The return of the incumbent LNP means Budget 2019/20, as presented in early April, should be rolled out. In terms of health, the focus was on continuing initiatives to progress the four pillars of the Coalition’s ‘Long Term National Health Plan’ (see later). The development of the Long-Term National Health Plan had been announced two years earlier by the Hon. Greg Hunt, who was at the time relatively new to the Health portfolio. The announcement was preceded by focused activity to sign compacts with potentially vocal and volatile stakeholders. These compacts and other relevant activities are listed in the Table below.
|Agreement / Compact||Other Party (ies)||End date||Key Purpose|
|Royal Commission into Aged Care Quality and Safety||Consumers, providers, States & Territories||Reports: Oct 2019 (I) Apr 2020||Terms of reference include quality and delivery of service, meeting needs, future challenges, sustainability|
|National Health Reform Agreement (and Addendum)||COAG States & Territories||30 Jun 2020||Public hospital funding; Health Care Home (HCH) model|
|Community Pharmacy Agreement (6CPA)||Pharmacy Guild||30 Jun 2020||Community Pharmacist renumeration; Wholesaler payments; funding for community pharmacy programmes, Pharmacy Location Rules|
|Compact: A Shared Vision for Australia’s Health System||Australian Medical Association||2020-21†||Early resumption of MBS indexation; reversal of bulk billing incentives for pathology and diagnostic imaging; MBS review; My Health Record uptake; Health Care Homes|
|Compact: Strengthening Medicare||Royal Australian College of GPs||2020-21†||Early resumption of MBS indexation; MBS review process; after-hours MBS items; workforce reform; My Health Record uptake|
|Agreement to improve access to & affordability of medical devices for privately insured Australians||Medical Technology Association of Australia||31 Jan 2022||Price certainty and reduce time to market for medical devices; transparency & efficiency of Protheses listing processes|
|Strategic Agreement||Medicines Australia||30 Jun 2022||Delivery of $1.8 billion in savings; PBS process improvements|
|Strategic Agreement. Compact: Strengthening PBS-Measures to Support Generic and Biosimilar Medicines Uptake (2-year extension)||Generic Biosimilar Medicines Association||30 Jun 2022||Greater certainty of Government pricing policies for F2 Formulary medicines with brand competition, in an environment of ongoing medicine price reductions associated with price disclosure|
† period of forward estimates from 2017-18 budget; (I) Interim
The compacts were said to be a platform for the national plan and ‘underpinned by a range of shared principles …, transparency in decision making, accountability for reforms, stability and certainty in regards to Government investment ‘. The ultimate success of this approach was reflected in how health was debated equally alongside the other common issues important to Australians in the lead up to yesterday’s election (no controversy, unlike ‘Mediscare’ in 2016). The roll-out of the National Plan reforms is scheduled in 3 waves:
- Wave 1: guaranteeing Medicare, agreement by COAG on an opt-out model for My Health Record and investments in mental health psycho-social support;
- Wave 2: sustainability and affordability of private health insurance, mental health particularly in rural areas, workforce strategy, aged care reform; and
- Wave 3:reform of public hospitals and post 2020 agreements with the states, primary health care and preventive care.
Activity appears to have been well progressed into Wave 2 when the election was called. The next Federal Minister of Health will be in demand as the compacts (and agreements) come up for review. The 4 pillars and Budget 2019/20 initiatives are loosely in line with the Department of Health operational Outcomes:
- Guaranteeing Medicare and Access to Medicines [TGA, MBS and PBS; Outcomes 4 & 5]
- Supporting our Hospitals [State funding; Outcome 2]
- Prioritising Mental Health, Preventive Health and Sport [Outcome 3]
- Life Saving and Job Creating Medical Research [Medical Research Future Fund; Outcome 1].
Note: Ageing and Aged Care [Outcome 6] was also specifically addressed by the Budget in the environment of an ongoing Royal Commission. Many of the identified activities for funding mirror those likely to be part of the Commission Recommendations when they are tabled.