Department of Health Annual Report 2016-17
We are increasingly embracing change as a means of continuous improvement – offering new models of care, structures, approaches and level of engagement with stakeholders, including consumers, to build much-needed sustainability into the health system. Over time, the result of our efforts will be a system that works better for consumers and health professionals alike, and fundamentally delivers better health outcomes for the nation.
Driving innovation in the health system
During the year, we continued to apply new thinking, research, evaluation, and different sources of data to better equip the health system to meet current and future health needs.
The first disbursements from the Medical Research Future Fund of $65.9 million were earmarked for programs to improve health system efficiency, patient care and access, health outcomes, and new technology in health. As well, the Biomedical Translation Fund was established to support commercialisation of health and medical research. The first investment of $10 million announced during the year will focus on researching new ways to treat peanut allergies in children.
The national My Health Record system moved closer to full implementation. Successful trials have demonstrated that opt-out participation is the fastest way to realise the significant health and economic benefits of this system, including through avoided hospital admissions, fewer adverse drug events, reduced duplication of tests, better coordination of care for people seeing multiple health care providers, and better informed treatment decisions. Working with the Australian Digital Health Agency, we have begun national opt-out arrangements which will give every Australian a My Health Record by December 2018, unless they choose not to have one.
Improving models of primary health care
The Department continued a large body of work reshaping the primary health care system. This work provides all Australians with access to preventive, primary and mental health care, with a particular focus on people with chronic and complex conditions, and those living in rural, regional and remote communities.
Primary Health Networks are at the forefront of primary health care in Australia, tailoring health services to local community needs, including an expanded role in mental health and suicide prevention, along with digital health, immunisation and cancer screening.
The Department developed implementation arrangements for the commencement of services under the Health Care Homes model from 1 October 2017 for up to 20 Health Care Homes; with the remaining practices to begin on 1 December 2017. Health Care Homes introduce a new way to fund and deliver health care for the increasing number of Australians with chronic and complex conditions. This gives them a home base for their conditions to be managed through a tailored care plan implemented by a team of health care providers. Phasing the rollout of services will ensure best practice implementation.
We are playing a critical role in shaping a new era of mental health care. Significant work was undertaken to implement the Government’s mental health reform agenda within a stepped care model, and develop the Fifth National Mental Health and Suicide Prevention Plan through extensive consultation with States and Territories, the sector, consumers and carers.
It is imperative that Australia’s health workforce is appropriately skilled and located in the right places. During the year, the Department coordinated work to improve the capacity and quality of the health workforce. This includes training more medical students in regional and rural areas through establishing 26 regional training hubs, and expanding specialist training.
Improving the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS)
Work continued to improve the sustainability of the MBS and the PBS. The Department continued to support the clinician-led review of the 5,700-odd items on the MBS. More than 2,850 MBS items are currently under active review by the independent MBS Taskforce. Aligning rebated services with contemporary, evidence-based medical practices improves patient outcomes and helps future proof the MBS. Alongside the MBS Taskforce Review, the Medical Services Advisory Committee continued to provide independent expert advice on the safety, effectiveness and cost-efficiency of new medical procedures and technologies.
The Department worked with the pharmaceutical industry to strengthen the PBS and provide certainty to the industry through a stable PBS pricing environment. This included supporting the use of generic and biosimilar medicines to give patients access to more, and cheaper medicines. In addition, the Sixth Community Pharmacy Agreement was varied to recognise and strengthen the important role of pharmacists in providing medicine, services and advice to patients. The agreement focuses on supporting the viability of community pharmacies, and the supply of medications and new services, to help patients manage their medications.
Supporting public hospitals
We are developing a long-term plan to place public hospital funding on a fiscally sustainable footing. The Council of Australian Governments approved a Heads of Agreement for public hospital funding from 1 July 2017 to 30 June 2020 ahead of consideration for the longer term. The relationships with States and Territories has been enhanced through a process of close and effective collaboration. Work will continue to support the efficient pricing, funding, delivery, performance, and reform of public hospitals services.
As of 1 July 2017, the Tasmanian Government resumed ownership of the Mersey Community Hospital, ending ownership by the Commonwealth and providing planning and certainty for consumers and providers of hospital services in north-west Tasmania.
Supporting aged care
We continue to work closely with stakeholders in reforming aged care for Australians, with the aim of giving people more choice and access to services. The successfully implemented Increasing Choice in Home Care initiative provides older people with consumer-driven, high quality and innovative aged care services required to meet individual needs and circumstances. In particular, it expands options for people to stay in their own homes for as long as possible, ensuring they receive the care they need, when and where they need it.
In addition, we engaged closely with the sector to improve the My Aged Care website and contact centre, the starting point for people looking for aged care services and easy to understand information about their options.
Promoting and learning from international best practice
Australia is well regarded in international health fora and the Department’s contribution is a major factor. In 2016-17, the Department continued to participate in international engagements, such as the first ever G20 Health Ministers’ Meeting in Berlin in May, maintaining partnerships and harnessing information on international best practice in health. Australia is considered to be a leader on a range of health issues including health emergency preparedness and response, antimicrobial resistance, universal health coverage, health technology assessments, and effective tobacco control.
The Department led Australia’s delegations to World Health Organization (WHO) governing body meetings, the World Health Assembly, meetings of the WHO Executive Boards and the Western Pacific Regional Committee Meeting.
The Department, through the Therapeutic Goods Administration, began implementing the response to the Review of Medicines and Medical Devices Regulation. This will enable lifesaving medicines and medical devices to come onto the Australian market faster, in some cases two years faster, through removing or streamlining unnecessary or inefficient processes.
Medicinal cannabis cultivation received the green light from Parliament. Updated laws allowed the Department to grant 15 licenses to cultivate, produce and manufacture cannabis for medicinal purposes in Australia.
Promoting sport and sport integrity
The Department continued to work closely with States and Territories, the Australian Sports Commission and the Australian Sports Anti-Doping Authority to ensure a coordinated and consistent approach to sports policy in Australia. We supported a range of initiatives to connect more Australians to local sport, to promote clean sport, and to prepare for major sporting events including the 2017 men’s and women’s Rugby League World Cups, and the Gold Coast 2018 Commonwealth Games.
Improving Indigenous health care
The Department has made progress in our ongoing commitment to closing the gap in health outcomes and life expectancy between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. This was detailed in the Aboriginal and Torres Strait Islander Health Performance Framework released in May 2017. Targeted activities have delivered genuine reductions in the burden of disease in Aboriginal and Torres Strait Islander peoples over the past couple of decades. These include smoking rates – down 9.7 per cent, child mortality – down 33 per cent, and blindness and vision impairment – down from six times to three times that of non-Indigenous Australians.
The new funding agreement with the National Aboriginal Community Controlled Health Organisation will assist in continuing improvements. We have also been working hard on the next iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan, which will address the social and cultural determinants of Indigenous health.
This is my last Secretary’s Review. After almost three years as Secretary at Health and nearly 40 years as a public servant, I have resigned to explore new opportunities. I believe I leave the Department in good shape, with a strong organisational culture and much improved capability to advance the health agenda. I thank staff and stakeholders for their rich and varied contributions and wish you all the best for the future.
Martin Bowles PSM