banner.jpg

Budget 2015: Australia's Public Health System Faces an Uncertain Future

May 2015

Despite welcome commitments related to e-health and the Medicare Benefits Schedule review, Australia’s health system faces an uncertain future after this year’s federal budget locked in the Commonwealth Government’s changes to public hospitals from last year and left other significant areas – such as public dental care – reliant on short-term funding, according to one of the nation’s leading health and aged care providers.

St Vincent’s Health Australia (SVHA) – the Catholic not-for-profit organisation which operates 27 hospitals and aged care facilities around the country, including the St Vincent’s public hospitals in Sydney and Melbourne – said anyone looking for this year’s budget to provide certainty and security to the nation’s health system would be disappointed.

Commonwealth’s role funding public hospitals

“Our main concern is that this budget locks in the Commonwealth’s decision to change the formula on how it will share the costs of hospital growth from 2017,” said SVHA’s CEO, Mr Toby Hall.

“State governments are telling us that patients will feel this through longer waiting times as public hospitals are forced to ration staff, beds and procedures to try and absorb the Commonwealth’s change.

“The biggest losers will be vulnerable and low income Australians – people who rely solely on public health care.

“We strongly encourage the Prime Minister to work with the Premiers and Chief Ministers to resolve this issue at the COAG Leaders’ Retreat in July.

Public dental care

“It’s discouraging that although the Commonwealth will provide $155 million in 2015-16 to the states for adult public dental services, this is $45 million less than was allocated in last year’s budget. Coupled with less generous indexation for child dental services, this means over the past two budgets the government has cut more than $550 million from public dental services.

“And with the lack of clarity around funding beyond 2015-16, it’s hard not to interpret that as the Commonwealth signalling its intention to withdraw from this area.

“Public dental services provide a safety net for the poor and vulnerable. We know from our dental clinic for homeless and mentally ill people at St Vincent’s Hospital Sydney just how critical public dental care is for people who simply cannot afford to pay.

“If the Commonwealth withdraws from public dental, these services will be at risk.

“Aside from pain and discomfort, for people trying to transform their lives and escape the cycle of poverty and homelessness, ongoing dental health issues can present a major barrier to change.

“For a homeless person, for example, finding the confidence that’s needed to get back on their feet and find a job can be hampered by the appearance of missing, damaged or rotting teeth.

Preventive health

“It’s disappointing to see this budget all but ignore the importance of preventive health.

“Last year’s budget cut $400 million out of preventive health, including programs focused on reducing alcohol-related harm.

“This budget will see the Commonwealth achieve savings of more than $950 million, which includes cuts to preventive health research.

“With 430 Australians hospitalised due to alcohol every day; and 5500 alcohol-related Australian deaths each year, we can little afford to drop the ball so dramatically on preventive health.

Pharmaceutical Benefits System safety net increase

“It’s also disappointing that, despite lack of support for the measure in the Senate, the budget confirms the government’s determination to pursue significant increases in PBS safety net thresholds.

“There’s strong evidence from the last time co-payments were increased significantly in 2005 that people stopped filling their scripts. Patients not being able to afford medications to manage their health will only increase health costs down the track.

“Chronic illness is a financial burden at any income level, however there are many low and middle income working Australians who do not qualify for a concession card and will be hit by the steep increase in the general PBS safety net threshold, given they spend a larger proportion of their income on health costs.

Medical Research Future Fund

“SVHA has long been on the record as supporting the government’s proposed Medical Research Future Fund. We believe it will radically improve the wellbeing of many Australians. Our problem has always been its method of funding.

“While we welcome the government’s dedication to the fund, we can’t support the fact it’s funded by measures that will hurt the most disadvantaged members of our community.

SVHA-supported initiatives

“As far as positives, we welcome the commitment to redevelop the e-health record system and trial an opt-out system.

“St Vincent’s Hospital in Sydney is already a pilot site for the Personally Controlled Electronic Health Record and we look forward to working with governments on the next stage.

“We also welcome the $20 million set aside for a National Drugs Campaign but note the need for extra funding for treatment and prevention.

“Similarly, $10.2 million to improve organ and tissue donation and transplantation rates is welcome news.

“Finally, we welcome the Commonwealth’s budget investment in the Medicare Benefits Schedule review which will ultimately contribute to a healthier Medicare system.

Conclusion

“The onus is now on the Commonwealth to address the huge amount of uncertainty that now exists in the public health system – the health of Australians, particularly those most in need, depends on it,” said Mr Hall.