Health: Supporting Regional Recovery and Growth

 

The health and wellbeing of Australians living in regional, remote and very remote Australia is a priority for the Australian Government. The 2021-22 Federal Budget builds on existing health workforce and training programs and reforms to secure jobs, invest in key health sectors and advance service system innovations identified through the COVID-19 pandemic.

 

Australians, no matter where they live, deserve access to high quality health care services. The Australian Government will contribute $800.3 million to build the rural health, mental health, aged care and disability care workforce. Delivering more doctors, nurses and allied health workers outside of our capital cities and into rural, regional and remote areas is a focus to ensure equity of access for all Australians. This continues core reforms under the 10 year  $550 million Stronger Rural Health Strategy 2018‑19, which has already seen an increase of more than 700 additional doctors and 700 additional nurses in regional Australian communities.

 

For the first time the Government will provide $65.8 million in additional financial incentives and support to rural-based registrars and doctors through increased Rural Bulk Billing Incentive payments based on remoteness. Scaling the Rural Bulk Billing Incentive will better recognise that doctors in rural and remote areas face higher operating costs, smaller patient populations, increased complexity in patient care, and carry a great burden of responsibility for the healthcare needs of people living in these communities.

 

The Government continues to build and expand the rural training pathway by investing $12.4 million through the new John Flynn Prevocational Doctor Training Program to expand training rotations in rural general practice. Prevocational doctors will be exposed to primary care settings earlier in their medical training which will support the rural medical workforce and improve access to medical services for residents in rural, regional and remote communities.

 

The Government is investing $2.2 million over five years to rural and remote communities to develop and trial innovative approaches to alleviate ongoing workforce shortages in a way that recognises local knowledge and opportunities to improve health outcomes. This will allow innovative approaches across several towns in a region, and support multidisciplinary care delivered through hospitals, primary care, aged care and disability care.

 

To support allied health professionals to work in rural areas the Government will invest $9.6 million to expand the Allied Health Rural Generalist Pathway. Recognising the varied nature of rural health, the Pathway will better equip allied health professionals to deliver a broad range of care based on community needs and improve capabilities to manage complex patients in rural healthcare settings. To recognise the role of allied health care within primary care, and support allied health professionals to participate in case conferencing, the Government is providing $14.2 million to support multidisciplinary care for patients. The Government remains committed to delivering the Rural Generalist Pathway and will develop a new streamlined program expand the scope of existing programs to support rural generalist GPs (General Practitioners), vocationally registered GPs and registrars to maintain their range of advanced skills and encourage practice in rural and remote communities.

 

Initiatives to support mental health and suicide prevention continue to be a key priority of the Government. The 2021-22 Federal Budget will increase the Government’s already significant support for mental health, responding to the recent reports of the Productivity Commission and the National Suicide Prevention Advisor. It includes $79.0 million for Aboriginal and Torres Strait Islander mental health national crisis services and support, $111.2 million to ensure all Australians, including those in regional, rural and remote areas, have greater access and choice in engaging with high quality, free and low cost digital mental health services, and $58.8 million to build and strengthen the mental health workforce with initiatives focusing on regional and rural Australia.

 

The Government’s response to the Royal Commission into Aged Care Quality and safety includes a comprehensive reform of the aged care sector creating a culture underpinned by the principles of respect, care and dignity by placing individuals at the centre – empowering senior Australians to have more control over their care and services as they age. The 2021-22 Federal Budget will commit $17.7 billion over five years from 2020-21 to set the path for reform in five critical areas including in-home care, residential aged care quality and safety, residential aged care provider sustainability, workforce and governance. New investment will benefit regional and remote aged care providers and their clients $668.4 million will be used to strengthen regional aged care governance, provide better connection to services, and enable equitable access to aged care for Aboriginal and Torres Strait Islander peoples and other special needs groups.

 

The Government is committed to improving health outcomes for Aboriginal and Torres Strait Islander peoples in line with the National Agreement on Closing the Gap. The 2021‑22 Federal Budget commits significant funding to drive progress against this Agreement through improved mental health and wellbeing, suicide prevention, and better access to health and aged care services, to be designed and delivered in partnership with Indigenous Australians with a focus on regional and remote areas. This includes investment services to treat and prevent rheumatic heart disease and trachoma, and other targeted prevention activities. In addition to this, Aboriginal Community Controlled Health Services (ACCHS) will be able to access specialist and allied health telehealth Medicare Benefits Schedule (MBS) items to ensure continuity of care and chronic disease management of Aboriginal and Torres Strait Islander patients.

 

The Government’s health care response to the COVID-19 pandemic, including roll out of the COVID-19 vaccine, has kept Australians in regional and remote locations safe and supported. It has also presented opportunities to innovate and trial potential health system reforms. The 2021-22 Budget will fast track elements of the Primary Health Care 10 Year Plan to be released for consultation in 2021-22. Specifically, the Government seeks to strengthen digital health, establish targeted support for diverse population groups, and maintain telehealth access for the community. Telehealth has improved responsiveness and access to quality primary health care particularly for population groups that experience barriers due to distance or mobility, such as rural and remote Australians, Indigenous Australians, people with disability and senior Australians.

 

As at 31 December 2020, the Health Portfolio employed 6,480 staff under the Public Service Act 1999. Of this total, 5,567 staff (86 per cent) are employed in Canberra, central Melbourne and central Sydney, 908 staff (14 per cent) in other capital cities and 5 staff (0.08 per cent) in regional areas.

 

New initiatives

 

COVID-19 Vaccines and Treatments – Vaccine Roll-Out

 

The rollout of COVID-19 vaccines into regional, rural and remote communities is a vital part of the Australian Government’s vaccine strategy to protect our regional, rural and remote communities. To date, the Australian Government has committed more than $7.2 billion to support to vaccine rollout.

 

The Australian Government also recognises advice from the Australian Technical Advisory Group on Immunisation on who would be most at risk of contracting COVID-19, or of serious illness if they contracted COVID-19, which includes Aboriginal and Torres Strait Islander peoples. This is why we are continuing to take expert advice on the best ways to protect our communities, especially those in rural, regional and remote Australia.

 

Vaccination locations have been established across metropolitan, regional, rural and remote Australia.

 

To ensure accessible and quality services, vaccination providers in regional, rural and remote Australia include:

 

• hospital hubs
• General Practitioners (GPs)
• COVID-19 GP respiratory clinics (GPRCs)
• State and Territory vaccination clinics
• ACCHS
• the Royal Flying Doctor Service
• in-reach ‘surge’ vaccination teams.

 

Following the recalibration of the vaccine program, National Cabinet agreed that the Pfizer COVID-19 vaccine could be used for all whole-of-community vaccination approaches in remote communities where the use of two vaccines is impractical, regardless of age cohorts. This will streamline vaccination of vulnerable people and communities by limiting the need to transfer workforce and relevant materials and assists with issues associated with distribution and access of two vaccines.

 

An additional vaccine workforce has been established by the Australian Government to support the delivery of Australia’s COVID-19 Vaccination Program. The workforce will support and supplement existing services and assist in outreach in areas such as aged care, remote, and Indigenous communities working with existing providers. They have also partnered with States and Territories, peak organisations and other providers to assist in administering the vaccine to harder-to-reach populations.

 

Prioritising Mental Health – Strengthening Access to and Connection between Mental Health Services via Digital Means

 

The Australian Government is providing an additional $111.2 million to support a range of initiatives to ensure all Australians, including those in regional, rural and remote areas, have greater access and choice in engaging with high quality, free and low cost digital mental health services. This includes continued funding support for digital mental health services, and additional funding in 2021-22 to help services manage increased demand due to the COVID-19 pandemic and the 2019-20 bushfires. This measure will also support the development of a new national mental health platform and the implementation of the National Safety and Quality Digital Mental Health Standards to improve the quality of digital mental health service provision, and protect service users.

 

Prioritising Mental Health – Aboriginal and Torres Strait Islander mental health National Crisis Services and Support

 

The Australian Government is investing $79.0 million over four years from 2021-22 to address the devastating and disproportionate impact of suicide and mental ill-health on Aboriginal and Torres Strait Islander peoples. This includes preventive action designed and led by Aboriginal and Torres Strait Islander peoples and implementation of key initiatives under a renewed National Aboriginal and Torres Strait Islander Suicide Prevention Strategy. Specific initiatives include:

 

• the establishment of regional suicide prevention networks
• the implementation of culturally‑sensitive, co-designed aftercare services through regionally-based organisations, with Aboriginal and Torres Strait Islander organisations being preferred service providers
• the establishment of a culturally-appropriate 24/7 crisis line to be governed and delivered by Aboriginal and Torres Strait Islander peoples
• a review to examine the capacity of, and ways to strengthen, the Aboriginal and Torres Strait Islander health sector to deliver mental health services for Aboriginal and Torres Strait Islander peoples
• funding to support the inclusion of people with lived experience in the co-design, implementation and evaluation of suicide prevention activity.

 

This measure will contribute to significant and sustained reduction of suicide of Aboriginal and Torres Strait Islander peoples as we work towards zero as part of the Closing the Gap Priority Reforms (Target 14: people enjoy high levels of social and emotional wellbeing). It also responds to key recommendations of the National Suicide Prevention Adviser and the Productivity Commission’s Inquiry into Mental Health.

 

Prioritising Mental Health – Building the Mental Health Workforce

 

The Australian Government is investing $58.8 million over two years from 2021‑22 to grow and upskill the mental health workforce in Australia. Ensuring an appropriately skilled and distributed mental health workforce is available to meet demand for mental health services is a key foundation of the Australian Government’s mental health reforms.

 

This measure includes specific initiatives to attract, train and retain skilled workers in the mental health workforce through promoting mental health as a career option, supporting professional collaboration, improving access to training, and providing more opportunities for training in non-acute settings. In particular, it includes specific initiatives to increase training places and support regional and remote training pathways for psychiatrists, support greater representation of Aboriginal and Torres Strait Islander peoples in the mental health workforce by boosting the Puggy Hunter Memorial Scholarship Scheme, and identifying practical approaches to boost the child mental health workforce, particularly in rural and remote areas.

 

Prioritising Mental Health - Enhancement and expansion of youth mental health services

 

The Australian Government is continuing to invest $278.6 million over four years from 2021‑22 in expanding and enhancing the national headspace network and other youth mental health services, including in partnership with State and Territory governments. This will address a number of gaps in the current delivery of youth mental health services to high needs groups, including Aboriginal and Torres Strait Islander, LGBTIQ+, and culturally and linguistically diverse young people. Further, the measure will contribute to addressing the ‘missing middle’ in mental health services and work to enhance the provision of a strengthened care continuum, increased clinical service capacity and a more stable mental health workforce.

 

Prioritising Mental Health – Ensuring Continuity of Psychosocial Support for Australians with Severe Mental Illness Not Supported by the National Disability Insurance Scheme

 

The Australian Government is investing $112.4 million over four years from 2021-22 for the continuation of psychosocial support services for people with a severe psychosocial disability who are not eligible for the National Disability Insurance Scheme. This includes a regional loading applied consistently across the psychosocial support program, in recognition of the higher costs of service delivery in regional, rural and remote communities. This is intended to incentivise service commissioning and improve service availability for people with severe mental illness living in these communities.

 

Strengthening Primary Care – Health Workforce Reform

 

In 2021-22, the Australian Government is focusing on improving investment in the health workforce with a broad reform package announced through the 2021-22 Budget. This is the next step in building on the Government’s Stronger Rural Health Strategy announced in the 2018-19 Budget. It maintains the momentum of our reforms, streamlining and better connecting programs to create more cohesive and visible support for rural and remote health practitioners. The package provides a foundation for future data and evidenced based reform and investment across our programs that teach, train, incentivise and support health professionals – with a key focus on continuing to build our regional, rural and remote health workforce.

 

Strengthening Primary Care – Delivering Innovative Rural Health

 

The Australian Government is investing $2.2 million over five years in the Delivering Collaborative Rural Health Models measure, which funds the trial of innovative, multidisciplinary primary care approaches aimed at alleviating ongoing workforce shortages and improving health outcomes in rural communities.

 

This measure funds implementation of community-supported multidisciplinary team models that make best use of existing resources to deliver services in a more effective and sustainable way within a region or sub-region, allowing services to be coordinated across primary care, hospital care, disability care and aged care. Funding supports governance and implementation activities, with service delivery to be self-sustaining.

 

This proposal builds on the Government’s $3.3 million investment in the 2020-21 Budget through the Innovative Models of Primary Care to Address Rural Workforce Shortages measure, which funded five early trials in New South Wales. This provides an opportunity for communities outside of New South Wales to trial sustainable, practical, community-supported models of care. This further investment reflects the high level of interest and support within rural communities for trialling locally-designed solutions to ongoing health access issues.

 

This funding complements the National Rural Health Commissioner Primary care Rural Innovative Multidisciplinary Models program, which will progress new designs for innovative rural service models.

 

Strengthening Primary Care - Streamlining and expanding support for rural GPs with advanced skills to align with the Rural Generalist Pathway

 

The Government is providing $0.3m in 2021-22 to undertake a consultation and design process which will develop a new streamlined program from the Rural Procedural Grants Program and the Practice Incentives Program Procedural GP payments. The new program will expand the scope of the existing programs to support rural generalists, vocationally registered GPs and registrars practising in MM3‑7 locations, to maintain or enhance their range of advanced skills. Improved support for rural generalists with skills to provide primary care, emergency medicine and other procedural and non-procedural advanced skills, including mental health skills, will improve access and quality of care for those in regional and rural communities.

 

Strengthening Primary Care – John Flynn Prevocational Doctor Program

 

The Australian Government is investing $12.4 million over four years from 2021-22 through the new John Flynn Prevocational Doctor Training Program which will fund rotations in rural primary care settings for prevocational doctors. This investment will improve access to medical services for residents in rural, regional and remote communities and help build the rural medical workforce by providing prevocational doctors with positive, well-structured experiences early in their careers.

 

The program builds on existing Government investment in prevocational doctor training, incrementally increasing the number of rural primary care rotations from 440 rotations (or at least 110 Full Time Equivalent (FTE) places) in 2022, to 800 rotations (or 200 FTE places) from 2025. This increase will enable an additional 360 hospital-based prevocational doctors to complete a clinical rotation working in a rural primary care setting, fostering interest in the speciality of general practice and working as a rural doctor.

 

Under the program rural hospitals and rural primary care settings partner to provide prevocational doctors with experience through a rotation in a primary care setting. Funding will support delivery of the primary care rotation, contributing towards salary costs for prevocational junior doctors, clinical supervision and other costs linked to training in the rural primary care setting. The program will support prevocational doctors from postgraduate years one to five, targeting those in their first two postgraduate years and will include a limited pool of rotations available to metropolitan hospital based prevocational doctors.

 

Strengthening Primary Care – Flexible Approach to Training in Expanded Settings

 

The Australian Government is investing $29.5 million over four years from 2021-22 to create a new innovative funding pool for non-GP medical specialist training commencing in 2022 that will help overcome identified barriers to deliver better distribution and supply of specialists matched to local community health needs.

 

The pool will fund innovative activities such as small scale trials of networked training models, expanded setting supervision and innovative supervision models to enhance training system quality and capacity, and support for junior specialists in training to transition to practise rurally.

 

This measure will better target the Australian Government’s existing investment in non‑GP medical specialist training, through the Specialist Training Program, by providing increased flexibility to support and promote growth in specialist medical training in settings where the workforce is needed.

 

Strengthening Primary Care – Rural Bulk Billing Incentive

 

From 1 January 2022, the Australian Government will, for the first time, implement a progressive incentive schedule for doctors to provide services in rural and remote areas, with an estimated cost of $65.8 million over the forward estimates.

 

By increasing the Rural Bulk Billing Incentive according to remoteness, the Government recognises the challenges of delivering healthcare in smaller rural communities and remote communities. The Rural Bulk Billing Incentive will be increased in rural and remote areas (MM3-7) progressively from its current 150% loading up to 190% in very remote areas.

 

This proposal will also amend the geographic eligibility for claiming MBS Item 10992 (bulk billing incentive for after-hours services). This extends the 2018-19 Budget measure, which updated geographic eligibility criteria using the Modified Monash Model classification system. All doctors regardless of their location will still be eligible for a Medicare bulk billing incentive for after-hours services.

 

Strengthening Primary Care – Allied Health Case Conferencing

 

The Australian Government is providing $14.2 million over four years to support allied health practitioners to participate in case conferencing when organised by a patient’s GP.

 

This proposal better supports multidisciplinary care for patients that need it, by financially recognising the role of allied health care as part of the primary care team. The items will incentivise allied providers to contribute to care planning processes, leading to improved care coordination, reduced acute care utilisation and better health and functional outcomes for patients. This measure particularly benefits people living in regional and remote areas, whose care providers may be geographically dispersed.

 

From 1 November 2021, new items will enable allied health practitioners who are providing chronic disease management services to eligible patients to receive a fee for participating in case conferencing when organised by the patient’s GP. A similar item will be created to enable allied health practitioners involved in the treatment and support of patients under 13 years of age with autism or another pervasive developmental disorder who are under the care of a psychiatrist or paediatrician.

 

Guaranteeing Medicare - Strengthening primary health care for Aboriginal and Torres Strait Islander people

 

The Government is investing $22.6 million to improve quality of care and health outcomes for Aboriginal and Torres Strait Islander peoples, by re-designing the Practice Incentives Program - Indigenous Health Incentive (PIP IHI). The changes will commence from 1 January 2023, through a two year transition period, with full implementation by 1 January 2025.

 

The changes include removing and redirecting the annual registration payment to better incentivise the provision of high quality chronic disease care. The program will also be expanded to include children aged 0-14, who had been previously ineligible under the PIP IHI. The measure will encourage better chronic disease management, mental health care planning, and continuity of care for patients.

 

The measure will reduce administrative burden and simplifying the PIP IHI to maximise use by clinicians and their practices, by moving towards a one-off registration process.

 

Guaranteeing Medicare – MBS telehealth

 

This measure provides $204.6 million to maintain MBS telehealth items as an extended COVID-19 health measure to 31 December 2021. The COVID-19 MBS telehealth items have helped maintain access to essential health care services for people across Australia during the COVID-19 pandemic and have been particularly welcomed by people in regional, rural and remote Australia. The telehealth items include GP services, nurse practitioner attendances, midwifery and equivalent obstetric services, nurse attendances, Aboriginal and Torres Strait Islander health practitioner services, specialist consultations and allied health services.

 

In addition, a range of new temporary telephone services will be created to support access to GP services for sexual and reproductive health and prescribing of highly specialised drugs. New services for nicotine cessation, including by telehealth, will also be introduced to support the Government’s commitment to reduce smoking prevalence to under 10 per cent by 2025.

 

Patients will continue to have access to telehealth services (phone and video) provided by procedural specialists, consultant physicians, paediatricians, psychiatrists, neurosurgeons, anaesthetists, geriatricians and public health physicians.

 

Telehealth has been found to increase accessibility, reduce travel time, and reduce waiting times for patients, leading to increased productivity. Importantly, telehealth also assists many Australians, such as those living in rural and remote areas, Indigenous Australians, people with disability, and residents of aged care facilities, to access care which may have otherwise been unavailable.

 

Guaranteeing Medicare – Support for replacing old diagnostic imaging equipment

 

The Australian Government is providing up to $20.7 million to assist diagnostic imaging practices in regional, rural and remote areas to replace older diagnostic imaging equipment. Practices with current exemptions in regional, rural and remote areas will be able apply for grants of up to 50 per cent of the average cost of diagnostic imaging equipment to replace equipment that will be out of date by 1 May 2022. It is expected that this proposal will benefit some 80 regional, rural and remote practices.

 

Transforming Digital Health – Next Wave of My Health Record

 

The Australian Government is investing $301.8 million over two years from 2021-22 to build the next wave for My Health Record (MHR) and strengthen the digital enablement of healthcare in Australia.

 

My Health Record is operated by the Australian Digital Health Agency and helps improve health outcomes and better coordinate healthcare through increased availability and quality of health information.

 

There are almost 23 million registered users of the My Health Record system, making it one of Australia’s most subscribed Government services. The system plays a central role in health services delivery and has seen a widespread uplift in use in the last 12 months:

 

• 89 per cent of all Australian’s My Health Record now have critical healthcare data in them.
• Public hospital usage of MHR has increased 172 per cent in the last 12 months.
• Outside of the hospital setting, there has been a 110 per cent increase in cross-healthcare settings viewing of MHR data amongst different healthcare providers, creating a burgeoning ‘network effect’.

 

Enhancing the MHR, and increasing the ways it can securely and reliably assist consumers and health professionals to manage their care day-to-day, will increase confidence, trust, and use of the system, and will pave the way for broader digital transformation across the country. Australia will subsequently become one of the first countries in the world to enable its people to truly hold their healthcare in their hand, with MHR as the backbone for the future of modern healthcare.

 

The My Health Record system benefits regional Australians by providing a digital summary of a person’s key interactions with the healthcare sector. It can be viewed anywhere, anytime by the consumer and healthcare providers involved in their care. This particularly benefits Australians living in rural and remote Australia who may need to travel away from their home community to access healthcare, require virtual care services, or are regularly serviced by multiple healthcare providers.

 

Ageing and Aged Care – Providing More Home Care Packages

 

The Australian Government is continuing to increase its support for senior Australians to stay in their homes for longer by investing in additional Home Care Packages (HCPSs). A further $6.5 billion over four years from 2021-22 has been committed in the 2021-22 Budget for the release of an additional 80,000 HCPs.

 

Since the 2018-19 Budget, the Government has invested a total of $12 billion in new funding to deliver more than 163,000 additional HCPs, including the 80,000 HCPs announced in the 2021-22 Budget and 10,000 HCPs announced in the 2020-21 MYEFO.

 

This additional investment will support senior Australians in regional and remote Australia who have expressed a strong preference to stay in their homes and communities for as long as possible.

 

Ageing and Aged Care - Reforms to Residential Care Funding to Drive Better Care and a Viable System

 

The Government will introduce a new funding model for residential aged care, the Australian National Aged Care Classification (AN-ACC) from October 2022. The AN‑ACC is a significant reform that will drive better care and establish a more sustainable, efficient and more transparent system. Residential aged care providers in remote and very remote areas will have a better funding outcome under the AN-ACC model, facilitating the provision of higher quality aged care. The Australian Government is investing $7.8 billion as part of Budget 2021-22 over four years from 2021-22.

 

Under AN-ACC the Government will fund support services to meet the Royal Commission recommended 200 minute average care time standard (including 40 minutes of registered nurse time). This represents a significant shift into how care is delivered in residential aged care facilities, including in rural and remote areas which will have access to the same amount of mandated care time as facilities in metropolitan areas. The total care staffing mix and the care time provided on a per resident per day average basis will be reported to Government and this information will be used to determine a case mix adjusted staffing star rating for each service to be published on MyAgedCare.

 

The role of the Independent Hospital Pricing Authority is being expanded to include providing advice to the Minister responsible for Health and Aged Care on the price of care in residential aged care. Part of the role of the independent pricing authority will be to continually assess costs of providing care in regional, remote and very remote areas.

 

The Australian Government is also providing interim funding support in 2021-22 prior to the commencement of AN-ACC. Regional, rural and remote providers will benefit from the continuation of the 30 per cent increase in the viability and homeless supplements, as well as a new $10 per resident per day Government Basic Daily Fee Supplement paid monthly from 1 July 2021 to 30 September 2022.

 

In addition, lump sum residential care support supplement payments of around $760 per resident in metropolitan areas, and $1,145 per resident in non-metropolitan areas were paid in April 2021 to approved providers of residential aged care as part of the initial response to the Royal Commission’s Final Report. The Residential care support supplement is 50 per cent higher in non-metropolitan areas in recognition of the higher costs experienced by providers in regional, rural and remote areas of Australia. Services located in rural and remote areas received 41 per cent of the overall residential care support supplement funding.

 

Ageing and Aged Care – More equitable access to aged care for First Nations people and special needs groups

 

The Australian Government in investing $630.2 million over five years from 2020‑21 in more equitable access to aged care. Senior Australians, including Aboriginal and Torres Strait Islander peoples, those who are homeless or at risk of homelessness and those living in rural and remote locations will benefit from increased choice and sustainability of services, assistance with accessing aged care and improved infrastructure to meet consumer expectations.

 

This funding includes an investment of $396.9 million over four years from 2020-21 to enable aged care providers to make needed improvements to their buildings and build new services in areas where senior Australians currently have limited access or where staff caring for their needs do not have suitable housing. Communities will benefit significantly from construction projects and increased aged care services. Projects will provide around 1400 construction jobs and benefit 471,000 senior Australians living in rural and remote locations.

 

This funding will allow evaluations of this measure to identify service gaps within regional, rural and remote Australia to assist with addressing areas of greatest demand, giving particular focus to Aboriginal and Torres Strait Islander peoples and consumers with special needs.

 

These capital infrastructure measures are ongoing, with $130 million per annum to be made available from 2025-26.

 

An investment of $106 million over four years from 2021-22 has been allocated to improve Aboriginal and Torres Strait Islander consumer experience, uptake and access to aged care and disability services by procuring an Indigenous workforce to provide face to face support. This will assist 60,000 Aboriginal and Torres Strait Islander peoples to better navigate and access aged and disability care.

 

The current funding model for the National Aboriginal and Torres Strait Islander Flexible Aged Care program will also be updated. This includes: $62 million over four years (from 2021-22) to support delivery of viable, high quality care to older Aboriginal and Torres Strait Islander peoples. From 1 July 2021, funding will be provided to ensure residential aged care consumers can stay connected to Country and culture, as well as meeting the travel costs of any people needed to provide clinical or other assistance to a resident.

 

An investment of $64 million will be provided over four years from 2021-22 to support delivery of viable, high quality integrated care to older Australians in regional and remote locations by broadly aligning the funding for Multi-Purpose Services with the new AN-ACC funding model.

 

Aged care service providers located in remote areas or who provide support to Aboriginal and Torres Strait Islander peoples will be given professional support to improve the organisations workforce capability and financial sustainability. This will be made available through a $5 million investment in 2021-22 to expand the Remote and Aboriginal and Torres Strait Islander Aged Care Service Development Assistance Panel.

 

The Government will also invest $35 million over four years from 2024-25 to assist rural and remote aged care providers experiencing high turnover and sudden departures by expanding the Rural Locum Assistance Program to provide:

• access to a surge locum workforce for an interim period while recruitment is undertaken.
• assistance with recruiting permanent staff with the requisite skills and experience.
• a new incentive scheme to increase the retention of permanent staff.

 

These initiatives promote sustainability in the aged care sector for services in regional and remote Australia. They also assist the sector where high costs of delivering care are limiting the ability to invest in infrastructure, where workforce challenges are undermining viability and continuity of care, where choice and uptake of services is limited and where intervention is required to make mainstream models fit for purpose.

 

This investment coincides with and complements the extension of the viability supplement across residential aged care, and the rollout of the AN-ACC funding model, and supports senior Australians in regional and remote Australia who have expressed a strong preference to stay in their homes and communities for as long as possible.

 

Preventive Health – Elimination of Trachoma in Indigenous Communities – Extension

 

The Australian Government is investing $19.1 million over four years from 2021-22 to continue and improve the Australian Government’s trachoma elimination program by extending agreements with Queensland, Western Australia, South Australia and the Northern Territory.

 

Australia has established a new target of 2022 (previously 2020) to eliminate trachoma. This funding enables continued investment in jurisdictions to support the screening and treatment of Aboriginal and Torres Strait Islander children and families in remote communities. It also improves delivery by ensuring closer connection with Primary Health Care providers through remote health services, which ensures greater continuity of effort in communities. 

 

Preventive Health – Rheumatic Fever Strategy Continuation

 

The Australian Government is investing $12 million over four years from 2021-22 to continue and improve the Rheumatic Fever Strategy by extending National Partnership Agreements with Queensland, Western Australia, South Australia and the Northern Territory.

 

The funding continues to support primary prevention and long-term secondary prevention treatment to reduce the incidence of recurrent Acute Rheumatic Fever and the related development or worsening of Rheumatic Heart Disease (RHD) in remote communities for Aboriginal and Torres Strait Islander peoples.

 

The delivery arrangements are continuing to be co-designed with the sector, including State and Territory organisations, to align with and support the priority reforms under the National Agreement on Closing the Gap. There will be shared decision-making with Indigenous leaders, and Aboriginal and Torres Strait Islander peoples will guide the design and implementation of RHD prevention strategies.

 

Preventive Health – Support for Surf Life Saving Training and Beach Safety Equipment

 

The Australian Government is providing $6.6 million in funding to Surf Life Saving Australia (SLSA) over two years from 2020-21 to enhance its ability to protect beachgoers.

 

Commencing in 2016-17, the Government has previously provided $10 million over four years for this initiative to boost SLSA’s capacity to deliver preventative safety measures at local beaches. Further funding allows SLSA to continue to provide vocational education and training to volunteers to save lives on Australia’s beaches and build on their organisational capability.

 

Furthermore, the Australian Government is providing $3.1 million over two years from 2020-21 through the Water and Snow Safety Program, to support SLSA’s Beach Safety Equipment Fund (BSEF).

 

SLSA currently receives funding through the Australian Government’s Water and Snow Safety program for the BSEF to provide 314 Surf Life Saving Clubs (SLSCs) across Australia with $5,000 per annum. This funding is used to purchase vital rescue equipment including rescue boards, life jackets, rescue manikins inflatable rescue boats, all-terrain vehicles, defibrillators, and first aid and medical supplies. This funding provides SLSCs with a total of $10,000 per annum to support the purchase of new patrol equipment and replacement of old and damaged equipment.

 

Funding supports all 314 SLSCs around Australia, which includes 136 clubs in regional areas and 7 clubs in remote areas.

 

Preventive Health – Sporting Schools

 

The Australian Government is investing a further $40.8 million over two years from 2021‑22 to continue the flagship sport and physical activity program for children, Sporting Schools for the 2022 calendar year. Sporting Schools provides grants to schools nationwide to deliver free, high quality programs to get Australian children of all abilities more physically active and establish a foundation for lifelong healthy behaviours. The program will seek to increase its presence in specific regional and remote locations where registration rates are low.

 

This initiative extends on the 2020-21 Budget initiative, Continuation of Sporting Schools.

 

Current Initiatives

 

Response to the COVID-19 Pandemic

 

Australia is leading the world out of the global COVID-19 pandemic and recession. As COVID-19 vaccines roll out across the nation, protecting Australians from the ongoing threats of the pandemic remains a priority. The Australian Government’s COVID-19 Emergency Health Response has focused on protecting all Australians, sustaining contingent capacity in the health sector, and supporting the roll out of the COVID-19 vaccine throughout 2021.

 

The Australian Government’s COVID-19 suppression strategy has focused on containing the virus through clear communication with the Australian people, rapid testing and contact tracing, implementation of boarder and travel measures, building and investing in the capacity of our health system and collaborating with States and Territories and the health sector to contain outbreaks and stop the spread of COVID-19.

 

Key measures continue to support regional Australia focusing on the safety, surveillance, diagnosis and treatment of Australians in these communities. Measures also complement other COVID-19 responses that have ensured the safety and protection of regional communities and economies, specifically remote travel restrictions.

 

Since the beginning of the COVID-19 pandemic, more than $25 billion has been committed as part of the Australian Government’s health response to COVID-19. This includes more than $7 billion to support the COVID-19 vaccine roll out and over $1.1 billion to extend key measures associated with the national COVID-19 health response and suppression strategy throughout 2021.

 

Strengthening Primary Care – COVID-19 General Practitioner Led Respiratory Clinics

 

As part of the COVID-19 pandemic response, the Australian Government has invested $465 million over three years from 2019-20 to 2021-22 to establish up to 150 General Practitioner led Respiratory Clinics (GPRCs) and continue their operation through the pandemic. This includes the Government’s announcement on 14 March 2021 for a further $87.5 million to extend the measure to 31 December 2021. Over half of these clinics, 83, were established outside of metropolitan areas. To date, the GPRCs have provided assessment services to patients from 2,420 postcodes, covering more than 99 per cent of the Australian population.

 

The GPRCs were established to provide dedicated assessment and testing services to people with mild to moderate COVID-19 symptoms. The GPRCs are a vital part of the Government’s strategy to keep the health system functioning – providing a safe and specialised service for people who have respiratory symptoms while preserving hospitals for people with severe injuries and disease, and general practices for usual care and chronic disease management. Given its broad geographic coverage, the GPRC network is also a key delivery mechanism for the vaccine roll-out. The network is providing equitable and safe access to vaccine services, particularly within rural and remote areas, where GPRCs may be the only primary care delivery platform.

 

As part of this funding, $18.2 million was provided to the National Aboriginal Community-Controlled Health Organisation to support its Sector Support Organisations member services and other Aboriginal and Torres Strait Islander health services to coordinate efforts around Australia’s COVID-19 pandemic response, and in particular facilitate cultural safety measures in the respiratory clinics.

 

Primary Health Networks have also been funded $43.4 million to provide sector support through the pandemic, including distribution of personal protective equipment to primary care providers, dedicated support to identify, establish and maintain the GPRCs, and assistance with the vaccine roll-out within general practices, aged and disability care facilities.

 

Strengthening Primary Care – COVID-19 Remote Community Preparedness and Retrieval

 

Part of the additional $1.1 billion to extend the national COVID-19 health response and suppression strategy to 31 December 2021, included the repurposing of a forecast $17 million underspend by the Royal Flying Doctor Service (RFDS). Underspend funds will be used to:

• extend RFDS services to 31 December 2021
• expand RFDS services to include vaccine administration in remote areas
• extend the Point of Care Testing program ($10.7 million).

 

The Remote Community Preparedness and Retrieval measure:

 

• Supports planning and preparedness activities in rural and remote communities, including increased screening protocols to reduce travel.
• Assists with early retrieval and evacuation for people with potential COVID-19, staffed mobile respiratory clinics and remote health service support. The early evacuation of suspected or confirmed COVID-19 cases allows isolation of cases where no or minimal quarantine facilities exist, which is essential to effectively contain any outbreaks in these locations.
• Provides grants for rural and remote areas enabling communities to engage in preparedness activities as prioritised and determined by the community. These grants have been used to connect Elders to the broader community through technology, ensure food security and pharmacy supplies, enhance screening protocols, make minor adjustments to service waiting areas and provide more on‑the-ground health staff.

 

Additionally, of the $52.8 million aeromedical support package, $2 million has been allocated to the Northern Territory Government’s Top End Health Service and Central Australian Health Service to assist with vaccine roll-out in remote communities. 

 

Strengthening Primary Care – COVID-19 Remote Point of Care Testing Program in Aboriginal and Torres Strait Islander Communities

 

As part of the extension of the national COVID-19 health response and suppression strategy, $10.7 million has been allocated to continue the successful COVID-19 Point of Care Testing (POCT) Program for remote and rural Aboriginal and Torres Strait Islander communities including $4 million announced in September 2020 and the extension announced on 14 March 2021.

 

POCT utilises the same gold standard polymerase chain reaction testing used for laboratory based COVID-19 testing and provides a test result within 45 minutes.  

 

This measures ensures primary care services are no more than two to three hours’ drive away from a testing location, whether POCT or conventional. 

 

The 86 sites are located in the Northern Territory (32), South Australia (9), Victoria (2), New South Wales (5), Queensland (18) and Western Australia (20). A further 67 services are acting as spoke sites, increasing the reach of the program to over 150 remote communities.  

 

Without access to rapid testing through the POCT program, it’s possible that an entire community could be infected before the early cases are detected. Having point of care testing available means more remote communities are protected from COVID-19, by ensuring people can access accurate testing in or close to their home community.

 

Prioritising Mental Health – Supporting Mental Health Nationally through additional Psychological Therapies

 

The Australian Government has invested $100.8 million over two years from 2020-21 to provide up to 10 additional Medicare-subsidised psychological sessions under the Better Access initiative until 30 June 2022. Under this measure, people in regional Australia will continue to be able to access essential mental health treatment and support, including via telehealth where it is safe and clinically appropriate to do so.

 

In 2021-22 the Government will conduct a rigorous evaluation of Better Access, in line with the recommendation from the Productivity Commission in its Inquiry into Mental Health. This will include consideration of the effectiveness of Better Access in increasing access to mental health support in regional areas. Future reforms to the program will be guided by the evaluation findings as well as the recommendations of the Productivity Commission and the report from the MBS Review Taskforce.

 

Prioritising Mental Health – Supporting the Mental Health of Australians through the COVID-19 Pandemic

 

The Australian Government continues to support the introduction or scaling up of critical mental health services in response to the COVID-19 pandemic. 

 

On 29 March 2020, the Government announced $74 million over two years for preventative mental health and crisis support services. This included funding to Beyond Blue to establish a dedicated COVID-19 Mental Wellbeing Support Line operating 24 hours a day, 7 days a week and funding for a range of digital services and targeted supports for vulnerable groups.

 

On 15 May 2020, the Australian Government announced a further $48.1 million, to support the delivery of the immediate priorities of the National Mental Health and Wellbeing Pandemic Response Plan – enhanced data and modelling of the mental health impacts of the pandemic, support for at risk groups such as older Australians, Aboriginal and Torres Strait Islander Australians and culturally and linguistically diverse communities, and funding to improve service connectivity.

 

On 6 August 2020 and 17 August 2020, the Government invested $12.0 million and $31.9 million, respectively, to provide additional mental health supports for Victorians and support for national measures. This included funding to establish 15 mental health clinics across Victoria ($26.9 million) in 2020 with six of these being located in regional Victoria. A priority for 2021-22 will be to continue to fund and evaluate the clinics. In addition, the Government’s digital mental health gateway, Head to Health, has expanded to provide further access to free and low cost phone and online mental health services and supports irrespective of geographical barriers.

 

On 14 March 2021, the Government announced an additional $7.1 million to fund an extension of the COVID-19 Mental Health Wellbeing Support Service until 31 December 2021.

 

Through the 2021-22 Budget the Australian Government has also provided additional funding in 2021-22 to digital mental health service providers to support continued increase demand related to the COVID-19 pandemic.

 

These key measures continue to support regional Australia, enhancing access to digital and mental health supports, complemented by the Government’s decision to expand the Better Access national initiative to provide additional Medicare-subsidised psychological sessions. 

 

Bushfire Health Response

 

Supporting the Mental Health of Australians Affected by Bushfires

 

On 12 January 2020, the Australian Government announced $76.1 million over three years from 2019–20 to support primarily regional communities affected by the 2019 bushfires. This includes support to regional Australians through:

 

• Provision of immediate frontline emergency distress and trauma counselling sessions.
• New MBS items available for up to 10 face‑to‑face and/or telehealth Medicare-subsidised psychological therapy sessions.
• Training in trauma informed care and psychological first aid for frontline emergency staff, and training to organisations managing frontline emergency staff to identify personnel at risk.
• Bushfire Trauma Response Coordinators in nine severely fire affected Primary Health Network regions to provide a single point of contact for individuals and communities.
• Development of a National Disaster Mental Health Framework to guide national preparedness to deliver effective mental health supports in response to future national disasters.
• Expansion of mental health services through Primary Health Networks to meet increased demand and any specific local needs of bushfire-affected communities; and administer community grants of up to $10,000 each to strengthen social connectedness and resilience.

 

On 11 May 2020, the Government invested a further $13.4 million in services to provide critical, localised, non-clinical mental health supports for bushfire-affected communities through Primary Health Networks in regional and rural Australia

 

As part of these packages the Government has provided $3.8 million to Lifeline Australia to establish a dedicated helpline (13HELP) for individuals impacted by the 2019 bushfire crisis, including the development of communication activities to promote this service. Funding was also provided to Kids Helpline to boost the capacity to respond to increased demand as a result of the bushfire crisis. This is providing support for individuals affected by the bushfires, including in regional areas to access the mental health support they need and provides easy access by phone from all locations.

 

During 2021-22 this funding will continue to support a number of priority areas impacted by the 2019-20 bushfires. Bushfire Trauma Response Coordinators will continue in nine severely fire affected Primary Health Network regions to provide a single point of contact for individuals and communities along with the provision of immediate frontline emergency distress and trauma counselling sessions. Community participation and wellbeing, training for frontline workers and delivery of the first National Mental Health and Wellbeing Framework will continue as priority area in 2021-22. 

 

Strengthening Primary Care – Indigenous Australians’ Health Programme

 

Approximately $4.1 billion will be provided over four years through the Indigenous Australians’ Health Programme (IAHP) from 2021-22 to 2024-25, building on our work in partnership with Aboriginal and Torres Strait Islander peoples to improve health outcomes.

 

Through this program, Aboriginal and Torres Strait Islander peoples 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. 

 

Under the IAHP, funding is allocated for primary health care services, with $546.6 million to be provided to 164 organisations (including 130 Aboriginal Community Controlled Health Services (ACCHSs)) in 2021-22, to provide culturally appropriate comprehensive primary health care. ACCHS play a critical role in supporting the health system, particularly in regional and remote areas.

 

A further $36.5 million over three years from 2020-21 to 2022-23 is also being provided, for the expansion of primary health care services. This funding will support the sector to expand access to comprehensive primary health care services to Aboriginal and Torres Strait Islander peoples, by investing in priority health areas in regions of high health need or high population growth, taking into account gaps in existing service delivery. This investment complements the additional $90 million provided under the IAHP Primary Health Care Funding Model, which commenced 1 July 2020, which was co-designed with the sector, to distribute funding fairly and transparently, based on activity levels, the cost of delivering services and the relative health needs of locations.

 

Strengthening Primary Care – Innovative Models of Primary Care to Address Rural Workforce Shortages

 

The Australian Government is investing $3.3 million over two years from 2020-21 to support five trials in sites across regional New South Wales to trial innovative, multidisciplinary primary care approaches aimed at alleviating ongoing workforce shortages, ensuring access to health services and improving health outcomes in these communities.

 

This measure is supporting well developed proof-of-concept pilots to transition into fully operational models, customised to address the primary care issues in each trial site. Trials are commencing in the 4Ts (Tullamore, Trangie, Tottenham and Trundle); Lachlan region (Parkes-Forbes); Canowindra and surrounding hamlets; Snowy Valleys (Tumut, Tumbarumba, Batlow and Adelong) and in the Wentworth area.

 

The trials build on and better integrate existing resources to deliver services in a more effective and sustainable way within a region. This includes multi-disciplinary team approaches and different employment models ensuring appropriate access to health services in rural and remote communities.

 

The trials complement work by the Office of the National Rural Health Commissioner, who will work with a number of regions, including outside of New South Wales, to support development of ‘trial ready’ and localised innovative models of care through the Primary care Rural Innovative Multidisciplinary Models (PRIMM) program. Together, these initiatives will support the development of a range of targeted and innovative approaches to the delivery of primary health care that reflect the unique needs of communities to address ongoing rural workforce challenges.

 

Strengthening Primary Care – Extension of the National Rural Health Commissioner Office

 

The Australian Government is investing $11.2 million over four years from 2020-21, and $2.1 million per year on an ongoing basis from 2024-25, demonstrating commitment to rural and remote reform by continuing and expanding the office of the National Rural Health Commissioner (the Commissioner).

 

Legislation to support the ongoing and expanded role for the Commissioner came into effect on 1 July 2020. The current National Rural Health Commissioner, Professor Ruth Stewart, was appointed on 3 July 2020 for a two year term.

 

The expanded National Rural Health Commissioner Office now includes two Deputy Commissioners to support the Commissioner and provide expertise across a range of vital rural health disciplines such as nursing and allied health.

 

Funding for the Commissioner’s Office includes an investment of $2.5 million over four years from 2020-21 for the PRIMM program, to enable the development of community-supported models of care to a point where they are ready to trial. This investment complements the Innovative Models of Primary Care to Address Rural Workforce Shortages measure, which was announced as part of the 2020-21 Budget. Rural health workforce and communities living in rural and remote areas benefit from the development and implementation of innovative models of primary care and the improvements to the delivery of health services in their region.

 

The Commissioner has actively supported the ongoing rural response to COVID-19, advised on the impact on the health workforce in regional, rural and remote Australia, and continues to support implementation of the National Rural Generalist Pathway.

 

Strengthening Primary Care - National Rural Generalist Pathway

 

As part of the 2019-20 Budget, the Government committed $62.2 million to commence development of the National Rural Generalist Pathway (the Pathway) – a medical training pathway to attract, retain and support doctors in regional, rural and remote areas. This funds three core initiatives:

 

• creation of Coordination Units in each State and the Northern Territory for rural generalist training
• an expansion of the Rural Junior Doctor Training Innovation Fund to support the Pathway
• application to the Medical Board of Australia for specialist recognition of Rural Generalist Medicine within the specialty of General Practice.

 

The National Rural Health Commissioner plays a key role supporting implementation of the Pathway.

 

Rural Generalists are general practitioners who provide primary care, as well as emergency medicine and other specialist services in regional, rural and remote areas. Growing a Rural Generalist workforce will broaden the range of locally available medical services for rural Australians, supporting these communities to access the right care, in the right place, at the right time, as close to home as possible.

 

Strengthening Primary Care – Extension of the Rural Health Workforce Support Activity

 

The Australian Government is investing $53.4 million over two years from 2020-21 to extend the Rural Health Workforce Support Activity administered by Rural Workforce Agencies. The program:

 

• Supports quality, continuous primary health care access for rural and remote communities
• Contributes to addressing health workforce shortages and misdistribution through workforce assessment and planning
• Provides a contemporary and jurisdictional approach to the specific issues and concerns in attracting, retaining training and supporting the health workforce.

 

Strengthening Primary Care – Health Workforce Scholarship Program

 

The Australian Government has invested $33 million over three years from 2020-21 for the Health Workforce Scholarship Program (HWSP). The HWSP aims to increase access to health services in rural and remote areas that are experiencing skill shortages, by providing scholarships and bursaries to health professionals committed to rural service.

 

Scholarships and bursaries are prioritised to address local needs and increase the skills, capacity and/or scope of practice of existing health professionals. Most scholarship types also include a return of service obligation to provide a greater return on investment.

 

Strengthening Primary Care – Remote Vocational Training Scheme

 

Australians living in rural Australia will have better access to doctors with the expansion of the Remote Vocational Training Scheme (RVTS) Targeted Recruitment Pilot. The Government has agreed to additional funding for RVTS in 2021 to provide salary incentives to the doctors as they train towards GP Fellowship. The scheme delivers structured distance education and supervision to doctors while they provide medical services in Aboriginal and Torres Strait Islander communities and rural and remote locations throughout Australia. The pilot aims to assist in the provision of medical services to regions that have had difficulty in recruiting doctors and have been identified as having a high medical workforce need. 

 

Guaranteeing Medicare – Rural Procedural Grants Program

 

The Government provides more than $19 million each year to the Rural Procedural Grants Program. This program enables vocationally recognised procedural GPs and registrars practising in rural and remote locations to access grants to attend training and up-skilling in emergency and procedural medicine. Grants are also available for GPs working in emergency medicine to maintain their skills in emergency mental health. The Government is also exploring options to streamline and expand the scope of this program.

 

Guaranteeing Medicare – Rural Health Multidisciplinary Training Program Infrastructure

 

The Government is investing $48.3 million over three years from 2021–22 in the long‑standing Rural Health Multidisciplinary Training (RHMT) Program. This investment builds the rural training pipeline for health students, with a focus on allied health students to deliver health, aged care and disability services in rural communities. The RHMT program has a direct economic benefit to communities and regions: for every dollar spent under the RHMT program, another dollar is generated in the local economy.

 

The package provides for capital works and recurrent funding and includes:

 

• Funding one new University Department of Rural Health (UDRH) to increase RHMT coverage.
• Funding up to seven projects through existing UDRHs to increase training in more remote settings from large rural towns (MM3) through to Modified very remote communities (MM7).
• Funding up to seven projects through existing UDRHs to partner with aged care services to provide dedicated teaching spaces focusing on the training of allied health and nursing students.
• Funding a feasibility study to identify best approaches to increase dental and oral health training in regional locations.

 

Guaranteeing Medicare and Access to Medicines – Rural, Regional and Remote Clinical Trial Enabling Infrastructure Program

 

The Australian Government is investing $125 million from 2020-21 to 2024-25 to improve access to innovative clinical trials for Australians living in rural, regional and remote areas. The Rural, Regional and Remote Clinical Trial Enabling Infrastructure Program removes barriers to participating in clinical trials by:

 

• improving facilities, equipment, services and systems in rural, regional and remote Australia
• reducing the burden, costs and risks for patients and their families related to clinical trial participation
• increasing research capacity.

 

This grant program, funded under the Medical Research Future Fund (MRFF), is giving patients access to clinical trials where they live.

 

Guaranteeing Medicare – Remote Area Health Corps program 

 

The Government is providing $18.7 million from 2019-20 to 2021-22 to continue the Remote Area Health Corps (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, by addressing identified workforce shortages. The RAHC program provides short-term placements of 3 to 12 weeks of urban health professionals in remote health clinics in the Northern Territory.

 

Guaranteeing Medicare - Seventh Community Pharmacy Agreement Rural Support Programs

 

The Government funds a range of rural and other pharmacy programs under the Seventh Community Pharmacy Agreement (7CPA) including the Rural Pharmacy Workforce Programs, which aim to support the recruitment, training and retention of pharmacists in rural and remote areas. The 7CPA Aboriginal and Torres Strait Islander Programs aim to support the Aboriginal and Torres Strait Islander pharmacy workforce, access to medicines and the quality use of medicines.

 

The 7CPA also outlines a shared intent to increase the investment in regional, rural and remote pharmacies through an increased investment in the Regional Pharmacy Maintenance Allowance (RPMA) program. This increase investment in the RPMA program was implemented 1 January 2021.

 

Guaranteeing Medicare - Section 100 Remote Area Aboriginal Health Service Program  

 

The Remote Area Aboriginal Health Services (RAAHS) Program enables people living in remote communities, who may have limited access to a community pharmacy, to access essential Pharmaceutical Benefits Scheme (PBS) medicines from their AHS upon consultation, at no cost and without a PBS prescription. In 2019-20, more than 1.7 million PBS items were supplied to approved RAAHS at a total cost of $39.3 million.

 

Guaranteeing Medicare – Intergovernmental Agreement on National Digital Health

 

The Australian Government is investing a further $32.3 million in 2021-22 to support the Government’s contribution to the 2018-2022 Intergovernmental Agreement on National Digital Health (the IGA). This investment will enable progress and completion of the commitments in accordance with the IGA, to ensure Australia’s national digital health infrastructure and interoperability principles can contribute to improving health system quality and safety, accountability, transparency and patient centred care. 

 

The IGA is signed by the Australian Government and State and Territory Governments and supports national digital health foundations including implementation of Australia’s National Digital Health Strategy - Safe, Seamless and Secure (the Strategy). Implementation of the Strategy supports capability (such as better enabling virtual care) that is leading to significant improvements in the quality and safety of healthcare provided to healthcare recipients, the efficiency of the Australian health system and the health and wellbeing of all Australians. This is of particular importance for regional Australians as digital tools continue to support the delivery of safe, quality healthcare services and outcomes irrespective of geographical barriers.

 

Guaranteeing Medicare – Funding for Regulation of Medicinal Cannabis Research, Cultivation and Manufacture with Charging Consistent with the Australian Government Charging Framework

 

The Australian Government is investing $1.7 million in additional funding from
2020-21 to 2023‑24 for the regulation of the Medicinal Cannabis Scheme (the Scheme) under the Narcotic Drugs Act 1967, which allows for the cultivation, production and/or manufacture of cannabis for medicinal or research purposes.

 

This measure provides a direct benefit to regional Australian businesses providing funding to subsidise the costs of travel for inspections that are associated with an application. This approach was taken to ensure that companies located in regional Australia are not unfairly impacted by higher costs that often result from travel to regional and remote communities.

 

This measure also supports the Government’s commitment to growing local industry by prioritising medicinal cannabis projects that make a significant contribution in the areas of supply to the domestic market, exports and industry development. Up to
5,000 direct and indirect jobs in regional areas can be attributed to the Scheme.

 

Stronger Rural Health – guaranteeing rural and remote access to dental, mental health service and emergency aeromedical services through the Royal Flying Doctor Service

 

The Government is providing more than $327 million over four years (2018–19 to 2021‑22) for the RFDS to provide a range of primary care and outreach services, including mental health services, in rural and remote areas beyond the normal medical infrastructure and in locations of market failure. Locations for these services are determined through a comprehensive needs assessment process undertaken by the RFDS in consultation with local communities and health care providers. Approximately $20.4 million of the total funding is being provided for mental health services in rural and remote Australia.

 

Stronger Rural Health – Heart of Australia

 

The Government is supporting regional, rural and remote Australians to access cardiac investigation, diagnosis and consultation services through Heart of Australia. Two mobile specialist clinics – Heart 1 and Heart 2, deliver services across Queensland. The Government is providing $12 million over three years to 30 June 2022 to further expand the operational capacity of the mobile health clinics and support the purchase and fit out of a third government-funded mobile clinic (Heart 4). Heart 4 was launched on 29 April 2021.

 

Supporting Our Hospitals – Block Funding for Small Rural and Regional Hospitals

 

The Australian Government, together with the State and Territory governments, signed the Addendum to the National Health Reform Agreement for the years 2020-21 to 2024‑25 which will provide an additional $33.6 billion for public hospitals.

 

Under the new five year Addendum, the Government is investing an estimated $6.1 billion over five years from 2020-21 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.

 

Supporting Our Hospitals – Community Health and Hospitals Program and other 2019-20 Budget Measures

 

The Government is investing $1.25 billion over seven financial years from 2018-19 in the Community Health and Hospitals Program (CHHP), in addition to more than $669 million through other 2019‑20 Budget measures to fund projects and services in every State and Territory, to support patient care while reducing pressure on community and hospital services. Through delivery of the 92 CHHP and 60 other 2019‑20 Budget measures projects, $204.9 million and $92.7 million, respectively, is committed in the 2021-22 financial year and will provide improved health facilities and services in a number of regional and remote communities.

 

The CHHP program emphasises a commitment to ensuring a high quality, sustainable health system, with investment in public hospitals, Primary Health Networks, community organisations and other health providers, to ensure all Australians can access health services where and when they need them.

 

Over 50 per cent of the projects funded through the CHHP and other 2019-20 Budget Measures contribute to infrastructure and services in rural and regional areas to support health priorities such as cancer, palliative care, eating disorders, chronic disease, injury, mental health, maternal and paediatric services and hospital infrastructure.

 

Ageing and Aged Care – Commonwealth Continuity of Support Programme and Disability Support for Older Australians – funding to older people with disability

 

The Disability Support for Older Australians (DSOA) Program replaces the Commonwealth Continuity of Support (CoS) Programme from 1 July 2021. The Australian Government is investing an additional $125.3 million over 2020-21 to 2023‑24 to meet the growing demand from providers and consumers for funding higher needs.

 

With this increased funding, the DSOA program will deliver a more client-centred program to around 3,600 clients. 

 

Both CoS and DSOA are closed programs that support older people with a disability who were in state administered care and not eligible for the National Disability Insurance Scheme.

 

Providers in regional areas for these programs will continue to deliver specialist disability services to clients in their local region. Maintaining providers in regional areas provides more choice to those clients.

 

Fighting Cancer – Regional Cancer Treatment Centres for Radiation Therapy

 

Through the Fighting Cancer – Regional Cancer Treatment Centres for Radiation Therapy program, the Australian Government is investing $45.5 million over five years from 2020-21 to expand cancer treatment capacity throughout regional Australia by enhancing existing and investing in new health infrastructure.

 

The objectives of the program are to:

 

• Work in partnerships to improve and update health infrastructure in rural and regional Australia
• Provide improved access to health facilities and services in a number of regional and remote communities.

 

The Government will work in collaboration with States and Territories and the broader health sector to ensure the health infrastructure for regional cancer treatment centres provide improved access to radiation therapy services and treatment closer to home for patients living in regional areas. Funding will enable the establishment of new radiation therapy services across ten regional areas within New South Wales, Queensland, Victoria and South Australia.

 

Funding and activities for this program will commence in 2020-21 with $9.8 million to be paid upon execution of funding agreements, followed by $8.9 million allocated each year from 2021-22 to 2023-24 and $9 million in 2024-25.

 

Preventive Health – Implementation of Roadmap for Hearing Health

 

The Australian Government is investing $21.2 million over five years from 2020-21 to implement measures from the Roadmap for Hearing Health and adjust Hearing Services Program settings to ensure consumer focused hearing services for all Australians.

 

The measure benefits all Australians who are hard of hearing. It includes:

 

• Supporting rural service delivery through a workforce audit and a rural hearing health workforce summit, to improve long-term planning and delivery of services in rural and remote areas.
• A national hearing awareness and prevention campaign over three years from 2020‑21, targeted at populations most vulnerable to hearing loss. The campaign focuses on the prevention of avoidable hearing loss, promoting practices to prevent hearing damage, destigmatising hearing loss, and encouraging people experiencing hearing loss to seek treatment, and targeted preventive messaging directed at the agricultural sector amongst others.
• Development and adoption of new tele-audiology standards so hearing services can be delivered through this medium without compromising the outcomes for clients.  For regional Australians this will mean less travel and related costs to hearing appointments.
• In 2020-21 work has been undertaken to improve early identification of hearing and speech difficulties for Aboriginal and Torres Strait Islander children. A total of $2 million has been made available to provide quiet spaces in Aboriginal Community Controlled Health Services suitable for audiologists to provide hearing assessments. A further $3 million has been provided to Hearing Australia to implement the Listen to Learn Program which will focus on children in the Early Childhood Education and Care and Primary School settings. Staff will be upskilled to identify hearing and communication problems and take early action.
• Pilot initiatives in the aged care sector have commenced, to improve the capability of the aged care workforce to support people with hearing loss.

 

The National Health and Medical Research Council (NHMRC), has been engaged to develop an evidence base for effective treatment, service delivery and prevention of hearing loss. In 2020-21, the NHMRC conducted consultations with key stakeholders of the hearing health sector and researchers to identify research gaps and priorities. The outcomes of the consultations will inform grant guidelines for a peer reviewed competitive grant opportunity to be open in early 2021-22.

 

Preventive Health – Aboriginal and Torres Strait Islander Hearing Health

 

The Australian Government is investing $9 million in 2021-22 for the Hearing Assessment Program – Early Ears Program. Announced in the 2018-19 Budget, this initiative provides $30 million over 2018-19 to 2021-22 for audiology assessments and follow up treatment for Aboriginal and Torres Strait Islander children before they start school.

 

Additionally, under the National Partnership Agreement on Northern Territory Remote Aboriginal Investment (NTRAI), $4 million is provided in 2021-22 to reduce the prevalence of ear disease and hearing problems for Aboriginal and Torres Strait Islander children in the Northern Territory. Total investment for hearing health under the NTRAI is $33.4 million over 10 years from 2012-13 to 2021-22.

 

Medical Research – Intergenerational Health and Mental Health Study

 

The Australian Government is funding the Australian Bureau of Statistics $89.5 million from 2020-21 to 2022-23 to undertake the Intergenerational Health and Mental Health Study (IHMHS).  

 

The IHMHS is the largest health study undertaken in Australian history. It will provide the most complete picture of Australia’s physical and mental health. The IHMHS will cover mental health, health status, conditions, risk factors, nutrition, physical activity and biomedical health status for both the general population and specifically for the population of Aboriginal and Torres Strait Islander peoples.

 

The IHMHS will include four national studies:

 

• National Study of Mental Health and Wellbeing
• National Health Study – including the National Health Survey and the National Aboriginal and Torres Strait Islander Health Survey
• National Nutrition and Physical Activity Study – including the National Nutrition and Physical Activity Survey and the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey
• National Health Measures Study – including the National Health Measures Survey and the National Aboriginal and Torres Strait Islander Health Measures Survey.

 

Approximately 60,000 Australians in urban, rural, remote, very remote areas and Indigenous communities will be included in study components.

 

The information collected by the IHMHS will enable the Government to monitor changes in health conditions and behaviours over time of all Australians including those that live in regional, rural and remote areas. 

 

Medical Research – Medical Research Future Fund

 

As part of the 2019-20 Budget, the Government committed to a $5.1 billion Medical Research Future Fund (MRFF) 10-year investment plan across four themes: Patients, Researchers, Missions and Translation.

 

The impact of location on access to health care and outcomes is acknowledged in the MRFF’s Australian Medical Research and Innovation Strategy 2016–2021, and health and medical research investment to support better rural health outcomes has been embedded in a range of MRFF open and competitive grant opportunities through the 10-year investment plan. This includes the MRFF:

 

• 2020 Rapid Applied Research Translation Grant Opportunity, which will provide up to $27.5 million for translational health and medical research conducted by organisations based in rural areas
• 2020 Primary Health Care Research Data Infrastructure Grant Opportunity, which includes a dedicated funding stream for research based in rural-led General Practices.

 

It is anticipated that all Australians will benefit from the outcomes of research funding by the MRFF both in terms of improved health outcomes through access to new therapies, drugs and devices and the associated outcomes through access to business that follows the translation and commercialisation of research.