Here are media statements on the budget from the Public Health Association, Consumers Health Forum and Doctors Reform Society…

(Update May 11/13: have also added some more reaction to bottom of post)

Public Health Association of Australia identifies budget winners and losers

Mental health, regional health, dental health and immunisation services are among the big winners in this year’s health budget, while funding for aged care, pathology and hearing services has been slashed, according to the Public Health Association of Australia (PHAA).

“It really is a mixed bag this year with both big winners and losers. The Government has delivered on key commitments in mental health and improved infrastructure in regional areas, while on the other hand areas such as community aged care and hearings services will see big cuts to existing program budgets,” said Michael Moore, PHAA Chief Executive Officer (CEO).

“The Mental Health Reform Package, worth $2.2 billion over 5 years, is a comprehensive suite of new and improved program measures in the critical areas of prevention, treatment and targeted interventions for at-risk groups. Funding is also provided for the establishment of a National Mental Health Commission to be located within the Prime Minister’s portfolio and the PHAA congratulates the Government for implementing a whole-of-government approach.

“Equity in access and availability of health services for people in regional and rural areas will be enhanced by an investment of $1.8 billion in infrastructure over 5 years, which will go towards improvements in health and hospital facilities and equipment.

“A National Advisory Council on Dental Health will be established to advise the Government on significant reforms to dental health. A further $52.6 million over 5 years has been allocated for a dental internship year program to provide enhanced access to dental health professionals and address unmet need. An additional $40.7 million over 4 years is also provided under the National Immunisation Program for a vaccine to protect children against pneumococcal disease.

“Also worth noting is the significant cross-portfolio investment for a package of education, employment and health initiatives designed to Close the Gap in Indigenous disadvantage – worth $526.6 million over 5 years.

“However, funding for community aged care places will be slashed by $211.7 million; pathology services funded under the Medicare Benefits Schedule will be cut by $406 million; and funding for better targeted services under the existing Hearing Services Program will reduce by $122.3 million over 5 years.

“Funding for a variety of population health and prevention programs and initiatives has remained on track, building on the Government’s response to the National Preventative Health Taskforce report. Support for health and medical research has also remained constant.

“While there are some important initiatives in key areas in this year’s health budget, there are also some significant concerns arising in areas where so-called efficiencies have been achieved,” concluded Mr Moore.

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Consumers Health Forum: Budget Pain Spared for Health Consumers

Health consumers will breathe a sigh of relief that there are many positives in tonight’s health budget, in particular massive increases in spending on much-needed mental health services, and more money for regional health infrastructure. This is despite much speculation about cuts and increases to co-payments mooted in recent weeks.

“While we would like assurances that the flagged substantial staff cuts and structural change in the health area will not have any impact on services, there are a number of new initiatives that we welcome,” said Carol Bennett, Chief Executive Officer of the peak national consumer health body, the Consumers Health Forum of Australia (CHF).

“The $1.5 billion in new money for mental health services will allow greater access to a range of mental health programs that have already demonstrated their effectiveness, in particular funding for the expansion of headspace and the EPPIC early psychosis intervention program. CHF welcomes significant money for better assessment and coordination of a range of mental health services, a new e-mental health portal, more primary care and innovative services, and a National Commission to ensure accountability for the mental health spend.

“This is a significant advance for an area of pressing need that has long been overlooked or ignored by major political parties. The benefits to the overall community of a coordinated and effective mental health programs should not be underestimated,” she said.

Ms Bennett said health consumers in regional areas would warmly welcome a further investment of $475m dollars for regional health infrastructure on top of the $1.3 billion that has already been announced in this area.

“People in regional and rural areas have long been the poor cousins of urban Australians when it comes to access and availability of quality health infrastructure and it is good to see that balance being redressed.”

CHF welcomes the continuation of the Bowel Cancer Screening program ($138m over 4 years) as an important preventative health measure, but Ms Bennett said that she agreed with Bowel Cancer Australia that this should not be at the expense of the listing of new medicines on the Pharmaceutical Benefits Scheme (PBS) recommended by the independent Pharmaceutical Benefits Advisory Committee (PBAC).

“We are pleased that the Prevenar3 pneumococcal vaccine booster has been approved for subsidy but a further six medicines are still delayed in the new Cabinet-approval process and these should be approved immediately. It is particularly ironic that while mental health has been the focus of this Budget, a medication that will deliver significant benefits to people with schizophrenia remains in limbo.

“Until there is return to the process where the recommendations of PBAC are accepted by Cabinet without delay, the most vulnerable in our society – the sick and chronically ill – will be denied affordable access to the best available health care.”

CHF also welcomes measures to improve availability and affordability of MRI services.

Ms Bennett said dental health reform remained an area of concern but that consumers would be pleased to be involved in the new Dental Health Advisory Council which is to recommend improvements in dental health care programs by 2012-13. The establishment of a new dental internship program is a welcome initiative to improve community access to dental services.

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Doctors Reform Society: it’s just more bandaids

‘The Federal Government’s budget initiatives for the health system continue to indicate this government has little interest or understanding of the serious problems facing our public health system’ claim Doctors Reform Society President, Dr Peter Davoren.

‘Increased spending on mental health is very welcome. A Mental Health Commission is even better. A Commission, however, will only be effective if it has the independence, authority and finances to run the mental health system properly’ said Dr Davoren.

‘The Government has trotted out the old standards of elective surgery waiting lists and casualty waiting times. It has conveniently ignored the crisis in primary care, the serious lack of health care workers in regional Australia and the immediate needs of our public hospitals..

‘This Government continues to dish out band-aid solutions when major surgery is needed’ argued Dr Davoren.

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Some more public health reaction

Added on May 11:

Here is Professor Stephen Leeder’s take at The Conversation.
He says: “…this is a budget that has done health quite well, especially mental health, given the commitment to austerity.”

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Public health policy consultant Margo Saunders writes:

A quick look at the Population Health side of things tells me that:

Health and gender: While both men and women will benefit from a range of initiatives, there is no obvious use being made of the new national health policies for men and women, or a commitment to taking gender into account in the design, delivery or evaluation of policies and programs.  There is funding for the design and establishment of the framework and methodology for the previously-announced Australian Longitudinal Study on Male Health, but there is nothing else specifically on men’s health.  In fact, the word ‘men’s’ in the Population Health papers only appears in the context of ‘women’s’.  Searching for ‘male’ produces the longitudinal male health study and a commitment to ‘provide regular statistical bulletins on male health’.  Well, I guess that’s better than not providing them.

Health literacy: Despite being highlighted in a raft of high-level strategic documents relating to prevention, primary care, chronic disease, men’s and women’s health, and health and hospital reform, health literacy does not get a mention here – not by the NHMRC or elsewhere in the Population Health papers.  With major national health literacy initiatives in the UK, the USA and Canada, Australia looks destined to fall further and further behind in terms of developing and supporting people’s skills in accessing, understanding and applying health information.

Health information: There are some potentially interesting developments in health information, but their actual impact remains to be seen. The Health Social Surveys Fund will consolidate administrative and funding arrangements for the new Australian Health Survey and the men’s and women’s longitudinal health studies, and will, according to the Government’s description, ‘provide flexibility to address social health data in a more considered way, ensuring complementary data to better support the evidence base for the development of health policy.’   The Australian Bureau of Statistics (ABS) will continue to conduct the Australian Health Survey, which will include new nutrition, physical activity, and biomedical components. ‘The survey will gather nationally representative data including food consumption patterns, nutritional status, obesity, physical activity and chronic disease indicators from adults and children two years of age and above, including Aboriginal and Torres Strait Islander peoples. Survey findings will provide objective prevalence estimates for a number of health indicators, enable effective monitoring of health trends and will be used to guide the development of future preventive health policies and programs and to guide the work on preventive health to be undertaken by the department and the Australian National Preventive Health Agency (ANPHA).

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Update, May 13

Reaction from Australian Health Care Reform Alliance: a mixed bag with some implementation challenges

The Australian Health Care Reform Alliance (AHCRA) today said that this year’s Federal Budget was a mixed bag of initiatives that would rely on smart implementation in order to deliver the expected outcomes.

“AHCRA welcomes the additional funding for mental health care which is long overdue and should go a long way towards addressing some of the current gaps in the delivery of mental health care. Mental illness is a common and serious health problem affecting 20 per cent of the population every year, with sometimes profound implications for one’s overall health and wellbeing.” Tony McBride, AHCRA Chair, said today.

“However, a major challenge in the implementation of this Budget initiative will be to ensure that the funding is directed to evidence-based services and programs which target those most in need of care. Another challenge will be to use the funding to support increased linkages between mental health services and primary health care (PHC) and to strengthen the capacity of PHC to provide high quality mental health care. The role of Medicare Locals will be crucial in this regard and AHCRA urges the Government to closely involve Medicare Locals and the primary health care sector in general in the roll-out of this Budget initiative.

“Other positives in the Budget include:

  • funding of some of the key health reform agenda items (eg rural health, mental health) to keep momentum going
  • means-testing of the private health insurance rebate which will reduce expenditure on this inefficient program;
  • continued funding for bowel cancer screening; and
  • increased funding for rural health services, including indigenous services.

“However, there are also some major gaps. In particular, AHCRA is disappointed that the Government has failed yet again to address the crisis in public dental services. 30% of the population currently struggle to access even basic dental services and this is resulting in serious health, economic and social problems throughout our community. It is also putting additional pressure on our already stressed public hospital system with dental conditions responsible for an estimated 58 000 potentially preventable hospital admissions every year (based on 2007-08 figures).

“There is also little in the Budget which focuses on preventive health or on reducing the demand for hospital services – both of which should be high priorities for the Australian health system. Overall, the Budget does not go far enough to address the current inequities in access to health care and does nothing to address the financial barriers faced by 3 out of every 10 sick Australians when seeking care.

“The lack of a clear vision for the primary health care system and adequate funding for Medicare Locals to steer the system in that direction, as well as the inadequate meaningful consumer and citizen involvement in the primary health system generally all remain of profound concern.

“To maximize the potential of the Budget initiatives to deliver a fairer and more effective health system, AHCRA urges the Government to work closely with health stakeholders in their implementation and to address the gaps identified above,” Mr McBride said.

* AHCRA is a coalition of 45 national and state peak health groups, including those representing the medical profession, nursing, allied health, the rural health sector, as well as consumer groups. AHCRA advocates for a fairer health system.

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Update, May 20

Australian Doctor’s full budget coverage (open access and available to all) 

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