There were minimal new announcements, nor initiatives to fundamentally change the health of the nation. Within the context of an election campaign, a government spruiking innovation and growth, the largest spending portfolio was largely rolled forward.
In the interest of balance, it must be acknowledged that the current economic position of the nation does not provide for significant spending opportunities as the government continues to drive towards seeking a means to balance the federal coffers. Nor does more spending equate to effective policy. Further, with NDIS, consumer directed care, still evolving PHN’s, Federal/state funding impasses, and My age care programs already in train, perhaps this is enough to cope with? Equally, the government may simply have kept some of its power dry for release during the current campaign.
Unsurprisingly, the various health sector peak bodies have lauded increases in spending, and derided the decreases to the extent it impacts their respective constituencies. Stepping back from these views, what was missing?
- Health efficiency through technology platforms – much talked about, but still not being harnessed by a nation that has numerous service channels and the tyranny of distance that impact sector efficiency and access to services.
- A broader preventative health program, beyond increasing the ‘user pays’ principal or taxation deterrent levied on smokers, and supporting dental access. What of other, often personally manageable, significant contributors to health spending such as obesity, alcohol, and diabetes?
- Suggestion or vision as to how the (not so) longer term increasing consumer volume demands, employee and skill requirements, and funding challenges of an aging population will be addressed through structural health sector reform.
- Clarity of purpose and a means to interact and coordinate services across NDIS, age care, and primary healthcare for efficiency and ease of use.
So what were the positives for the sector from the budget papers?
- The overall spend by the department at a federal level has increased by 13%. The overall health budget represents a spend of approximately $62billion, 15% of the total budget spend.
- Healthcare homes is a new initiative, that while being a small investment, may be a future contributor to better coordinated service delivery for high frequency users of health services.
- Increased access to publicly funded dental services for many
- The NDIS saving scheme, another means to assist the sustainable funding of a very significant and broad initiative.
On balance, I’d suggest the missing elements speaker louder than the new initiatives.
So how was the 13% increased spent, or $7 billion allocated? Below is a representation of key expenditure classifications for the forthcoming year and their percentage increase from the prior year.