2.1
At the 2022–23 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 April 2022
Corporate matters
2.3
The Government provided an update on the COVID-19 vaccine rollout. Lieutenant General John Frewen, Coordinator General, Operation COVID Shield, provided the following data on vaccination rates for vulnerable and hard-to-reach cohorts:
…90.9 per cent of aged-care residents and over 98 per cent of aged-care workers are fully vaccinated; 86.9 per cent of disability residents, 85.4 per cent of NDIS participants and 94.5 per cent of disability support workers are fully vaccinated; 80.1 per cent of Indigenous Australians are fully vaccinated; and 80.1 per cent of 12–15 year-olds are fully vaccinated.
Outcome 3: Ageing and Aged Care
2.4
The committee discussed the Government’s $18.8 billion funding package for the aged care sector, with a focus on workforce and wages.
2.5
The committee asked for an update on the Government’s response to recommendations made in the final report by the Royal Commission into Aged Care Quality and Safety.
2.6
The committee also discussed the Royal Commission’s recommendation
for minimum staff time standards for residential care. Senator the Hon Linda Reynolds outlined that the Government has:
…accepted the royal commission's recommendation for an increase in the aged-care minutes and we're responding through measures to the residential aged-care services and sustainability funding drive to do that. From 1 July 2024 the minimum staff standard should increase to require approved providers to engage registered nurses, enrolled nurses and personal care workers for the average resident for at least—at least—215 minutes per resident, per day. This is backed by that extra $3.9 billion in additional funding. We are also supporting our nurses with a wage bonus to attract more nurses into aged care.
2.7
The committee inquired into the progress of bonus payments grants for aged care workers and the Government’s nutrition-based funding uplift for aged care providers.
2.8
The committee also asked about the following topics:
the sustainability of regional aged care facilities;
eliminating the use of chemical restraints in residential aged care homes;
additional COVID-19 vaccination for aged care residents and workers;
funding for home care packages under the Home Care Workforce Support Program; and
the role of allied health in aged care.
Outcome 1: Health Policy, Access and Support
2.9
The committee discussed COVID-19 vaccinations and the role of boosters in reducing rates of serious illness. Chief Medical Officer, Professor Paul Kelly, explained the importance of vaccination in Australia’s public health response to COVID‑19:
There’s no doubt that the absolute best way to avoiding COVID-19 has been vaccination…They are a safe and effective way of preventing death. They are a safe and effective way of preventing severe complications of disease…vaccination is protection against infection as well as severe disease.
2.10
Departmental officials provided extensive information about quality assurance, efficacy and safeguards in place for the COVID-19 vaccination program.
2.11
The committee also discussed access to vaccination for Japanese encephalitis.
2.12
The committee asked for an update on the Government’s implementation of recommendations made by the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, particularly regarding the experiences of people with disability during the ongoing COVID-19 pandemic.
2.13
Officials provided information about primary care measures contained in the budget, including:
changes to MRI eligibility under the Medicare Benefits Schedule (MBS);
measures to support women’s health, including endometriosis and pelvic pain management, cervical cancer screening and to progress the National Stillbirth Action and Implementation Plan;
ongoing funding for telehealth services under Medicare;
funding for after-hours primary care services; and
public dental services for adults and the National Child Oral Health Study.
2.14
The committee also heard evidence about an additional $300 million in funding for the Stronger Rural Health Strategy.
Health portfolio hearing–6 April 2022
Whole of portfolio / corporate matters
2.15
The Department of Health updated the committee on actions taken under the final phase of the national plan to respond to COVID-19.
Outcome 1: Health Policy, Access and Support
2.16
The committee continued to discuss the COVID-19 booster rollout program, focusing on the aged care sector.
2.17
The committee also discussed safeguards, public health advice, and efficacy of vaccines.
2.18
The committee heard evidence about the Government’s 10-year primary health care plan and the Stronger Rural Health Strategy, with a particular focus on primary health in rural and regional areas. The Government also outlined measures to address rural primary health workforce issues, including under the National Medical Workforce Strategy.
2.19
Other topics discussed included:
winter preparations for aged care facilities, including the pre-deployment of personal protective equipment, and ongoing vaccination support for aged care residents and workers;
the role of nicotine vaping products as a method to reduce smoking rates, including under the National Tobacco Strategy 2022–30; and
$58 million allocated to support research, early diagnosis and treatment of endometriosis.
Outcome 2: Individual Health Benefits
2.20
The committee asked for an update on the development of a website to report on out-of-pocket expenses for treatments listed on the MBS.
2.21
The committee also discussed the inclusion of new medicines on the Pharmaceutical Benefits Scheme.
Outcome 3: Ageing and Aged Care
2.22
The committee asked about aged care workforce issues, including in relation to the case before the Fair Work Commission to increase the wages of the aged care sector, processing Aged Care Workforce Bonus payments, issues affecting home care workers and the surge workforce.
2.23
The committee discussed implementation of recommendations made by the Royal Commission into Aged Care Quality and Safety, including recommendations concerning the new general duty of care, minimum minutes of direct care and ‘24/7’ availability of nurses in aged care settings.
2.24
The committee also heard evidence about access to residential and home care services for rural and regional Australians.
Outcome 4: Sport and Recreation
2.25
The committee discussed a range of budget measures overseen by Sport Australia, including:
a new women’s health and leadership hub;
promotion of leadership, safety and employment opportunities for women in sport;
funding for Sport Integrity Australia and anti-doping programs;
measures relating to international sporting events and community sport participation;
funding for the AusPlay survey and national sports injury database;
sports related community development grants; and
unallocated funding for female facilities and water safety.
2.26
Department officials discussed the benefits of appointing a single person
as both Chief Executive Officer of Sport Australia and as Director of High Performance at the Australian Institute of Sport.
Social Services portfolio hearing–1 April 2022
Outcome 1: Social Security
2.27
The committee asked for an update on the delivery of the Cost of Living Payment to help eligible recipients meet cost of living pressures. Senator the Hon Anne Ruston stated:
…unusual circumstances with supply chains and the disruption in northern Europe have seen a spike in prices, particularly at the bowser. The $250 payment that six million Australians will be receiving in April, we hope, will be able to provide them with some additional cost of living pressure relief.
2.28
Other topics discussed by the committee were:
changes to paid parental leave policy;
the rate of jobseeker payments;
consideration of recommendations made by Economic Justice Australia relating to social security recipients facing domestic violence; and
review of the disability support pension impairment tables.
Outcome 2: Families and Communities
2.29
The committee asked about budget measures for women’s safety and the consultation process for the next National Plan to Reduce Violence Against Women and their Children.
2.30
This committee asked about an additional $40 million for escaping domestic violence payments.
2.31
Other topics of interest to the committee were:
strong and resilient communities grants;
the cashless debit cards (CDC); and
the Equal Remuneration Order supplement for the National Housing and Homelessness Agreement.
Outcome 3: Disability and Carers
2.32
The committee questioned the National Disability Insurance Agency (NDIA) about fraud intelligence investigations by the NDIA and National Disability Insurance Scheme (NDIS) appeal outcomes.
2.33
The committee asked about provision of early childhood services under the Partners in the Community Program, including financial support for the development of a NDIS plan.
2.34
The committee also asked about the selection process for the Chair of the NDIA Board.
Services Australia
2.35
Senator the Hon Linda Reynolds CSC advised the committee of Services Australia’s response to flood affected regions, including Commonwealth financial support payments and on-the-ground services:
Since 1 March we've supported more than 1.5 million Australians in flood affected regions and have paid more than $1.4 billion in Commonwealth financial supports to some 81 local government areas…Across flood affected regions, Services Australia has more than 200 service points already directly assisting over 25 000 people on the ground.
2.36
The committee asked about the Cost of Living Payment and its notification process for recipients.
2.37
Officials provided information about delivery of services by Services Australia, including staffing levels, availability of face‑to‑face services, call wait times, and the location of Centrelink shopfronts.
Social Services portfolio hearing–7 April 2022
Whole of portfolio / corporate matters
2.38
The committee questioned officials about the structure of core and project funding for the Department of Social Services (department) over the forward estimates. Officials confirmed that while some projects will be completed during the period of the forward estimates, there is no reduction affecting the department’s core activities.
Outcome 1: Social Security
2.39
The committee discussed progress through the Parliament of workforce incentive reforms to enable pensioners to retain their pension status and healthcare card access for two years after re-entering the workforce.
Outcome 2: Families and Communities
2.40
The committee asked the department about a range of matters relating to income management using CDC, including:
the number of people using these cards and the proportion who are Aboriginal or Torres Strait Islanders;
meetings of the CDC technology working group;
expiry of the Government’s contract with Indue to provide CDC;
the budget allocation for the Cashless Welfare Policy and Technology Branch within the department; and
2.41
The committee discussed the provision of emergency relief services to flood affected regions, including coordination with non-government organisations.
2.42
Officials provided information about the National Redress Scheme, including in relation to processing times, the two-year review of the scheme, access to redress by prisoners, non-citizens and non-permanent residents, and advanced payments for some victim-survivors.
2.43
The committee also discussed budget measures for an Aboriginal and Torres Strait Islander centre for excellence in child and family support and the next National Plan to Reduce Violence Against Women and their Children.
Outcome 3: Disability and Carers
2.44
The committee discussed actions taken by the department in response to reports of WISE Employment’s treatment of a jobseeker recipient.
2.45
The committee asked about implementation of the National Disability Strategy. Officials provided information about actions taken under:
the Employment Targeted Action Plan
the Early Childhood Targeted Action Plan
the Safety Targeted Action Plan, and
the Emergency Management Targeted Action Plan.
2.46
The committee continued discussions about early childhood services under the Partners in the Community Program. Departmental officials provided information about a time in motion study underpinning estimates of the time required to complete various activities as part of a NDIS plan review, and funding for those activities.
2.47
The committee asked the NDIS Quality and Safeguards Commission about the selection process for the recently appointed Complaints Commissioner. The committee also asked about:
distribution of rapid antigen tests under the NDIS, and
a framework review to ensure the structure of the NDIS Commission enables it to perform its function as a disability services market regulator.
2.48
The committee asked the NDIA about progress of the 2021–22 annual price review.
Services Australia
2.49
The committee continued discussions about service delivery by Services Australia, including in relation to staffing levels, contingency planning for future pandemics and natural disasters and the location of Centrelink shopfronts.
2.50
The committee asked Services Australia about provision of information relating to the Centrelink Income Compliance Program.
2.51
Other topics discussed with Services Australia were:
changes to project funding over the forward estimates; and
Medicare compensation recovery.
Chair