Health: Regional Australia—Driving Our Economy 2017–18
The Australian Government recognises that people living outside the major Australian cities can face barriers in accessing the same range of health and aged care services as those living in urban areas. To help with these barriers, the Australian Government directs significant assistance to improving the quality of, and access to, health and aged care services for people living outside metropolitan areas.
The Australian Government has worked to improve health outcomes in regional areas and is continuing this effort with the aforementioned benefits. These improvements arise from the delivery of services tailored to meet the needs of local communities and improvements in the coverage of the health workforce. Additionally, Rural and Regional Health Australia provides easily accessible information about health programs in regional Australia through its website (see www.ruralhealthaustralia.gov.au) and its free call 1800 020 103 telephone line.
Assistance is provided through general health programs, and programs targeted specifically at regional Australia, where the Australian Government provides funding to address factors that specifically impact on the health and wellbeing of people living in rural and remote communities. In addition, substantial Australian Government assistance is provided to States and Territories through various specific purpose payments, with a significant amount directed to people living in regional Australia.
The Australian Government continues to provide targeted initiatives and incentives to improve service delivery and the health workforce in regional, rural and remote Australia. These initiatives and incentives have resulted in, but are not limited to:
- tailored services that meet the needs of local communities;
- increased accessibility to services; and
- improvements to workforce coverage and distribution.
Of particular note, in 2017–18 the Australian Government will provide $4.4 million over four years to support the National Rural Health Commissioner; an independent, statutory position, supported by departmental staff. The National Rural Health Commissioner will work with rural, regional and remote communities, the health sector, universities, specialist training colleges and across all levels of government to better target and address the health needs in rural and remote Australia, and champion the cause of rural practice.
Prioritising Mental Health—Improving Telehealth for Psychological Services in Regional, Rural and Remote Australia
The Enhance Telehealth Access for Psychological Services in Rural and Regional Australia measure will remove barriers to telehealth through enabling better access to psychological services in rural and regional Australia via a range of telehealth delivery channels. This will provide $9.1 million over four years from 2017–18 to increase access to psychological services for those living in rural and remote areas who would otherwise have limited access to those services. Access via telehealth will allow appropriate health professionals to connect with patients sooner than otherwise might have been the case, and without the time and expense involved in travelling to major cities or larger regional centres.
National Partnership Agreement on Rheumatic Fever Strategy—Continuation and Expansion
The Australian Government will provide funding of $18.8 million over four years from 2017–18 to the Rheumatic Fever Strategy. The strategy supports the prevention and management of acute rheumatic fever and rheumatic heart disease in Indigenous communities, including those in regional and remote areas, through:
- state-based register and control programs to improve detection, monitoring and management of acute rheumatic fever and rheumatic heart disease; and
- national coordination to develop national education and training resources, support jurisdictions and establish a data collection system.
Strengthening Aged Care—My Aged Care—Operations
The Australian Government will provide funding of $3.1 million in 2017–18 for ICT systems support to keep the My Aged Care platform operating for one year. My Aged Care supports over 1 million older people to access the $17 billion of aged care services funded by the Australian Government annually.
Strengthening Aged Care—Developing an Aged Care Workforce Strategy
The Australian Government will establish an aged care industry-led Taskforce to explore short, medium and longer term options to boost supply, address demand and improve productivity for the aged care workforce. It will also harness existing employment services to match local job seekers to local jobs and establish regional coordinators to support providers adjust to a rapidly expanding competitive market based on consumer choice and control for both the National Disability Insurance Scheme and the aged care sector.
Supporting Living Organ Donors—Continuation and Expansion
The Supporting Living Organ Donors Program will provide funding of $4.1 million over four years from 2017–18 to ensure that cost is not a barrier to living organ donors to donate.
The Supporting Living Organ Donors Program is a continuation and expansion of the Australian Government’s Supporting Leave for Living Organ Donors Program that will cease on 30 June 2017.
The Supporting Living Organ Donors Program will continue to make a financial contribution to employers to either replenish an employee's leave or reimburse an employer who has made a payment to their employee (who may have exhausted their leave) in place of income lost due to organ donation.
From 1 July 2017, the Supporting Living Organ Donors Program will be expanded to allow donors to claim reimbursement for some out-of-pocket expenses, enabling donors who are not employed to participate. As transplant units are based in major metropolitan hospitals, providing for some out-of-pocket expenses will particularly assist living donors from regional or rural Australia.
Preventative Health—Targeted Activities
The Healthy Heart Initiative will invest $15.0 million over four years from 2017–18 to implement the Prime Minister’s January 2017 Press Club announcement of a focus on preventive health. It will address the critical preventive health focus of cardio-vascular programs through partnerships with the Heart Foundation and General Practitioners:
- $10.0 million over four years for the PM's Walk for Life Challenge, designed to raise awareness of the benefits of physical activity and start a national conversation about being more physically active, delivered through both schools and universities as well as broader community networks; and
- $5.0 million over four years to develop education and training material to enhance the knowledge and skills of General Practitioners to more effectively manage and support overweight/obese patients.
Prioritising Mental Health—Research
The Mental Health Research measure will invest $15.0 million over two years from 2017–18 to support mental health research within Australia by providing one off funding that will contribute to infrastructure and research targeted at mental health.
BreastScreen Australia Program—Additional Support
This measure will provide $64.3 million over four years from 2017–18 to continue an expansion of the BreastScreen Australia program to actively invite women aged 70–74 years to participate in the program, through agreements with States and Territories which will be extended for a further four years from 2017–18 to 2020-21. The program includes a number of initiatives to encourage participation by women living in regional areas, including mobile BreastScreen units.
Cancer Screening—Victorian Cytology Service—Continuation
This measure will provide $41.6 million over four years from 2017–18 to continue services delivered under an agreement with the Victorian Government for its Cytology Service which provides high-quality cytology services to support cervical screening. As part of these services, the Victorian Cytology Service will also continue to assess cervical screens taken by nurses and Aboriginal Health Workers, which provides important flexibility to ensure equal participation in regional areas.
Improving Access to Medicines—Maintaining Remote Area Aboriginal Health Services Pharmaceutical Dispensing
From 1 January 2018, arrangements will be established to enable eligible pharmacists, providing Pharmaceutical Benefits Scheme medicines that are labelled for individual chronic disease patients who are clients of Remote Area Aboriginal Health Services, to be able to claim these as standard Pharmaceutical Benefits Scheme items and to receive the applicable remuneration.
Proposed Options for Communities Affected by Per- and Poly-fluoroalkyl Contamination
The Australian Government will provide $12.5 million over four years to establish a national research program into the human health effects of prolonged exposure to per and poly-fluoroalkyl (PFAS) contamination. This funding also includes the establishment and administration of an expert health panel, which will use its expertise to identify research priorities and gaps in the knowledge base.
Rural Health Workforce Support Program
The Rural Health Workforce Support Program consolidates the International Recruitment Strategy and Rural and Remote General Practice Programme. Under this program, the Australian Government funds the Rural Workforce Agencies (one in every State, and the Northern Territory) to support the rural health workforce in three priority areas:
- Health Workforce Access: to improve access and continuity of access to essential primary health care, particularly in priority areas identified by the Department of Health and through the Health Workforce Needs Assessment process involving a jurisdictional Health Workforce Planning Stakeholder Group.
- Improving Workforce Quality: to build local health workforce capability with a view to ensuring communities can access the right health professional at the right time; and ensuring health practitioners have the right skills and qualifications for their positions.
- Building a Sustainable Workforce: to grow the sustainability and supply of the health workforce with a view to strengthening the long-term access to appropriately qualified health professionals, with consideration of continuity and growing the sustainability of the health workforce.
Strengthening Mental Health Care in Australia
Central to the Australian Government's mental health reforms is a regional approach to service planning and integration, and better matching of services to individual needs. The Australian Government's response to the Review of Mental Health Programmes and Services takes a whole of system perspective, enabling Australian Government services to complement the role of States and Territories in mental health care.
In 2016–17, the Australian Government commenced implementing its mental health reform agenda, with an immediate focus on initiating the delivery of the expanded Primary Health Network role, child and youth integration, the Digital Mental Health Gateway and the new community-based approach to suicide prevention.
In 2017–18, work will continue on the phased implementation of the reforms and will be combined with the election commitments under the Strengthening Mental Health Care in Australia measure announced in the 2016–17 Mid-Year Economic and Fiscal Outlook. The focus will include expansion of the headspace network, suicide prevention trials across 12 sites in regional Australia, and build on the investment in digital services, including through enhancement and promotion of the Digital Mental Health Gateway. The Digital Gateway will bring together and streamline access to existing evidence–based information, advice and digital mental health treatment and will connect people to the services they need through a centralised telephone and web portal, including for people in regional and rural areas.
Headspace—Strengthening Mental Health Care in Australia
The Strengthening Mental Health Care in Australia measure provides an additional $28.9 million over three years from 2017–18 for an additional ten headspace centres across Australia by 2019. These additional headspace services will assist to increase access for young people aged 12-25 years living in regional and remote areas, increasing headspace services from 100 to 110 across Australia.
Funding will be provided to Primary Health Networks as the current commissioners of headspace services to promote integration and regional approaches in the delivery of headspace services for young people.
Suicide Prevention Trial Sites—Strengthening Mental Health Care in Australia
The Strengthening Mental Health Care in Australia measure provides an additional $34.0 million over three years from 2016–17 to fund the implementation and evaluation of 12 suicide prevention trial sites in identified priority areas. The trials will be led by Primary Health Networks and will bring together the best evidence-based strategies and models to better target people at risk of suicide and to ensure a more integrated, regionally-based approach to suicide prevention.
The national suicide prevention trial will also improve our understanding of what strategies are most effective in preventing suicide at a local level and for at-risk populations. Findings from the trial will be made available to all Primary Health Networks to guide future suicide prevention activities, and will inform Australian Government policy development going forward.
The Australian Government is also providing $11.1 million over three years from 2017–18 as part of the measures Investing in Mental Health—suicide prevention support programs, to help prevent suicide at high risk locations.
New Investment in Digital Technologies for Mental Health—Strengthening Mental Health Care in Australia
The Strengthening Mental Health Care in Australia measure provides an additional $32.4 million over three years from 2016–17 to support a new investment in digital technologies which will support regional access to services. Funding will enable Project Synergy, which has been trialled as an online system of care, to continue as a research and capacity building project. Synergy will trial customised IT-based solutions, and develop the next generation of digital mental health services and apps. Funding will also enable Lifeline Australia to trial a new text service for crisis support and suicide prevention.
Youth Mental Health—Early Psychosis Youth Services Program—Strengthening Mental Health Care in Australia
The Australian Government will provide $115.6 million over three years from 2016–17 to continue efforts to reduce the impact of severe mental illness on young Australians aged 12-25 and their families by restoring funding to six Early Psychosis Youth Services in South East Melbourne, Western Sydney, Gold Coast, North Perth, Darwin and Adelaide. During this time, the program will be independently evaluated. Orygen, the National Centre of Excellence in Youth Mental Health, will provide guidance, support and expert advice to Primary Health Networks commissioning early intervention services for young people with, or at risk of, severe mental illness, including early psychosis.
Rural Health Commissioner and Pathway for Rural Professionals—Establishment
The Australian Government is providing $4.4 million over four years from 2016–17 to establish a National Rural Health Commissioner to provide advice on opportunities to reform rural health services, including the development of a National Rural Generalist Pathway for the training of rural doctors.
Elimination of Trachoma in Indigenous Communities—Extension
The Australian Government is providing funding of $20.8 million to States and Territories for the elimination of trachoma in Indigenous communities for four years from 2017–18 to 2020-21 to reduce the incidence of trachoma. Trachoma continues to be a significant problem in hotspots in remote Indigenous communities in the Northern Territory, South Australia and Western Australia. Continued investment supports screening and treatment of children and provides an increased focus on health hygiene and efforts to improve environmental conditions.
Medicare Benefits Schedule—Listing of Photography with Non-Mydriatic Retinal Cameras
This measure will provide $33.8 million over four years from 2016–17 to list new items onto the Medicare Benefits Schedule to cover the testing of Diabetic Retinopathy with a non–mydriatic retinal camera. This service will benefit approximately 370,000 people with diabetes, of which approximately a quarter are Indigenous. The introduction of this service will improve the monitoring of diabetic eye disease especially in rural and remote regions and amongst Indigenous populations. Complications from diabetes, including blindness, are expensive to the health care system and are easily prevented if diagnosed early through this type of service.
Medicare Benefits Schedule—Support for Rural and Remote Registrars
This measure, which is providing $8.0 million over four years from 1 November 2016, enables general practice registrars training on the Australian College of Rural and Remote Medicine Independent Pathway to claim Medicare benefits (at the A1 level 1) for the services they provide whilst training. Australian College of Rural and Remote Medicine is one of two colleges accredited by the Australian Medical Council for setting professional medical standards for training, assessment, certification and continuing professional development in the specialty of general practice. Australian College of Rural and Remote Medicine Fellows receive full vocational recognition for A1 Medicare rebates and may practise unsupervised anywhere in Australia (A1 is a consultation type where there is personal attendance by a practitioner. The personal attendance of the medical practitioner upon the patient is necessary before a consultation may be regarded as a professional attendance).
This measure will have a positive impact on regional Australia, as registrars training on the Independent Pathway are likely to be providing services in regional and rural areas during their training. The program also leads to Fellowship of the College; the Australian College of Rural and Remote Medicine advises that most of their Fellows choose to practise in rural and remote communities so that they can fully utilise the scope of clinical skills and knowledge they have gained through the Fellowship program.
Management of Per- and Poly-Fluorinated Alkyl Substances at Defence Bases
The Australian Government will provide $14.0 million over four years from 2016–17 to undertake human health related initiatives to support communities in Williamtown, New South Wales, and Oakey, Queensland affected by Per- and Poly-Fluorinated Alkyl Substance (PFAS) contamination. These initiatives include:
- an epidemiological study that will look at potential causes and patterns of health effects in the Williamtown and Oakey communities;
- a Voluntary Blood Testing Program for those who have lived or worked in the Williamtown and Oakey investigation areas;
- additional dedicated mental health and counselling services in affected communities of Williamtown and Oakey; and
- a communication strategy focusing on human-health related aspects of PFAS contamination.
Rural General Practice Grants Programme
This measure will provide $13.1 million over two years from 2016–17 to support the whole-of-government priority of strategic investments in health infrastructure in rural, regional and remote Australia, and supports general practice to deliver increased health services and increased opportunities to provide teaching and training for health practitioners. The Rural General Practice Grants Programme will provide grants of up to $300,000 to general practices and is intended to deliver improved health services through additional infrastructure, increased levels of teaching and training for health practitioners, and more opportunities to deliver ‘healthy living’ education to local communities.
Healthier Medicare—Trial of Health Care Homes
In 2017–18 the Australian Government will commence service delivery of the Health Care Homes trial in 200 general practices and Aboriginal Community Controlled Health Services across Australia, including rural and remote regions. A total of $21.3 million has been allocated to support the measure from 2015–16 over four years to better support patients with chronic and complex illnesses, reducing the risk of hospitalisation. This is in addition to $93.3 million in re-directed funding from the Medicare Benefits Schedule for two years from 2017–18. Participating practices are located across ten Primary Health Network regions, including rural and remote areas.
With many aspects of the Health Care Homes model already in place in regional and remote general practices and Aboriginal Community Controlled Health Services across the country, this initiative will support them to formalise their approach and build on local innovative solutions.
An evaluation of the impacts of the trial will be conducted and a report considered in 2018.
Rural Locum Assistance Programme
The Rural Locum Assistance Programme supports the health workforce in rural locations by enabling eligible allied health professionals, obstetricians and anaesthetists to access continuing professional development or to take leave for recreation purposes. The Programme also provides an opportunity for urban General Practitioners to experience regional and rural practice by enabling them to undertake emergency medicine training in return for a commitment to undertake a locum placement in regional and rural Australia.
Drug and Alcohol Programme
The Drug and Alcohol Programme provides funding of $685.0 million over four years from 2016–17 to 2019–20 and aims to reduce the impact of alcohol and other drugs on individuals, families and communities across Australia through funding a range of activities that will improve access to quality alcohol and other drug treatment services and improve the evidence base behind alcohol and other drug treatment approaches and related issues.
These activities include:
- funding non–government organisations to operate a range of drug and alcohol treatment services;
- supporting alcohol and other drug treatment services across Australia to provide better outcomes for clients through a range of capacity building activities;
- supporting early intervention and prevention activities relating to alcohol and other drug misuse and promoting evidence–based information about alcohol and other drugs through education;
- supporting the development of evidence–based alcohol and other drug treatment service delivery and national policy through research and data collection; and
- supporting the development of evidence–based alcohol and other drug treatment service delivery commissioned through Primary Health Networks across Australia and national policy through structured advisory mechanisms.
These activities are all available in regional and rural areas.
The Australian Government’s Response to the National Ice Taskforce Final Report
In response to the findings of the National Ice Taskforce, the Australian Government is providing an extra $298.2 million over four years from 2016–17 towards a number of measures aimed at reducing the impacts associated with ice and other drugs to individuals, families and communities. This funding will strengthen responses across education, prevention, treatment, support and community engagement.
A number of these measures focus on empowering local communities, including those within regional areas, with the establishment of a new online portal of information for parents, teachers and community organisations, the implementation of Local Drug Action Teams to bring together community groups to reduce drug related harms, with a focus on ice, and support for community sporting clubs to deliver prevention messages about ice with a focus on rural, regional, remote and Indigenous communities.
This additional investment also includes $241.5 million for Primary Health Networks to commission more alcohol and other drug treatment services, with a focus on ice, including $78.6 million for Indigenous–specific services, based on what is necessary and appropriate to the needs of their local communities. Primary Health Networks are well–placed to fund local services according to agreed evidence and based on population planning, to ensure the coordination of services across the continuum of care.
National Tobacco Campaign
In 2017–18, the Government will allocate $6.9 million to continue to support the National Tobacco Campaign. The National Tobacco Campaign forms part of the Australian Government’s comprehensive range of initiatives designed to contribute to a reduction in the prevalence of adult daily smoking rates.
Macular Disease Foundation
The Macular Disease Foundation provides education to general practitioners on macular disease and awareness sessions to the general public on macular disease and diabetic retinopathy across urban, regional and rural locations.
Macular Disease Foundation is funded by the Australian Government under the Health Peak and Advisory Bodies Programme to:
- share information with the health sector and community in relation to the eye diseases macular degeneration and diabetic retinopathy; and
- provide training and education to general practitioners in relation to macular degeneration.
Funding of $1.4 million for the period 2015–16 to 2018–19 is provided to the Macular Disease Foundation to undertake this work across urban, regional and rural locations.
Closing the Gap Pharmaceutical Benefits Scheme Co-Payment Measure
The Closing the Gap Pharmaceutical Benefits Scheme Co–payment Measure improves access to Pharmaceutical Benefits Scheme medicines for eligible Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease in urban and rural settings. This measure lowers or removes the patient co–payment for Pharmaceutical Benefits Scheme medicines. More than 100,000 Aboriginal and Torres Strait Islander people benefit from the measure each month, many in regional and rural areas.
Section 100 Remote Area Aboriginal Health Service Programme
The Remote Area Aboriginal Health Service Programme is administered under section 100 of the National Health Act 1953 and allows for the supply of Pharmaceutical Benefits Scheme medicines to clients of eligible remote area Aboriginal Health Services at the time of medical consultation, without the need for a normal prescription form, and without charge.
The Remote Area Aboriginal Health Service Programme aims to address geographic, financial and cultural barriers experienced by Aboriginal and Torres Strait Islander peoples living in remote areas of Australia in accessing essential medicines through the Pharmaceutical Benefits Scheme.
Section 100 Remote Area Pharmacy Support Allowance
The Section 100 Remote Area Aboriginal Health Service program provides an annual financial allowance that supports visits by pharmacists to provide targeted quality use of medicines and medication management support services to remote area Aboriginal Health Services which participate in the program. The visits assist in improving health outcomes for clients of remote area Aboriginal Health Services by supporting quality use of medicines at those services.
Remote Area Pharmaceutical Dispensing—Additional Remuneration
From 1 January 2017 to 31 December 2017, surplus funding from the Section 100 Remote Area Pharmacy Support Allowance will be redirected to provide additional remuneration to eligible pharmacists providing Pharmaceutical Benefit Scheme medicines that are labelled for individual chronic disease patients who are clients of Remote Area Aboriginal Health Services (rather than just in bulk). This is an interim measure pending establishment of longer term arrangement and is expected to cost approximately $3.3 million.
Medication Management Review Programmes
These Medication Management Review Programmes aim to improve the quality use of medicine and reduce the risk of medication misadventure, including in rural and remote areas. Services include Home Medicines Review and the Residential Medication Management Review, which are conducted by an accredited pharmacist in the consumer’s home or in an Australian Government funded aged care facility respectively. The Home Medicines Review Programme also includes a Rural Loading Allowance to provide support to pharmacists to enable patients in rural and remote locations to access this Programme. Other services include the MedsCheck and Diabetes MedsCheck, which aim to improve the use of medicine by providing an in–pharmacy review of a patient’s medicines by a registered pharmacist.
Pharmacy Practice Incentives Programme
The Pharmacy Practice Incentives Programme provides incentives to community pharmacies, including those in rural and regional areas, which deliver services to consumers to a defined quality standard, with the goal of improving patient health outcomes.
Aboriginal and Torres Strait Islander Peoples Pharmacy Workforce Programme
The Aboriginal and Torres Strait Islander Peoples Pharmacy Workforce Programme supports Aboriginal and Torres Strait Islander participation in the pharmacy workforce, which in turn provides improved culturally appropriate pharmacy services to better meet the needs of Indigenous communities and patients. It is preferred that applicants for the Aboriginal and Torres Strait Islander Pharmacy Scholarship Scheme are from rural or remote localities, although, this is not mandatory. Sixteen Aboriginal and Torres Strait Islander Pharmacy Assistant traineeships are offered annually, with up to $10,000 available to a community pharmacy that employs and supports a trainee through the course of their studies (up to two years). Three undergraduate or post graduate Aboriginal and Torres Strait Islander Pharmacy scholarships of up to $15,000 per annum are offered annually. The normal course length is four years (students can access up to $60,000 over the period of their degree).
Rural Pharmacy Maintenance Allowance
This Rural Pharmacy Maintenance Allowance is paid monthly to eligible rural or remote Section 90 pharmacies, in recognition of the additional burden of maintaining a pharmacy in rural and remote areas of Australia.
Rural Pharmacy Workforce Programme
This Rural Pharmacy Workforce Programme aims to maintain and improve access to quality community pharmacy services in rural and remote communities and strengthen and support the rural and remote pharmacy workforce in Australia. It comprises various initiatives designed to recruit, train and retain pharmacists for rural and remote areas, including undergraduate scholarships, intern support, professional development support and an emergency locum scheme. There are 30 Rural Pharmacy Scholarships offered annually of up to $10,000 per annum. The normal course length is four years (students can access up to $40,000 over the period of their degree).
Streamlining Health Workforce Scholarships
This measure is delivering $72.5 million in savings over four years from 2015–16 and provides greater flexibility and consistency in targeting scholarships to areas of need by streamlining a number of existing scholarship programs into one—the Health Workforce Scholarship Programme. Additionally, a rural return of service obligation will be associated with some scholarship types to provide a greater return on the investment. Obligations under the scholarships ensure exposure to practices in rural settings, and to the lifestyle and types of work available, to encourage these healthcare professionals to continue to work in rural areas.
Better Targeted Rural Financial Incentives for Doctors
In 2015, the Australian Government reprioritised existing financial incentives for doctors to work in rural areas by introducing a new geographical classification system, the Modified Monash Model, to more effectively direct incentives to areas that experience greater difficulty in attracting and retaining a general practice workforce. Through the measure several activities (such as the More Doctors for Outer Metropolitan Areas Relocation Incentive Grant and the Higher Education Contribution Reimbursement Scheme) ceased, with funding redirected to the redesigned General Practice Rural Incentives Program. The redesigned General Practice Rural Incentives Program provides $457.8 million over four years from 2016–17.
Full implementation of National Bowel Cancer Screening Programme
The National Bowel Cancer Screening Programme invites eligible people from across Australia to undertake bowel screening tests in the privacy of their home. The program currently provides screening to Australians aged 50, 54, 55, 58, 60, 64, 68, 70, 72 and 74 years, and from 2018 those aged 62 and 66 years will be added.
Participation in screening has the potential to significantly reduce the number of deaths from bowel cancer. In the 2014–15 Budget, the Australian Government announced a further $95.9 million over four years to accelerate the implementation of biennial screening for all Australians aged 50 to 74 years by 2019–20.
McGrath Foundation Breast Care Nurses—Continued Funding
McGrath Foundation Breast Care Nurses are specially trained registered nurses who provide information, care, and practical and emotional support to women diagnosed with breast cancer, their families and carers. There are currently 57 Australian Government funded McGrath Foundation Breast Care Nurses in place around Australia, with 80 per cent required to be located in regional and remote areas.
On 4 November 2016, the Australian Government announced a further four years of funding of $20.5 million for the McGrath Foundation Breast Care Nurses from 2017–18. It is anticipated that in this four year period the McGrath Foundation Breast Care Nurses will support up to 15,000 women and their families.
World leading Cancer Care package—Additional Funding for Prostate Cancer Nurses
The Specialist Prostate Cancer Nurse Initiative currently supports the placement of 14 full time equivalent prostate cancer nurses in 15 locations across Australia, assisting up to 4,000 men and their families from 2013-14 to 2016–17.
This initiative will continue for three years from 2017–18 to 2019–20 to support the needs of men and their families living in metropolitan and regional Australia who have been affected by prostate cancer, by providing information, care and support to men with prostate cancer and their families. The Australian Government is providing funding of $5.9 million from 2017–18 over three years to the Prostate Cancer Foundation Australia to deliver this initiative. It is anticipated that approximately 4,000 men and their families will be supported by this measure from 2017–18.
Block Funding for Small Rural and Regional Hospitals
To ensure rural and regional communities continue to have access to vital public hospital services, the Australian Government provides States and Territories with a dedicated block funding contribution for small rural and regional hospitals. The Australian Government will provide approximately $4.0 billion over four years from 2017–18 in block funding to States and Territories to support services provided by small rural and regional hospitals.
Emergency Medicine Education and Training Programme
The Australian Government will provide $112.0 million over four years from 2016–17 to the Emergency Medicine Education and Training program. The program, with 33 participating hub hospitals, provides training and educational support to non–specialist doctors and other staff working in emergency departments in regional and rural areas.
National Critical Care and Trauma Response Centre
The Australian Government provides funds to the Northern Territory Government to support the operation of the National Critical Care and Trauma Response Centre based in Darwin. The centre is equipped and ready to assist in response to large scale emergencies and disasters in Australia and the region. Beneficiaries of the program include regional Australians, particularly during times of emergency when an event has the potential to overwhelm or exhaust a State’s or Territory’s health resources. The location of the centre also supports a positive regional impact by attracting health expertise and infrastructure to the Northern Territory. Funding of $63.5 million is being provided from 2015–16 to 2018–19 to support its continued operation.
Developing Northern Australia—Positioning the North as a Leader in Tropical Health
The Northern Australia Tropical Disease Collaborative Research Programme is providing $6.4 million over four years from 2015–16 to the Menzies School of Health Research to undertake innovative high quality research into the prevention, diagnosis, and treatment of tropical diseases in Northern Australia.
The Northern Australia Tropical Disease Collaborative Research Programme will strengthen partnerships with research institutions across Australia, by undertaking a research agenda that will help close the gap in Indigenous health disadvantage, protect Northern Australia from emerging infectious threats and engage regional neighbours.
A Northern Australian network will be established that will incorporate Indigenous engagement, mentoring and knowledge translation, and facilitate collaboration with southern partners.
This investment is part of a broader Australian Government strategy to build Australia’s primary research capacity and support the development of Northern Australia as outlined in the Our North, Our Future: White Paper on Developing Northern Australia.
Centres for Innovation in Regional Health
The National Health and Medical Research Council will recognise and promote leading collaborations between health care organisations, academia and research institutions, through the designation and promotion of Centres for Innovation in Regional Health.
The Centres for Innovation in Regional Health will encourage leadership in health research and translation of direct relevance and benefit to regional and remote areas of Australia. The initiative provides National Health and Medical Research Council recognition (not funding) for Centres for Innovation in Regional Health that are exemplars of collaboration in health and medical research, research translation and research-infused education, training, and health care in a regional and/or remote setting. In 2017–18 these collaborations will increase the translation of research into better clinical practices.
National Partnership Agreement on Specified Projects—Addressing Blood Borne Viruses and Sexually Transmissible Infections
The Blood Borne Viruses and Sexually Transmissible Infections Prevention Program aims to address rising rates of blood borne viruses and sexually transmissible infections (STI). One of the elements of the Blood Borne Viruses and Sexually Transmissible Infections Prevention Program is the delivery of STI reduction programs targeted towards Aboriginal and Torres Strait Islander priority populations in regional and remote settings. This element of the Blood Borne Viruses and Sexually Transmissible Infections Prevention Program aims to increase STI testing and treatment, and raise awareness about STI prevention. Areas of focus include models of care that reach high prevalence communities and young people. This agreement provides funding of $4.5 million over four years from 2016–17.
National Partnership on Management of Torres Strait—Papua New Guinea Cross Border Health Issues
The Australian Government provides funding for the Project Agreement for the management of Torres Strait/Papua New Guinea cross border health issues. Under this agreement, the Australian Government contributes funding to the Queensland Department of Health for the treatment of Papua New Guinea nationals who travel through the Torres Strait Treaty Zone and access health facilities in the Torres Strait and elsewhere within the Queensland Health hospital network. This Agreement provides funding of $19.0 million over four years from 2016–17.
National Partnership on the Torres Strait Health Protection Strategy—Mosquito Control
The Australian Government provides funding for the Project Agreement for the Torres Strait Health Protection Strategy—mosquito control and cross border liaison in the Torres Strait Protected Zone. This agreement supports surveillance, control and elimination, if possible, of Aedes albopictus mosquitoes in the Torres Strait, and to prevent the spread and establishment of Aedes albopictus from the Torres Strait to mainland Australia. The agreement also supports the employment of a Torres Strait Communications Officer to coordinate improved data sharing with Papua New Guinea on communicable diseases and health issues arising from cross border movements in the Torres Strait Protected Zone. The National Partnership Agreement on Specified Projects—Addressing Blood Borne Viruses and Sexually Transmissable Infections provides funding of $4.5 million over four years from 2016–17.
National Partnership on the Torres Strait Health Protection Strategy—Saibai Island Health Clinic
The Australian Government provides funding for the National Partnership on the Torres Strait Health Protection Strategy—Saibai Island health clinic to provide additional staff for the treatment of communicable diseases at the health care clinic on Saibai Island, and for development and implementation of a culturally appropriate sexual health education campaign for people in the Torres Strait. This program targets young people to make them aware of Blood Borne Viruses and Sexually Transmissible Infections and to encourage them to access clinical services and health checks. Work will continue to develop short and long-term options to address the lack of health staff accommodation on Saibai Island. The success of this program will improve the health outcomes of Saibai Island inhabitants under the objectives of the partnership arrangement between the Australian Government and Queensland.
Practice Incentives Program
The Australian Government will provide $1.5 billion over four years from 2017–18 to the Practice Incentives Program (PIP) to support general practice activities that encourage continuing improvement and quality care, enhance capacity and improve access and health outcomes for patients. There are currently 11 incentives under the PIP that focus on eHealth, teaching, Indigenous health, asthma, cervical screening, diabetes, quality prescribing, general practitioner aged care access, procedural services, after-hours access and rural health. A rural loading is paid in recognition of the difficulties of providing care, often with little professional support, in rural and remote areas and to provide access to services which are available through other means to patients in metropolitan and other urban areas.
The rural loading ranges from 15 to 50 per cent (depending on the remoteness of the practice location) and is applied to the incentive payments of practices in rural and remote areas.
In the 2016–17 Budget, the Australian Government announced it will work towards introducing changes to the PIP through the measure: Quality Improvement in General Practice—Simplification of the PIP. This measure will establish a new Quality Improvement Incentive to be delivered through the PIP. The changes will consolidate some existing PIP payments into one quality improvement incentive, available to all PIP eligible practices. This incentive will streamline and simplify current PIP payments to help general practice achieve high quality health care and improved patient outcomes.
Primary Health Networks
Primary Health Networks (PHNs) are a national network of 31 independent, regionally based, primary healthcare commissioning organisations, established to improve efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes and to improve the coordination of care. Ten PHN regions have populations where the remoteness area (RA) is classified at five, the most rural area. Twenty Two PHNs have populations with rural areas classified between RA3 and RA5. The Australian Government has currently provided approximately $2.6 billion over three years from 2015–16.
- PHN functions include planning, integrating and coordinating primary health care services, and the commissioning of services, across their regions.
- PHNs receive funding which includes loading for rurality, Indigenous population and low population density.
- The commissioning model provides opportunities to identify and implement iterative and innovative solutions to local and remote problems, and work within the unique circumstances of different communities.
- PHN Boards are supported by GP-led Clinical Councils and by Community Advisory Committees. In rural areas some PHNs have established multiple branches of Clinical Councils and Community Advisory Committees to appropriately reflect the diversity of their regions.
- PHNs are aligning planning and designing activities with other funded stakeholders in their regions (for example, Rural Workforce Agency and Royal Flying Doctor services).
After Hours Primary Health Care Arrangements
Amended after-hours primary health care funding arrangements commenced on 1 July 2015 to ensure access for all Australians to primary health care services during the after–hours period. This included:
- a Practice Incentives Programme after hours incentive payment to eligible accredited general practices registered for the Practice Incentives Programme;
- funding to Primary Health Networks to support locally tailored after hours services, including support for ‘at risk’ populations such as those in rural and remote areas ($287.9 million over four years from 2015–16); and
- an after–hours general practice advice and support line for all Australians who do not have access to face to face general practice services in the after-hours period ($47.4 million over four years from 2015–16).
Northern Territory Remote Aboriginal investment—Health Component
The health component of the National Partnership on Northern Territory Remote Aboriginal Investment provides $26.4 million from 2017–18 to 2020-21 to reduce the incidence and severity of ear and oral disease in Aboriginal children in the Northern Territory, with a focus on remote areas. The Northern Territory Remote Aboriginal Investment commenced in 2015–16, continuing the ten year commitment to this activity which commenced in 2012-13 under the National Partnership on Stronger Futures in the Northern Territory.
Indigenous Australians’ Health Programme
The Australian Government will provide $3.6 billion over four years from 2017–18 to the Indigenous Australians’ Health Programme. Through the program, Aboriginal and Torres Strait Islander people have access to effective health care services in areas of need (including medical outreach to rural and remote areas), targeted initiatives to improve prevention and primary health care management of chronic diseases, and maternal and child health activities. In 2017–18, continued implementation of the Aboriginal and Torres Strait Islander Health Plan will ensure that regional investments are made in priority areas in consultation with the Indigenous health sector.
Quality Assurance for Aboriginal and Torres Strait Islander Medical Services Programme
The Australian Government is providing $5.5 million over four years from 2017–18 to the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services Programme. The program supports the better management of diabetes in Aboriginal and Torres Strait Islander communities by enabling participating health services to provide culturally appropriate and clinically effective point-of-care diabetes related pathology testing. The program also includes training, technical support, quality assurance and a consultation program for community leaders to support program management on site.
As at 31 December 2016, a total of 200 sites participated in the program, with the majority of these located in rural and remote areas.
Support for Outreach Health Services
The Rural Health Outreach Fund improves access to health services for people living in rural, regional and remote Australia by supporting a range of outreach health activities. Four health priorities are specifically addressed: maternity and paediatric health, eye health, mental health and support for chronic disease management.
Services are provided directly to communities by specialists, general practitioners, nurses and allied health professionals. The Rural Health Outreach Fund commenced in 2013-14 following the consolidation of five previous rural outreach programs and provides $111.0 million over four years from 2016–17.
The Royal Flying Doctor Service is funded by the Australian Government to deliver primary aero–medical evacuations, primary health clinics, remote consultations and medical chests containing pharmaceutical and medical supplies to remote locations. The Royal Flying Doctor Service has been funded by the Australian Government since the 1930s. The Government committed to extend funding arrangements for a further three years to 2020 as part of 2016 election commitments.
Royal Flying Doctor Dental Services—Continued Delivery
The Australian Government announced it would continue to support the Royal Flying Doctor Service by providing $11.0 million over two years from 2016–17 to enable the Royal Flying Doctor Service to expand its existing dental outreach service.
Australian Government Hearing Services Programme
The Australian Government is expected to provide around $2.3 billion over four years from 2017–18 to the Hearing Services Programme to provide eligible people with access to a range of high quality hearing services and devices. Eligible clients in regional communities can access these services through two mechanisms:
- the Voucher program uses a national network of approximately 270 contracted service providers, including Australian Hearing, with 119 service providers located at 1,299 regional sites across Australia; and
- Community Service Obligations—Australian Hearing is funded to deliver specialist services from permanent, visiting and remote sites across Australia, to children and young adults up to the age of 26, and to other high risk groups such as eligible Indigenous Australians. Australian Hearing works closely with local services to deliver its Indigenous outreach program providing hearing services to more than 130 of Australia’s most remote communities. In 2015–16, (the most recent full year data), 8,256 outreach services were delivered at 235 sites across Australia.
Visiting Optometrists Scheme
The Visiting Optometrists Scheme provides outreach optometry services for people in rural and remote areas, who would not otherwise have access to eye health services. Funding of $20.7 million will be provided over three years from 2017–18.
Rebuilding General Practice Education and Training to Deliver More General Practices
The Australian Government will provide $981.9 million over four years from 2016–17 to the Australian General Practice Training Program to support training for 300 extra general practitioners a year by increasing commencing training places from 1,200 to 1,500 from 2015. The new training positions are based in rural areas as much as possible, and at least 50 per cent of the new trainees are required to train on the rural pathway. As registrars deliver services to the community while training, the increase in training places is providing more services to communities in rural and regional areas.
Improving Maternity Services in Australia—General Practitioner Procedural Training Support Programme
The General Practitioner Procedural Training Support Programme aims to improve access to maternity services for women living in rural and remote communities by supporting general practitioners to attain procedural skills in obstetrics or in anaesthetics.
The General Practitioner Procedural Training Support Programme targets existing general practitioners in rural and remote areas.
Funding to CRANAplus
Funding to CRANAplus supports the remote and isolated health workforce through programs such as the Bush Support Services (including the Bush Support Line), which provides access to trained counsellors for remote health workers and their families. This initiative also encourages health service providers in remote areas of Australia to network and engage in professional development.
Remote Vocational Training Scheme
The Australian Government will provide $10.5 million over two years from 2016–17 to the Remote Vocational Training Scheme. The scheme supports doctors practicing in some of Australia’s most remote locations to undertake vocational general practice training. It delivers structured distance education and supervision to doctors completing general practice vocational training, while they continue to provide general practice medical services to remote and/or isolated communities. The training includes weekly tutorials through video and teleconferences, twice yearly education workshops, remote supervision and individualised training advice.
The Remote Vocational Training Scheme supports 22 new training places each year. Since 2015, an annual cohort of ten registrars has commenced training in Aboriginal Community Controlled Health Services under the Remote Vocational Training Scheme.
Rural Health Multidisciplinary Training Programme
The Australian Government will provide $775.0 million over four years from 2016–17 to the Rural Health and Multidisciplinary Training Programme. The program is designed to encourage the recruitment and retention of rural and remote health professionals by:
- providing effective rural training experiences for health students;
- developing an evidence base for the efficacy of rural training strategies in delivering rural health workforce outcomes;
- supporting rural health professionals to improve Aboriginal and Torres Strait Islander health;
- increasing the number of rural origin health and medical students; and
- maximising the investment of program funds in rural, regional and remote areas for the maintenance of well supported academic networks to enhance the delivery of training to students to support the provision of medical services to communities.
The Rural Health and Multidisciplinary Training Programme supports a network of 18 rural clinical schools, 12 University Departments of Rural Health and six dental schools that support extended rural placements. The Rural Health and Multidisciplinary Training Programme also incorporates funding support for Northern Territory Medical Programme and the Indigenous Transition Pathways to Medicine Programme. The Regional Training Hubs component of the Integrated Rural Training Pipeline for Medicine will be delivered through the Rural Health and Multidisciplinary Training Programme.
Funding is also provided for the National Rural Health Student Network, a national, rural health focused, multidisciplinary student network representing more than 10,000 medical, nursing, and allied health students and supporting 28 university rural health clubs around Australia.
Practice Nurse Incentives Programme
The Practice Nurse Incentives Programme provides up to $125,000 per year to eligible general practices to expand the role of their practice nurses, to deliver services and support to best meet the needs of their patients, while allowing General Practitioners to focus on more complex care. Practices may also be eligible for a rural and remote loading in Australian Standard Geographic Classification—Remote Areas (ASGC-RA) 2–5 locations. The Practice Nurse Incentives Programme was introduced in January 2012, replacing the previous incentive arrangements.
Bonded Medical Places Scheme
The Bonded Medical Places Scheme provides a medical place at university in exchange for which participants agree to work in a District of Workforce Shortage or Modified Monash Model category 4-7 for a period of time equal to the length of their medical degree (less any credit obtained through scaling) once they become fully qualified fellows. Funding is provided by the Department of Education and Training through the Commonwealth Grants Scheme to universities. Up to 98 per cent of the 7,241 participants in the Bonded Medical Places Scheme are still to reach the stage at which they will be expected to commence their return of service obligation. Return of service commencements are expected to rise significantly over the next few years, approaching 700 per year by 2022.
Medical Rural Bonded Scholarships Scheme
The Medical Rural Bonded Scholarships Scheme provided up to 100 Commonwealth–supported medical school places with an attached scholarship each year ($27,131 in 2017, indexed annually) to commencing Australian medical students. Recipients signed a contract requiring them to work as a doctor in a rural or remote area for six years once they have attained fellowship (less any credit obtained through scaling incentives). The Scheme was closed to new entrants after the 2015 academic year but continuing participants will be funded $19.1 million from 2016–17 to 2020-21. The one hundred bonded places relinquished by the Scheme’s closure were transferred to the Bonded Medical Places Scheme and continue to be bonded. Up to 83 per cent of the 1,405 participants in the Scheme are still to reach the stage at which they will be expected to commence their return of service obligation. Return of service commencements are expected to rise significantly over the next few years, approaching 140 per year by 2019. The scheme was first implemented in 2001, and is now closed to new entrants.
John Flynn Placement Programme
The Australian Government will provide $15.2 million over four years from 2016–17 to the John Flynn Placement Programme. The program is designed to enable medical students to form a long-term relationship with a community and to gain a better understanding of rural or remote medical practice and non-metropolitan health services. The program focuses on forging a link between medical students and regional, rural and remote communities.
Medicare—Continued Higher Rebate for Other Medical Practitioners in Rural Areas
The Rural Other Medical Practitioners Programme recognises the value of services provided by non–vocationally registered medical practitioners in rural and remote areas, and provides higher Medicare benefits for their patients. The Rural Other Medical Practitioners Programme also provides an incentive to encourage non–vocationally registered medical practitioners (both Australian and overseas trained) to provide general practice services in eligible rural and remote locations. Funding for the Rural Other Medical Practitioners program is through the Medicare Special Appropriation Bill, but has an annual spend of $145.0 million on average.
Strengthening Medicare—Rural Procedural Grants Programme
The Australian Government will provide $73.3 million over four years from 2016–17 to the Rural Procedural Grants program. The program enables procedural general practitioners in rural and remote areas to access grants to attend training and up–skilling in emergency and procedural medicine.
Scaling Incentive for Overseas Trained Doctors
The scaling incentive is a non–cash incentive offering overseas trained doctors and foreign graduates, of an accredited medical school, opportunities to reduce the ten year moratorium restriction period for access to the Medicare system. Time reductions are significantly greater for doctors who choose to work in more remote areas. The effect of scaling is to ensure that benefits will be significantly greater for doctors choosing to live and work in more remote areas of Australia. Moratorium restriction periods for access to the Medicare system by area are:
- Major cities—10 years;
- Inner Regional—9 years;
- Outer Regional—7 years;
- Remote—6 years; and
- Very Remote—5 years.
National Health and Hospitals Network—Workforce Training Specialist Doctors
The Australian Government will provide $616.8 million over four years from 2016–17 to the Specialist Training Programme. The program, which commenced in 2010, increases the capacity of the private and community health care sector to provide high quality training opportunities for trainee medical specialists. In 2015 and 2016, 900 training full time equivalent places were funded, this will increase to 950 places in 2017 and 1,000 places in 2018, following the announcement of funding for 100 new dedicated rural training places in December 2015. Around 45 per cent of current training places include a rural component.
Aged Care Provider Funding—Addressing Growth in Residential Aged Care
To address any impacts from the changes to the Aged Care Funding Instrument, the Australian Government announced on 6 December 2016 that eligible rural, remote and homeless service providers eligible under the 2017 scheme will receive an increase to the Viability Supplement. From 1 July 2017, the 2017 scheme of the Viability Supplement will be increased by $19.3 million over four years, through a flat rate increase of an additional $2.12 per resident per day.
Aged Care Provider Funding—Improving the Targeting of the Viability Supplement for Regional Aged Care Facilities
The Australian Government is providing an extra $102.3 million over four years from 2016–17 to increase and better target the viability supplement under the Modified Monash Model. Changes to residential care, home care and flexible care came into effect on 1 January 2017. Approximately 250 mainstream services benefitted from the new arrangements.
The majority of these services are small services in or near outer regional towns, for example, Holbrook (New South Wales), Childers (Queensland), and Rushworth (Victoria). Around 3,000 out of 59,300 home care packages previously attracted viability supplement funding. Around 7,000 older Australians on these packages benefitted from higher funding. Around 100 multi-purpose services attracted higher rates of viability supplement funding under the new arrangements. Five National Aboriginal Torres Strait Islander Flexible Aged Care Programme providers also benefitted from higher funding.
Residential Aged Care Viability Supplement
The Residential Aged Care Viability Supplement is paid to eligible home care providers operating in rural and remote areas. This supplement provides support for the higher operating costs (such as wages, fuel and training) associated with providing care in rural and regional locations.
Home Care Viability Supplement
The Home Care Viability Supplement is paid to eligible home care providers operating in rural and remote areas. This supplement provides support for the higher operating costs (such as wages, fuel and training) associated with providing care in rural and regional locations.
Multi-Purpose Services Program—Aged Care Subsidies
The Multi-Purpose Services Programme is a joint initiative of the Australian Government and State and Territory governments, and provides integrated health and aged care services for small regional and remote communities. The Australian Government is providing $743.6 million over four years from 2017–18. As at 30 June 2016, there were 179 Multi-Purpose Services delivering 3,630 aged care places through this program.
Sporting Schools Programme
The Government will continue funding of $59.6 million for the Australian Sports Commission-managed Sporting Schools Programme for 18 months from 1 July 2017 until 31 December 2018, to reach up to 1.1 million children (up from 860,000). The program helps schools maximise the significant contribution that sport participation offers to physical health, and social, cognitive and community development. Sporting Schools runs nationwide and is open to schools in regional and remote areas.
Support Australia's Surf Life Savers
The Australian Government is providing funding of $10.0 million over four years from 2016–17 to 2019–20 to Surf Life Saving Australia. This funding will help develop the skills of volunteers and keep its trainers up-to-date with the latest teaching methods.
Water and Snow Safety Programmes
The Australian Government has a long standing commitment to support water and snow safety and will provide $46.0 million over four years from 2017–18 to major water and snow safety organisations for activities delivered Australia wide. This is done through: the Water Safety: Reduce Drownings program; the National Recreation Safety Programme; and Saving Lives in the Water-Element 1 and Element 2.