FEDERAL BUDGET 2019-20
The Hon. Greg Hunt MP
Minister for Health
The Hon. Ken Wyatt MP
Minister for Senior Australians and Aged Care
Minister for Indigenous Health
The Liberal National Government is investing a record $104 billion in 2019–20, up from $75 billion in 2012–13, as part of a comprehensive, patient-focused investment of $435 billion over the next four years. It guarantees Medicare, makes a range of life-saving medicines and services more accessible and affordable, reduces out-of-pocket costs, strengthens primary care and mental health and invests in breakthrough medical research.
The Budget consolidates and continues our health reform agenda. It reinforces the four pillars of our long term national health plan – guaranteeing Medicare and improving access to medicines, supporting our hospitals, prioritising mental health and preventive health and investing in health and medical research.
We are addressing community need through a range of investments under our $1.25 billion landmark Community Health and Hospitals Program (CHHP) to keep people healthy and out of hospital.
We are acting on aged care reform. Improvements to accessibility, quality and safety continue apace with a further investment of $7 billion since the last Budget.
The Government is investing record funding for Health:
· Medicare boosted by $6 billion
o with $1.1 billion for Primary Care
· Hospital funding boosted by $5 billion
o on top of the $1.25 billion CHHP
· Aged Care funding boosted by $7 billion
· $40 billion for life-saving and life-changing medicines provisioned in the forward estimates
· $5 billion for a 10 year Medical Research Future Fund investment plan
· $736.6 million for mental health including youth suicide prevention
· $1 billion for Indigenous health
· Over $1 billion for child dental services
We are increasing Medicare funding by $6 billion, up from $19.5 billion in 2012–13, to $24.9 billion in 2018–19, to $30.7 billion in 2022–23. The Medicare Guarantee Fund, established in 2017–18, allocates $36.6 billion in guaranteed funds for spending on the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS) in
We are increasing the Medicare rebate for important diagnostic services, including ultrasound and X-ray imaging to reduce the costs to patients. This will support Australians’ access to bulk-billed diagnostic imaging services. It will encourage radiologists, obstetricians, cardiologists and other specialties to maintain or increase their level of bulk-billing. The Government is investing $198.6 million in this initiative.
We are investing $151.9 million to expand the number of Medicare-eligible MRI machines to more than 50 newly funded units in the past 12 months. New MBS services for MRI of the breast, costing $32.6 million over four years, will help diagnosis for around 14,000 breast cancer patients each year.
The independent experts continue to recommend improvements to the MBS. New and amended Medicare-eligible services will support breast cancer, prostate cancer and brain surgery patients, people having X-rays, and patients in private hospital emergency departments and intensive care units.
We are committed to reducing out-of-pocket health care costs for Australians. The Government supports all the recommendations of, and will implement the first stage of our response to, the report of the Ministerial Advisory Committee on Out-of-Pocket Costs.
We will make publicly available the fees and resulting out-of-pocket costs charged by medical specialists, with an initial focus on specialist fees for gynaecology, obstetrics, and cancer services. This will be supported by a community awareness campaign, including a website. It will increase transparency, and enable people, particularly those with private health insurance, to be more informed about costs when choosing a specialist.
Strengthening primary care
We are delivering a $1.1 billion ‘Strengthening Primary Care’ package, building on the $512 million package in the 2018–19 MYEFO, to support Australia’s doctors and specialists to deliver improved access and outcomes for patients. The Government will invest $448.5 million in increased funding to deliver a new population based funding approach to support GPs to provide enhanced care and services, initially focussing on Australians over 70 years.
Australians over the age of 70 will be able to voluntarily enter into an agreement with their general practitioner, and receive more personalised, coordinated care, with usual services continuing to be rebatable for the patient under Medicare. GPs and others in their practice will be able to provide consultations, referrals, scripts and test results remotely – without seeing patients face-to-face. This will make it easier and more convenient for people to access timely care and medical advice.
Our investment complements and strengthens Medicare. Doctors will be further supported by a $201.5 million boost for the Practice Incentives Program Quality Improvement Initiative, including retention of the Aged Care Access Incentive, and $187.2 million to increase rebates for 176 GP services from 1 July 2019.
We will further tackle the ever increasing burden of chronic disease through our Public Health and Chronic Disease program. Funding of $17.2 million over five years will develop several national strategic action plans aimed at improving the lives of Australians living with chronic conditions – specifically, osteoporosis, kidney health, rare diseases, heart disease and stroke, and children’s health. We will also provide a new heart health check under Medicare to better address cardiovascular disease.
Eligible Australian children will continue to be able to access basic dental services and claim up to $1,000 in benefits under the Child Dental Benefits Schedule, with the Government investing over $1.0 billion for the next three years from 1 January 2020.
We will spend $12 million over the next three years to extend the reach of the childhood immunisation education campaign to save lives by protecting children from serious diseases.
We are implementing a National Rural Generalist Pathway, allocating $62.2 million over five years to ensure rural generalists are trained, recognised and resourced to meet the critical health needs of rural Australians.
Improving Indigenous health remains a key target of our refreshed Closing the Gap framework. Funding is boosted to $4.1 billion from 2019–20 to 2022–23 and more than $10 billion over a decade.
Improving access to medicines
The Liberal National Government has provisioned $40 billion in the forward estimates for life-saving and life-changing medicines. We are averaging 31 new or amended listings per month – approximately one per day.
We continue our commitment to ensure people have affordable access to medicines when they need it, through listing all medicines on the PBS that have received a positive recommendation from the Pharmaceutical Benefits Advisory Committee (PBAC).
From 1 May 2019, Ibrance® will be available on the PBS for the treatment of inoperable advanced metastatic breast cancer. Patients will pay $6.50 or $40.30 for the drug. Without subsidy, they would pay $55,000 per year.
From 1 May 2019, Bavencio® will be available on the PBS for the treatment of metastatic merkel cell carcinoma, a rare and highly aggressive type of skin cancer. Without subsidy, they would pay $150,000 per year.
From 1 May 2019, Besponsa® will be available on the PBS for the treatment of acute lymphoblastic leukaemia. Without subsidy, they would pay $120,000 per year.
Tagrisso® is now available on the PBS for the treatment of lung cancer, which would otherwise cost patients $88,000 per course of treatment.
Opdivo® + Yervoy® is now available on the PBS for the treatment of advanced renal cell carcinoma, which would otherwise cost patients $254,200 per course of treatment.
Venclexta® is now available on the PBS, in combination with rituximab for the treatment of adult patients with chronic lymphocytic leukaemia, which would otherwise cost patients around $165,000 per course of treatment.
We are allocating $15 million for a one-off increase to community pharmacy to continue providing support to consumers, to improve the safe use of medication.
Supporting our hospitals
We have increased funding for the nation’s public hospitals by $5 billion, up from $13.3 billion in 2012–13, to $21.7 billion in 2018–19, to $26.2 billion in 2022–23.
In addition, patients in every state and territory will have access to improved health and hospital services under our landmark $1.25 billion Community Health and Hospitals Program (CHHP).
Projects will be delivered through Primary Health Networks, grant funding, and transfer payments to state and territory governments. They include the Comprehensive Children’s Cancer Centre at Sydney’s Children’s Hospital, NSW; Centre for Excellence in Cellular Immunotherapy at the Peter MacCallum Cancer Centre, Victoria; James Cook University – Cairns Tropical Enterprise Centre, Queensland; Repatriation Hospital – Brain and Spinal Centre, South Australia; improved health outcomes for individuals living with brain and spinal cord injuries in Queensland; Peel Health Campus, Western Australia; Ambulatory Care Centre, Alice Springs, Northern Territory; Canberra Hospital Intensive Care Unit, Australian Capital Territory; and North West Cancer Centre linear accelerator, North West Regional Hospital, Tasmania.
The CHHP complements our record investment in public hospitals, which will more than double from $13.3 billion in 2012–13 to $29.1 billion in 2024–25. Our new five year National Health Reform Agreement will deliver more than $30 billion in additional public hospital funding from 2020–21 to 2024–25.
Addressing youth mental health and suicide prevention
The Government is boosting mental health funding by $736.6 million, with $461.1 million focused on addressing youth mental health and suicide prevention. The high rate of suicide, particularly among young people, is a national tragedy which we are taking strong action to address. Recognising that the causes of suicide are complex and extend into social services and finances, the Prime Minister will make suicide prevention a key personal priority by creating a Suicide Prevention Co-ordinator in his department to coordinate suicide prevention initiatives across the whole of Government.
The Government’s $461.1 million commitment to addressing youth mental health and suicide prevention is guaranteed, including by providing:
· $15 million to ensure that communities and services can respond quickly to areas affected by high incidences of suicides and self-harm by creating a new national information system.
· $15 million to empower Indigenous suicide prevention.
· $111 million to expand the headspace network by 30 – from the current 115 services to 145 by 2021, to enable more young people to access support.
· $152 million to reduce wait times at headspace centres around the country. This will bring our total investment in headspace to over $120 million a year.
· $2 million investment in the Young Ambassadors for Mental Health project, which will enrich these services by enabling young ambassadors with lived experience of mental health issues to get out into the community to promote mental health literacy, and improve how people seek help.
· $110 million to continue the Early Psychosis Youth Services program at 14 headspace centres to provide specialist clinical services for young people at the early stages of severe mental illness.
Our Government is also dedicated to supporting the mental health of adults around the country in order to promote wellbeing and prevent suicides. To improve how people access care, and the quality of services, we will deliver a trial of adult mental health centres in eight locations nationally, at a cost of $115 million. These will provide walk-in, coordinated care and advice for anyone with concerns, and will address what is seen by many as a missing gap in the health system. We will improve perinatal mental health services by providing $43.9 million to support Australians affected by perinatal mental illness during or after pregnancy, or experiencing grief after the death of an infant. By investing $11.5 million in a National Mental Health Workplace Initiative we will support businesses – from sole traders to multinationals – and workers to create a mentally healthy workplace, giving workers the opportunity to maintain the best possible mental health and wellbeing.
We are also investing an additional $112 million in mental health through the CHHP with a focus on youth and Indigenous mental health and suicide prevention, and integrated community mental health.
Investing in life saving and job creating medical research
The Government is ensuring record funding of $6 billion over the forward estimates for medical research, with $3.5 billion for the National Health and Medical Research Council, $0.5 billion for the Biotechnology Translation Fund, and $2.3 billion for the MRFF – up from $222 million in 2018–19 to $650 million in 2022–23.
The Government is committing to a new $5 billion 10-year MRFF investment plan across four themes Patients, Researchers, Missions and Translation. Under the Patients theme, the government will invest $614 million in the rare cancers, rare diseases clinical trials program.
The Government’s 10-year investment plan will give researchers and industry certainty and direction through the four key areas:
The Government will commit a further $931.0 million for a total of $1.3 billion allocated under the Investment Plan to improve the health of Australians through the development of new treatments and cures informed by the latest research and using cutting edge technology, which includes:
· Clinical Trials for Rare Cancers, Rare Diseases and Unmet Needs ‑ a further $354.0 million for a total of $614.2 million;
· Emerging Priorities and Consumer Driven Research ‑ a further $554.0 million for a total of $633.0 million; and
· Global Health ‑ Tackling Antimicrobial Resistance and Drug Resistant Tuberculosis ‑ a further $23.0 million for a total of $28.4 million.
The Government will commit a further $444.6 million for a total of $792.8 million allocated under the Investment Plan to support our best health and medical researchers to make breakthrough discoveries, develop their skills and progress their careers in Australia, which includes:
· Frontier Health and Medical Research ‑ a further $330.0 million for a total of $570.0 million;
· Industry Researcher Exchange and Training ‑ existing allocation of $32.0 million; and
· Clinical Researchers ‑ a further $114.6 million for a total of $190.8 million.
The Government will commit a further $1.2 billion for a total of $1.4 billion allocated under the Investment Plan for long term focused missions to address complex and sizeable health issues requiring a concerted effort to transition great ideas through to proof‑of‑concept and beyond, which includes:
· Australian Brain Cancer Mission – a further $2.0 million for a total of $123.6 million (including $65.3 million in philanthropic contributions, $5.0 million in clinical trials funding and $3.4 million in research funding);
· Million Minds Mental Health Research Mission ‑ existing allocation of $125.0 million;
· Genomics Health Futures Mission ‑ a further $430.2 million for a total of $500.0 million;
· Ageing, and Aged Care and Dementia Mission ‑ a new investment of $185.0 million;
· Indigenous Health Futures ‑ a new investment of $125.0 million for a total of $160.0 million;
· Stem Cell Mission ‑ a new investment of $150.0 million;
· Cardiovascular Mission ‑ a new investment of $220.0 million; and
· Traumatic Brain Injury ‑ a new investment of $50.0 million.
The Government will commit a further $1.2 billion for a total of $1.5 billion allocated under the Investment Plan to progress research ideas from the lab to the clinic, ensuring new medical discoveries are part of the clinical practice of GPs, specialists and hospitals, which includes:
· Preventive and Public Health Research ‑ a further $60.0 million for a total of $260.4 million.
· Primary Health Care Research ‑ a new investment of $45.0 million;
· Rapid Applied Research Translation Centres ‑ a further $143.0 million for a total of $218.0 million;
· Medical Research Commercialisation ‑ a further $254.0 million for a total of $311.3 million;
· National Critical Infrastructure ‑ a new investment of $605.0 million; and
· Data Infrastructure ‑ focus on registries, biobanks & linkage platforms ‑ a new investment of $80.0 million.
Investing in preventive health
The Budget funds a range of preventive health initiatives to tackle some of Australia’s most pressing social and health challenges. These include lifestyle-related blood diseases, drugs, family and domestic violence, and unhealthy eating.
We are allocating $45.4 million to implement national awareness and prevention strategies to reduce the impact of blood borne viruses, such as HIV, hepatitis B and hepatitis C, and sexually transmissible infections, such as syphilis, gonorrhoea and chlamydia. These strategies focus on the needs of Aboriginal and Torres Strait Islander people.
More alcohol and other drug treatment and support services will be established in remote, rural and regional areas, costing $9.6 million. An additional 65 specialist service providers will operate after hours and on weekends across hundreds of under-serviced areas.
Funding of $4.3 million will provide local support for families and communities struggling with the impacts of illicit drug misuse, including ice.
We will also invest $7.2 million establishing a take-home naloxone program to reduce deaths associated with opioids. Naloxone is a proven treatment in reversing the effect of an opioid overdose.
Family and domestic violence has a profound impact on women and children’s health and wellbeing, families and communities, and society. A ‘Recognise, Respond, Refer’ pilot, already under way in Brisbane, will receive a $7.5 million boost to be extended across five Primary Health Network regions to train GPs and their staff to recognise and manage family violence. A complementary $2.1 million training initiative will further improve the domestic violence response of GPs and primary care workers nationally.
The Government will allocate $20 million for a pivotal anti-smoking campaign.
Supporting senior Australians
We have increased funding for aged care by $7 billion over the forward estimates, up from $13.3 billion in 2012–13 to $20.5 billion in 2018–19 to $25.4 billion in 2022–23.
We have increased the number of home care packages from 60,308 in 2012–13 to 124,032 in 2018–19 and 157,154 in 2022–23 as part of our ongoing response to senior Australians’ clear preference to receive aged care in their own homes and live independently for longer.
With the rapid growth in home care, the Government is providing $5.6 million to strengthen compliance to tackle the risk of poor quality service and fraud. The Aged Care Quality and Safety Commission – Australia’s new cop on the aged care beat – will have a key role, including increasing home care audits.
The Commonwealth Home Support Program will be extended for a further two years to 30 June 2022, representing an investment of $5.9 billion. This will give certainty to around 1500 organisations, such as meals-on-wheels, supporting almost one million older Australians as they age and start to require assistance while still living in their own home.
In residential aged care, the Government has invested $320 million in 2018–19 as a one-off increase to the general subsidy through to 30 June 2020. This will support the increase in residential places from 186,000 in 2012–13 to 212,000 in 2018–19 to 243,000 in 2022–23. We will also work to significantly improve monitoring and reporting of serious incidents involving residents, including incidents involving physical or chemical restraint.
Funding of $7.7 million will help to ensure the use of medication, in particular inappropriate use of psychotropics and antibiotics, in residential aged care is brought into line with best practice and community expectations. Clinical pharmacists will work directly with aged care providers to better inform them about appropriate use. Providers will be obliged to provide medication management data.
Building the aged care workforce for the future is a high Government priority. We are allocating $2.6 million to step up industry-led implementation of the Aged Care Workforce Strategy. This will improve capability, conditions and career opportunities for more than 366,000 aged care workers.