Budget 2018 – Health and Aged Care

Key points

  • Substantial package of services for older people, including Homecare packages, residential aged care places and a sharper focus on aged care quality. However, significantly more needs to be done to meet demand.
  • Significant mental health package, including new funding for Lifeline, new services for older people and funding for suicide prevention. However, again, more investment is needed to close the gap between supply and demand for mental health services.
  • Despite record overall spending on health, spending has reduced once you take into account population growth. Without increased funding, people will continue to be hit with increasing out of pocket costs.
  • Urgent action is still needed on preventive health and oral health.
 
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What’s in the Budget?

Aged Care

The Government will implement a new program “More Choices for a Longer Life — healthy ageing and high quality care” that will include a number of initiatives including:  

  • an additional 14,000 new high level home care packages over four years from 2018-19 in addition to the 6,000 high level packages delivered in the 2017-18 MYEFO
  • 13,500 residential aged care places and 775 short term restorative care places in the 2018-19 Aged Care Approvals Round, with a $60.0 million capital investment to support new places
  • Additional residential aged care places and home care packages in remote Aboriginal and Torres Strait Islander communities; (Cost $105.7 million over four years from 2018-19 (including $32.0 million from within the existing resources))
  • Spending to make the My Aged Care website easier to use and to develop simpler assessment forms for people to access aged care services (Cost $61.7 million over two years from 2018-19)
  • Capital grants funding for aged care facilities in regional, rural and remote Australia; (Cost of $40.0 million over four years from 2019-20)
  • A new Aged Care Quality and Safety Commission from 1 January 2019 (Cost $253.8 million over four years)
  • A Quality Care Fund to improve the quality of residential aged care; (Cost $50.0 million over two years from 2018-19)

Health

  • Aligning the distribution of the health workforce to areas of greatest need and building the capability of Australia’s medical practitioner workforce. (Cost $83.3 million over five years from 2017-18)
  • Listing new medicines on the Pharmaceutical Benefits Scheme (PBS) that have been recommended for listing by the independent Pharmaceutical Benefits Advisory Committee. (Cost $1.0 billion over the forward estimates)
  • A Million Minds Mental Health Research Mission to support priorities under the Fifth Mental Health and Suicide Prevention Plan (Cost $275.4 million from the Medical Research Future Fund, including $125.0 million over 10 years from 2017-18)
  • New and amended listings on the PBS and the Repatriation Pharmaceutical Benefits Scheme (RPBS), including drugs to treat refractory multiple myeloma, relapsing- remitting multiple sclerosis, relapsed or refractory Hodgkin lymphoma, and the prevention of HIV (Cost $1.4 billion over five years from 2017-18)
  • Mental health initiatives including to improve follow-up care for people discharged from hospital following a suicide attempt, to expand Lifeline’s telephone counselling service, to strengthen the mental health commission, mental health services for people in residential aged care facilities, mental health nurses to target the mental health of older Australians in the community, particularly those at risk from isolation, and other initiatives. (Cost $190.2 million in total for all initiatives)
 
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Impacts on People

  • The investment in Homecare will mean less people waiting for a package, and more people supported to stay in their homes, although many will remain on waitlists as supply fails to meet demand.
  • The new mental health services for older people will mean more people accessing mental health services in residential aged care settings and more older people in the community are able to access mental health services.
  • People calling Lifeline will get through to help more quickly – Lifeline says that the budget commitment means that no call will go unanswered.

 

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Missing in action

  • Limited new money for dental care/oral health – significant investment needed
  • No action on sugary drinks tax
  • No money for a preventative care package

 

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ACOSS commentary

While the Budget contains record overall spending on health, when population growth is taken into account, spending per capita has reduced. In future years spending on health will need to not only grow to take into account population growth, but grow on a per capita basis to ensure that people are not further hit with increased out of pocket costs. 

This Budget’s package of measures for older people is welcome, and the new Homecare packages will reduce the waitlist. That said, a significant waitlist will remain after these investments, given that the backlog was about 100 000 packages, and more needs to be done in aged care to actually meet demand. 

Also in the package of measures for older people is a substantial investment in mental health. This investment is also welcome, comprising roughly half of the $190 million in overall new investment in mental health. Overall, the new investment in mental health and suicide prevention will make a difference, but the gap between supply and demand for mental health services remains, and more investment is needed. 

Missing from the Budget was a substantial investment in preventive health. The investment in the listing of the new HIV prevention drugs is welcome, however a comprehensive package was needed.

Also missing was a substantial investment in oral health. ACOSS advocated for access to basic, preventive dental care through the public health system for children and adults, funded through the redirection of savings from the abolition of the Private Health Insurance rebate. Only small investments in oral health came out of this budget.

 

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