Chapter 2Key Issues

2.1This chapter provides an overview of some key issues raised during the committee’s Budget Estimates 2024–25 hearings. Page numbers reference relevant committee Hansard transcripts.

Social Services portfolio hearing—3 June 2024

Services Australia

2.2The committee called officers from the Services Australia to discuss matters relating to Whole of Portfolio and Corporate Matters, and Outcome 1. Mr David Hazlehurst, Chief Executive Officer, was joined by officials from Services Australia.

2.3Topics discussed for Services Australia, Whole of Portfolio and Corporate Matters included:

staff attrition rates and distribution of resourcing, including during pre- and post-COVID-19 (p. 5; pp. 7–11);

promoting a positive culture in Services Australia, including the role of senior leadership (pp. 16–17);

debt recovery and income apportionment, in light of the Commonwealth Ombudsman’s reporting (pp. 20–23);

the review into Centrepay and issues around business compliance (pp. 28–30);

processes of commencing a secondment arrangement, and issues relating to declared conflicts of interest (pp. 36–39);

the Health Delivery Modernisation Project (pp. 51–53); and

AusTender contract related to speechwriting services for Services Australia and Minister Shorten (pp. 60–74).

2.4Topics discussed for Services Australia, Outcome 1 included:

the administration of various payments to NZYQ cohorts (p. 12; p. 17; pp. 47–49);

crisis payments, including claims processing times varying by local government area (pp. 12–13);

delays in processing aged and disability support pension claims (pp. 17–18); and

the Family and Domestic Violence Pilot Program (p. 51).

Outcome 3: Disability and Carers

2.5The committee called officers from the Department of Social Services (DSS), and discussed matters relating to Outcome 3. Mr Ray Griggs AO CSC, Secretary of DSS, gave evidence alongside departmental officials.

2.6Topics discussed with DSS relating to Outcome 3 included:

the Information Linkages and Capacity Building grants program (pp. 74–75);

the negotiations between states and territories over the International Agreement, with particular reference to ‘Tier 2’ foundational disability supports (pp. 76–77);

the Disability Employment Service program and associated reforms (pp. 77–79); and

funding for disability representative organisations (pp. 85–86).

Social Services portfolio agencies

2.7The committee continued its examination of the Social Services portfolio by calling officers from the National Disability Insurance Agency (NDIA) and the NDIS Quality and Safeguards Commission (NDIS Commission).

National Disability Insurance Agency

2.8Ms Rebecca Falkingham, Chief Executive Officer of the NDIA, was joined by officials from the NDIA.

2.9Topics discussed for the NDIA included:

the reform of the NDIA’s Administrative Appeals Tribunal pathway and reducing the usage of external lawyers (p. 89);

RedBridge Group’s reporting on community perceptions of the role of the NDIS (pp. 91–93);

the auditing of NDIS service providers to address fraud and ensure participant safety (pp. 94–96);

individuals in the NDIS who have interacted with the justice system (pp.105–107);

projected savings in the Annual Financial Sustainability Report (pp. 109–111);

observations around plan overspends as a result of intra-plan inflation and change of circumstances (pp. 120–122); and

frameworks on the role, scope, function and delivery methodology of support coordination (pp. 124–125).

NDIS Quality and Safeguards Commission

2.10Mr Michael Phelan, Acting Commissioner, represented the NDIS Commission.

2.11Topics discussed for the NDIS Commission included:

the provision of $160 million to upgrade the NDIS Commission’s registration, compliance and complaints systems (pp. 111–112);

the increased number of complains made to the NDIS Commission (p. 113); and

models for understanding disability and its application within the NDIS Commission (pp. 117–119).

Social Services portfolio hearing—4 June 2024

2.12The committee called officers from DSS and discussed matters relating to Whole of Portfolio and Corporate Matters, Outcomes 1–2 and Outcome 4. Mr Ray Griggs AO CSC, Secretary of DSS, gave evidence alongside departmental officials.

Whole of Portfolio and Corporate Matters

2.13Topics discussed with DSS relating to Whole of Portfolio and Corporate Matters included:

the Department of the Prime Minister and Cabinet’s guidelines on how to answer questions from Senate Estimates (pp. 5–8);

estimates variations over $20 million which result in increased departmental funding (pp. 9–11); and

the breakdown of DSS staffing structures and corporate policies, including Freedom of Information provisions (pp. 18–21).

Outcome 1: Social Security

2.14Topics discussed with DSS relating to Outcome 1 included:

the breakdown of various payments and parameters that are indexed on 1 July 2024 (pp. 24–25);

income apportionment and the Robodebt Royal Commission (pp. 26–28);

the Assistance for Isolated Children payment (p. 29);

the Economic Inclusion Advisory Board’s proposal to raise the rate of various social security payments (pp. 29–30);

the adequacy of Commonwealth Rental Assistance, including increases to indexation (pp. 31–33);

Paid Parental Leave and Child Support payment, including instances of noncompliance and financial abuse (pp. 34–36); and

the accessibility of the Disability Support Pension payment, and the number of recipients receiving the Aged Pension payment (pp. 44–46).

Outcome 2: Families and Communities

2.15Topics discussed with DSS relating to Outcome 2 included:

the provision of 500 additional family, domestic and sexual violence frontline workers (pp. 68–70);

the Rapid Review Panel into best practice prevention approaches, including First Nations and lived experience representation and the scope and outcomes of the panel (pp. 76–80);

the Escaping Violence Payment, including associated crisis-related payments (pp. 80–81);

the provision of $4.3 million for Australia’s National Research Organisation for Women’s Safety to look at pathways into and out of perpetration of family, domestic and sexual violence (pp. 83–86);

the Innovative Perpetrator Response Program, including men’s behaviour change programs (pp. 89–91);

the number of contacts made to 1800RESPECT (p. 101); and

issues relating to the Cashless Debit Card, including anti-social and destructive behaviours exhibited after its repeal, including the number of individuals voluntarily opting in to the Smart Card (pp. 101–105).

Outcome 4: Housing and Homelessness

2.16 Topics discussed with DSS relating to Outcome 4 included:

the National Agreement on Social Housing and Homelessness (pp. 50–51);

the predominance of homelessness in Australia, including the level of homelessness experienced by younger demographics (p. 54); and

Australia’s current housing crisis as it pertains to women and children escaping violence (pp. 60–62).

Social Services portfolio agencies

2.17The committee continued its examination of the Social Services portfolio by calling officers from the Domestic, Family and Sexual Violence Commission (DFSVC) and the Australian Institute of Family Studies (AIFS).

Domestic, Family and Sexual Violence Commission

2.18Ms Micaela Cronin, Commissioner, represented the DFSVC.

2.19Topics discussed for the DFSVC included:

measuring the impact of the National Plan to End Violence Against Women and Children 2022–2032 (p. 112);

7 May 2024 crisis talks into murdered and missing women, hosted by the DFSVC (p. 115); and

staff resourcing within the DFSVC amid the existing envelope of funding from the government (pp. 116–117).

Australian Institute of Family Studies

2.20Ms Liz Neville, Acting Director of AIFS, was joined by officials from AIFS.

2.21Topics discussed for AIFS included:

AIFS’ research report: ‘Summarising the evidence: exploring what we know about drivers of violence against women, family violence and other forms of gendered violence’, commissioned by Respect Victoria (pp. 117–118); and

the current state of AIFS’ research, particularly the National Elder Abuse Prevalence Study funded by the Attorney-General’s Department (p. 118).

Health and Aged Care portfolio hearing—5 June 2024

2.22The committee called officers from the Department of Health and Aged Care (DoHAC), and discussed matters relating to Whole of Portfolio and Corporate Matters, and Outcome 1. Mr Blair Comley PSM, Secretary of DoHAC, gave evidence alongside departmental officials.

Whole of Portfolio and Corporate Matters

2.23Topics discussed with DoHAC relating to Whole of Portfolio and Corporate Matters included:

changes to staffing levels, including the surveying of staff within the department (pp. 8–10);

Departmental guidelines in relation to answering Questions on Notice (pp.10–11);

change of name of Sirius building, including process and costs (pp. 11–13; 17);

international agreements on pandemic preparedness, including International Health Regulations and Australia’s obligations (pp. 13–16; 19–20);

role of the Chief Health Economist (pp. 18–19);

COVID-19, including Gain of Function Research, excess mortality, and vaccinations (pp. 20–23); and

life insurance, including testing and rating (pp. 23–24).

Outcome 1: Health Policy, Access and Support

2.24Topics discussed with DoHAC relating to Outcome 1 included:

provision of Urgent Care Clinics, including funding, expansion, organisation, and reporting (pp. 24–30; 31–34; 70–71; 85–86);

tabling of department documents (p. 29);

hospices in Tasmania, with particular reference to stakeholder engagement and funding (pp. 30–31);

GP Clinics, with particular reference to access in Tasmania (pp. 35–38);

distribution of teddy bears in Parliament (pp. 38­–39);

Use of thinking-style assessment tools, including contract details (p. 40);

The government’s response to the Community Affairs References Committee’s Inquiry into Universal Access to Reproductive Healthcare, (pp. 43–44);

women’s health items in Budget, including reference to Menopause training for GPs (pp. 44–47);

COVID-19, including origins, gain-of-function research, vaccine safety, vaccine requirements, ivermectin as treatment, variants of virus, and government response (pp. 50–52; 53; 72–73; 73–74; 75–77; 77–78; 122–126; 126–129);

transgender healthcare, including jurisdictional standards and responses (pp. 52–53);

mental health services, including therapy, referral, crisis services, early intervention, funding, Medicare rebates (pp. 53–57; 62–64; 68–70; 81–82; 87–88; 101);

midwife insurance, with references to budget measures extending professional indemnity insurance (pp. 58–60);

Health in My Language program (p. 60);

funding/grants for peak health bodies, including timeframes and commitments (pp. 60–61);

Better Access Evaluation Report, and government’s response (p. 61);

bulk-billing rates and incentives (p. 64; 82–83);

GP training and uptake (pp. 64–65; 83);

investing in Our Communities Program, with particular reference to status of government’s previous commitments (pp. 65–66);

National Suicide Prevention Strategy (pp. 66–68; 79–81);

respiratory syncytial virus vaccine, including safety for children (pp. 71–72);

employment of Mr Duncan McIntyre (pp. 78–79);

residential eating disorder centres and their progress (pp. 83–84);

Ozempic, including compounding replicas, as well as supply and risks (pp.84–85; 89–90);

access to healthcare in the Australian Capital Territory (pp. 85–87);

use of Difluoromethylornithine (DFMO) for treatment of neuroblastoma, including effectiveness and safety for children (pp. 88; 93–94);

Government response to report of Select Committee into the Provision of and Access to Dental Services in Australia (pp. 90–92);

potential proposals for Seniors Dental Benefits Scheme, including advice given to the Minister (pp. 92; 95–­96);

Government response to Senate Community Affairs Reference Committee’s Report on Assessment and support services for people with ADHD (pp. 92–93);

nuclear safety for health care professionals (pp. 94–95);

supply and shortage of Vyvanse (pp. 96–97; 103–106);

current status of the Australian Centre for Disease Control (pp. 97–98; 106);

delivery of Proton Beam therapy facilities (pp. 98–99);

vaping, including rates of use and regulations (pp. 99–100);

endometriosis clinics, including funding and strategy (pp. 101–103);

National Stigma and Discrimination Strategy (p. 103);

National Health and Climate Strategy (pp. 106­–108);

food systems (p. 108);

shingles vaccine, including rollout (pp. 119–121); and

National Immunisation Strategy, with specific reference to consultation and discussion papers (pp. 121–122).

Health and Aged Care Portfolio Agencies and Statutory Offices

2.25The committee continued its examination of the Health and Aged Care portfolio by calling officers from the Australian Health Practitioner Regulation Agency (Ahpra), Food Standards Australia New Zealand, the National Health and Medical Research Council, the National Mental Health Commission, the National Rural Health Commissioner (NRHC), the Office of the Gene Technology Regulator and the National Blood Authority.

Australian Health Practitioner Regulation Agency

2.26Mr Martin Fletcher, Chief Executive Officer, was joined by officials from Ahpra.

2.27Topics discussed for Ahpra included:

Health and Cultural Safety Strategy (pp. 108–111);

reporting of vaccine-related deaths (pp. 111–113); and

immune imprinting (p. 113).

Food Standards Australia and New Zealand

2.28Dr Sandra Cuthbert, Chief Executive Officer, was joined by officials from Food Standards Australia and New Zealand.

2.29Topics discussed for Food Standards Australia and New Zealand included:

lab-grown meat, including genotoxicity and naming (pp. 113–115).

National Health and Medical Research Council

2.30Prof Steve Wesselingh, Chief Executive Officer, was joined by officials from the National Health and Medical Research Council.

2.31Topics discussed for the National Health and Medical Research Council included:

proposed changes to Australian Dietary guidelines, with particular reference to sustainability, stakeholders, membership of expert committee (pp. 41–43; 47–49);

funding in relation to Edward Holmes, including security checks (p.49); and

COVID-19, including origins (pp. 74–75; 77).

National Mental Health Commission

2.32Mr Paul McCormack, Interim Chief Executive Officer, was joined by officials from the National Mental Health Commission.

2.33Topics discussed for the National Mental Health Commission included:

functions of the Commission, including annual reports, progress, and proposed structural change (pp. 61–63).

National Rural Health Commissioner

2.34Professor Ruth Stewart, Commissioner, represented the NRHC.

2.35Topics discussed for the NRHC included:

MM 4 Communities, with particular reference to workforce issues and IMOC Grants (pp. 117–119); and

mental health issues in rural communities (p. 119).

Office of the Gene Technology Regulator

2.36Dr Raj Bhula, Gene Technology Regulator, was joined by officials from the Office of the Gene Technology Regulator.

2.37Topics discussed for the Office of the Gene Technology Regulator included:

mRNA vaccines, with particular reference to safety of facilities and COVID‑19 (pp. 129–132).

National Blood Authority

2.38Dr John Cahill, Chief Executive Officer, was joined by officials from the National Blood Authority.

2.39Topics discussed for the National Blood Authority included:

contamination in blood transfusions (pp. 132–33); and

distribution and cleaning of blood (p. 133).

Health and Aged Care portfolio hearing—6 June 2024

2.40The committee called officers from DoHAC, and discussed matters relating to Outcomes 2, 3, and 4. Mr Blair Comley PSM, Secretary of DoHAC, gave evidence alongside departmental officials.

DoHAC – Outcome 2: Individual Health Benefits

2.41Topics discussed with DoHAC relating to Outcome 2 included:

Bulk-billing, including rates of attendance, incentives, payroll tax (pp. 7–8; 16; 20–22; 26–27);

General Use Items, including advice around removal from Prescription List (pp. 8–10);

National Diabetes Services Scheme, including tender for subsidised products (pp. 10–11; 34; 39–40; 43–44);

Community Pharmacy Agreement, including payments (pp. 11–13; 16–20; 23–24);

cost of surgery, with particular reference to the ACT (pp. 13–16);

freezing of the co-payment on both concessional and non-concessional medicines (pp. 24–26);

medicare rebates for consultations on vaccines (p. 26);

medicines listings in relation to PBAC recommendation and PBS (pp. 30-33);

access to neuroblastoma treatment, particularly DFMO (p. 33; 45–46);

treatments to cystic fibrosis for children, particularly early access to Trikafta (pp. 33–34);

access to medical services and results for regional and rural Australians (p.35);

menopausal hormone therapies (pp. 35–37);

LARCs, with particular reference to new MBS items (pp. 37–38);

Medicare Benefits Schedule (MBS) item for endometriosis and pelvic pain, including coverage and potential for replication (pp. 38–39);

provision of $377.3 million funding for opioid dependence treatment (pp.40–41);

Health Technology Assessment Policy and Methods Review (pp. 41–42);

medicines for Type 2 Diabetes (pp. 42–43);

consultancy in relation to the Spinal Cord Stimulator review of comparative clinical and cost effectiveness (pp. 44–45); and

amendments to the MBS pathology items in line with the recommendations of the MBS Review Task Force (pp. 46–47).

Health and Aged Care Portfolio Agencies and Statutory Offices

2.42The committee continued its examination of Outcome 2 by calling officers from the Professional Services Review.

Professional Services Review

2.43Mr Bruce Topperwien, Executive Officer and General Counsel, was joined by officials from the Professional Services Review.

2.44Topics discussed for the Professional Services Review included:

administrative investigations of doctors conducted by the Professional Services Review (pp. 28–30).

DoHAC – Outcome 3: Ageing and Aged Care

2.45Topics discussed with DoHAC relating to Outcome 3 included:

ICT infrastructure, including budget (pp. 47–49; 72–73);

My Aged Care Contact Centre and website (p. 49; 76–77);

Future Fit Program, including IP, contracts, relationship with Miles Morgan (pp. 50–51; 68);

Home Care Packages, including waitlists, statistics, costs, waitlists, unspent funds (pp. 51–54; 57–58; 61–63; 65);

Aged Care wage increase, including oversight, current status (pp. 58–60);

release of public data, including provider obligations (pp. 60–61);

ACAT assessments, including geographic disparities, waiting times (pp. 63–65);

care minutes, including current allocation, proposed changes, quality assurance, feedback (pp. 68–71);

exposure draft of the new Aged Care Act, including civil and criminal penalties pertaining to misconduct (pp. 71–72; 73–76; 78);

proposed Dementia Unit in Tasmania, including feasibility (p. 77);

Aged Care Capital Assistance Program (p. 78);

financial statistics, including liquidity and payment ratios (pp. 78–80);

COVID-19, including vaccination rates in aged care (pp. 80–82); and

labour agreements (pp. 82–84).

Health and Aged Care Portfolio Agencies and Statutory Offices

2.46The committee continued its examination of Outcome 3 by calling officers from the Aged Care Quality and Safety Commission, the Independent Health and Aged Care Pricing Authority, and the Inspector-General of Aged Care.

Aged Care Quality and Safety Commission

2.47Ms Janet Anderson PSM, Commissioner, was joined by officials from the Aged Care Quality and Safety Commission.

2.48Topics discussed for the Aged Care and Safety Commission included:

compliance and monitoring of Aged Care facilities, with particular reference to Tasmania (pp. 54–56); and

exposure draft of the new Aged Care Act, including civil and criminal penalties pertaining to misconduct (pp. 75–76).

Independent Health and Aged Care Pricing Authority

2.49Professor Michael Pervan, Chief Executive Officer, was joined by officials from the Independent Health and Aged Care Pricing Authority.

2.50Topics discussed for the Independent Health and Aged Care Pricing Authority included:

allocation of funds, including work plans (p. 84);

direction from ministers (pp. 84–85); and

efficacy and accuracy of Independent Health and Aged Care Pricing Authority (pp. 85–86).

Inspector-General of Aged Care

2.51Mr Ian Yates, Acting Inspector-General of Aged Care, was joined by officials from the Inspector-General of Aged Care.

2.52Topics discussed for the Inspector-General of Aged Care included:

recommendations of the Royal Commission into Aged Care Quality and Safety (pp. 65–67); and

meetings with minister (pp 67–68).

DoHAC – Outcome 4: Sport and Physical Activity

2.53Topics discussed with DoHAC relating to Outcome 3 included:

2032 Olympics, including preparedness (pp. 86–87);

2025 Beach Volleyball World Championships, including federal and state‑level involvement (pp. 87–88);

staffing levels and resourcing, particularly in relation to elite sport (pp. 88–89);

Netball World Cup, including planning (pp. 89–90; 99; 101);

impact of climate change on athletes and events, with particular reference to heat and sustainability (pp. 94–96);

review of ASC Act, including consultation (pp. 96–97);

women’s sport, including funding, with particular reference to Netball Australia (pp. 99–100); and

2024 Olympics (p. 100).

Health and Aged Care Portfolio Agencies and Statutory Offices

2.54The committee continued its examination of Outcome 4 by calling officers from the Australian Sports Commission.

Australian Sports Commission

2.55Mr Kieren Perkins OAM, Chief Executive Officer, was joined by officials from the Australian Sports Commission.

2.56Topics discussed for the Australian Sports Commission included:

funding, with particular reference to certainty (pp. 90–92; 98–99; 100–101);

Risk Management Strategies (p. 92);

Win Well Strategy (pp. 92–94);

Prime Minister’s Olympic Dinner (p. 96); and

upgrade of AIS, including funding and process (pp. 97–98).

Senator Marielle Smith

Chair