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Outcome 1 - Health System Policy, Design and Innovation

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

 International engagement on health issues. Australia is leading a resolution through the World Health Organization to eliminate cervical cancer globally. Program 1.5.

 MRFF funded 54 clinical trials and established 8 missions. 90.1% of Australians (22.55 million people) have a My Health Record. 15 biomedical innovations have been fast tracked towards clinical practice. In 2018 10,500 people accessed eye and tissue transplants in Australia.

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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

4

-

-

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

1

-

-

Total

8

-

-

Program 1.1: Health Policy Research and Analysis

The Department met all performance targets related to this program.

In 2018-19, the Government increased investment in health and medical research to fuel new ideas and discoveries that improve health outcomes for patients. This aims to strengthen Australia’s position as a destination for health and medical research activity, and drive growth in the economy. Eight missions have been established to address chronic conditions, improve care for brain and neurological conditions, and transform health care delivery through innovative technologies. Further achievements in 2018-19 included the development of the second set of Medical Research Future Fund (MRFF) Priorities, work on the development of a National Framework for the Haemopoietic Progenitor Cell (HPC) sector and the 2019–21 Jurisdictional Blood Committee Strategic Plan.

Productive collaboration continued through the Council of Australian Governments (COAG) Health Council (CHC), which comprises Commonwealth, state and territory health ministers, and the New Zealand Health Minister. Supported and advised by the Australian Health Ministers’ Advisory Council (AHMAC), the CHC met three times during 2018-19 and progressed key issues, including the announcement of the National Action Plan for Endometriosis, and endorsement of the Australian National Breastfeeding Strategy: 2019 and beyond and Optimal Cancer Care Pathway for Aboriginal and Torres Strait Islander Australians. It was agreed that a national obesity strategy would be developed, resulting in a National Obesity Summit held on 15 February 2019.

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

Australian Government Ministers and officials are effectively supported to collaborate with states and territories on health issues.

Source: 2018-19 Health Portfolio Budget Statements, p.52

2018-19 Target

2018-19 Result

Health reform priorities and health initiatives requiring a Commonwealth/state interface will be progressed through the CHC and the AHMAC.

In 2018-19, COAG priorities include improving efficiency and ensuring financial sustainability; delivering safe, high quality care in the right place at the right time; prioritising prevention and helping people manage their health across their lifetime; and driving best practice and performance using data and research.

Health issues were agreed to and progressed by the AHMAC and endorsed by the CHC. In 2018-19, priority health issues were progressed by the CHC at its meetings on 2 August 2018, 12 October 2018 and 8 March 2019.

Result: Met

The Commonwealth and state and territory governments work in partnership to improve health outcomes for all Australians and ensure the sustainability of the Australian health system. CHC and AHMAC provide the Australian community with a forum for continued cooperation on health issues across all Australian governments and with the New Zealand Government.

The CHC, supported by its advisory body AHMAC, focused on progressing a broad range of issues in 2018-19. This included: long term health reform; prevention of obesity; improving mental health and wellbeing; suicide prevention; a national medical workforce strategy; addressing the interface between health care and aged care matters; increasing access to influenza antivirals; and national collaboration to improve health outcomes for Aboriginal and Torres Strait Islander Australians.

In 2018-19, Ministers identified opportunities for collaborative action to improve Aboriginal and Torres Strait Islander health outcomes that build on the work already underway across Australia. Ministers committed to working jointly to end rheumatic heart disease, avoidable blindness and deafness and preventing and managing kidney disease. Ministers also agreed to develop a national strategy on obesity, focusing on prevention measures and social determinants of health, especially in relation to early childhood and rural and regional issues.

CHC and AHMAC review primary and secondary care arrangements to ensure that they best meet community needs. At the 2 August 2018 CHC meeting, Ministers agreed to create a data and reporting environment that increases patient choice through greater public disclosure of hospital and clinician performance and information. Ministers also endorsed the Optimal Cancer Care Pathway for Aboriginal and Torres Strait Islander Australians, the first under the National Cancer Work Plan that specifically addresses the needs of a cultural group.

Improving health policy research and data capacity

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

Source: 2018-19 Health Portfolio Budget Statements, p.53 and Health Corporate Plan 2018-19, p.15

2018-19 Target

2018-19 Result

The second set of MRFF Priorities to be released by end 2018 following public consultation.

Further disbursements to be made consistent with the Medical Research Future Fund Act 2015.

The second set of MRFF Priorities were released on 8 November 2018 following a public consultation process.

$206.4 million was disbursed from the MRFF in 2018-19 consistent with the Medical Research Future Fund Act 2015.

Result: Met

A comprehensive consultation process was undertaken for the second set of MRFF priorities, with the Australian Medical Research Advisory Board conducting public consultations in five capital cities.

To date, $5 billion over 10 years has been allocated to research through the MRFF. Patients will benefit through improved health care outcomes from new medicines, devices and treatments, embedded genomics technology, clinical trial activity and data analytics. Researchers will benefit from the boost in research funding and career opportunities.

Disbursements from the MRFF continued to grow in 2018-19, with $206.4 million disbursed over the period. Investments over the MRFF streams were:

  • $112.6 million for patients;
  • $44.7 million for missions;
  • $44.2 million for translation; and
  • $4.9 million for researchers.

These MRFF initiatives will improve health outcomes and create new jobs and innovative businesses delivering breakthrough drugs, medical devices and clinical therapies to the world.

Case Study
Medical Research Future Fund – Frontier Health and Medical Research Initiative

The Frontiers Health and Medical Research Initiative (Frontiers) is a unique model of research funding, using a two-stage grant opportunity approach:

  • In stage one, 10 successful applicants receive up to $1 million each to develop a detailed research proposal over 12 months.
  • In stage two, the 10 applicants compete for a multi-year investment of up to $50 million.

The staged approach supports the Government to fund innovative research that might not be funded through traditional research funding pathways. The goal is to identify bold and innovative ideas and/or make discoveries of great potential and impact.

These projects will aim to:

  • assist those with medical conditions such as epilepsy, dementia, cerebral palsy and stroke;
  • improve technologies to detect infectious diseases and antimicrobial resistance; and
  • develop ways to scale up use of an Australian method for controlling Zika virus, dengue fever and other mosquito-borne diseases.

The Frontiers initiative has the potential to transform health care globally by supporting truly transformational health and medical research with sustainable funding, which will ultimately create new life changing health interventions.

This image depicts the Medical Research Future Fund (MRFF) logo.

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

Access to Haemopoietic Progenitor Cells for Australian patients requiring a Haemopoietic Progenitor Cell transplant for agreed therapeutic purposes is improved.

Source: 2018-19 Health Portfolio Budget Statements, p.53

2018-19 Target

2018-19 Result

Work with states and territories to develop action plans to implement agreed strategic directions in the HPC sector, including funding arrangements and governance structures.

The Department continued working with the states and territories to develop a national policy framework for the HPC sector, following a review of the sector that concluded in mid-2018, for consideration by all governments in 2019-20.

Result: Met

The national policy framework for the sector will build on the findings of the review and set out the agreed long term strategic objectives, governance structures and funding arrangements for the sector to enable sustainability and self-sufficiency.

Once agreed by all governments, implementation of the national policy framework for the sector will lead to robust decision-making, national oversight and targeted funding to enable continued equitable access to life saving transplants for Australian patients.

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

Source: 2018-19 Health Portfolio Budget Statements, p.54

2018-19 Target

2018-19 Result

Continue working with states and territories and the National Blood Authority (NBA) to meet the objectives of the National Blood Agreement1 through ongoing involvement and contribution to strategic policy development; contribution to and supporting the approval of the National Supply Plan and Budget (NSP&B); and advice to the CHC.

The Department continued working with states, territories and the NBA to progress strategic priorities under the 2016–18 Jurisdictional Blood Committee (JBC) Strategic Plan and led development of the 2019–21 JBC Strategic Plan.

The JBC has effectively overseen the annual blood supply through the NBA’s implementation of the 2018-19 NSP&B, and approval of the 2019-20 NSP&B through the CHC.

Result: Met

The JBC Strategic Plan outlines key strategic policy priorities for action and intended outcomes to promote appropriate management and use of blood products. Under an effective, nationally coordinated approach, it will ensure high quality, safe, secure and affordable blood supply in Australia. The NSP&B ensures sufficient, evidence-based access to blood and blood products for all Australians.

The Commonwealth funded 63 per cent of the National Blood Agreement expenditure. Access to safe and secure supply of blood and blood products is a critical component of Australia’s health care system, saving lives and improving the health of patients. Implementation of priorities will support and improve supply risk management, national variability in blood and blood product usage, data quality/access, accountability and waste reduction.

Program 1.2: Health Innovation and Technology

The Department met the performance target related to this program.

The Department worked with the Australian Digital Health Agency (the Agency) to transition Australia’s secure online health record system called My Health Record to an opt-out participation model. The My Health Record system improves health outcomes by providing consumers and health care providers involved in their care with access to important health information, anywhere, anytime. More than 90 per cent of eligible Australians now have a My Health Record.

The Department provided ongoing support and advice to the Agency and jurisdictions to commence implementation of Australia’s National Digital Health Strategy – Safe, Seamless and Secure (2018–2022).

Supporting the Government’s Digital Health agenda

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

Source: 2018-19 Health Portfolio Budget Statements, p.55

2018-19 Target

2018-19 Result

Provide high quality, relevant and well-informed research, policy and legal advice to support the delivery of the My Health Record national opt-out arrangements.

The Department continued to provide well-informed research and high-level policy and legal advice that informed and supported the transition to national opt-out participation arrangements for the My Health Record system.

Result: Met

Following the conclusion of the opt-out period on 31 January 2019, a My Health Record was created for every eligible Australian, unless they chose to opt-out. The transition to national
opt-out participation arrangements for the My Health Record system supports improved health outcomes and greater system efficiencies through a range of benefits, which are expected to include avoided hospital admissions, fewer adverse drug events, reduced duplication of tests, better coordination of care for people seeing multiple health care providers and better informed treatment decisions.

The Department supported the Minister for Health and provided policy and legislative advice on the development of the My Health Records Amendment (Strengthening Privacy) Act 2018. These amendments sought to further strengthen the security and privacy provisions of the My Health Record system, including strengthening penalties for improper use of a My Health Record and prohibiting employers or insurers from accessing My Health Record information.

The Department facilitated and managed the Statutory Review of the Healthcare Identifiers
Act 2010
(HI Act) and Healthcare Identifiers (HI) Service. The HI Service is a national system for consistently identifying consumers and health care providers. The Review considered the extent to which the purpose of the HI Act and regulations has been achieved and whether it enables the HI Service to operate efficiently and effectively. The final report was tabled in Parliament in April 2019.

Implementation of Australia’s National Digital Health Strategy – Safe, Seamless and
Secure (2018–2022)
commenced in 2018-19. The Department contributed to the development of key aspects of the strategy, including early development of a Medicines Safety Blueprint, Interoperability Framework, Digital Health Workforce Roadmap, mobile health application (mHealth) Framework and Secure Messaging standards. This work will continue during 2019-20.

Program 1.3: Health Infrastructure

The Department met the performance target related to this program.

The Department focused on delivery of Health Infrastructure projects throughout 2018-19, finding the majority of projects were progressing as scheduled. The Department took appropriate action where potential non-compliance was identified.

Health infrastructure projects improve the Australian community’s access to health services and provide health professionals with professional learning and development opportunities. Some major projects completed during 2018-19 include the Bringing Renal Dialysis and Support Services Closer to Home project in the Northern Territory and the Bowen Hospital Expansion project in Queensland.

Improving and investing in health infrastructure

Investment in health infrastructure supports improved health services.

Source: 2018-19 Health Portfolio Budget Statements, p.56

2018-19 Target

2018-19 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 milestones within the required timeframe.

Result: Met

In 2018-19, infrastructure projects funded in both the primary and acute care settings were monitored in accordance with the requirements under their respective project funding agreements.

The program increased access to health services and facilitation of professional learning and development for providers. As a result of funded projects:

  • residents of Fitzroy Crossing, in the Northern Territory have access to four new renal dialysis chairs and a 20-bed renal hostel; and
  • staff and patients benefit from the total refurbishment of the Bowen Hospital Emergency Department. Allied health and procedure units include enhanced security, new furnishings, enhanced staff training and improved primary care and service delivery.

Program 1.4: Health Peak and Advisory Bodies

The Department met the performance target related to this program.

The Department continued to support 23 national peak health organisations and advisory bodies through grant agreements to share information and consult with their members, the wider health sector and the community on health policy and program matters and develop expert, evidence-based and impartial policy advice.

Continuous collaboration with peak health organisations and advisory bodies broadens the scope for the community to communicate with the government about health issues.

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: 2018-19 Health Portfolio Budget Statements, p.57

2018-19 Target

2018-19 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.

Organisations meet the performance conditions and milestones in grant agreements.

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

Extensions of existing agreements for a further three years were completed before the end of 2018-19.

Organisations continue to meet the performance conditions and milestones in their grant agreements.

Result: Met

The Government continued to fund health-related national peak and advisory organisations to provide input to national policies and share critical information. The organisations funded under the Health Peak and Advisory Bodies Programme represent a range of health care practitioners, health consumers and pharmacists. They also represent community groups interested in issues such as asthma, allergies, continence, haemophilia, hepatitis, HIV/AIDS, vision impairment and mental health.

All funded organisations provided input to government policy throughout 2018-19, including through membership on various government and agency committees. Some notable contributions include consultation with their members on matters such as:

  • the Medicare Benefits Schedule Review, Pharmaceutical Benefits Scheme and aged care reforms;
  • the implementation and oversight of the Fifth National Mental Health and Suicide Prevention Plan;
  • implementation of Health Care Homes;
  • preparation of an environmental scan of issues impacting health professions in a rural context; and
  • supporting a Youth Health Forum and a Rural Health Consumers Special Interest group.

Program 1.5: International Policy

The Department met the performance target related to this program.

Australia’s health system continues to gain benefits and insights from international engagements and relationships. During 2018-19, Australia engaged with and contributed to bodies such as the World Health Organization (WHO); the Organisation for Economic Co-operation and Development (OECD) Health Committee; the G20 Health Working Group; and the Asia-Pacific Economic Cooperation (APEC) Health Working Group.

In June 2019, Department representatives met with members of the United Kingdom’s Department of Health and Social Care to discuss shared interests. The Department signed a Memorandum of Understanding on Health Cooperation, which supports efforts to keep Australia’s health system at the forefront of international best practice.

Also in June 2019, a representative from the Department attended the 25th session of the OECD Health Committee and associated meetings. Discussions included preparation for a significant OECD project – the Patient Reported Indicator Survey. This survey will support health systems to become more people centred, using a new approach to measure health system performance through patient reported outcomes.

Engaging internationally on health issues

Australia’s active engagement in international fora and relationships with key countries enables Australia’s health system to integrate evidence-based international standards and remain at the forefront of international best practice.

Source: 2018-19 Health Portfolio Budget Statements, p.58

2018-19 Target

2018-19 Result

Australia will engage at the WHO; the OECD Health Committee; the G20 Health Working Group Meetings; and the APEC Health Working Group; and contribute to the development and adoption of international best practice and improved governance, and focus on identifying and responding to global health security threats.

Australia, through the Department of Health, participated in a number of international fora in 2018-19 including the WHO; the OECD Health Committee; the G20 Health Working Group; and the APEC Health Working Group.

Through this engagement, the Department has strengthened Australia’s health system and improved our ability to prevent, detect and respond to health security threats by negotiating the adoption of international standards and best practice.

Result: Met

Australia is currently serving a three-year term on the Executive Board of the WHO, and participated in Executive Board meetings in January and May 2019. Participating on the Executive Board allows Australia to influence the global health agenda. During 2018-19, Australia led a resolution requesting the WHO to develop a strategy for the elimination of cervical cancer as a global public health problem. Australia’s leadership on the issue will drive global efforts to achieve long term cervical cancer elimination.

During 2018-19, the Department engaged in the APEC Health Working Group and other health focused fora. APEC is the premier forum for facilitating economic growth through cooperation, trade and investment in the Asia-Pacific Region, and the Department leads the Australian Government’s responsibilities on health-related issues in APEC.

Australia is actively participating in the work of the G20 Health Working Group, under Japan’s 2019 Presidency. The purpose of the G20 Health Working Group is to develop a shared international agenda across a range of health issues. Key topics for discussion over 2018-19 were the achievement of Universal Health Care, response to ageing societies, health risk management and health security, including antimicrobial resistance.

Australia also provides a leadership role in international fora, through promoting its own expertise and best practice in key areas such as preventative health, emergency response preparedness and medical products regulation. 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 contributes to improving global and regional public health.

Outcome 1 - Expenses and Resources

Budget Estimate 2018-19

$’000 (A)

Actual 2018-19

$’000 (B)

Variation

$’000

(B) - (A)

Program 1.1: Health Policy Research and Analysis1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

65,617

63,136

(2,481)

Special Accounts

Medical Research Future Fund

222,383

206,367

(16,016)

Special appropriations

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

754,745

754,744

(1)

Public Governance, Performance and Accountability Act 2013 s77 - repayments

20,000

18,105

(1,895)

Other Services (Appropriation Act No. 2)

-

4,926

4,926

Departmental expenses

Departmental appropriation2

54,181

55,308

1,127

Expenses not requiring appropriation in the budget year3

1,769

2,522

753

Total for Program 1.1

1,118,695

1,105,108

(13,587)

Program 1.2: Health Innovation and Technology

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

8,136

8,066

(70)

Departmental expenses

Departmental appropriation2

5,637

5,541

(96)

Expenses not requiring appropriation in the budget year3

171

238

67

Total for Program 1.2

13,944

13,845

(99)

Program 1.3: Health Infrastructure1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

107,371

71,360

(36,011)

Special appropriations

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

30,770

9,612

(21,158)

Departmental expenses

Departmental appropriation2

2,652

27,482

24,830

Expenses not requiring appropriation in the budget year3

85

114

29

Total for Program 1.3

140,878

108,568

(32,310)

Program 1.4: Health Peak and Advisory Bodies

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

7,458

7,556

98

Departmental expenses

Departmental appropriation2

2,211

2,735

524

Expenses not requiring appropriation in the budget year3

73

126

53

Total for Program 1.4

9,742

10,417

675

Program 1.5: International Policy

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

17,293

17,028

(265)

Departmental expenses

Departmental appropriation2

8,596

7,863

(733)

Expenses not requiring appropriation in the budget year3

260

331

71

Total for Program 1.5

26,149

25,222

(927)

Outcome 1 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

205,875

167,146

(38,729)

Special appropriations

805,515

782,461

(23,054)

Special Accounts

222,383

206,367

(16,016)

Other Services (Appropriation Act No. 2)

-

4,926

4,926

Departmental expenses

Departmental appropriation2

73,277

98,929

25,652

Expenses not requiring appropriation in the budget year3

2,358

3,331

973

Total expenses for Outcome 1

1,309,408

1,263,160

(46,248)

Average staffing level (number)

372

378

6

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 No. Act 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.