Australians living in regional, rural and remote areas will have improved access to high quality health and aged care, and will enjoy better local sporting facilities, through a range of initiatives funded in the 2019-20 Budget.
They will share in the benefits flowing to all Australians from the Australian Government’s ongoing Medicare guarantee, and its commitment to more accessible and affordable medicines, reduced out-of-pocket costs, strengthened primary care, more telehealth primary care services, and increased funding for community-based drug and alcohol treatment, family and domestic violence, youth suicide, mental health and preventive health services across Australia, as well as substantial additional investment in medical research.
To further enhance our Government’s $550 million investment from Budget 2018-19 in the Stronger Rural Health Strategy, the Government will implement a National Rural Generalist Pathway, allocating $62.2 million over five years as part of a $1.1 billion strengthening primary care package to ensure rural generalists, with their broad range of skills, are trained, recognised and resourced to meet the critical health needs of rural Australians. This will provide rural and remote communities with better access to comprehensive, safe and continuous care as close to home as possible by increasing the number of highly skilled rural generalists.
The Government is investing in key projects in partnership with communities, states and territories, health and hospital services and research institutions, through its new $1.25 billion Community Health and Hospitals Program. This will directly improve on-the-ground access to services in regional Australia.
Regional Australia can also expect to share in the establishment of 10 new headspace centres and 20 new headspace satelite services around the nation with an additional investment of $111.3 million over five years, benefitting young people with mental health issues. More alcohol and other drug treatment and support services will be established in regional rural and remote areas at a cost of $9.6 million. To reduce prescription opioid use, the Government will spend $4.3 million expanding the Rural Health Outreach Fund to give people better access to pain management specialist services in regional, rural and remote areas.
Senior Australians in regional Australia will also share in the Government’s recent releases of more home care packages, and further initiatives to support the delivery of quality aged care and improve safety for aged care residents.
Australians will benefit from a range of sport and physical activity programs aimed at getting Australians moving more often and restoring Australia as a world leader in elite sport. This will include expanding the Community Sport Infrastructure program, with grants of up to $500,000 to local sporting organisations and clubs, investment in talented young athletes, and a new social inclusion through sport and physical activity program.
Through this Budget and other initiatives, the Department of Health continues to consolidate its regional footprint, with offices in all jurisdictions. As at 31 December 2018, 6,271 staff were employed by the Department of Health and portfolio agencies under the Public Service Act 1999. Of this total, 5,352 staff (85.3 per cent) are employed in Canberra, central Melbourne and central Sydney, 857 staff (13.7 per cent) in other capital cities and 62 staff (1.0 per cent) in regional areas. Regional staff include those employed by the Australian Aged Care Quality Agency (replaced by the Aged Care Quality and Safety Commission on 1 January 2019), the Australian Commission on Safety and Quality in Health Care, Food Standards Australia and New Zealand, and the Office of the Rural Health Commissioner.
Guaranteeing Medicare—strengthening primary care
The Government is committed to strengthening primary care in regional, rural and remote communities. To build on and enhance our Government’s previous investment in primary care, further initiatives include:
Primary Care/Chronic Care Funding Model
The Government will provide $448.5 million over three years from 2020-21 to support more flexible care models and improve continuity of care and convenience for patients. Under the new arrangements, from mid-2020 people aged 70 and over will be able to voluntarily enrol with their preferred GP and will receive services such as telehealth consultations, electronic prescriptions and referrals where clinically appropriate.
Increasing the Practice Incentives Program Quality Improvement Incentive
The Government will provide $201.5 million over five years from 2018-19 to the Practice Incentives Program (PIP) to support general practice activities which encourage continuing improvement and quality care, enhance capacity and improve access and health outcomes for patients. In 2018-19, there were 11 incentives under the PIP focusing on eHealth, teaching, Indigenous health, asthma, cervical screening, diabetes, quality prescribing, general practitioner aged care access, procedural services, after-hours access and rural health.
From 2019-20 this measure will see the cessation of four existing PIP incentives, and the creation of a new PIP Quality Improvement incentive to support quality improvement activities in general practice. The General Practitioner Aged Care Access Incentive will be retained as a separate incentive.
A 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.
Enhanced Childhood Immunisation Education Campaign
The Government is providing $12.0 million over three years from 2019-20 to extend and enhance the reach of the current Childhood Immunisation Education Campaign, bringing total funding to $20.0 million over 6 years. The additional three phases of Campaign will continue to support the National Immunisation Program in protecting all Australians from vaccine-preventable diseases and will continue a focus on low coverage areas and hard to reach populations such Aboriginal and Torres Strait Islander people who are more likely to experience poor outcomes from vaccine preventable disease.
Public Health and Chronic Disease Grant Program—Sustainable Funding
The Government will invest $17.2 million over five years from 2018-19 to address the rising burden of chronic conditions and reduce preventable mortality and morbidity by funding a selection of activities to address gaps in services recommended from National Strategic Action Plans (the Action Plans). This complements funding already allocated for Action Plans through the 2018-19 Budget; and through the 2018-19 MYEFO. Activities will focus on addressing gaps in service in the areas of osteoporosis, kidney health, rare diseases, heart disease and stroke, and children’s health.
National Rural Generalist Pathway
The Government will provide $62.2 million over five years from 2018-19 to commence implementation of a National Rural Generalist Pathway. This measure will provide a coordinated, efficient medical training pathway to gain nationally recognised skills to allow rural generalists to deliver quality health care in rural, remote and regional communities. This will build momentum for a national pathway across three elements: improving workforce supply by coordinating the training pipeline for rural generalists; increasing retention of medical staff through early exposure to rural training by further investment in rural junior doctor training; and seeking sub-specialty recognition of rural generalism through the Medical Board of Australia to provide appropriate recognition for rural generalists.
Guaranteeing Medicare—improved patient access to diagnostic imaging—expansion of Medicare eligibility for magnetic resonance imaging
The Government is improving access to magnetic resonance imaging (MRI) services for patients by adding and upgrading fully Medicare eligible machines in regional Australia from 1 March 2019.
A total of nine additional MRI licences will be provided at a cost of $42.5 million over five years from 2018-19 for regional areas. This will build on the Government’s earlier investment of $47.0 million for eight regional MRI licences announced at MYEFO 2018-19 over the same period, and will help ensure patients in regional Australia get the most appropriate treatment when they need it. It will also reduce the amount of time patients have to spend travelling to get an MRI.
Guaranteeing Medicare—improving transparency of out of pocket costs
The Australian Government is providing $7.2 million over three years from 2019-20 to improve information available to consumers about out of pocket costs for most common treatments by medical specialists. Commencing in April 2019, this measure will include an education initiative to target consumers and support more informed referral conversations between General Practitioners (GPs) and consumers. Information will also be made available on the range of fees charged by specialists for particular treatments within a geographic area.
More transparency around the range of fees for particular specialties in a geographic area means regional consumers can more easily research the potential range of costs. Where the most appropriate provider may be a long distance from home, consumers could take out health insurance with travel and accommodation benefits, which some insurers will offer as part of hospital cover from 1 April 2019 under recent reforms to private health insurance.
Guaranteeing Medicare—Heart of Australia—three year partnership
In addition to the Government’s $1.0 million funding injection in 2017 to support Heart of Australia’s mobile cardiology Heart Bus, North Queenslanders will now be able to access a mobile cardiology service with the Government announcing $12.0 million over three years in further funding to Heart of Australia from 1 July 2019.
This funding will support Heart of Australia’s two mobile specialist clinics and help to provide a third service to Northern Queensland and the Cape, bringing the total number of communities serviced by Heart of Australia across Queensland from 16 to 25.
Specialist consultations in these clinics will include: cardiology, endocrinology, sleep medicine, psychiatry, geriatric medicine, immunology, general medicine, neurology, gastroenterology, and gynaecology.
This $12.0 million in new funding will improve the capacity, quality and mix of the health workforce to meet the requirements of the Australian health system. It will also improve the health outcomes of people living in regional, rural and remote locations in Queensland by encouraging health professionals to work in these areas, while supporting the delivery of outreach activities.
Guaranteeing Medicare—telehealth services for people living in flood-affected communities in Queensland
From 1 March 2019 to 30 June 2019, new time-limited Medicare Benefits Schedule items for telehealth services will be available for people living in flood-affected communities in Queensland experiencing restricted access to GPs. This initiative supports patients who remain isolated due to infrastructure damage resulting from the flooding or whose doctor’s usual practice has been impacted by flooding. It will help ensure patients in flood affected areas, particularly regional and rural patients, continue to have access to their usual level of care.
This initiative expands access under the 2018-19 MYEFO 2018-19 measure Guaranteeing Medicare—Access to Medicare Benefits Schedule GP Telehealth for Rural and Remote Australia. Under this measure from 1 November 2019, all people living in rural and remote areas (Modified Monash Model areas 6-7) are able to access GP services via telehealth general consultations, at an estimated cost of $33.5 million over four years. Receiving timely primary care services can be difficult in rural and remote Australia and flexible service delivery models are needed to help address this inequity and to support improved health outcomes for Australians living in rural areas. These measures complement action taken through the Government’s drought package.
Guaranteeing Medicare—My Health Record
The Government has committed $200.0 million for 2019-20 to continue delivering the My Health Record system and key national digital health infrastructure.
The My Health Record is a national system operated by the Australian Digital Health Agency. It supports improved health outcomes and better coordination and quality of healthcare through increased availability and quality of health information for healthcare providers.
In early 2019, more than 90 per cent of eligible Australians had a My Health Record following the end of the opt-out period on 31 January 2019.
The My Health Record system benefits regional Australians by providing a digital summary of a person’s key interaction with the healthcare sector. It can be viewed anywhere, anytime by the consumer and their healthcare providers. This will particularly benefit Australians living in rural and remote Australia who may need to travel away from their home community to access healthcare.
Supporting our Hospitals—Community Health and Hospitals Program
The Government will provide $1.25 billion for a range of local services, infrastructure projects and programs under the landmark Community Health and Hospitals Program (CHHP). The CHHP will tackle pressing health and social issues by addressing local service gaps and funding new and existing facilities. It will fund projects in four key areas—specialist hospital services and critical health infrastructure such as cancer treatment, rural health, and hospital research infrastructure; drug and alcohol treatment and rehabilitation; preventive care, primary care and chronic disease management, including palliative care; and mental health.
Projects will be delivered through Primary Health Networks, grant funding to community-based organisations, and transfer payments to states and territories. The CHHP complements the Government’s record $131.8 billion 5 year hospitals funding commitment from 2020 and the $1.7 billion Strengthening Primary Care package over five years from 2018-19.
Projects include the Comprehensive Children’s Cancer Centre, Sydney Children’s Hospital, NSW; Peter MacCallum Centre of Excellence in Cellular Immunotherapy, VIC; James Cook University—Cairns Tropical Enterprise Centre, QLD; improving outcomes for people with brain and spinal cord injuries and new inpatient and community services, QLD; Repatriation Hospital Hampstead Campus—Brain and Spinal Centre, SA; Peel Health Campus, WA; new linear accelerator for the North West Cancer Centre, TAS; Ambulatory Care Centre, Alice Springs Hospital, NT; and expanding the intensive care unit at Canberra Hospital, ACT.
Supporting our Hospitals—additional infrastructure and services
The Government will continue to invest in important hospital infrastructure projects and lifesaving health services to ensure Australians can access the care they need, where they need it. This includes supporting the delivery of a new CT scanner for Bowen Hospital, QLD; enhanced services such as radiology, chemotherapy and paediatric for Bass Coast Health, VIC; redevelopment of patient facilities including improved patient access at Redland Hospital, QLD; expanded specialist care services at Wodonga Hospital, VIC; and additional on‑call medical staff and special family accommodation for Ronald McDonald House, QLD.
This is complemented by record hospitals funding, the landmark $1.25 billion Community Health and Hospitals Program and more than $1.1 billion investment in strengthening primary care services and support for doctors.
More Choices for a longer Life—Investing in Aged Care
The Government is further strengthening its ongoing response to senior Australians’ preference to receive aged care in their own homes and live independently for longer and has funded an additional 40,000 home care packages since December 2017.
The Government will invest an additional $282.4 million over five years from 2018-19 into the Home Care Packages Program to allow more people to receive a home care package sooner.
This builds on the 2018-19 MYEFO measure Strengthening Aged Care—more places, lower fees, better access that provided an additional investment of $287.3 million over three years from 2018-19 into the Home Care Packages Program.
This additional investment will support Senior Australians in regional and remote Australia who have expressed a strong preference to stay in the homes and communities they have built their lives around for as long as possible.
Residential Care—Increased Viability Supplement / Strengthening Aged Care—more places, lower fees, better access
The Government is providing an extra $101.9 million over four years from 2018-19 under the MYEFO 2018-19 Strengthening Aged Care—more places, lower fees, better access measure to increase the viability supplement by 30 per cent for eligible residential aged care providers. Approximately 550 Multi-Purpose Services (MPS) and National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) providers will benefit from this increase.
This funding is part of the Government’s investment of $655.7 million for the Residential Aged Care Viability Supplement over five years from 2018-19, which is paid to eligible residential care, MPS and NATSIFACP providers operating in rural and remote areas. This supplement provides support for the higher operating costs associated with providing care in rural and regional locations.
Fighting Cancer—additional infrastructure and services
The Government will invest $70.8 million in vital infrastructure and services to support Australians who are fighting cancer. Rural and regional Australians will benefit from $45.5 million in funding for new regional cancer treatment centres. Further investments include $6 million to the world-class cancer treatment centre Chris O’Brien Lifehouse to support the work of the sarcoma surgical research centre. Cancer patients living on the Mornington Peninsula, VIC, will be better supported with a new, purpose-built comprehensive cancer and rehabilitation centre. People living on the Sunshine Coast, QLD, will also be able to continue to receive world-class care and support from Bloomhill Cancer Care.
Ovarian Cancer Australia—mental health support targeted to women and families in regional and remote areas
The Government will invest $1.6 million over two years from 2018-19 in an innovative pilot project to support women living with ovarian cancer. Delivered through Ovarian Cancer Australia, the pilot program is built upon a psychosocial support case management model using telehealth to provide care and support to ovarian cancer patients and their families. It is estimated over 400 of the most vulnerable women living with ovarian cancer are expected to receive support through this project, including women living in rural, regional and remote Australia, who may not otherwise have access to a case management approach.
Fighting Cancer—McGrath Foundation breast care nurses
An additional $27.7 million will be provided by the Government to expand the McGrath Breast Care Initiative, beginning in 2019-20 over four years, as announced in January 2019. This will increase the number of breast care nurses in Australia to 117 by 2022-23.
This measure builds on current funding of $20.5 million from 2017-18 to 2020-21 for the McGrath Breast Care Initiative, which provides 57 Government-funded McGrath Breast Care Nurses in 55 locations around Australia. Over 80 per cent of these nurses are located in regional and rural areas.
Fighting Cancer—Prostate Cancer Nurses Program—continuation
The Australian Government is investing $17.4 million over three years from 2020-21 to the Prostate Cancer Foundation of Australia to continue and expand the ongoing Prostate Cancer Nurse (PCN) Program by up to 42 PCNs. The Australian Government currently funds 28 PCNs across Australia. This measure will result in more PCNs located across Australia in areas of high need, including regional areas.
Prioritising Mental Health—natural disaster assistance
The Government will provide an additional $2.5 million under the Empowering our Communities initiative over two financial years (2018-19 and 2019-20) to fund mental health support for drought-affected farmers and families in the Gippsland region of Victoria.
It will also contribute $3.0 million to bolster mental health services to disaster affected communities. This includes on the ground support to enable a surge response team to help flood-affected people in northern and western Queensland.
These investments build on funding for mental health support initiatives already being provided through the Prioritising Mental Health—Mental Health Support for Farmers in Hardship measure at MYEFO 2018-19. Under this measure the Government is investing $28.3 million over two years from 2018-19, for mental health support initiatives to help farmers and communities deal with the anxiety, stress and uncertainty of drought conditions:
- $23.3 million over two years from 2018-19 for Empowering our Communities to enable eight Primary Health Networks (PHNs) to plan and commission community-led initiatives to address the immediate support needs of rural and regional communities, and fosters longer term recovery and resilience. The PHNs are Western New South Wales PHN, Hunter New England and Central Coast PHN, Murrumbidgee PHN, Darling Downs and West Moreton, Western Queensland PHN, Country South Australia PHN, Nepean Blue Mountains PHN, South Eastern NSW PHN; and Gippsland PHN;
- $0.2 million in 2018-19 to ReachOut to target awareness-raising activities for digital (phone and online) mental health supports and services in drought affected areas for young people, their families and communities;
- $1.2 million over four years from 2018-19 to expand telehealth access to psychological therapies via video conferencing to those who face barriers to accessing services; and
- $3.6 million over two years from 2018-19 to expand the Medicare Benefits Schedule for General Practitioners to deliver telehealth in drought-affected rural and remote areas.
Prioritising Mental Health—caring for our community
Perinatal Mental Health and Wellbeing Program
The Government will provide $43.9 million over seven years from 2018-19 to improve the Maternity Peer Support Program to include new dedicated grant rounds for perinatal mental health support, as well as perinatal loss and bereavement peer support, and perinatal mental health training. The improved program will continue the Maternity Peer Support Program’s digital and telephone supports, which will help increase regional access to perinatal mental health services.
Prioritising Mental Health—National Mental Health Workplace Initiative
The Government will provide $11.5 million over four years from 2019-20 to the National Mental Health Commission to implement the National Mental Health Workplace Initiative in collaboration with members of the Mentally Healthy Workplace Alliance. This initiative will deliver a suite of practical tools and guides to the most effective strategies for creating mentally healthy workplaces and best ways to put them into action. It will establish a nationally consistent approach to mental health in the workplace, and will provide businesses with assistance and guidance on how to build work environments that promote good mental health, reduce mental ilness, and help people recover when they are unwell.
Prioritising Mental Health—adult mental health centres
The Government will invest $114.5 million over five years from 2020-21 in a trial of eight adult mental health centres. These centres, which will operate over extended hours and be commissioned by PHNs, will provide free, on the spot counselling services to adults experiencing mental distress, and will represent an alternative to presenting at already under pressure emergency departments. No appointment will be needed, and the centres will also be able to connect or refer people to other specialist or local health services.
Prioritising Mental Health—National Suicide Information Initiative
The Government will provide $15.0 million over three years from 2019-20 to consolidate and enhance access to more timely and accurate suicide and self-harm data and reporting than is currently available. Funding will be provided under the Department of Health’s Memorandum of Understanding with the Australian Institute of Health and Welfare (AIHW) to work collaboratively with the National Mental Health Commission (NMHC) to create a suicide information resource for mental health and suicide prevention stakeholders and for broad reporting purposes. This measure will have a positive impact on regional communities impacted by suicide because improved data will help to better identify groups and areas at increased risk of suicide. Better data will also help mental health and suicide prevention stakeholders, including local mental health service providers, in providing appropriate servicesby improving the collection and reporting for these communities.
Prioritising Mental Health—youth mental health and suicide prevention plan
The Government will provide $461 million for a national strategy to prevent suicide and promote the mental wellbeing of young and indigenous Australians. This represents the single largest investment in youth suicide prevention in the country’s history. We are prioritising three key areas as our nation’s best protection against suicide—strengthening the headspace network, Indigenous suicide prevention, and early childhood and parenting support.
Expansion of the headspace Network ($375 million)
We will ensure that young people can get help where and when they need it through unprecedented investment in headspace, including: $111 million for 30 new centres around the country; $152 million to reduce wait times and improve the quality of services at headspace sites; $2 million for a Young Ambassadors program; and $110 million to continue the Early Psychosis Youth Service at 14 headspace centres to support young people at the early stages of severe mental illness.
Indigenous Suicide Prevention ($15 million)
We will empower Indigenous suicide prevention by providing: $4.5 million for Indigenous leadership to create a national plan for culturally-appropriate care, and services that recognise the value of community and protective social factors; $5 million for young Indigenous leaders to participate in place‑based cultural programs; $3 million for a centre of excellence in childhood wellness to assist children and adolescents affected by childhood trauma; $0.8 million to adapt CFT psychological treatments to include cultural traditions; and $1.2 million for Red Dust to deliver social and emotional wellbeing initiatives in the Northern Territory.
Childhood and Parenting Support ($11.8 million)
To guarantee that our youngest Australians get the best start to life, build the skills to face challenges, and get assistance when they need it, we will support children and parents through $1.5 million for the Raising Children Network to help parents recognise when their children are struggling and what to do to help; $2.5 million for Smiling Minds to help children in schools learn the skills to manage their mental and emotional wellbeing; and an additional $4 million for Kids Helpline to provide 24/7 counselling support so that young people aged 5 to 25 have somewhere to turn to in times of need. As some young people prefer to rely on their peers for support, we will provide $2.8 million for batyr to amplify the voices of peers to encourage others to seek help; $0.4 million for the Banksia project to expand its community program, and $0.6 million for a trial of peer workers in Beyondblue’s Way Back suicide aftercare service. This is in addition to general peer support initiatives included in other initiatives.
Additionally, we are leading a change in the way that Australians and Australian governments think about suicide prevention. Recognising that social, financial, legal, health, and mental health may all be contributing factors to suicidality, a Special Adviser for Suicide Prevention will be established within the Prime Minister’s portfolio to coordinate activities across the whole of government, and help design services that make a real difference for those at risk.
We will also provide $15 million to create a new national information system that will help communities and services respond quickly to areas affected by high incidences of suicide and self-harm.
These measures are in addition to a range of community-based services funded through our Community Health and Hospitals Program (CHHP), and a range of adult focused mental health initiatives.
Investing in Preventive Health—implementation of the national strategies for blood borne viruses and sexually transmissible infections
The Government will provide a total of $45.4 million over three years from 2019-20 to implement the priority actions of the National Strategies for Blood Borne Viruses (BBV) and Sexually Transmissible Infections (STI) 2018-2022. This measure will increase public health prevention and promotion activities and continue to build upon the work already being done to improve knowledge and awareness of STI and BBV among at risk groups, health professionals and the wider community.
Funding of $20.2 million over three years from 2019-20 will be directed towards activities targeting prevention, treatment and health education for Indigenous Australians, who have higher rates of BBV and STI than Australian-born non-Indigenous people.
Investing in Preventive Health—implementation of recommendations of the Third Review of the National Gene Technology Scheme
The Government is providing $4.4 million over four years, from 2019-20, to implement the 27 recommendations of the Third Review of the National Gene Technology Scheme. Implementation is an ‘all Australian governments’ initiative under the governance of the interjurisdictional Legislative and Governance Forum on Gene Technology, a Ministerial Forum chaired by the Commonwealth.
Oversight of the Scheme is a national issue impacting both regional and metropolitan Australia. This measure will assist regional and rural areas by supporting innovation and access to emerging technologies in the agricultural industry while maintaining adequate protections for people and the environment.
Whole of Government Drug Strategy—Increasing access to services in regional, rural and remote areas
The Government will provide $9.6 million over three years from 2018-19 to address existing workforce shortages and increase access to alcohol and other drug treatment services in regional, rural and remote areas across Australia. Treatment providers will be able to deliver more services, provide after-hours and weekend service coverage and improve the mix of service modalities to better meet the needs of their clients. This proposal will also allow for the delivery of more than 100, two day specialist outreach services to locations which do not currently have access to alcohol and other drug treatment services.
Whole of Government Drug Strategy—Providing Local Family Drug Support
The Government will provide $4.3 million over four years from 2018-19 to fund local family drug support services across the country. These services will help families and friends of those experiencing harm from illicit drugs deal with the range of challenges they are facing. Services will provide on-the-ground access to local drug treatment service information, peer support and family issues assistance to address a gap not currently met by existing treatment services. This is particularly important for rural and regional areas, where access to local face-to-face support networks, specialist services and other support is limited.
Whole of Government Drug Strategy—Reducing Prescription Opioid Use through Better Access to Pain Management Services
The Australian Government will provide $4.3 million over three years from 2018-19 to support delivery of outreach pain management specialist services in regional, rural and remote areas of Australia and undertake upskilling of primary care providers in these areas to improve prescribing habits and awareness of appropriate pain management.
This new funding will support additional specialist pain management services being delivered through the Rural Health Outreach Fund (RHOF) with service delivery to be prioritised to those areas showing the highest rates of opioid prescriptions. These new services will reduce the overuse and potential harms of prescription opioids being used for chronic long-term pain management.
The RHOF aims to improve access to health services for people who live in regional, rural and remote locations. This funding improves access to medical specialists, GPs, allied and other health professionals. Funding is provided to address a range of disincentives incurred by health professionals seeking to provide outreach services (such as travel, accommodation, room hire and lease of equipment).
Whole of Government Drug Strategy—Extension of the National Ice Action Strategy
The Government will provide an additional $153.3 million over two years from 2020-21 for the Australian Government’s National Ice Action Strategy (NIAS), ensuring access to critical treatment, prevention, research and data improvement and information services is maintained. This measure will continue activities under the NIAS including treatment services commissioned by Primary Health Networks (PHNs) and Local Drug Action Teams, and will extend the National Clinical Centre for Research Excellence on Emerging Drugs of Concern and ongoing investment in research and data. This measure will improve access to services in regional, rural and remote areas.
Whole of Government Domestic Violence Strategy—Fourth Action Plan (2019-22) to prevent violence against women and their children—‘Recognise, Respond, Refer’ and national training for primary care workforce
The Government is providing $7.5 million over three years from 2019-20 to roll out the ‘Recognise, Respond, Refer’ Pilot in five PHN locations, as well as
$2.1 million over four years from 2019-20 for the provision of training to improve the family violence response capability of the primary care workforce, particularly targeting General Practitioners (GPs). The program will enable up to 5,000 health practitioners and practice staff in metropolitan and regional areas across Australia to be trained to better respond to the needs of victims. Training will be delivered through existing accredited providers of trauma training and professional development for the health and community sectors.
People living in rural and remote areas have been identified as being more likely to experience family violence. For example, an ABS survey (2013) found that women living outside of capital cities were 40 per cent more likely to have experienced violence from an intimate partner than women living in capital cities. A range of flexible training delivery options will be available which may include off-site training, in-house training, digital media and telephone-based options. This flexibility will ensure the training will be available for GPs servicing rural and remote areas.
Investing in Health and Medical Research—Medical Research Future Fund—10-year investment plan
The Government is committing to a new $5 billion 10-year MRFF investment plan across four themes: Patients, Researchers, Missions and Translation. Under the Patients theme, the government will invest $614 million in the rare cancer, rare disease clinical trial program.
The Government’s 10-year investment plan will give researchers and industry certainty and direction through the four key areas:
The Government will commit a further $931.0 million for a total of $1.3 billion allocated under the Investment Plan to improve the health of Australians through the development of new treatments and cures informed by the latest research and using cutting edge technology, which includes:
- Clinical Trials for Rare Cancers, Rare Diseases and Unmet Needs—a further $354.0 million for a total of $614.2 million;
- Emerging Priorities and Consumer Driven Research—a further $554.0 million for a total of $633.0 million; and
- Global Health Tackling Antimicrobial Resistance and Drug Resistant Tuberculosis—a further $23.0 million for a total of $28.4 million.
The Government will commit a further $444.6 million for a of total $792.8 million allocated under the Investment Plan to support our best health and medical researchers to make breakthrough discoveries, develop their skills and progress their careers in Australia, which includes:
- Frontier Health and Medical Research—a further $330.0 million for a total of $570.0 million;
- Industry Researcher Exchange and Training—existing allocation of $32.0 million; and
- Clinical Researchers—a further $114.6 million for a total of $190.8 million.
The Government will commit $1.2 billion for a total of $1.4 billion allocated under the Investment Plan for long term focussed missions to address complex and sizeable health issues requiring a concerted effort to transition great ideas through to proof of concept and beyond, which includes:
- Australian Brain Cancer Mission—a further $2.0 million for a total of $123.6 million (including $65.3 million in philanthropic contributions, $5.0 million in clinical trials funding and $3.4 million in research funding);
- Million Minds Mental Health Research Mission—existing allocation of $125.0 million;
- Genomics Health Futures Mission—a further $430.2 million for a total of $500.0 million;
- Ageing, and Aged Care and Dementia Mission—a new investment of $185.0 million;
- Indigenous Health Futures—a new investment of $160.0 million;
- Stem Cell Mission—a new investment of $150.0 million;
- Cardiovascular Mission—a new investment of $220.0 million; and
- Traumatic Brain Injury—a new investment of $50.0 million.
The Government will commit $1.2 billion for a total of $1.5 billion allocated under the Investment Plan to progress research ideas from the lab to the clinic, ensuring new medical discoveries are part of the clinical practice of GPs, specialists and hospitals, which includes:
- Preventive and Public Health Research—a further $60.0 million for a total of $260.4 million.
- Primary Health Care Research—a new investment of $45.0 million;
- Rapid Applied Research Translation Centres—a further $143.0 million for a total of $218.0 million;
- Medical Research Commercialisation—a further $254.0 million for a total of $311.3 million;
- National Critical Infrastructure—a new investment of $605.0 million; and
- Data Infrastructure focus on registries, biobanks & linkage platforms—a new investment of $80.0 million.
Investing in Health and Medical Research—additional research infrastructure
The Government will invest in critical infrastructure to support lifesaving health and medical research, building on its $605 million investment to support the provision of vital infrastructure through the Medical Research Future Fund 10‑year plan. The Government will invest $18 million for the new Institute for Regional, Rural and Remote Health and Medical Research in Orange, NSW, which will implement a research program to address the health and medical needs of Australia’s regional, rural and remote communities. The Government will also invest $10 million to build a new Dementia Centre of Excellence at Curtin University in Perth, WA, to showcase best practice, research, student training and working collaboratively with external stakeholders.
Implementing Sport 2030
Athlete wellbeing, pathways and high performance
The Government will provide $54.1 million over two years from 2019-20 to support athlete wellbeing and pathways to high performance. This measure will use a multi-pronged approach to increase opportunities for young Australians to develop and pursue sporting success with a particular focus on the engagement, progression and retention of women and girls and those in regional areas. It will:
- improve the identification and development of young athletes by increasing access to quality coaching and other support staff;
- enhance the talent identification processes within sporting organisations, providing greater exposure to quality competitions;
- expand proven systems for mentoring young athletes; and
- build the capability of sports organisations to develop and leverage technological solutions to support quality athlete development.
The measure will also target talented young athletes across Australia with a focus on women and girls and those in regional areas. It will also impact coaches, sports scientists, medical professionals and other support staff involved in athlete identification and development.
The Government will also invest a further $2.5 million over five years from 2019-20 to expand the Sport Australia Hall of Fame Athlete Mentoring Program. The SAHOF program partners Australia’s sporting heroes with young Australians who aspire to represent their country. The new funding will support 25 additional scholarships to athletes under the age of 21.
Extension of the Community Sport Infrastructure Grants
The Government will provide an additional $42.5 million in 2018-19 to extend the competitive community sport infrastructure grant program to fund additional small to medium-scale projects to improve existing sport facilities. This measure follows a significant over-subscription of the 2018 competitive grants round and will have a positive impact across Australia, including in regional and remote communities through increased investment in community sport facilities.
This investment builds on the $29.7 million in funding provided by the Government in 2018-19, together with an additional $30.3 million in 2018-19 MYEFO to meet the high level of demand for the program. Under these initiatives, infrastructure grants were available in amounts up to $500,000, with the program aiming to ensure more Australians have access to quality sporting facilities throughout the nation and encouraging greater community participation in sport and physical activity.
Accessible, safe, inclusive and sustainable sporting and physical activity infrastructure is essential to getting Australians to be more physically active and plays an important role in promoting social connectedness.
Continuing Sporting Schools
The Australian Government will provide $41.0 million over two years from 2019-20 to continue funding the Sport Australia-managed Sporting Schools Program for the calendar year 2020. The program will expand delivery to more than 500 secondary schools from the 300 secondary schools currently involved, and continue to provide funding for more than 5,200 primary schools each year. This extension reflects the success of the existing program and will incentivise schools to embed sport and physical activity into their daily routines.
The program will have a strong commitment to improving sustainable sport and physical activity participation in regional and remote communities, with equity of access a key principle. The program will provide a platform for children in regional and remote areas to participate in regular sport and physical activity which is otherwise not achieved due to reduced access to community sporting clubs and structured physical activity opportunities in these areas.
The Sporting Schools Program has set targets for engaging rural and remote communities, reflecting the distribution of schools nationwide.
Driving social inclusion through sport and physical activity
The Government will provide $23.6 million over four years from 2019-20 to enable established National Sporting Organisations, local community organisations, and community groups to deliver diversity and inclusion programs in regional Australia using sport and physical activity as well as extend the Big Issue Street Soccer Community Sport Street Soccer Program.
The Government will also invest a further $5.2 million over two years from 2019-20 to support hosting of the Brisbane INAS Global Games in October 2019, for Special Olympics Australia to improve health and physical activity outcomes for young people with intellectual disability, and for Get Skilled Access to provide support for schools and community clubs.
Boosting Grassroots Participation in Sport—tennis and netball
Boosting grass roots tennis for girls
The Government will provide $12.0 million over four years from 2019-20 to Tennis Australia to increase opportunities for women and girls from all regions, towns and cities around Australia to participate in grassroots tennis.
Support for Netball Northern Territory
The Government will provide $0.04 million in 2018-19 to support the participation in and sustainability of Netball Northern Territory (NNT). This measure will provide positive exposure to netball and allow NNT to continue to provide a pathway for netball players, coaches, umpires and officials in the Northern Territory.
International Sporting Events—support for the T20 World Cup 2020
The Government will provide $7.7 million over two years from 2019-20 in support for the International Cricket Council T20 World Cup 2020 in Australia. Hosting the tournament is anticipated to deliver positive regional impacts, with matches and pre-event training camps likely to be held in regional locations.
Medicare Benefits Schedule—Listing of Photography with Non-Mydriatic Retinal Cameras
Since 1 November 2016, the MBS has provided items to fund Retinal Photography with non-Mydriatic Retinal Camera (RP-NMRC). The listing was agreed by the Government following a recommendation by the Medical Services Advisory Committee (MSAC).
NMRCs are portable and easily transported to rural or remote settings for use by accredited non-medical staff. Photographs can be interpreted remotely, via electronic link/telemedicine, by an optometrist, ophthalmologist or trained reader. MSAC recommended the listing of RP-NMRC testing for Diabetic Retinopathy (DR) in order to improve access to eye health services for patients with limited (or no) ability to access local services. MSAC noted the less intrusive nature of the procedure could encourage uptake and early intervention, and access to eye-care services for Indigenous people is likely to improve if services can be delivered within culturally appropriate settings. Further, provision of RP-NMRC within these communities could increase compliance with recommended screening for DR, and also reduce unnecessary travel for those in whom DR is not detected.
Two MBS items are available for RP-NMRC—12325 for Indigenous patients and 12326 for non-Indigenous patients. These items are consistent with National Health and Medical Research Centre guidelines regarding recommended frequency of repeat testing in persons of Aboriginal and Torres Strait Islander descent and the general population. In 2018 there were 1,162 services claimed for item 12325 (compared to 881 services in 2017) and 860 services for item 12326 (compared to 632 in 2017).
Strengthening Medicare—Rural Procedural Grants Program
The Government is providing $75.0 million over four years from 2018-19 to the Rural Procedural Grants Program. This program enables procedural general practitioners in rural and remote areas to access grants to attend training and up-skilling in emergency and procedural medicine.
Primary Health Networks
Primary Health Networks (PHNs) are a national network of 31 independent, regionally based, primary healthcare commissioning organisations, established to improve efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes and to improve the coordination of care. Seventeen PHN regions have populations where the Modified Monash Model (MMM) remoteness is classified at six or seven, the most remote areas. All 31 PHNs have populations with regional areas classified between MMM2 (large regional) and MMM7 (very remote).
The PHNs are currently contracted for $4.7 billion (from 2015 to 2021).
- PHN functions include planning, integrating and coordinating primary health care services, and the commissioning of services, across their regions.
- PHNs receive funding which includes loading for rurality, Indigenous population, social and economic disadvantage and low population density.
- The commissioning model provides opportunities to identify and implement iterative and innovative solutions to local and remote problems, and work within the unique circumstances of different communities.
- PHN Boards are supported by General Practitioner-led Clinical Councils and by Community Advisory Committees. In rural areas some PHNs have established multiple branches of Clinical Councils and Community Advisory Committees to appropriately reflect the diversity of their regions.
PHNs are aligning planning and designing activities with other funded stakeholders in their regions (for example, Rural Workforce Agency and Royal Flying Doctor services).
After-Hours Primary Health Care Arrangements
The after-hours primary health care funding model commenced on 1 July 2015 to ensure access for all Australians to primary health care services during the after-hours period. This includes:
- a Practice Incentives Program (PIP) after-hours incentive payment to eligible accredited general practices registered for PIP; and
- continued 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 with a further $146.5 million over two years from 2019-20 provided in MYEFO 2018-19.
Trial of Health Care Homes
This measure supports the trial of Health Care Homes in up to 170 general practices and Aboriginal Community Controlled Health Services across Australia, including rural and remote regions. A total of $72.2 million has been allocated to support this measure from 2016-17 over five years to better support patients with chronic and complex illnesses, reducing the risk of hospitalisation. This includes re-directed funding from the MBS for four years from 2017-18. Participating practices are located across 10 Primary Health Network regions, including rural and remote areas.
With many aspects of the Health Care Homes model already in place in regional and remote general practices and Aboriginal Community Controlled Health Services across the country, this measure will support them to formalise their approach and build on local innovative solutions.
An evaluation of the impacts of the trial will be conducted and an interim report considered in 2020, with a final report due in 2021.
Home Medicines Review Program
The Home Medicines Review Program (the Program) aims to improve the quality use of medicine by a patient and reduce the risk of medication misadventure. Patients receive in-home reviews of their medication by an accredited pharmacist, following referral from their general practitioner.
Block Funding for Small Rural and Regional Hospitals
The Government is providing approximately $4.3 billion over four years from 2018-19 in block funding contributions to states and territories to support services provided by small, rural and regional hospitals. This funding ensures rural and regional communities continue to have access to vital public hospital services.
Prioritising Mental Health: Improving telehealth for psychological services in Rural, Regional and Remote Australia
The Government is providing $9.1 million over four years from 2017-18 to remove barriers to telehealth through enabling better access to psychological services in rural and regional Australia via a range of telehealth delivery channels. This measure will increase access to psychological services for those living in rural and remote areas who would otherwise have limited access to those services. Access via telehealth will allow appropriate health professionals to connect with patients sooner than otherwise might have been the case, and without the time and expense involved in travelling to major cities or larger regional centres.
Prioritising Mental Health: suicide prevention support program
The Government is providing $11.1 million over three years from 2017-18 to help prevent suicide in high risk locations. The Australian Government will work with states and Territories to deliver small infrastructure projects to reduce incidences of suicide and self-harm at identified hotspot sites in regional and metropolitan locations across Australia.
The Australian Government’s Response to the National Ice Taskforce Final Report
In response to the findings of the National Ice Taskforce, the Government is providing an extra $298.2 million over four years from 2016-17 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 Local 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 investment also includes $241.5 million for Primary Health Networks (PHNs) to commission more alcohol and other drug treatment services, with a focus on ice, including $78.6 million for Indigenous specific services, based on what is necessary and appropriate to the needs of their local communities. PHNs 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.
Support for Alcohol and Drug Abuse
The Government is providing $40 million over three years from 2018-19 for this measure, consisting of:
- $20 million in South Australia for the treatment and support for alcohol and drug abuse and residential rehabilitation services; and
- $20 million to support professional development in primary care for the treatment and support for alcohol and drug addiction.
Increasing the level of funding for drug and alcohol treatment services including residential rehabilitation in South Australia is to assist those people affected by drug and alcohol misuse, including the broader community and the treatment sector, with particular consideration for rural access.
Funding under the professional development component aims to improve support, increase resources and training available to General Practitioners in regional and remote communities to treat drug and alcohol addiction.
Keeping Children Safe by Reducing Childhood injuries
The Government is providing $0.9 million over three years from 2018-19 to develop a new National Injury Prevention Strategy (the Strategy) to support interventions to reduce the risk of injury amongst the Australian population. Children will be a key focus within the Strategy. Noting both the higher rates and the greater level of impact preventable injury has in rural and regional communities, the Strategy will include rural and remote populations as a key investment area and will advocate for increased resources for injury prevention and safety promotion in these communities.
Epilepsy Action Response Service
The Government is providing $1.3 million over three years from 2018-19 for the establishment of the national Epilepsy Action Response Service to provide access to high quality information and expertise on epilepsy, especially in rural and remote areas in Australia.
Alcohol and Drug Foundation: Good sports program
The Government is providing additional funding of $10.0 million over two years from 2018-19 to the Alcohol and Drug Foundation for the continuation of the Good Sports Program. The program supports community sporting clubs to reduce harmful alcohol consumption through grassroots prevention and health promotion activity. The Good Sports Program will reach more than two million Australians through 10,000 participating sporting clubs, across 70 sporting codes with a focus on clubs in rural and remote Australia.
Increasing Participation in Sport and Physical Activity
The Australian Government is investing $50.4 million over four years from 2018-19 in a suite of sport and physical activity programs to get more Australians more active more often. This includes grants to sports and physical activity providers to increase participation in physical activity; an expansion of the Local Sporting Champions Program; training and resources for community-based sports organisations to ensure environments are child safe; and the collection of quality data nationwide regarding how active Australians are and what motivates them to move. These initiatives complement the new physical activity program for older Australians.
One of the key elements is the Move It Australia—Participation Program open to sport and physical activity organisations, to develop and implement community-based activities across Australia. The program focuses on getting the inactive active and contributes to chronic disease prevention.
Another key element of this measure is the expansion of the Local Sporting Champions grant program which provides support to elite young athletes to help with costs related to competing at a state and national level. Young athletes in the regions have greater barriers to attend such sporting competitions. Local Sporting Champions program will see 3,000 additional young athletes receiving support to attend events, with more support for young athletes in the regions to support greater travel costs. This support will create more opportunities for children in regional areas and will reduce the financial burden on parents in these areas.
This initiative is being delivered in partnership with national organisations capable of delivering to rural and remote locations, where people are less likely to be as active as other Australians. Sport and physical activity can deliver a range of health, social and economic benefits, particularly in rural and regional areas, where clubs and sporting organisations play a vital role in connecting individuals and communities.
Water and Snow Safety Program
The Government has committed funding of $36.9 million from 1 July 2018 to 30 June 2021 to support the water and snow safety organisations, Surf Life Saving Australia, Royal Life Saving Society Australia, AUSTSWIM, Laurie Lawrence Swimming Enterprises and the Australian Ski Patrol Association to deliver the Water and Snow Safety Program. This Program delivers a range of activities and interventions aimed at reducing the incidence of water and snow-related injury and drowning in Australia.
The 2018 Royal Life Saving National Drowning Report indicated the highest proportion of drownings occurred in a river, creek or stream at 25 per cent, much higher than the second highest location of beaches at 19 per cent.
Recognising this important data, the Program includes significant investment for inland, regional and rural waterways. It provides funding for water safety education, the river black spot identification program and promoting access to accredited swimming and water safety teachers in rural and regional areas. Funding continues to be provided to Laurie Lawrence Swimming Enterprises for his educational material, aimed at children under five and includes a book about water safety on the farm.
National Critical Care and Trauma Response Centre
The Government is providing funding of $67.6 million over four years from 2019-20 to the Northern Territory Government to support its continued operation of the National Critical Care and Trauma Response Centre based in Darwin. The centre is equipped and ready to assist in response to large scale emergencies and disasters in Australia and the region. Beneficiaries of the program 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 location of the centre also supports a positive regional impact by attracting health expertise and infrastructure to the Northern Territory.
Multi-purpose services program—aged care subsidies
The Government is providing $782.0 million over four years from 2018-19. The Multi-Purpose Services Program is a joint initiative of the Australian Government and state and territory governments, and provides integrated health and aged care services for small regional and remote communities. As at 1 January 2019, there were 180 Multi-Purpose Services delivering 3,650 aged care places through this program aged care places through this program.
Aged Care Approvals Round / Rural, Regional and Other Special Needs Building Fund
The Government recognises rural and remote aged care service providers face greater challenges compared to providers located in metropolitan areas. These challenge include: higher operating costs, less financial means, workforce issues relating to recruitment and retention, and less capacity to invest in capital upgrades. In response, the Government committed to prioritise the allocation of residential care places and capital grant funding in the 2018-19 Aged Care Approvals Round (ACAR) to services located in rural and remote areas.
This focus resulted in 5,276 residential care places, worth an estimated $354 million in annual recurrent funding, being allocated into rural and regional Australia, along with $60 million in capital grants to assist with the construction or upgrade of 28 services. The results of the 2018-19 ACAR were announced on 5 March 2019.
Australian Government Hearing Services Program
The Government will provide up to $2.3 billion over four years from 2018-19 to the Hearing Services Program to provide 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 program uses a national network of approximately 277 contracted service providers, including Australian Hearing, with 109 service providers located at 1,303 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 program providing hearing services to more than 146 of Australia’s most remote communities. In 2017 18, around 10,500 services were delivered at 243 outreach sites across Australia.
Supporting Activity in Older Australians
This measure implements a competitive community grants program to improve access to and increase participation in physical activity among Australians aged 65 years and older to improve their overall health and wellbeing. The community grants program supports Australian national sporting organisations and non-government organisations to develop and implement local, community-based activities which promote physical activity among older Australians including women, Indigenous Australians, people with a disability and people from rural and remote regions.
Older Australians, particularly those outside metropolitan centres, can find it difficult to access relevant and appropriate physical activities. Leveraging the reach of sporting organisations and other physical activity providers, this measure will improve the connectedness as well as the physical and mental health of older Australians, including in our regional communities.
Indigenous Australians’ Health Programme—Primary Health Care
The Government is providing $4.1 billion over four years from 2019-20 to the Indigenous Australians’ Health Programme (IAHP). Through this program, 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 2019-20, continued implementation of the Aboriginal and Torres Strait Islander Health Plan will ensure regional investments are made in priority areas in consultation with the Indigenous health sector.
More than 160 organisations (in+cluding around 130 Aboriginal Community Controlled Health Services (ACCHSs) are funded under the IAHP to provide culturally appropriate comprehensive primary health care. ACCHS play a critical role in supporting the health system, particularly in regional and remote areas. According to the Aboriginal and Torres Strait Islander Health Performance Framework 2017 report, Indigenous specific primary health care services represent 5 per cent of all primary health care services in major cities and inner regional areas, 32 per cent in remote areas and 71 per cent in very remote areas.
The Government is also investing $18.6 million (GST inclusive) to implement an independent Evaluation of the Australian Government’s Investment in Primary Health Care through the Indigenous Australians’ Health Programme over four years (2018-19 to 2021-22). The evaluation has been co-designed with Indigenous stakeholders across Australia, including regional and remote areas.
Indigenous Australians’ Health Programme—Primary Health Care Funding Model and other projects
Implementation of the Indigenous Australians’ Health Programme (IAHP) Primary Health Care Funding Model has been deferred from 1 July 2019 to 1 July 2020. The deferral will allow further time to work with the sector and to ensure data integrity.
The funding model will deliver better health outcomes by distributing the available IAHP primary health care funding fairly and transparently, targeting communities with the highest levels of health need and providing greater assistance to clinics in very remote areas. The Government remains committed to the implementation of an improved model.
The Government is also undertaking a range of projects to improve primary health care services for Aboriginal and Torres Strait Islander people, including:
- increasing the uptake of MBS 715 Aboriginal and Torres Strait Islander Health Assessments through the development of communication products and improved clinical resources;
- improving access to and the effective use of Pharmaceutical Benefits Scheme (PBS) medicines for Aboriginal and Torres Strait Islander people under the four Indigenous Pharmacy Programs; and
- reviewing the Practice Incentives Program Indigenous Health Incentive (PIP IHI) to improve its efficiency and effectiveness.
Prior to the new model being introduced, the Department is running a targeted, non-competitive grant opportunity for IAHP funded primary health care services for up to $493.9 million in 2019-20, providing organisations currently delivering essential primary health care to Aboriginal and Torres Strait Islander people with funding continuity to support services.
This is part of the overall primary health care allocation which includes other services particularly focused on children and young people.
$45.0 million (GST exclusive) has been allocated over three years (2019-20 to 2021-22) for Primary Health Care service expansion funding under the IAHP. Expansion funding will address service gaps and allow for a small growth in Indigenous-specific PHC services. It is critical funding is targeted and effective, given the limited funds available and the significant PHC needs of Aboriginal and Torres Strait Islander people. Funding is expected to focus on priority areas of need, areas with high population growth and areas which had previously confirmed the intention to transition to community control.
Continuation and expansion of support for Aboriginal and Torres Strait Islander Health Professional Organisations
The Government is supporting the work of Aboriginal and Torres Strait Islander Health Professional Organisations (ATSIHPOs). The Government’s investment in ATSIHPOs is increasing by around $1.6 million a year and enables these organisations to continue and expand activities to meet increased demand for their services.
Priorities include training and mentoring, developing leadership, strengthening cultural safety, and engaging and supporting students. This benefits Aboriginal and Torres Strait Islander people currently working in health, or studying to take up a career in the health sector. Aboriginal and Torres Strait Islander people will get better access to appropriate, culturally safe health care across the health system, including in regional and remote areas.
Closing the Gap: PBS Co-Payment Program
This program is providing around $40.0 million annually to improve access to Pharmaceutical Benefits Scheme (PBS) medicines for eligible Aboriginal and Torres Strait Islander people living with, or at risk of, chronic disease in urban and rural settings. This program lowers or removes the patient co-payment for PBS medicines.
Aboriginal and Torres Strait Islander Peoples Pharmacy Workforce Program
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 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 which 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).
Quality Use of Medicines Maximised for Aboriginal and Torres Strait Islander People Program
The Quality Use of Medicines Maximised for Aboriginal and Torres Strait Islander People Program, funded under the Sixth Community Pharmacy Agreement, complements the Closing the Gap PBS Co-payment Program by funding a range of Quality Use of Medicine support services, pharmacy services and education for consumers and staff of Aboriginal Community Controlled Health Services located in urban and rural areas.
Section 100 Remote Area Aboriginal Health Service Program
The Remote Area Aboriginal Health Service Program (the Program), established under section 100 of the National Health Act 1953, aims to address geographic, financial and cultural barriers experienced by people living in remote areas of Australia in accessing essential medicines through the PBS.
Section 100 Remote Area Pharmacy Support Allowance
The section 100 Remote Area Pharmacy Support Allowance, funded under the Sixth Community Pharmacy Agreement, provides an annual financial allowance supporting 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 Program. The visits assist in improving health outcomes for clients of remote area Aboriginal Health Services by supporting quality use of medicines at those services.
Improving Access to Medicines—Maintaining remote area Aboriginal health services pharmaceutical dispensing
From 1 January 2018, arrangements were established to enable eligible pharmacists providing PBS medicines labelled for individual clients of Remote Area Aboriginal Health Services, to claim an additional payment for this service from the Department of Human Services.
Elimination of Trachoma in Indigenous Communities—extension
The Government is providing funding of $15.6 million over three years from 2018‑19 to affected states and territories for the elimination of trachoma as a public health problem in Indigenous communities. Trachoma continues to be a significant problem in hotspots in remote Indigenous communities in the Northern Territory, South Australia and Western Australia. Continued investment in these jurisdictions supports screening and treatment of children and provides an increased focus on health hygiene and efforts to improve environmental conditions. Trachoma monitoring will continue in Queensland and New South Wales.
National Partnership Agreement on Rheumatic Fever Strategy—continuation and expansion
The Government is providing $18.8 million over four years from 2017-18 to the Rheumatic Fever Strategy. The strategy supports the prevention and management of acute rheumatic fever and rheumatic heart disease in Indigenous communities, including those in regional and remote areas, through:
- the continuation of state-based register and control programs to improve detection, monitoring and management of acute rheumatic fever and rheumatic heart disease in the Northern Territory, Western Australian, Queensland and South Australia; and
- new, focused prevention activities in high-risk communities, to prevent the initial incidence of acute rheumatic fever.
This measure continues the focus on activities aimed at improving clinical care and secondary prevention, such as education and training through RHD Australia at Menzies School of Health Research. It also strengthens the data collection system through its transfer to the Australian Institute of Health and Welfare.
Northern Territory Remote Aboriginal investment—Health component
The health component of the National Partnership on Northern Territory Remote Aboriginal Investment is providing $26.3 million over four years from 2017‑18 to reduce the incidence and severity of ear and oral disease in Aboriginal children in the Northern Territory, with a focus on remote areas. The Northern Territory Remote Aboriginal Investment commenced in 2015‑16, continuing the ten-year commitment to this activity which commenced in 2012‑13 under the National Partnership on Stronger Futures in the Northern Territory.
Remote Area Health Corps program
The Government will provide $18.7 million from 2019-20 to 2021-22 to continue the RAHC program. This program aims to increase access to primary health care services in remote Aboriginal and Torres Strait Islander communities in the Northern Territory (NT), by addressing identified workforce shortages. The RAHC program provides short-term placements of three to 12 weeks of urban health professionals in remote health clinics in the NT.
Regionalisation in the Northern Territory
The Government is providing funding of $27.5m over ten years (2011-12 to 2021-22) to support enhanced regionalised approaches to PHC service delivery in the Northern Territory. A component of the former Stronger Futures in the Northern Territory, this funding enables the transition of Northern Territory Government run clinics to Aboriginal Community Control in regional, remote and very remote locations. The current priority regions for this funding are East Arnhem, West Arnhem and Maningrida, all of which have active projects in place.
Crusted Scabies Elimination program
The Australian Government is providing $4.8 million from 2017-18 to 2019-20 (including $1.1 million in 2019-20) to the One Disease organisation for its Crusted Scabies Elimination program in the NT, and to expand it to parts of Western Australia and Queensland. This program aims to improve the detection, treatment and management of crusted scabies, and to eliminate it in Aboriginal and Torres Strait Islander communities in remote northern Australia by 2022.
Quality Assurance for Aboriginal and Torres Strait Islander Medical Services Programme
The Government is providing $5.5 million over four years from 2017-18 to the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services Pathology Program (the Program). The Program supports the better diagnosis and 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 program also includes training, technical support, quality assurance and a consultation program for community leaders to support program management on site.
As at 22 January 2019, a total of 215 active services were enrolled to participate in the program, with the majority of these located in rural and remote areas. A further 6 sites are anticipated to be enrolled once staffing is in place.
Eye Health and Ear Health
Visiting Optometrists Scheme
The Government is providing funding of $13.9 million from 2018‑19 to 2019-20 to provide outreach optometry services for people in rural, regional, and remote areas, who would not otherwise have access to eye health services. Funding provided helps address financial disincentives incurred by optometrists providing outreach services (travel, accommodation, facility hire).
Eye and Ear Surgical Support Program
The Government is providing funding of $4.0 million from 2018-19 to 2019-20 to expedite eye and ear surgery for Indigenous Australians who have been placed on public hospital waiting lists in rural and remote areas.
Remote and Indigenous Eye Health Service (IRIS)
The Government is providing funding of $2.0 million from 2018-19 to 2019-20 for additional 500 cataract surgeries for Indigenous Australians in rural and remote locations through IRIS.
Indigenous Diabetes Eye and Screening (IDEAS) Van
Funding of $0.9 million has been provided to the IDEAS Van in 2018-19 to deliver eye health screening and treatment services to address service delivery gaps in rural and remote areas of Queensland.
Hearing Assessment Program
The Government is providing $30 million over 2018-19 to 2021-22 for diagnostic hearing assessments and follow-up treatment for Aboriginal and Torres Strait Islander children in the years before school. The program is targeted to regional, rural and remote communities.
Support for the National Fetal Alcohol Spectrum Disorder Strategic Action Plan
The Government is providing $8.0 million over five years from 2018-19 to support the implementation of activities aligning with the priority areas under the National Fetal Alcohol Spectrum Disorder Strategic Action Plan 2018-2028 (the Strategic Action Plan). This measure will contribute to reducing decreasing the impact of Fetal Alcohol Spectrum Disorder (FASD) in regional communities, as some activities will be tailored to respond to the needs of known high-risk population groups including Aboriginal and Torres Strait Islander people and people in rural and regional areas.
It will also have a positive impact on regional communities through targeted diagnosis and support activities. This measure builds on the $10.5 million 2016-17 Budget Measure over four years titled Taking More Action on FASD. Prior to the Taking More Action on Fetal Alcohol Spectrum Disorder measure, the Government provided $9.2 million from 2013-14 to 2016-17 towards activities to prevent FASD, aligned with the National FASD Action Plan.
Developing Northern Australia—Positioning the North as a leader in Tropical Health
The Northern Australia Tropical Disease Collaborative Research Program is providing $6.0 million, having commenced in January 2017 with an expected completion date of December 2020, to the Menzies School of Health Research to undertake innovative high quality research into the prevention, diagnosis, and treatment of tropical diseases in Northern Australia.
This program strengthens partnerships with research institutions across Australia, by undertaking a research agenda to help close the gap in Indigenous health disadvantage, protect Northern Australia from emerging infectious threats and engage regional neighbours.
A Northern Australian network is being established and will incorporate Indigenous engagement, mentoring and knowledge translation, and facilitate collaboration with southern partners.
This investment is part of a broader Government strategy to build Australia’s primary research capacity and support the development of Northern Australia as outlined in the White Paper on Developing Northern Australia (link is external).
Project Agreement on Healthcare and Disease Prevention in the Torres Strait Islands—Schedule A: Addressing Blood Borne Viruses and Sexually Transmissible Infections
This agreement provides funding of $4.4 million over three years from 2017-18 and aims to address rising rates of blood borne viruses and sexually transmissible infections (STI). One of the elements of the Blood Borne Viruses and Sexually Transmissible Infections Prevention Program (the Program) is the delivery of STI reduction programs targeted towards Aboriginal and Torres Strait Islander priority populations in regional and remote settings. This element of the Program aims to increase STI testing and treatment and raise awareness about STI prevention. Areas of focus include models of care reaching high prevalence communities and young people.
Project Agreement on Healthcare and Disease Prevention in the Torres Strait Islands—Schedule B: Managing Torres Strait / Papua New Guinea Cross Border Health Issues
This agreement provides funding of $19.1 million over three years from 2017-18 for the management of Torres Strait/Papua New Guinea cross border health issues. Under this agreement, the Australian Government contributes funding to the 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 and hospital network.
Project Agreement on Healthcare and Disease Prevention in the Torres Strait Islands—Schedule C: Mosquito Control and Cross Boarder Liaison in the Torres Strait Protected Zone
This agreement provides funding of $3.0 million over three years from 2017 18 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.
Enhanced Response to the Syphilis Outbreak
The Government is providing an additional $12.4 million from 2018-19 to 2020-21 on top of the $8.8 million already committed from 2017-18 to progress the enhanced syphilis outbreak response in in remote and regional Indigenous communities in Queensland, the NT, WA and SA. Funding will go towards:
- rapid point of care tests and treatment;
- some additional staff and a short-term surge response to support states and territories to address the issue;
- assisting the Aboriginal Community Controlled Health Organisations (ACCHOs) should additional support for the ACCHOs be required for the Test and Treat response;
- development of communication and education materials; and
- enhanced surveillance.
Human T-lymphotropic virus type 1 (HTLV-1)
Funding of up to $8.0 million from the Indigenous Australians’ Health Programme will support an enhanced response to emerging infectious diseases in remote Indigenous communities, including HTLV-1.
This includes grant funding of up to $4.5 million for a specific project over five years to 2022-23 which will support the public health response to HTLV-1 in Australian Indigenous communities, particularly those in Central and Western Australia.
Stronger Rural Health Strategy delivering high quality care
The Government is providing a $550.0 million investment ($83.3 million net spend) over five years from 2017-18 to achieve stronger rural, regional and remote health outcomes by aligning the distribution of the health workforce to areas of greatest need and building the capability of Australia's medical practitioner workforce. In addition, the Stronger Rural Health Strategy will provide greater opportunities for Australian doctors through better teaching, training, recruitment and retention.
The distribution of the workforce in rural, regional and remote areas will be improved by:
- establishing a Murray-Darling Medical Schools Network to support an end-to-end training continuum for students to study medicine in the region;
- creating a new Junior Doctor Training program with a strong focus on supporting training in rural settings, integral to the development of a National Rural Generalist Pathway by the National Rural Health Commissioner;
- expanding the Rural Health Multidisciplinary Training Program;
- updating the geographic eligibility criteria for rural bulk billing incentives;
- a Workforce Incentive Program to provide targeted financial incentives to encourage doctors to deliver eligible primary care services in regional, rural and remote Australia. This program also provides financial incentives for eligible general practices to engage nurses, Aboriginal and Torres Strait Islander Health Workers and Health Practitioners, and allied health professionals;
- improving the return of service obligations under the Bonded Medical Programs;
- better monitoring and planning for future workforce needs; and
- supporting the medical training pipeline and better targeting training places to rural Australia.
Measures will be implemented to improve the capability of the health workforce and provide greater opportunities for Australian doctors by:
- introducing new fee arrangements recognising the additional qualifications of vocationally registered General Practitioners (GPs) and to provide support for existing non-vocationally registered GPs to upgrade their qualifications;
- streamlining the GP training arrangements to be provided through the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine for non-vocationally registered GPs to gain vocational recognition;
- providing 100 additional vocational training places through the Australian General Practice Training Program from 1 January 2021;
- strengthening the role of the nursing workforce in team-based and multidisciplinary primary care service settings and reviewing the nursing curricula used to develop the nursing workforce; and
- continuing and expanding support for Aboriginal and Torres Strait Islander health professional organisations.
The Government will also improve the delivery and availability of dental, mental health and emergency aeromedical services in rural and remote areas by providing additional funding to the Royal Flying Doctor Service.
A Stronger Rural Health Strategy—guaranteeing rural and remote access to dental, mental health services and emergency aeromedical services through the Royal Flying Doctor Service
The Government is providing an additional $84.1 million to the Royal Flying Doctor Service (RFDS) for four years from 2018-19 to increase the availability of dental care, mental health services and emergency aeromedical services to Australia's rural and remote communities. Additional funding for dental outreach services is extended beyond 2019, and from 1 January 2019 a new Mental Health Outreach Clinic program is providing professional mental health services to areas where there are currently few or none. The measure also increases the Australian Government contribution to ensuring ambulance services are available from RFDS bases.
Patients in rural and remote areas will benefit from increased access to services through this measure.
Stronger Rural Health—Royal Flying Doctor Service—Additional Support
On 13 October 2018, the Government announced a one-off contribution of $4.5 million to the Royal Flying Doctor Service in Western Australia towards the purchase of two new Pilatus PC-24 jet aircraft.
The new jets will halve long haul flying times, carry more patients and boost the overall capacity of the Western Australian fleet.
National Rural Health Commissioner
The Government is providing $4.6 million over four years from 2018-19 to establish a National Rural Health Commissioner to provide advice on opportunities to reform rural health services\The Commissioner is working with regional, rural and remote communities, the health sector, universities and specialist training colleges and across all levels of government to improve rural health policies and champion the cause of rural practice.
Emeritus Professor Paul Worley commenced in his role on 11 November 2017. The Commissioner’s first piece of work has been the development of advice regarding a National Rural Generalist Pathway, a medical training pathway to attract, retain and support doctors in regional, rural and remote areas. The advice paper was released on 21 December 2018 and can be accessed at: www.health.gov.au/internet/main/publishing.nsf/Content/National-Rural-Health-Commissioner.
The Commissioner will provide advice to the Government on rural allied health reform. A paper will be developed by October 2019.
Rural Health Workforce Support Program
The Government is providing funding to Rural Workforce Agencies (one in every State and the Northern Territory) to support the rural health workforce in three priority areas:
- Health Workforce Access: to improve access and continuity of access to essential primary health care, particularly in priority areas identified by the Department of Health and through the Health Workforce Needs Assessment process involving a jurisdictional Health Workforce Planning Stakeholder Group.
- Improving Workforce Quality: to build local health workforce capability with a view to ensuring communities can access the right health professional at the right time; and ensuring health practitioners have the right skills and qualifications for their positions.
- Building a Sustainable Workforce: to grow the sustainability and supply of the health workforce with a view to strengthening the long-term access to appropriately qualified health professionals, with consideration of continuity and growing the sustainability of the health workforce.
Rural Locum Assistance Program
The Government supports the health workforce in rural locations by enabling eligible allied health professionals, obstetricians and anaesthetists to access continuing professional development or to take leave for recreation purposes. The Rural Locum Assistance Program also provides an opportunity for urban General Practitioners to experience regional and rural practice by enabling them to undertake emergency medicine training in return for a commitment to undertake a locum placement in regional and rural Australia.
Remote Area Workforce Support
Remote Area Workforce Support supports the remote and isolated health workforce through the CRANAplus Bush Services Support Line, which provides 24-hour access to trained counsellors for remote health workers and their families. CRANAplus also provides educational and professional development programs for the remote and isolated health workforce.
Health Workforce Scholarships
The Government is providing funding to provide greater flexibility and consistency in targeting scholarships to areas of need by streamlining a number of existing scholarship programs into one—through the streamlined Health Workforce Scholarship Program.
- Additionally, a rural return of service obligation is 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.
Support for Outreach Health Services
From 2017-18, the Rural Health Outreach Program Fund has been providing $112.0 million over three years. This program 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.
A range of health professionals are supported, including specialists (such as paediatricians, psychiatrists, and surgeons), allied health professionals (such as dieticians and occupational therapists), as well as GPs, nurses and midwives.
The Government is providing $243.1 million over four years from 2018‑19 to the Royal Flying Doctor Service to deliver primary aero medical evacuations, primary health clinics, remote consultations and medical chests containing pharmaceutical and medical supplies to remote locations.
Improving Maternity Services in Australia—General Practitioner Procedural Training Support Program
The Government will provide $8.2 million over four years from 2018-19 for the General Practitioner Procedural Training Support Program, which aims 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 Program targets existing general practitioners in rural and remote areas.
Remote Vocational Training Scheme
The Government is providing $26.9 million over four years from 2018‑19 to the Remote Vocational Training Scheme (the Scheme). The 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 Scheme supports 22 new training places each year. Since 2015, an annual cohort of ten registrars has commenced training in Aboriginal Community Controlled Health Services under the Scheme.
Rural Health Multidisciplinary Training Program
The Government is providing $793.9 million over four years from 2018‑19 to the Rural Health and Multidisciplinary Training Program (the Program). The Program is designed to encourage the recruitment and retention of rural and remote health professionals by:
- providing effective rural training experiences for health students;
- developing an evidence base for the efficacy of rural training strategies in delivering rural health workforce outcomes;
- supporting rural health professionals to improve Aboriginal and Torres Strait Islander health;
- increasing the number of rural origin health and medical students; and
- maximising the investment of program funds in rural, regional and remote areas for the maintenance of well-supported academic networks to enhance the delivery of training to students to support the provision of medical services to communities.
The Program supports a network of 18 rural clinical schools, 15 University Departments of Rural Health, six dental schools which support extended rural placements and 26 regional training hubs. The regional training hubs are part of the Integrated Rural Training Pipeline Initiative and are responsible for better connecting the various stages of medical training—from undergraduate through to prevocational and vocational training—in rural communities. The Program also incorporates funding support for the Northern Territory Medical Program and the Indigenous Transition Pathways to Medicine Program.
Funding is also provided for the National Rural Health Student Network, a national, rural health focused, multidisciplinary student network representing more than 10,000 medical, nursing, and allied health students and supporting 28 university rural health clubs around Australia.
John Flynn Placement Program
The Government is providing $15.8 million over four years from 2018‑19 to the John Flynn Placement Program. The program is designed to enable medical students to form a long-term relationship with a community and to gain a better understanding of rural or remote medical practice and non-metropolitan health services. The program supports participating medical students to undertake vacation placements in the same rural, regional or remote community each year over a four‑year period.
National Health and Hospitals Network—Workforce Training Specialist Doctors
The Government is providing $717.1 million over four years from 2018‑19 to the Specialist Training Program. This program, which commenced in 2010, increases the capacity of the private, rural and community health care sectors to provide high quality training opportunities for trainee medical specialists. In 2015 and 2016, 900 training full time equivalent places were funded, this increased to 950 places in 2017 and 1,077 places in 2018, following the announcement of funding for 100 new dedicated rural training places in December 2015 and the program's consolidation with the Emergency Medicine Program. Around 45 per cent of current training places include a rural component.
Medicare Benefits Schedule—Support for Rural and Remote Registrars
This program enables 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 program has a positive impact on regional Australia, as registrars training on the Independent Pathway are likely to be providing services in rural and regional areas during their training. The program also leads to Fellowship of the College; the Australian College of Rural and Remote Medicine advises most of their Fellows choose to practise in rural and remote communities so they can fully utilise the scope of clinical skills and knowledge they have gained through the Fellowship program.
Bonded Medical Programs (Bonded Programs)
The Government is providing $20.2 million over four years to 30 June 2022 to reform the Bonded Medical Programs, announced as part of the 2018-19 Budget’s Stronger Rural Health Strategy. The reforms will deliver a more flexible system with greater capacity to encourage more doctors to work and stay in rural and remote areas. Improvements will attract new medical students to the Bonded Programs and make it easier for bonded doctors to work in locations of workforce need. The reform implementation project has commenced with the first intake of bonded medical students scheduled to occur from 1 January 2020.
The Bonded Programs are made up of the Bonded Medical Places (BMP) Scheme and the Medical Rural Bonded Scholarship (MRBS) Scheme and are designed to address doctor shortages, especially in rural and remote areas. The Bonded Programs provide students a medical place at university in return for a commitment to practice in areas of workforce shortage for a specified period (return of service obligation).
Rural Pharmacy Maintenance Allowance
The Rural Pharmacy Maintenance 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 Program
The Rural Pharmacy Workforce Program 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).
Management of Per- and Poly-Fluorinated Alkyl Substances at Defence bases
The Government is providing $14.0 million over four years from 2016‑17 to undertake human health related initiatives to support communities in Williamtown, New South Wales (classified as MMM1 and MMM2) and Oakey, Queensland (MMM5) affected by Per- and Poly-Fluorinated Alkyl Substance (PFAS) contamination. These initiatives include:
- an epidemiological study to look at potential causes and patterns of health effects in the Williamtown and Oakey communities;
- a Voluntary Blood Testing Programme for those who live or work or who have lived or worked in the Williamtown and Oakey investigation areas;
- additional dedicated mental health and counselling services in affected communities of Williamtown and Oakey; and
- a communication strategy focusing on human-health related aspects of PFAS contamination.
From 2017‑18, the Government is providing $5.7 million over four years to extend the above initiatives to include Katherine, Northern Territory (MMM6) and provide support to the Katherine community affected by PFAS contamination.
Proposed Options for Communities Affected by Per- and Poly-fluoroalkyl Contamination
The Government is providing $12.5 million over four years from 2017‑18 to establish a national research program into the human health effects of prolonged exposure to per- and poly-fluoroalkyl (PFAS) contamination. The program will be administered by the National Health and Medical Research Council, with grant funding to be delivered to researchers through a targeted call for proposals. This funding also included the establishment and administration of an expert health panel, which assisted in identifying priority areas for research.
PFAS contamination is a national issue impacting both regional and metropolitan areas. This measure will help improve our understanding of the potentials health effects of PFAS exposure, which will support regional communities impacted by PFAS contamination.