The devil, as they always say, is in the detail. A Keen Observer has been looking at some of the devilish detail in the health budget papers, and provided Croakey readers with these observations:
• How much money will be left in the Health and Hospitals Fund (HHF) after tonight’s budget? Just under three billion was allocated over the Forward Estimates (FE) in the 2009-10 Budget (a total of five billion was allocated).
This Budget has allocated (over the FE, all in millions) $749m under the national significance component, $758m for both regional priority rounds, $817m for cancer and $71m for translation research. By my calculations that is around $2.4 billion. The Budget papers mention some funding outside the FE for the HHF but are silent on where this will come from. The original intention was that the HHF would be ‘topped up’ when the Budget returns to surplus.
• National Healthcare Specific Purpose Payments (SPP) will change to National Health Reform funding in 2012-13.
• The viability supplement for aged care is likely to be welcomed but may not be considered sufficient by some parts of the aged care sector. Significant funding for aged care in this Budget was always unlikely, as the Government does not receive the PC report about aged care until June 2011.
• Aged care workforce initiatives haven’t traditionally been overly successful and the implementation of programs either funded or administered by the ‘Aged Care Workforce Fund’ are likely to be viewed with interest. The key issue will be take-up as well as accountability and reporting
• Dementia advocates will probably argue that this Budget doesn’t go far enough
• Interesting that the language of ‘one stop shops for aged care’ that featured in the national health reform documents has disappeared. The concept is now called a ‘new front end’ for the aged care system (p. 180 of the Health and Ageing PBS)
• Extension of funding for consumer directed aged care packages – this is good policy, although it appears that is tightly controlled by DoHA (see p. 201 of the Health and Ageing PBS)
• The time to repay Zero Interest Real Loans has been doubled from 12 to 22 years – likely to be welcomed by the aged care industry (although those with loans under previous terms might not be too happy).
• What are the accountability and measures for the Long Stay Older Patients initiative? This measure has is often mentioned by Government as important to reforming the hospital sector but it is not clear if the funding is actually working and how many older patients have moved from hospital to more appropriate care. More initiatives have been announced in this Budget.
• It is not clear what is happening under Transition Care Program – it is being expanded to 4000 places in 2011-12 but no places will be allocated in 2011-12 (see p. 202 of the Health and Ageing PBS).
• Medicare Locals have another task to add to their list: the ‘Regionally tailored primary health care initiative’ to be administered through Medicare Locals (p. 212 of the Health and Ageing PBS).
• Reading between the lines it looks like the Dept of Health is taking some tentative steps towards fund holding for Medicare Locals with aged care (p. 211-12 of the Health and Ageing PBS).
• Consolidation of Practice Incentives Program (PIP) is likely to cause some protest! (p. 222 of the Health and Ageing PBS)