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Part 2: Annual Performance Statement

Part 2.1: 2017-18 Annual Performance Statements

The 2017-18 Annual Performance Statements are in accordance with s39(1)(a) of the Public Governance, Performance and Accountability Act 2013 (PGPA Act) for the 2017-18 financial year. The Annual Performance Statements accurately present the Department of Health’s performance in accordance with s39(2) of the PGPA Act.


Glenys Beauchamp PSM
Secretary
September 2018

Introduction

As required under the PGPA Act, this report contains the Department of Health’s Annual Performance Statements for 2017-18. The Annual Performance Statements detail results achieved against the planned performance criteria set out in the 2017-18 Health Portfolio Budget Statements, 2017-18 Health Portfolio Additional Estimates Statements and the Department’s Corporate Plan 2017-18.

Structure of the Annual Performance Statements

The Annual Performance Statements demonstrate the direct link between the Department’s activities throughout the year and the contribution to achieving the Department’s purpose. The Annual Performance Statements are divided into chapters, with each chapter focusing on the objectives of an outcome and addressing the associated performance criteria. Each chapter contains:

  • an analysis of the Department’s performance by program;
  • activity highlights that occurred during 2017-18; and
  • results and discussion against each performance criteria.

Results Key

Met
100% of the target for 2017-18 has been achieved.

Substantially met
75–99% of the target for 2017-18 has been achieved.

Not met
Less than 75% of the target for 2017-18 has been achieved.

Data not available
Data is not available to report for the 2017-18 reporting year.

N/A
The use of N/A in performance trend

Outcome 1 - Health System Policy, Design and Innovation

Australia’s health system is better equipped to meet current and future health needs by applying research, evaluation, innovation, and use of data to develop and implement integrated, evidence-based health policies, and through support for sustainable funding for health infrastructure

Highlights

Living longer and better lives through investment in genomics technology

Through research in to better testing, diagnosis and treatment that targets the unique genetic make-up of individuals, the $500 million investment in the Genomics Health Futures Mission will save and transform the lives of more than 200,000 Australians.

Program 1.1

Commitment to global and regional cooperation further strengthened

Australia hosted the sixty-eighth session of the World Health Organization Regional Committee for the Western Pacific in Brisbane.

Program 1.5

Programs contributing to Outcome 1

Summary of results against performance criteria

Program

Targets met

Targets substantially met

Targets not met

Program 1.1: Health Policy Research and Analysis

6

-

-

Program 1.2: Health Innovation and Technology

1

-

-

Program 1.3: Health Infrastructure

1

-

-

Program 1.4: Health Peak and Advisory Bodies

1

-

-

Program 1.5: International Policy

2

-

-

Total

11

-

-

Program 1.1: Health Policy Research and Analysis

The Department met all performance targets related to this program.

In 2017-18, the Department continued to support the Government to deliver increased investments for health and medical research, and work to strengthen safety and quality across the health system to reduce patient risks and generate efficiencies.

The Government’s landmark $20 billion Medical Research Future Fund (MRFF) has already designated over $1.7 billion in strategic research investments. These include the establishment of a $500 million Genomics Health Futures Mission that will help more than 200,000 Australians live longer and get better treatment tailored to their medical needs, as well the $240 million Frontier Health and Medical Research initiative to support innovative and ‘out of the box’ ideas and discoveries. Other key investments include the Australian Brain Cancer Mission, a $105 million fund to fight brain cancer with the aim of doubling the survival rates and improving the quality of life for patients with brain cancer over the next ten years, and the longer term aim of defeating the disease. More than $261 million has also been committed to date under the MRFF to increase clinical trial activity and international collaboration, with a focus on rare cancer and areas of unmet need.

Patients will benefit from the suite of investments under the MRFF, through improved healthcare outcomes from new medicines, devices and treatments, embedded genomics technology, clinical trial activity and data analytics. These initiatives will also deliver new jobs and industries and will position Australia as a world leader in health and medical research.

In 2017-18, the Department worked with the National Blood Authority and states and territories to ensure all Australians had access to blood and blood products required for treatment after surgery, for treatment of traumatic injury, and for a range of diseases and chronic conditions, including blood disorders (for example haemophilia) and immunodeficiency conditions.

Collaborating with states and territories to facilitate a nationally consistent focus on achieving better health outcomes for all Australians

Support Australian Government officials on the Council of Australian Governments’ (COAG) Health Council and the Australian Health Ministers’ Advisory Council (AHMAC) to progress health issues with states and territories.

Source: 2017-18 Health Portfolio Budget Statements, p.48

2017-18 Target

2017-18 Result

Health issues will be progressed by the AHMAC and the COAG Health Council.

Health issues were agreed and progressed by the AHMAC and endorsed by the COAG Health Council.1

Result: Met

The COAG Health Council, supported by its advisory body AHMAC, focused on progressing a broad range of issues in 2017-18 including: long-term health reform and negotiation of the next Health Agreement; mandatory reporting requirements for registered health practitioners; mental health and suicide prevention; enhancing the clinical trial sector; and Indigenous health and medical workforce.

In 2017-18, Australian Health Ministers agreed to review the organ donation, retrieval and transplantation sector to identify barriers to equity of access to transplant waiting lists and transplantation services. Ministers also agreed to develop a federated model for national real time prescription monitoring, where state and territory systems will connect to and interface with Commonwealth systems to achieve a national solution.

Ministers also agreed to streamline access to medicinal cannabis by developing a single entry point to cover both Commonwealth and state and territory approval processes and the National Health Genomics Policy Framework. Earlier in the year, Health Ministers endorsed the Fifth National Mental Health and Suicide Prevention Plan.

Case Study: Zero Childhood Cancer program saves lives

In 2017-18, the Australian Government established the Australian Brain Cancer Mission (the Mission) with the brave goal of doubling survival rates in a decade and ultimately defeating brain cancer. Over $100 million has been committed to the Mission with funding of $55 million through the Medical Research Future Fund matched with generous contributions from industry philanthropy and other governments.

The Zero Childhood Cancer national clinical trial program is a significant first investment under the Mission. It offers a first time comprehensive precision medicine approach for all Australian children with high-risk or relapsed cancer, of whom a third to a half, to date, are suffering with brain cancer. The program, led by Children’s Cancer Institute and the Kids Cancer Centre, Sydney Children’s Hospital Randwick, recognises that each child’s cancer is unique and will respond differently to anti-cancer treatments, based on the genetics and biology of each child’s tumour. The Zero Childhood Cancer Program has had many exciting outcomes to date, one of which is Ellie’s Story.

Ellie’s Story

At just eleven months old Ellie was brought to the emergency department at Sydney Children’s Hospital because she had been unwell for a few weeks. As part of a routine check-up, the hospital X-rayed Ellie’s chest and what they found was devastating. Ellie had a tumour in her chest so large it has pushed her heart to the right and there was little room left in her chest cavity. The tumour was aggressive, growing quickly and soon Ellie was on life support as she struggled to breathe.

The challenge facing the cancer team was trying to identify exactly what type of cancer Ellie had, and what genetic changes were driving her cancer, so they could identify the right anti-cancer drugs to treat her disease. Identifying the precise type of cancer with the standard information available, proved difficult. Even with aggressive chemotherapy Ellie’s cancer continued to grow rapidly. The clinical team was running out of options and Ellie was running out of time.

This is when Ellie was enrolled with the Zero Childhood Cancer program. Given the urgency of Ellie’s situation, the whole Zero Childhood Cancer team worked together to complete all the complex genetic tests in just ten days. Sequencing the entire genome of Ellie’s tumour identified a rare genetic change not previously described, that was likely to be driving her tumour’s growth, and the clinical team were then able to source a new and exciting drug that targeted the exact genetic change now identified in Ellie’s tumour’s – a simple, non-invasive syrup – and treatment began immediately.

The impact was dramatic. After just two weeks the cancer had shrunk so that Ellie could come off life support and breathe independently and, after just four weeks, Ellie was discharged from hospital. Today Ellie is a happy, energetic and fun loving two year old. Medical research and programs like Zero Childhood Cancer are keys to a cure for brain cancer.

For further information, including the promising trial Results, please see www.zerochildhoodcancer.org.au

Improving health policy research and data capacity

Provide a sustainable source of funding for transformative health and medical research that improves lives, contributes to health system sustainability and drives innovation.

Source: 2017-18 Health Portfolio Budget Statements, p.48 and Health Corporate Plan 2017-18, p.28

2017-18 Target

2017-18 Result

Further Medical Research Future Fund (MRFF) disbursements will be announced consistent with the Australian Medical Research Advisory Board’s (Advisory Board) Strategy and Priorities, with an increased focus on long-term and transformative investments.

The Advisory Board will commence consultation on the 2018–2020 Priorities.

Further MRFF disbursements were announced and were consistent with the Advisory Board’s Priorities.

The Advisory Board commenced public consultation on 29 June 2018 on the 2018–2020 Priorities.

Result: Met

Further strategic investments under the MRFF were announced in May 2018 as a part of the 2018-19 Budget, including a $1.3 billion National Health and Medical Research Industry Growth Plan and the Genomics Health Futures Mission. This bold new Mission aligns with the National Health Genomics Policy agreed by all Australian governments. The Industry Growth Plan will deliver better health care as well as new jobs and industries and focus on translation projects and support for researchers.

These commitments will introduce 11 new initiatives and extend five existing initiatives committed to in 2016-17. The commitments align with the Australian Medical Research and Innovation Strategy 2016–2021 and related Priorities 2016–2018, prepared by the independent Advisory Board.

Case Study: National Health Genomics Policy Framework – ensuring the benefits of genomics

Genomic testing involves analysis of a person’s DNA to provide information about a person’s genes and chromosomes. This information can be used to better understand the biology of human disease.

Genomic knowledge and technology has the increasing potential to help people live longer and better lives through more effective prevention, diagnosis, treatment, and monitoring of disease.

The National Health Genomics Policy Framework (the Framework) provides a shared direction and commitment between all governments in Australia to consistently and strategically integrate genomics into the Australian health system. Endorsed through the Council of Australian Government’s Health Council in November 2017, it sets out an agreed high-level national approach to policy, regulatory and investment decision-making for genomics.

A strategic priority of the Framework is a person-centred approach to genomics, which will result in individuals being empowered to ask for, access, and use information about themselves. Making sure that people are central to their own care is a key component of developing high-quality health care, including care that is informed by genomic knowledge.

Development of the Framework was led by the Commonwealth, in partnership with the states and territories. It was informed through an extensive consultation process including online submissions, targeted discussions, and public consultation forums held in each state and territory. This collaboration and engagement process was integral to shaping the Framework from the perspectives of a range of stakeholders, including consumers, researchers, academics, private industry, clinicians and goverments.

Improve health outcomes and bring economic benefits to Australia through investing in biomedical discoveries with potential.

Source: 2017-18 Health Portfolio Budget Statements, p.49

2017-18 Target

2017-18 Result

Biomedical Translation Fund (BTF) managers will continue to identify suitable investees and manage portfolio investments consistent with program guidelines.2

BTF managers continued to identify suitable investees with nine investments announced in 2017-18 by the three licensed fund managers totalling $53.85 million.

All investments were consistent with program guidelines.

Result: Met

2 Further information on these companies and the discoveries they are developing available at: www.business.gov.au/assistance/ venture-capital/biomedical-translation-fund

In 2017-18, BTF managers made investments to support promising biomedical start-up companies.1

The investments from the BTF aim to improve health outcomes and contribute significant economic benefits for Australia as a result of transforming great Australian health and medical ideas into commercial realities. The BTF specifically targets late stage research discoveries with commercialisation potential.

To date BTF fund managers have made ten investments totalling $63.85 million into late stage research including for the development of an artificial heart and for the development of a drug to treat kidney disease.

Better position Australia globally as a preferred destination for clinical trials.

Source: 2017-18 Health Portfolio Budget Statements, p.49

2017-18 Target

2017-18 Result

Assist states and territories to improve administration efficiency, sponsorship engagement, recruitment and start-up times by streamlining their clinical trial systems.

Monitor state and territory system redesign agendas as per project agreements.

The Department assisted states and territories to streamline and improve clinical trial delivery systems.

State and territory system redesign agendas continued to be monitored as per project agreements.

Result: Met

In March 2018, the Encouraging More Clinical Trials in Australia Project Agreement was executed between the Commonwealth and states and territories. The project agreement provides funding of $7 million nationally over four years to support activities aimed at achieving national consistency of clinical trial systems.

Redesigned clinical trial systems and improved trial networks will enhance opportunities for Australians to participate in clinical trials.

Improving access to organ, tissue and Haemopoietic Progenitor Cell (HPC)2 transplants and blood and blood products for life saving treatments

Improve access to HPC for Australian patients requiring a HPC transplant for agreed therapeutic purposes.

Source: 2017-18 Health Portfolio Budget Statements, p.50

2017-18 Target

2017-18 Result

In consultation with states and territories commence the development of a strategic framework for the HPC sector taking into account the findings of the 2016-17 independent review of the HPC sector. The strategic framework will guide future policy decisions for improvements in the HPC transplant sector in Australia.

The Jurisdictional HPC Committee, established in February 2018 to consider the review’s findings, had its first meeting in April 2018. At this meeting a work plan to develop a national policy framework to inform and guide future HPC sector arrangements was agreed.

Result: Met

In February 2018, the AHMAC agreed to establish a jurisdictional committee, led by the Commonwealth, to:

  • oversee the development of the national policy framework;
  • consider the findings and recommendations of the independent review of the HPC sector; and
  • bring forward advice and recommendations on future HPC sector arrangements.

It is expected the national framework to guide sector reform will be provided to the COAG Health Council for consideration in 2019.

Ensure access to a safe and secure supply of essential blood and blood products to meet Australia’s clinical need through strategic policy and funding contributions.

Source: 2017-18 Health Portfolio Budget Statements, p.51

2017-18 Target

2017-18 Result

Continue working with states and territories and the National Blood Authority (NBA) to meet the objectives of the National Blood Agreement5 through ongoing involvement and contribution to strategic policy development and advice to the Ministerial Council.

Effective planning and management of the annual blood supply through supporting the implementation, development and approval of the annual National Supply Plan and Budget, including management of the Commonwealth’s funding contribution under the National Blood Agreement.

The Department continued to work with the states and territories and the NBA to meet the objectives of the National Blood Agreement.

Effective planning and management of the annual blood supply including through the COAG Health Council endorsing the 2017-18 National Supply Plan and Budget.

Result: Met

In 2017-18, the National Supply Plan and Budget ensured there was sufficient supply of blood and a range of essential blood products for hospitals. The Commonwealth met 63% of the funding, in accordance with the payment ratio determined under the National Blood Agreement.

The NBA executed the new National Fractionation Agreement (the Agreement) for Australia for the domestic manufacture of plasma products, as developed by the Jurisdictional Blood Committee, on which the Department is represented. Timely execution allowed uninterrupted access to potentially life-saving plasma products manufactured from plasma collected by the Australian Red Cross Blood Service. The Agreement, valued at $3.35 billion will run for a core five year period from 2018. Subject to satisfactory performance and the outcomes of a mid-term review, it will run for an additional four years to 2026.

The Department has commenced development of a health technology assessment review of immunoglobulin indications currently funded under the national blood arrangements to ensure that access to government funded products are based on evidence of efficacy and cost-effectiveness.

Program 1.2: Health Innovation and Technology

The Department met the performance target related to this program.

In 2017-18, the Department continued to work closely with the Australian Digital Health Agency to finalise the My Health Records (National Application) Rules 2017 to enable the national transition of the My Health Record system to opt-out participation arrangements. By the end of 2018, every Australian will have a My Health Record created for them unless they choose not to have one. The transition to opt-out participation arrangements will bring forward the health and economic benefits of the My Health Record system an estimated nine years earlier than through the previous opt-in model.

Supporting the Government’s Digital Health agenda

Support the Minister and the Australian Digital Health Agency to improve health outcomes for Australians through digital health systems.

Source: 2017-18 Health Portfolio Budget Statements, p.52 and Health Corporate Plan 2017-18, p.28

2017-18 Target

2017-18 Result

Provide high quality, relevant and well-informed research, policy and legal advice, within agreed timeframes, to inform and support the Australian Government’s digital health agenda.6

The Department continued to provide well-informed research and high level policy and legal advice that informed and supported the Australian Government’s digital health agenda.

Result: Met

The Department provided advice to inform a new Intergovernmental Agreement on National Digital Health for the period 2018–2022. This Agreement has been agreed in principle by the Commonwealth and all state and territory governments.

The My Health Record opt-out legislation was tabled in Parliament on 4 December 2017, with the three month opt-out period commencing on 16 July 2018. The opt-out approach has been supported by all Health Ministers and this support was reaffirmed through the Council of Australian Governments’ Health Council meeting in August 2018.

Informed by a national public consultation process, the Framework to guide the secondary use of My Health Record system data, released on 11 May 2018, will support the realisation of My Health Record benefits and protect the use of health data.

Case: My Health Record

My Health Record is an online summary of an individual’s key health information that can be viewed securely online, from anywhere, at any time.

A My Health Record puts consumers at the centre of their healthcare by enabling access to their key health information privately and securely, when and where it is needed, by consumers and their healthcare providers. It allows consumers to control their own health information and for healthcare providers to access important details, such as medications, allergies, vaccinations and medical conditions.

In 2017-18, the Government announced that it would transition the My Health Record system to national opt-out participation arrangements. This means that every Australian will get a My Health Record by the end of 2018, unless they advise they do not want one. These arrangements will bring forward the significant benefits of My Health Record, which include:

  • the prevention of adverse drug events;
  • enhanced patient self-management;
  • improvements in patient health outcomes;
  • reduced time spent gathering information; and
  • avoid duplication of services.

Following the implementation of the opt-out arrangements, it is anticipated that the vast majority of Australian’s will have a My Health Record. Healthcare providers will be able to access timely information about their patients, such as shared health summaries, discharge summaries, prescription and dispense records, pathology reports and diagnostic imaging reports to support improved decision making and continuity of care.

Additionally, data contained within the My Health Record system will have the potential to deliver unprecedented levels of insight into population health outcomes, more sustainable resourcing, and inspire new clinical developments to further improve Australia’s health system.

The Department continues to work closely with the Australian Digital Health Agency to improve patient healthcare through supporting the use of the My Health Record system.

Program 1.3: Health Infrastructure

The Department met the performance target related to this program.

In 2017-18, the Department supported improvements to the health system through strategic investments in health infrastructure projects. The projects enable local primary health care providers to deliver improved and increased health services to the community and increase opportunities to provide teaching and training to health practitioners. These infrastructure projects also support state and territory governments and non-government organisations to deliver additional and/or improved health services that may not have been otherwise possible.

Improving and investing in health infrastructure

Investment in health infrastructure supports improved health services.

Source: 2017-18 Health Portfolio Budget Statements, p.53

2017-18 Target

2017-18 Result

Monitor infrastructure projects for compliance to demonstrate effective delivery of infrastructure projects that support local services.

Infrastructure projects were monitored with the majority of projects compliant in providing project reports and achieving agreed project outputs within the required timeframe. Where projects were found to be non-compliant, the Department undertook remedial action.

Result: Met

In 2017-18, infrastructure projects funded in both the primary and acute care settings were monitored in line with their respective project funding agreement requirements. Local services were supported through increased access to health services, facilitation of professional learning and development, and health literacy for consumers.

In 2017-18, the Department supported a range of infrastructure projects in conjunction with state and territory governments, including:

  • construction of the Palmerston Regional Hospital in the Northern Territory (NT) in conjunction with the NT Department of Health;
  • upgrades to, and expansion of, ten small and medium sized regional and remote hospitals across four regions of Western Australia (Kimberley, Pilbara, Goldfields and Midwest) to provide increased renal infrastructure, dialysis and support services, including additional renal dialysis chairs and patient accommodation units; and
  • redevelopment of the New South Wales Wagga Wagga Base Hospital to increase the acute and emergency capacity to enhance services and decrease waiting times.
Program 1.4: Health Peak and Advisory Bodies

The Department met the performance target related to this program.

In 2017-18, the Department engaged with national peak and advisory bodies on a range of issues contributing to the Australian Government’s health agenda. The Department continued to facilitate open lines of communication between government, stakeholders and the community, ensuring members’ and subject matter experts’ contributions were considered when developing policies and implementing programs.

Engaging with the health sector to communicate and facilitate the development of informed health policy

Successfully harness the health sector to share information relating to the Australian Government’s health agenda.

Source: 2017-18 Health Portfolio Budget Statements, p.54

2017-18 Target

2017-18 Result

Maintain agreements with health-related national peak and advisory bodies in order to harness input into the Australian Government’s health agenda, through information sharing and relevant,

well-informed advice.

Agreements were maintained with health-related national peak and advisory bodies.

Result: Met

The Government continued to fund health-related national peak and advisory organisations to deliver on required outcomes. The funded organisations represent a range of healthcare practitioners, health consumers and pharmacists as well as community groups interested in issues such as asthma, allergies, continence, haemophilia, hepatitis, HIV/AIDS, rural health, vision impairment and mental health.

All funded organisations provided input to policy and programs throughout 2017-18. These organisations consulted with their members on matters such as the Fifth National Mental Health and Suicide Prevention Plan, the fifth edition of the National Palliative Care Standards and Health Care Homes.

Program 1.5: International Policy

The Department met both performance targets related to this program.

In 2017-18, the Department continued to pursue Australia’s health interests through participation in international fora, maintaining country-to-country partnerships and harnessing information on international best practice.

Active engagement in international health fora, and securing Australia’s interests at relevant meetings of key international health bodies and organisations, helps to strengthen global health systems capacity, and fulfils Australia’s responsibility to contribute to improving global and regional public health. These outcomes assist in protecting the health of Australians and contribute to policies and actions that help to advance the health of the Australian community.

Australia’s continued engagement with the Organisation for Economic Co-operation and Development (OECD) Health Committee’s work in 2017-18, underpinned the development of health policy by providing internationally comparable data with a range of indicators such as health care quality and health system performance. The OECD Health Committee’s work informed Australia’s long-term health reform agenda in areas such as people-centered care, mental health benchmarking, digital health data governance and preventive health. The Department also reports on Australia’s progress against the United Nations Sustainable Development Goals (SDG) health indicators through the Australian Government’s Reporting Platform on the SDG Indicators website. For further information refer www.sdgdata.gov.au/

Australia had the honour of hosting the sixty-eighth session of the World Health Organization (WHO) Regional Committee for the Western Pacific (RCM68) from 9–13 October 2017 in Brisbane. The meeting was attended by Health Ministers and senior government officials from across the 37 countries and areas of the WHO’s Western Pacific region, as well as leading academics and non-government representatives active in international health.The Secretary chaired the week long meeting, where discussions focused on critical issues for our region, including strengthening regulatory and food safety systems, accelerating action on non-communicable diseases, including childhood obesity and mental health, and furthering efforts to combat communicable diseases including tuberculosis, hepatitis, measles and rubella. Hosting RCM68 provided a valuable opportunity for Australia to showcase its credentials as a global and regional leader in health and to strengthen its bilateral relationships with regional partners on priority health issues, such as regional health security and implementation of the International Health Regulations.

Engaging internationally on health issues

Australia’s health system integrates evidence-based international norms and standards and remains at the forefront of international best practice.

Source: 2017-18 Health Portfolio Budget Statements, p.55 and Health Corporate Plan 2017-18, p.28

2017-18 Target

2017-18 Result

Australia’s engagement and active participation at the WHO, the OECD and the Asia-Pacific Economic Cooperation (APEC) Health Working Group contributes to development and adoption

of international best practice, improved governance and focus on identifying and responding to global health security threats.

The Department actively engaged and led Australia’s participation in meetings of the WHO governing bodies, the OECD Health Committee, APEC Health Working Group, G20 Health Working Group and other international fora.

The Department provided leadership in these diverse international health fora, promoting and learning from international best practice and sharing its technical and policy expertise focusing on domestic, regional and global health priorities.

Result: Met

In 2017-18, the Department continued to lead Australia’s delegations to WHO governing body meetings. As an active and well respected member of the WHO, Australia’s delegations participated in these meetings to ensure Australia’s domestic, regional and global interests were promoted and protected.

Australia’s participation ensured all decisions or resolutions adopted during the meetings were aligned with, or not contrary to, Australia’s domestic and foreign policies.

In May 2018, Australia was elected onto the WHO Executive Board for a three-year term. Membership on the Executive Board enables Australia to more directly influence and inform the work of the WHO, and provides a platform to showcase Australia’s leadership in global health. In October 2017, the Department also signed the first Australia-WHO Country Cooperation Strategy.

Through engagement in the APEC and the Pacific Heads of Health Meeting, the Department continued to support improved regional capacity to respond to global health security threats. As agreed to at the March 2018 APEC Health Working Group meeting, Australia led the development of reporting requirements for the APEC Healthy Asia Pacific 2020 Initiative. This provides a framework for APEC economies to improve health standards across a variety of priority areas, including health emergencies and emerging diseases.

Australia’s relationships with key countries are strengthened and its interests in health are supported.

Source: 2017-18 Health Portfolio Budget Statements, p.56

2017-18 Target

2017-18 Result

Departmental representatives actively promote international cooperation on a case-by-case basis to build relationships, encourage information exchanges and support capacity building to protect the health of Australians and others

in the Western Pacific region.

Work with the WHO Western Pacific Regional Office to host RCM68 in October 2017.

The Department has continued to strengthen and invigorate long standing relationships as well as build new relationships with emerging countries in the Western Pacific region.

The Department successfully hosted RCM68 from 9–13 October 2017 in Brisbane.

Result: Met

In 2017-18, Australia became a full member of the Pacific Health Ministers Meeting (PHMM), which is indicative of our level of constructive engagement in the Western Pacific region in terms of health. Membership of the PHMM enables Australia to fully contribute to regional health dialogue, such as discussions on addressing health security issues in the region, as well as common challenges with chronic disease.

RCM68 provided a platform to establish and reinforce important bilateral relationships with Health Ministers and senior leaders from across the region.

Outcome 1 - Budgeted expenses and resources

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 1.1: Health Policy Research and Analysis1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

44,941

45,988

1,047

Special Accounts

Medical Research Future Fund

143,315

30,100

(113,215)

Special appropriations

National Health Act 1953 – blood fractionation, products and blood related products to National Blood Authority

718,621

718,621

-

Public Governance, Performance and Accountability Act 2013 s77 – repayments

2,000

583

(1,417)

Other Services (Appropriation Act No. 2)

-

4,720

4,720

Departmental expenses

Departmental appropriation2

53,975

53,308

(667)

Expenses not requiring appropriation in the budget year3

2,756

2,454

(302)

Total for Program 1.1

965,608

855,774

(109,834)

Program 1.2: Health Innovation and Technology

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

50,396

43,718

(6,678)

Departmental expenses

Departmental appropriation2

6,498

5,936

(562)

Expenses not requiring appropriation in the budget year3

164

157

(7)

Total for Program 1.2

57,058

49,811

(7,247)

Program 1.3: Health Infrastructure1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

8,712

8,001

(711)

Special appropriations

Health Insurance Act 1973 – payments relating to the former Health and Hospitals Fund

26,039

10,506

(15,533)

Departmental expenses

Departmental appropriation2

3,909

4,221

312

Expenses not requiring appropriation in the budget year3

98

113

15

Total for Program 1.3

38,758

22,841

(15,917)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

2 Departmental appropriation combines ‘Ordinary annual services(Appropriation Act No. 1)’ and‘Revenuefromindependentsources(s74)’.

3 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 1.4: Health Peak and Advisory Bodies

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

7,696

8,046

350

Departmental expenses

Departmental appropriation2

3,510

3,307

(203)

Expenses not requiring appropriation in the budget year3

88

87

(1)

Total for Program 1.4

11,294

11,440

146

Program 1.5: International Policy

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

15,874

14,212

(1,662)

Departmental expenses

Departmental appropriation2

9,298

8,525

(773)

Expenses not requiring appropriation in the budget year3

234

226

(8)

Total for Program 1.5

25,406

22,963

(2,443)

Outcome 1 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

127,619

119,964

(7,655)

Special Accounts

143,315

30,100

(113,215)

Special appropriations

746,660

729,710

(16,950)

Other Services (Appropriation Act No. 2)

-

4,720

4,720

Departmental expenses

Departmental appropriation2

77,190

75,297

(1,893)

Expenses not requiring appropriation in the budget year3

3,340

3,037

(303)

Total expenses for Outcome 1

1,098,124

962,829

(135,295)

Average staffing level (number)

427

402

(25)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

2 Departmental appropriation combines ‘Ordinary annual services(Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

3 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

Outcome 2 - Health Access and Support Services

Support for sustainable funding for public hospital services and improved access to high quality, comprehensive and coordinated preventive, primary and mental health care for all Australians, with a focus on those with complex health care needs and those living in regional, rural and remote areas, including through access to a skilled health workforce

Highlights

Launch of new ‘Head to Health’ digital gateway

‘Head to Health’ provides a place where people can more easily access a range of mental health information most suited to their needs.

Program 2.1

Aboriginal and Torres Strait Islander children immunisation targets exceeded

Immunisation rates for Indigenous five year olds continues to exceed non-Indigenous rates (95% compared to 93%).

Program 2.2

More health practitioners in rural and remote communities

Recruitment and retention of health practitioners in rural and remote areas of Australia continues to support access to a sustainable, highly-trained and better distributed health workforce.

Program 2.3

The Cervical Screening Test replaces the two-yearly Pap test

The Cervical Screening Test is more effective at preventing cervical cancers and will detect the Human Papillomavirus earlier.

Program 2.4

Programs contributing to Outcome 2

Summary of results against performance criteria

Program

Targets met

Targets substantially met

Targets not met

Data not available

Program 2.1: Mental Health

-

1

-

-

Program 2.2: Aboriginal and Torres Strait Islander Health

1

-

2

1

Program 2.3: Health Workforce

3

-

-

-

Program 2.4: Preventive Health and

Chronic Disease Support

2

2

-

4

Program 2.5: Primary Health Care Quality

and Coordination

3

-

-

-

Program 2.6: Primary Care Practice Incentives

1

-

-

-

Program 2.7: Hospital Services

1

-

-

-

Total

11

3

2

5

Program 2.1: Mental Health

The Department substantially met the performance target related to this program.

Significant work was undertaken in 2017-18 to implement reforms under the Government’s mental health reform agenda. The introduction of ‘Head to Health’ has enabled the Australian community to more easily access evidence-based digital mental health information, advice and treatment options and non-digital options if more appropriate.

The Department continued to work with the National Mental Health Commission to address the inadequacies and inefficiencies experienced by individuals currently using the mental health service system. This work was undertaken both through the work it is currently delivering as well as its expanded role under the Fifth National Mental Health and Suicide Prevention Plan (the Fifth Plan).

Supporting people with mental illness through more and better coordinated services

Improve mental health care through implementation of reforms under the Strengthening mental health care in Australia measure to achieve a more efficient, integrated and sustainable mental health system.

Source: 2017-18 Health Portfolio Budget Statements, p.64 and Health Corporate Plan 2017-18, p.29

2017-18 Target

2017-18 Result

Supporting Primary Health Networks (PHNs),

service providers, and mental health stakeholders to facilitate delivery on mental health reforms through:

  • development of Stage 1 of the digital gateway ‘Head to Health’;
  • delivery of the Fifth Plan by 30 September 2017;
  • development of PHN regional mental health and suicide prevention plans by 31 March 2018; and
  • completing the implementation of the commitment to strengthen the National Mental Health Commission (the Commission).

  • Stage 1 of the digital gateway ‘Head to Health’ was launched in October 2017.
  • The Fifth Plan and its associated Implementation Plan, was endorsed by the Council of Australian Governments’ (COAG) Health Council on 4 August 2017.
  • The timeframe for the development of regional mental health and suicide prevention plans by PHNs has been extended to ensure that PHNs develop joint regional plans with their corresponding Local Health Network as required by the Fifth Plan.
  • The commitment to strengthen the Commission was substantially progressed with additional funding through the 2018-19 Budget.

Result: Substantially met

The Fifth Plan spans a five year period and commits the Commonwealth and state and territory governments to mental health reform activities to improve mental healthcare.

The digital gateway ‘Head to Health’ was launched in October 2017 and has been positively received by the community. The number of visits to the website are steadily increasing and feedback from users continues to inform ongoing iterations to the site, ensuring it continues to meet user needs.

The 2018-19 Budget provided resourcing to the Commission to support its expanded role in reviewing and reporting on the performance of the mental health system in Australia and to ensure across-sectoral perspective is taken to mental health policy development and reform.

CaseStudy: ‘Head to Health’

Australia’s National Mental Health Commission’s Review of Mental Health Programmes and Services ‘Contributing Lives,Thriving Communities’ highlighted that clinically effective digital mental health services offer one of the greatest invest-to-save opportunities for government and the community.

The Review noted however, that there was poor integration of existing digital mental health services, creating difficulty for consumers accessing and navigating relevant services.

In response to these findings, the Australian Government committed to delivering a new digital mental health gateway, ‘Head to Health’, to make it easier for consumers to access a range of free or low-cost Australian digital mental health services.

‘Head to Health’ aims to optimise the use of digital technologies, and forms an important element of a stepped care approach in helping people get the mental health services most suited to their needs.

‘Head to Health’ enables users to seek help anonymously when everyday distress requires additional support and in doing so aims to improve early detection and treatment rates.

Digital mental health services generally focus on common mental health conditions such as anxiety and depression, which can range in severity from low to severe. Digital mental health services are generally delivered online via desktops, mobile devices and apps but can also be delivered via telephone. The term ‘digital’ also extends to encompass telephone and online crisis and counselling services.

‘For school counsellors and their clients – a helpful website to direct people to helpful resources.’

‘The website is SO GOOD! Easy to navigate, looks modern, huge library of resources and recommendations for mental health. This is a great tool for clinicians to go through with patients as well. Well done @healthgovau.’

Program 2.2: Aboriginal and Torres Strait Islander Health

The Department continued to work towards meeting the performance targets related to this program.

The Closing the Gap target on Aboriginal and Torres Strait Islander child mortality is on track to be met with the rate significantly declining (by 35%) over the long-term (1998 to 2016).

During 2017-18, the Department continued to implement activities under the Implementation Plan for the Aboriginal and Torres Strait Islander Health Plan (2013–2023). The Implementation Plan provides agreed priorities for improving health outcomes in Aboriginal and Torres Strait Islander communities. Current results show the immunisation goals for Indigenous one and five year olds are being exceeded. There has also been an increase in the rates of Indigenous mothers accessing antenatal care along with gradual increases in health check rates.

The New Directions: Mothers and Babies Services and the Australian Nurse-Family Partnership Program have been extended, providing greater access to communities where these services are needed most.

Improve health outcomes of Aboriginal and Torres Strait Islander peoples through implementing actions under the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.7

Source: 2017-18 Health Portfolio Budget Statements, p.66

2017-18 Target

2017-18 Result

Undertake actions to inform and complete the drafting of the next iteration of the Implementation Plan (2018–2023).

Assess progress against the deliverables and goals for 2018 as specified in the Implementation Plan.

In 2017, the My Life My Lead national consultation process on social determinants and cultural determinants of Indigenous health was held to inform the development of the next Implementation Plan (2018–2023).

A report on the outcomes of the consultations was released by the Minister for Indigenous Health

The Hon Ken Wyatt AM, MP in December 2017, with the next Implementation Plan due to be finalised in 2018-19.

The Implementation Plan Advisory Group continues to monitor and assess progress against the current Implementation Plan. A report card, detailing the progress made against deliverables, will be released towards the end of 2018. Progress against the

20 goals was made available by the Australian Institute of Health and Welfare (AIHW).8

Result: Met

Supporting access to high quality essential health services for Aboriginal and Torres Strait Islander peoples

The next iteration of the Implementation Plan is being drafted in partnership with the Implementation Plan Advisory Group and will be informed by the My Life My Lead work. It will feature contributions from jurisdictions and will be aligned to the outcomes of the Closing the Gap refresh.

The Department continues to make progress against deliverables under the current Implementation Plan. As at July 2018, all maternal/antenatal health and smoking goals are on track to be achieved and immunisation rates for Indigenous five year olds exceed non-Indigenous rates (95% compared to 93%).

Reduce the rate difference of child 0-4 mortality rate per 100,000 between Aboriginal and Torres Strait Islander peoples and non- Aboriginal and Torres Strait Islander people.9,10

  1. Rate difference.
  2. Aboriginal and Torres Strait Islander.
  3. Non- Aboriginal and Torres Strait Islander.

Source: 2017-18 Health Portfolio Budget Statements, p.66

2016 Target

2016 Estimated Result11

2015

2014

2013

2012

a. 19–70

76.6

88.6

85.7

101

87

b. 101–151

145.6

163.6

159.1

185

165

c. 78–86

69.2

75.0

74.7

84

77

Result: Not met

9 Available at: https://closingthegap.pmc.gov.au

10 Aboriginal and Torres Strait Islander and non- Aboriginal and Torres Strait Islander rates are contextual data and are listed to provide a comparison.

11 Source: AIHW National Mortality Database, calendar years 1998–2016 (which is the most up-to-date data available) and includes jurisdictions for which data is available and of sufficient quality to publish (New South Wales, Queensland, Western Australia, South Australia and Northern Territory combined). Note that this data is reported on a calendar year basis, reflecting the Australian Bureau of Statistics mortality data collection and publication processes.

Indigenous child mortality rates have declined by 35% between 1998 and 2016, with the mortality gap also declining by 32% over the same period. Continued improvements in key preventive factors, such as access to antenatal care and reducing smoking during pregnancy, continue to be important contributors to declining rates. The Indigenous child mortality rate is within the range required to meet the Closing the Gap target by 2018.

Reduce the rate difference of chronic disease related mortality rate per 100,000 between

Aboriginal and Torres Strait Islander peoples and non-Aboriginal and Torres Strait Islander people.12

  1. Rate difference.
  2. Aboriginal and Torres Strait Islander.
  3. Non- Aboriginal and Torres Strait Islander.

Source: 2017-18 Health Portfolio Budget Statements, p.67

2016 Target

2016 Estimated Result13

2015

2014

2013

2012

a. 173–209

346.7

325.6

309.1

335

447

b. 593–628

779.1

774.4

756.5

784

898

c. 417–424

432.4

448.8

447.4

449

451

Result: Not met

12 Aboriginal and Torres Strait Islander and non- Aboriginal and Torres Strait Islander rates are contextual data and are listed to provide a comparison.

13 Source: AIHW National Mortality Database, calendar years 1998–2015 (which is the most up-to-date data available) and includes jurisdictions for which data is available and of sufficient quality to publish (New South Wales, Queensland, Western Australia, South Australia and Northern Territory combined). Note that this data is reported on a calendar year basis, reflecting the ABS mortality data collection and publication processes. Estimated result is based on preliminary data that will not be finalised until 2018.

Although there has been a statistically significant decline in Aboriginal and Torres Strait Islander chronic disease mortality rates over the period 1998–2016, there has been no statistically significant change in the gap between the two populations. This is due to the non-Indigenous rates in chronic disease mortality declining faster than Indigenous rates.

Continued improvements in chronic disease prevention and management, including reducing smoking rates, continue to be important contributors to declining rates of chronic disease related mortality for Aboriginal and Torres Strait Islander peoples.

Increase the percentage of Aboriginal and/or Torres Strait Islander clients with type 2 diabetes who have had a blood pressure measurement result recorded within the previous 6 months.

Source: 2017-18 Health Portfolio Budget Statements, p.67

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

60–65%

Data not available.14

Data not available.15

63%

N/A

N/A

14 Data for 2017-18 will be available in November 2018.

15 Data for 2016-17 was expected to be available by June 2018, however due to technical issues results will now be available in November 2018.

Case: Study Australian Nurse-Family Partnership Program (ANFPP)

In 2017-18, the Department supported the Government to continue to deliver funding to the ANFPP, a nurse-led home visiting program that supports women who are pregnant with an Aboriginal or Torres Strait Islander baby, who may benefit from more intensive support to improve their own health and that of their baby’s. The Department provides strategic oversight and works with the ANFPP National Program Centre to support services to deliver this program. The program’s success has led to an expansion from three to 13 sites, which was completed in 2017-18.

The value the ANFPP provides Australians is apparent in the case of an 18 year old pregnant woman who had recently moved to a new community. She was recruited to ANFPP with her first baby, having attended no antenatal care and with a history of anxiety and depression. She was withdrawn and felt isolated from her family and friends. She smoked, ate poorly and was not accessing social security payments and support.

Her ANFPP Nurse Home Visitor (NHV) worked with her to prioritise achievable and practical goals that focused on education, networking and empowerment to prepare her for the birth of her baby.

The ANFPP team established a community of support around this young mother. She visited a sacred Aboriginal women’s site and met with community Elders and other women, where she was able to connect with her culture and country.

She now attends the ANFPP drop-in sessions once a week to socialise with other mums and bubs, participating in creative activities such as cooking, painting and making plaster casts of her baby’s feet. She also learnt relaxation and mindfulness techniques.

With support from her NHV she was able to engage with a range of services in and outside the health system including: antenatal, intrapartum and postnatal; Mums and Bubs clinic; housing support; social security; and other government services and supports.

ANFPP supported her to attend health checks for herself and her baby, resulting in referrals to optometry and dental services.

Further successes from this case included exclusive breastfeeding and an infant who is fully immunised. The mother has ceased smoking and is now accessing a dietitian, a physiotherapist and a psychologist to further support her self-knowledge and the general health and wellbeing of herself and her baby.

More information about the ANFPP and its services available at: www.anfpp.com.au

Program 2.3: Health Workforce

The Department met all performance targets related to this program.

In 2017-18, the Department supported the Government as it continued to address workforce distribution by better targeting investment in workforce support and training, with a focus on improving access in regional, rural and remote areas.

During 2017-18, the Department continued to support the distribution of the health workforce in rural, regional and remote areas of Australia through the Rural Health Multidisciplinary Training(RHMT) Program, which aims to increase the number of health practitioners working in rural and remote areas. The Department continued to provide training programs such as the Specialist Training Program (STP) and the Australian General Practice Training (AGPT) Program. These programs allow trainees to provide valuable services to local communities while undertaking further training. Communities, particularly those in rural and remote areas, will benefit from more qualified general practitioners (GP) distributed across training regions.

Increasing the capacity and effectiveness of the health workforce and improving access to health services for rural Australians

Effective investment in long-term education and training initiatives assists to develop a health workforce that will provide safe, high quality services to meet community need.

  1. Maintain the number of medical and multidisciplinary rural placement weeks delivered through the RHMT Program.
  2. Establish and maintain the number of training posts for specialist registrars working in expanded health care settings through the STP.
  3. Maintain the annual intake of general practice registrars in the AGPT Program.
  4. Work with Regional Training Organisations to help registrars gain fellowship from the Royal Australian College of General Practitioners and/or the Australian College of Rural and Remote Medicine.16

Source: 2017-18 Health Portfolio Budget Statements, p.68

Academic year 2017 Target17

Academic Year 2017 Result18

2016

2015

2014

2013

a. 75,000

b. 1,07719

c. 1,500

d. 920

167,372

1,077

1,514

1,095

N/A

N/A

N/A

N/A

Result: Met

16 Target assumes an ongoing intake of 1,500 registrars per year and that fellowship requirements, which are outside the scope of the Department, remain unchanged.

17 The target year was incorrectly published as 2018 in the 2017-18 Health Portfolio Budget Statements. This measure is reported on an academic year basis and the correct year is 2017.

18 This data is reported on an academic year basis.

19 From 2017, the STP merged with the Emergency Medicine Program. The target from 2017 includes transferred emergency medicine places.

During the 2017 academic year, 15 University Departments of Rural Health, 18 Rural Clinical Schools and six dental schools supported rural placements as part of the RHMT program, which aims to increase the recruitment and retention of health practitioners in rural and remote areas.

The Department has funding agreements in place with 13 specialist medical colleges participating in the STP. The STP aims to improve the quality of the future specialist workforce by providing registrars with exposure to a broader range of health care settings.

Improve the distribution of the medical workforce through the delivery of major health workforce education and training initiatives.

  1. Increase the selection of students with a rural background accepted into medical degree courses at universities participating in the RHMTP.
  2. Expand the proportion of STP activity provided in rural areas to provide immediate services to rural communities and help attract the next generation of medical specialists to work in these areas.
  3. Maintain the level of training for general practice registrars delivered in rural areas through the AGPTP.

Source: 2017-18 Health Portfolio Budget Statements, p.69

Academic Year 2017 Target20

Academic Year 2017 Result21

2016

2015

2014

2013

a. 26%

b. 40%

c. 50%

33%

42%

50%

N/A

N/A

N/A

N/A

Result: Met

20 The target year was incorrectly published as 2018 in the 2017-18 Health Portfolio Budget Statements. This measure is reported on an academic year basis and the correct reporting year is 2017.

21 This data is reported on an academic year basis.

Universities in the RHMT Program have implemented strategies to streamline and prioritise rural origin medical students. Some universities achieved over 60% of Commonwealth supported places filled by medical students from a rural origin.

The STP is currently funding 450 full time equivalent training posts in rural settings, which is 42% of the overall number of specialist training posts within the program. The STP will contribute to a sustainable, Australian-trained future medical workforce for regional, rural and remote communities. The AGPT Program continues to ensure at least half of all general practice training is delivered in rural areas. The medical workforce and local communities benefit from well-supervised and highly trained doctors,working in rural areas while they work towards becoming vocationally recognised GPs. The continued support of rural vocational training is part of a continuum for doctors to learn, train and work in regional, rural and remote Australia.

Support access to health care services in rural communities through the Rural Health Outreach Fund (RHOF).

  1. Number of communities receiving outreach services through the RHOF.
  2. Number of patient contacts delivered through the RHOF.22

Source: 2017-18 Health Portfolio Budget Statements, p.69

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

a. 450

458

484

515

483

460

b. 195,000

228,071

225,865

474,455

216,787

190,460

22 This represents the number of patient contacts, not the number of individual patients.

458 regional, rural and remote communities have received services under the RHOF comprising of 228,071 patient contacts under the RHOF. The fund allows improved access to medical specialists, GPs, allied and other health professionals for people living in regional, rural and remote Australia.

Case Study: Improving health care in rural communities

The Australian Government has funded the Royal Flying Doctor Service (RFDS) since the 1930s to deliver the RFDS Program. In 2018, the RFDS is celebrating 90 years of service to rural and remote Australians.

The RFDS delivers sustainable, flexible, effective and efficient emergency and primary care services to people where there are little to no other services. These services include aeromedical evacuations, general practice and nursing clinics, and dental health services – delivered to rural and remote areas beyond the normal medical infrastructure and in locations of market failure.

A mother’s story

Two brothers had been driving a light off-road buggy heading kangaroos off a boundary fence at their grandfather’s property in western NSW when the accident occurred.

‘My eldest son was driving and his brother was a passenger, and despite being told to wear helmets and the safety harness, they did not. They turned too quickly and the buggy flipped and crashed’, the boy’s mother said.

‘They radioed for help and managed to start limping home. Meanwhile a family friend called the RFDS via telephone as she was concerned that one of the boys may have broken some bones and both boys were at risk of concussion.’

‘The doctor arrived within the hour – amazingly fast when you consider it is a two and a half hour trip by car.’

‘The plane landed on the homestead airstrip and the nurse and doctor chatted to the boys while examining them and completely put them at ease. The boys still talk about how lovely the doctor, pilot and nurse were.’

‘My eldest son suffered a dislocated shoulder. He was given some strong pain killers and his shoulder was popped back into place. He said it all happened so quickly and the doctor and pilot were so chatty that he didn’t even feel the procedure.’

There were concerns the boys may have cracked bones so they were flown to Adelaide for x-rays. Thankfully however, the eldest boy’s shoulder was only badly swollen and his brother was given a clean bill of health apart from a few bruises.

‘We are so grateful to the doctors, nurses and pilots of the RFDS,’ their mother said. ‘The level of care, compassion and expertise they offer people in isolated areas is as good, likely better, than the care offered in metropolitan areas. The RFDS provides an essential service to those who live and travel in the outback – they really do have our backs and it gives great peace of mind knowing that.’

‘My eldest son is currently completing his restricted pilot’s licence and his experience with the RFDS has been so positive that he hopes to fly for them one day.’

Program 2.4: Preventive Health and Chronic Disease Support

There were four performance targets for which data was not available at time of publication. Where data was available, the Department met or substantially met all the targets.

During 2017-18, the National Diabetes Strategy Implementation Plan aimed at better supporting people with type 1 and 2 diabetes was released.

The Department promoted evidence-based information to support Australians to make healthy lifestyle choices, partly through programs such as the Health Star Rating system.

Throughout 2017-18, the Department supported the Government in its on going efforts to increase participation in cancer screening programs for cervical and bowel cancer. Increasing participation rates is a key contributor to early detection, treatment and reduced incidence of mortality.

The Department continued to support the provision of high quality palliative care in Australia through a range of National Palliative Care Projects, including workforce development and advance care planning. These projects have had a major impact on the palliative care sector as well as the broader health system and have contributed significantly to achieving the objectives of the National Palliative Care Strategy and supporting the provision of quality palliative care.

The Department continued to support activities aimed at reducing the misuse of alcohol and other drugs through increasing treatment services to assist communities to address drug and alcohol misuse by providing a range of treatment services that adequately reflect the needs of local communities. The National Drugs Campaign (NDC) website was launched on 24 September 2017 and provides information about the range of drug support services available to the community, including links to state and territory services. The NDC, through the National Alcohol and Other Drug Hotline, connects people to services that offer support, information, counselling and referrals for treatment.

Case Study: Bowel Cancer Screening Program saves lives

Australia has one of the highest rates of bowel cancer in the world. Each year around 17,000 Australians are diagnosed with bowel cancer and around 92% of these people are aged over 50. The good news is that if found early nine out of ten cases of bowel cancer can be successfully treated.

The National Bowel Cancer Screening Program (the Program) invites eligible people aged 50 to 74 to screen for bowel cancer using a free, simple test which gets mailed to them at home.

Bowel cancer screening is the best way of detecting bowel cancer early, and involves testing people who do not have any obvious symptoms. The Program aims to help detect bowel cancer early and reduce the number of Australians who die each year from the disease.

A 2018 study by the Australian Institute of Health and Welfare demonstrated that the Program invitees had 13% less risk of dying from bowel cancer, and were more likely to have less-advanced bowel cancers when diagnosed, than non-invitees.3 It is estimated that the Program will prevent over 90,000 bowel cancer cases and 59,000 deaths from 2015 to 2040.4

Don’s story

Don Ash, 58, received his test kit in the mail in December 2015, and ‘partly due to a busy schedule, travel to Africa; partly due to being a "bloke" and partly due to the anxiety of taking tests I only got around to doing the test in March 2016’. Don was diagnosed with bowel cancer, and as he was recuperating from surgery in hospital two things kept coming to mind: ‘1) Bowel cancer is called by some of the people I have met, a silent killer, and in my case that resonates because I was 100% asymptomatic. Prior to the screening I was living an active, healthy and happy life. No weight loss to speak of, no fatigue, no visible blood in my stools and yet I was living with a time bomb inside of me. 2) The screening kit was, for me, a gift for living, the best and most significant gift I have ever been given.’

Ross’ story

Ross Anthony, 55, has ‘always lived a healthy existence. I have participated in sports and exercise for 50 of these years and have the aching bones and body to attest to that.’

‘In 2012, I received a free test kit to screen for bowel cancer in the mail. I duly placed it in my top drawer. A bit over two years later, I stumbled across it and thought, "Maybe it would be a good idea to try the test." When I opened the kit, I noticed that it had expired. Luckily for me I followed up and requested that another kit be sent so that I could complete the test.’

Ross completed the test kit, which led to a diagnosis of bowel cancer, followed by surgery and other treatment. Ross says that, ‘I was one of the lucky ones… I have no doubt that this screening program saved my life and I’m sure it will save many, many more.'

Improving public health and reducing the incidence of chronic disease and complications through promoting healthier lifestyles

Provide national guidance to states and territories, and health professionals, on and through the development and implementation of initiatives to reduce the prevalence of chronic conditions and associated complications.

Source: 2017-18 Health Portfolio Budget Statements, p.72

2017-18 Target

2017-18 Result

Release of the National Diabetes Strategy Implementation Plan (Implementation Plan).

Development of a reporting framework for the National Strategic Framework for Chronic Conditions (NSFCC).

Submission of the Australian National Breast Feeding Strategy (the Strategy) for the Australian Health Ministers’ Advisory Council (AHMAC) and Council of Australian Governments’ (COAG) Health Council approval by the end of 2017.

The Implementation Plan was released on 19 December 2017.

A reporting framework for the NSFCC is currently underway and expected to be finalised mid-2019.

It is anticipated that the final Strategy will be submitted for approval to AHMAC and the COAG Health Council by the end of 2018.

Result: Substantially met

The Implementation Plan identifies priority areas that require further investment to better support people with type 1 and type 2 diabetes. The reporting framework will create accountability and enable formal and consistent reporting to AHMAC on progress made against the objectives of the NSFCC.

The Strategy is intended to have no end date. To inform the draft Strategy and to ensure the most up-to-date evidence is incorporated, the Department commissioned an Evidence Check for the Strategy in September 2017. The Evidence Check was informed by extensive stakeholder consultation workshops held in early 2017.

The Strategy is anticipated to be submitted for approval to both AHMAC and the COAG Health Council by the end of 2018.

Supporting the development of preventive health initiatives

Provide national leadership to support people to make informed decisions and healthy lifestyle choices.

Source: 2017-18 Health Portfolio Budget Statements, p.73

2017-18 Target

2017-18 Result

Increase in the number of businesses adopting the Health Star Rating System and an increase in products displaying Health Star Ratings.

Encourage collaboration between Government, food industry bodies and public health

groups through the Healthy Food Partnership Working Groups, including the Portion Size and Reformulation Working Groups, to empower food manufacturers to make positive changes.

Provide support to general practitioners to encourage their patients to achieve a healthy lifestyle through increased physical activity and better nutrition, through the Healthy Heart Initiative.

The number of businesses adopting the Health Star Rating System and the number of products displaying a Health Star Rating has continued to increase in 2017-18. There has been an approximate 37% increase in food companies implementing the Health Star Rating System on their products since 31 March 2017.

Collaboration between Government, food industry bodies and public health groups has continued through the Healthy Food Partnership Working Groups.

The Royal Australian College of General Practitioners are currently developing resources and tools for general practitioners to enhance their knowledge and skills, to work more effectively with their patients and encourage lifestyle change, focusing on patients with high risk lifestyle factors, through the Healthy Heart Initiative.

Result: Met

The Health Star Rating System continues to have a growing presence in the retail food market with good coverage across products, categories and manufacturers. As at 31 March 2018, over 165 food companies have implemented the Health Star Rating on over 10,300 products to assist consumers to make healthier food choices.

Partnerships have also been established with the National Heart Foundation and the Royal Australian College of General Practitioners to implement the Healthy Heart Initiative.

Improving early detection, treatment and survival outcomes for people with cancer and supporting access to palliative care services

Increase the percentage of people participating in the National Bowel Cancer Screening Program.25

Source: 2017-18 Health Portfolio Budget Statements, p.74 and Health Corporate Plan 2017-18, p.29

Jan 2017 –

Dec 2018 Target26

Jan 2017 –

Dec 2018 Result27

Jan 2016 –

Dec 2017

Jan 2015 –

Dec 2016

Jan 2014 –

Dec 2015

Jan 2013 –

Dec 2014

48.1%

Data not available

Data not available

40.9%

38.9%

37.3%

25 Participation is defined as the percentage of people invited to screen through the National Bowel Cancer Screening Program over a two year period (1 January to 31 December) who return a completed screening test within that period or by 30 June of the following year.

26 This measure is reported on a rolling two-calendar-year basis.

27 Ibid.

As there is a time lag between an invitation being sent, test results and collection of data from the program register, final participation rates for 1 January 2016–31 December 2017 will be published in the Australian Institute of Health and Welfare’s (AIHW) National Bowel Cancer Screening Program: Monitoring report (1 January 2016 – 31 December 2017 participation data) in mid-2019.

Maintain the percentage of women 50–74 years of age participating in BreastScreen Australia.

Source: 2017-18 Health Portfolio Budget Statements, p.74

Jan 2017 –

Dec 2018 Target28

Jan 2017 –

Dec 2018 Result29

Jan 2016 –

Dec 2017

Jan 2015 –

Dec 2016

Jan 2014 –

Dec 2015

Jan 2013 –

Dec 2014

54%

Data not available

Data not available

54%

N/A

N/A

28 Participation is defined as the percentage of people invited to screen through the National Bowel Cancer Screening Program over a two year period (1 January to 31 December) who return a completed screening test within that period or by 30 June of the following year.

29 This measure is reported on a rolling two-calendar-year basis.

In 2017-18, the Government continued to actively invite women aged 50–74 to participate in Breast Screen Australia. In 2015 and 2016, around 55%of the eligible population participated in the program. Participation in the BreastScreen Australia Program has remained stable over the past five years with ongoing participation trends expected to remain stable over the forward years. As there is a time lag between an invitation being sent, test results and collection of data from registries, participation rates for 1 January 2016–31 December 2017 will be published in the AIHW’s BreastScreen Australia monitoring report (1 January 2016–31 December 2017 participation results) in October 2019.

Maintain the percentage of women in the target age group (20–69 years) participating in the National Cervical Screening Program (NCSP).30

Source: 2017-18 Health Portfolio Budget Statements, p.74

Jan 2017 –

Dec 2018 Target31

Jan 2017 –

Dec 2018 Result

Jan 2016 –

Dec 2017

Jan 2015 –

Dec 2016

Jan 2014 –

Dec 2015

Jan 2013 –

Dec 2014

57%

Data not available32

Data not available

56.0%

56.6%

57.7%

30 From 1 December 2017, the two-yearly Pap test for women 18–69 years of age changed to a five-yearly cervical screening test for women 25–74 years of age.

31 This measure is reported on a rolling two-calendar-year basis.

32 Ibid.

AIHW’s‘ Cervical Screening in Australia Report’ for 2019 will publish participation rates for 2017-18, as this data is not currently available.

From 1 January 2015–31 December 2016, 56% of women aged 20–69 participated in the NCSP, which is more than 3.8 million women. In accordance with advice from the Medical Services Advisory Committee, renewal of the NCSP was implemented on 1 December 2017.

A new five-yearly cervical screening test will replace the current biennial test, ensuring access to a safe and effective screening program based on current evidence.

Build capability through national leadership to ensure that Australians are provided with high quality palliative care.

Source: 2017-18 Health Portfolio Budget Statements, p.75

2017-18 Target

2017-18 Result

Implement national projects that improve access to high quality palliative care and service delivery, and provide support for people who are dying, their families and carers.

Release a draft updated National Palliative Care Strategy (the Strategy) for consultation by end of July 2017.

Finalise the revised National Palliative Care Strategy by 30 June 2018.

National Palliative Care Projects continued to be implemented in 2017-18.

A draft Strategy was released for consultation in July 2017.

The Strategy was endorsed by the Health Services Principal Committee and will be considered by AHMAC and Health Ministers in 2018-19.

Result: Substantially met

In 2017-18, the Department implemented National Palliative Care Projects including advance care planning, workforce development, national benchmarking and national continuous quality improvement processes. This work resulted in national training materials, assessment tools and other resources to assist health, social service and residential aged care providers, including a focus on the uptake of advance care plans and other mechanisms for increasing individual choice, improving care quality and engagement in planning for goals of care.

Reducing the harmful effects of tobacco use

Reduce the percentage of the population 18 years of age and over who are daily smokers.33,34

Source: 2017-18 Health Portfolio Budget Statements, p.75 and Health Corporate Plan 2017-18, p.29

2017-18 Target

2017-18 Result

2014-15

2011-12

2007-08

11%

Data not available35

14.7%

16.3%

19.1%

33 In line with the monitoring of progress against the 2018 Council of Australian Governments’ performance benchmark for tobacco in the general population, results reported under this target have been amended to show age-standardised data sourced from the Australian Bureau of Statistics National Health Survey (NHS).

34 The Department also monitors and reports on smoking prevalence in the general population using data from the National Drug Strategy Survey.

35 The Australian Bureau of Statistics National Health Survey is undertaken every three years. Updated information from the next NHS is expected to be available in early 2019.

The 2017-18 National Health Survey is in progress with preliminary results to be made available in late 2018. The Department supported the implementation of the National Tobacco Campaign to focus on high prevalence groups, including Aboriginal and Torres Strait Islander peoples, people from disadvantaged backgrounds and people in rural, regional and remote areas.

Case Study: National Tobacco Campaign – Don’t Make Smokes Your Story

Tobacco use remains the leading cause of preventable and premature death and disability in Australia and contributes to health and social inequalities.

As a part of Australia’s comprehensive approach to tobacco control, marketing campaigns have been successful in affecting outcomes such as: preventing initiation; encouraging cessation; mobilising community support to legitimise the passage of tobacco control policies; and contributing towards shifting cultural and social norms.

The National Tobacco Campaign contributes to reducing the adult daily smoking rate in Australia. The recent iteration of the campaign, Don’t Make Smokes Your Story launched in 2016 and aims to empower Aboriginal and Torres Strait Islander smokers aged 18–40 years to quit smoking and stay smoke free.

The campaign uses the theme of family to focus on encouraging quit attempts through a positive and empowering message that speaks directly to Aboriginal and Torres Strait Islander peoples. The campaign works with communities to develop culturally relevant smoking cessation resources and support community events to challenge the social norms around the acceptance of smoking.

Advertising is used across traditional, digital and social media channels as well as Indigenous specific media channels. It highlights the support services available such as the Quitline, the My QuitBuddy mobile application which has received over 850,000 downloads, and the QuitNow website.

Evaluation results of the 2017 campaign found 87% of Indigenous smokers and recent quitters surveyed were aware of the campaign, with 8% stating they had quit smoking and 27% saying that they intended to quit. The campaign also achieved significant cross-over appeal with mainstream audiences.

Preventing and reducing harm to individuals and communities from alcohol, tobacco and other drugs

National direction supports a collaborative approach to preventing and reducing the harms from alcohol, tobacco and other drugs.

Source: 2017-18 Health Portfolio Budget Statements, p.76

2017-18 Target

2017-18 Result

Implementation of Commonwealth funded activities under the National Ice Action Strategy (NIAS).

Support the delivery of alcohol and other drug treatment services.

Development and promotion of prevention activities to raise awareness of Fetal Alcohol Spectrum Disorders (FASD).

Delivery of the next phase of the National Drugs Campaign (NDC).

Continued engagement of non-governmental organisations and stakeholders to shape the Commonwealth priorities in preventing and reducing harms from alcohol and drugs.

Work with states and territories, and other relevant agencies to:

  • establish reporting frameworks and implementation plans for the National Drug Strategy and the National Alcohol Strategy;
  • continue reporting on activities under the National Ice Action Strategy; and
  • oversee and monitor the progress of the National Drug Strategy, and associated sub-strategies through the National Drug

Strategy Committee and the Ministerial Drug and Alcohol Forum (MDAF).

Commonwealth funded activities have been implemented with an additional 158 services

to be delivered to local communities to increase accessibility to treatment under the NIAS.

The Department supported the delivery of alcohol and other drug treatment services.

Prevention and awareness activities for FASD were developed and promoted.

The most recent phase of the NDC ran from 24 September 2017 until 20 January 2018,

focusing on reducing the use of ice and party drugs such as ecstasy, pills and MDMA.

The Department liaised with non-government stakeholders through a variety of fora including formal meetings, conferences and roundtable events to shape the Commonwealth priorities in preventing and reducing harms from alcohol and drugs.

The Department continues to work with states and territories and other relevant agencies through the MDAF and the National Drug Strategy Committee to oversee and monitor progress against the National Drugs Strategy. A National Quality Framework has been endorsed by the MDAF.

Result: Met

Significant progress continues to be made on the implementation of the NIAS, including:

  • increasing the number of Local Drug Action Teams (LDATs) in 2017-18 to bring the total across Australia to 172, well ahead of the target of 220 LDATs by the end of 2020;
  • the addition of further Primary Health Network-supported drug and alcohol treatment based services on the needs of their local communities;
  • a national Alcohol and Other Drug Hotline available to all Australians that provides information, counselling support and services; and
  • data enhancement, to ensure that policy and program development is evidence informed.

A national radio campaign and a targeted social media campaign, supported by prevention awareness activities have increased awareness and understanding of FASD amongst Australians. A FASD Strategic Action Plan is being developed that will aim to reduce the prevalence of FASD and the impact it has on individuals, families, carers and communities by identifying a series of priorities and opportunities to inform future approaches by governments, service providers and communities.

The Department worked with all states and territories on their responses to drugs and alcohol, including through the finalisation of the National Drug Strategy in July 2017 and ongoing work towards its sub-strategy, the National Alcohol Strategy. The Department also liaised widely with non-government organisations and stakeholders, throughout the development of the National Alcohol Strategy.

Case Study: National Drugs Campaign

The National Drugs Campaign launched a new phase of activity in 2017 with a focus on informing young people using ice how to get help, preparing parents to talk to their children about illicit drugs, and highlighting the risks of party drugs.

This campaign was strongly promoted during September to December 2017 across television, digital, social and outdoor advertising, for example billboards.

The ice advertising targeted current users aged 18–25 with messaging on how to get help, while reminding at-risk young people how dangerous ice can be. The help-seeking message was a new campaign element, and 85% of evaluation survey respondents agreed it was effective. Current users were the most likely to take action after seeing the campaign – 20% talked to a friend, 13% stopped or reduced their ice use and 13% sought more information.

The parent-focused advertising was in response to a developmental research finding that one in three young people would go to their parents for advice about drugs. These advertisements prompted 44% of parents to take action. In addition to reinforcing or expanding their drug knowledge, 33% of parents talked to their children about drugs after seeing the campaign.

The third advertising stream featured videos showcasing the impacts of party drugs from loss of friendships, to mental illness and even death. Aimed at 14–17 year-olds, research found that 75% said the videos made them stop and think, 37% said they would avoid using party drugs and 32% thought more about the consequences of using.

With more than 300,000 visits to the campaign website and close to 4,000 calls to the National Alcohol and Other Drug Hotline, the three campaign streams effectively encouraged more young Australians and their parents to seek out information and assistance for drug use.

For more information on the National Drugs Campaign visit www.drughelp.gov.au

Program 2.5: Primary Health Care Quality and Coordination

The Department met all performance targets related to this program.

The Department works with Primary Health Networks (PHNs) to increase the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, to improve coordination of care to ensure patients receive the right care in the right place at the right time. The Departmental so supports trials of activities that aim to improve integration of services for people living with complex and chronic conditions.

The Department continues to support the Government to pursue different models of healthcare for patients with chronic and complex conditions, supported by technology and new payment approaches. These approaches aim to provide better coordinated care; support patients to improve their health literacy and play a greater role in their healthcare; and more effectively allocate resources in accordance with need.

PHNs continue to engage with local stakeholders to improve services they deliver in their communities, including access to after-hours primary health services, ensuring patients have access to care when they need it.

The Department continued to support access to health information, 24 hours a day, through telephone and digital communication channels.

Strengthening primary health care through improved quality and coordination

Improve efficiency and effectiveness of health services and coordination of care at the local level.

Source: 2017-18 Health Portfolio Budget Statements, p.77

2017-18 Target

2017-18 Result

All PHNs engage with their local health care providers, including Local Hospital Networks (or their equivalent) and other stakeholders to improve health services and care coordination for their communities.36

All PHNs are engaging with their local health care providers and other relevant stakeholders to improve health services and care coordination for their communities.

Result: Met

36 Stakeholder engagement, including engagement with local health providers, is a performance indicator under the Primary Health Network Performance Framework (version 1). PHNs reported against this indicator through their 2017-18 six and twelve month performance reports.

PHNs engage with stakeholders within their region through specific governance structures, such as clinical councils and community advisory committees and broader community consultations, including with Local Hospital Networks (or their equivalent) and the local community. This input is used to identify and prioritise needs, plan services to meet needs and evaluate effectiveness of delivered services.

Improve continuity of care and coordinated services for patients with chronic and complex illnesses.

Source: 2017-18 Health Portfolio Budget Statements, p.78

2017-18 Target

2017-18 Result

Commencement of patient enrolment and service delivery through Health Care Homes (HCH).

Deliver training modules successfully to selected practices.

Ongoing support mechanisms are in place to support HCH.

Implementation of evaluation framework across enrolled practices and patients.

Patient enrolment and service delivery has commenced through HCH and training modules have been successfully delivered to selected practices.

Ongoing support mechanisms are now in place and the evaluation framework has been implemented across enrolled practices and patients.

Result: Met

Patient enrolment and service delivery has commenced, with enrolment numbers lower than anticipated. Training modules have been delivered to selected practices and continue to be delivered to practices that have joined the trial following the second phase of commencement from December 2017. Departmental and PHN support mechanisms are in place and are being adjusted to support increased enrolment.

Improve access to health advice, information and support services for the Australian community.

Source: 2017-18 Health Portfolio Budget Statements, p.78

2017-18 Target

2017-18 Result

Health information and advice is successfully provided to the community.37

Health information and advice continued to be provided 24 hours a day through telephone and digital communication channels. There has been an increase in visits to the health information website and an increase in information requests made through the National Health Service Directory.

Result: Met

37 Success is measured through appropriate information uptake and cost-effectiveness. The Government will ensure that regular randomised sample post surveys are undertaken to measure and determine the uptake of clinical advice and information from the public following use of the national health communication infrastructure.

The quality of information and website material is continually improving and regularly updated to support the advice and information provided to the public. A framework has been established to ensure relevant clinical subject matter experts within Australia are consulted to maintain best practice at all times.

On average there has been a 70% increase in new visits to the health information website and return visitor rate of approximately 21%.

Program 2.6: Primary Care Practice Incentives

The Department met the performance target related to this program.

In 2017-18, the Department supported the Government to continue to fund the Practice Incentives Program (PIP) supporting general practice activities by encouraging continuing improvements, increased quality of care, enhanced capacity and improved access and health outcomes for patients.

In recognition of the need to provide general practices with additional time to prepare for the changes and to ensure all implementation issues have been fully identified and addressed, implementation of the new PIP Quality Improvement Incentive was postponed for 12 months and will now occur on 1 May 2019.

Supporting quality care, enhanced capacity and improved access through general practice incentives

Improve access to quality accredited general practitioner care through maintaining

the percentage of general practice patient care services provided by Practice Incentives Program (PIP) practices.38

Source: 2017-18 Health Portfolio Budget Statements, p.79

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥84.2%

85%39

91.0%

86.0%

85.0%

84.7%

Result: Met

38 This is calculated as the proportion of total Medicare Benefit Schedule fees for non-referred attendances provided by PIP practices, standardised for age and sex.

39 The figure of 85% is an estimate only as the final figure cannot be confirmed until November 2018.

There are 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.

Program 2.7: Hospital Services

The Department met the performance target related to this program.

The Department supports the Government to improve access to and efficiency of, public hospitals through the provision of funding to states and territories. In 2017-18, the National Health Reform Agreement Addendum commenced and a five-year Heads of Agreement on hospital funding from 2020 was signed by six states and territories. These agreements will support more doctors, nurses, services, patients and reforms to the system in preventive health and health data.

Supporting the states and territories to deliver efficient public hospital services

Provide advice to the Minister and external stakeholders in relation to public hospital funding policy.

Source: 2017-18 Health Portfolio Budget Statements, p.80

2017-18 Target

2017-18 Result

Provide advice and analysis in relation to public hospital funding, including:

  • implementation of the National Health Reform Agreement Addendum; and
  • development of longer term public hospital funding arrangements.

Advice and analysis in relation to public hospital funding was provided through implementation of the National Health Reform Agreement Addendum and development of longer term public hospital funding agreements.

Result: Met

On 1 July 2017, the National Health Reform Agreement Addendum 2017-18 to 2019-20 commenced. A new Heads of Agreement was signed by six states and territories to cover the five years from 2020.The Heads of Agreement outlines areas for long term reform in Australia’s health system.

Outcome 2 - Budgeted expenses and resources

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 2.1: Mental Health1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

778,042

759,708

(18,334)

Departmental expenses

Departmental appropriation2

20,701

21,474

773

Expenses not requiring appropriation in the budget year3

537

584

47

Total for Program 2.1

799,280

781,766

(17,514)

Program 2.2: Aboriginal and Torres Strait Islander Health1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

865,806

856,784

(9,022)

Departmental expenses

Departmental appropriation2

35,229

35,383

154

Expenses not requiring appropriation in the budget year3

918

964

46

Total for Program 2.2

901,953

893,131

(8,822)

Program 2.3: Health Workforce

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

1,287,695

1,296,175

8,480

Departmental expenses

Departmental appropriation2

34,181

34,924

743

Expenses not requiring appropriation in the budget year3

884

947

63

Total for Program 2.3

1,322,760

1,332,046

9,286

Program 2.4: Preventive Health and Chronic Disease Support1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

442,472

373,999

(68,473)

Departmental expenses

Departmental appropriation2

43,934

46,173

2,239

Expenses not requiring appropriation in the budget year3

1,121

1,243

122

Total for Program 2.4

487,527

421,415

(66,112)

Program 2.5: Primary Health Care Quality and Coordination

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

404,896

400,252

(4,644)

Departmental expenses

Departmental appropriation2

27,282

27,396

114

Expenses not requiring appropriation in the budget year3

703

746

43

Total for Program 2.5

432,881

428,394

(4,487)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

2 Departmental appropriation combines ‘Ordinary annual services(Appropriation Act No. 1)’ and‘ Revenue from independent sources (s74)’.

3 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 2.6: Primary Care Practice Incentives

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

352,063

343,487

(8,576)

Departmental expenses

Departmental appropriation2

2,216

1,779

(437)

Expenses not requiring appropriation in the budget year3

57

49

(8)

Total for Program 2.6

354,336

345,315

(9,021)

Program 2.7: Hospital Services1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

14,474

14,435

(39)

Departmental expenses

Departmental appropriation2

25,821

25,887

66

Expenses not requiring appropriation in the budget year3

3,739

3,742

3

Total for Program 2.7

44,034

44,064

30

Outcome 2 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

4,145,448

4,044,839

(100,609)

Departmental expenses

Departmental appropriation2

189,364

193,016

3,652

Expenses not requiring appropriation in the budget year3

7,959

8,275

316

Total expenses for Outcome 2

4,342,771

4,246,130

(96,641)

Average staffing level (number)

997

960

(37)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

2 Departmental appropriation combines ‘Ordinary annual services(Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

3 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

Outcome 3 - Sport and Recreation

Improved opportunities for community participation in sport and recreation, excellence in high-performance athletes, and protecting the integrity of sport through investment in sport infrastructure, coordination of Commonwealth involvement in major sporting events, and research and international cooperation on sport issues

Highlights

Sporting Schools program exceeding expectations

The Sporting Schools program has continued to exceed expected targets, with children from across 6,570 schools participating in the program.

Program 3.1

World sport returns to Australia

Australia successfully hosted the Gold Coast 2018 Commonwealth Games, the Women’s Rugby League World Cup and co-hosted the men’s Rugby League World Cup.

Program 3.1

Summary of results against performance criteria

Program

Targets met

Targets substantially met

Targets not met

Program 3.1: Sport and Recreation

2

1

-

Total

2

1

-

Program 3.1: Sport and Recreation

The Department met or substantially met all performance targets related to this program.

Sport holds a special place in Australia’s society and makes a substantial contribution to economic, health, cultural and social outcomes in the community. The Department worked closely with a range of partners and stakeholders to ensure the Australian community has confidence in fair sporting competitions and the sporting sector as a whole. This work also extended beyond Australia’s borders to contribute to global efforts for all athletes to compete on a level playing field, free from undue external enhancements or criminal influence.

The Department supported the Government in enhancing Australia’s reputation as a pre-eminent host of major sporting events, with the successful hosting of the Rugby League World Cup in 2017 and the Gold Coast 2018 Commonwealth Games. The success of both these events showcased Australia’s capacity to stage world-class events.

Case Study: XXI Commonwealth Games – Gold Coast 2018

The XXI Commonwealth Games were held in Australia on 4–15 April 2018, comprising 18 sports and seven para sports. The majority of events were held on the Gold Coast with additional events in Brisbane, Cairns and Townsville. The Gold Coast 2018 Commonwealth Games (GC2018) had the largest integrated para-sports program in Commonwealth Games history, and for the first time in a major international multi-sport Games, there were an equal number of medal events for men and women across all sports.

The Australian Government invested substantial strategic policy, financial, governance and operational assistance to support the delivery of a safe and successful GC2018 and ensure a lasting legacy for the Gold Coast, Queensland and Australia.

GC2018 was the culmination of significant Australian Government coordination and planning over a number of years, led by the Department’s Office for Sport (OFS). From the bid phase commencing in 2010, OFS managed the strategic planning and implementation of GC2018 operational services across more than 20 Australian Government agencies. This was in partnership with the Department of Home Affairs, which managed Australian Government security arrangements.

At Games time, OFS deployed a team of eight liaison officers to represent the Australian Government in the Games Operations Centre on the Gold Coast. OFS liaison officers provided strategic advice and issue resolution support to Games delivery partners including the Queensland Government, the Gold Coast 2018 Commonwealth Games Corporation and the Commonwealth Games Federation to support the smooth and effective delivery of Games operations. OFS liaison officers also supported the attendance of a number of Australian Government representatives at GC2018, including the Governor-General, Prime Minister and Minister for Sport.

Increasing participation in sport and recreation activities, fostering excellence in Australia’s high-performance athletes and protecting the integrity of Australian sport

Support participation in sport through the development, implementation and promotion of national policies and strategies.

Source: 2017-18 Health Portfolio Budget Statements, p.84 and Health Corporate Plan 2017-18, p.30

2017-18 Target

2017-18 Result

Provide strategic, high quality policy advice to Government and ensure a coordinated, whole-of-government approach to the development and implementation of relevant policies and strategies, including the release of the National Sport Plan.

The Department worked across government and with key stakeholders on the development of significant sport, participation and water and snow safety policies. Following significant public consultation in 2017-18, the National Sport Plan (the Plan) was released on 1 August 2018.

Result: Substantially met

The Department also worked with other entities on policies and programs aimed at increasing participation in sport. The Sporting Schools program, run by the Australian Sports Commission (ASC) remains a key initiative to drive increased participation. Since 2015, Sporting Schools program has exceeded expected targets, with over 350,000 children per term participating in the program across 6,570 schools.

The Department continued to support the Girls Make Your Move campaign (the campaign), which is aimed at inspiring, energising and empowering young women and girls aged 12–21 years to be more active.

It reinforces the many benefits of an active life, whether through recreation, incidental physical activity or sport.

Phase three of the campaign launched in March 2018. The campaign continued to address the issue of inactivity by encouraging young women’s participation in physical activity and sport by reducing barriers, generating positive perceptions towards exercise and prompting them to be more active.5

The Department, as part of the Committee of Australian Sport and Recreation Officials, endorsed the National Policy Framework for Girls and Women in Sport for presentation at the next Meeting of Sport and Recreation Ministers. The Framework is a national commitment from all jurisdictions to challenge societal perception of gendered norms and create change to increase the number of girls and women in sport.

The Department supported the Government to deliver funding to water and snow safety providers to prevent the incidence of deaths and injuries in aquatic and alpine environments. In addition, water and snow safety participation strategies and initiatives were amalgamated in order to streamline operations and service delivery.

In 2017-18, the National Sport Plan – Sport 2030 was developed and subsequently launched by Senator The Hon Bridget McKenzie on 1 August 2018. The Plan’s focus is on four strategic priorities: participation in sport and physical activity; high performance; integrity of sport; and the sports industry.

The Plan sets out the Government’s vision for Australia to be the world’s most active and healthy sporting nation, known for its integrity and sporting success. The Plan aims to achieve increased physical activity for all Australians, for life.

Case Study: Girls Make Your Move – empowering young women to be more active

The Girls Make Your Move campaign is about inspiring, energising and empowering young women and girls aged 12–21 years to be more active. It reinforces the many benefits of an active life, whether through recreation, incidental physical activity or sport.

The campaign was developed in response to research that identified over 55% of girls aged
15–17 years reported no or low exercise levels, compared to boys (38%). Young women also tend to reduce their participation in sport and their physical activity levels at a faster rate than their male counterparts.

Now in its third year, the campaign addresses this issue by encouraging young women’s participation in physical activity and sport by reducing perceived barriers, generating positive perceptions towards exercise and generating intentions to be more active.

The campaign encourages sport and physical activity to be a natural part of young women’s lives – a habit they lay down in their teenage years that will hopefully become lifelong.

Being active has many physical, social, emotional and economic benefits for individuals and the community. Regular physical activity can help with managing stress, alleviating depression and anxiety, strengthening self-esteem, enhancing mood and boosting mental alertness. It also provides social benefits through increased social interaction and integration.

Comprising of a website, Instagram and Facebook presence (both have over 31,000 followers), advertising across traditional and social media, events and public relations, the campaign has reached over 80% of young women and girls aged 12–21 years. The campaign has been positively received, with more than one in five girls surveyed indicating they had done more physical activity or sport as a result of the campaign.

Provide whole-of-government leadership and coordination of major international sporting events in Australia, including the development and implementation of related policies and strategies,

to support each event.

Source: 2017-18 Health Portfolio Budget Statements, p.84 and Health Corporate Plan 2017-18, p.30

2017-18 Target

2017-18 Result

Strategies and policies are implemented to meet agreed Australian Government obligations to support the:

  • 2017 Rugby League World Cup; and
  • Gold Coast 2018 Commonwealth Games.

To support the Australian Government’s obligations, the Department led and coordinated a wide array

of activity across government departments. These strategies ensured the successful staging of the Gold Coast 2018 Commonwealth Games and the 2017 Rugby League World Cup.

Result: Met

In 2017-18, the Department implemented a range of activities in conjunction with other relevant portfolios to support these major sporting events. Activities included customs, visas and biosecurity arrangements at airports; radio-communication spectrum management6; anti-doping; legacy7, trade and tourism; and security.

The Department is currently undertaking coordination strategies and preparations for the 2018 Invictus Games, 2018 IWRF8 Wheelchair Rugby World Championship, 2019 INAS9 Global Games and 2020 International Cricket Council World Twenty20. The Department is also supporting Australian bids for the 2021 Women’s Rugby World Cup and 2023 FIFA10 Women’s World Cup.

Case Study: Rugby League World Cup 2017 – History was made

The fifteenth staging of the Rugby League World Cup 2017 (RLWC2017) took place from 27 October to 2 December 2017. Twenty national teams participated across both men’s and women’s competitions playing matches in 13 host cities across Australia, New Zealand and Papua New Guinea.

For the first time in the sport’s history, the women’s Rugby League World Cup was held in conjunction with the men’s Rugby League World Cup. The men’s tournament comprised 28 matches in a five week tournament across the three host nations. The women’s tournament was staged over two weeks with all pool matches and semi-finals played in Cronulla, New South Wales, and the final played as a double header with the men’s final in Brisbane, Queensland. The culmination saw both the Australian men’s and women’s teams crowned World Champions on home soil.

The Government provided a one-off grant of $500,000 to RLWC2017 to support planning and enhance the delivery of the women’s tournament. In doing so, the women’s RLWC2017 set new standards for both athletes and spectators, including team logistics, training and playing conditions, game-day experience and international broadcast. Australian Government support was primarily recognised through marketing and promotional opportunities for the Girls Make Your Move physical activity campaign directed toward girls and young women.

The Department’s Office for Sport led Australian Government support for the RLWC2017, including the coordination of national security (in partnership with the Department of Home Affairs), immigration, customs, biosecurity, sports diplomacy and international relations, tourism and communications. The Office for Sport also provided strategic support to event delivery partners including state and territory governments, the RLWC2017 Organising Committee and the Rugby League International Federation.

Protect the integrity of Australian sport from threats of match-fixing, doping, criminal infiltration and other forms of corruption.

Source: 2017-18 Health Portfolio Budget Statements, p.85 and Health Corporate Plan 2017-18, p.30

2017-18 Target

2017-18 Result

Australian anti-doping arrangements are compliant with the World Anti-Doping Code. Sports integrity efforts of national sporting organisations and states and territories are supported through ongoing assessment of the sports integrity threats and related briefings, education platforms and initiatives.

As part of the National Sport Plan, review anti-doping and integrity structures.

Australian anti-doping arrangements were identified by the World Anti-Doping Agency as compliant

with the World Anti-Doping Code.

The Department supported the integrity efforts of national sporting organisations and states and territories through a range of outreach

and educative initiatives.

The joint National Integrity of Sport Unit/Australian Criminal Intelligence Commission Sports

Betting Integrity Unit was formally established in November 2017.

The Department supported the conduct of the Review of Australia’s Sports Integrity Arrangements (Wood Review), as part of the National Sport Plan.

Result: Met

The sports integrity threat environment continued to present challenges at local, national and international levels and required a robust response across the sector. The Wood Review provides comprehensive analysis and recommendations to enhance the protection of Australian sport. The Department has established a taskforce and a Commonwealth Interdepartmental Committee to develop Wood Review implementation options for Government consideration, in consultation with stakeholders.

The establishment of the Sports Betting Integrity Unit provides, for the first time, a single national platform to monitor and respond to match-fixing and sports wagering related corruption and to interact with similar international bodies.

The Sports Integrity Program provided support for a range of integrity initiatives including the anti-doping response to the Gold Coast 2018 Commonwealth Games; local regional and international anti-doping arrangements; anti-doping research; the conduct of the Wood Review; enhanced national sports drug testing capability; and national sports criminal intelligence capability.

In 2017-18, Australia continued to make a significant contribution to global efforts to combat sports corruption, particularly through collaboration with the World Anti-Doping Agency; United Nations Educational, Scientific and Cultural Organization; the Commonwealth; Council of Europe; Interpol; the International Olympic Committee; and other organisations.

Outcome 3 - Budgeted expenses and resources

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 3.1: Sport and Recreation1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

23,377

23,328

(49)

Special Accounts

Sport and Recreation

407

404

(3)

Departmental expenses

Departmental appropriation2

7,439

6,438

(1,001)

Expenses not requiring appropriation in the budget year3

214

192

(22)

Total for Program 3.1

31,437

30,361

(1,076)

Outcome 3 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

23,377

23,328

(49)

Special Accounts

407

404

(3)

Departmental expenses

Departmental appropriation2

7,439

6,438

(1,001)

Expenses not requiring appropriation in the budget year3

214

192

(22)

Total expenses for Outcome 3

31,437

30,361

(1,076)

Average staffing level (number)

40

36

(4)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

2 Departmental appropriation combines ‘Ordinary annual services(Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

3 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

Outcome 4 - Individual Health Benefits

Access to cost-effective medicines, medical, dental and hearing services, and improved choice in health services, including through the Pharmaceutical Benefits Scheme, Medicare, targeted assistance strategies and private health insurance

Highlights

MBS continues to support access to modern, high-quality and cost-effective services in line with best clinical evidence

Over 414.3 million Medicare funded services and benefits of over $23.2 billion provided to Australian patients.

Program 4.1

293.5 million prescriptions11 for medicines filled under the PBS

The PBS continued to provide timely, reliable and affordable access to necessary medicines for Australians, with 329 new medicines listed in 2017-18.

Program 4.3

More than 1.1 million children provided with essential dental services

Through the Child Dental Benefits Schedule, eligible Australian children aged 2–17 years continued to have access to essential dental services.

Program 4.6

8,722 children and young people provided with subsidised continuous glucose monitoring products

Through the National Diabetes Services Scheme, children and young people under 21 years of age with type 1 diabetes are assisted to manage their blood glucose levels and control their diabetes.

Program 4.8

Programs contributing to Outcome 4

Summary of results against performance criteria

Program

Targets met

Targets substantially met

Targets not met

Program 4.1: Medical Benefits

5

-

-

Program 4.2: Hearing Services

1

-

-

Program 4.3: Pharmaceutical Benefits

13

1

-

Program 4.4: Private Health Insurance

2

-

-

Program 4.5: Medical Indemnity

2

-

-

Program 4.6: Dental Services

1

-

-

Program 4.7: Health Benefit Compliance

1

-

-

Program 4.8: Targeted Assistance – Aids and Appliances

3

-

-

Total

28

1

-

Program 4.1: Medical Benefits

The Department met all performance targets related to this program.

The Department supported the Government to provide continued access to a modern, high-quality Medicare system based on current clinical evidence. This has included supporting the review of Medicare Benefits Schedule (MBS) items, run by the clinician-led MBS Review Taskforce. Over 90% of all MBS items were either under active review or had been reviewed and the Taskforce finalised its advice to the Minister for Health through a number of clinical reports.

The Department continued to support the Government to operate targeted assistance programs for Australians who require life-saving treatment not available in Australia and the provision of medical assistance to eligible Australians following specific overseas disasters. Assistance was also provided to women who have undergone a mastectomy as a result of breast cancer through the Breast Prostheses Reimbursement Program.

In 2017-18, the Department produced six revised pathology accreditation standards. Accreditation standards ensure that Australians have access to safe and effective pathology services. The Department supported our Ministers to also provide funding for an additional ten radiotherapy facilities, to provide Australians access to high quality radiotherapy services.

Ensuring continued access to a Medicare system that provides modern, high quality and cost-effective professional health services that are in line with current clinical evidence

Continued review of MBS items to maintain a Medicare system that provides high value care to the Australian public based on evidence and best clinical practice.

Source: 2017-18 Health Portfolio Budget Statements, p.93 and Health Corporate Plan 2017-18, p.31

2017-18 Target

2017-18 Result

Clinical Committees47 will have considered 70% of the MBS items for the review.

Clinical Committees have considered 90% of the MBS items for the review.

Result: Met

Since the review commenced, there have been over 70 Clinical Committees and working groups established by the independent, clinician-led MBS Review Taskforce. As at 30 June 2018, more than 90% of the over 5,700 MBS items were under active review or had been reviewed. The Taskforce has finalised its advice to the Minister through a number of clinical reports.

The Taskforce is aiming to finalise the majority of its recommendations to Government, with implementation of accepted recommendations to occur into 2019-20.

Providing targeted medical assistance, including to Australians who require life-saving medical treatment not available in Australia; and access to breast prostheses for women who have had breast cancer

To provide financial assistance to Australians for appropriate medical treatment not available in Australia or for out-of-pocket healthcare costs as a result of specific overseas disasters.

Source: 2017-18 Health Portfolio Budget Statements, p.94

2017-18 Target

2017-18 Result

Applications for financial assistance for medical treatment overseas are assessed in a timely manner in accordance with program guidelines.

Ensure that the Reciprocal Health Care Agreements48 are supporting Australians who travel overseas.

All applications for financial assistance for medical treatment overseas were assessed in accordance with the established program guidelines, with financial assistance provided to eligible applicants.

Agreements with 11 countries cover the cost of medically necessary care when Australians visit these countries and visitors from these countries visit Australia.

Result: Met

The Department received 20 applications during 2017-18 for financial assistance under the Medical Treatment Overseas Program (MTOP). Eleven individuals with life-threatening conditions received MTOP funding to undergo life-saving treatment overseas. These applicants were supported by independent expert advice from medical professionals.

The Australian Government has Reciprocal Health Care Agreements (RHCA) with New Zealand, United Kingdom, Republic of Ireland, Sweden, the Netherlands, Finland, Italy, Belgium, Malta, Slovenia and Norway. In 2017-18, 106,461 MBS services were provided to visitors to Australia under the RHCA with a total of $7.17 million paid in benefits.

Improving the quality of life of women who have undergone a mastectomy as a result of breast cancer, through efficient processing of claims from eligible women under the National External Breast Prostheses Reimbursement Program.

Source: 2017-18 Health Portfolio Budget Statements, p.94

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥90%

97%

95%

98%

98%

98%

Result: Met

In 2017-18, $6.2 million was paid in reimbursements under this program.

Of the 14,448 eligible claims made, 97% were processed within ten business days of lodgement. Timely processing of claims under this program benefits recipients through the provision of reimbursement for the cost of their prostheses.

Supporting safe and effective diagnostic imaging and pathology services

Maintain a consistent and contemporary accreditation framework which underpins all Medicare eligible pathology services.

Source: 2017-18 Health Portfolio Budget Statements, p.94

2017-18 Target

2017-18 Result

Ensure consumers have continued access to up-to-date, quality pathology services through reviewing and updating the Australian Pathology Accreditation Framework, as required.

The Department ensured consumers had continued access to safe and quality pathology services through contemporary quality standards.

Six revised pathology accreditation standards were recently endorsed.

Result: Met

Six revised pathology accreditation standards were recently endorsed by the National Pathology Accreditation Advisory Council.

These revised accreditation standards reflect current best practice and continue to ensure Australians have access to high quality pathology services through the National Pathology Accreditation Program.

Supporting the delivery of high quality radiation oncology services

Ensure Australians have access to high quality radiotherapy services through the Radiation Oncology Health Program Grant Scheme.

Source: 2017-18 Health Portfolio Budget Statements, p.95

2017-18 Target

2017-18 Result

Provide targeted financial contributions to the capital cost of radiation oncology linear accelerators49 located in priority areas as agreed between the Commonwealth and relevant states and territories.

Targeted financial contributions were provided, with an increase of ten approved facilities, bringing the approved facility count to 96.

Result: Met

49 The device most commonly used for external beam radiation treatments for patients with cancer.

Ten additional radiotherapy facilities were funded for an additional $7.8 million in 2017-18 under the Scheme. These additional facilities are an increase from the approved facility count of 86 in 2016-17. This will ensure Australians have access to high quality radiotherapy services through the Scheme.

Program 4.2: Hearing Services

The Department met the performance target related to this program.

The Hearing Services Voucher Program provides eligible clients with a range of services to help manage their hearing loss, including assessments, hearing aids, fittings, maintenance and rehabilitation services. Under the program, hearing services and devices are provided by a national network of service providers.

The Department supported our Ministers on delivering continued support to hearing research that focuses on ways to reduce the impact of hearing loss and the incidence and consequences of avoidable hearing loss in the Australian community.

Supporting access to high quality hearing services and research into hearing loss prevention and management

Support access to high quality hearing services by providing voucher services nationally.

Source: 2017-18 Health Portfolio Budget Statements, p.96

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

745,000 voucher clients

733,400

713,182

692,283

669,793

647,545

Result: Met

The voucher component of the program is client demand-driven and the projected target is an estimation based on population parameters and historical trends.

In 2017-18, 733,400 clients accessed the voucher component of the program at a cost of $449.2 million.

The performance result of ‘met’ is based on meeting all of the 2017-18 actual demand.

Program 4.3: Pharmaceutical Benefits

The Department met or substantially met all performance targets related to this program.

Reliable, timely and affordable access to cost-effective, high quality medicines and pharmaceutical services is key to improving the health of all Australians. In 2017-18, the Department supported the Government to strengthen the Pharmaceutical Benefits Scheme (PBS) to ensure it remains affordable into the future through extensive consultation with stakeholders and the medicines industry. The Department continued to support Australians’ access to PBS medicines and patient focussed care through programs and services delivered under the Sixth Community Pharmacy Agreement and compacts developed in partnership with Medicines Australia, the Pharmacy Guild of Australia and the Generic and Biosimilar Medicines Association.

The Department supported the Government to continue to ensure that patients with life threatening conditions had access to essential medicines through the Life Saving Drugs Program and supported access to PBS-funded medicines and medicines data.

The Department also supported the Pharmaceutical Benefits Advisory Committee (PBAC) to ensure new medicines are considered and listed on the PBS in a timely manner. This ensures the Australian public has access to new and affordable innovative medicines.

Providing access to new and existing medicines for patients with life-threatening conditions

Ensure eligible patients have access to the Life Saving Drugs Program.

Source: 2017-18 Health Portfolio Budget Statements, p.98

2017-18 Target

2017-18 Result

Patient applications are processed within 30 calendar days of receipt.

All patient applications were processed within 30 calendar days of receipt.

Result: Met

Ensure continued access to eligible patients to medicines under the Life Saving Drugs Program.

Source: 2017-18 Health Portfolio Budget Statements, p.98

2017-18 Target

2017-18 Result

Facilitate continued eligible patient access to life saving medicines.

The Department facilitated access to life saving medicines for all eligible patients.

Result: Met

The Life Saving Drugs Program (LSDP) provides fully subsidised access for eligible patients to expensive and life saving medicines for rare and life-threatening medical conditions. Eligible patients had timely access to subsidised treatment and all patient applications with the required information were processed within 30 calendar days of receipt.

There are currently 13 drugs funded on the LSDP (one new drug listed in 2017-18), at no cost to patients. The new drug Vimizim® (elosulfase alfa), was made available to provide life-saving treatment to Australian patients who have a rare medical condition known as Morquio A Syndrome. As at 30 June 2018, there were 403 patients being treated on the LSDP.

Ensuring access to innovative, clinically effective and cost-effective medicines through the PBS

Percentage of submissions for new medicines that are recommended for listing by Pharmaceutical Benefits Advisory Committee (PBAC), that are listed on the PBS within six months of agreement of budget impact and price.

Source: 2017-18 Health Portfolio Budget Statements, p.99

2017-18 Target

2017-18 Result

2016-17

2015-16

80%

88%

85%

92%

Result: Met

Negotiations with product sponsors and listing activities for new listings of medicines on the PBS were completed in a timely manner, with 88% being listed on the PBS within six months of agreement on price and the overall cost to Government.

The Department uses this metric because agreement must be reached with a sponsor on price and budget impact before a listing can be finalised by Government. Discussion regarding the finalisation of price and budget impact following PBAC recommendation are often complex and may, in limited circumstances, require further PBAC consideration.

For more information on submissions to the PBAC, refer Appendix 2: Process leading to PBAC consideration – Annual Report for 2017-18.

Supporting timely access to medicines and pharmacy services

Deliver an increased suite of reporting and data related to pharmacy and PBS funded medicine access and cost made available to Parliament, consumers and business.

Source: 2017-18 Health Portfolio Budget Statements, p.99

2017-18 Target

2017-18 Result

Periodically increase the volume and nature of data on the Department of Health website during the course of 2017-18.

The Department increased the volume and nature of data related to pharmacy and PBS funded medicines on its website.50

Result: Met

50 Available at: www.pbs.gov.au/pbs/home

The Department has access to more detailed data and is now reporting based on the date of supply.

Each month more data in relation to the volume and type of medicines dispensed in community pharmacies is released on the PBS website. This is used by businesses, pharmaceutical industry stakeholders and researchers to create a better understanding of pharmacy and the pharmaceutical sector in Australia. In addition, each month the Department, through its data governance and release processes, makes PBS and other pharmacy related data available to researchers, state and territory governments and non-government health administrators.

Percentage of Urban Centres51 in Australia with a population of 1,000 persons or more with an approved supplier52 of PBS medicines.

Source: 2017-18 Health Portfolio Budget Statements, p.99 and Health Corporate Plan 2017-18, p.31

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

>90%

90.56%

91.96%

91.8%

N/A

N/A

Result: Met

51 Available at: www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1270.0.55.004~July%202016~Main%20 Features~Design%20of%20UCL~8

52 For this criterion, an approved supplier includes a pharmacy, a medical practitioner (in rural/remote locations where there is no access to a pharmacy) or an Aboriginal Health Service, approved to supply PBS medicines to the community. It does not include an approved hospital authority, approved to supply PBS medicines to its patients.

Percentage of Urban Centres in Australia with a population of 1,000 persons or more with a resident service provider of, or recipient of, Medscheck, Home Medicines Review, Residential Medication Management Review or Clinical Intervention.

Source: 2017-18 Health Portfolio Budget Statements, p.100

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

>80%

89.1%

90%

97%

N/A

N/A

In 2017-18, 89.1% of communities with a population of 1,000 persons or more had access to medication adherence and medication management programs to support safe, effective and appropriate use of medicines; including avoiding adverse events and decreasing hospitalisations. The 2017-18 target was amended from prior years from Urban Centres/Localities to Urban Centres only.

Percentage of subsidised PBS units delivered to community pharmacy within agreed requirements of the Community Service Obligation.

Source: 2017-18 Health Portfolio Budget Statements, p.100

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

>95%

98.4%

97.5%

96%

N/A

N/A

Result: Met

Average cost per subsidised script funded by the PBS.53

Source: 2017-18 Health Portfolio Budget Statements, p.100

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

$35.46

$29.11

$31.08

$27.37

N/A

N/A

Result: Met

53 This is the projected average cost to Government for section 85 PBS subsidised prescriptions.

Average cost per script (subsidised and non-subsidised) paid by consumers for PBS medicines.54

Source: 2017-18 Health Portfolio Budget Statements, p.100

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

$10.41

$9.99

$9.84

$9.27

N/A

N/A

Result: Met

54 This is the projected average for section 85 PBS prescriptions, including under co-payment prescriptions.

The average cost targets are estimates only. The results are driven by external market forces, and outside the control of the Department. Downward pressure on prices for consumers continues through price disclosure policies. Analysis indicates the average number of section 8512 hepatitis C prescriptions per month in 2017-18 was 50% lower than in 2016-17. These medicines form a significant proportion of Government spending on the PBS.

Maintaining the effectiveness of the PBS through monitoring and post-market surveillance

Post-market reviews deliver relevant and high quality advice to the PBAC and Government.

Source: 2017-18 Health Portfolio Budget Statements, p.101

2017-18 Target

2017-18 Result

Reference groups established, and continue to engage constructively with professional and community stakeholders in the conduct of the reviews.

Reference groups were established and engaged constructively with key stakeholders in the conduct of post-market reviews.

Result: Met

Percentage of post-market reviews completed within scheduled timeframes.

Source: 2017-18 Health Portfolio Budget Statements, p.101

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

90%

94%

100%

100%

N/A

N/A

Result: Met

Percentage of Government-accepted recommendations from post-market reviews that have been implemented within agreed timeframes.

Source: 2017-18 Health Portfolio Budget Statements, p.101

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

80%

100%

85%

80%

N/A

N/A

Result: Met

Reference groups supported each of the post-market reviews for:

  • ezetimibe;
  • chronic obstructive pulmonary disease medicines (COPD);
  • pulmonary arterial hypertension medicines; and
  • the use of biologics in the treatment of severe chronic plaque psoriasis.

For each review, reference groups were established and engaged constructively with key stakeholders in the conduct of post-market reviews. Each reference group included members with clinical and technical expertise, industry representatives and consumer advocates to ensure relevant and high quality advice was provided.

Two reviews were completed in 2017-18; ezetimibe and COPD. The post-market review of ezetimibe recommended PBS restriction changes to lipid lowering medicines and a price reduction to restore cost-effectiveness. The Australian public will benefit from updated restrictions for lipid lowering medicines, that reflect contemporary treatment guidelines, and from reduced cost to the community.

The post-market review of COPD will benefit the Australian public through updated restrictions for COPD medicines that now align with clinical guidelines. Health professionals and consumers will benefit from information and access to medicines designed to meet clinical needs, and which reduce any inappropriate use of combination inhaler medicines.

The post-market reviews of pulmonary arterial hypertension medicines and the use of biologics in the treatment of severe chronic plaque psoriasis conducted during 2017-18 are expected to be completed by October 2019.

Information regarding quality use of medicines is provided to health professionals and consumers to support use of therapeutics wisely, judiciously and safely to achieve better health and economic outcomes.

Source: 2017-18 Health Portfolio Budget Statements, p.101

2017-18 Target

2017-18 Result

The Department will provide funding for the provision of quality use of medicines information to be available in a variety of formats throughout the year, designed to support health professionals and consumers.

The Department supported the Government to fund NPS MedicineWise to produce publications, resources and educational visits, which provided evidence-based information on therapeutics, including new and revised listings of medicines

on the PBSfor health professionals and consumers.

Result: Met

Education was provided to health professionals in the form of educational visits, online modules, resources and publications. Targeted consumer information campaigns included antibiotic awareness and a range of other targeted topics. NPS MedicineWise published Rational Assessment of Drugs and Research, Australian Prescriber and an annual evaluation report of all NPS MedicineWise programs.

NPS MedicineWise continues to make progress through its Choosing Wisely Australia initiative, increasing membership across a broad section of professional colleges, societies and associations. The initiative helps healthcare providers and consumers start important conversations about improving the quality of healthcare by eliminating unnecessary or harmful tests, treatments and procedures.

Estimated savings to Government from price disclosure.

Source: 2017-18 Health Portfolio Budget Statements, p.102

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

$3,600m

$2,735.9m

$2,429.2m

$2,258.4m

N/A

N/A

Result: Substantially met

Price disclosure is continuing to produce significant savings, that are driven by market forces. While savings to Government are lower than estimated, medicine prices continue to reduce to below the general patient co-payment of $39.50, resulting in a reduction to consumers out-of-pocket costs.

Savings from price disclosure are expected to continue as a result of increased generic dispensing generating further price reductions, driven by e-Prescribing (including International Nonproprietary Name prescribing) upgrades announced in the 2018-19 Budget.

From 2018-19, the Department will measure performance in terms of the ‘percentage of eligible medicines assessed’ by the Department in accordance with price disclosure requirements under the National Health Act 1953 and National Health (Pharmaceutical Benefits) Regulations 2017, rather than against financial savings targets.

Program 4.4: Private Health Insurance

The Department met all performance targets related to this program.

The Department assists the Government to work with private health insurers to support cost-effective private health insurance products and encourages membership and sustainability in the private health insurance industry. The Department monitors the compliance of the industry and discusses any compliance and legislative issues with insurers, to ensure that the protections offered to the community under the regulatory framework are adopted appropriately and consistently.

In 2017-18, the Department supported the Government to deliver reforms to make private health insurance simpler and more affordable. This includes simpler coverage for mental health treatment.

The Department also works to ensure that privately insured patients have access to clinically effective and cost effective prostheses. Through the agreement between the Government and the Medical Technology Association of Australia, the cost of prostheses to private health insurers has decreased by $188 million for the 2018 private health insurance premium round. This reduction in prostheses expenditure places downward pressure on private health insurance premium increases, meaning lower premium changes for consumers. The 2018 average weighted premium increase of 3.95 per cent was the lowest in 17 years.

In 2017-18, the Department continued to support the Private Health Ministerial Advisory Committee, chaired by Dr Jeffrey Harmer AO, which includes consumer, health insurer, hospital, clinician and allied health representatives. This committee provides advice to the Minister for Health on the private health insurance reforms and monitors the implementation of the reforms announced in 2017.

Supporting a viable, sustainable and cost-effective private health insurance sector, including through the private health insurance rebate

Robust policies and procedures are in place, including ensuring all private health insurers are compliant with relevant statutory and legislative requirements.

Source: 2017-18 Health Portfolio Budget Statements, p.103

2017-18 Target

2017-18 Result

Undertake effective compliance and enforcement through applying transparent and consistent procedures agreed with all industry stakeholders.

Undertake regular stakeholder communications with insurers and other regulatory agencies to provide two-way dissemination of information.

Compliance with private health insurance legislation was achieved through transparent, consistent and targeted stakeholder communications with insurers and other industry stakeholders, including other regulatory agencies.

Result: Met

The Department consults with a number of other regulatory agencies, including the Private Health Insurance Ombudsman, Australian Prudential Regulatory Authority and the Australian Competition and Consumer Commission. The regulatory agencies, together with the Department, actively monitor and enforce private health insurers’ legislative obligations.

The Department publishes industry circulars relating to compliance matters and identified areas for improvement or clarification. These circulars address issues such as:

  • legislative amendments and policy changes;
  • legislative clarification;
  • private health insurer processing requirements;
  • data requirements;
  • annual audit requirements; and
  • levy arrangements.

Ensure privately insured patients have access to clinically and cost-effective prostheses under the Private Health Insurance Act 2007.

Source: 2017-18 Health Portfolio Budget Statements, p.103

2017-18 Target

2017-18 Result

Support the Prostheses List Advisory Committee56 to reform the Prostheses List arrangements. Publish the Prostheses List enabling access to devices for privately insured patients.

The agreement between the Government and the Medical Technology Association Australia (the Agreement) specified a number of deliverables for 2017-18. These have been delivered.

The Prostheses List was published in August 201757 and February 201858.

Result: Met

56 Available at: www.health.gov.au/internet/main/publishing.nsf/Content/health-privatehealth-prostheseslist.htm

57 An amendment to the August 2017 Prostheses List was published with an effective date of 1 February 2018 to implement the first round of 2018 Prostheses List benefit reductions as outlined in the Agreement.

58 An amendment to the February 2018 Prostheses List was published in June 2018, with an effective date of 1 August 2018, to reflect the second round of 2018 Prostheses List benefit reductions.

The following commitments under the Agreement were implemented.

  • No duplication of safety and efficacy assessment by Prostheses List Advisory Committee and the Therapeutic Goods Administration.
  • Three industry working groups were established, which are considering the Prostheses List benefit setting and benefit review framework, funding of cardiac services to support active implantable cardiac devices and quality information and guidance for sponsors of medical devices.
  • A governance group was established to oversee the implementation of the Agreement.
Program 4.5: Medical Indemnity

The Department met all performance targets related to this program.

The Department supports the Government to administer a range of schemes, with the Department of Human Services, to support the stability of the medical indemnity industry and provide assurance to privately practicing doctors, midwives and their patients.

The Premium Support Scheme assists eligible doctors to reduce medical indemnity costs through a Government-funded subsidy. In 2017-18, the Government also maintained a contract with Medical Insurance Group Australia to subsidise the cost of medical indemnity insurance for eligible midwives.

These schemes improve the accessibility of professional indemnity insurance and help reduce out-of-pocket costs and improve choice for patients.

Ensuring the ongoing stability of the medical insurance industry and that insurance products are available and affordable

Enable continued availability of professional indemnity insurance for eligible midwives.

Source: 2017-18 Health Portfolio Budget Statements, p.104

2017-18 Target

2017-18 Result

Maintain a contract with an indemnity provider for the provision of professional indemnity insurance to eligible midwives.

A contract has been maintained with a medical indemnity provider for the provision of professional indemnity insurance to eligible midwives.

Result: Met

Eligible midwives receive a subsidy towards the cost of purchasing Commonwealth supported professional indemnity insurance from Medical Insurance Group Australia, assisting in keeping midwife care accessible and affordable to the community.

Decrease the number of doctors that require support through the Premium Support Scheme.59

Source: 2017-18 Health Portfolio Budget Statements, p.104

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

<1,500

985

1,268

1,237

1,400

1,613

Result: Met

59 A decline in doctors accessing the Premium Support Scheme is an indication of medical indemnity insurance being affordable.

Eligible doctors receive a subsidy towards the cost of their medical indemnity insurance, assisting in keeping medical care accessible and affordable to the community. All eligible applicants received a premium subsidy through the Premium Support Scheme in 2017-18.

Program 4.6: Dental Services

The Department met the performance target related to this program.

The Child Dental Benefits Schedule (CDBS) continued to provide access to essential dental health services to eligible children. Adult public dental patients were provided access to services through the extension to the National Partnership Agreement on Adult Public Dental Services.

Improving access to dental services

Support eligible children to access essential dental health services through the CDBS.

Source: 2017-18 Health Portfolio Budget Statements, p.105

2017-18 Target

2017-18 Result

1.11 million children access the CDBS.

Almost 1.12 million children accessed the CDBS in 2017-18.

Result: Met

The CDBS is a demand-driven, calendar year program, providing access to benefits for basic dental services for eligible children aged 2–17 years. Since the program commenced in 2014 the take-up rate has continued to trend upwards.

Program 4.7: Health Benefit Compliance

The Department met the performance target related to this program.

Under this program, the Department supports the Government to protect the integrity of Australia’s health payments system through prevention, identification and treatment of incorrect claiming, inappropriate practice and fraud by health care providers and suppliers and manages pathology rents regulations.

In 2017-18, the Department continued to build its data analytics capability and apply behavioural economics approaches to its Medicare provider compliance activities to enhance the integrity of the MBS, the PBS, the CDBS and health incentive payments.

Ensuring the integrity of health provider claiming

Improve health provider compliance through a contemporary program that utilises advanced analytics and behavioural economics to identify irregular payments and behaviours, measured through:

  1. Value of debts recovered.
  2. Behavioural change from activities from prior years.60

Source: 2017-18 Health Portfolio Budget Statements, p.106 and Health Corporate Plan 2017-18, p.31

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

a. $15.6m

$22.1m

$13.0m

$9.9m

N/A

N/A

b. $13.0m

$148.5m

N/A

N/A

N/A

N/A

Result: Met

60 Estimated savings to Government from improved health provider compliance, achieved through positive behavioural change.

In 2018-19, performance of this program will focus on ensuring we are targeting our compliance effectively to those providers whose claiming is non-compliant, so that the proportion of audits and reviews that are undertaken find non-compliance in greater than 90% of cases. The approach will better enable the delivery of a quality health provider compliance program that: prevents non-compliance by assisting health providers to meet their compliance obligations when claiming benefits; intervenes and corrects claims when honest mistakes occur; and detects and investigates fraud and inappropriate practice.

In 2017-18, the Department:

  • worked closely with professional bodies and stakeholder groups on its compliance strategies;
  • commenced strengthening compliance activities relating to prohibited practices concerning Pathology Approved Collection Centres; and
  • introduced legislation that commenced on 1 July 2018 to further support the integrity of Australia’s health payments system.

Improvements to the program resulted in: 20 fraud cases successfully prosecuted; 109 requests to the Director of Professional Services Review to review the appropriateness of services of health practitioners; and 3,074 completed audits and reviews of health providers. A total of
$48.7 million of debt was raised for recovery.

The success of the investments in improved capabilities since 2016-17 is demonstrated by the Department meeting the performance targets.

Program 4.8: Targeted Assistance – Aids and Appliances

The Department met all performance targets related to this program.

The National Diabetes Services Scheme (NDSS) ensures that people with diabetes have timely, reliable and affordable access to products and services that assist them to effectively self-manage their condition. This includes services and products for people with type 1, type 2 and gestational diabetes and fully-subsidised continuous glucose monitoring products for over 8,000 eligible children and young people aged under 21 years.

In 2017-18, the Department helped our Ministers to continue to support Australians managing a number of other specific health conditions, including stoma13 and Epidermolysis Bullosa14. The Stoma Appliance Scheme provides support to people with a stoma by ensuring they have timely access to stoma products through the 22 Stoma Associations. The National Epidermolysis Bullosa Dressing Scheme provided nearly 200 people with over $3 million of products to manage their condition.

Improving health outcomes through the provision of targeted assistance for aids and appliances

The NDSS meets the needs of registrants.63

Source: 2017-18 Health Portfolio Budget Statements, p.107

2017-18 Target

2017-18 Result

Annual NDSS registrant survey demonstrates that the needs of registrants are being met.

Of the surveyed registrants, the vast majority

(over 90%) indicated that the NDSS met their needs, by improving their knowledge and understanding of diabetes and helping them manage their condition more effectively.

Result: Met

63 Registrants are people with type 1 diabetes, type 2 diabetes, gestational diabetes or ‘other diabetes’ who are registered on the NDSS.

In 2017-18, 1,276,939 people with type 1, type 2 and gestational diabetes received benefit from the NDSS. A further 142,358 people were registered on the post-gestational diabetes register, who were eligible to receive services (but not products) from the NDSS. All eligible individuals were provided access throughout the financial year.

Support children and young people under 21 years of age, with type 1 diabetes, through the NDSS.

Source: 2017-18 Health Portfolio Budget Statements, p.107

2017-18 Target

2017-18 Result

Provide eligible children and young people under 21 years of age with subsidised continuous glucose monitoring products through the NDSS to assist

in the management of their type 1 diabetes.

8,722 children and young people under 21 years of age were provided access to fully subsidised continuous glucose monitoring.

Result: Met

The number of eligible children and young people who accessed this program was higher than anticipated with 8,722 people benefiting from fully subsidised continuous glucose monitoring.

Support Australians to assist in the management of specific chronic health conditions (diabetes, stoma and Epidermolysis Bullosa).

Source: 2017-18 Health Portfolio Budget Statements, p.108

2017-18 Target

2017-18 Result

Ensure provision of subsidised aids and appliances to assist eligible Australians in the management

of their chronic health conditions.

Subsidised aids and appliances have been provided to eligible Australians.

Result: Met

In 2017-18, 24 new products were listed on the Stoma Appliance Scheme, providing greater choice of products which could lead to improved health outcomes.

Close to 200 recipients were supplied with over $3 million worth of products under the National Epidermolysis Bullosa Dressing Scheme.

Outcome 4 - Budgeted expenses and resources

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 4.1: Medical Benefits

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

105,544

100,301

(5,243)

Special account

Medicare Guarantee Fund – medical benefits

23,169,289

22,807,734

(361,555)

accrual adjustment

9,496

395,410

385,914

Departmental expenses

Departmental appropriation1

31,666

32,049

383

Expenses not requiring appropriation in the budget year2

808

871

63

Total for Program 4.1

23,316,803

23,336,365

19,562

Program 4.2: Hearing Services

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

528,894

518,467

(10,427)

Departmental expenses

Departmental appropriation1

7,417

7,221

(196)

Expenses not requiring appropriation in the budget year2

1,987

1,841

(146)

Total for Program 4.2

538,298

527,529

(10,769)

Program 4.3: Pharmaceutical Benefits

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

821,200

719,268

(101,932)

Special account

Medicare Guarantee Fund pharmaceutical benefits

11,605,605

11,434,595

(171,010)

accrual adjustment

28,042

255,629

227,587

Departmental expenses

Departmental appropriation1

58,983

57,753

(1,230)

Expenses not requiring appropriation in the budget year2

2,067

1,889

(178)

Total for Program 4.3

12,515,897

12,469,134

(46,763)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

2 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

3 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 4.7: Health Benefit Compliance

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

15,900

15,416

(484)

Departmental expenses

Departmental appropriation1

65,004

60,533

(4,471)

Expenses not requiring appropriation in the budget year2

1,626

1,566

(60)

Total for Program 4.7

82,530

77,515

(5,015)

Program 4.8: Targeted Assistance - Aids and Appliances

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

12,294

14,696

2,402

Special appropriations

National Health Act 1953 – aids and appliances

353,784

351,420

(2,364)

Departmental expenses

Departmental appropriation1

4,640

4,869

229

Expenses not requiring appropriation in the budget year2

109

132

23

Total for Program 4.8

370,827

371,117

290

Outcome 4 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

1,488,545

1,370,684

(117,861)

Special appropriations

6,797,832

6,774,838

(22,994)

Special account

34,774,894

34,242,330

(532,564)

accrual adjustment

37,538

651,039

613,501

Departmental expenses

Departmental appropriation1

185,069

177,872

(7,197)

Expenses not requiring appropriation in the budget year2

6,943

6,676

(267)

Total expenses for Outcome 4

43,290,821

43,223,439

(67,382)

Average staffing level (number)

926

876

(50)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

2 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

3 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

Outcome 5 - Regulation, Safety and Protection

Protection of the health and safety of the Australian community and preparedness to respond to national health emergencies and risks, including through immunisation initiatives, and regulation of therapeutic goods, chemicals, gene technology, and blood and organ products

Highlights

Better access to quality medicines and medical devices

The finalisation of significant regulation streamlining is set to bring life-saving medicines and medical devices onto the Australian market faster.

Program 5.1

Reducing the spread of antimicrobial resistance (AMR)

Progress continued on a range of initiatives to reduce the development and spread of AMR in Australia.

Program 5.2

Defending against disease-carrying mosquitoes

The risk of mosquito-borne diseases in the Torres Strait continued to be reduced through strategic suppression, control and monitoring of the disease-carrying mosquito Aedes albopictus.

Program 5.2

Programs contributing to Outcome 5

Summary of results against performance criteria

Program

Targets met

Targets substantially met

Targets not met

Program 5.1: Protect the Health and Safety of the Community Through Regulation

9

4

-

Program 5.2: Health Protection and Emergency Response

3

1

-

Program 5.3: Immunisation

2

-

-

Total

14

5

-

Program 5.1: Protect the Health and Safety of the Community

The Department met or substantially met all performance targets related to this program.

The Department protects the health and safety of the community and the environment through regulating therapeutic goods, controlled substances, industrial chemicals and genetically modified organisms (GMOs).

In 2017-18, the Department continued to participate in international fora and engage with international regulators through the Therapeutic Goods Administration (TGA), the Office of Chemical Safety (OCS) and the Office of the Gene Technology Regulator (OGTR).

The TGA progressed implementation of recommendations from the Review of Medicines and Medical Devices Regulation. These reforms aim to enhance the range of medicines and medical devices on the Australian market, strengthen product safety, increase transparency for consumers and industry, provide consumers more information on the products they purchase and improve compliance with legislation. In 2017-18, there were over 7,300 new medical devices and nearly 400 new medicine applications (prescription, over the counter and complementary) approved to be included in the Australian Register of Therapeutic Goods.

The OCS has continued to administer the National Industrial Chemicals Notification and Assessment Scheme (NICNAS). Legislation to implement reforms to NICNAS has been introduced into Parliament and consultation on the technical details of the reforms has continued. These reforms aim to achieve a more appropriate balance between regulatory efforts and the likelihood of risk to the health and wellbeing of the community and the environment.

The OGTR continued to administer the Gene Technology Regulatory Scheme to ensure that medical, agricultural and other research involving GMOs is conducted in accordance with best practice and in a manner that protects human health and safety and the environment. The scheme also ensures that all GMOs are subject to a scientifically rigorous risk assessment that must be completed prior to release into the Australian environment.

The Department, through the Office of Drug Control, continued to work closely with law enforcement agencies to ensure the Australian community had access to essential medicines and continued to support the operations of businesses involved in lawful trade of controlled substances.

Regulating therapeutic goods for safety, effectiveness/performance and quality while promoting best practice

Regulate therapeutic goods for safety, effectiveness/performance and quality.

  1. Percentage of applications lodged under prescription medicines registration (Category 1 applications) processed within the legislated timeframes.
  2. Percentage of quality related evaluations of prescription medicines (Category 3 applications) processed within 45 working days.
  3. Percentage of conformity assessments for medical devices processed within 255 working days.
  4. Percentage of licensing and surveillance inspections completed within target timeframes.

Source: 2017-18 Health Portfolio Additional Estimates Statements, p.55

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

a. 100%

100%

100%

100%

99.7%

99.8%

b. 100%

99.5%

99.8%

99.1%

98%

100%

c. 100%

100%

100%

100%

100%

N/A

d. 85%

85%

N/A

N/A

N/A

N/A

Result: Substantially met

Category 1 applications are for new medicines, presentations and indications. All 357 Category 1 applications were processed within the legislated timeframes. This is attributed to the structured registration process, which consists of eight phases with eight milestones, enabling effective planning and tracking by the TGA and sponsors.

Category 3 applications are initiated by sponsors for manufacturing and quality changes, usually to an existing, marketed medicine. Of 1,451 Category 3 applications, 1,444 were processed within the legislated timeframe.

All 271 conformity assessments for medical devices were processed within the legislated timeframe of 255 working days. Of these assessments, 266 were processed in under 200 working days.

Contribute to the evolving international environment to help support the quality and safety of medicines and medical devices in Australia.

Source: 2017-18 Health Portfolio Budget Statements, p.116 and Health Corporate Plan 2017-18, p.32

2017-18 Target

2017-18 Result

Increase engagement with overseas regulators in comparable health systems, and with regional

and international organisations, such as the World Health Organization, to improve public health and safety.

Increase use of overseas assessments by comparable regulators, while maintaining sovereignty of regulatory decisions.

The Department continues to engage with overseas regulators through established fora and bilateral meetings.

The TGA makes extensive use of overseas assessments for medical devices, relying on certification from European notified bodies.

Result: Met

The Department continues to participate in international fora that promote information sharing, cooperation and regulatory convergence in relation to therapeutic goods. These include international initiatives such as: the International Coalition of Medicines Regulatory Authorities; the International Medical Devices Regulators’ Forum; the Australia, Canada, Singapore and Switzerland Consortium; as well as bilateral collaboration with other regulators.

Case Study: Collaboration with overseas regulators – Generic Medicines Work Sharing Trial

In 2017-18, the Therapeutic Goods Administration (TGA) and the therapeutic products regulators from Canada (Health Canada), Switzerland (Swissmedic) and Singapore (Health Sciences Authority) conducted a trial for the joint evaluation of an application for a new generic medicine. This was the first work-sharing trial of its type and resulted in the new medicine receiving marketing authorisation in Australia, Canada and Switzerland almost simultaneously (Singapore participated in the trial as an observer). The process proved to be both informative for the regulators and rewarding for the sponsor. The application went through three assessment rounds, with the first being the most challenging as it made the applicant aware of the large data requirements to support their submission. The subsequent assessment rounds were managed with greater ease as evidenced by the fact that all three countries were able to approve the application within the standard assessment length set by the regulatory agencies. Importantly, the trial resulted in the regulators gaining a better understanding of each other’s processes, which will facilitate further work-sharing and ensure subsequent trial applications also remain within legislated assessment timeframes.

Collaborating with overseas regulators benefits the development of internationally consistent regulatory processes and ensures emerging regulatory policy is aligned with international best practice. The community benefits from quicker access to quality, safe and effective therapeutic products leading to improved health and safety outcomes. The therapeutic products industry benefits from lower costs and reduced assessment times when applying for market authorisation in multiple countries.

‘This trial has been a positive first step in streamlining approaches for the regulatory agencies involved, leading to increased efficiency in the registration of new medicines.’

A public statement on generic medicine work-sharing is available at www.tga.gov.au/acss-generic-medicine-work-sharing-trial

Who is this program intended for/aimed at?

The target audience is the TGA and its counterpart regulators, with the ultimate aim of early access to safe, quality and effective medicines for the Australian community. International collaboration builds synergies between the TGA and other mid-sized, trusted regulators. It brings greater alignment of regulatory approaches, technical requirements and makes more efficient use of resources.

Improve intelligence, monitoring and compliance functions to ensure compliance with the Therapeutic Goods Act 1989.

Source: 2017-18 Health Portfolio Budget Statements, p.117

2017-18 Target

2017-18 Result

Implement the Compliance and Enforcement Plan.

Strengthen inter-agency partnerships to enable greater monitoring and use intelligence to target non-compliance.

Remove illegal and/or non-compliant products that pose an unacceptable risk from the Australian market.

The Compliance and Enforcement Plan for 2017-18 was documented and implemented.

The Department has developed improved, cooperative partnerships with state, territory, Federal and international partners across health agencies, law enforcement and regulator entities and has a strong partnership with the Australian Border Force.

The Department has assessed over 2,554 compliance referrals in the reporting period which resulted in 403,421 units of illegal therapeutic goods destroyed.

Result: Met

Stakeholder engagement was enhanced both domestically and internationally, including the execution of joint compliance activities across state, territory, Federal and international jurisdictions.

All allegations of compliance breaches were assessed against the Case Categorisation and Prioritisation Model to determine the appropriate compliance action to be applied.

Improve access to therapeutic goods for consumers whilst maintaining the safety of therapeutic goods in Australia.

Source: 2017-18 Health Portfolio Budget Statements, p.117

2017-18 Target

2017-18 Result

Implementation of the Australian Government’s reforms arising from the Review progressed through:

  • developing and implementing new regulatory pathways for prescription and complementary medicines and medical devices;
  • a risk-based approach to variations to registered medicines;
  • improving patient-specific access to unapproved therapeutic goods; and
  • more effective regulation of therapeutic goods advertising.

Reforms from the Review of Medicine and Medical Devices Regulation have been progressed through establishment of:

  • new regulatory pathways for prescription and complementary medicines and medical devices;
  • a risk-based approach to variations to registered medicines;
  • improved patient-specific access to unapproved therapeutic goods; and
  • improved regulation of therapeutic goods advertising.

Result: Met

The second tranche of legislative changes to implement the reforms from the Expert Panel Review of Medicines and Medical Devices Regulation, the Therapeutic Goods Amendment (2017 Measures No. 1) Act 2018, was enacted in March 2018.

Key reforms achieved included establishing new regulatory pathways allowing priority review of prescription medicines and medical devices, enabling some overseas assessments of medical devices to be used to support shorter assessment times and establishing a new pathway where listed complementary medicines can be assessed for effectiveness.

The TGA reviewed and implemented a new version of the orphan15 designation pathway and made a number of changes to the regulatory framework for medical devices during 2017-18.

Maintain the Poisons Standard in accordance with the requirements of the Therapeutic Goods Regulations 1990 to support protection of the community.

Source: 2017-18 Health Portfolio Budget Statements, p.117

2017-18 Target

2017-18 Result

Consider advice from the Advisory Committee on Medicines and Chemicals Scheduling to inform updates to the Poisons Standard.

Implement scheduling policy reforms.

Advice from the Advisory Committee on Medicines and Chemicals Scheduling was considered when updating the Poisons Standard. The Poisons Standard was revised four times during 2017-18.

Implementation of scheduling policy reforms has been initiated.

Result: Substantially met

All required amendments to the Poisons Standard were published on the TGA website16 prior to implementation and in the Poisons Standard as soon as practicable after the Secretary’s delegates’ final decisions.

Regulating the import, export, and manufacture of controlled drugs, and cultivation of medicinal cannabis

Applications for the import, export, and manufacture of controlled substances are assessed and processed within appropriate timeframes to support Australian industry to engage in international trade, and ensure that medicinal products are available to Australian patients.

Source: 2017-18 Health Portfolio Budget Statements, p.118

2017-18 Target

2017-18 Result

Applications are processed within agreed timeframes.

94% of applications were processed within agreed timeframes.

Result: Substantially met

The Department issued 9,197 licences and permits authorising the import, export and manufacture of controlled drugs. This represents a 22% increase compared with 2016-17. This substantial increase in volumes led to a decrease in completion of applications within agreed timeframes.

The Department also issued 93 checks and statements to law enforcement in support of investigations into possible criminal importation.

In part, these increases are driven by the introduction of the Medicinal Cannabis Scheme, as well as increases to the numbers of substances on prohibited import and export schedules.

Ensure that licence applications for the cultivation and production of medicinal cannabis are subject to fit and proper person and security tests through engagement with law enforcement and state and territory regulatory authorities.

Source: 2017-18 Health Portfolio Budget Statements, p.118 and Health Corporate Plan 2017-18, p.32

2017-18 Target

2017-18 Result

Improve response rates from law enforcement agencies through the formalisation of Memoranda of Understanding.

Build internal intelligence holdings supporting repeat and new applications.

Law enforcement responses to application assessments are now completed for all applications.

Internal intelligence holdings are now in place and in use.

Result: Met

The majority of requests for information that Office of Drug Control (ODC) submits to contacts in law enforcement and state and territory governments yielded no adverse findings about the persons of interest. There have been a number of situations where adverse findings against a person have been shared with ODC, resulting in the exclusion of those persons from any licences. The exclusions are enforced either through the application of conditions to the licence or by the licence holder removing the person from the body corporate.

Four such exclusions have occurred out of 41 licences granted or reviewed in 2017-18. In all cases, information about persons identified as being of interest is captured in ODC records to add to existing intelligence holdings.

Protecting people and the environment by assessing the risks of industrial chemicals and providing information to promote their safe use

Increased proportion of NICNAS risk management recommendations considered by Commonwealth and state and territory risk management agencies and accepted to promote safer use of industrial chemicals.

Source: 2017-18 Health Portfolio Budget Statements, p.118

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥80%

99.6%

N/A

N/A

N/A

N/A

Result: Met

A total of 222 recommendations were considered and accepted in part or whole by risk management agencies, including Safe Work Australia and the delegate of the Secretary of the Department of Health for maintaining the Poisons Standard.

Increased proportion of known importers and manufacturers of industrial chemicals registered with NICNAS, to promote awareness among the regulated community of their legal obligations.

Source: 2017-18 Health Portfolio Budget Statements, p.118

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥90%

99%

N/A

N/A

N/A

N/A

Result: Met

All introducers (importers and manufacturers) of industrial chemicals are required to register with NICNAS each year. As a result of compliance monitoring activities to identify unregistered industrial chemicals introducers, 381 new introducers were registered with the scheme in 2017-18.

A sample of registered introducers were audited to determine their compliance with their obligations under the Industrial Chemicals (Notification and Assessment) Act 1989 with respect to new chemicals, resulting in the identification of five non-compliant introducers. Subsequently, 18 new chemicals were notified or reported to NICNAS.

Maintain proportion of NICNAS risk assessments completed within statutory timeframes to minimise regulatory burden on businesses.

Source: 2017-18 Health Portfolio Budget Statements, p.118

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥95%

99%

99.6%

99%

98%

98%

Result: Met

During 2017-18, the Department completed 287 pre-market assessments of new chemicals with 285 of these completed within statutory timeframes. Assessment reports on three secondary notification assessments of previously assessed chemicals were also published within statutory timeframes.

Assessment quality is maintained through peer reviewing and seeking stakeholder feedback prior to finalising all reports. In 2017-18, no applications concerning the outcomes of chemical assessments were submitted to the Administrative Appeals Tribunal for review.

Protecting the health and safety of people and the environment by regulating activities with genetically modified organisms

Protect people and the environment through open, effective and transparent regulation of genetically modified organisms (GMOs).

Source: 2017-18 Health Portfolio Budget Statements, p.119

2017-18 Target

2017-18 Result

Risk assessments and risk management plans prepared for 100% of applications for licensed dealings.

100% of licence decisions made within statutory timeframes.

High level of compliance with gene technology legislation and no adverse effect on human health or environment from authorised GMOs.

Stakeholders, including the public, consulted on all assessments for proposed release of GMOs into the environment.

Risk assessments and risk management plans

were prepared and decisions made within statutory timeframes, for 100% of licensed dealings.

There was a high level of compliance with gene technology legislation with no evidence of any adverse effect on human health or environment from authorised GMOs.

Stakeholders, including the public, were consulted on all assessments for proposed release of GMOs into the environment.

Result: Met

The Office of the Gene Technology Regulator (OGTR) has skilled technical staff to conduct science-based risk assessments. There are project management structures for all licence applications, including milestones for both timing and quality assurance, and public consultation procedures built in to relevant decision making processes.

Monitoring and compliance inspections have confirmed a high level of compliance with licence and certification requirements. Stakeholders are continuing to work with inspectors using a cooperative compliance approach.

Enhance harmonisation in the regulation of GMOs and genetically modified products.

Source: 2017-18 Health Portfolio Budget Statements, p.119

2017-18 Target

2017-18 Result

Maintained best practice regulation through participation in international harmonisation activities and collaboration with relevant national regulators.

The OGTR and the Gene Technology Regulator

participated in a range of international and national activities that focused on best practice regulation of GMOs. New and emerging technologies and

their regulation was a key topic of discussion for both national and international harmonisation.

Result: Met

The Gene Technology Regulator and OGTR staff engage effectively in international fora and activities relevant to the regulation of GMOs.

The OGTR is invited to participate in international conferences and to host delegates due to its internationally acknowledged technical expertise and experience. The Australian gene technology regulatory system represents international best practice and has effectively protected people and the environment for 17 years.

Protecting the health of people and the environment through effective regulation

Strengthen existing frameworks to ban cosmetic testing on animals.

Source: 2017-18 Health Portfolio Budget Statements, p.120

2017-18 Target

2017-18 Result

Amend the National Health and Medical Research Council (NHMRC) Australian Code for the care and use of animals for scientific purposes (Animal Ethics Code) to ban cosmetic testing on animals.

Undertake procurement and commence work program to develop a voluntary Industry Code of Practice and a product information and communication package.

Legislate Animal Cosmetic Testing Ban as part of the new Industrial Chemicals Bill 2017.

Work has commenced on amending the Animal Ethics Code.

Initial discussions were held with industry and other key stakeholders on the voluntary Industry Code of Practice and the product information and communication package.

Animal Cosmetic Testing Ban legislation was developed as part of the Industrial Chemicals Bill 2017 that is currently before the Senate.

Result: Substantially met

The use of animals in scientific research is regulated by the states and territories, with the NHMRC’s Animal Ethics Code offering national guidance. By amending the Animal Ethics Code in combination with legislative changes, a ban on the testing of cosmetic ingredients or products on animals in Australia can be delivered. The work to amend the Animal Ethics Code is not yet complete due to the delays in the passage of the Industrial Chemicals Bill 2017, as amendments to the Animal Ethics Code need to be aligned with the ban as passed by Parliament.

Program 5.2: Health Protection and Emergency Response

The Department met or substantially met all performance targets related to this program.

In 2017-18, the Department developed five national strategies that define the priority populations most at risk or impacted by blood borne viruses (BBV) and sexually transmissible infections (STI) in Australia. The strategies set out a range of actions for 2018–2022 to reduce the transmission of BBVs and STIs and minimise their social and personal impact.

The Department has maintained effective preparation and mitigation measures and has responded to national health emergencies, minimising the health impact on the community of those events. Strengthening Australia’s health security capacity enables greater detection, prevention and response to public health threats, ultimately improving community protection.

A number of key initiatives to reduce the development and spread of antimicrobial resistance (AMR) have been progressed in 2017-18, including through surveillance, awareness raising and supporting health professionals to reduce antibiotic prescribing where it was safe and appropriate to do so.

Exotic mosquitoes and vector-borne diseases present a public health risk to Australia. Several factors have increased the risk and distribution of mosquitoes and the viruses they carry, including increased international travel and trade, increased urbanisation and changing climate. The Department worked closely with the Department of Agriculture and Water Resources and the states and territories at Australia’s international airports and seaports and in the Torres Strait, on the surveillance and control of exotic mosquitoes. This has reduced the risk of new populations of exotic mosquitoes establishing in Australia and the risk of dengue fever and other mosquito-borne diseases in the Torres Strait.

Reducing the incidence of blood borne viruses (BBV) and sexually transmissible infections (STI)

National direction supports a coordinated response to reducing the spread of BBVs and STIs.

Source: 2017-18 Health Portfolio Budget Statements, p.122

2017-18 Target

2017-18 Result

All partners, including states and territories, clinicians, researchers, and community and professional organisations are supported to address rising rates of BBVs and STIs in the community through development and publication of the new National BBV and STI Strategy 2018–2022, incorporating HIV, hepatitis B, hepatitis C, and STI, with a focus on Aboriginal and Torres Strait Islander BBV and STI.

Five National BBV and STI Strategies for 2018–2022 were drafted in 2017-18:

  • Eighth National HIV Strategy;
  • Fifth National Hepatitis C Strategy;
  • Third National Hepatitis B Strategy;
  • Fourth National STI Strategy; and
  • Fifth National Aboriginal and Torres Strait Islander BBV and STI Strategy.

All five Strategies are expected to be launched in the second half of 2018.

Result: Substantially met

At the Minister’s request, five separate Strategies were developed in preference to a single National BBV and STI Strategy 2018–2022.

Consultations on the national strategies were extensive and considerable feedback and input has been received from stakeholders. The Australian Health Protection Principal Committee (AHPPC) endorsed three of the five Strategies in 2017-18. Once the final two Strategies are endorsed by AHPPC, all five National Strategies will be provided to the Australian Health Ministers’ Advisory Council and the Council of Australian Governments’ Health Council for endorsement.

The Department considers that the significant stakeholder engagement in the development of these strategies indicates a high level of commitment to the implementation of the Strategies from 2018–2022.

Providing an effective response to national health emergencies, improving biosecurity and minimising the risks posed by communicable diseases

Manage and respond to national health emergencies and emerging health protection issues through effective preparation and mitigation measures.

Source: 2017-18 Health Portfolio Budget Statements, p.122

2017-18 Target

2017-18 Result

National responses to health emergencies are successfully managed through the timely engagement of national health coordination mechanisms and response plans.

Collect and disseminate data in the National Notifiable Diseases Surveillance System, including publishing on the Department’s website.66

Complete World Health Organization (WHO) International Health Regulations (2005) Joint External Evaluation of core capacities.

The Department continued to manage and respond to national health emergencies and emerging health protection issues through effective preparation and mitigation measures.

Data was provided electronically to the National Notifiable Diseases Surveillance System from states and territories daily. Aggregated data was made available on the Department of Health’s website, updated daily.

Australia’s national health security capabilities were evaluated through completion of the

WHO International Health Regulations (2005) Joint External Evaluation in 2017-18. The evaluation found Australia has a high level capacity to detect, prevent, prepare for and respond to health emergencies.

Result: Met

In 2017-18 the Department’s National Incident Room (NIR) responded to approximately 14 incidents per month. The three most common hazards notified to the NIR, accounting for over two-thirds of the year’s incidents, were tuberculosis, measles and Legionnaires’ disease.

Over the reporting period, 105 incidents involved the use of protected information within the meaning of section 18 of the National Health Security Act 2007.

On a larger scale, the NIR provided the capability to coordinate a national response to health emergencies and health aspects of other emergencies. In 2017-18, responses coordinated by the Department included the response to the rise in invasive meningococcal disease cases and multiple Australian Government international deployments of the Australian Medical Assistance Teams.

Australia’s Joint External Evaluation of compliance with the International Health Regulations mission took place between 24 November and 1 December 2017. A team of international experts conducted an external, objective assessment of 19 core capacities of health security. The final mission report was published on 18 April 2018. The report confirms that Australia has a very high level of capacity for health security across all the targeted core capacities and provides recommendations to further build on our capabilities.

Provide national direction to minimise the spread of antimicrobial resistance (AMR).

Source: 2017-18 Health Portfolio Budget Statements, p.123

2017-18 Target

2017-18 Result

Action against the spread of AMR is supported by implementation of programs that support the National AMR Strategy 2015–2019.67

A range of key activities to reduce the development and spread of AMR has been implemented under the National AMR Strategy 2015–2019.

Result: Met

The Department has progressed a number of key activities to reduce the development and spread of AMR in Australia, in particular the:

  1. development and release of a dedicated AMR website to raise awareness and understanding about AMR and antibiotic use;17
  2. continuation of and enhancements to the Antimicrobial Resistance and Use in Australia Surveillance System to further understand the current AMR situation in Australia and target efforts accordingly; and
  3. establishment of clear governance mechanisms to oversee and drive the work to stop the spread of AMR.

Support Australia’s defences against the potential spread of mosquito-borne diseases on mainland Australia and in the Torres Strait.

Source: 2017-18 Health Portfolio Budget Statements, p.123

2017-18 Target

2017-18 Result

Undertake targeted vector surveillance and control programs in the Torres Strait.69

Work closely with the Department of Agriculture and Water Resources and states and territories, on exotic vector surveillance and control at Australia’s international airports and seaports.

Surveillance reports continue to confirm the suppression of exotic mosquito populations in the Torres Strait. There have been no detections of the targeted exotic mosquito on mainland Australia.

The Department of Health engaged closely with the Department of Agriculture and Water Resources and states and territories to implement exotic vector surveillance and control at Australia’s international air and sea ports. Several exotic mosquitoes were detected through trapping and specimen analysis during 2017-18 and in all cases effective chemical treatments were implemented.

Result: Met

69 Vector control and surveillance aims to manage and eradicate disease carrying mosquito populations.

The program to protect Australia from the exotic mosquito Aedes albopictus has remained successful during 2017-18. Focus has been maintained on suppression of the exotic mosquito on the strategic transport hubs of Horn Island and Thursday Island. The intensive control and monitoring activities on these islands in recent years have resulted in near elimination, such that the species has been undetectable in most of the surveys conducted on these islands.

Mosquito suppression strategies have effectively prevented growth or expansion of the residual population of exotic mosquitoes and consequently there have been no detections of the exotic mosquito in surveys conducted on the mainland of Australia.

Program 5.3: Immunisation

The Department met both performance targets related to this program.

The Government aims to reduce the incidence of vaccine-preventable diseases and protect individuals and the Australian community through the National Immunisation Program (NIP) and associated initiatives. Through the NIP, childhood immunisation rates continue to be high, indicating a high level of protection in the community.

The Department is also supporting the Government to close the gap between Aboriginal and Torres Strait Islander children aged 12–15 months and non-Indigenous children of the same cohort. While there has been an increase in immunisation coverage rates for Aboriginal and Torres Strait Islander children at 12–15 months of age, a significant gap still remains and further work is required to reduce this disparity.

To improve population coverage of the vaccines usually given in early childhood, the Department implemented the Supporting No Jab, No Pay – National Immunisation Program to expand the NIP to all individuals up to the age of 19 years and refugee and humanitarian entrants of all ages.

In addition, the Department implemented the Supporting No Jab, No Pay – improving awareness and uptake of immunisation initiative through the launch of a Childhood Immunisation Education Campaign. This campaign supports expectant parents and those with children under the age of five by explaining the benefits of childhood vaccination, addressing misconceptions and encouraging timely completion of the childhood immunisation schedule.

A new National Partnership on Essential Vaccines (NPEV) has also been put in place which establishes the ongoing collaborative arrangements that support the delivery of the NIP. The new NPEV is an important step in protecting Australians from the spread of vaccine preventable diseases through the cost-effective and efficient delivery of the NIP and increasing immunisation coverage rates including in geographic areas of low coverage.

Case Study: Getting the facts about childhood immunisation

Launched in August 2017, the Childhood Immunisation Education campaign encourages Australian parents and carers to get their kids vaccinated. It was developed in response to research that showed that when people are fully informed about the benefits of vaccination, they are more likely to vaccinate. The campaign addressed perceived misconceptions and informed parents of the evidence-based facts about childhood vaccinations.

Two phases of the campaign were delivered in 2017-18 reaching parents through online communication channels including social media, digital advertising and online video. Real families who experienced the devastating loss of their young children due to vaccine-preventable disease were included in the advertising materials. Their engaging stories were supported with immunisation facts presented by Immunologist, Professor Ian Frazer AC.

‘Our baby son Riley died from a vaccine-preventable disease. Nothing can bring him back. But together we can all help to prevent this tragedy from happening to other families.’

Catherine and Greg Hughes

While immunisation rates in Australia are already high, with 94.4% of five-year-old children fully vaccinated18, there are some areas where the immunisation rate is too low. It is these pockets of low coverage which pose risks to the community, especially to people who can’t be vaccinated, like newborns or those with certain medical conditions. While this campaign targeted all Australian parents with children aged 0-5 years, areas with the lowest immunisation coverage rate for children aged 0-5 years were supplemented with increased advertising placement.

Evaluation of the campaign has indicated positive results, including increases in future vaccination intent and increased positive perceptions of childhood immunisation.

Increasing national immunisation coverage rates and improving the effectiveness of the National Immunisation Program

Increase the immunisation coverage rates in children at 5 years of age.71

Source: 2017-18 Health Portfolio Budget Statements, p.124 and Health Corporate Plan 2017-18, p.32

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥92.5%

94.4%

93.6%

92.9%

92.3%

92.0%

Result: Met

Immunisation coverage rates have continued to increase in 2017-18. This trend is expected to continue towards the World Health Organization Western Pacific Region, Chief Medical Officer’s and Chief Health Officers’ aspirational target coverage rate of 95%. The Department will continue to work with states and territories to achieve this target.

Increase the immunisation coverage rates among 12–15 months of age Aboriginal and Torres Strait Islander children.72

Source: 2017-18 Health Portfolio Budget Statements, p.124

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥89.0%

92.5%

92.2%

89.8%

N/A

N/A

Result: Met

Immunisation coverage rates among 12–15 months of age Aboriginal and Torres Strait Islander children continue to improve with the gap between non-Indigenous children in the same cohort decreasing from 1.6% in 2016-17 to 1.5% in 2017-18.

Outcome 5 - Budgeted expenses and resources

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 5.1: Protect the Health and Safety of the Community Through Regulation

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

659

109

(550)

Departmental expenses

Departmental appropriation1

15,600

15,267

(333)

to Special Accounts

(10,305)

(10,305)

-

Expenses not requiring appropriation in the budget year2

3,720

116

(3,604)

Special Accounts

OGTR3

7,673

7,534

(139)

NICNAS4

19,489

17,907

(1,582)

TGA5

148,324

142,280

(6,044)

Expense adjustment6

(2,730)

4,647

7,377

Expenses not requiring appropriation in the budget year2

-

3

3

Total for Program 5.1

182,430

177,557

(4,873)

Program 5.2: Health Protection and Emergency Response7

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

88,727

85,992

(2,735)

Non cash expenses8

24,408

24,422

14

Special Accounts

Human Pituitary Hormones Special Account (s78 PGPA Act)

170

115

(55)

Departmental expenses

Departmental appropriation1

25,443

25,395

(48)

Expenses not requiring appropriation in the budget year2

752

756

4

Total for Program 5.2

139,500

136,680

(2,820)

Program 5.3: Immunisation7

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

36,430

34,565

(1,865)

to Australian Childhood Immunisation Special Account

(7,055)

(3,222)

3,833

Special Accounts

Australian Childhood Immunisation Register Special Account (s78 PGPA Act)

9,820

9,895

75

Special appropriations

National Health Act 1953 – essential vaccines

374,572

344,427

(30,145)

Departmental expenses

Departmental appropriation1

8,918

9,180

262

Expenses not requiring appropriation in the budget year2

229

246

17

Total for Program 5.3

422,914

395,092

(27,822)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from

independent sources (s74)’.

2 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense,

operating losses and audit fees.

3 Office of the Gene Technology Regulator Special Account.

4 National Industrial Chemicals Notification and Assessment Scheme Special Account.

5 Therapeutic Goods Administration Special Account.

6 Special accounts are reported on a cash basis. The adjustment reflects the difference between expense and cash,

and eliminates inter-entity transactions between the core Department and TGA.

7 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the

Federal Financial Relations (FFR) Framework.

8 Non cash expenses relate to the write down of drug stockpile inventory due to expiration, consumption and distribution.

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Outcome 5 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

125,816

120,666

(5,150)

to Special Accounts

(7,055)

(3,222)

3,833

Non cash expenses8

24,408

24,422

14

Special Accounts

9,990

10,010

20

Special appropriations

374,572

344,427

(30,145)

Departmental expenses

Departmental appropriation1

49,961

49,842

(119)

to Special Accounts

(10,305)

(10,305)

-

Expenses not requiring appropriation in the budget year2

4,701

1,118

(3,583)

Special Accounts

172,756

172,371

(385)

Total expenses for Outcome 5

744,844

709,329

(35,515)

Average staffing level (number)

944

894

(50)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from

independent sources (s74)’.

2 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense,

operating losses and audit fees.

3 Office of the Gene Technology Regulator Special Account.

4 National Industrial Chemicals Notification and Assessment Scheme Special Account.

5 Therapeutic Goods Administration Special Account.

6 Special accounts are reported on a cash basis. The adjustment reflects the difference between expense and cash,

and eliminates inter-entity transactions between the core Department and TGA.

7 This program excludes National Partnership payments to state and territory governments by the Treasury as part of the

Federal Financial Relations (FFR) Framework.

8 Non cash expenses relate to the write down of drug stockpile inventory due to expiration, consumption and distribution.

Outcome 6 - Ageing and Aged Care

Improved wellbeing for older Australians through targeted support, access to quality care and related information services

Enhancements to My Aged Care

Improvements made to My Aged Care will lead to improved client outcomes through increased responsiveness of assessments and timely access to aged care services.

Program 6.1

Supporting older Australians to live at home longer

A range of flexible aged care programs continued to be delivered, providing services to older Australians living at home.

Program 6.2

Programs contributing to Outcome 6

Summary of results against performance criteria

Program

Targets met

Targets substantially met

Targets not met

Program 6.1: Access and Information

-

2

-

Program 6.2: Home Support and Care

4

-

-

Program 6.3: Residential and Flexible Care

5

2

-

Program 6.4: Aged Care Quality

4

-

-

Total

13

4

-

Program 6.1: Access and Information

The Department substantially met both performance targets related to this program.

During 2017-18, the Department continued to make enhancements to the My Aged Care platform, including a major restructure of the website to improve navigation and content. Access to information relating to aged care services has been greatly improved through enhancements to system performance and efficiency. These enhancements have provided improved and more consistent client outcomes, responsive assessments of clients’ needs and goals, appropriate referrals and equitable access to aged care services.

Supporting equitable and timely access to aged care services and information for older Australians, their families, representatives and carers

Demonstrated system efficiency of My Aged Care through maintaining:

  1. the percentage of high priority comprehensive assessments with clinical intervention completed within 48 hours of referral acceptance; and
  2. the percentage of high priority home support assessments completed within ten calendar days of referral acceptance.

Source: 2017-18 Health Portfolio Budget Statements, p.130

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

a. >90%

88%

71.0%

96.9%

94.8%

89.0%

b. >90%

93%

N/A

N/A

N/A

N/A

Result: Substantially met

The Department substantially met the target for the number of high priority comprehensive assessments with clinical intervention that were completed within 48 hours of referral acceptance in 2017-18. Due to a number of factors the target was not met, including unanticipated spikes in assessment volumes, complexity of cases and availability of clients.

The Department exceeded the target for the number of home support assessments completed within ten days of referral acceptance.

Percentage of surveyed users73 who are satisfied74 with the service provided by the:

  1. My Aged Care Contact Centre.
  2. My Aged Care website.

Source: 2017-18 Health Portfolio Budget Statements, p.130 and Health Corporate Plan 2017-18, p.33

2017-18 Target

2017-18 Result

2016-17

2015-16

a. ≥95% b. ≥65%

92%

56%

95%

54%

97%

59%

Result: Substantially met

73 ‘Users’ refers broadly to different types of callers to the My Aged Care Contact Centre and visitors to the My Aged Care website, including people seeking information and/or services for themselves, or others, as well as aged care service providers seeking information or system help.

74 ‘Satisfied’ callers to the My Aged Care Contact Centre and visitors to the My Aged Care website are those who respond ‘very satisfied’ or ‘satisfied’ to the My Aged Care Customer Satisfaction Survey question: ‘How satisfied were you overall with your experience?’

Significant changes to aged care programs during the past year has impacted the satisfaction results for the My Aged Care Contact Centre, a primary information channel for consumers. The Department continues to improve and develop information and support services available to users of the system, to ensure that information is clear and readily available.

As part of a continuous improvement approach, the My Aged Care website is constantly updated and improved to make it easier for older Australians and their families to access information about aged care services.

Program 6.2: Home Support and Care

The Department met all performance targets related to this program.

The Government has continued to support older Australians to live at home for longer by providing choice through a range of flexible options. These include: the Commonwealth Home Support Programme (CHSP), which provides assistance to carry on living independently at home and in the community; the Home Care Packages Program, which provides consumers with more choice about their care and who provides it; and the Continence Aids Payments Scheme, which provides financial support to eligible recipients.

The CHSP provided continuity of essential services such as transport, meals, domestic assistance, personal care, nursing, allied health and respite services. These services assisted clients to remain independent and connected to their community for longer.

Providing home support for older people who need assistance to keep living independently

Commonwealth Home Support Programme continues to assist older people to stay independent and live in their homes and communities for longer.

Source: 2017-18 Health Portfolio Budget Statements, p.132 and Health Corporate Plan 2017-18, p.33

2017-18 Target

2017-18 Result

Continue to provide services through the CHSP.

Services were provided through the CHSP.

Result: Met

During 2017-18, the Department supported the Government to fund CHSP providers to deliver services in all states and territories except Western Australia. Home and Community Care services in Western Australia transitioned to the CHSP on 1 July 2018.

The Commonwealth Continuity of Support (CoS) Programme75 continues to be implemented in a phased approach to support eligible older people with a disability.

Source: 2017-18 Health Portfolio Budget Statements, p.132

2017-18 Target

2017-18 Result

Progressive regional implementation is ongoing.

In 2017-18, the Department continued the phased implementation of the CoS Programme with Victoria, Northern Territory and South Australia transitioning to the program.

Result: Met

75 The CoS Programme provides support to older people with a disability currently receiving state and territory-managed specialist disability services, who are not eligible for the NDIS, at the time the NDIS is implemented in a region. The CoS Programme is being implemented in line with the NDIS rollout.

The CoS Programme was implemented from 1 December 2016 in regions of New South Wales, Queensland and Tasmania in line with the phased rollout of the National Disability Insurance Scheme (NDIS). In 2017-18, Victoria, South Australia and the Northern Territory also commenced phased transitions.

As at 30 June 2018, South Australia, the Australian Capital Territory and New South Wales reached full implementation, with all eligible state disability clients transitioning to the CoS Programme.

Western Australia will begin transitioning from 1 July 2019 and will be finalised by 30 June 2020.

Providing older people access to a range of ongoing care services to keep living in their own homes

Provide support to older people with complex care needs to keep them living independently in their own homes through the Home Care Packages Program.

a. Number of allocated Home Care Packages.76

Source: 2017-18 Health Portfolio Budget Statements, p.132

2017-18 Target

2017-18 Result

2016-17

87,59077

99,932

91,980

Result: Met

76 Includes mainstream and flexible Home Care Packages.

77 The 2017-18 target was revised downwards from 100,436 published in the 2017-18 Health Portfolio Budget Statements as a result of the Government’s decision at the Mid-Year Economic outlook to rebalance home care packages to Levels 3 and 4.

Home Care Packages are assigned to older Australians through the national prioritisation system, managed by My Aged Care. The Department provides Home Care Packages regularly, at a rate appropriate to meet the target, including mainstream and flexible Home Care Packages.

Providing assistance to eligible recipients through the Continence Aids Payments Scheme

Assist people with permanent and severe incontinence to maintain a good quality of life enabling them to participate in the community.

Source: 2017-18 Health Portfolio Budget Statements, p.133

2017-18 Target

2017-18 Result

Provide financial assistance through the Continence Aids Payments Scheme to eligible people to support the purchase of continence products.

Clients were provided assistance through the Continence Aids Payments Scheme during 2017-18.

Result: Met

The total number of clients for the Continence Aids Payments Scheme changes based on the need of the eligible population who meet the application criteria as the program is demand driven.

Case Study: Home Care Packages Program – helping senior Australians to live at home longer

The Australian Government’s Home Care Packages Program (home care) helps senior Australians 65 years or older through a coordinated package of care and services to help them to live independently in their own home for as long as they can.

This year the Department has been working with the sector to bed down the significant changes implemented as part of the Increasing Choice in Home Care reforms. The changes give senior Australians greater choice and control over who deliver their care and services.

In doing so, the changes support senior Australians to choose their preferred home care provider and to direct their government subsidy to that provider. This also means that consumers can change their home care provider if they wish, including if they move to another area to live.

To receive a home care package, a person must first be assessed as eligible by an Aged Care Assessment Team. There are four levels of home care packages to help meet the different levels of care needs. During the assessment, the assessor will discuss the person’s current care needs and determine the best level to meet those needs.

The benefit of a home care package is that the provider will work with a client to identify and manage a package of care and services to meet a person’s specific needs so they can live a more active and independent life.

‘I got on to My Aged Care and had some people come over to assess Mum…she’s now more independent, and she has extra help. It’s great.’

Family member of care recipient.

‘With the workers coming in from home care, it’s given me a better quality of life… that gives me the independence to live here and live quite comfortably.’

Aboriginal and Torres Strait Islander care recipient.

Program 6.3: Residential and Flexible Care

The Department met or substantially met all performance targets related to this program.

Residential aged care provides a range of care options and accommodation for older Australians who are unable to continue living independently in their own home. This can be on both a permanent or short-term basis. As at 30 June 2018, there were 210,815 operational residential aged care places, an increase of 6,480 over the year.

Supporting mainstream residential and home-based aged care services are a number of different flexible care programs, which recognise that the needs of some people may require a different care approach. This includes the Short-Term Restorative Care Programme, which became operational in February 2017 and provides a range of restorative care services aimed at improving wellbeing and independence of older Australians to enable them to continue living in their own homes.

In addition, the Transition Care Program provides a time-limited package of restorative services that seek to optimise the functioning and independence of older people after a hospital stay, enabling them to return to their own homes.

The Department, in a joint initiative with state and territory governments, continued to provide integrated health and aged care services for small rural and remote communities through the Multi-Purpose Services Program, allowing services to exist in regions that could not viably support a stand-alone hospital or aged care service. Grants under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program resulted in additional residential aged care services providing flexible, culturally safe, aged care services to older Aboriginal and Torres Strait Islander peoples close to their home and community.

Supporting people with different care needs through flexible care arrangements

Increase in the number of older people who accessed restorative interventions through the Short-Term Restorative Care (STRC) Programme or the Transition Care Program (TCP).

Source: 2017-18 Health Portfolio Budget Statements, p.135

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

≥27,000

26,024

N/A

N/A

N/A

N/A

Result: Substantially met

In 2017-18, there were 475 STRC places and 4,060 TCP places, which can be used for up to eight weeks and 12 weeks respectively. The total number of people that access the places in any given year will reflect the assessed need and length of stay of individuals. The target is an estimate of how many people the Department considers will access the places.

Since its establishment in 2016-17, a total of 475 STRC places have been made available, with over 3,000 people a year able to access care through these places. There has been a significant increase in the number of people accessing restorative care through STRC in 2017-18.

Number of places funded through Multi-Purpose Services (MPS).

Source: 2017-18 Health Portfolio Budget Statements, p.135

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

3,712

3,624

3,636

3,592

3,545

3,525

Result: Substantially met

The 2017-18 MPS Program allocations round resulted in the establishment of a new MPS in Bonalbo New South Wales, with the allocation of 15 new flexible places (high care residential).

The level of care designated to 63 existing flexible aged care places was changed from low care to high care in 18 services in South Australia, New South Wales and Victoria. There was significantly less demand for MPS from providers in 2017-18 compared to the past two years.

Number of places funded through the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP).

Source: 2017-18 Health Portfolio Budget Statements, p.135

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

850

860

820

820

802

739

Result: Met

The 2017-18 NATSIFACP expansion round resulted in three additional residential aged care services with a total of 35 aged care places being funded under the program from 1 January 2018. These services are located in the Gulf of Carpentaria and in Doomadgee, Normanton and Mornington Island in Queensland.

In addition, two current NATSIFACP aged care service providers received additional funding to change the mix of places already funded under the program.

Supporting people in residential aged care

Provide residential care options and accommodation for older people who are unable to continue living independently in their own homes.

a. Residential aged care places available as at 30 June.

Source: 2017-18 Health Portfolio Budget Statements, p.135

2017-18 Target

2017-18 Result

2016-17

2015-16

2014-15

2013-14

209,700

210,815

204,335

199,449

195,953

192,834

Result: Met

This is the number of operational places available in the market, noting that at any point in time not all places will be occupied.

The number of operational residential aged care places has increased since 2016-17. The Department continues to monitor the impact of the red tape reduction measures introduced in early 2016 that encourage providers to operationalise their provisionally allocated places.

Ensure that subsidies paid to residential aged care providers accurately reflect the assessed care needs of residents.

Source: 2017-18 Health Portfolio Budget Statements, p.135

2017-18 Target

2017-18 Result

Aged Care Funding Instrument (ACFI) reviews are undertaken for all residential aged care services that are determined to be at high-risk of inaccurate claiming.

There were 2,334 ACFI claims relating to the assessment of a resident that resulted in adjustments to the amount of subsidies paid as a result of the Department’s review activities of all residential aged care services.

Result: Met

The Department has continued to ensure subsidies paid to residential aged care providers accurately reflect the assessed care needs of residents.

High risk services are identified through detailed analysis of the ACFI claiming patterns of all 2,700 residential aged care services in Australia.

Facilitating equitable access to residential aged care through capital grants

Provide assistance for essential capital improvements to support access to residential aged care.

Source: 2017-18 Health Portfolio Budget Statements, p.136

2017-18 Target

2017-18 Result

Where access is impeded, the Rural, Regional and Other Special Needs Building Fund provides limited funding to support ongoing improvements for essential construction, maintenance and upgrades where eligible aged care providers are unable

to meet the whole cost of capital works.

$64 million in capital grants was allocated to 22 projects around Australia that will improve or maintain access to residential aged care.

Result: Met

The $64 million in grants was allocated as part of the 2016-17 Aged Care Approvals Round and was prioritised to projects in rural, regional and remote areas of Australia and/or areas with projects that specifically focus on the provision of residential care to people from special needs groups.

Protecting the financial security of people in Commonwealth-subsidised residential aged care through the Accommodation Payment Guarantee Scheme

Accommodation payment refunds made to eligible aged care recipients within 14 days following the Secretary’s refund declaration under the Aged Care (Accommodation Payment Security) Act 2006.78

Source: 2017-18 Health Portfolio Additional Estimates Statements, p.62

2017-18 Target

2017-18 Result

100% of accommodation payment refunds are made within 14 days.

100% of accommodation payment refunds were made within 14 days.

Result: Met

78 The administering of the Accommodation Payment Guarantee Scheme is a demand driven process. In accordance with the Aged Care (Accommodation Payment Security) Act 2006, where the scheme is triggered the Department will make 100% of payments under the scheme for residents who are owed an accommodation payment. The Commonwealth has discretion to levy all approved residential aged care providers to recover the cost of each trigger of the scheme. Further information available at: www.myagedcare.gov.au/financial-and-legal/protecting-consumer-rights

During 2017-18 the Secretary made one refund declaration under the Accommodation Payment Guarantee Scheme. The Department made the refund within a week of the declaration.

Case Study: GEN – the one stop shop for aged care data and reporting

GEN is a new, freely-available and user-friendly website that provides unprecedented detail and access to information and data for Australia’s aged care system. GEN is designed to cater to all levels of users, with easily understood language and illustrations, interactive visualisations and infographics, and downloadable data files. GEN is inviting and universally accessible, from technically skilled users such as academics, researchers and policy makers, to members of the public, including students, current and prospective recipients of aged care services and aged care service providers.

GEN reports on capacity and activity in the aged care system, with particular focus on key topic areas including aged care services and places, people receiving aged care and their pathways through the system, the assessments of their care needs and Australian Government funding of aged care. Information, publications and other resources concerning additional subjects are also provided and a service providing customised analyses and extracts of data is available on request. Key departmental publications such as the annual Report on the Operation of the Aged Care Act 1997 are also published on GEN and thereby receive a wider audience than previously was the case.

GEN hosts a number of key data products that have become highly valued by users, including: the interactive ‘My aged care region’ tool, which provides users with dynamic data specific to their geographic region of interest; the Aged Care Services Information data files, which provide extensive and regularly updated information from providers regarding the services they operate; and the Aged Care Data Snapshot’s dashboard and detailed data files, which are of particular use to a number of government agencies.

The Department of Health and the Australian Institute of Health and Welfare have collaborated on, and jointly developed, GEN. GEN is Australia’s only centralised and independent repository of national aged care data and publications. GEN was launched by the Minister for Aged Care, The Hon Ken Wyatt AM, MP on 15 August 2017, and since its launch the public utilisation of, and familiarity with, aged care data and resources has greatly improved. Many updates to GEN’s content and enhancements to its functionality have been made to date, and many more are planned for the future.

Program 6.4: Aged Care Quality

The Department met all performance targets related to this program.

During 2017-18, the Department continued to address aged care provider non-compliance with the assistance of the Australian Aged Care Quality Agency (the Quality Agency) and the Aged Care Complaints Commissioner (the Complaints Commissioner).

Through the Dementia and Aged Care Services (DACS) Fund, the Department supported the Government to deliver funding for a range of activities to support emerging priorities in dementia care. The Department is also supporting improvements in the quality of care for people living with dementia through the delivery of high quality training in dementia care.

Ensuring the provision of quality aged care, including equitable care for people from diverse backgrounds, and support for people with dementia

Protect the safety, wellbeing, and interests of Commonwealth-subsidised care recipients through regulatory activities.

Source: 2017-18 Health Portfolio Budget Statements, p.137

2017-18 Target

2017-18 Result

Identify, respond to, and take appropriate action to address approved provider non-compliance under the Aged Care Act 1997 (the Act).

The Department undertook appropriate action to address approved provider non-compliance.

For each incidence of potential non-compliance received by the Department, a risk assessment has been undertaken to determine the appropriate action to address non-compliance.

The Department’s role in responding to non-compliance complements the complaints resolution function of the Complaints Commissioner and the accreditation assessment and monitoring function of the Quality Agency.

Result: Met

Identified non-compliance has been addressed, with a substantial increase in the amount of compliance activity across the aged care sector.

In return for government subsidy, providers of aged care are expected to meet certain responsibilities relating to the provision of care and services. These responsibilities are set out in the Act.

The objective of the Department’s regulatory activities is for providers to voluntarily comply with their responsibilities and where non-compliance is identified, to return the provider to compliance as quickly as possible to protect the health, safety and wellbeing of care recipients.

The Department responded to non-compliance in a variety of ways including using administrative approaches and regulatory resolutions such as imposing sanctions.

Respond to existing and emerging challenges in the provision of aged care for older Australians.

Source: 2017-18 Health Portfolio Budget Statements, p.138

2017-18 Target

2017-18 Result

Provide $76.138m through the DACS Fund for support activities including dementia care, services targeting lesbian, gay, bisexual, transgender and intersex people and people from culturally and linguistically diverse backgrounds; and special measures for Aboriginal and Torres Strait Islander peoples.

$77.368m funding was provided through the DACS Fund to support a range of activities.

Result: Met

The DACS Fund is focused on providing support for emerging priorities in dementia care, special measures to support Aboriginal and Torres Strait Islander peoples and ensuring people from diverse backgrounds receive the same quality of aged care as other senior Australians. DACS also funded the development of an Aged Care Workforce Strategy and the Aged Care Diversity Framework.

Improve the quality of care for people with dementia by the provision of vocational-level training to aged care workers or continuing professional development training to health professionals.

Source: 2017-18 Health Portfolio Budget Statements, p.138

2017-18 Target

2017-18 Result

At least 70% of people surveyed79 think that the quality of care they are receiving has improved since their associated aged care worker/health professional has undertaken training through the national Dementia Training Program.

96% of people surveyed think that Dementia Training Australia has improved the quality of care they are receiving.

Result: Met

79 People surveyed include providers of care for, and the families of, people living with dementia. This survey was developed by the Dementia Training Program in collaboration with the Australian Institute of Health Innovation. The survey is not publically available.

The Dementia Training Program provided accredited education, upskilling and professional development for the workforce providing dementia care in the primary, acute and aged care sectors.

The consortium delivering the Dementia Training Program, Dementia Training Australia, uses a network of teams to ensure training is available nationally, including in rural and remote areas, through face to face training, online learning and a comprehensive range of free online resources and webinars.

People providing care, family members and people living with dementia have verified that the knowledge and skills imparted through training has translated into a higher quality of care.

Increase the confidence of aged care providers in managing behavioural and psychological symptoms of dementia.

Source: 2017-18 Health Portfolio Budget Statements, p.138 and Health Corporate Plan 2017-18, p.33

2017-18 Target

2017-18 Result

At least 75% of sampled care givers80 report an improvement in confidence when managing behavioural and psychological symptoms

of dementia, following an intervention from the Dementia Behaviour Management Advisory Services (DBMAS).

92% of care givers surveyed report an improvement in confidence when managing behavioural and psychological symptoms of dementia following an intervention from the DBMAS.

Result: Met

80 Sampled care givers include family, carers, acute care staff and aged care staff/providers. The survey was provided by DBMAS provider. The survey is not publically available.

DBMAS provides nationally coordinated, locally based support and advice to aged, primary and acute care providers and individuals caring for people living with dementia, where behavioural and psychological symptoms of dementia are impacting on their care and quality of life.

The results show that care providers who use this service are becoming more skilled and confident in caring for people living with dementia.

Outcome 6 - Budgeted expenses and resources

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 6.1: Access and Information

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

208,414

206,229

(2,185)

Departmental expenses

Departmental appropriation1

43,583

43,968

385

Expenses not requiring appropriation in the budget year2

1,118

1,173

55

Total for Program 6.1

253,115

251,370

(1,745)

Program 6.2: Home Support and Care3

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

2,559,699

2,400,487

(159,212)

Special appropriations

Aged Care Act 1997 – Home Care Packages

1,968,204

2,032,079

63,875

National Health Act 1953 – continence aids payments

92,009

90,409

(1,600)

Departmental expenses

Departmental appropriation1

36,253

35,718

(535)

Expenses not requiring appropriation in the budget year2

945

972

27

Total for Program 6.2

4,657,110

4,559,666

(97,444)

Program 6.3: Residential and Flexible Care

Administered expenses

Ordinary annual services (Appropriation Act No. 1)4

110,929

110,120

(809)

Zero Real Interest Loans

– appropriation

44,200

29,451

(14,749)

– expense adjustment5

(28,448)

(26,480)

1,968

Special appropriations

Aged Care Act 1997 – residential care

11,500,060

11,219,254

(280,806)

Aged Care Act 1997 – flexible care

470,072

454,371

(15,701)

Aged Care (Accommodation Payment Security) Act 2006

85

83

(2)

Departmental expenses

Departmental appropriation1

40,730

39,891

(839)

Expenses not requiring appropriation in the budget year2

1,138

1,122

(16)

Total for Program 6.3

12,138,766

11,827,812

(310,954)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

2 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

3 This program excludes Home and Community Care National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

4 ‘Ordinary annual services (Appropriation Act No. 1)’ against program 6.3 excludes amounts appropriated in Bill 1 for Zero Real Interest Loans as this funding is not accounted for as an expense.

5 Payments under the zero real interest loans program are a loan to aged care providers and not accounted for as an expense. The concessional loan discount is the expense and represents the difference between an estimate of the market rate of interest, and that recovered under the loan agreement, over the life of the loan. This adjustment recognises the difference between the appropriation and the concessional loan discount expense.

Budget estimate 2017-18

$’000

(A)

Actual 2017-18

$’000

(B)

Variation

$’000

(B) - (A)

Program 6.4: Aged Care Quality

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

121,436

117,942

(3,494)

Departmental expenses

Departmental appropriation1

51,584

52,705

1,121

Expenses not requiring appropriation in the budget year2

1,313

1,417

104

Total for Program 6.4

174,333

172,064

(2,269)

Outcome 6 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)4

3,044,678

2,864,230

(180,448)

– expense adjustment5

(28,448)

(26,480)

1,968

Special appropriations

14,030,430

13,796,196

(234,234)

Departmental expenses

Departmental appropriation1

172,150

172,282

132

Expenses not requiring appropriation in the budget year2

4,514

4,684

170

Total expenses for Outcome 6

17,223,324

16,810,913

(412,411)

Average staffing level (number)

1,012

972

(40)

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.

2 Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.

3 This program excludes Home and Community Care National Partnership payments to state and territory governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.

4 ‘Ordinary annual services (Appropriation Act No. 1)’ against program 6.3 excludes amounts appropriated in Bill 1 for Zero Real Interest Loans as this funding is not accounted for as an expense.

5 Payments under the zero real interest loans program are a loan to aged care providers and not accounted for as an expense. The concessional loan discount is the expense and represents the difference between an estimate of the market rate of interest, and that recovered under the loan agreement, over the life of the loan. This adjustment recognises the difference between the appropriation and the concessional loan discount expense.

Part 2.2: Entity Resource Statements

Actual available appropriation

2017-18

$’000

(A)

Payments

made 2017-18

$’000

(B)

Balance remaining 2017-18

$’000

(A) - (B)

Ordinary annual services1

Departmental appropriation

Prior year departmental appropriation

35,416

35,416

-

Departmental appropriation2

658,441

609,173

49,268

Departmental capital budget3

11,095

10,992

103

Receipts retained under PGPA Act – section 74

107,463

107,463

-

Total

812,415

763,044

49,371

Administered expenses4

Outcome 1

127,510

108,028

Outcome 2

4,145,448

3,909,729

Outcome 3

23,377

20,520

Outcome 4

1,488,545

1,338,493

Outcome 5

125,925

116,167

Outcome 6

3,044,678

2,813,005

Receipts retained under PGPA Act – section 74

16,935

-

Payments to Corporate Commonwealth Entities

510,429

510,429

Total

9,482,847

8,816,371

Total ordinary annual services

A

10,295,262

9,579,415

Other services5

Departmental non-operating

Prior year departmental appropriation

2,675

2,075

600

Equity injections

7,422

1,070

6,352

Total

10,097

3,145

6,952

Administered non-operating

Prior year administered appropriation

242,315

22,182

Administered Assets and Liabilities

25,000

22,712

Payments to Corporate Commonwealth Entities

54,533

54,533

Total

321,848

99,427

Total other services

B

331,945

102,572

Total available annual appropriations and payments

10,627,207

9,681,987

Special appropriations

Special appropriations limited by criteria/entitlement

Agedcare (Accommodation Payment Security) Act 2006

83

Aged Care Act 1997

13,678,701

Health Insurance Act 1973

309,229

National Health Act 1953

1,760,120

Medical Indemnity Act 2002

75,838

Dental Benefits Act 2008

333,993

Private Health Insurance Act 2007

6,017,801

Public Governance, Performance and Accountability Act 2013 – section 77

583

Total special appropriations

C

22,176,348

Special accounts6

Opening balance

144,417

34,451,787

Appropriation receipts7

13,527

Appropriation receipts – other entities8

34,774,894

Non-appropriation receipts to Special Accounts

171,973

Payments made

Total Special Account

D

35,104,811

34,451,787

653,024

Total resourcing and payments9

A+B+ C+D

45,732,018

66,310,122

Less appropriations drawn from annual or special appropriations above

and credit to special accounts

13,527

and Corporate Entities

564,962

564,962

Total net resourcing and payments for the Department of Health

45,153,529

65,745,160

Budget refers to estimated actual expenses for 2017-18 as disclosed in the 2018-19 Health Portfolio Budget Statements.

1 Appropriation Act (No.1) 2017-2018, Appropriation Act (No.3) 2017-2018, Appropriation Act (No.5) 2017-2018. This also includes prior year departmental appropriation and section 74 retained revenue receipts.

2 This excludes an amount of $577,000 appropriated in 2017-18 budget relating to 2016-17. This amount is included in the prior year balance.

3 For accounting purposes this amount has been designated as ‘contributions by owners’.

4 In 2018, administered ordinary annual services appropriations $21,617,000 of the Appropriation Act (No. 1) 2017-2018

was permanently quarantined under section 51 of the PGPA Act.

5 Appropriation Act (No.2) 2017-2018, Appropriation Act (No.4) 2017-2018, Appropriation Act (No.6) 2017-2018.

6 Does not include ‘Relevant Money’ held in Services for Other Entities and Trust Moneys special account (SOETM).

7 Appropriation receipts from the Department of Health’s annual appropriations for 2017-18 included above.

8 Appropriation receipts from other entities credited to the Department of Health’s special accounts.

9 Total resourcing excludes the actual available appropriation for all Special Appropriations.

Footnotes

  1. 3 Ibid.
  2. 4 HPC are blood stem cells capable of self-renewal as well as differentiation and maturation into all blood cell types. They can be found in bone marrow, mobilised peripheral blood and umbilical cord blood. Further information, including information about the agreed therapeutic purposes available at: www.health.gov.au/internet/main/publishing.nsf/Content/ health-organ-bmtransplant.htm
  3. 23 Australian Institute of Health and Welfare 2018. Analysis of bowel cancer outcomes for the National Bowel Cancer Screening Program: 2018. Cat. no. CAN 113. Canberra: AIHW.
  4. 24 Lew JB et al, Long-term evaluation of benefits, harms and cost-effectiveness of the National Bowel Cancer Screening Program
  5. 40 More information on the campaign visit www.girlsmove.gov.au
  6. 41 The role of the Australian Communications and Media Authority in allocating radio-spectrum to sporting event users, media, broadcasters and then their real-time radio-spectrum monitoring function to detect interference and take action to resolve.
  7. 42 Programs intended to create a lasting benefit to the community after the sporting events have occurred. For example,
  8. 43 International Wheelchair Rugby Federation.
  9. 44 The International Federation for para-athletes with Intellectual Impairments.
  10. 45 Fédération Internationale de Football Association.
  11. 46 Includes above and under co-payment PBS prescriptions for S85 and S100 medicines, including prescriber bags; by date of supply;
  12. 55 Section 85 hepatitis C prescriptions are hepatitis medicines available through the PBS general schedule.
  13. 61 A stoma is a natural or surgically-created body opening, to allow bodily waste to leave the body.
  14. 62 Epidermolysis Bullosa is a rare genetic disease that primarily affects children and is characterised by extremely fragile and
  15. 64 An orphan is a medicine, vaccine or in vivo diagnostic agent that meets the requirements of regulation 16J of the
  16. 65 Available at: www.tga.gov.au/publication/poisons-standard-susmp
  17. 68 Available at: www.amr.gov.au
  18. 70 Australian Immunisation Register June 2018 assessment quarter available at: