There is little in the Budget that was not already foreshadowed. Most of the extra health spending goes to public hospitals with some commendable measures in preventive health. The private insurers take a hit in terms of removing one of the penalties for choosing not to take out private health insurance. Queensland does particularly well on additional medical workforce training and there are lots and lots of local initiatives for sports ovals and health initiatives. A lot of very specific and local election commitments have been honoured.
Unfortunately at this stage there is little evidence of an underlying or even emerging strategy to give effect to the rhetoric and hype that has so excited those in the health sector that perhaps an era of reform has arrived.
And for a Government strongly advocating a preventive focus for health, the removal of the incentive for GPs to immunise children seems odd.
The increase in the threshold for the tax surcharge on those who do not take out private health insurance could have been part of a broader public/private strategy. By effectively removing one of the three public supports for private health insurance (the other two being: the PHI rebate; and Lifetime Health Cover premium penalties for those who delay taking out insurance until after age 30) it looks like one-third of a policy on private insurance. Perhaps there will be more in future budgets.
The ‘blame game’ removal in health comes at a significant price: several billions more for public hospitals without as yet any specific requirement for accountability by the states. More money seems to be an alternative to hard thinking about what we expect from our public hospitals and how much we are prepared to pay for them.
Even before the ink is dry on these cheques, the states are putting their hands out for more because of fears of greater demands for public hospital beds by all the people who might give up their private insurance (presumably because they feel too well to get value from it).
There is the promise of much more to come. The Hospitals and Health Reform Commission is just cranking up and has another year to run. The health investment fund promises lots of goodies for hospitals and medical researchers but inevitably these will be some way off and probably will not start appearing on the ground until around 2010.
Nevertheless, Rome was not built in a day nor will the Australian health system be reformed in one budget. One can only hope that the zest for reform does not fade as the electoral cycle progresses.