Department of Health Annual Report 2016-17

Outcome 2: Health Access and Support Services

Page last updated: 19 October 2017

Support for sustainable funding for public hospital services and improved access to high quality, comprehensive and coordinated preventive, primary and mental health care for all Australians, with a focus on those with complex health care needs and those living in regional, rural and remote areas, including through access to a skilled health workforce

Analysis of performance

In 2016-17, the Department continued working towards providing all Australians with access to preventive, primary and mental health care, with a particular focus on members of the community with complex health care needs and those living outside of metropolitan and urban areas. As part of this work, the Department has also continued to improve the capacity and quality of the health workforce.

The Department has made significant progress in implementing the Australian Government’s mental health reforms, including expanding the role of Primary Health Networks to lead mental health and suicide prevention planning at a regional level. A number of key outcomes were also achieved in the Department’s ongoing commitment to closing the gap by improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

These activities have contributed to the Department’s achievement of objectives under Outcome 2 and our Purpose.

Highlights

This icon depicts a head from the side with cogs in it.

Twelve suicide prevention trial sites established to deliver tailored mental health services

Each of the 12 trial sites will be administered by a local Primary Health Network and bring together community representatives, mental health primary care service providers, representatives of the education and emergency services sector, and State and Territory representatives to identify issues and deliver tailored services at the local level.
Refer Program 2.1

This icon depicts an eye.

The gap in vision is closing for Indigenous Australians

Through improved access to early screening and clinical services, blindness and vision impairment among Aboriginal and Torres Strait Islander peoples has reduced from six times that of non-Indigenous Australians in 2008 to three times that of non-Indigenous Australians in 2016.
Refer Program 2.2

This icon depicts a medical building.

Increased opportunities for medical students to continue training in regional and rural communities

Twenty-six regional training hubs have been established to help retain medical students in regional and rural communities. The training hubs will work collaboratively with health services, medical colleges and other medical and education training stakeholders to develop training pathways which will enable more training to be undertaken in regional and rural Australia.
Refer Program 2.3

This icon depicts a folded ribbon.

Saving lives through early detection of bowel cancer

Additional age cohorts were invited to screen under an accelerated transition to biennial screening for people aged 50­–74. It is estimated that the National Bowel Cancer Screening Program will prevent over 90,000 bowel cancer cases and 59,000 deaths from 2015 to 2040.5 Increasing participation rates, in line with current projections, will have an even greater impact, with the potential to prevent up to 84,000 deaths by 2040.
Refer Program 2.4

This icon depicts three medical buildings.

Improving primary health care services

The 31 Primary Health Networks have commissioned new services to meet the needs of their communities. They have supported general practice and other primary care providers, particularly to increase uptake of digital health, immunisation and cancer screening.
Refer Program 2.5

Looking ahead

  • The Head to Health website will be launched giving Australians easy access to mental health advice and resources.
  • The National Cancer Screening Register will be in place to support the renewal of the National Cervical Screening Program and the expansion of the National Bowel Cancer Screening Program.
  • The Department will lead key activities that focus on palliative and end-of-life care. This will include updating the National Palliative Care Strategy, in collaboration with States and Territories, and developing a national implementation plan.
  • The Department will continue to support the Government to address the impact of cancer in children and young people through a range of initiatives, including support for adolescents and young adults with cancer and supporting CanTeen to continue to deliver the Government’s Youth Cancer Services Program.
  • Together with State and Territory Governments, the Department will continue to promote and support breastfeeding in Australia, through the production of a National Enduring Breastfeeding Strategy.

Purpose, programs and program objectives contributing to Outcome 2

Purpose
Lead and shape Australia’s health and aged care system and sporting outcomes through evidence-based policy, well targeted programs, and best practice regulation.
Investing in more and better coordinated services for people with mental illness
Performance criteria from the 2016-17 Corporate Plan
Improving access to comprehensive and culturally appropriate health care in areas of need
Reducing chronic disease
Improving child and maternal health
Performance criteria from the 2016-17 Corporate Plan
Increasing the capacity and effectiveness of training and education for the future health workforce
Redesigning the supply of, and support for, health professionals in rural, regional and remote Australia
Improving access to health services for rural Australians
Performance criteria from the 2016-17 Corporate Plan
Reducing the incidence of chronic disease and complications, and promoting healthier lifestyles
Supporting the development and implementation of evidence-based food regulatory policy
Improving early detection, treatment and survival outcomes for people with cancer
Improving access to high quality palliative care services for all Australians
Reducing harm to individuals and communities from misuse of alcohol, pharmaceuticals and use of illicit drugs
Reducing the harmful effects of tobacco use
Performance criteria from the 2016-17 Corporate Plan
Focussing investment in frontline medical services for patients through Primary Health Networks
Improving models of primary care
Establishing the Primary Health Care Development Program
Providing general practice incentive payments
Supporting the States and Territories to deliver efficient public hospital services
Improving health services in Tasmania
Supporting the Mersey Community Hospital
Performance criteria from the 2016-17 Corporate Plan

Program 2.1: Mental Health

The Department met or substantially met all performance targets related to Program 2.1: Mental Health.

Significant work was undertaken to implement the Government’s mental health reform agenda, with a number of key achievements being reached.

From 1 July 2016, Primary Health Networks commenced commissioning mental health and suicide prevention services, within a stepped care model, to deliver the level and type of care that meets the needs of consumers through integrated regional services.

Twelve suicide prevention trials were established in 11 Primary Health Networks to respond to the increasing number of suicides across Australia.

To allow for a greater level of consumer feedback, there was a delay in launching the Head to Health website. A first draft of the website was co-designed with key stakeholders, and testing commenced seeking feedback from a range of intended users to inform its public release.

The Fifth National Mental Health and Suicide Prevention Plan was developed through an extensive consultation process undertaken in conjunction with States and Territories and the mental health sector, including consumers and carers. It was endorsed by the Council of Australian Governments’ Health Council on 4 August 2017.

In 2017-18, the Government will deliver additional funding for community mental health, mental health research, assistance to prevent suicide at hotspot locations, and telehealth access for psychological services in rural and regional Australia.

Investing in more and better coordinated services for people with mental illness

Support Primary Health Networks to effectively implement reform activities and maximise use of the flexible funding pool.
Source: 2016-17 Health Portfolio Budget Statements, p. 60
2016-17 Target2016-17 Result
Transition of regionally delivered mental health and suicide prevention programs to the Primary Health Networks funding pool, to enable service commissioning to commence from July 2016.All 31 Primary Health Networks have been funded, and were commissioning services for a range of regionally delivered mental health and suicide prevention services from 1 July 2016.
Result: Met

The Government is providing $1.2 billion from 2016-17 to 2018-19 to Primary Health Networks to lead mental health and suicide prevention planning at a regional level.

Through a new flexible primary mental health care funding pool, Primary Health Networks will improve outcomes for people with or at risk of mental illness and/or suicide, in partnership with relevant services.

Support better coordination and integration of mental health and suicide prevention services at a national and regional level to improve consumer outcomes.
Source: 2016-17 Health Portfolio Budget Statements, p. 60
2016-17 Target2016-17 Result
Development of Primary Health Networks regional mental health and suicide prevention plans commenced by 30 June 2017.The Department has consulted with Primary Health Networks, States and Territories, peak bodies, carers and consumers on the draft regional planning guidance material. The majority of Primary Health Networks commenced their regional planning prior to 30 June 2017.
Result: Substantially met

Primary Health Network development of the Regional Mental Health and Suicide Prevention Plan is a pivotal element of broader mental health reform. The Department has decided to extend the timeframe in which Primary Health Networks are to submit their regional mental health and suicide prevention plans. This will align with the implementation of Primary Health Network training in the use of the National Mental Health Service Planning Framework and the release of the Fifth National Mental Health and Suicide Prevention Plan which includes a strong focus on regional planning.

Establish a new digital mental health gateway that promotes access to information, advice and digital mental health treatment.
Source: 2016-17 Health Portfolio Budget Statements, p. 60
2016-17 Target2016-17 Result
Early consultation with the digital mental health sector in the design, development and delivery of the gateway to be completed by 31 August 2016.Substantial early consultation and development was completed by August 2016. A test version was released to stakeholders in March 2017, with the public release of the Head to Health website being delayed by Government until the last quarter of 2017.
Result: Substantially met

Throughout 2016-17, the Department undertook substantial consultation on the design and development of Head to Health. This included:

  • more than 20 site visits with service providers and academics;
  • two discovery workshops with more than 40 people;
  • 11 meetings of the Digital Mental Health Advisory Committee;
  • 11 co-design workshops across Australia with 129 participants; and
  • engagement with a Core Community Group of 20 members with lived experience of mental illness and carers as subject matter experts.

The Department is now in the process of seeking feedback on the website from a diverse range of people prior to its release to the public in the last quarter of 2017. The decision to delay the launch of Head to Health ensures a better, more fit-for-purpose product to be released, through a greater level of feedback and consumer testing.

Performance criteria from the 2016-17 Corporate Plan

Reduction in the proportion of adults with very high psychological distress.
Source: 2016-17 Department of Health Corporate Plan, p. 25
Future data will be captured as part of the Australian Health Survey and will be published by the Australian Bureau of Statistics (ABS).

Program 2.2: Aboriginal and Torres Strait Islander Health

The Department met the majority of performance targets related to Program 2.2: Aboriginal and Torres Strait Islander Health.

The Department is making significant progress improving Aboriginal and Torres Strait Islander Health outcomes, however, despite a 15 per cent reduction in mortality rates between 1998 and 2015, there have been no significant gains made against the Closing The Gap target in life expectancy by 2031.

There has also been a 33 per cent decline in Indigenous child mortality between 1998 and 2015. The target to halve the gap in child mortality by 2018 has been on track in previous years; however, the 2016 Indigenous child mortality rate was slightly outside the range required for this target to be on track this year.

The Department continues to work with Aboriginal and Torres Strait Islander peoples to accelerate our progress through the delivery of culturally appropriate primary health care and targeted programs.

The prevalence of blindness and vision impairment among Aboriginal and Torres Strait Islander peoples has reduced from six times that of non-Indigenous Australians in 2008 to three times that of non-Indigenous Australians in 2016. These results are due to: more Indigenous Australians having the recommended annual eye check; the number of outreach optometry services almost tripling; and cataract surgery rates increasing significantly. Through improved screening and treatment, trachoma prevalence has reduced from 14 per cent in 2009 to less than five per cent in 2016.

In 2016-17, the Department continued working in partnership with the Indigenous community to improve health outcomes for Aboriginal and Torres Strait Islander peoples. In September 2016, the Implementation Plan Advisory Group (IPAG) was established to provide a forum for Government to work in partnership with Aboriginal and Torres Strait Islander health leaders to review, assess and guide action under the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023. The role of the IPAG is to review progress, assess action and identify emerging policy and strategic issues for the Implementation Plan, as well as provide advice to the Department and the Department of the Prime Minister and Cabinet.

In August 2016, the Australian Health Ministers’ Advisory Council (AHMAC) endorsed the National Framework for Health Services for Aboriginal and Torres Strait Islander Children and Families to guide the development, implementation and evaluation of maternal, child and family health services for Aboriginal and Torres Strait Islander peoples across Australia.

The Framework was developed in collaboration with community leaders and a cultural advisory group. The Department consulted widely with Aboriginal and Torres Strait Islander communities across the country, listening to what they need, so services are delivered in the way that best suits the community.

The Framework provides guidance for policy and program design, and for the development and implementation of culturally appropriate services to meet the needs of Aboriginal and Torres Strait Islander peoples.

In October 2016, the Cultural Respect Framework 2016–2026 for Aboriginal and Torres Strait Islander Health was released by AHMAC. The Framework provides a guide for a national approach to support the delivery of culturally safe and responsive health care to Aboriginal and Torres Strait Islander peoples. The objective of the Framework is to improve health outcomes for Aboriginal and Torres Strait Islander peoples in a more timely, efficient and effective way, with a reduction in experiences of racism and discrimination and improved consumer and community satisfaction.

In June 2017, a new Network Funding Agreement was signed with the National Aboriginal Community Controlled Health Organisation (NACCHO). Through this agreement, NACCHO will form a collaborative network with its State and Territory counterpart organisations to support Aboriginal Community Controlled Health Services and strengthen links between the sector and mainstream health providers. The agreement will also support Aboriginal Community Controlled Health Services to improve their service delivery and assist mainstream health services in delivering accessible, responsive and culturally safe care to Aboriginal and Torres Strait Islander peoples.

In 2017-18, the Department will continue work to develop new and innovative approaches to better address the social and cultural determinants of health, which is expected to accelerate progress in closing the gap in health outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

Improving access to comprehensive and culturally appropriate health care in areas of need

Continue to implement actions in the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan (the plan) 2013–2023.
Source: 2016-17 Health Portfolio Budget Statements, p. 61
2016-17 Target2016-17 Result
Monitor and review progress against the plan in consultation with the Indigenous health sector.Progress against the deliverables and goals of the plan continue to be monitored and reviewed through the Implementation Plan Advisory Group and the 2017 Aboriginal and Torres Strait Islander Health Performance Framework.
Result: Met

Published in May 2017, the 2017 Aboriginal and Torres Strait Islander Health Performance Framework reports on progress against the 20 Implementation Plan goals for the first time. Of the 20 Implementation Plan goals, ten are currently on track, five are not on track, and five were unable to be assessed.

The results show that the Government is exceeding the immunisation targets for Indigenous one and five year olds. There have also been continued increases in the rates of Indigenous mothers accessing antenatal care.

While the rates of health assessments have increased over time across all the age groups, they currently fall below the trajectories required to be assessed as on track to meet the 2023 goal.

Number of Indigenous adult and child health checks completed.
Source: 2016-17 Health Portfolio Budget Statements, p. 61
2016-17 Target2016-17 Result2015-162014-152013-142012-13
189,394217,678
Result: Met
196,759171,786150,534122,161

All Aboriginal and Torres Strait Islander peoples are eligible for an annual Indigenous-specific health check. The health check includes an assessment of the patient’s physical health, as well as their psychological and social wellbeing. It also assesses what preventive health care, education and other assistance should be offered to the patient to improve their health and wellbeing. Early intervention and preventive care are crucial to delivering many long-term health and life expectancy goals.

Reducing chronic disease

Percentage of regular Aboriginal and/or Torres Strait Islander clients with type 2 diabetes that have had a blood pressure measurement result recorded at the primary health care service within the previous 6 months.
Source: 2016-17 Health Portfolio Budget Statements, p. 62
2016-17 Target2016-17 Result2015-162014-152013-142012-13
60–65%Data not available63%N/AN/AN/A

Data to support this performance criterion will be available in June 2018.

People with type 2 diabetes are more prone to high blood pressure, increasing the risk of other health conditions including stroke, heart disease and kidney disease. Regular blood pressure monitoring is important to reduce the consequences of diabetes.

Chronic disease related mortality rate per 100,000:
  • Aboriginal and Torres Strait Islander
  • Non-Aboriginal and Torres Strait Islander
  • Rate difference
Source: Source: 2016-17 Health Portfolio Budget Statements, p. 62
2015 Target2015 Estimated result62014201320122011
614–650
426–431
185–222
774.47
448.88
325.69
Result: Not met
756.5
447.4
309.1
784
449
335
898
451
447
N/A
N/A
N/A

Although there has been a statistically significant decline in Aboriginal and Torres Strait Islander rates of chronic disease mortality over the period 1998–2015, there has been no statistically significant change in the gap between the two populations. This is partly because the non-Indigenous rates in chronic disease mortality have declined faster than Indigenous rates.

Child 0-4 mortality rate per 100,000:
  • Aboriginal and Torres Strait Islander
  • Non-Aboriginal and Torres Strait Islander
  • Rate difference
Source: 2016-17 Health Portfolio Budget Statements, p. 62
2015 Target2015 Estimated result102014201320122011
107–158
78–89
23–76
163.611
75.012
88.613
Result: Not met
159.1
74.7
85.7
185
84
101
165
77
87
N/A
N/A
N/A

Indigenous child mortality rates have declined by 33% between 1998 and 2015, with the mortality gap also declining by 31% over the same period. Continued improvements in key preventive factors, such as access to antenatal care and reducing smoking during pregnancy, continue to be important contributors to declining rates. However, the most recent data put rates just outside the Closing the Gap target to halve the mortality rate of children under five by 2018, despite having been above the required trend since 2013. Less than satisfactory reductions in child mortality rates also alter the progress in reducing the gap in life expectancy.

Improving child and maternal health

Number of services funded to provide New Directions: Mothers and Babies Services.
Source: 2016-17 Health Portfolio Budget Statements, p. 63
2016-17 Target2016-17 Result2015-162014-152013-142012-13
124124
Result: Met
110858585

The Department continued working towards the goal of funding a total of 136 New Directions: Mothers and Babies Services (NDMBS) by 2018.

The NDMBS program provides Aboriginal and Torres Strait Islander families with young children access to: antenatal care; standard information about baby care; practical advice and assistance with breast-feeding; nutrition and parenting; monitoring of developmental milestones; immunisation status and infections; and health checks for children before starting school. The program is flexible to local needs and provides access to a broad range of child and maternal health functions as part of a broader primary health care service.

Number of organisations funded to provide Australian Nurse Family Partnership Program Services.
Source: 2016-17 Health Portfolio Budget Statements, p. 63
2016-17 Target2016-17 Result2015-162014-152013-142012-13
912
Result: Met
53N/AN/A

In 2016-17, an additional seven organisations were contracted to implement the Australian Nurse Family Partnership Program (ANFPP). Due to a staggered implementation approach, the Department was able to engage an additional three organisations earlier than anticipated. The goal of having 13 organisations supported will be achieved by 2018.

The ANFPP is a specialised nurse-led home visiting program that supports women pregnant with an Aboriginal and/or Torres Strait Islander child who may benefit from a more intensive level of support to improve their own health and the health of their baby. It is an evidence-based program that aims to improve pregnancy outcomes by helping women engage in good preventive health practices; support parents to improve their child’s health and development; and help parents develop a vision for their own future, including continuing education and finding work.

Performance criteria from the 2016-17 Corporate Plan

Halve the mortality gap for Indigenous children under five by 2018.
Source: 2016-17 Department of Health Corporate Plan, p. 24
Refer to performance criterion addressing the mortality gap for Indigenous children under four.
Increased average number of years a person could expect to live if they experienced the age/sex specific death rates that applied at their birth throughout their lifetime.
Source: 2016-17 Department of Health Corporate Plan, p. 24
This performance criterion is supported by data from the Australian Bureau of Statistics, which is reported each year with a two year data lag. Data for 2016-17 will be available in 2019.

Life expectancy estimates continue to improve in Australia. This increase can be attributed to factors such as improved health services, safer working environments and advances in medical technology.
Reduction in presentation of Type 2 diabetes.
Source: 2016-17 Department of Health Corporate Plan, p. 24
In 2014-15, an estimated 1.2 million (5.1%) Australians had diabetes, an increase from 4.5% in 2011-12.14The majority of these (85%) had type 2 diabetes and 15% had type 1 diabetes.15

In 2014-15, non-Indigenous Australians, compared with Indigenous Australians were:

  • 3.5 times as likely to have diabetes (3.3 times as likely in 2011-12);
  • 4.0 times as likely to be hospitalised for diabetes; and
  • 4.0 times as likely to die from diabetes.
Improved equity and access to health care.
Source: 2016-17 Department of Health Corporate Plan, p. 24
Indigenous Australians have a lower life expectancy, higher rates of chronic and preventable illnesses, and poorer self-reported health than non-Indigenous Australians. Similarly, Australians living in rural and remote areas tend to have shorter lives and higher rates of disease and injury than their major cities counterparts.16 For more information about initiatives supporting improvement in equity and access to health care for Indigenous Australians and Australian’s living in rural and remote areas, refer Program 2.2: Aboriginal and Torres Strait Islander Health, p. 65 and Program 2.3: Health Workforce p. 70.

Program 2.3: Health Workforce

The Department met the majority of performance targets related to Program 2.3: Health Workforce.

In 2016-17, the Government invested in a Specialist Training Program extending vocational training for specialist registrars to provide services to the community during their training. The investment in this program is to expand training capacity helping to meet community needs for specialist medical services.

Additionally, the Commonwealth Medical Internships program has increased clinical training capacity nationally for junior doctors expanding their training into private hospital settings, including regional locations, growing the medical workforce and improving access and service delivery for patients.

The Department continues to support long-term rural medical clinical training placements which aim to increase the number of appropriately qualified doctors working in rural, regional, and remote Australia.

Three new University Departments of Rural Health (UDRH) were established in Broome, Toowoomba and Wagga Wagga, adding to the 12 existing UDRH. This expansion will provide increased rural practice opportunities for nursing, midwifery and allied health students.

The Health Workforce Data website17 was launched in January 2017. The website provides stakeholders and the public with access to the National Health Workforce Dataset, reports and summary tables for the health workforce in Australia. The website allows users to generate tables and graphs for individual health professions by demographic, geographic and employment characteristics. Users can also analyse data across all the registered professions according to their area(s) of interest. The health workforce data tool enables users to better understand and plan the health workforce of Australia.

The Department managed the redesign of the Rural Workforce Agencies Program to deliver better health outcomes for people living in regional, rural and remote communities. Through the program the network agencies will undertake activities to meet community needs, and health workforce demands, in regional,
rural and remote Australia. The agencies will focus on enabling access to essential primary health care,quality of access and future workforce planning.

In 2017-18, the Department will further implement the 2015-16 Mid-Year Economic and Fiscal Outlook measure Integrated Rural Training Pipeline and increase training opportunities in rural areas with investment in a Rural Junior Doctor Training Innovation Fund. The Rural Health Multidisciplinary Training Program will continue to deliver high quality rural clinical training placements for medical, nursing, midwifery and allied health students, building on the expansion of the program.

Increasing the capacity and effectiveness of training and education for the future health workforce

Establish a grants program for professional entry nursing, midwifery and allied health students to undertake clinical placements in the private and non-government sectors.
Source: 2016-17 Health Portfolio Budget Statements, p. 64
2016-17 Target2016-17 Result
Implement a grants program for professional entry nursing, midwifery and allied health students to undertake clinical placements in the private
and non-government sectors commencing in semester one 2017.
Following a decision of Government this initiative will not be proceeding. Instead, the Government is focussing its investment on distribution of health workforce in rural and remote areas with the continued support of the Rural Health Multidisciplinary Training Program.
Result: Not met

Through the University Departments of Rural Health, there has been a doubling of the support provided to expand clinical training capacity for nursing, midwifery and allied health students in rural and remote Australia.

Number of commencing GP trainees funded through the Australian General Practice Training Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 64
Academic Year 2016 TargetAcademic Year 2016 Result2015201420132012
1,5001,500
Result: Met
1,5001,1921,1081,000

In total, 1,500 new GP registrars commenced training across Australia with at least 50% of all Australian General Practice Training Program training being undertaken in rural, regional and remote locations.

Number of medical internship positions funded through the Commonwealth Medical Internships Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 64
Academic Year 2016 TargetAcademic Year 2016 Result2015201420132012
≤100100
Result: Met
100N/AN/AN/A

Medical students must complete a medical internship to obtain full registration as a general medical practitioner in Australia. The Commonwealth Medical Internships Program provides medical internships for Australian-trained international full-fee paying medical students. The program was established in partnership with the private sector to increase the number of internships available in Australia.

Number of training positions funded through the Specialist Training Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 64
Academic Year 2016 TargetAcademic Year 2016 Result2015201420132012
900900
Result: Met
900900750600

The Specialist Training Program seeks to extend vocational training for specialist registrars into settings outside traditional metropolitan teaching hospitals, including regional, rural and remote and private facilities. The Specialist Training Program is delivered through 12 specialist medical colleges under funding agreements with the Department.

Redesigning the supply of, and support for, health professionals in rural, regional and remote Australia

Implementation of the Integrated Rural Training Pipeline for Medicine measure.
Source: 2016-17 Health Portfolio Budget Statements, p. 65
2016-17 Target2016-17 Result
Regional training hubs selected through a competitive process by 1 January 2017.A competitive process was conducted in late 2016. 26 regional training hubs will be established across rural and regional Australia, with implementation to commence in mid-2017.
Result: Met

The regional training hubs will enable students to continue rural training past university into postgraduate medical training. The hubs will work with local health services to help medical students continue their training through university into postgraduate medical training, and then working within rural Australia.

Percentage of medical students participating in the Rural Health Multidisciplinary Training Program – 1 year rural clinical placement.
Source: 2016-17 Health Portfolio Budget Statements, p. 65
Academic Year 2016 TargetAcademic Year 2016 Result2015201420132012
>25%34%
Result: Met
33%33%33%32%

The Government continues to support the Rural Health Multidisciplinary Training Program.

In the 2016 academic year, 992 graduating medical students spent a year or more at a rural clinical school, representing 34% of graduating medical students.

Number of weeks of rural multidisciplinary placements supported through the Rural Health Multidisciplinary Training Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 65
Academic Year 2016 TargetAcademic Year 2016 Result2015201420132012
20,38433,000
Result: Met
24,290N/AN/AN/A

In the 2016 academic year, 12 University Departments of Rural Health, under the Rural Health Multidisciplinary Training Program, supported over 7,000 undergraduate students to undertake rural clinical placements of two weeks or longer, comprising around 33,000 placement weeks.

This result has exceeded the Department’s target. The significant increase in placement weeks was achieved following the Government’s decision to double the support provided to expand clinical training capacity for nursing, midwifery and allied health students in rural and remote Australia. This is in addition to new funding for the establishment of three new University Departments of Rural Health in areas that are not serviced by the existing network. These decisions were part of the Government’s Building a Health Workforce for Rural Australia initiative, announced in the 2015-16 Mid-Year Economic and Fiscal Outlook.

Number of practices supported through the Practice Nurse Incentive Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 65
2016-17 Target2016-17 Result2015-162014-152013-142012-13
4,1005,487
Result: Met
4,5944,3384,2363,978

The Practice Nurse Incentive Program (PNIP) is a demand-driven program that provides incentive payments to practices to support an enhanced role for nurses working in general practice. Uptake of the PNIP has been steadily increasing since commencement in 2012.

Urban areas account for approximately 50% of participating PNIP practices. Rural and remote incentive payments attract a rural loading of up to 50%, depending on rurality to encourage uptake in non-urban areas.

Improving access to health services for rural Australians

Strengthen the quality, capacity and training opportunities of the health workforce.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result
Implement a grants program for professional entry nursing, midwifery and allied health students to undertake clinical placements in the private and non-government sectors commencing in semester one 2017.Following a decision of the Government this initiative will not be proceeding. Instead, the Government is focussing its investment on distribution of health workforce in rural and remote areas with the continued support of the Rural Health Multidisciplinary Training Program.
Result: Not met

Through the University Departments of Rural Health, there has been a doubling of the support provided to expand clinical training capacity for nursing, midwifery and allied health students in rural and remote Australia. The three new University Departments of Rural Health that were established during the year will further support rural clinical training.

Establishment of the Health Workforce Program to strengthen the capacity of the health workforce.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result
Implementation of the new Health Workforce Program by 30 June 2016 with funding agreements to commence in 2016-17.The new Health Workforce Program was set up during 2015-16 to allow for commencement on 1 July 2016. Programs formerly under the Health Workforce Capacity and Primary Health Care (Rural Health Services) programs formally transferred to the Health Workforce Program on 1 July 2016.
Result: Met

The consolidation of the Government’s access quality and health workforce distribution programs under the single Health Workforce Program allows more transparency and better consideration of those programs.

Improve access to training scholarships for health professionals.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result
Through the delivery of scholarships by a single agency to the health workforce for the 2017 academic year.The new Health Workforce Scholarship Program (HWSP) combines previous scholarship schemes for the medical, nursing and allied health professions into a single program that achieves consistency in the application process, rules and obligations for all participants. Commencement of the HWSP was delayed until the second half of the 2017 academic year. At this time it is anticipated that the application process for scholarships will be commencing late in the 2017 academic year.
Result: Substantially met

While previous scholarship programs placed significant focus on undergraduates, the HWSP targets efforts toward further training for existing health professionals in rural, regional and remote Australia through support for up-skilling, continuing professional development and broadening scope of practice through post-graduate study. This scholarship support will bring training costs more in line with urban health professionals.

The Department delayed the commencement of the HWSP to enable a comprehensive consultation process and ensure the new program meets the needs of Australia’s health workforce. The design of the HWSP was finalised in early 2017 and a targeted, competitive Grant Opportunity was conducted.

A funding agreement was finalised with the new administrator, Rural Workforce Agencies (led by Health Workforce Queensland) in June 2017.

Medical specialist, GP, allied and other health services provided through the Rural Health Outreach Fund meet the needs of regional, rural and remote communities.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result
Organisations funded to support rural outreach will be guided by existing advisory forums and Indigenous Health Partnership forums, to identify community needs and better meet the needs of regional, rural and remote communities.Organisations funded through the Rural Health Outreach Fund (RHOF) undertook comprehensive consultation processes to identify and address community needs.
Result: Met

Organisations funded through the RHOF undertook needs assessment and planning for outreach services in consultation with a range of organisations including: local health services; State and Territory health departments; Aboriginal and Torres Strait Islander health organisations; and Primary Health Networks. These consultations were guided by Advisory Forums and Indigenous Health Partnership Forums to identify community needs.

Number of communities receiving outreach services through the Rural Health Outreach Fund.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result2015-162014-152013-142012-13
375484
Result: Met
515483460421

484 regional, rural and remote communities have received services under the Rural Health Outreach Fund. Targets have been exceeded due to jurisdictional fundholders undertaking ongoing reviews and streamlining of services to ensure they are delivered by the most efficient and effective means.

Number of patient contacts delivered through the Rural Health Outreach Fund.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result2015-162014-152013-142012-13
163,000225,865
Result: Met
247,455216,787190,460192,985

There were over 225,865 patient contacts under the Rural Health Outreach Fund.

Number of patient consultations at Royal Flying Doctor Service primary health clinics.
Source: 2016-17 Health Portfolio Budget Statements, p. 66
2016-17 Target2016-17 Result2015-162014-152013-142012-13
36,00044,325
Result: Met
34,35236,36542,60843,142

Over 44,000 patient consultations were conducted at Royal Flying Doctor Service primary health clinics. Through the clinics, patients are able to access a range of health care services including general practitioner, women or children’s health care nurse, population health and emergency care.

Performance criteria from the 2016-17 Corporate Plan

Increased ratio of nurses, GPs and specialists to population in regional and remote areas.
Source: 2016-17 Department of Health Corporate Plan, p. 25
Between 2001 and 2011 the number of General Practitioners, specialists and nurses increased an average of 3.1%, 4.8%, and 3.0% per annum.18

In 2014, there were 1,134 full-time equivalent nurses and midwives, 387 medical practitioners and 508 other health professionals employed for every 100,000 people.19

Full-time equivalent nurses and midwives and medical practitioners per 100,000 people in 2014

LocationsNurses and midwivesMedical practitioners
Major cities1,145437
Inner regional areas1,096292
Outer regional areas1,077272
Remote areas1,239264
Very remote areas1,233264

Program 2.4: Preventive Health and Chronic Disease Support

The Department met the majority of the performance targets related to Program 2.4: Preventive Health and Chronic Disease Support. However data were not available to report on some of the performance target for the program.

In 2016-17, the Department supported the Government in its ongoing efforts to increase cancer screening rates. Early detection and treatment saves lives. The National Bowel Cancer Screening Program and the National Breast Cancer Screening Program (BreastScreen Australia) both actively invited participation by eligible Australians. As well as saving lives, increased participation also has the potential to lead to savings for the health system, including from averted cancer treatment costs.

To support the renewal of the National Cervical Screening Program and the expansion of the National Bowel Cancer Screening Program, the Department is developing a National Cancer Screening Register. The national register was to be implemented by 1 May 2017. There was a delay in implementation due to the complexity of assimilating and migrating data from eight State and Territory cervical registers and the Department of Human Services data migration, into one register. The National Cancer Screening Register implementation schedule has been re-phased to incorporate cervical screening data by 1 December 2017 and bowel screening following in mid-2018.

In February 2017, all Health Ministers endorsed the National Strategic Framework for Chronic Conditions. The Framework was developed by the Australian Government, in partnership with States and Territories, to address the increasing prevalence and impact of chronic conditions in Australia. It forms the overarching policy for the prevention and management of chronic conditions in Australia. It moves away from a disease specific approach and provides guidance for the development and implementation of policies, strategies, actions and services to address chronic conditions, improve the health and wellbeing of individuals, and deliver a more sustainable health system.

A review of the mandatory folic acid fortification of wheat flour for bread making (in Australia) and mandatory iodine fortification of bread (in both Australia and New Zealand) was completed in 2017. The joint Food Regulation Standing Committee/Australian Health Ministers’ Advisory Council Mandatory Fortification Working Group, chaired by the Department, was established to oversee the review. The Department managed the contracts associated with the review.

Mandatory folic acid fortification was introduced to reduce the incidence of neural tube defects (NTDs) in Australia by improving the folate status of women of child bearing age. Mandatory iodine fortification was introduced to address the re-emergence of iodine deficiencies in the general populations of Australia and New Zealand. The review found that the policy objectives of the initiatives have been achieved. The mandatory folic acid fortification results showed that the rate of decline in NTDs was within the range predicted. A particularly significant decline was seen in the rate of NTDs among babies of teenage mothers, and of Aboriginal and Torres Strait Islander women.

For the first time, Australia has a long-term framework for reducing and preventing the harms associated with alcohol and other drugs through the agreement of a ten-year National Drug Strategy (NDS). The National Drug Strategy 2017–2026 continues the strong partnership between health agencies, law enforcement and justice agencies and represents the agreement of all governments on the policy priorities for the next ten years to build safe, healthy and resilient Australian communities. The Department was a key contributor in finalising the new NDS both through representation on the National Drug Strategy Committee (and its predecessor the Intergovernmental Committee on Drugs) and also the provision of secretariat support to the Ministerial Drug and Alcohol Forum.

In 2017-18, the Department will continue to support the provision of high quality palliative care in Australia through a range of National Palliative Care Projects. The Department will lead work, in collaboration with States and Territories, to develop a nationally agreed reporting mechanism to complement the National Strategic Framework for Chronic Conditions. The Department will also continue implementation of biennial screening under the National Bowel Cancer Screening Program. Three million people will be invited to screen in 2017-18 and all eligible Australians aged 50–74 will be invited to screen every two years by 2020. This will result in more people having bowel cancer detected as early as possible when it can be most successfully treated.

BreastScreen Australia – helping to save the lives of Australian women

This image, from the National Breast Screen Australia campaign, depicts four women holding an invitation to participate in the program.Launched in April 2015, the National BreastScreen Australia campaign is contributing to an increase in the number of older women undergoing free breast screenings which could save their lives.

The campaign was developed to improve the early detection of breast cancer. In 2013-14, $55.7 million was provided over four years to expand BreastScreen Australia’s target age range from women 50–69 years to women 70–74 years. In 2017-18 a further $64.3 million was provided over four years until 2020-21.

The campaign lets women know that the invitation for free breast screening has been expanded to include women aged 70–74 years. It encourages women to be screened every two years and where to call to make a screening appointment.

The risk of breast cancer increases with age, and by expanding the target age range to include these older women, BreastScreen Australia will deliver up to 220,000 additional screening services over four years and detect up to 600 additional breast cancers per year.

The campaign encourages women to act when they receive their free breast screening invitation every two years:

“… the letter kept staring at me so I decided to just get it over with. They found one lump close to my breast bone which fortunately hadn’t spread to the lymph nodes which was good news.” – Gladys, 77

“If I hadn’t have had the breast screen I wouldn’t have known I had cancer, I didn’t have any symptoms. If I hadn’t been prompted to go, I may not have gone for a few years. It could be the difference between me sitting here today and not sitting here at all.” – Rachel, 53

The campaign has been delivered over three phases, in April 2015, February 2016 and most recently February 2017. Advertising was online through paid search, digital display and social media as well as traditional channels including women’s magazines and newspapers.

The proportion of 70–74 year old women who took part in the BreastScreen Australia Program in 2014-15 was 48.7%. The campaign is expected to further increase participation rates in this age group.

Reducing the incidence of chronic disease and complications, and promoting healthier lifestyles

Implementation Plan for the Australian National Diabetes Strategy 2016–2020 developed in negotiation with jurisdictions.
Source: 2016-17 Health Portfolio Budget Statements, p68
2016-17 Target2016-17 Result
Australian National Diabetes Strategy 2016–2020 Implementation Plan finalised by the end of 2016.The Implementation Plan is expected to be finalised in the second half of 2017.
Result: Not met

The finalisation of the Implementation Plan has been delayed by a number of factors including: time taken to finalise the Australian Health Ministers’ Advisory Council cost-shared budget bid supporting this work; the comprehensive nature of the national stakeholder activity; and, following a consultation process, the need to comprehensively consider all stakeholder comments on the draft Implementation Plan. The development of the Implementation Plan has been informed by:

  • The Australian National Diabetes Strategy 2016–2020;
  • a national stocktake of diabetes related activities undertaken by all jurisdictions;
  • the report from the National Diabetes Strategy Advisory Group to the Minister for Health; and
  • the advice of all jurisdictions through the jurisdictional working group.
Australian Government nutrition policy is informed by evidence-based advice.
Source: 2016-17 Health Portfolio Budget Statements, p68
2016-17 Target2016-17 Result
Ongoing promotion and implementation of Australian Dietary Guidelines and Australian Guide to Healthy Eating.Australian Dietary Guidelines and Australian Guide to Healthy Eating were promoted and implemented in a variety of settings.
Result: Met

Australian Dietary Guidelines and Australian Guide to Healthy Eating informed nutrition programs such as the Health Star Rating front-of-pack labelling system, Healthy Weight Guide and Healthy Food Partnership. These resources were also promoted through the Eat for Health website20 and through brochures and posters.

The Health Star Rating campaign – inspiring positive behavioural change

This image, from the Health Star Rating campaign, shows a shopper holding two packets of cereal that display the Health Star Rating System.The Health Star Rating is a front-of-pack labelling system that assesses the nutritional profile of packaged food and assigns it a rating from a star to 5 stars. It provides a quick, easy, standard way to compare similar packaged foods (such as one breakfast cereal against another). The more stars, the healthier the choice.

Australia has one of the highest rates of obesity in the world, with 63.8% of Australians overweight or obese. Food plays a key role in health and wellbeing, but many Australians are struggling to maintain a balanced diet aligned with the Australian Dietary Guidelines. The Health Star Rating system is one of the many initiatives working to address this.

The campaign educates and encourages consumers to use the Health Stars to make healthier choices through a mix of advertising, public relations and online communication. The campaign also encourages industry uptake of the system.

The most recent campaign phase, partnered with social media influencers, was launched in February 2017. This successfully generated positive discussion and questions from consumers around the Health Star Rating system. For example:

“Oh wow! how does that work? I figure there’s a team of scientists that work this stuff out. Tell me what you’re thinking?” – Instagram user

“Find them really useful especially when buying things like muesli bars. So much hidden calories in some of the brands” – Instagram user

The most recent campaign evaluation showed an increase in consumer awareness and understanding of the Health Star Rating system, from 59% in June 2016 to 75% in April 2017, equating to 3 in 4 Australians.

The Health Star Rating system continues to increase positive behaviour change. The most recent campaign evaluation found that 20% of all consumers aged 18 and above had bought a product with a higher Health Star Rating than their usual product. This number increased to 46% of consumers who had reported seeing the latest campaign.

This image depicts the health star rating guide.
A National Strategic Framework for Chronic Conditions is developed in partnership with jurisdictions to guide chronic conditions policy and strategies into the future.
Source: 2016-17 Health Portfolio Budget Statements, p68
2016-17 Target2016-17 Result
The National Strategic Framework for Chronic Conditions is submitted for approval through the Australian Health Ministers’ Advisory Council process by the end of 2016.The National Strategic Framework for Chronic Conditions (the Framework) was submitted through the Australian Health Ministers’ Advisory Council approval process for its 2 December 2016 meeting. The Framework was endorsed by all Health Ministers in February 2017 and publicly released on 22 May 2017.
Result: Met

The Framework supersedes the National Chronic Disease Strategy 2005 and the associated national service improvement frameworks.

The Framework moves away from a disease specific approach and will provide high level guidance to enable all levels of Government and health professionals to develop future policies, strategies, actions and services to work towards delivery of a more effective and coordinated national response to chronic conditions and their risk factors. This will improve the health and wellbeing of individuals, and deliver a more sustainable health system.

Supporting the development and implementation of evidence-based food regulatory policy

Develop advice and policy for the Australian Government on food regulatory issues.
Source: 2016-17 Health Portfolio Budget Statements, p68
2016-17 Target2016-17 Result
Relevant, evidence-based advice produced in a timely manner.Relevant, evidence-based advice was produced in a timely manner.
Result: Met

The Department provided advice to the Australian Government in relation to food regulation issues such as maternal and infant nutrition, front-of-pack labelling, low tetrahydrocannabinol hemp in food, and labelling of food including health claims, which assisted in evidence-based policy decision making.

Throughout 2016-17, the Department commissioned consumer research on the outcomes of the implementation of key food regulation policies such as front-of-pack labelling, obtained and conducted data analysis of key reports such as the Australian Burden of Disease Study 2011 and Australia’s Health 2016 from the Australian Institute of Health and Welfare and the National Health Survey 2014-15 from the Australian Bureau of Statistics. These key reports were used to extract data and longer term trends to provide advice to Government and as evidence in formulating advice and policy development.

Promote a nationally consistent, evidence-based approach to food policy and regulation.
Source: 2016-17 Health Portfolio Budget Statements, p68
2016-17 Target2016-17 Result
Consistent regulatory approach across Australia is achieved through nationally agreed evidence-based policies and standards.A consistent regulatory approach was applied across Australia through nationally agreed evidence-based policies and standards.
Result: Met

In 2016-17, the Department continued to work with the Australia and New Zealand Ministerial Forum on Food Regulation, the Food Regulation Standing Committee, and the Implementation Subcommittee for Food Regulation to develop and implement consistent food policies and regulations.

Improving early detection, treatment and survival outcomes for people with cancer

Continue to implement the accelerated expansion of the National Bowel Cancer Screening Program to a biennial screening interval (by 2020).
Source: 2016-17 Health Portfolio Budget Statements, p. 69
2016-17 Target2016-17 Result
Commencement of invitations to 54, 58 and 68 year olds in 2017 and the continued delivery of communication and program enhancement activities.Invitations to 54, 58 and 68 year olds commenced on 1 January 2017. Ongoing program enhancement activities are continuing to be delivered.
Result: Met

Invitations to the additional age cohorts commenced as planned, through existing program implementation arrangements.

Program resources continue to support promotion of the program and encourage participation, as well as assisting with State and Territory based campaign activities to promote the program. The resources are continually reviewed to ensure effective communication with consumers and health care professionals.

Program enhancement activities are underway, including under the Primary Healthcare Engagement Strategy (for example, program-specific promotion, training and resources to support the primary care workforce to engage with the program) and development of an Alternative Pathways Pilot to support increased participation of Aboriginal and Torres Strait Islander peoples.

Support the renewal of the National Cervical Screening Program and expansion of the National Bowel Cancer Screening Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 69
2016-17 Target2016-17 Result
Implementation of the National Cancer Screening Register to commence on 1 May 2017.In February 2017 it was announced that the implementation of the National Cancer Screening Register would be delayed and would commence on 1 December 2017.
Result: Not met

The National Cancer Screening Register schedule has been re-phased to incorporate cervical screening data by 1 December 2017 and bowel screening following in mid-2018. The National Cancer Screening Register system and operations will meet rigorous privacy, security and clinical safety standards before the system is implemented.

Support the expansion of the BreastScreen Australia Program to extend the invitation to Australian women 70–74 years of age through the implementation of a nationally consistent communication strategy.
Source: 2016-17 Health Portfolio Budget Statements, p. 69
2016-17 Target2016-17 Result
Continue delivery of communication activities such as print, radio and online promotion.Phase three of communication activities to support the expansion of BreastScreen Australia was launched in February 2017.
Result: Met

In February 2017, the Government launched the third and final phase of the campaign An invitation that could save your life to support the expansion of the BreastScreen Australia Program target age to include women 70–74 years of age.

Public relations activities included a film interview with Deborah Hutton as part of an Australian Women’s Weekly editorial activity.

Stakeholder engagement was achieved through mail outs and provision of campaign resources, information packages, case study stories, and stakeholder engagement tools. The Department’s Facebook and Twitter accounts were used to promote campaign messages and increase community engagement. Media activities were also adapted for Aboriginal and Torres Strait Islander peoples and people from culturally and linguistically diverse backgrounds.

Number of breast care nurses employed through the McGrath Foundation.
Source: 2016-17 Health Portfolio Budget Statements, p. 70
2016-17 Target2016-17 Result2015-162014-152013-142012-13
5757
Result: Met
57575344

There are 57 Commonwealth-supported breast care nurses located across Australia, with around 86% of these nurses situated in regional and remote communities. Breast care nurses funded through the McGrath Foundation provide vital information, care and support to women diagnosed with breast cancer and their families.

Percentage of people invited to take part in the National Bowel Cancer Screening Program who participated.
Source: 2016-17 Health Portfolio Budget Statements, p. 70
2016-17 Target2016-17 ResultJan 2014 –
Dec 2015
Jan 2013 –
Dec 2014
Jan 2012 –
Dec 2013
41.0%Data not available38.9%2137.0%2236.0%

Results are published over a two-year rolling period. As there is a time lag between an invitation being sent, test results and collection of data from the National Bowel Cancer Screening Program Register, final participation rates for 2016-17 will be published in the Australian Institute of Health and Welfare’s National Bowel Cancer Screening Program: Monitoring report (1 Jan 2015 – 31 Dec 2016 participation data) in mid-2018.

Percentage of women 50–69 years of age participating in BreastScreen Australia.
Source: 2016-17 Health Portfolio Budget Statements, p. 70
2016-17 Target2016-17 Result2015-162014-152013-142012-13
55.0%Data not available54.7%54.0%53.7%54.4%
Percentage of women 70–74 years of age participating in BreastScreen Australia.
Source: 2016-17 Health Portfolio Budget Statements, p. 70
2016-17 Target2016-17 Result2015-162014-152013-142012-13
54.0%Data not available52.4%48.7%40.8%N/A

In 2016-17, the Government continued to work with the States and Territories to provide free screening to ensure more Australian women are screened. This included continuing to actively invite women 70–74 years of age to participate in BreastScreen Australia.

As there is a time lag between an invitation being sent, test results and collection of data from registries, participation rates for 2016 and 2017 are not yet available. These participation rates will be published in the Australian Institute of Health and Welfare’s BreastScreen Australia monitoring report (1 Jan 2015 – 31 Dec 2016 participation results) in September 2018.

Percentage of women in the target age group participating in the National Cervical Screening Program.
Source: 2016-17 Health Portfolio Budget Statements, p. 70
2016-17 Target2016-17 Result2015-162014-152013-142012-13
57.0%Data not available56.3%56.9%57.8%2358.2%24

As there is a time lag between test results and collection of data from state and territory registers, participation rates for 2016-17 are not yet available. These participation rates will be published in the Australian Institute of Health and Welfare’s Cervical Screening in Australia report in 2018.

In 2014 and 2015, 56.9% of women aged 20–69 participated in the National Cervical Screening Program (NCSP), which is more than 3.8 million women.

In April 2014, the Medical Services Advisory Committee recommended that a five yearly primary human papillomavirus test should replace the current biennial Pap test for cervical screening. This will ensure Australian women will have access to a cervical screening program that is safe, effective, efficient, and based on current evidence. In accordance with this advice, the renewal of the NCSP will be implemented on 1 December 2017.

Improving access to high quality palliative care services for all Australians

Implementation of the National Palliative Care Projects and other activities consistent with the National Palliative Care Strategy 2010.
Source: 2016-17 Health Portfolio Budget Statements, p. 71
2016-17 Target2016-17 Result
Continue to implement national projects that support quality improvement in palliative care priority areas including education, training, quality standards and advance care planning. Full implementation of the National Palliative Care Projects by 30 June 2017. Following June 2017, evaluation of these projects will inform future palliative and end of life care funding and activities.National palliative care projects continued to be implemented in 2016-17. These projects supported quality improvement in palliative care priority areas including education, training, quality standards and advance care planning.

The National Palliative Care Strategy (the Strategy) was evaluated and a process to update the Strategy in collaboration with State and Territory Governments commenced.
Result: Met

National palliative care projects include significant investment in advance care planning, workforce development, and national benchmarking and national continuous quality improvement processes. Through collaboration across projects and within the sector, this investment resulted in national training materials, assessment tools, and other resources to assist health, social service and residential aged care providers. This included a focus on the uptake of advance care plans and other mechanisms for increasing individual choice, improving care quality, and engagement in the planning for care goals. These projects have had a major influence on the palliative care sector as well as the broader health system, and have contributed significantly to achieving the objectives of the Strategy and improving access to quality palliative care.

Reducing harm to individuals and communities from misuse of alcohol, pharmaceuticals and use of illicit drugs

Establish a new Centre for Clinical Excellence for Emerging Drugs of Concern, which will provide timely and relevant data and research that informs the development of alcohol and other drug information, early intervention, prevention, and treatment activities.
Source: 2016-17 Health Portfolio Budget Statements, p. 72
2016-17 Target2016-17 Result
Clinical Centre for Excellence will be established during 2016-17.The Centre for Clinical Excellence (the Centre) was established on 6 March 2017.
Result: Met

Under the National Ice Action Strategy, funding has been allocated to the establishment of a Centre for Clinical Excellence for Emerging Drugs of Concern. This centre will support clinical research into new treatment options, training of health professionals and evaluating treatment effectiveness. The contract with the consortium managing the Centre was executed in March 2017. The Centre has identified its board of management and has appointed Associate Professor Nadine Ezard as Director. It is anticipated the Centre will be fully operational in 2017-18.

Provide funding to drug and alcohol organisations to support early intervention, prevention, information, and treatment activities.
Source: 2016-17 Health Portfolio Budget Statements, p. 72
2016-17 Target2016-17 Result
Implementation of the new Drug and Alcohol Program commencing in 2016-17.The new Drug and Alcohol Program was implemented in November 2016 and program guidelines were published on the Department’s website.25
Result: Met

The new Drug and Alcohol Program will provide funding to a range of drug and alcohol-related activities.
This includes funding drug and alcohol treatment services, a range of prevention activities, as well as supporting national leadership activities to guide Australian drug and alcohol policy.

Provide up-to-date information to young people on the risks and harms of illicit drug use. Availability of prevention and early intervention substance misuse resources for teachers, parents and students.
Source: 2016-17 Health Portfolio Budget Statements, p. 72
2016-17 Target2016-17 Result
Continue dissemination of materials and delivery of the National Drugs Campaign including provision of resources for parents, teachers and students.

Increasing access to new material through the National Drugs Campaign website as measured by an increase in site visits.
Up-to-date information on alcohol and other drugs continues to be disseminated via the Positive Choices web portal,26 and the new Cracks in the Ice online Community Toolkit.

The Positive Choices web-portal has over 60,000 users and there have been over 427,944 page views.

Since the launch of the Cracks in the Ice Community Toolkit on 3 April 2017, there have been over 11,000 requests for hard copy resources by over 370 organisations and community groups.

Development work to support future roll out of the next phase of the National Drugs Campaign was undertaken throughout 2016-17.
Result: Met

The Positive Choices web portal enhances access to evidence-based alcohol and other drug prevention resources and programs, which can be used by schools in an Australian context, for students, parents and teachers.

Over this period, a range of promotional activities have been undertaken including: cross-promotion across other alcohol and other drug websites conferences; seminars; webinars; e-newsletters; Facebook; and Twitter.

Percentage of population 14 years of age and older recently (in the last 12 months) using an illicit drug.
Source: 2016-17 Health Portfolio Budget Statements, p. 73
2016-17 Target2016-17 Result2013201020072004
<13.4%15.6%
Result: Not met
15.0%14.7%13.4%15.3%

The results of the 2016 National Drug Strategy Household Survey27 show an increase in illicit drug use for people aged 14 years and older from the previous survey conducted in 2013. The marginal increase in illicit drug use is largely driven by increases in cannabis use, and pharmaceutical misuse in older age groups. However, there has been significant overall reduction among Australians aged 14 years and older who have recently or ever used meth/amphetamine. These include a significant reduction in lifetime use of meth/amphetamines from 7% in 2013 to 6.3% in 2016 and a significant reduction in recent (in the last 12 months) use of meth/amphetamines from 2.1% in 2013 to 1.4% in 2016.

Reducing the harmful effects of tobacco use

Implement social marketing campaigns to raise awareness of the dangers of smoking and encourage and support attempts to quit.
Source: 2016-17 Health Portfolio Budget Statements, p. 73
2016-17 Target2016-17 Result
Deliver a campaign within the agreed timeframes focussing on groups with high smoking prevalence, which will raise awareness of the dangers of smoking.The latest phase of the Don’t Make Smokes Your Story campaign, which focussed on Aboriginal and Torres Strait Islander smokers aged 18–40 years, was launched online on 29 January 2017.
Result: Met

The Don’t Make Smokes Your Story campaign supports Indigenous smokers and the broader smoking population to quit smoking and remain smoke free. The campaign commenced on television, print, radio, digital and out-of-home formats on 5 March 2017 and concluded in mid-June 2017. Public relations activities were also implemented to extend the key campaign message.

The initial evaluation research was undertaken in July and August 2016, with 310 Indigenous smokers and recent quitters. Amongst those surveyed, the campaign was found to have high appeal with the primary target audience, effectively demonstrated the benefits of quitting for smokers and their families, and encouraged quit attempts. The story and character of Ted was believable, credible, relatable and appealing. Overall the audience felt the campaign was delivering important messages.

The campaign achieved considerable behaviour change, with 64% of the target audience taking some action towards quitting smoking as a result of seeing the campaign. Of the Indigenous smokers exposed to the campaign, 9% reported that they had quit as a result of the campaign and 27% stated they had reduced the amount they smoke. Substantial proportions of Indigenous smokers stated they had discussed smoking/quitting with family or friends (20%), or with a doctor (8%) or health intermediary (7%). Stated future intentions to change smoking behaviour were also very high.

The 2017 phase of media activity is currently being evaluated.

Percentage of population 18 years of age and over who are daily smokers.28, 29, 30
Source: 2016-17 Health Portfolio Budget Statements, p. 73
2016-17 Target2016-17 Result2014-152011-122007-08
11.3%Data not available14.7%16.3%19.1%

The Australian Bureau of Statistics National Health Survey (NHS) is undertaken every three years. The next NHS is expected to be reported in early 2019. The latest results from the Australian Institute of Health and Welfare National Drug Strategy Household Survey shows that the smoking rate for daily smokers aged 18 years or older was 12.8% in 2016.

Performance criteria from the 2016-17 Corporate Plan

Increased participation in cancer screening programs.
Source: 2016-17 Department of Health Corporate Plan, p. 23
Refer to performance criteria addressing participation in cancer screening programs.
Reduction in deaths from bowel, breast and cervical cancer through prevention and early detection.
Source: 2016-17 Department of Health Corporate Plan, p. 23
Cancer screening programs aim to reduce illness and death resulting from cancer through an organised approach to screening. For more information about participation in cancer screening programs, refer p. 76. While the data below show the number of deaths are increasing for each cancer, this is due to the overall increase in population size. A more accurate measure is the mortality rate which adjusts for the overall increase in population size. Mortality rates for these cancers have not been estimated for 2017 however historical trend data on mortality rates for these cancers up until 2014 show decreases in mortality over time.

In 2013, there were 14,962 new cases of bowel cancer diagnosed in Australia (8,214 males and 6,748 females). In 2017, it is estimated that 16,682 new cases of bowel cancer will be diagnosed in Australia (9,127 males and 7,555 females). In 2014, there were 4,071 deaths from bowel cancer in Australia (2,236 males and 1,835 females). In 2017, it is estimated that this will increase to 4,114 deaths (2,136 males and 1,978 females).31

In 2013, there were 16,045 new cases of breast cancer diagnosed in Australia (142 males and 15,902 females). In 2017, it is estimated that 17,730 new cases of breast cancer will be diagnosed in Australia (144 males and 17,586 females). In 2014, there were 2,844 deaths from breast cancer in Australia (30 males and 2,814 females). In 2017, it is estimated that this will increase to 3,114 deaths (28 males and 3,087 females).32

In 2013, there were 813 new cases of cervical cancer diagnosed in Australia. In 2017, it is estimated that 912 new cases of cervical cancer will be diagnosed in Australia. In 2014, there were 223 deaths from cervical cancer in Australia. In 2017, it is estimated that this will increase to 254 deaths.33

Increased upload of Advance Care Plans in My Health Record and timely referral to palliative care services.
Source: 2016-17 Department of Health Corporate Plan, p. 25
In 2016-17 the number of Advance Care Plans uploaded to My Health Record was 1,162, this was an increase from 209 in 2015-16. Data relating to timely referral to palliative care services is not collected.
Reduced rate of risky alcohol use and reduced rate of illicit drug use.
Source: 2016-17 Department of Health Corporate Plan, p. 23
Key findings from the 2016 National Drug Strategy Household Survey show that between 2013 and 2016, the proportion of people who drank alcohol at levels placing them at lifetime risk of harm (more than two standard drinks per day on average) fell from 18.2% to 17.1%.

Males were more than twice as likely as females to exceed the lifetime risk guidelines in 2016 (24% compared with 9.8%). However, the difference is narrowing as fewer males drank at risky levels in 2016 (significantly declined from 26% in 2013 to 24%) while female risky drinking remained unchanged (10.0% to 9.8%).34

In 2016, about 8.5 million (or 43%) people in Australia aged 14 or older had used an illicit drug in their lifetime (including misuse of pharmaceuticals). Around 3.1 million (or 15.6%) had illicitly used in the last 12 months and 2.5 million (12.6%) had used an illegal drug not including pharmaceuticals.

Although the proportion using any illicit drug did not significantly increase from 2013 to 2016, there has been a gradual increase in use since 2007 (from 13.4% to 15.6%) and the number of people illicitly using drugs has increased from about 2.3 million to 3.1 million.35

Increase in the number of Commonwealth funded alcohol and other drug treatment episodes.
Source: 2016-17 Department of Health Corporate Plan, p. 25
2015-162014-152013-142012-13
206,635170,367180,783162,362

The above performance criterion is supported by data from the Australian Institute of Health and Welfare.36 Data for 2016-17 will be released in 2018.

In 2015-16, there were an estimated 133,895 clients aged 10 years and over who received treatment from publicly funded alcohol and other drug (AOD) treatment agencies across Australia. The number of closed treatment episodes has increased over the last 10 years, from 147,325 in 2006-07 to 206,635 in 2015-16. In 2015-16, 14% of all clients were Aboriginal or Torres Strait Islander peoples aged 10 and over.37

The top four drugs that led clients to seek treatment were alcohol (32%), cannabis (23%), amphetamines (23%), and heroin (6%). The median age of clients in AOD treatment services is rising, from 31 years of age in 2006-07 to 33 years of age in 2015-16.

Reduced rate of daily smokers.
Source: 2016-17 Department of Health Corporate Plan, p. 23
Refer to performance criterion addressing rates of daily smokers.
Increase in the number of people accessing treatment support services for youth, prostate and breast cancers.
Source: 2016-17 Department of Health Corporate Plan, p. 23
During 2016-17, 1,534 patients were supported by Youth Cancer Services and 657 new patients were referred. This compares to 1,599 patients and 621 new referrals in 2015-16.

In 2016-17, there were 57 Commonwealth-supported breast care nurses located across Australia, with around 86% of these nurses situated in regional and remote communities. This compares to 44 breast care nurses funded in 2012-13.

In 2016-17, there were 14 Full-Time Equivalent Commonwealth-supported prostate cancer nurses. The 2017-18 Budget provided further funding of $5.9 million over three years to expand the current Prostate Cancer Nurse program to fund up to an additional 14 prostate nurses across Australia.

Halt the rising prevalence of adults who are overweight or obese.
Source: 2016-17 Department of Health Corporate Plan, p. 23
This performance criterion is supported by data from the Australian Bureau of Statistics, which is collected approximately every three years through the National Health Survey. Data for 2014-15, indicates that there was no significant increase of adults who were overweight or obese compared to 2011-12 figures.

Program 2.5: Primary Health Care Quality and Coordination

The Department met the majority of performance targets related to Program 2.5: Primary Health Care Quality and Coordination.

In 2016-17, the Department continued to support the Government to strengthen primary health care by focussing on frontline health services and improving delivery, quality and coordination of services.

Primary Health Networks were established to increase the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improve coordination of care to ensure patients receive the right care in the right place at the right time. In 2016-17, Primary Health Networks commenced commissioning activities to address the priorities identified through their baseline regional needs assessments.

The Department commenced implementation of Health Care Homes. Patient enrolments have been deferred to ensure that tools and resources are developed to a high standard. A Health Care Home is a general practice or Aboriginal Community Controlled Health Service that coordinates care for patients with chronic and complex conditions and provides patients with continuity of care using a team based approach according to each patients’ needs and wishes.

Focussing investment in frontline medical services for patients through Primary Health Networks

Primary Health Networks move to a commissioning role.
Source: 2016-17 Health Portfolio Budget Statements, p. 75
2016-17 Target2016-17 Result
All Primary Health Networks commence commissioning activities within the first six months of 2016-17.All Primary Health Networks commenced commissioning activities within the first six months of 2016-17.
Result: Met

All Primary Health Networks have commenced their commissioning activities within the target timeframe. Commissioning describes a broad set of linked activities, including: strategic planning through assessing regional health needs; priority setting; procurement of health services through contracts; monitoring service delivery; and reviewing and evaluating the services which have been delivered.

Percentage of Primary Health Networks with updated baseline needs assessments and strategies for responding to identified service gaps.
Source: 2016-17 Health Portfolio Budget Statements, p. 75
2016-17 Target2016-17 Result
Completed by 100% of Primary Health Networks by 30 June 2017.100% of Primary Health Networks have submitted updated needs assessments and strategies for responding to identified service gaps.
Result: Met

All Primary Health Networks have reviewed their initial needs assessments and updated them after analysis of relevant new population health data, market analysis and further stakeholder consultation on service gaps, major health concerns and system capacity issues.

Strategies to address the priority needs identified through the needs assessment process are articulated in annual Primary Health Network activity work plans. These work plans outline the commissioning and integration activities which Primary Health Networks intend to undertake.

Improving models of primary care

Establishment of a governance structure to facilitate stage 1 of a new Health Care Home model.
Source: 2016-17 Health Portfolio Budget Statements, p. 75
2016-17 Target2016-17 Result
The governance structure will be established by November 2016.The governance structure was established in July 2016.
Result: Met

An Implementation Advisory Group and supporting working groups have been established to provide advice to the Department on the implementation of Health Care Homes. These will continue to support the program during stage one.

Number of Primary Health Network regions which have begun patient enrolment into Health Care Homes.
Source: 2016-17 Health Portfolio Budget Statements, p. 75
2016-17 Target2016-17 Result
Patient enrolment has commenced in up to seven Primary Health Network regions by 30 June 2017.Patient enrolment has not yet commenced.
Result: Not met

A deferred and staged commencement of Health Care Homes was announced in the 2017-18 Budget. The deferral will ensure that the tools and resources to support Health Care Homes are available and developed to a high standard. This has included an independent privacy impact assessment to inform implementation, including the development of a Risk Stratification Tool. Health Care Homes will commence service delivery in 20 practices from 1 October 2017 and the remaining practices from 1 December 2017. Health Care Homes will be implemented across ten Primary Health Network regions, as announced in August 2016.

Establishing the Primary Health Care Development Program

Improved delivery of health services through current and emerging interactive communication channels.
Source: 2016-17 Health Portfolio Budget Statements, p. 75
2016-17 Target2016-17 Result
Increased use of the National Health Services Directory and first point of call services by the Australian population and health professionals.There has been a 40% increase in the use of the National Health Services Directory and first point of call services.
Result: Met

Total web enquiries for the period 1 July 2016 to 30 June 2017 was 3,735,318.

The National Health Services Directory continues to provide a comprehensive, reliable and accurate database of Australian health and related services. It provides a central source of information that supports both consumers and health professionals looking for information about services and service providers.

Program 2.6: Primary Care Practice Incentives

The Department met all performance targets related to Program 2.6: Primary Care Practice Incentives.

In 2016-17, the Government continued to fund the Practice Incentives Program (PIP) supporting general practice activities. PIP continued to support general practice activities by encouraging continuing improvements, increased quality of care, enhanced capacity and improved access and health outcomes for patients. With increased use of My Health Record, consumers and health care providers had better access to health information.

In 2016-17 the PIP eHealth Incentive continued to support general practices to remain up-to-date with the latest developments in eHealth technology as it became available.

In 2017-18, the Department will implement the 2017 Budget measure Quality Improvements in General Practice – implementation of the Practice Incentive Program. This measure will benefit Indigenous Australians with chronic disease and patients in rural and remote areas through retaining the Indigenous Health Incentive and the Procedural General Practitioner Payment.

Providing general practice incentive payments

Revise the Digital Health PIP Incentive.
Source: 2016-17 Health Portfolio Budget Statements, p. 76
2016-17 Target2016-17 Result
Provide general practices with access to the revised Digital Health Incentive from 1 August 2016.From 1 May 2016, general practices have access to the revised Practice Incentives Program (PIP) eHealth incentive. 88% of PIP registered general practices participated in the PIP eHealth Incentive in 2016-17.
Result: Met

From 1 May 2016, the PIP eHealth Incentive eligibility requirements were changed to encourage the use of the My Health Record system, through the upload of shared health summaries at a rate of 0.5% per 1,000 Standardised Whole Patient Equivalent.

Percentage of general practice (GP) patient care services provided by PIP practices.
Source: 2016-17 Health Portfolio Budget Statements, p. 76
2016-17 Target2016-17 Result2015-162014-152013-142012-13
84.2%91.0%
Result: Met
86.0%85.0%84.7%84.4%

The Government has continued to support improvements to primary health care delivery through the Practice Incentives Program (PIP), with 91% of general practice patient care provided by practices participating in the PIP.

There are 11 incentives under the PIP that focus on eHealth, teaching, Indigenous health, asthma, cervical screening, diabetes, quality prescribing, general practitioner aged care access, procedural services, after hours access and rural health.

Number of general practices participating in the PIP After Hours Incentive.
Source: 2016-17 Health Portfolio Budget Statements, p. 76
2016-17 Target2016-17 Result2015-162014-152013-142012-13
4,6505,068
Result: Met
4,680N/AN/AN/A

In 2016-17 a total of 5,068 practices were registered for the Practice Incentives Program (PIP) after hours incentive which provides the community with access to after hours primary care.

The PIP after hours incentive consists of five payment levels and provides practices with flexibility to select the level of after hours coverage to provide to their patients.

Program 2.7: Hospital Services

The Department met all performance targets related to Program 2.7: Hospital Services.

On 1 July 2017, the Tasmanian Government resumed ownership of the Mersey Community Hospital, following the signing of the Mersey National Partnership Agreement on 19 June 2017, allowing the facility to operate seamlessly as part of the Tasmanian public hospital system. Funding of $730.4 million has been provided to ensure the sustainability of hospital services for a further ten years.

Supporting the States and Territories to deliver efficient public hospital services

Provide accurate advice to the Minister on public hospital funding policy.
Source: 2016-17 Health Portfolio Budget Statements, p. 77
2016-17 Target2016-17 Result
Relevant advice produced in a timely manner.Relevant advice to the Minister on public hospital funding matters was provided within agreed timeframes, consistent with Government agreed processes.
Result: Met

Relevant advice to the Minister for Health on public hospital funding matters was provided within agreed timeframes, consistent with Government agreed processes. Advice provided specifically supported the development of the Addendum to the National Health Reform Agreement, and collaborative efforts with State and Territory Governments meetings of the Council of Australian Governments.

Improving health services in Tasmania

Implementation of elective surgery reform activities across Tasmania.
Source: 2016-17 Health Portfolio Budget Statements, p. 77
2016-17 Target2016-17 Result
Reform activities, including the purchase of elective surgery procedures from public and private providers, are undertaken in accordance with the National Partnership Agreement requirements.The performance indicator for this schedule required 1,223 surgeries to be completed in the period. Tasmania has reported 1,510 surgeries completed for the period.
Result: Met

Tasmania has exceeded the planned number of surgeries to be delivered by 287 for the period ending April 2017.

Supporting the Mersey Community Hospital

Ensure that residents of north-west Tasmania have ongoing access to hospital services.
Source: 2016-17 Health Portfolio Budget Statements, p. 78
2016-17 Target2016-17 Result
The Australian Government will work with the Tasmanian Government to determine future arrangements for the management, administration and operation of the Mersey Community Hospital once the current Heads of Agreement expires on 30 June 2017.On 19 June 2017, arrangements for the return of the Mersey Community Hospital to Tasmanian Government ownership from 1 July 2017 were formalised, with financial support provided by the Commonwealth to support the continued operation of the hospital.
Result: Met

On 1 July 2017, the Tasmanian Government resumed ownership of the Mersey Community Hospital, supporting the facility to operate seamlessly as part of the Tasmanian public hospital system. A lump sum payment of $730.4 million in 2016-17 has been provided to Tasmania to ensure the sustainability of hospital services for a period of ten years.

Performance criteria from the 2016-17 Corporate Plan

Shorter waiting times for elective surgery in days.
Source: 2016-17 Department of Health Corporate Plan, p. 25
 2015-162014-152013-142012-132011-12
Days waited at 50th percentile3735363636
Days waited at 90th percentile260253262265250
Percentage who waited more than 365 days2.01.82.42.72.7

This performance criterion is supported by data from the Australian Institute of Health and Welfare. Data for 2016-17 is not yet available.

Between 2011-12 and 2015-16, the number of admissions from public hospital elective surgery waiting lists increased by an average of 2.4% each year. In 2015-16, approximately 712,000 patients were admitted from public hospital elective surgery waiting lists.

Reduced waiting times for emergency hospital care.
Source: 2016-17 Department of Health Corporate Plan, p. 25
 2015-162014-152013-142012-132011-12
Median waiting time (minutes)1918181921
90th percentile waiting time (minutes)939393101108
Proportion seen on time (%)7474757372

This performance criterion is supported by data from the Australian Institute of Health and Welfare.
Data for 2016-17 is not yet available.

Patients receiving emergency care are assigned one of five clinically-relevant triage categories which indicate how quickly they should receive treatment. In 2015-16:

  • 1 ‘Resuscitation’ (within seconds): 100% of patients were seen on time;
  • 2 ‘Emergency’ (within 10 minutes): 77% of patients were seen on time;
  • 3 ‘Urgent’ (within 30 minutes): 67% of patients were seen on time;
  • 4 ‘Semi-urgent’ (within 60 minutes): 74% of patients were seen on time; and
  • 5 ‘Non-urgent’ (within 120 minutes): 93% of patients were seen on time.

In 2015-16, 73% of patients had their treatment completed within four hours.

Outcome 2 – Budgeted expenses and resources

Budget
estimate
2016-17
$’000
(A)
Actual
2016-17
$’000
(B)
Variation
$’000
(B) - (A)
Program 2.1: Mental Health1
Administered expenses
Ordinary annual services (Appropriation Act No. 1)711,603712,8321,229
Departmental expenses
Departmental appropriation222,93321,088(1,845)
Expenses not requiring appropriation in the budget year31,3602,4061,046
Total for Program 2.1735,896736,326430
Program 2.2: Aboriginal and Torres Strait Islander Health1
Administered expenses
Ordinary annual services (Appropriation Act No. 1)780,207779,044(1,163)
Departmental expenses
Departmental appropriation341,49742,052555
Expenses not requiring appropriation in the budget year43,2314,7951,564
Total for Program 2.2824,935825,891956
Program 2.3: Health Workforce
Administered expenses
Ordinary annual services (Appropriation Act No. 1)51,292,0301,243,345(48,685)
Departmental expenses
Departmental appropriation234,68632,078(2,608)
Expenses not requiring appropriation in the budget year31,7143,7021,988
Total for Program 2.31,328,4301,279,125(49,305)
Program 2.4: Preventive Health and Chronic Disease Support1
Administered expenses
Ordinary annual services (Appropriation Act No. 1)6384,973364,773(20,200)
Departmental expenses
Departmental appropriation237,10242,4625,360
Expenses not requiring appropriation in the budget year33,5074,9011,394
Total for Program 2.4425,582412,136(13,446)
Program 2.5: Primary Health Care Quality and Coordination
Administered expenses
Ordinary annual services (Appropriation Act No. 1)405,076400,498(4,578)
Departmental expenses
Departmental appropriation218,78418,403(381)
Expenses not requiring appropriation in the budget year31,1782,098920
Total for Program 2.5425,038420,999(4,039)
Program 2.6: Primary Care Practice Incentives
Administered expenses
Ordinary annual services (Appropriation Act No. 1)372,977341,845(31,132)
Departmental expenses
Departmental appropriation22,1342,129(5)
Expenses not requiring appropriation in the budget year3103246143
Total for Program 2.6375,214344,220(30,994)
Program 2.7: Hospital Services1
Administered expenses
Ordinary annual services (Appropriation Act No. 1)92,534109,01916,485
Non cash expenses433,1971,355(31,842)
Departmental expenses
Departmental appropriation227,72626,250(1,476)
Expenses not requiring appropriation in the budget year33,8216,5882,767
Total for Program 2.7157,278143,212(14,066)
Outcome 2 totals by appropriation type
Administered expenses
Ordinary annual services (Appropriation Act No. 1)4,039,4003,951,356(88,044)
Non cash expenses433,1971,355(31,842)
Departmental expenses
Departmental appropriation2184,862184,462(400)
Expenses not requiring appropriation in the budget year314,91424,7369,822
Total expenses for Outcome 24,272,3734,161,909(110,464)
Average staffing level (number)1,0371,0403

Note: Budget estimate represents estimated actual from 2017-18 Health Portfolio Budget Statements.

  1. This program excludes National Partnership payments to State and Territory Governments by the Treasury as part of the Federal Financial Relations (FFR) Framework.
  2. Departmental appropriation combines ‘Ordinary annual services (Appropriation Act No. 1)’ and ‘Revenue from independent sources (s74)’.
  3. Expenses not requiring appropriation in the budget year are made up of depreciation expense, amortisation, make good expense, operating losses and audit fees.
  4. Non cash expenses relate to depreciation of buildings.
  5. Internal allocation of $4.85m from Program 2.3 to Program 2.4 approved by the Minister for Health post-Budget 2017.
  6. Re-allocation of $0.95m from Program 2.3 to Program 3.1 agreed by Department of Finance.