Chapter 2Key Issues
2.1This chapter provides an overview of some of the key issues raised during the committee’s 2023–24 budget estimates hearings. Page numbers reference relevant committee Hansard transcripts.
Social Services portfolio hearing—30 May 2023
2.2The committee called officers from the Department of Social Services (DSS) to discuss matters relating to whole of portfolio, corporate, and Outcomes 1 and 2. Mr Ray Griggs AO CSC, Secretary of DSS, gave evidence alongside departmental officials.
Whole of portfolio and corporate matters
2.3Topics discussed with DSS relating to whole of portfolio and corporate matters included:
the management of answers to questions on notice (p. 5);
recommendations of the Interim Economic Inclusion Advisory Committee’s 2023–24 Report to the Australian Government, including funding to the secretariat (pp. 10–11; p. 21);
DSS’ active contracts and consultancies with PricewaterhouseCoopers (PwC), and broader processes around the assessment of tenders and procurements (p. 23);
indexation arrangements for Commonwealth grants and review of the wage cost index framework (p. 25); and
update on the department’s advertising expenditure in the 2022–23 financial year (p. 26).
Outcome 1: Social Security
2.4Topics discussed with DSS relating to Outcome 1 included:
the adequacy of the JobSeeker rate to meet cost-of-living pressures and indexation of the payment (pp. 17–19 and 33);
the expansion of the eligibility for the Parenting Payment (Single) (p. 35);
increases to the income threshold at which a Commonwealth Seniors Health Card is available (pp. 40–41);
the extension of the Assistance for Isolated Children Scheme to preschool, and the adequacy of the Second Home Allowance (p. 51);
the role of the Payment Accuracy Review to mitigate inaccuracy risks associated with various payments (pp. 55–56); and
the current total number of Disability Support Pension (DSP) recipients, including trends in DSP expenditure across the forward estimates (p. 57).
Outcome 2: Families and Communities
2.5Topics discussed with DSS relating to Outcome 2 included:
measures to address entrenched disadvantage and ending violence against women (p. 82);
sexual assault trauma counselling and referrals made to 1800 RESPECT (pp.92–93);
transition from the Cashless Debit Card to the Enhanced Income Management and SmartCard (p. 94);
gambling harm reduction activities and associated consultation mechanisms, including the implementation of the National Consumer Protection Framework for Online Wagering in Australia (p. 100);
the national early interventional trial identifying young men and adolescent boys at risk of perpetrating violence (p. 106); and
the government’s $169 million allocation towards additional frontline service and community workers supporting victims of family, domestic and sexual violence (p. 108).
Social Services portfolio agencies
Australian Institute of Family Studies
2.6The committee continued its examination of the Social Services portfolio by calling officers from the Australian Institute of Family Studies (AIFS) and the Domestic, Family and Sexual Violence Commission (DFSVC).
2.7The Hon Dr Sharman Stone, Director of AIFS, provided an opening statement about AIFS’ current state of research into factors affecting the wellbeing of Australian families (pp. 62–64).
2.8Topics discussed for AIFS included:
findings from various short-term and longitudinal studies, such as the recently released Australian Child Maltreatment Study (pp. 64–65);
the release of AIFS’ resource around reproductive coercion and abuse and associated consultations (p. 65);
the Australian Gambling Research Centre’s assistance to banning the use of credit cards for online wagering (p. 67); and
AIFS’ Emerging Minds program examining children’s mental health, particularly in culturally and linguistically diverse communities and for children in out-of-home-care (pp. 63 and 69).
Domestic, Family and Sexual Violence Commission
2.9Ms Micaela Cronin, Commissioner, represented the DFSVC.
2.10Topics discussed for DFSVC included:
work of the Lived Experience Advisory Council and exploration of other mechanisms to amplify the voices of victim-survivors to inform government policy (pp. 71–72);
the National Community Attitudes Towards Violence Against Women Survey and its examination of attitudinal responses to gendered violence (p.74);
the DFSVC’s input to implementing of the National Action Plan to End Violence Against Women and Children (p. 77); and
the Little Children Are Sacred report findings on environmental factors contributing to child sexual abuse (pp. 77–78).
Social Services portfolio hearing—31 May 2023
2.11The committee commenced its second day of budget estimates hearings by continuing its examination of the Social Services portfolio. Mr Ray Griggs AO CSC, Secretary of DSS, was joined by departmental officials to discuss matters relating to Outcomes 3 and 4 which respectively relate to disability and carers, and housing.
Outcome 3: Disability and Carers
2.12Topics discussed with DSS relating to Outcome 3 included:
the Telethon Kids Institute’s Inklings pilot program supporting babies showing early signs of autism in Western Australia (pp. 118–119);
the co-design national consultation engagement process in the National Autism Strategy, including the establishment of the Oversight Council (pp.119–120); and
Disability Employment Services, including recent investigations into its start ratings and performance assessments (pp. 122–123).
Outcome 4: Housing
2.13Topics discussed with DSS relating to Outcome 4 included:
the National Rental Affordability Scheme (p. 61);
supports for women and children fleeing family violence and escaping homelessness (pp. 64–65); and
the National Housing and Homelessness Agreement (p. 67).
Social Services portfolio agencies
Services Australia
2.14The committee continued its examination of the Social Services portfolio by calling officers from Services Australia, the National Disability Insurance Agency (NDIA) and the National Disability Insurance Scheme (NDIS) Quality and Safeguards Commission.
2.15Senator the Hon Don Farrell made an opening statement concerning the incident which occurred at Services Australia’s Airport West service centre in Melbourne where a frontline officer was violently attacked by a customer.
2.16Ms Rebecca Skinner PSM, Chief Executive Officer, in her opening statement reiterated comments from Senator the Hon Don Farrell about the incident, and underlined Services Australia’s commitment to protecting its staff:
I'm determined we'll do all we can to support the staff from Airport West Service Centre and all our staff serving customers across the country, so they can get on with their important jobs without having to worry about their safety and without fear of violence. I'm committed to protecting our staff. It's why Mr Graham Ashton, the former Chief Commissioner of Victoria Police, is now leading an urgent review into our security measures. It will take into account the agency's already strong security basis, but examine what we can do better to deter future incidents (p. 6).
2.17Ms Skinner was joined by officials from Services Australia to discuss matters relating to whole of portfolio and corporate matters.
Whole of portfolio and corporate matters
2.18Topics discussed for Services Australia, whole of portfolio and corporate matters included:
telephony figures and wait times (pp. 8–9);
the management of answers questions on notice (p. 17);
the Independent Review of Services Australia and NDIA procurements and contracts related to Synergy 360 and its associated entities (p. 18);
Services Australia’s use of spyware technologies by Israeli firm 'Cellebrite' to investigate serious non-compliance (pp. 26–29);
the number of payments to Esther House via Centrepay (pp. 29–30); and
Services Australia’s efforts to combat fraud and corruption, including referrals made to the Commonwealth Department of Public Prosecutions (p.33).
Outcome 1: Deliver high-quality, accessible services and payments to individuals, families, businesses and partner agencies on behalf of Government; with a focus on contemporary service delivery and customer experience
2.19Topics discussed for Services Australia, Outcome 1 included:
the timeliness of Disaster Recovery Payments following an emergency declaration made by the National Emergency Management Agency (p. 38);
the application of vulnerability indicators to Centrelink records and in customer interactions (pp. 41–43);
transition from the Cashless Debit Card to the Enhanced Income Management and SmartCard (pp. 43–44);
services the agency’s remote servicing teams provide to remote communities (p. 49);
the mechanisms by which the Indigenous Employees Network consult on issues affecting First Nations people (p. 50); and
the continuation and expansion of the three-year Family and Domestic Violence pilot (pp. 59–60).
National Disability Insurance Agency
2.20Senator the Hon Tim Ayres made an opening statement about the government’s commitment to reforming the NDIS.
2.21Ms Rebecca Falkingham, Chief Executive Officer, was joined by officials from NDIA.
2.22Topics discussed for NDIA included:
the notification process for participants and providers when plan funds are exhausted (p. 76);
bulk purchasing of assistive technologies (pp. 89–90);
transparency of NDIS monthly and quarterly reporting, including the provision of data (p. 95);
trial of the PACE ICT business system (pp. 97–99);
update on the Independent Expert Review program to streamline Administrative Appeals Tribunal dispute resolution (p. 107);
the revision of NDIA rules around funding assistance animals (pp. 113–114);
the consultation process around the establishment of the co-design engagement branch (p. 114); and
the average payment for participants with autism (p. 116).
NDIS Quality and Safeguards Commission
2.23Ms Tracy Mackey, NDIS Quality and Safeguards Commissioner, was joined by officials from the NDIS Quality and Safeguards Commission.
2.24Topics discussed for the NDIS Quality and Safeguards Commission included:
the commencement of a single national intake process to triage, safeguard and facilitate early resolution outcomes (pp. 70–71);
active contracts and consultancies as published on AusTender (p. 71);
service agreements where participants are not aware of, or find it difficult to understand the contents (p. 73); and
the process of raising a complaint where participants are under a public guardianship arrangement (pp. 73–75).
Health and Aged Care portfolio hearing – 1 June 2023
2.25The committee called officers from the Department of Health and Aged Care (DoHAC) to discuss matters relating to whole of portfolio, corporate, and Outcome 1. Professor Brendan Murphy AC, Secretary of DoHAC, gave evidence alongside departmental officials.
Whole of portfolio and corporate matters
2.26Topics discussed for DoHAC, whole of portfolio and corporate matters included:
Budget 2023–24 measures related to the Medicare Benefits Schedule, including investments for people with chronic disease (pp.7–9);
engagement of PwC as a consultant and DoHAC’s general management of contracts (pp.9–11);
the censorship of COVID-19 misinformation on social media (pp. 12, 15, 24, 35–36 and 38–39);
causes of the recorded 30,000 excess deaths in 2022 (pp. 13–15 and 22–24);
funding for brain cancer research and treatment (pp. 15–17);
funding of Urgent Care Clinics (pp. 17–19);
departmental contracts with 89 Degrees East and potential conflicts of interest (pp. 19–22, 25–28, 38 and 45);
departmental impact assessments on major policy announcements and the impact of the 60–day dispensing of Pharmaceutical Benefits Scheme medicines on community pharmacists (pp. 28–33 and 42–44);
timing of a Royal Commission into COVID-19 (pp. 36–37); and
compensation for individuals injured by COVID-19 vaccines (pp. 40–41).
Outcome 1: Health Policy, Access and Support
2.27Topics discussed for DoHAC, Outcome 1 included:
expenditure on health workforce incentives and training programs (pp.69–70);
Urgent Care Clinics in Tasmania and the Victorian Government’s Primary Care Clinics initiative (pp. 70–72, 76–79, 82–84 and 91);
the establishment of the national wound’s consumables scheme (pp. 74–76);
the Australian Centres for Disease Control and the introduction of its enabling legislation (pp. 84–85 and 88);
shortage of access to general practitioners and bulk-billing incentives (pp.85–87 and 89–91);
the Supporting Recovery Primary Health Network pilot (pp. 91–93);
methods used to determine a District Workforce Shortage status (pp. 96–97);
use of puberty blocking agents (pp. 97–98 and 123–124);
funding for the newborn bloodspot screening program to increase the number of genetic and end–of–life conditions that newborns are screened for (pp. 99–102);
government consultations that informed the development of its vaping policy and actions taken related to tobacco control (pp. 102–103, 111‑114,117–120 and 124–127);
funding for the endometriosis program (pp. 103–105); and
changes to the Better Access program and measures to address mental health and suicide prevention (pp. 105–108).
Health and Aged Care portfolio agencies and statutory officers
2.28Professor Brendan Murphy AC, Secretary of DoHAC, was joined by relevant agency heads and officials.
Australian Health Practitioner Regulation Agency
2.29Mr Martin Fletcher, Chief Executive Officer, was joined by officials from the Australian Health Practitioner Regulation Agency (Ahpra).
2.30Topics discussed for Ahpra included:
existing accreditation standards for cosmetic surgery practice endorsement (pp.45–48 and 51–53);
criminal history of health practitioners and support for victims of sexual misconduct within the healthcare system, as well as Ahpra’s investigative powers related to misconduct (pp. 48–50 and 57–62);
suspension and cancellation of registration for health practitioners relating to COVID-19 issues (pp. 53–56);
COVID-19 vaccine related injuries and deaths (pp. 56–57); and
qualifications of members on the Ahpra board (pp. 63–64).
National Rural Health Commissioner
2.31Adjunct Professor Ruth Stewart, Commissioner, represented the Office of the National Rural Health Commissioner (NRHC).
2.32Topics discussed for NRHC included:
access to reproductive healthcare for women living in rural and regional Australia, including workforce shortages and measures to improve access, such as the National Scope of Practice Review (pp. 64–65);
the expansion of Distribution Priority Areas (pp.65–67);
shortage of general practitioners in rural and remote Australia (p. 67); and
the 60–day dispensing of Pharmaceutical Benefits Scheme medicines initiative and its impact on rural pharmacies (pp. 67–69).
Australian Institute of Health and Welfare
2.33Mr Rob Heferen, Chief Executive Officer, was joined by officials from the Australian Institute of Health and Welfare (AIHW).
2.34Topics discussed for AIHW included:
the use of Body Mass Index as a measure of physical wellness (p. 132); and
elective surgery trends (pp. 132–133).
Health and Aged Care portfolio hearing – 2 June 2023
2.35The committee commenced its final day of budget estimates hearings by continuing its examination of the Health and Aged Care portfolio. The committee called officers from DoHAC to discuss matters relating to Outcome 2, 3 and 4. Professor Brendan Murphy AC, Secretary of DoHAC, gave evidence alongside departmental officials.
Outcome 2: Individual Health Benefits
2.36Topics discussed for DoHAC, Outcome 2 included:
modelling on bulk-billing rates and the impact of tripling the bulk‑billing rate in rural and regional communities and capital cities (pp. 6–10);
the department’s engagement with PwC and analysis that PwC has provided for health stakeholders (pp. 12–15);
the 60–day dispensing of Pharmaceutical Benefits Scheme medicines initiative’s impact on community pharmacists, residential aged care facilities, consumer savings and medicine shortages (pp. 15–26 and 30–49);
measures to improve access to reproductive and sexual healthcare (pp. 26–30);
Pharmacy Guild of Australia’s communications with the public regarding medicine shortages (pp. 38–39); and
continuous glucose monitoring tender and diabetes related products, as well as the whole of the National Diabetes Services Scheme (pp. 50–52).
Outcome 3: Ageing and Aged Care
2.37Topics discussed for DoHAC, Outcome 3 included:
PwC's involvement in auditing and financial advisory services to aged care providers (pp. 52–56);
outstanding COVID-19 Aged Care Support Program Extension grants (pp.56–59);
progress on recommendations from the Royal Commission into Aged Care and Quality and Safety (p. 59);
pay rise afforded to aged care workers (pp. 61 and 75–76);
exemptions to the 24/7 registered nurse supplement for residential aged care and causes for the closure of aged care facilities (pp. 62–63 and 69–74);
Mirus Australia’s advice to aged care providers on the Australian National Aged Care Classification (AN-ACC) funding model (pp. 68–69); and
response to the David Tune Capability Review of the Aged Care Quality and Safety Commission (p. 74).
Outcome 4: Sport and Physical Activity
2.38Topics discussed for DoHAC, Outcome 4 included:
the legacy strategy for the Brisbane 2032 Olympic and Paralympic Games (p.80);
preparation and allocated funding for the FIFA Women’s World Cup (pp.80–81); and
the Victorian Government’s legacy strategy for the 2026 Commonwealth Games (pp. 81–82).
Health and Aged Care portfolio agencies and statutory officers
Aged Care Quality and Safety Commission
2.39Ms Janet Anderson PSM, Commissioner, was joined by officials from the Aged Care Quality and Safety Commission (ACQSC).
2.40Topics discussed for ACQSC included:
Star Ratings for residential aged care services, and consequent site audits (pp.60–61);
requirements related to the 24/7 registered nurse supplement for residential aged care and the Commission’s regulatory approach to the supplement (pp. 63–66); and
the Commission’s contract with KPMG to conduct site audits and potential conflicts of interest (pp. 67–68 and 77–79).
Independent Health and Aged Care Pricing Authority
2.41Professor Michael Pervan, Chief Executive Officer, was joined by officials from the Independent Health and Aged Care Pricing Authority (IHACPA).
2.42Topics discussed for IHACPA included:
the Authority’s contracts with PwC (pp. 55–56 and 66–67);
the Authority’s former Chief Executive Officer’s role at PwC (p. 77); and
pay rise for aged care workers (p. 79).
Australian Sports Commission
2.43Mr Kieren Perkins OAM, Chief Executive Officer, was joined by officials from the Australian Sports Commission (ASC).
2.44Topics discussed for ASC included:
gambling advertising during live sporting events (p. 82); and
funding assistance requests from the Victorian Government regarding the 2026 Commonwealth Games (pp. 82–83).
Senator Marielle Smith
Chair