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Outcome 2 - Health Access and Support Services

Health Access and Support Services

Support for sustainable funding for public hospital services and improved access to high quality, comprehensive and coordinated preventative, 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

 Increase in products displaying the Health Star Rating system. As of November 2018, 13,243 products display the Health Star Rating system, making it easier for consumers to choose healthier options when shopping for their groceries. Program 2.4. This image depicts two medical professionals/carers and a person inside a house, with text reading: Extension to Health Care Homes (HCH) trial. The HCH trial was extended and eligible patient enrolment has increased by 7,889 in 2018-19. Eligible patients benefit from the HCH model by receiving better access to flexible and coordinated care. Program 2.5.

 110 headspace services operating across the country. The five year survival rate for breast cancer is at 90.8%. Aboriginal and Torres Strait Islander 715 health checks up from 71,400 to 85,928 per year. 47,146 nurses working in General Practices in Australia.

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

-

3

Program 2.3: Health Workforce

1

1

-

-

Program 2.4: Preventive Health and Chronic Disease Support

3

1

-

4

Program 2.5: Primary Health Care Quality and Coordination

2

1

-

-

Program 2.6: Primary Care Practice Incentives

-

-

-

1

Program 2.7: Hospital Services

1

-

-

-

Total

7

5

-

8

Program 2.1: Mental Health

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

Primary Health Networks (PHNs), service providers and mental health stakeholders were supported in 2018-19 to continue delivering on mental health reforms. Mental health services were improved through a range of funding, expansion and enhancements to ensure that Australian communities, particularly those in rural and regional areas, have continued access to high quality mental health education, information and services.

A key focus in 2018-19 was the youth mental health support and programs, including the expansion of the headspace network, eheadspace and other digital platforms, Early Psychosis Youth Service and the Be You education initiative.

Supporting people with mental illness through more and better coordinated services

Mental health services are more coordinated and supported through the implementation of the Strengthening mental health care in Australia measure.

Source: 2018-19 Health Portfolio Budget Statements, p.68 and Health Corporate Plan 2018-19, p.10

2018-19 Target

2018-19 Result

Support PHNs, service providers, and mental health stakeholders to continue to deliver on mental health reforms through:

  • monitoring progress of PHN commissioning and delivery of mental health services, for example the Way Back Support Service;
  • delivery of enhancements to ‘Head to Health’, including ensuring greater usability by health professionals;
  • transition of Partners in Recovery and Day to Day Living Programs into the National Disability Insurance Scheme (NDIS);
  • supporting development of regional mental health and suicide prevention plans by PHNs and LHNs, under the auspices of the Fifth National Mental Health and Suicide Prevention Plan;
  • continued establishment of new headspace services in rural and regional areas; and
  • commencement of Mental Health in Education initiative in schools and early learning services.

Funding was provided to PHNs in anticipation of establishing the first tranche of Way Back Support Services sites, and ensuring service continuity for existing sites.

The digital gateway ‘Head to Health’ was enhanced in response to feedback from users, including health professionals, to improve the usability of the site.

Partners in Recovery and Day to Day Living programs ceased on 30 June 2019. Funding was provided to PHNs for the commissioning of service providers to continue supporting clients to test eligibility for supports under the NDIS, as not all clients were transitioned by 30 June 2019.

Partners in Recovery and Day to Day Living programs ceased on 30 June 2019. Funding was provided to PHNs for the commissioning of service providers to continue supporting clients to test eligibility for supports under the NDIS, as not all clients were transitioned by 30 June 2019.

Six new headspace services were established in rural and regional areas across Australia.

The Mental Health in Education initiative, Be You, was launched on 1 November 2018.

Result: Substantially met

During 2018-19, the Department focused on securing state and territory agreements to contribute funding to PHNs for Way Back Support Service sites. The services provide outreach and follow-up care to individuals after a suicide attempt or suicidal crisis.

The digital mental health gateway, ‘Head to Health’1, continued to be well received in the community. Increased promotional communication saw sessions on the site, where a user visits and actively interacts with site material, triple over the 2018 Christmas holiday period. A number of further enhancements to the site were delivered in response to user feedback, including the introduction of a service provider portal, news and announcements page, communication materials page and improvements to feedback and search mechanisms. Since the website’s launch in October 2017, 727,000 online sessions have taken place (averaging approximately 1,200 sessions per day). Additionally, an average of 5,000 referrals to digital resources, such as phone and online counselling, peer support programs, structured online psychological treatment and information websites, have been disseminated each month.

Through funding to Partners in Recovery and Day to Day Living service providers, the Department continued supporting clients to test their eligibility for, and transition to, the NDIS. To support the continuing transition and demand for Commonwealth funded psychosocial programs, the Australian Government has provided an additional 12 months funding to give more time for clients to test eligibility with the NDIS, until 30 June 2020.

PHNs have demonstrated ongoing engagement with the Department’s regional planning activities by using data from the Service Planning Framework and Planning Support Tool for their regional planning, sharing good practice ideas through the Regional Planning Group and applying the regional planning guidance as appropriate.

As at June 2019, 110 headspace services were operating across the country, with six new rural and regional sites established during 2018-19.2 Headspace services provide holistic mental health, related physical health, alcohol and other drug use and social and vocational support to young people aged 12–25 years.

The Mental Health in Education initiative, Be You, integrates and builds on the success of previously funded evidence-based school mental health programs. Since its launch in 2018-19, it has provided an end-to-end mental health promotion, prevention and early intervention initiative, with a critical incidence response service to support schools in the event of a suicide. As at 30 June 2019, 62,816 individual users were registered on the Be You website, 7,048 schools and early learning services were participating in Be You and there were over 355,000 unique visitors to the Be You website.

Case Study
Head to Health campaign

The Government’s digital mental health gateway Head to Health (www.headtohealth.gov.au) continues to connect Australians to trusted free or low cost online and phone based mental health services, information and resources. It contains links to around 400 mental health support websites, apps, online programs and community forums, as well as phone, chat and email services.

The Head to Health campaign launched in December 2018, with the majority of advertising activity concluding in February 2019. The campaign promoted Head to Health as a trusted source of mental health information and digital services, aiming to increase Australians’ confidence in the availability and use of digital services. The campaign targeted people seeking mental health information, those experiencing mental health challenges but not currently seeking support and people seeking information and support for a friend or family member.

To reach the Australian community, advertising occurred across digital, social and search channels. Campaign effectiveness was quickly demonstrated, with a 37.8 per cent increase in website traffic immediately after the launch.

One in five Australians over the age of 16 experience mental illness each year.3 For many people experiencing mental health issues, particularly highly prevalent conditions like anxiety and depression, online resources can be as effective as face-to-face treatment, especially if there is additional practitioner support. The Head to Health campaign assisted greatly in guiding people experiencing mental health issues, and those who want to support them, to this informative gateway.

 Head to Health For your mental health and wellbeing.

Program 2.2: Aboriginal and Torres Strait Islander Health

There were three performance targets for which data sets were not available at the time of publication. Where data sets were available, the Department substantially met the target.

During 2018-19, the Department continued to enact activities under the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (the Implementation Plan). A working group was established to lead drafting of the revised iteration of the Implementation Plan, with an extended timeframe for release set for the 2019-20 financial year. The new plan will progress strategies and actions that improve health and life outcomes for Aboriginal and Torres Strait Islander Australians.

The Council of Australian Governments’ (COAG) Closing the Gap 2018 target on Aboriginal and Torres Strait Islander child mortality is not on track to be met. However, data shows that the Indigenous child mortality rate has dropped significantly in recent years, with a long term improvement of 33 per cent between 1998 and 2015.

Case Study
Health Data Portal for Indigenous health reporting

The Health Data Portal (the Portal), hosted in the Department of Health’s Enterprise Data Warehouse, was extended in December 2018 to provide a reporting mechanism for funded Aboriginal Community Controlled Health Services (ACCHS) to report Australian Health Ministers’ Advisory Council endorsed National Key Performance Indicators (nKPI). The nKPI collection is critical to measuring progress towards achieving the Australian Government’s Closing the Gap targets.

The Portal was co-designed with the Indigenous health sector through 20 stakeholder workshops conducted around Australia between June 2017 and March 2019, where over 240 people attended. This enabled collaborative prototyping, feedback sessions and continuous user testing. Regular communication via a monthly e-newsletter with over 1,100 subscribers, along with face-to-face training to over 145 people, has built end user engagement, a sense of co-ownership and managed expectations during the design process.

The Department also collaborated on the Portal with the Australian Institute of Health and Welfare in the development of administrative features and functions to facilitate data receipt, analysis and processing, as well as administrative management reports.

ACCHS requested a faster and more reliable reporting system so they can focus on delivering health services in Aboriginal and Torres Strait Islander communities. In January 2019, for the first time since this data collection started in June 2012, 100 per cent of ACCHS successfully submitted their data on time by using the Portal.

Overall, the Portal is providing ACCHS with a streamlined, simplified and better reporting experience. The Portal enables instant validation of submitted data, providing rapid insight into data quality, while a data analytics dashboard supports continuous quality improvement at a local level.

This image depicts a smiling Indigenous woman sitting in front of a computer logged on to the Health Data Portal (the Portal).

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

Health outcomes of Aboriginal and Torres Strait Islander peoples are improved through implementing actions under the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.4

Source: 2018-19 Health Portfolio Budget Statements, p.70 and Health Corporate Plan 2018-19, p.11

2018-19 Target

2018-19 Result

Release revised iteration of the Implementation Plan.

Continue towards achieving the identified deliverables and goals for 2023 as specified in the Implementation Plan.

Engage with the Implementation Plan Advisory Group (IPAG), other Commonwealth agencies, COAG Health Council (CHC) and its subcommittees, Health Partnership Forums and the Indigenous health sector to progress Implementation Plan activities, including those on the social determinants of health.

The timeframe for release of the revised iteration of the Implementation Plan has been extended to 2019-20 in order to better align with revised timeframes of the broader COAG Closing the Gap agenda.

The IPAG met four times in 2018-19 and discussed the approach to the next iteration of the Plan.

In May 2019, the IPAG established a Working Group to lead drafting of the revised iteration of the Implementation Plan for release in 2020.

The CHC, Australian Health Ministers’ Advisory Council and Health Services Principal Committee continued to be engaged in progressing Implementation Plan activities.

Regular updates on progress against the Plan were provided to Health Partnership Forums in each jurisdiction.

Result: Substantially met

The Implementation Plan provides high level policy and program direction to guide community level data, with the aim of the health system becoming more responsive to the needs of Aboriginal and Torres Strait Islander Australians over time. Of the 20 goals identified in the Implementation Plan, two goals cannot currently be assessed due to limitations of available data. Of the 18 goals currently able to be assessed, 12 are on track to be met.

All three goals in the maternal health and parenting domain are currently on track to be achieved. This includes 87 per cent of Aboriginal and Torres Strait Islander mothers who gave birth having attended five or more antenatal visits in 2016 (in seven of the eight states/territories), which means this goal is on track to meet the target of 90 per cent by 2023. Furthermore, the 88 per cent immunisation target for Aboriginal and Torres Strait Islander one year olds and the 96 per cent immunisation goal for five year olds are both on track to be met by 2023. Aboriginal and Torres Strait Islander five year olds also have the highest immunisation rates of any group nationally, at 97 per cent. The goal to reduce the smoking rate among Aboriginal and Torres Strait Islander Australians aged 18 plus to 40 per cent by 2023 is on track to be met. This is expected to have an impact on the burden of disease over time.

Six of the Implementation Plan goals are currently not on track to be achieved by 2023. Four of these goals relate to Aboriginal and Torres Strait Islander health assessments (MBS item 7155), although data from recent years show that the rate of health checks is increasing. The rate of full immunisation for Aboriginal and Torres Strait Islander two year olds is also not on track, although this is expected to increase over time. Recent data from the Australian Institute of Health and Welfare (AIHW) shows that further work is needed to increase the proportion of Aboriginal and Torres Strait Islander people with type 2 diabetes who had a kidney (renal) test in the previous twelve months if this goal is to be met.

Over time, there have been notable improvements to Aboriginal and Torres Strait Islander health outcomes. These include a decline in overall and child mortality rates and a decline in mortality from circulatory, respiratory and kidney disease. There has been a decline in risky levels of drinking in Aboriginal and Torres Strait Islander Australians aged 15 years and over for both single occasion and lifetime risk, and drinking during pregnancy has halved.6 Australia is also on track to eliminate trachoma as a public health problem by 2020.7

Notable achievements under the current Implementation Plan include; national endorsement of the Cultural Respect Framework; embedding of the Better Start to Life program to increase access to antenatal and postnatal care; and integration of early childhood services through the Connected Beginnings program.

Aboriginal and Torres Strait Islander child 0-4 mortality rate per 100,000.8

Source: 2018-19 Health Portfolio Budget Statements, p.71

2017 Target

2017 Result

2016

2015

2014

2013

95–143

Data not available9

Data not available10

163.6

159.1

185

While confirmed 2016 and 2017 data will not be available until the release of ABS revised data around mid 2020, preliminary data suggests that in 2017, the rate of Indigenous child mortality was not on track to meet the COAG Closing the Gap target by 2018. However, based on the confirmed mortality data available up to 2015, Indigenous child mortality rates have declined by 33 per cent between 1998 and 2015.

A good start in life gives children the best chance for success and making the most of their opportunities later in life. Giving children a good start relies on taking an integrated approach that supports positive parenting skills and provides maternal and child health intervention to enhance childhood development. The Department continued to fund initiatives to improve Indigenous child health, including the New Directions: Mothers and Babies Services Program and the Australian Nurse-Family Partnership Program. These programs provide improvements in key preventative factors, such as early access to antenatal care, parenting advice and assistance, immunisation and health checks for children.

Aboriginal and Torres Strait Islander chronic disease-related mortality rate per 100,000.

Source: 2018-19 Health Portfolio Budget Statements, p.71

2017 Target

2017 Result11

2016

2015

2014

2013

572–606

Data not available12

Data not available13

774.4

756.5

784.0

While confirmed 2016 and 2017 data is currently unavailable, preliminary data suggests that in 2017, the chronic disease related mortality rate was not on track to meet the target. However, there has been a significant decline over time in the Aboriginal and Torres Strait Islander chronic disease mortality rate.

When considering confirmed data available up to 2015, the Indigenous mortality rate from chronic disease declined by 19 per cent between 1998 and 2015. This decrease is largely due to the decline in mortality from circulatory diseases. Continued improvements in chronic disease prevention, detection and management, including reducing smoking rates, are important contributors to declining rates.

However, cancer mortality rates are rising. Between 1998 and 2017, Indigenous cancer mortality rates rose by 25 per cent.14 This may be due to the long lead time before the impact of a recent reduction in smoking rates is seen on cancer deaths. Based on available evidence, smoking related cancer mortality is expected to remain high and peak within the next decade.

Case Study
Tackling Indigenous Smoking (TIS) program

Smoking is the single most preventable cause of ill-health and early death among Aboriginal and Torres Strait Islander Australians. The TIS program is a multi-faceted initiative that supports tobacco control strategies targeted at Aboriginal and Torres Strait Islander Australians.

Approaches implemented under TIS serve to support tobacco control strategies, such as smoking cessation counselling by primary health care services, national media campaigns and policy initiatives such as plain packaging, health warnings and excise duties.

The TIS program includes:

  • Regional Tobacco Control Grants (RTCG) for activities performed at a local level;
  • a National Best Practice Unit to assist RTCG recipients;
  • a National Coordinator available to provide high-level advice, support and leadership;
  • the Indigenous Quitline; and
  • Quitskills training to Aboriginal health workers and other health professionals.

The program targets all Aboriginal and Torres Strait Islander Australians. Additionally, TIS has two specific priority groups: smokers living in remote areas; and pregnant women who smoke. RTCG recipients also have flexibility to determine local or regional priority groups through community consultation.

Statistics show that the investment in Indigenous tobacco control is making a difference. The Australian Bureau of Statistics compared the 1994–2005 ‘pre-investment’ period to the 2008–2015 ‘post investment’ period. They found a 2.1 percentage point decline per year in the smoking rates of Indigenous Australians aged 18+ during the investment period, compared to a 0.7 percentage point per year increase in the pre-investment period. They also found a 1.9 percentage point per year decline in smoking initiation during the investment period, compared to no decline in the pre-investment period.

“It’s important for us to see and know people we love and care about advocate for this, as it holds us accountable to some extent, especially with blackfellas. If you see Elders come up to you and ask ‘why you smoking for still?’ It hurts you. Now people are leading the talk. Not just Elders. People who walk besides us every day, the young ones etc. I feel like the younger generation don’t smoke as much, in comparison to mine.” – Community member.

This image depicts a large group of Aboriginal and/or Torres Strait Islander Australians, who took part in the Tackling Indigenous Smoking (TIS) Workers’ Workshop in Alice Springs, sitting on steps outside and cheering.

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 is increased.

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

2018-19 Target

2018-19 Result

2017-18

2016-17

2015-16

2014-15

60–65%

Data not available15

66%

64%16

63%

N/A

High blood pressure is a major risk factor for stroke, coronary heart disease, heart failure, kidney disease, deteriorating vision and peripheral vascular disease that leads to leg ulcers and gangrene. Reducing the prevalence of high blood pressure is one of the most important means of reducing circulatory diseases, which were the leading cause of death among Aboriginal and Torres Strait Islander Australians in 2011–15, equating to 24 per cent of total deaths.17

Program 2.3: Health Workforce

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

The Department continued to support the Government in addressing inequities of health workforce distribution across Australia, with a focus on improving access to health services in rural and regional areas.

The Stronger Rural Health Strategy, which began implementation in 2018-19, is a series of complementary measures to build a sustainable, high quality and well distributed health workforce across the country. It includes a range of incentives, funding and arrangements to give doctors, nurses and other health practitioners more opportunities to train and practice in remote and rural areas.

In 2018-19, the Australian General Practice Training program and Remote Vocational Training Scheme continued to ensure that at least half of all general practice training was delivered in rural areas. These communities continued to benefit from having well supervised and highly trained doctors working in their locality.

Supporting a well-distributed health workforce across Australia

Effective investment in workforce programs will improve the distribution of the health workforce.

a. The number of general practitioners (GPs)18 in Australia.

b. The number of non-general practice medical specialists19 in Australia.

c. The number of nurses20 working in General Practices in Australia.

d. The number of allied health practitioners21 working in General Practices in Australia.

Source: 2018-19 Health Portfolio Budget Statements, p.73 and Health Corporate Plan 2018–19, p.19

2018-19 Target

2018-19 Result

2017-18

2016-17

2015-16

2014-15

Cities22

a. 20,315

b. 28,091

c. 25,389

d. 2,841

Rural23

8,786

5,148

16,100

668

Cities

26,516

31,068

30,552

2,760

Rural

12,678

9,333

16,594

939

N/A

N/A

N/A

N/A

Result: Substantially Met

While the determinants of health outcomes are multi-faceted, access to the right health professional is a key part of managing the health of all Australians. People in rural and remote areas have poorer health outcomes and one factor is less access to the right health professionals for their needs.

In 2018-19, the Government began implementing the Stronger Rural Health Strategy, which aims to build a sustainable and high quality health workforce, as well as improve access to health professionals in the areas they are most needed.

Among the reforms are improved incentives to employ nurses and allied health professionals in general practice, improved incentives to direct health professionals to areas in need and reformed training programs that will improve the quality of health professionals working in rural and remote areas.

Improving the quality of the health workforce

Ensuring Australians have access to high quality services provided by qualified health practitioners through training delivered in all areas of Australia.

a. Percentage of medical practitioners working in general practice with fellowship of either the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine.

b. The percentage of general practice training outside major cities.24

c. Proportion of Specialist Training Program activity in rural areas.25

Source: 2018-19 Health Portfolio Budget Statements, p.73 and Health Corporate Plan 2018-19, p.19

2018-19 Target

2018-19 Result

2017-18

2016-17

2015-16

2014-15

a. 76.6%

b. 50.0%

c. 40.0%

78.6%

50.3%

48.9%

N/A

N/A

N/A

N/A

Result: Met

The proportion of GPs with vocational registration continues to grow. This is one of the key elements of the Stronger Rural Health Strategy, to provide incentives and training pathways for GPs to attain fellowship, which is the quality standard set in the Health Insurance Act 1973.

The Australian General Practice Training program and Remote Vocational Training Scheme continues to ensure at least half of all general practice training is delivered outside major cities. This contributes to improving access to well-supervised and highly trained health professionals in rural and remote Australia.

Program 2.4: Preventative Health and Chronic Disease Support

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

The Department supported the Government in developing strategies and initiatives to reduce the prevalence of chronic conditions. National Strategic Action Plans for a number of chronic conditions, including endometriosis and lung disease, were developed and launched. Initiatives contributing to the goals of the National Diabetes Strategy were undertaken to address the risk factors involved in people developing type 2 diabetes.

The Department continued to assist Australians in making healthier lifestyle choices through a number of programs, including the Health Star Rating system and the Healthy Heart Initiative. The purpose of these programs is to improve the long term health of Australians by educating and encouraging them to make more informed health decisions, make healthier food choices and increase physical activity.

In 2018-19, the Department worked to increase participation in bowel, breast and cervical cancer screening programs. The programs aim to reduce the morbidity and mortality rate of these cancers through early detection, diagnosis and treatment.

The Department continued to improve access to high quality palliative care through projects linked to the National Palliative Care Strategy (the Strategy), including advanced care planning, workforce development and quality improvement processes. The Strategy represents the commitment of the Commonwealth, state and territory governments, palliative care service providers and community-based organisations to ensure that people affected by life limiting illnesses receive the care they need.

Investment in quality alcohol and drug treatment services continued in 2018-19, providing a range of treatment services reflective of community needs. The next iteration of the National Alcohol Strategy and National Tobacco Strategy will be provided to the Ministerial Drug and Alcohol Forum for endorsement in 2019-20. Both are important sub-strategies of the overarching National Drug Strategy 2017–2026, a long term framework to reduce and prevent harms associated with alcohol, tobacco and other drugs.

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

National guidance is provided to States and Territories, and health professionals, on strategies to reduce the prevalence of chronic conditions and associated complications.

Source: 2018-19 Health Portfolio Budget Statements, p.76

2018-19 Target

2018-19 Result

Release of reporting framework for the National Strategic Framework for Chronic Conditions.

Implement Commonwealth responsibilities under the National Diabetes Strategy Implementation Plan.

Develop action plans for a number of diseases identified as a priority, including:

  • Endometriosis;
  • Arthritis;
  • Childhood Heart Disease;
  • Inflammatory Bowel Disease;
  • Lung Disease’ and
  • Macular Disease.

Australian Health Ministers’ Advisory Council (AHMAC) and Council of Australian Governments’ (COAG) Health Council approval of the Submission on the Australian National Breastfeeding Strategy by the end of 2018.

The reporting framework for the National Strategic Framework for Chronic Conditions was not released in 2018-19. It is expected to be released in early 2020.

A wide range of initiatives are being undertaken that contribute to the goals in the Australian National Diabetes Strategy.

The National Strategic Action Plans for Endometriosis, Arthritis, Childhood Heart Disease, Inflammatory Bowel Disease, Lung Disease, and Macular Disease were developed and launched.

The Australian National Breastfeeding Strategy: 2019 and Beyond was approved by the AHMAC on 8 February 2019 and by the CHC on 8 March 2019.

Result: Substantially Met

Additional work to finalise meaningful indicators has delayed the reporting framework for the National Strategic Framework for Chronic Conditions. The reporting framework is currently being progressed to the AHMAC for endorsement, through the Health Services Principal Committee, prior to its release. After approval from the AHMAC, the baseline data for the reporting framework is expected to be available in early 2020.

A wide range of initiatives support the priority actions in the Implementation Plan for the Australian National Diabetes Strategy. Initiatives are underway to address modifiable risk factors to prevent people from developing type 2 diabetes, including promoting healthier food choices and increasing physical activity.

Recommendations linked to the National Strategic Action Plans for priority diseases are wide ranging and include community awareness, clinical education and training and future research opportunities. Funding has been provided to support early implementation of action plan recommendations. The evidence-based initiatives and recommendations are designed to better prevent, detect, manage and treat a range of chronic conditions, leading to an improvement in quality of life for Australians living with them.

Breastfeeding is an important first step to improved physical and mental health outcomes for both babies and mothers, contributing to reduced future health costs and burden of disease. A number of stakeholders provided input to the Australian National Breastfeeding Strategy: 2019 and Beyond, including through the Breastfeeding Jurisdictional Officers Group, the Expert Reference Group, Commonwealth agencies and an online consultation process. The strategy aims to provide an enabling and empowering environment that protects, promotes, supports and values breastfeeding as the biological and social norm for infant and young child feeding.

Case Study
Health Star Rating – making healthier choices easier

With three in four Australians now aware of the Health Star Rating system, which came into effect 1 March 2016, the latest phase of the Health Star Rating campaign aims to help educate Australian grocery shoppers about how to use the ratings correctly.

The campaign explains the need to compare similarly packaged products in the same food category and reminds people that a strict calculation has been used to determine the Health Star Rating on the front of packaged products.

Animated characters of key products in each of the five food groups, as well as typical packaged food items bought in supermarkets, were developed to deliver the key messages. The characters are used in television advertising, complemented by digital video displays on shopping centre advertising screens, social media and internet search channels.

Campaign evaluation research found that 75 per cent of people who had seen the advertising had bought a health star rated product, compared the Health Star Rating to other nutritional information or considered using the Health Star Rating when completing future grocery shopping. Additionally, 70 per cent of those that are aware of the system reported that they understood how to use it correctly.

The Health Star Rating campaign is aimed at all Australian grocery buyers aged 18+, with key messages and fact sheets available in six languages.

Australia has one of the highest rates of obesity in the world, with 67 per cent of adults and one in four children being overweight or obese.26 Improving peoples’ health can often start with the choices they make in the supermarket. By using the Health Star Rating system correctly, people are able to make healthier and more informed choices when shopping for their food.

This image depicts two cartoon cereal boxes with Health Star Rating system logos attached to each, with one logo depicting a ‘2’ star rating and the other depicting a ‘5’ star rating.

Supporting the development of preventive health initiatives

National leadership is provided to support people to make informed decisions and healthy lifestyle choices.

Source: 2018-19 Health Portfolio Budget Statements, p.77

2018-19 Target

2018-19 Result

Increase in the number of businesses adopting the Health Star Rating (HSR) 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.

Encourage healthy lifestyles through increased physical activity and better nutrition through the Healthy Heart Initiative, including:

  • develop training and education material/resources for general practitioners to support their patients;
  • a steps competition, promoting innovate uses of technology to support increased physical activity; and
  • encourage innovative physical activity ideas in schools, universities and community environments.

Improve the long-term health of Australians, including through the development of:

  • resources to support families to manage their weight, improve their diet and increase exercise levels;
  • resources to encourage women to better manage gestational diabetes; and
  • a new National Injury Prevention Strategy.

Implement a grants program to increase levels of physical activity in over 65 year olds.

A total of 13,243 products displayed the HSR System graphic in Australia, according to October-November 2018 store uptake figures. This was a 28.2% increase from the previous collection period of February-March 2018. In total, 204 businesses have adopted the HSR System in Australia; an additional 40 compared to the previous collection period.

The Reformulation Working Group continued to finalise draft reformulation targets. The other Healthy Food Partnerships Working Groups have concluded their work plans and are moving into the implementation phase.

The general practitioners’ (GPs) Healthy Heart Partnership, now known as the Shaping a Healthy Australia project, piloted an online resource to assist GPs in supporting their patients to achieve a healthy lifestyle.

Two app-based steps programs were launched in 2018-19; the Prime Minister’s One Million Steps and MotivApril.

The first phase of the Active Australia Innovation Challenge, aimed toward schools, universities and communities, launched on 27 August 2018. Eight grants across Australia were awarded by the panel.

The Department engaged a review of Australia’s Physical Activity and Sedentary Behaviour Guidelines for children and young people.

Research to inform the development of educational resources for women to better manage gestational diabetes is progressing.

The National Injury Prevention Strategy is due for completion in June 2020.

The Better Ageing grants program, launched to increase physical activity levels in over 65 year olds, was conducted in the second half of 2018 and resulted in funding for 27 organisations.

Result: Met

The number of products and businesses adopting the HSR System has continued to increase each year since the first in-store collection in September 2015. Ongoing awareness campaigns and the demonstrated increasing awareness of and trust in the system has helped with its adoption. For example, by November 2018, 20.2 per cent of consumers recalled the HSR System without prompting and 69.5 per cent stated that the HSR System influenced their purchasing decisions.27

The Healthy Food Partnership Executive Committee has considered the recommendations put forward by the working groups for implementation in 2019-20. Activities for implementation include the development of the Portion Size Best Practice Guide for Industry, adoption of consistent portion size terminology and piloting the Food Service Pledge Scheme.

The Shaping a Healthy Australia project included the development of an online solution that supports a change in GP behaviour when working with patients to achieve a healthy lifestyle. The digital tool was piloted across 14 Australian general practices in both urban and rural settings between November 2018 and February 2019. A pilot evaluation occurred in late February through to March 2019. Further refinement of the tools and resources have occurred based on the pilot feedback and evaluation results. A larger scale pilot of the Shaping a Healthy Australia project will occur towards the end of 2019, with a national rollout of the resources likely to occur in early 2020.

The Prime Minister’s One Million Steps was a campaign open to all Australians, with the aim of walking one million steps in 20 weeks. The campaign saw more than 20,000 app users complete over 10.6 billion total steps. A total of 4,844 people achieved the goal of one million steps, with 22,357 new participants taking part in the challenge. The MotivApril Challenge was a 30 day walking challenge to reach 250,000 steps or complete eight group walks. This recruitment and retention strategy by the Heart Foundation resulted in 11,320 participants, of which 40 per cent were re-engaged users.

The first phase of the Active Australia Innovation Challenge received 138 applications from states and territories, schools, universities and community groups. Of those, 46 went on to submit a more detailed proposal resulting in 16 finalists presenting in the final round. After thorough consideration, the panel awarded eight grants across Australia. The second phase of the challenge launched on 2 June 2019 and was open until 31 July 2019.

The Department engaged the University of Wollongong to review Australia’s Physical Activity and Sedentary Behaviour Guidelines for children and young people. The revised guidelines, now known as the Australian 24-Hour Movement Guidelines for Children and Young People (5–17 years), provide recommendations on what duration and intensity of physical activity, and what sedentary behaviour, is considered appropriate to benefit overall health and wellbeing, as well as how much sleep is required. The Department also continued to maintain a range of resources and guidance materials designed to encourage healthy eating and undertaking physical activity.

Deakin University has been contracted to undertake research into better engagement of care for women with gestational diabetes to have follow-up testing for type 2 diabetes.

A literature review for the National Injury Prevention Strategy was finalised in June 2019. Consultation began with round tables in Sydney and Melbourne in March 2019 and governance arrangements to support the development of the strategy were agreed.

There were 251 applications received by Sport Australia as part of the Better Ageing grants program, requesting more money than the amount of funding available. Ultimately, 27 applications were deemed successful. The grants program aims to improve the health and wellbeing of older Australians by enhancing the understanding and benefits of regular physical activity, improving access to and engagement with sport and physical activity and enhancing the capability and capacity of organisations to deliver age-appropriate activities.

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

The percentage of people participating in the National Bowel Cancer Screening Program is increasing.28

Source: 2018-19 Health Portfolio Budget Statements, p.78 and Health Corporate Plan 2018–19, p.11

Jan 2018 -

Dec 2019 Target

Jan 2018 -

Dec 2019 Result

Jan 2017 -

Dec 2018

Jan 2016 -Dec 2017

Jan 2015-Dec 2016

Jan 2014 -Dec 2015

53.1%

Data not available

Data not available

41.3%

40.9%

38.9%

As there is a time lag between an invitation being sent, test results and collection of data from the National Bowel Cancer Screening Program register, participation rates for 1 January 2018 to 31 December 2019 will not be available until early 2021. However, a higher participation rate is expected for the January 2018 to December 2019 period.

The higher expected participation rate is due to a number of factors. These include large scale national, state and territory media campaigns, the introduction of a bowel screening kit with simplified instructions and the expansion and maturity of the program resulting in the invitation of additional people more likely to take part (older people and people who have screened before).

Increasing participation in the program means that more eligible people are completing the potentially life-saving test, increasing early detection and successful treatment of bowel cancer. At current participation rates, modelling shows that 59,000 lives will be saved between 2015 and 2040. Increasing participation rates further to 60 per cent could potentially save over 80,000 lives by 2040.

The percentage of women 50–74 years of age participating in BreastScreen Australia is maintained.29

Source: 2018-19 Health Portfolio Budget Statements, p.78 and Health Corporate Plan 2018–19, p.11

Jan 2018 –

Dec 2019 Target

Jan 2018 –

Dec 2019 Result

Jan 2017 –

Dec 2018

Jan 2016 – Dec 2017

Jan 2015 – Dec 2016

Jan 2014 – Dec 2015

54%

Data not available30

Data not available31

55%

54%

N/A

In 2018-19, the Australian Government continued to actively invite women aged 50–74 to participate in BreastScreen Australia.

As there is a time lag between an invitation being sent, test results and collection of data from registries, participation rates for 2018 and 2019 will not be available until mid 2021. The most recent monitoring report from the Australian Institute of Health and Welfare (AIHW) on participation in the BreastScreen Australia program found that in 2016-17, around 55 per cent of the eligible population participated in the program.

Case Study
BreastScreen Australia – reducing the impact of breast cancer

BreastScreen Australia is jointly funded by the Commonwealth and state and territory governments, and is one of Australia’s three population screening programs designed to detect cancer or its precursors before symptoms are apparent. The early detection of breast cancer reduces the impact of treatment and increases an individual’s chance of survival.

BreastScreen Australia aims to reduce morbidity and mortality from breast cancer by actively inviting women in the target age group of 50–74 years of age to attend free two yearly screening mammograms. Women aged 40–49 years and 75+ are also eligible to receive free screening mammograms, but do not receive an invitation to attend.

Rose’s Story

Rose made an appointment with BreastScreen ACT in the lead up to her 50th birthday, after her GP recommended she undergo a screening mammogram. She was subsequently diagnosed with high grade ductal carcinoma in situ (cancerous cells contained within the duct before it has spread and usually before it can be felt through physical examination). Due to the early stage of diagnosis and in consultation with her specialist, Rose was able to opt for a lumpectomy that did not require further treatment. She has since had her 12 month follow-up, which was clear.

Rose did not have a family history of breast cancer and had not had any recent breast changes; she just knew she needed to have a mammogram when turning 50. Rose says the support and service she received throughout the entire screening and follow-up investigation process were fantastic.

“When I was diagnosed with breast cancer I got a lot of information, reassurance, and clear discussion about options for next steps, which resulted in seeing a breast surgeon the following week. I had surgery and as the cancer was detected so early, I don’t need any more treatment.”

“I suppose mine is one of the many great stories of early detection from BreastScreen.”

Breast cancer mortality has decreased since BreastScreen Australia began, from 74 deaths per 100,000 women aged 50–74 in 1991 to less than 44 deaths per 100,000 in 2015. Breast cancers detected through BreastScreen Australia have a 69 per cent lower risk of causing death than those diagnosed in unscreened women.

In 2019, the Australian Institute of Health and Welfare estimates that breast cancer will be the most commonly diagnosed cancer in Australian women, with 19,371 new cancers diagnosed, and the second most common cause of cancer-related deaths in women, at 3,058 deaths.32 Despite these numbers, the five year survival rate for breast cancer is high at 90.8 per cent.

This image depicts the BreastScreen Australia logo.

The percentage of women in the target age group (20-69 years) participating in the National Cervical Screening Program (NCSP) is maintained.33 34

Source: 2018-19 Health Portfolio Budget Statements, p.78 and Health Corporate Plan 2018–19, p.11

Jan 2018 –

Dec 2019 Target35

Jan 2018 –

Dec 2019 Result

Jan 2017 –

Dec 2018

Jan 2016 –

Dec 201736

Jan 2015 –

Dec 2016

Jan 2014 –

Dec 2015

57%

Data not available37

Data not available38

56.3%

56.0%

56.6%

The AIHW will publish participation rates for the 2018 calendar year in December 2019 and participation rates for the 2019 calendar year in December 2020. This data is currently not available due to the renewal of the NCSP on 1 December 2017, when the two yearly Pap smear program was replaced with a five yearly human papillomavirus (HPV) test. Participation rates cannot yet be calculated for the renewed NCSP as not all participants have been recalled to screen.

The most recent available participation rates show that from 1 January 2016 to 30 June 2017, approximately 56.3 per cent of women aged 20–69 participated in the NCSP, which equates to more than 2.9 million screening tests taken.

The NCSP aims to prevent mortality and morbidity from cervical cancer through early detection. It is predicted that the introduction of a HPV based screening test will reduce cervical cancer incidence and mortality by up to 30 per cent.

Case Study
National Cervical Screening Program

The National Cervical Screening Program (NCSP) is a joint Australian Government and state and territory initiative that aims to prevent cervical cancer through early detection. Australia renewed the NCSP on 1 December 2017, supported by a National Cancer Screening Register (NCSR).

On 1 December 2017, Australia introduced a five yearly human papillomavirus (HPV) Cervical Screening Test for women aged 25–74. This replaced the two yearly Pap test previously offered for those aged 18–69.

After June 2018, the NCSR started sending correspondence to women, reminding them that they were due for a Cervical Screening Test as part of the renewed screening program. The NCSR invites women to screen and re-screen, and provides a safety net to patients and health care providers to support usual care.

“I would not have booked the test if I had not received the reminder letter.”

“When I opened the letter I felt that someone really cared.” 39

Australia is one of the first countries in the world to introduce the HPV test for cervical cancer as part of a national screening program. The new Cervical Screening Test looks for HPV, which can be detected before there are any cell changes in the cervix. Moving to the Cervical Screening Test has been estimated to reduce cervical cancer incidence and mortality by up to 30 per cent compared to the previous two yearly Pap test.

Lanny’s Story

Lanny, aged 40 from Western Australia had been getting regular Pap tests through the years and, with the exception of one showing possible low-grade changes, the test results were consistently returned normal. However, on having her first Cervical Screening Test, HPV 16 was detected and she was subsequently referred for a colposcopy. A biopsy taken at the time of the colposcopy showed a type of cancer called adenocarcinoma.

“Because of the new Cervical Screening Test, which found my high risk HPV, my adenocarcinoma was detected at an early stage. I was soon receiving specialist treatment. Given that I had no symptoms, I am very thankful that Australia now offers this new test.”

This image depicts the National Cervical Screening Program logo.

Capability is built through national leadership to ensure that Australians are provided with high quality palliative care.

Source: 2018-19 Health Portfolio Budget Statements, p.79

2018-19 Target

2018-19 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.

Finalise and release the revised National Palliative Care Strategy by December 2018.

Implement the More Choices for a Longer Life – healthy ageing and high quality care measure, commencing with bilateral negotiations with each jurisdiction.

National palliative care projects continued to be implemented.

The National Palliative Care Strategy was endorsed by Australian Health Ministers in December 2018 and the development of the National Palliative Care Strategy Implementation Plan is currently underway.

Bilateral agreements under the palliative care element of the More Choices for a Longer Life – healthy ageing and high quality care measure were offered to states and territories and negotiations are ongoing.

Result: Met

In 2018-19, the Department implemented national palliative care projects, including advance care planning, workforce development, national benchmarking and 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. The work included a focus on the uptake of advance care plans and other mechanisms for increasing individual choice, improving care quality and greater engagement in planning for goals of care.

The development of the National Palliative Care Strategy Implementation Plan is currently in process, with input from all jurisdictions. These projects have contributed significantly to achieving the objectives of the National Palliative Care Strategy and supporting the provision of quality palliative care in Australia.

 My End of Life Care – Talking about what matters to me.

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: 2018-19 Health Portfolio Budget Statements, p.80 and Health Corporate Plan 2018–19, p.10

2018-19 Target

2018-19 Result

Continue investment in quality alcohol and drug treatment services.

Continue to build the evidence base in relation to alcohol and drugs through high quality research.

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

  • finalise the next iteration of the National Alcohol Strategy and the National Tobacco Strategy and continue to focus on the priority areas identified; and
  • continue reporting on the National Drug Strategy and associated sub-strategies.

The Department invested $152.4 million in alcohol and drug treatment this financial year.

Significant progress has been made on the development of both the National Alcohol Strategy and the National Tobacco Strategy by the National Drug Strategy Committee, which are expected to be provided to the Ministerial Drug and Alcohol Forum in late 2019 for endorsement.

The Department continued to fund five dedicated National Research Centres that undertake research to inform evidence-based policy in relation to alcohol and other drugs. This includes research on new and emerging substances, workforce development and education and to inform treatment programs.

Result: Met

In 2018-19, the Department invested $152.4 million in drug and alcohol treatment services. This included $103.3 million for Primary Health Networks (PHNs) to commission locally based treatment services in line with community needs and $49 million in directly funded services with a national and state wide intake.

The Department liaised widely with non-government organisations and stakeholders during the progression of the National Alcohol Strategy. State and territory and local government agencies were also consulted and have contributed during development of the strategy.

Work to inform the development of the next National Tobacco Strategy has progressed. Initial consultation was conducted between July and September 2018, including targeted consultation with government officials and public health and tobacco control experts and organisations, and a public call for written submissions.

The National Drug Strategy Committee developed reporting templates to facilitate the first annual report against the National Drug Strategy 2017–2026. The templates collect information that demonstrates progress against the indicators outlined in the National Drug Strategy.

The National Fetal Alcohol Spectrum Disorder (FASD) Strategic Action Plan was launched as a sub-strategy of the National Drug Strategy. Monitoring of the progress against this national framework will be the responsibility of the FASD Advisory Group, which will be established in 2019-20. National efforts to address FASD continues to focus on the priority areas identified under the FASD Strategic Action Plan.

The percentage of the population 18 years of age and over who are daily smokers is reduced.40 41

Source: 2018-19 Health Portfolio Budget Statements, p.80

2018-19 Target

2018-19 Result

2017-18

2014-15

2011-12

10%

Data not available42

14.0%43

14.7%

16.3%

Initial results of the 2017-18 National Health Survey were released in late 2018. Although confirmed 2018-19 results are not yet available, there has been a long term decline in the daily smoking rate of Australian adults. Since 2001, the proportion of adults who are daily smokers has decreased from 22.4 per cent (22.3 per cent age-standardised) to 13.8 per cent (14 per cent age-standardised) in 2017-18.

In 2015, tobacco use was responsible for 13 per cent of deaths in Australia, equivalent to almost 21,000 deaths. When fatal and non-fatal burden is taken into account, tobacco use was estimated to be responsible for 9.3 per cent of the total burden of disease and injury.44 Effective efforts to reduce smoking prevalence will reduce smoking attributable death and disease, as well as the associated social and economic costs of tobacco use.

This image depicts the logo for the My QuitBuddy mobile app.

Program 2.5: Primary Health Care Quality and Coordination

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

The Department continued to support increasing the efficiency and effectiveness of health services to improve health outcomes for patients across Australia, including through the Primary Health Networks (PHNs). PHNs continue to work with health service providers in their regions to address the needs of the local community and improve the coordination of care for patients.

An extension of the Health Care Homes (HCH) trial and an increased patient cap was announced in 2018-19. The extension will allow further time for general practices and Aboriginal Community Controlled Health Services already participating in the program to implement new models of care tailored to the needs of their patients. The HCH trial aims to provide flexible, coordinated care to patients living with chronic and complex conditions and feed into the development of broader reforms to the primary health care system.

The Department continued to improve the quality of health information available 24 hours a day to the Australian community through telephone and digital communication channels, including on the Healthdirect website.

Strengthening primary health care through improved quality and coordination

Efficiency and effectiveness of health services and coordination of care at the local level is improved.

Source: 2018-19 Health Portfolio Budget Statements, p.81 and Health Corporate Plan 2018–19, p.8

2018-19 Target

2018-19 Result

All PHNs monitor and evaluate their commissioned services to inform future commissioning and continuous improvement.

All PHNs monitored their commissioned services, and most PHNs have either completed or have planned evaluations to inform future commissioning and continuous improvement.

Result: Met

PHNs continued to assess the health needs in their region, commission services to meet these needs and support health providers to improve quality of services and care coordination for patients. PHNs are moving towards incorporating outcomes based commissioning approaches to help ensure a greater focus on identifying and achieving priority outcomes for the communities in their regions.

Approximately 2,00045 service providers were commissioned to provide services in the areas of mental health, drug and alcohol treatment, after hours care, aged care, population health, digital health and workforce.

Continuity of care and coordinated services for patients with chronic and complex illnesses is improved.

Source: 2018-19 Health Portfolio Budget Statements, p.82

2018-19 Target

2018-19 Result

Increase eligible patient enrolment in Health Care Homes (HCH).

Ongoing support mechanisms effectively supporting HCH practices.

Delivery of interim evaluation report to Government by 30 June 2019.46

An extension of the HCH trial was announced. The trial will now operate to 30 June 2021 with a new patient cap of up to 12,000. In 2018-19, eligible patient enrolments in the HCH trial increased from 2,366 to 10,255.

PHN facilitators in each eligible PHN region provided support and assistance to enrolled practices around implementation of the HCH model.

The timeframe for the HCH evaluation has been extended to reflect the extension of the trial. As a result, the first interim report is due 30 September 2019, which will allow for additional data collection and analysis.

Result: Substantially Met

The Australian General Practice Accreditation Limited (AGPAL) developed online training and education modules to assist practices with patient enrolment in the HCH trial and change management related to implementation of new models of care. The AGPAL training modules have been used throughout the project period by general practitioners, nurses, practice managers, Aboriginal health workers and PHN Practice Facilitators.

Access to health advice, information and support services for the Australian community is improved.

Source: 2018-19 Health Portfolio Budget Statements, p.82

2018-19 Target

2018-19 Result

Continue to provide access to trusted healthcare information, advice and counselling services and improve information on local health and community services through the National Health Service Directory.

Health information and advice continued to be provided 24 hours a day through telephone and digital communication channels, such as the Healthdirect website.

Australians made over 34.3 million visits to the Healthdirect Australia website in 2018-19 (an increase of 36% over the previous year) with 33.4% returning for further visits. In the same period, 764,689 callers spoke to a triage nurse.

Result: Met

The quality of health information and website material is continually improving and regularly updated, ensuring that the Australian public are able to access free health information and advice 24 hours a day. Digital information services were expanded, providing the community with a more effective alternative choice to telephone services.

Since its release, there have been over 1.7 million visits from Australians to the interactive digital symptom checker on the Healthdirect Australia website.

Program 2.6: Primary Care Practice Incentives

Data sets were not available at the time of publishing for the performance target related to this program.

The Department continued to support the Government in funding the Practice Incentives Program (PIP). The PIP supports general practice activities that encourage continuing improvements and quality care, enhance capacity and improve access and health outcomes for patients. PIP practice payments are intended to support practices to purchase new equipment, upgrade facilities and increase remuneration for general practitioners working there. This, in turn, improves community health outcomes through earlier diagnosis and treatment of chronic illness, improving outcomes for Aboriginal and Torres Strait Islander Australians and encouraging general practices to adopt more effective and efficient technologies.

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

Access to accredited general practitioner care maintained through percentage of general practitioner patient care services provided by Practice Incentives Program practices.

Source: 2018-19 Health Portfolio Budget Statements, p.83

2018-19 Target

2018-19 Result

2017-18

2016-17

2015-16

2014-15

≥84.2%

Data not available47

85.2%

91.0%

86.0%

85.0%

The PIP continued to support general practice activities that encourage continuing improvements. There are 11 incentives under the PIP that focus on digital health, 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.

In 2018-19, the Department supported the Government to improve access to and efficiency of public hospitals through the provision of funding to states and territories. The Department also supported the Australian Government in negotiations on the National Health Reform Agreement (NHRA) 2020–25, to support sustainable and efficient funding for public hospitals.

Supporting the States and Territories to deliver efficient public hospital services

Advice is provided to the Minister and external stakeholders in relation to public hospital funding policy.

Source: 2018-19 Health Portfolio Budget Statements, p.84 and Health Corporate Plan 2018-19, p.8

2018-19 Target

2018-19 Result

Provide advice and support the development of a new Agreement on public hospital funding arrangements.

Advice and analysis was provided to the Minister and other government agencies in relation to public hospital funding throughout the development of longer term public hospital funding agreements.

The Health Innovation Fund Stage 1 Project Agreement between the Commonwealth, New South Wales and Western Australia was signed by all parties.

Result: Met

In 2018-19, the Department supported the Australian Government in negotiations for the NHRA for 2020–25, to support sustainable and efficient funding for Australia’s public hospitals into the future.

In December 2018, The Council of Australian Governments (COAG) agreed that Health Ministers would continue to lead development of this agreement for COAG approval before the end of 2019.

Health Innovation Fund projects in New South Wales and Western Australia have commenced, which will aim to deliver new projects that support health prevention and better use of health data.

Outcome 2 - Expenses and Resources

Budget Estimate 2018-19

$’000 (A)

Actual 2018-19

$’000 (B)

Variation

$’000

(B) - (A)

Program 2.1: Mental Health1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

929,268

892,319

(36,949)

Departmental expenses

Departmental appropriation

18,722

18,763

41

Expenses not requiring appropriation in the budget year3

604

847

243

Total for Program 2.1

948,594

911,929

(36,665)

Program 2.2: Aboriginal and Torres Strait Islander Health1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

903,974

899,099

(4,875)

Departmental expenses

Departmental appropriation2

28,953

29,759

806

Expenses not requiring appropriation in the budget year3

956

1,474

518

Total for Program 2.2

933,883

930,332

(3,551)

Program 2.3: Health Workforce

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

1,424,020

1,410,646

(13,374)

Departmental expenses

Departmental appropriation2

39,513

38,437

(1,076)

Expenses not requiring appropriation in the budget year3

1,287

1,740

453

Total for Program 2.3

1,464,820

1,450,823

(13,997)

Program 2.4: Preventive Health and Chronic Disease Support1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

496,595

473,719

(22,876)

Departmental expenses

Departmental appropriation2

39,374

37,751

(1,623)

Expenses not requiring appropriation in the budget year3

1,286

1,711

425

Total for Program 2.4

537,255

513,181

(24,074)

Program 2.5: Primary Health Care Quality and Coordination

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

399,845

394,455

(5,390)

Departmental expenses

Departmental appropriation2

18,781

19,593

812

Expenses not requiring appropriation in the budget year3

614

885

271

Total for Program 2.5

419,240

414,933

(4,307)

Program 2.6: Primary Care Practice Incentives

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

365,670

352,103

(13,567)

Departmental expenses

Departmental appropriation2

1,957

1,668

(289)

Expenses not requiring appropriation in the budget year3

61

76

15

Total for Program 2.6

367,688

353,847

(13,841)

Program 2.7: Hospital Services1

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

14,832

15,825

993

Departmental expenses

Departmental appropriation2

26,043

25,533

(510)

Expenses not requiring appropriation in the budget year3

3,542

3,740

198

Total for Program 2.7

44,417

45,098

681

Outcome 2 totals by appropriation type

Administered expenses

Ordinary annual services (Appropriation Act No. 1)

4,534,204

4,438,166

(96,038)

Departmental expenses

Departmental appropriation2

173,343

171,504

(1,839)

Expenses not requiring appropriation in the budget year3

8,350

10,473

2,123

Total expenses for Outcome 2

4,715,897

4,620,143

(95,754)

Average staffing level (number)

811

839

28

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.

Footnotes

  1. Available at: www.headtohealth.gov.au
  2. The new rural and regional headspace sites include: Armidale, Moree, Gunnedah and Narrabri in New South Wales (considered one service, satellite services from headspace Tamworth), Bega and Lithgow in New South Wales, Gympie in Queensland, Wonthaggi and Portland in Victoria.
  3. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing, Australia, 2007.
  4. Available at: www.health.gov.au/internet/main/publishing.nsf/Content/indigenous-implem...
  5. Available at: www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_AT...
  6. Australian Health Ministers’ Advisory Council 2017, Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report
  7. National Trachoma Surveillance and Reporting Unit 2018.
  8. Further information available at: closingthegap.pmc.gov.au
  9. The Australian Bureau of Statistics (ABS) will release 2017 revised data around mid-March 2020. 2017 final data will be released around mid-March 2021. The AIHW receives these data files about 3 months after the ABS release.
  10. 2016 final deaths data is not yet available. The ABS will release final data around mid-March 2020. The AIHW receives these data files about 3 months after the ABS release.
  11. During 2019, the approach to calculating Indigenous and non-Indigenous mortality rates and related target trajectories will be adjusted as official statistics move from 2011 Census based population denominators to 2016 Census based denominators following the publication of Indigenous population projections and backcasts. Accordingly, the child mortality and chronic disease results (as well as the trajectories) are likely to be revised.
  12. Results for 2017 are not yet final and have been reported as ‘data not available’. Currently, only data up to 2015 has been released as final by the ABS, allowing it to revise estimated results at a future date. This is standard ABS practice.
  13. Results for 2016 are not yet final and have been reported as ‘data not available’. Currently, only data up to 2015 has been released as final by the ABS, allowing it to revise estimated results at a further date. This is standard ABS practice.
  14. Commonwealth of Australia, Department of the Prime Minister and Cabinet, Closing the Gap Report, 2019.
  15. Data for 2018-19 will be available in December 2019.
  16. As of June 2017, changes were made to the data extraction method. This means that data from June 2017 onwards are not comparable with earlier collections because it represents a new baseline for the National Key Performance Indicators for Aboriginal and Torres Strait Islander Primary Health Care results.
  17. Australian Health Ministers’ Advisory Council, 2017, Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report, AHMAC, Canberra, p.48.
  18. GPs are defined as medical practitioners with fellowship, or training towards fellowship under an accredited training program, of the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine.
  19. Non-general practice medical specialists are defined as medical practitioners with fellowship, or training towards fellowship under an accredited training program, of a medical college recognised by the Medical Board of Australia, working in private practice, except those classified as GPs above.
  20. Nurses, defined under the Health Practitioner Regulation National Law, as in force in each state and territory.
  21. Allied Health Practitioners are defined as workers registered under one of the 15 professions under the National Law.
  22. Defined as locations identified as major cities under the geographic classification Modified Monash Model (MMM) 2015 (Modified Monash area 1) note providers may work in both city and rural and will be double counted across regions in Medical Benefits Schedule (MBS) data, providers with an unknown MMM location are excluded.
  23. Defined as locations identified as rural areas under the geographic classification MMM 2015 (Modified Monash areas 2-7) note providers may work in both city and rural and will be double counted across regions in MBS data, providers with an unknown MMM location are excluded.
  24. Defined as locations identified as outside major cities under the Australian Standard Geographical Classification – Remoteness Area System (ASGC-RA 2-5 2006). For the Remote Vocational Training Scheme, it is a condition that registrars under Stream A are in rural and remote areas (MMM4-7 locations) and those under Stream B are in Aboriginal and Community Controlled Health Services (MMM2-7 locations).
  25. Defined as Commonwealth funded posts supported under Agreements with participating specialist colleges through the Specialist Training Program, reported for 2018 (the calendar year ending during the relevant financial year) in Australian Standard Geographical Classification – Remoteness Area (ASGS-RA) areas 2-5.
  26. Australian Bureau of Statistics, 2017-18 National Health Survey.
  27. National Heart Foundation 2019, Report on the monitoring of the implementation of the Health Star Rating system in the first four years of implementation: June 2014 to June 2018, Canberra.
  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. Participation in the BreastScreen Australia Program has remained stable over the past five years. The ongoing participation trend is expected to remain stable over the forward years.
  30. AIHW collect and report BreastScreen Australia participation data based on two calendar years. January 2018 to December 2019 participation data will not be available until after the end of 2019. AIHW will request this data in 2020, which would be released in the BreastScreen Australia Monitoring Report 2021.
  31. AIHW will request the data for the two calendar years January 2017 to December 2018 in 2019, and this data will be released in the BreastScreen Australia Monitoring Report 2020.
  32. Australian Institute of Health and Welfare, Cancer in Australia 2019. Available at: www.aihw.gov.au/reports/cancer/cancer-in-australia-2019/contents/table-o...
  33. From 1 December 2017, the two yearly Pap test for women 18 to 69 years of age changed to a five-yearly HPV test for women 25 to 74 years of age.
  34. Data is not available to forecast forward year targets. Targets will be updated following implementation of the renewal of the NCSP and the National Cancer Screening Register.
  35. This measure is reported on a rolling two-calendar-year basis.
  36. Due to the renewal of the NCSP on 1 December 2017, participation rates for 2016-17 were reported on an 18 month basis.
  37. Data for the 2018 calendar year will be published by AIHW in December 2019.
  38. Data for the 2018 calendar year will be published by AIHW in December 2019.
  39. Anonymous feedback in response to receiving Cervical Screening Test letters.
  40. This measure is being monitored using the Australian Bureau of Statistics (ABS) National Health Survey and refers to age-standardised rates of daily smokers. Results from the next ABS National Health Survey are expected to be released in early 2022.
  41. Targets set for 2017-18 and 2018-19 are based on a 2018 performance benchmark previously agreed to by the Council of Australian Governments’ in the 2008 National Healthcare Agreement and its 2012 update. Targets for 2019-20, 2020-21 and 2021-22 will be confirmed in 2019-20, and informed by the next iteration of the National Tobacco Strategy.
  42. The ABS National Health Survey (NHS) is undertaken every three years. The next NHS will be conducted in the 2020-21 financial year.
  43. The age-standardised rate is 14%. Available at: www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001~2017-18~Main%20Features~Smoking~85
  44. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015, AIHW. Available at: www.aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-d...
  45. This is an approximate figure based on information supplied by PHNs as at 30 September 2018. The Department will confirm this figure following receipt and assessment of PHN 2018-19 Twelve Month Performance Reports.
  46. The evaluation of the stage one trial HCH will inform Government consideration of the national rollout of the program.
  47. A confirmed result for the 2018-19 financial year will not be available until November 2019, as data cannot be compiled until five months after the reference period (May/June 2019).