Health: Investing in Regional Growth—2016-17

The Australian Government recognises that people living outside the major Australian cities can face barriers in accessing the same range of health and aged care services as those living in urban areas. Consequently, it directs significant assistance to improving the quality of, and access to, health and aged care services for people living outside metropolitan areas.

The Australian Government continues to see improvements in the health outcomes of people living in regional Australia. These improvements arise from the delivery  of services tailored to meet the needs of local communities and improvements  in the coverage of the health workforce. Additionally, Rural and Regional Health Australia provides easily accessible information about health programmes in  regional Australia through its website (see www.ruralhealthaustralia.gov.au) and its free call 1800 020 103 telephone line.

Assistance is provided through general health programmes, and programmes targeted specifically at regional Australia, where the Australian Government provides funding to address factors that specifically impact on the health and wellbeing of people living in rural and remote communities. In addition, substantial Australian Government assistance is provided to States and Territories through various specific purpose payments, with a significant amount directed to people living in regional Australia.

The Australian Government continues to provide targeted initiatives and incentives to improve service delivery and the health workforce in regional, rural and remote Australia. These initiatives and incentives have resulted in, but are not limited to:

  • tailored services that meet the needs of local communities;
  • increased accessibility to services; and
  • improvements to workforce coverage and distribution.

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New Initiatives

Medicare Benefits Schedule—Listing of Photography with Non-Mydriatic Retinal Cameras

This initiative will provide $33.8 million over four years from 2016-17 to list new items onto the Medicare Benefits Schedule to cover the testing of Diabetic Retinopathy with a non-mydriatic retinal camera. This service will benefit approximately 370,000 people with diabetes, of which approximately a quarter are Indigenous. The introduction of this service will improve the monitoring of diabetic eye disease especially in rural and remote regions and amongst Indigenous populations. Complications from diabetes, including blindness, are expensive to the health care system and are easily prevented if diagnosed early through this type of service.

Medicare Benefits Schedule Support for Rural and Remote Registrars

This measure, which will provide $7.6 million over four years from 1 November 2016, will enable general practice registrars training on the Australian College of Rural and Remote Medicine Independent Pathway to claim Medicare benefits (at the A1 level 1) for the services they provide whilst training. Australian College of Rural and Remote Medicine is one of two colleges accredited by the Australian Medical Council for setting professional medical standards for training, assessment, certification and continuing professional development in the specialty of general practice. Australian College of Rural and Remote Medicine Fellows receive full vocational recognition for A1 Medicare rebates and may practise unsupervised anywhere in Australia (A1 is a consultation type where there is personal attendance by a practitioner. The personal attendance of the medical practitioner upon the patient is necessary before a consultation may be regarded as a professional attendance).

This measure will have a positive impact on regional Australia, as registrars training on the Australian College of Rural and Remote Medicine Independent Pathway are likely to be providing services in regional and rural areas during their training. The programme also leads to fellowship of the college. The Australian College of Rural and Remote Medicine advise that most of their fellows choose to practise in rural and remote communities so that they can fully utilise the scope of clinical skills and knowledge they have gained through the fellowship programme.

Rural General Practice Grants Programme

This measure, which will provide $20.7 million over three years from 2015-16, will improve rural health services by redesigning the Rural and Regional Teaching Infrastructure Grants Programme, to create a more streamlined and simple Rural General Practice Grants Programme. This measure supports high quality and appropriate provision of services in-line with the whole-of-government priority of innovation and ensuring the consideration of rural, regional and remote Australians in broader health care reforms.

Aged Care Provider Funding—Improving the Targeting of the Viability Supplement for Regional Aged Care Facilities

In response to the Aged Care Financing Authority report Financial Issues Affecting Rural and Remote Providers, which identified greater cost pressures in rural and remote areas and noted that the geographical classification system of the Viability Supplement in aged care was out-dated and may not be best targeting funding, the Australian Government will introduce changes to the Viability Supplement in 2017. This will include updating the remoteness classification system with the more contemporary Modified Monash Model. The Modified Monash Model was developed by the Department of Health to improve targeting of the District of Workforce Shortage programme and other rural incentives programmes. In addition, the Viability Supplement rates payable for mainstream residential aged care services scoring 80 points or above (services score points on the basis of geographical location, number of occupied places and catering to special needs groups) will be increased.

The Australian Government will provide $102.3 million over five years from 2015-16 to support the supplement.

Residents of approximately 250 mainstream services will benefit from the new arrangements. The majority of these services are in or near outer regional towns, for example, Holbrook in New South Wales, Childers in Queensland, and Rushworth in Victoria. Around 3,000 out of 59,300 Home Care Packages programme recipients currently attract Viability Supplement funding. Around 7,000 recipients will benefit from higher funding under these changes, most of whom are located in or near outer regional locations.

Of the 181 Multi-Purpose Services that currently provide residential and/or home care, 109 will attract higher rates of funding for Viability Supplement under the new arrangements. An additional five National Aboriginal Torres Strait Islander Flexible Aged Care programme providers will also benefit from higher funding under these changes.

To ensure no services or care recipients are disadvantaged as a result of the shift to the Modified Monash Model, grandfathering arrangements will apply.

Healthier Medicare Trail of Health Care Homes

This initiative, which will provide $21.3 million over four years from 2015-16, supports the trial and evaluation of the Health Care Home model of care in seven Primary Health Network regions around Australia. Chronic conditions are the leading cause of illness, disability and death in Australia, with one in three Australians having at least one chronic condition and one in five having two or more. Rates of chronic disease are generally much higher in rural and regional Australia. Health Care Homes will improve the management of chronic conditions by providing patients with a "home base" for their care, ensuring greater continuity of care, better coordination of services and a team based approach to care designed around their specific needs.

Quality Improvement in General Practice—Simplification of the Practice Incentives Programme

This measure will establish a new Quality Improvement Incentive to be delivered through the Practice Incentives Programme. The changes will consolidate some existing Practice Incentives Programme payments into one Quality Improvement Incentive, available to all Practice Incentives Programme eligible practices, delivering a saving of $21.2 million. This incentive will streamline and simplify current Practice Incentives Programme payments to help general practice achieve high quality health care and improved patient outcomes.

Perinatal Depression On-line Support

This measure will provide $0.8 million over two years from 2015-16 for a targeted online perinatal support tool and smart phone app to address a gap in services for pregnant women and new mothers suffering from, or at risk of, perinatal depression. It would help up to 20,000 pregnant women and new mothers who do not currently access support for perinatal depression particularly due to barriers for seeking help for depression, including fear of stigma, being time poor and reluctant to engage with face to face services. The impact is amplified for women in rural and regional areas who face barriers due to geographic isolation and lack of access to face to face services.

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Current Initiatives

Rural Locum Assistance Programme

The Rural Locum Assistance Programme is the consolidation of three rural locum schemes under a single administrator. This will provide a single point of access for rural health services seeking locum relief support, as well as for those seeking to undertake rural work. The programmes that the Rural Locum Assistance Programme is replacing are:

  • the Rural Locum Education Assistance Programme;
  • the Nursing and Allied Health Rural Locum Scheme; and
  • the Rural Obstetric and Anaesthetic Locum Scheme.

Under the Rural Locum Assistance Programme, locum relief support will be provided to back-fill health practitioners who are taking leave for continual professional development or recreation purposes. The length of support is for 14 working days, or 28 working days in remote Australia to backfill a health professional undertaking professional development. On an annual basis, the Rural Locum Assistance Programme will provide:

  • 10,000 funded days for nursing and midwifery locum support in rural Australia;
  • 1,400 funded days for allied health locum support in rural Australia;
  • 950 funded days for obstetrician locum support (both specialist and procedural general practitioners); and
  • 400 funded days for anaesthetist locum support (both specialist and procedural general practitioners).

The Rural Locum Assistance Programme will also allow up to 50 general practitioners annually to access a grant of up to $6,000 to undertake emergency medicine training in return for a commitment to undertake a four week locum placement in a rural location.

Drug and Alcohol Programme

The Drug and Alcohol Programme aims to reduce the impact of alcohol and other drugs on individuals, families and communities across Australia through funding a range of activities that will improve access to quality alcohol and other drug treatment services and improve the evidence base behind alcohol and other drug treatment approaches and related issues.

These activities include:

  • funding non-government organisations to operate a range of drug and alcohol treatment services;
  • supporting alcohol and other drug treatment services across Australia to provide better outcomes for clients through a range of capacity building activities;
  • supporting early intervention and prevention activities relating to alcohol and other drug misuse and promoting evidence-based information about alcohol and other drugs through education;
  • supporting the development of evidence-based alcohol and other drug treatment service delivery and national policy through research and data collection; and
  • supporting the development of evidence-based alcohol and other drug treatment service delivery commissioned through Primary Health Networks across Australia and national policy through structured advisory mechanisms.

These activities are all available in regional and rural areas.

Macular Disease Foundation

The Macular Disease Foundation provides education to general practitioners on macular disease and awareness sessions to the general public on macular disease and diabetic retinopathy across urban, regional and rural locations.

  • Macular Disease Foundation is funded by the Australian Government under the Health Peak and Advisory Bodies Programme to:
    • Share information with the health sector and community in relation to the eye diseases macular degeneration and diabetic retinopathy; and
    • Provide training and education to general practitioners in relation to macular degeneration.
  • Funding of $1.36 million for the period 2015-16 to 2018-19 is provided to the Macular Disease Foundation to undertake this work across urban, regional and rural locations.

National Tobacco Campaign

In 2016-17, the Australian Government will support the next phase of the National Tobacco Campaign. The National Tobacco Campaign forms part of the Australian Government's comprehensive range of initiatives designed to contribute to a reduction in the prevalence of adult daily smoking rates. The objective of the campaign is to contribute to a reduction in the Australian adult daily smoking rate to 10 per cent or less and halve the daily smoking rate of Aboriginal and Torres Strait Islander people, from 47 per cent, by 2018.

National Ice Action Strategy

In response to the findings of the National Ice Taskforce, the Australian Government is providing an extra $298.2 million over four years from 1 July 2016 towards a number of measures aimed at reducing the impacts associated with ice and other drugs to individuals, families and communities. This funding will strengthen responses across education, prevention, treatment, support and community engagement.

A number of these measures focus on empowering local communities, including those within regional areas, with the establishment of a new online portal of information for parents, teachers and community organisations, the implementation of Community Drug Action Teams to bring together community groups to reduce drug related harms, with a focus on ice, and support for community sporting clubs to deliver prevention messages about ice with a focus on rural, regional, remote and Indigenous communities.

This additional investment also includes $241.5 million for Primary Health Networks to commission more alcohol and other drug treatment services, with a focus on ice, including Indigenous-specific services, based on what is necessary and appropriate to the needs of their local communities. Primary Health Networks are well-placed to fund local services according to agreed evidence and based on population planning, to ensure the coordination of services across the continuum of care.

Investing in More and Better Coordinated Services for People with Mental Illness

Central to the Australian Government's mental health reforms will be a regional approach to service planning and integration, and better matching of services to individual needs. The Australian Government's response to the Review of Mental Health Programmes and Services takes a whole of system perspective, enabling Australian Government services to complement the role of State and Territories in mental health care.

In 2016-17, the Australian Government will commence implementing its mental health reform agenda, with an immediate focus on initiating the delivery of the expanded Primary Health Network role, child and youth integration, the Digital Mental Health Gateway and the new community-based approach to suicide prevention.

From 1 July 2016, through a newly established flexible primary mental health care funding pool, Primary Health Networks will plan and commission regionally delivered primary mental health services in partnership with relevant services. Primary Health Networks will play a key role in leading the development of regional mental health and suicide prevention plans.

The Australian Government will begin work on developing a new digital mental health gateway which will bring together and streamline access to existing evidence-based information, advice and digital mental health treatment and will connect people to the services they need through a centralised telephone and web portal, including for people in regional and rural areas.

The Australian Government will also continue to support the mental health of young people across Australia, including through headspace centres under the phased implementation of reforms.

Closing the Gap Pharmaceutical Benefits Scheme Co-Payment Measure

The Closing the Gap Pharmaceutical Benefits Scheme Co-payment Measure improves access to Pharmaceutical Benefits Scheme medicines for eligible Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease in urban and rural settings. This measure lowers or removes the patient co-payment for Pharmaceutical Benefits Scheme medicines. More than 100,000 Aboriginal and Torres Strait Islander people benefit from the measure each month, many in regional and rural areas. This measure is expected to cost $32.4 million in 2016-17.

Section 100 Remote Area Aboriginal Health Service Programme

The Remote Area Aboriginal Health Service Programme is administered under section 100 of the National Health Act 1953 and allows for the supply of Pharmaceutical Benefits Scheme medicines to clients of eligible remote area Aboriginal Health Services at the time of medical consultation, without the need for a normal prescription form, and without charge.

The Remote Area Aboriginal Health Service Programme aims to address geographic, financial and cultural barriers experienced by Aboriginal and Torres Strait Islander peoples living in remote areas of Australia in accessing essential medicines through the Pharmaceutical Benefits Scheme. This programme is expected to cost $48.6 million in 2016-17.

Section 100 Remote Area Pharmacy Support Allowance

This programme provides an annual financial allowance that supports visits by pharmacists to provide targeted quality use of medicines and medication management support services to remote area Aboriginal Health Services which participate in the Section 100 Remote Area Aboriginal Health Service programme. The visits assist in improving health outcomes for clients of remote area Aboriginal Health Services by supporting quality use of medicines at those services.

Medication Management Review Programmes

These programmes aim to improve the quality use of medicine and reduce the risk of medication misadventure, including in rural and remote areas. Services include Home Medicines Review and the Residential Medication Management Review, which are conducted by an accredited pharmacist in the consumer's home or in an Australian Government funded aged care facility respectively. The Home Medicines Review programme also includes a Rural Loading Allowance to provide support to pharmacists to enable patients in rural and remote locations to access this programme. Other services include the MedsCheck and Diabetes MedsCheck, which aim to improve the use of medicine by providing an in-pharmacy review of a patient's medicines by a registered pharmacist.

Pharmacy Practice Incentives Programme

The Pharmacy Practice Incentives programme provides incentives to community pharmacies, including those in rural and regional areas, which deliver services to consumers to a defined quality standard, with the goal of improving patient health outcomes.

Aboriginal and Torres Strait Islander Peoples Pharmacy Workforce Programme

The Aboriginal and Torres Strait Islander Peoples Pharmacy Workforce programme supports Aboriginal and Torres Strait Islander participation in the pharmacy workforce, which in turn provides improved culturally appropriate pharmacy services to better meet the needs of Indigenous communities and patients. It is preferred that applicants for the Aboriginal and Torres Strait Islander Pharmacy Scholarship Scheme are from rural or remote localities, although, this is not mandatory. Sixteen Aboriginal and Torres Strait Islander Pharmacy Assistant traineeships are offered annually, with up to $10,000 available to a community pharmacy that employs and supports a trainee through the course of their studies (up to two years). Three undergraduate or post graduate Aboriginal and Torres Strait Islander Pharmacy scholarships of up to $15,000 per annum are offered annually. The normal course length is four years (students can access up to $60,000 over the period of their degree).

Rural Pharmacy Maintenance Allowance

This allowance is paid monthly to eligible rural or remote Section 90 pharmacies, in recognition of the additional burden of maintaining a pharmacy in rural and remote areas of Australia.

Rural Pharmacy Workforce Programme

This programme aims to maintain and improve access to quality community pharmacy services in rural and remote communities and strengthen and support the rural and remote pharmacy workforce in Australia. It comprises various initiatives designed to recruit, train and retain pharmacists for rural and remote areas, including undergraduate scholarships, intern support, professional development support and an emergency locum scheme. There are 30 Rural Pharmacy Scholarships offered annually of up to $10,000 per annum. The normal course length is four years (students can access up to $40,000 over the period of their degree).

Streamlining Health Workforce Scholarships

This initiative will provide greater flexibility and consistency in targeting scholarships to areas of need by streamlining a number of existing scholarship programmes into one—the Health Workforce Scholarship programme. Additionally, a rural return of service obligation will be associated with some scholarship types to provide a greater return on the investment. Obligations under the scholarships ensure exposure to practices in rural settings, and to the lifestyle and types of work available, to encourage these healthcare professionals to continue to work in rural areas.

Better Targeted Rural Financial Incentives for Doctors

In 2015, the Australian Government reprioritised existing financial incentives for doctors to work in rural areas by introducing a new geographical classification system, the Modified Monash Model, to more effectively direct incentives to areas that experience greater difficulty in attracting and retaining a general practice workforce.

Redesign of Dental Workforce Programmes

This initiative builds on other rural workforce initiatives, such as Better Targeted Rural Financial Incentives for Doctors, to more effectively target support in remote and rural locations that are in greatest workforce need. This initiative applies the new classification system, the Modified Monash Model to the Dental Relocation and Infrastructure Support Scheme to deliver incentives to dentists who relocate to work in rural and remote communities.

Positioning the North as a Global Leader in Tropical Health

The Australian Government will establish the Northern Australia Tropical Disease Collaboration programme, and the Australian Tropical Medicine Commercialisation grants, an Austrade initiative delivered by the Department of Industry and Science. The Northern Australia Tropical Disease Collaboration programme will support innovative, high quality research into tropical diseases, build strong collaborations and capacity in the health and medical research workforce and promote effective translation of research into health policy and practice. Research will focus on tropical diseases with high impact on human health including those such as:

  • dengue, malaria and melioidosis;
  • Australian Bat Lyssavirus;
  • the henipaviruses (Hendra and Nipah);
  • chikungunya and Murray Valley encephalitis;
  • multi-drug resistant tuberculosis; and
  • other novel and emerging pathogens.

The research will aid in the early detection and effective response to incursions when they occur.

Australian Tropical Medicine Commercialisation grants will take advantage of business opportunities from the growing tropical economy by establishing targeted funding to translate and commercialise research in new therapeutics and diagnostics in tropical medicine undertaken in Australia.

Full implementation of National Bowel Cancer Screening Programme

The National Bowel Cancer Screening programme invites eligible people from across Australia to undertake bowel screening tests in the privacy of their home. The National Bowel Cancer Screening programme currently provides screening to Australians  aged 50, 55, 60, 64, 65, 70, 72 and 74 years, and from 2017 those aged 54, 58 and 68 years.

Participation in screening has the potential to significantly reduce the number of deaths from bowel cancer. In the 2014-15 Budget, the Australian Government announced a further $95.9 million over four years to accelerate the implementation of biennial screening for all Australians aged 50 to 74 years by 2019-2020.

The development of a National Cancer Screening Register was announced in the 2015-16 Budget, which will support the expansion of the National Bowel Cancer Screening programme.

Blood Borne Viruses and Sexually Transmissible Infections Prevention Programme

The Blood Borne Viruses and Sexually Transmissible Infections Prevention programme aims to address rising rates of blood borne viruses and sexually transmissible infections. One of the elements of the Blood Borne Viruses and Sexually Transmissible Infections Prevention programme is the delivery of sexually transmissible infections reduction programmes targeted towards Aboriginal and Torres Strait Islander priority populations in regional and remote settings. This element of the Blood Borne Viruses and Sexually Transmissible Infections Prevention programme aims to increase sexually transmissible infections testing and treatment, and raise awareness about sexually transmissible infections prevention. Areas of focus include models of care that reach high prevalence communities and young people.

McGrath Specialist Breast Care Nurses

McGrath Specialist Breast Care Nurses are specially trained registered nurses who provide information, care, and practical and emotional support to women diagnosed with breast cancer, their families and carers.

There are currently 57 Australian Government funded McGrath Specialist Breast Care Nurses in place around Australia, with 86 per cent located in regional and remote areas.

The McGrath Specialist Breast Care Nurses will support up to 15,000 women and their families over the four year funding agreement.

Specialist Prostate Cancer Nurse Initiative

The Specialist Prostate Cancer Nurse Initiative supports the placement of up to 15 full time equivalent prostate cancer nurses over three years through to September 2017, assisting up to 4,000 men and their families.

These prostate cancer nurses are part of a pilot project. The initiative aims to develop, test and evaluate a model for specially trained nurses to address the needs of people living in metropolitan and regional Australia who have been affected by prostate cancer by providing information, care and support to men with prostate cancer and their families.

The Australian Government is contributing funding of $6.2 million from 2013-14 to 2016-17 to the Prostate Cancer Foundation Australia for this initiative.

Improving Access to Primary Care Services in Rural and Remote Areas—COAG s19 (2) Exemptions Initiative

This initiative provides conditional funding through the Medicare Benefits Schedule to approved rural and remote public hospital sites. The initiative supports greater patient access to primary health care services locally, including to after hours' services in small public hospitals, and to health services which are better able to attract and retain health professionals.

Block Funding for Small Rural and Regional Hospitals

To ensure rural and regional communities continue to have access to vital public hospital services, the Australian Government provides States and Territories with a dedicated block funding contribution for small rural and regional hospitals. In 2015-16, the Australian Government will provide approximately $800 million in block funding to States and Territories to support services provided by small rural and regional hospitals.

Emergency Medicine Education and Training Programme

The Emergency Medicine Education and Training programme, with 33 participating hub hospitals, provides training and educational support to non-specialist doctors and other staff working in emergency departments in regional and rural areas.

National Critical Care and Trauma Response Centre

The Australian Government funds the operation of the National Critical Care and Trauma Response Centre based in Darwin (Northern Territory). The centre is equipped and ready to assist in responses to large scale emergencies and disasters in Australia and the region. Beneficiaries of the programme include regional Australians, particularly during times of emergency when an event has the potential to overwhelm or exhaust a State's or Territory's health resources. The centre provides an enhanced domestic response capability, and generates goodwill with disaster affected regional communities. The location of the centre also supports a positive regional impact by attracting health expertise and infrastructure to the Northern Territory. Funding is allocated from 2015-16 to 2018-19 to support its continued operation.

National Partnership on Health Care Grants for the Torres Strait

The Australian Government provides funding for the Project Agreement for the management of Torres Strait/Papua New Guinea cross border health issues. Under this agreement, the Australian Government contributes funding to Queensland Department of Health for the treatment of Papua New Guinea nationals who travel through the Torres Strait Treaty Zone and access health facilities in the Torres Strait and elsewhere within the Queensland Health hospital network.

National Partnership on the Torres Strait Health Protection Strategy—Mosquito Control

The Australian Government provides funding for the Project Agreement for the Torres Strait Health Protection Strategy—mosquito control and cross border liaison in the Torres Strait Protected Zone. This agreement supports surveillance, control and elimination, if possible, of Aedes albopictus mosquitoes in the Torres Strait, and to prevent the spread and establishment of Aedes albopictus from the Torres Strait to mainland Australia. The agreement also supports the employment of a Torres Strait Communications Officer to coordinate improved data sharing with Papua New Guinea on communicable diseases and health issues arising from cross border movements in the Torres Strait Protected Zone.

National Partnership on the Torres Strait Health Protection Strategy—Saibai Island Health Clinic

The Australian Government provides funding for the National Partnership on the Torres Strait Health Protection Strategy—Saibai Island health clinic to provide additional staff for the treatment of communicable diseases at the health care clinic on Saibai Island, and for development and implementation of a culturally appropriate sexual health education campaign for people in the Torres Strait. This programme targets young people to make them aware of Blood Borne Viruses and Sexually Transmissible Infections and to encourage them to access clinical services and health checks. Work will continue to develop short and long term options to address the lack of health staff accommodation on Saibai Island. The success of this programme will improve the health outcomes of Saibai Island inhabitants under the objectives of the partnership arrangement between the Australian Government and Queensland.

Practice Incentives Programme

The Practice Incentives Programme includes a rural loading ranging from 15 to 50 per cent (depending on the remoteness of the practice location) which is applied to the incentive payments of practices in rural and remote areas. The rural loading is paid in recognition of the difficulties of providing care, often with little professional support, in rural and remote areas and to provide access to services which are available through other means to patients in metropolitan and other urban areas.

Doubling the Practice Incentives Programme Teaching Payment

From 1 January 2015, the Australian Government has doubled the Practice Incentives Programme teaching payment to $200 for each three hour teaching session provided to undergraduate and graduate medical students.

This payment will better compensate practices for the time invested in teaching, and encourage practices to provide more teaching opportunities for students. As a greater number of students can experience general practice through these opportunities, more students are expected to pursue a future career in primary care.

Primary Health Networks

Primary Health Networks have been established to increase the efficiency and effectiveness of medical services for patients, particularly for those at risk of poor health outcomes, and to improve coordination of care to ensure patients receive the right care, in the right place, at the right time. In 2016-17, Primary Health Networks move to commissioning models for planning and purchasing medical and health services. Commissioning involves a strategic approach to the procurement of health services, informed by local health needs assessment, market analysis of local health care supply, and ongoing monitoring and evaluation of service quality and performance.

After Hours Primary Health Care Arrangements

New after-hours primary health care funding arrangements commenced on 1 July 2015 to ensure access for all Australians to primary health care services during the after-hours period. This included:

  • a Practice Incentives Programme after hours incentive payment to eligible accredited general practices registered for the Practice Incentives Programme;
  • funding to Primary Health Networks to support locally tailored after hours services, including support for "at risk" populations such as those in rural and remote areas; and
  • a new after-hours general practices advice and support line for all Australians who do not have access to face to face general practices services in the after-hours period.

headspace

The Australian Government is providing funding to Primary Health Networks to support headspace services. Primary Health Networks will integrate the delivery of headspace services with other local youth mental health and primary care services. Of the 100 headspace centres announced to date, 44 sites will be located in rural and regional areas across Australia.

The Australian Government has also committed to providing continued funding for the headspace National Youth Mental Health Foundation to deliver eheadspace. Young people in communities that do not have a headspace centre are encouraged to use the free, confidential telephone and web-based service for young people with, or at risk of, developing a mild to moderate mental illness.

Indigenous Australians' Health Programme

Through the Indigenous Australians' Health Programme, Aboriginal and Torres Strait Islander people have access to effective health care services in areas of need (including medical outreach to rural and remote areas), targeted initiatives to improve prevention and primary health care management of chronic diseases, and maternal and child health activities. In 2016-17, continued implementation of the Aboriginal and Torres Strait Islander Health Plan will ensure that regional investments are made in priority areas in consultation with the Indigenous health sector.

Supporting the Royal Flying Doctor Service

Further funding of $20.0 million is being provided over two years from 2015-16 to supplement the recurrent base funding to the Royal Flying Doctor Service. Funding will support the delivery of traditional services including primary aeromedical evacuations, primary health clinics, consultations and medical chests in rural, remote and very remote communities.

This initiative aligns with the Australian Government's commitment to support the delivery of primary health care services in rural and remote communities, and in areas beyond normal medical infrastructure.

Quality Assurance for Aboriginal and Torres Strait Islander Medical Services Programme

The Quality Assurance for Aboriginal and Torres Strait Islander Medical Services programme supports the better management of diabetes in Aboriginal and Torres Strait Islander communities by enabling participating health services to provide culturally appropriate and clinically effective point-of-care diabetes related pathology testing. The Quality Assurance for Aboriginal and Torres Strait Islander Medical Services programme also includes training, technical support, quality assurance and a consultation programme for community leaders to support programme management on site.

As at 31 December 2015, a total of 200 sites participated in the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services programme, with the majority of these located in rural and remote areas.

Support for Outreach Health Services

The Rural Health Outreach Fund improves access to health services for people living in rural, regional and remote Australia by supporting a range of outreach health activities. Four health priorities are specifically addressed: maternity and paediatric health, eye health, mental health and support for chronic disease management.

Services are provided directly to communities by specialists, general practitioners, nurses and allied health professionals.

The Royal Flying Doctor Service is funded by the Australian Government to deliver primary aero-medical evacuations, primary health clinics, remote consultations and medical chests containing pharmaceutical and medical supplies to remote locations.

Australian Government Hearing Services Programme

The Australian Government Hearing Services programme provides eligible people with access to a range of high quality hearing services and devices. Eligible clients in regional communities can access these services through two mechanisms:

  • the Voucher programme uses a national network of approximately 275 contracted service providers, including Australian Hearing, with 67 service providers located at 1,177 regional sites across Australia; and
  • Community Service Obligations—Australian Hearing is funded to deliver specialist services from permanent, visiting and remote sites across Australia, to children and young adults up to the age of 26, and to other high risk groups such as eligible Indigenous Australians. Australian Hearing works closely with local services to deliver its Indigenous outreach programme providing hearing services to more than 130 of Australia's most remote communities. In 2014-15, (the most recent full year data), 128 audiologists delivered services to these communities at over 233 sites across Australia.

Visiting Optometrists Scheme

The Visiting Optometrists Scheme improves access to optometry services for people living and working in rural and remote communities, and includes additional optometrist services for Aboriginal and Torres Strait Islander people.

The scheme addresses some of the financial disincentives incurred by optometrists providing outreach services, with funding provided for costs that include travel and accommodation, facility fees and administrative support at the outreach location, and lease and transport of equipment.

Supporting Leave for Living Organ Donors Programme

The Supporting Leave for Living Organ Donors Programme ran as a pilot from 1 July 2013 to 30 June 2015. Following the success of the two year pilot, the Australian Government announced that the Supporting Leave for Living Organ Donors Programme would continue for a further two years from 1 July 2015 to 30 June 2017.

The programme makes a financial contribution to employers, to either replenish an employee's leave or reimburse an employer who has made a payment to their employee (who may have exhausted their leave) in place of income lost due to time off for organ donation. A key change to the continuing programme was that the maximum reimbursement available under the programme was extended from six weeks to nine weeks (based on a 38 hour week) of leave, at an amount up to the National Minimum Wage.

The Supporting Leave for Living Organ Donors Programme continues to raise the profile of living organ donors, reduce financial stress associated with being a living organ donor and encourage employers to support employees who have chosen to donate an organ. Because transplant units are based in major metropolitan hospitals, the Supporting Leave for Living Organ Donors Programme is of particular assistance to donors from regional or rural Australia, as they may need more time away from work for their surgery and other post-operative treatment than donors from the city.

Rebuilding General Practice Education and Training to Deliver More General Practices

The Australian Government is supporting training for 300 extra general practitioners a year by boosting commencing training places from 1,200 to 1,500 in 2015. The new training positions are based in rural areas as much as possible, and at least 50 per cent of the new trainees are required to train on the rural pathway. As registrars deliver services to the community while training, the increase in training places is providing more services to communities in rural and regional areas.

Commonwealth Medical Internships

The Australian Government committed $40.0 million over four years, from 2013-14 to 2016-17, for the Commonwealth Medical Internships initiative, to support additional medical internships in private hospitals.

Under this initiative, priority is given to positions and rotations outside of metropolitan areas to bolster the medical workforce in rural and regional areas. As States and Territories guarantee internships for domestic medical graduates, the initiative is available only to full fee paying international graduates of Australian universities.

In 2014, 76 positions were filled under this programme. In return for a funded intern position, interns agree to work for a period of 48 weeks in regional and rural areas, within five years of commencing their internship. In 2015, of the 81 positions that were filled:

  • twenty-six interns will complete their internship in full in either Townsville, Bundaberg or Mackay;
  • nine interns are based in Sydney with rotations to Wagga Wagga and Kempsey;
  • seven interns are based in Perth with one or more rural/regional rotations; and
  • thirty-nine interns are based in Brisbane with one or more rotations in locations including Port Macquarie, Kempsey, Mt Isa, Kingaroy, Mackay, Bundaberg, Bowen, Proserpine, Townsville, Katherine, Alice Springs and Darwin.

General Practitioner Procedural Training Support Programme

The General Practitioner Procedural Training Support programmeaims to improve access to maternity services for women living in rural and remote communities by supporting general practitioners to attain procedural skills in obstetrics or in anaesthetics.

The General Practitioner Procedural Training Support programme targets existing general practitioners in rural and remote areas. For the 2014 training year, 26 obstetrics scholarships and 15 anaesthetics scholarships were awarded to rural and remote doctors.

Funding to CRANAplus

Funding to CRANAplus supports the remote and isolated health workforce through programmes such as the Bush Support Services (including the Bush Support Line), which provides access to trained counsellors for remote health workers and their families. This initiative also encourages health service providers in remote areas of Australia to network and engage in professional development.

Northern Territory Medical Programme

The Northern Territory Medical programme addresses medical workforce shortages and retention issues by providing a full four year graduate entry medical course in the Northern Territory. It supports medical education for up to 24 students (in each year of study) as part of the Flinders University medical degree programme, and receives funding support from the Australian and Northern Territory Governments.

The Northern Territory Medical programme is aimed at recruiting Northern Territory residents and Aboriginal and Torres Strait Islander students. It trains medical graduates to become capable of working in remote areas and with Aboriginal and Torres Strait Islander people.

International Recruitment Strategy

The International Recruitment Strategy aims to increase the supply of appropriately qualified overseas trained health professionals to districts of workforce shortage throughout Australia. The International Recruitment Strategy has five components for recruitment and resettlement support to overseas trained doctors, nurses and allied health professionals:

  • the International Recruitment Strategy;
  • the Five Year Overseas Trained Doctor Scheme;
  • the Additional Assistance Scheme;
  • the Rural Locum Relief programme; and
  • the Rural Health Professionals Programme.

Remote Vocational Training Scheme

The Remote Vocational Training Scheme supports doctors practicing in some of Australia's most remote locations to undertake vocational general practice training. It delivers structured distance education and supervision to doctors completing general practice vocational training, while they continue to provide general practice medical services to remote and/or isolated communities. The training includes weekly tutorials through video and teleconferences, twice yearly education workshops, remote supervision and individualised training advice.

The Remote Vocational Training Scheme supports 22 new training places each year. In 2015, a new cohort of 10 registrars training in Aboriginal Community Controlled Health Services commenced training under the Remote Vocational Training Scheme.

Rural and Remote General Practice Programme

The Rural and Remote General Practice programme supports the recruitment and retention of general practitioners in rural and remote areas. Rural Workforce Agencies, located in each State and the Northern Territory receive funding under the Rural and Remote General Practice programme to deliver a range of services to help communities to recruit general practitioners, find appropriate placements for those who want to relocate to rural Australia, assist with the costs of relocation, support their families to settle into a new community and help general practitioners to access the necessary infrastructure, support and training.

Rural Health Multidisciplinary Training Programme

Rural training encourages the next generation of health professionals to consider rural careers and enhances the capacity of health services to meet community needs. Involvement in education and training also reduces professional isolation for existing rural practitioners, enhancing workforce retention and sustainability. The Rural Health Multidisciplinary Training programme includes four sub-programmes that support undergraduate clinical training of medical, nursing and allied health students in rural and remote Australia. Students support existing rural health professionals, alleviating the shortage of adequate health care services in rural areas through the following programmes:

  • Rural Clinical Training and Support programme;
  • University Departments of Rural Health programme;
  • Dental Training Expanding Rural Placements programme; and
  • John Flynn Placement programme.

Rural Other Medical Practitioners Programme

The Rural Other Medical Practitioners programmerecognises the value of services provided by non-vocationally registered medical practitioners in rural and remote areas, and provides higher Medicare benefits for their patients. The Rural Other Medical Practitioners programme also provides an incentive to encourage non-vocationally registered medical practitioners (both Australian and overseas trained) to provide general practice services in eligible rural and remote locations.

Rural Procedural Grants Programme

The Rural Procedural Grants programmeenables procedural general practitioners in rural and remote areas to access grants to attend training and up-skilling in emergency and procedural medicine.

Scaling Incentive for Overseas Trained Doctors

The scaling incentive is a non-cash incentive offering Overseas Trained Doctors and foreign graduates, of an accredited medical school, opportunities to reduce the 10 year moratorium restriction period for access to the Medicare system. Time reductions are significantly greater for doctors who choose to work in more remote areas. The effect of scaling is to ensure that benefits will be significantly greater for doctors choosing to live and work in more remote areas of Australia. Moratorium restriction periods for access to the Medicare system by area are:

  • Major cities—10 years;
  • Inner Regional—9 years;
  • Outer Regional—7 years;
  • Remote—6 years; and
  • Very Remote—5 years.

Scaling Rural Workforce Communications—Go Rural Programme

The aim of the Scaling Rural Workforce Communications—Go Rural programme is to encourage Australian trained doctors and medical students to consider a career in rural practice through a range of multimedia, communication and information sessions, including the use of rural ambassadors. Events are coordinated by Rural Workforce Agencies in each State and the Northern Territory.

Specialist Training Programme

The Specialist Training programme increases the capacity of the private and community health care sector to provide high quality training opportunities for trainee medical specialists. In 2015 and 2016, 900 training full time equivalent places are being funded. Over 50 per cent of training posts have an element of training in regional and rural areas.

Residential Aged Care Viability Supplement

The Residential Aged Care Viability Supplement is paid to eligible providers operating in rural and remote areas; providers with small numbers of residents; and providers specialising in the care of homeless people or people from Aboriginal and Torres Strait Islander communities. It aims to improve the capacity of eligible services to offer quality care to residents. The supplement was increased by 20 per cent from 1 July 2014.

Home Care Viability Supplement

The Home Care Viability Supplement is paid to eligible home care providers operating in rural and remote areas. This supplement provides support for the higher operating costs (such as wages, fuel and training) associated with providing care in rural and regional locations. The supplement was increased by 20 per cent from 1 July 2014.

Multi-Purpose Services Programme—Aged Care Subsidies

The Multi-Purpose Services programme is a joint initiative of the Australian Government and State and Territory governments, which aims to deliver flexible and integrated health and aged care services for small regional and remote communities.

Multi-Purpose Services receive Australian Government funding for aged care and State and Territory Government funding for a range of health services. As at 30 June 2015, there were 165 Multi-Purpose Services providing 3,545 aged care places in regional and remote areas Australia-wide.

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