The old adage of the devil bring in the detail is never more true than when it comes to the federal budget. The hidden disaster in the 2012-13 MYEFO is the hit (unacknowledged by anyone in the government) taken by preventive and public health.
We know that $1.5 billion over four years ($254 million in 2012-13) has been cut from the National Health Reform funding. The MYEFO documents say this reflects downward revisions to both the weighted population used to calculate hospital utilisation following the 2011 Census and the Australian Institute of Health and Welfare health price index.
However, closer examination reveals that cuts have been made in both hospital services and public health funding. The latter funding has been reduced by $400 million over the forward estimates, down from a total of $1.383 billion. With public health funding always such a negligible proportion of healthcare funding, every dollar counts here.
What is even more distressing is to discover that major cuts have been made in the National Partnership for Preventive Health. What was originally $584 million provided over the years 2012-13 to 2014-15 for the Healthy Children, Healthy Communities and Healthy Workers program is now only $397 million.
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Presumably, some of the $188.6 million that is clawed back goes towards the $74.1 million over four years provided since the 2012-13 budget to support preventive health activities.
Of this funding, $29.1 million will support the Australian National Preventive Health Agency’s core activities and research as well as initiatives to combat eating disorders. The remaining $45.0 million will fund social marketing to discourage tobacco use, complementing the plain packaging initiative.
However, in the light of closer MYEFO scrutiny, this is not such a generous policy initiative and overall the Treasury has pocketed $100 million in savings from preventive health activities.
If Australia is to tackle the growing and costly burden of non-communicable diseases and ensure that our population is as healthy as possible throughout life, then increased efforts and investments in public health and prevention are essential. To date there is little evidence that the government is committed to these.