2.1
At the 2020–21 Budget estimates hearings, the Senate Community Affairs Legislation Committee (committee) considered matters relating to the expenditure and operations of the Australian Government for the Health portfolio and Social Services portfolio.
2.2
The key issues considered by the committee during the hearings are reported in this chapter. Key issues reported include references to the Committee Hansard, which provides a verbatim record of the evidence received by the committee.
Health portfolio hearing – 26 October 2020
Whole of portfolio / Corporate matters
2.3
The committee discussed the work being undertaken by the government on the development and supply of a COVID-19 vaccine. Ms Schofield, First Assistant Secretary, Health Economics and Research Division noted that the government has signed an agreement with Gavi to join the Covax Facility. Ms Schofield highlighted:
There are two components to the Covax Facility, just to be really clear. There's a self-financing component, which is the piece that we joined on 21 September, and there's also something called the advanced market commitment, which is for developing countries. Australia has provided an $80 million commitment to that piece. On the self-financing component of Covax: Covax has said that it will guarantee 20 per cent population coverage for all countries who join. Countries have an option to sign up to more than that and Australia has signed up for 50 per cent population coverage. So, essentially, under Covax Australia is working on the basis that we will have enough doses for 50 per cent of our population. In terms of which vaccines that would be: that's yet to be determined. We don't have any data on any of the vaccines yet—about which ones may be successful.
2.4
Ms Edwards, Associate Secretary, added:
At the moment, through the arrangements we have so far, in addition to the 50 per cent through the Covax Facility, we have access to 80 million doses. We're expecting that any vaccine that we know about at this stage would require two doses. That means we need 50 million for the Australian population.
Outcome 1: Health System Policy, Design and Innovation
2.5
The committee discussed the Medical Research Future Fund grant application process and progress on dispersing this funding. Ms Somi, Assistant Secretary, Health Economics and Research Division stated '81 per cent of funding in 2019-20 was provided through competitive or targeted competitive processes'.
2.6
The committee asked the Australian Institute of Health and Welfare and Australian Commission on Quality and Safety in Health Care about the collection of hospital data and changes to performance indicators to analyse this data.
Outcome 2: Health Access and Support Services
2.7
The committee asked departmental officials about the impacts of the pandemic on mental health, including access to digital health services, and progress being made on the delivery of additional headspace clinics.
2.8
Mr Roddam, First Assistant Secretary, Mental Health Division, commented on the demand for mental health services during the pandemic:
We're really closely monitoring the use of services such as Lifeline, Kids Helpline and Beyond Blue. That tells us very much about the demand out there. All of those services are experiencing a significant increase on last year—around 28 per cent higher than the same time in 2019, if you combine Lifeline, Kids Helpline and Beyond Blue. In a package announced on 15 May, there was funding announced for modelling the pandemic.
2.9
The committee discussed the effect of the pandemic on the mental health of young people. Ms Morgan, Chief Executive Officer, NMHC explained:
If you look at the trends for young people, certainly for young people who are facing disruption with their education in the last couple of years of their schooling, there has been a significant increase in psychological distress and anxiety ... And young people are more than just in that demographic of those in the last couple of years at school; you look at the trends for those up to about 25, and there have been those increases. There will be anecdotes behind that. The reasons for their distress are, in some instances, specific to young people. We have heard that young people have felt a real sense of loss of hope in terms of the future and what it may hold.
2.10
The committee also asked about the 'Stronger Rural Health Strategy' and the government's announcement of funding to support trials of different primary care models to identify ways of improving access to health professionals in rural and remote Australia.
Outcome 4: Individual Health Benefits
2.11
Departmental officials noted the uptake in Telehealth due to the pandemic and spoke about an extension of Telehealth arrangements following an evaluation process.
2.12
The committee asked about a proposal for stillbirth autopsies to be covered by the Medicare Benefits Scheme and other possible funding arrangements.
2.13
Departmental officials advised the committee that the government has reached an agreement with Medicines Australia to extend statutory price reductions for a further two years, the agreement was due to cease in 2022.
Health portfolio hearing – 27 October 2020
Outcome 5: Regulation, Safety and Protection
2.14
The committee asked about manufacturing of medicines within Australia and how the department identifies and responds to critical shortages.
2.15
Departmental officials advised the committee that the 'Clinical Evidence Taskforce' reviews potential products to treat COVID-19 and provides advice to government on whether there's evidence for or against this treatment, or if the taskforce is still investigating its suitability.
2.16
The committee asked departmental officials about the national medical stockpile, the availability of personal protective equipment (PPE) and what supplies had been provided to state and territories.
2.17
The committee also asked about the how the government coordinated Australia's response to the pandemic. Dr Murphy, Secretary of the Department of Health, outlined the government's role:
Our health protection system in a federation consists of the Office of Health Protection and Response in the Department of Health, but within that sits the Australian Health Protection Principal Committee [AHPPC], which Professor Kelly now chairs, and that comprises all of the state and territory chief health officers and a range of invited experts. One of the challenges in a federation is that the on-the-ground response is delivered by states and territories, and the Commonwealth plays a coordinating and leadership role and brings everything together through this AHPPC structure.
Outcome 6: Ageing and Aged Care
2.18
The committee asked about the spread of COVID-19 in aged care facilities and data on deaths in aged care caused by the virus.
2.19
Departmental officials discussed aged care workers working across multiple sites, and plans for a national 'worker registration program' to track workers that are covered under the one-worker one-site provisions.
2.20
The committee asked questions relating to the government's response to recommendations from Royal Commission into Aged Care Quality and Safety and the additional funding provided to the sector to assist with visitation and infection control officers. Mr Lye, Deputy Secretary, Ageing and Aged Care Group stated:
That announcement involved a payment of $245 million to support providers with COVID costs, including supporting communication with families and managing visitation arrangements. That payment is paid upon their provision of acquittals against the last period, so those payments are made as those reports come in. Those payments started in early October and are continuing through this month.
Outcome 3: Sport and Recreation
2.21
The committee asked about the impacts of COVID-19 on community clubs. Mr Walker, Chief Executive Officer, Australian Sports Foundation outlined:
We partnered with Victoria University, who did a contemporaneous study on the impact on physical and mental health of sports participants who suffered during the shutdown. That study showed a 30 per cent decline in physical and mental health through the absence of community sport.
2.22
Departmental officials discussed guidelines for community sport development grants and funding for sports club grants.
Other topics raised
2.23
Other topics covered during the two days of hearings with the Health portfolio included:
thalidomide support package;
opioid dependence treatment program;
private health insurance;
alcohol and drug services;
home medicine delivery program;
Medical Cost Finder website;
National Diabetes Service Scheme;
climate change and preparedness of health systems; and
storage and regulation of radioactive waste.
Social Services portfolio hearing – 28 October 2020
Whole of portfolio / Corporate matters
2.24
The committee discussed the coronavirus supplement and Jobseeker payment. Departmental officers discussed the advice provided regarding decisions to adjust and extend the payments.
Outcome 1: Social Security
2.25
The committee asked about the JobMaker Hiring Credits, Minister Ruston stated:
The hiring credits program that was announced as part of the budget, it was particularly focused at younger Australians who'd found themselves out of work because, disproportionately, the people who have lost their jobs during this pandemic have been younger Australians.
2.26
The committee also discussed the payments provided during lockdown, Minister Ruston outlined:
The effective doubling of the JobSeeker payment, with the addition of the coronavirus supplement at that time, recognised the fact that there would be no expectation that anybody who was on a working age payment would be able to look for work.
2.27
Departmental officials discussed the seasonal work measure and package to encourage people into the agriculture and horticultural sector.
Outcome 2: Families and Communities
2.28
Departmental officials advised the committee on aspects of the cashless debit card (CDC) program:
evaluation of trial sites and community consultation undertaken;
if the Bill (Social Security (Administration) Amendment (Continuation of Cashless Welfare) Bill 2020) passes there will be a transition of people on a BasicsCard to CDC. This implementation processes would commence three months after royal assent; and
the product level blocking technology used on EFTPOS machines to prevent the sale of restricted items.
2.29
The committee discussed the domestic and family violence funding given to states and territories to deliver frontline services during the pandemic.
2.30
The committee asked about the operation of the National Redress Scheme by the department, specifically details on the privacy breaches and processing of applications.
Social Services portfolio hearing – 29 October 2020
Outcome 3: Disability and Carers
2.31
The NDIS commission was asked about the process of investigating complaints, the role of investigators and additional authorised officers that support this work.
2.32
The NDIS commission advised the committee on the increase in its workload due to the addition of five jurisdictions at the beginning of 2019-20. Mr Head, NDIS Quality and Safeguards Commissioner stated:
The volume of reportable incidents are partly driven by the fact that this scheme is new for most providers around the country ... there are aspects of the activity levels that we believe are likely to change when transition is complete in about 12 months time.
2.33
The NDIA advised the committee on the role of health liaison officers in hospitals to assist with educating potential participants about NDIS and assisting with access to services.
2.34
The committee asked the NDIA about its response to the pandemic and approach the agency took to ensure access to support services particularly during lockdowns.
Outcome 4: Housing and Homelessness
2.35
The committee discussed the 'National Housing and Homelessness Agreement' and arrangements for federal funding to be provided to states and territories to deliver social housing and homelessness services.
Digital Transformation Agency
2.36
The committee asked the officials from the Digital Transformation Agency (DTA) about the COVIDSafe app. Officials advised the committee that the app's definition of a close contact is provided by AHPPC and can be updated based on health advice. The app is considered one aspect of the broader public health response. Mr Brugeaud, Chief Executive Officer, DTA advised it can 'validate close contacts that are identified through manual contact tracing' and also allows health officials to manage close contacts and identify clusters.
Services Australia
2.37
The committee asked officials how they identify customers experiencing family and domestic violence and about the additional support provided to these customers.
2.38
The committee discussed the progress being made on refunds and zeroing of debt by Services Australia.
2.39
Officials from Services Australia advised the committee on income compliance reporting, the recommencement of debt raising and how 'Single Touch Payroll' should improve this process for customers.
Other issues
2.40
Other topics covered during the two days of hearings with the Social Services portfolio included:
consultancy costs and staffing contracts;
Commonwealth Rent Assistance;
demographics on Jobseeker payments and Youth Allowance;
Disability Support Pension;
'Help is Here' campaign – response to domestic violence during COVID-19 lockdown; and
mobiles services and surge workforce from Services Australia to respond to disasters.
Senator Wendy Askew
Chair