check program and Round the
Clock Medicare program, the Patient Assisted Travel Scheme, and obstetrics in
regional and rural areas.[37]
1.52
Indigenous health matters included alcohol and drug evaluation, and the evaluation
of health benefits of swimming pools in outback communities, eye health and
trachoma, petrol sniffing, primary health care services for Indigenous peoples,
and maternal and child health.[38]
1.53
A range of rural health matters, including the Medical Specialist
Outreach Assistance Program, were discussed. The Committee was also informed on
matters relating to hearing services and devices, the hearing loss prevention
program, and eHealth.[39]
1.54
The Committee was also provided with information on reductions in
funding for mental health programs and services, the take-up of funding,
assistance for the mental health nurse workforce, Better Access to
Psychiatrists, Psychologists and the GPs program.[40]
1.55
The Chair of the National Health and Hospitals Reform Commission and
departmental Secretary provided the Committee with information regarding the
role of the Commission, funding, staffing, and the planned consultation program,
and future work.[41]
1.56
Questions were asked relating to the tender process for the Mersey
Hospital, Tasmania, including the number of expressions of interest received
and the number invited to tender. The Departmental Secretary advised the
Committee that she had taken advice on the matter and stated that the tender
process had been concluded and the government was considering its position and
that no further information could be provided at the time. The Secretary drew
attention to the relevant guideline in the Government Guidelines for
Official Witnesses before Parliamentary Committees and Related Matters:
In relation to the guidelines for witnesses, I cannot advise you
if, in advising you, it would identify considerations which are germane to
government decisions. In fact, the guideline [2.15] says:
(c) should not identify
considerations leading to government decisions or possible decisions, in areas
of any sensitivity, unless those considerations have already been made public
or the Minister authorises the department to identify them ...
The minister has not authorised me to identify these.[42]
1.57
The Committee notes that the Minister announced the outcome the
following day, 6 June, that the two-stage tender process commenced in
March had not resulted in a concluding bid and that the Australian Government
is now in negotiations with the Tasmanian Government to operate the hospital on
the Commonwealth’s behalf. The Australian Government will continue to own and
fund the Mersey Hospital, but the hospital will be integrated with services
provided by the Tasmanian Government elsewhere in the North and North West and
the rest of the State.[43]
1.58
Further matters included in discussions with DoHA were hospital waiting
lists, elective surgery waiting lists, the Commonwealth Dental Health Program, and
the rural medical workforce shortage.[44]
1.59
In addition to the above issues a number of administrative and process
issues involving both portfolios were discussed during the estimates hearings
and these are detailed in the Hansard transcripts of evidence.
Senator Claire Moore
Chair
June 2008
Navigation: Previous Page | Contents