2.1
At the 2021–22 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 and social services portfolios.
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 – 1 June 2021
Whole of portfolio / Corporate matters
2.3
The committee discussed the COVID vaccine rollout to vaccinate aged care residents. Senator the Hon Richard Colbeck provided the following data:
… in aged care who have received their first vaccination across the country is 153,641. That is out of 183,000, which is the notional number of vaccinations to be applied. And 116,688 have received their second dose. But we don't have with us the granularity on that information by state.
2.4
The committee also asked about the change in health advice to vaccinate aged care workers separately to aged care residents. Senator the Hon Richard Colbeck stated:
The original process was that we were going to vaccinate staff and residents at the same time. We received health advice that we shouldn't do that…We are providing a number of different channels for staff to access the vaccine so that we can make it as easy as possible for them to do so…We've had to then design a system and work with providers who most reasonably hold that data to provide us with reporting...any figures that we gave to you at this point in time would underreport the number of staff who have actually taken up the vaccination.
2.5
The committee asked for an update regarding the recent change in health advice that recommended the AstraZeneca vaccine only be given to people over the age of 50.
2.6
The committee also raised the following topics:
the efficacy of the vaccines and importance of first dose for protection against hospitalisation;
COVID variants and the possibility people will require boosters for protection; and
vaccine campaigns that target culturally and linguistically diverse audiences and Aboriginal and Torres Strait Islander communities.
Outcome 1: Health Policy, Access and Support
2.7
The committee discussed the general practitioner training and update to clinical guidelines regarding the new requirement for a prescription to purchase nicotine for e-cigarettes.
2.8
The committee asked the National Health and Medical Research Council about the review of Australian Dietary Guidelines and public consultation process.
2.9
Department officials provided an update on the $2.3 billion allocated for suicide prevention in First Nations communities. The largest portion of this funding going to establishing suicide prevention networks, culturally appropriate aftercare services and a 24/7 crisis line.
2.10
The committee also heard evidence about the ongoing negotiation of the new mental health and suicide prevention agreement with the states and territories and work being done to integrate services in areas identified by the Productivity Commission.
2.11
Within outcome 1 the committee also asked about:
suitability of hotel quarantine due to issues with ventilation;
work being done to establish quarantine facilities similar to Howard Springs in other jurisdictions;
the commonwealth's per activity contribution to public hospitals and response if demand exceeds the current 6.5 per cent cap; and
the mental health of frontline workers and funding to provide trauma informed care and mental health first aid to frontline workers.
Health portfolio hearing – 2 June 2021
Outcome 3: Ageing and Aged Care
2.12
The committee discussed the $17.7 billion funding package for the aged-care sector, with a focus on home care, sector sustainability and workforce.
2.13
The committee asked for an update on the government's response to the 148 recommendations in the Royal Commission's Aged Care Quality and Safety final report.
2.14
The Department of Health updated the committee on the introduction of $10 per resident per day payment, with providers required to report quarterly on adequacy of living conditions against new quality standards.
2.15
The committee also discussed the following areas:
release of an additional 80,000 home-care packages and funding for home‑care workforce;
single site working arrangements for aged care workers when a hotspot is declared;
mental health of older Australians in aged care; and
drafting of legislative principles on the use of chemical and physical restraints in aged care.
Outcome 2: Individual Health Benefits
2.16
The committee asked for an update on the new or amended PBS listings, including medication for chronic migraines.
2.17
The committee asked the department about their work to finalise the terms of reference for opioid dependency treatment program review and other investments in alcohol and drug treatment services.
2.18
The committee also asked about access to Medicare for people within the justice system.
Outcome 4: Sport and Recreation
2.19
The committee asked about the processes for approving and announcing grants for sporting facilities made under the Community Sport Infrastructure Grants program.
2.20
The committee discussed Gymnastics Australia commissioning the Human Rights Commission investigation into abuse allegations within the sport, and the process of dealing with issues highlighted in the report, including reform to how the sport operates.
2.21
Another area of focus for the committee was the upcoming Olympic and Paralympic games. The committee asked about plans in place for the teams, including vaccination of athletes, continuous COVID testing and restrictions while in Tokyo.
2.22
The committee also asked about the 2032 Olympic bid and other international sporting competitions to be hosted by Australia in the coming years.
2.23
Another topic raised was female representation in Sport Australia, particularly at executive levels.
Social Services portfolio hearing – 3 June 2021
Whole of portfolio / Corporate matters
2.24
The committee asked officials about the income support payments available for Victorians in lockdown and the potential for a new disaster payment to provide grants to people in lockdown.
2.25
Other topics raised were:
the department's third reconciliation action plan to guide their contribution to the overall reconciliation movement; and
the work being undertaken by Boston Consulting.
Outcome 2: Families and Communities
2.26
The committee asked about plans for a women's safety summit and the consultation process for the next National Plan to Reduce Violence Against Women and their Children.
2.27
This committee also discussed the women's economic security and safety funding package and transitional funding to ensure additional resources are available until the next plan comes into effect.
2.28
Other topics of interest to the committee were:
review of campaign materials developed by Our Watch;
funding for frontline service providers responding to domestic and family violence; and
the cashless debit card (CDC) transition process for people on a BasicsCard and the exit process for participants.
Outcome 1: Social Security
2.29
The committee asked for an update on the announcement of a COVID disaster payment to assist people in an extended lockdown (longer than 7 days). Minister Ruston stated:
The provisions that have been announced today, on day 6 of the Victorian lockdown, relate to the fact that we have now been advised that the Victorian lockdown in metropolitan Melbourne is going to continue past the seven days. The measure that has been put in place has been put in place using a mechanism that is under the jurisdiction of the Department of Home Affairs.
2.30
Other topics discussed by the committee were:
jobseekers with partial capacity to work and review of the Disability Support Pension (DSP) impairment tables; and
expansion of the Pension Loan Scheme.
Social Services portfolio hearing – 4 June 2021
Outcome 4: Housing
2.31
The committee asked about the allocation of the Safe Places grants and additional funding to extend the program to cover geographical areas identified as most in need.
2.32
The committee also asked about the National Housing and Homelessness Agreement and the plan to improve data available to the government by collecting a broader range of reportable information from states and territories.
Outcome 3: Disability and Carers
2.33
The committee discussed the performance of the Carer Gateway server, which commenced in April 2020, and work being done to improve engagement with the service.
2.34
The committee asked about Disability Employment Service (DES) provider obligations and possible areas to reform.
2.35
The committee questioned the National Disability Insurance Agency (NDIA) about participants having difficulty getting a psychiatric assistance animal funded in their plan.
2.36
Other topics discussed with the NDIA were, the independent assessment tools to be used as part of the personalised budget process for participants, the data sources required to build a personalised budget, and a need to understand environmental factors to determine how to weight a person's functionality score in this process.
2.37
Other areas of interest to the committee were:
pause of independent assessments legislation;
a participant privacy breach; and
vaccination of NDIS participants, carers, and workers.
Services Australia
2.38
The committee asked Services Australia about their legal fees for the Gordon Legal class action and Victoria Legal Aid challenge.
2.39
The committee also asked about Jobseeker and heard the number of claims were generally returning to pre-pandemic levels.
2.40
Other topics discussed with Services Australia were:
process of identifying and responding to client's experiencing family or domestic violence, and protections for those seeking child support;
Ernst & Young reviewing how the agency protects customer information from unauthorised disclosure to a former partner; and
their role in maintaining Australia's immunisation records on behalf of the Department of Health, including a certificate for COVID vaccinations.
Spill over hearing
2.41
The committee examined outcomes of the health and social services portfolio at a spill over hearing on 3 September 2021. The areas examined were:
Department of Health, outcomes 1, 2 and 3, including the National Rural Health Commissioner and the Aged Care Quality and Safety Commission;
Services Australia whole of portfolio; and
Department of Social Services, outcome 3, including the NDIA and NDIS Quality and Safeguards Commission.
Key topics
2.42
The committee received an update on the vaccine rollout, Lieutenant General Frewen, Coordinator General, National COVID Vaccine Taskforce Division stated:
We have now passed 20 million doses administered in Australia. Over 61 per cent of people aged over 16 have received their first vaccination, and over 37 per cent have received their second dose…In the last seven days, 1.94 million doses have been delivered.
2.43
The committee asked about the national plan and transitioning to living with COVID. Dr Murphy, Secretary, Department of Health, noted:
…state and territory leaders will jointly be developing and signing off on a plan for living with COVID, which is one that involves sustainable use of the health system and maintenance of elective surgery and has significant reserve capacity should significant outbreaks happen and pressure be there.
2.44
The committee also asked about the plan to improve vaccination rates among First Nations people. Dr Lucas de Toca, First Assistant Secretary, National COVID Vaccine Taskforce Division outlined:
…we are specifically focusing those activities in areas where there might already be access and there might be vaccination rates ongoing, as they are in most remote communities, but they will require additional support from workforce to augment current services to actually lift those rates up.
2.45
Other topics discussed by the committee were:
COVID hospitalisation numbers across the country;
plans to target the 30 local government areas with the lowest COVID vaccination rates;
broadening the use of rapid antigen testing, for example in schools;
COVID misinformation and analysis of vaccine hesitancy;
vaccinating 12 to 15 year olds;
allowing the prescription of psychedelics in psychotherapy;
progress on the preventative health strategy;
round table with regional and rural healthcare providers to discuss preparedness for living with COVID;
funding for Meals On Wheels; and
aged care workforce and staffing of facilities in rural areas.
2.46
The committee asked Services Australia about the number of people accessing their immunisation history and COVID vaccine certificate.
2.47
The committee also asked about safeguards in place to ensure that the COVID vaccination certificates are not subject to fraud. Ms Skinner, Chief Executive Officer, noted:
…That certificate, which people will see through the Express Plus Medicare app, has an increasing range of features, including a moving tick and a shimmering coat of arms. And, of course, you also have to authenticate to get into that space. So there's a range of measures to ensure that that certificate is safe.
2.48
The committee discussed with the NDIA their data on participants plan utilisation. Ms Sarah Johnson, Scheme Actuary, highlighted:
In looking at plan utilisation, we look at it by participants in supported independent living and participants who are not in supported independent living. Participants in supported independent living use a high proportion of their plan … In the projection, because over time the number of people in that scheme compared with the new entrants that come in each year is a growing proportion, we expect utilisation to increase because, on average, participants have been in the scheme for longer.
2.49
Other areas of interest to the committee were:
financial modelling and sustainability of the NDIS scheme;
COVID cases and deaths among NDIS participates and workers;
vaccination rates among NDIS participates and workers; and
appointment of NDIS Quality and Safeguards Commissioner.
Senator Wendy Askew
Chair