Budget Estimates 2006-07
20 June 2006
© Commonwealth of Australia 2006
ISBN 0 642 71661 7
View the report as a single document - (PDF 109KB)
Membership of the Committee
Senator Gary Humphries, Chairman |
LP, Australian Capital Territory |
Senator Claire Moore, Deputy Chair |
ALP, Queensland |
Senator Judith Adams |
LP, Western Australia |
Senator Guy Barnett |
LP, Tasmania |
Senator Kerry Nettle |
AG, New South Wales |
Senator Helen Polley |
ALP, Tasmania |
Senator Fiona Nash [replaced
Senator Adams on 29 May 2006] |
NATS, New South Wales |
Senate Community Affairs Legislation Committee Secretariat
Mr Elton Humphery – Secretary
Ms Leonie Peake – Research Officer
The Senate
Parliament House
Canberra ACT 2600
Phone: 02 6277 3515
Fax: 02 6277 5829
E-mail: community.affairs.sen@aph.gov.au
Internet: http://www.aph.gov.au/senate_ca
Senate Community Affairs Legislation Committee
Report on Budget Estimates 2006-2007
1.1 On 9 May 2006 the Senate referred the following documents to the Committee for examination and report in relation to the portfolios of Families, Community Services and Indigenous Affairs, and Health and Ageing:
- Particulars of certain proposed expenditure in respect of the year ending on 30 June 2007
- Particulars of proposed expenditure in respect of the year ending on 30 June 2007
- Particulars of certain proposed supplementary expenditure in respect of the year ending on 30 June 2006
- Particulars of proposed supplementary expenditure in respect of the year ending on 30 June 2006.
1.2 The Committee has considered the budget expenditure of the portfolios set out in their respective Portfolio Budget Statements 2006-2007 (PBS) and Portfolio Supplementary Additional Estimates Statements 2005-06. Explanations relating to the estimates were received from Senator the Hon Rod Kemp, representing the Minister for Families, Community Services and Indigenous Affairs and Senator the Hon Santo Santoro, Minister for Ageing and Minister representing the Minister for Health, and officers from the portfolio Departments at hearings held on 29, 30, 31 May and 1 June 2006. The Committee expresses its appreciation for the assistance of the Ministers; Dr Jeff Harmer, Secretary, Department of Families, Community Services and Indigenous Affairs (FaCSIA), and Ms Jane Halton, Secretary, Department of Health and Ageing (DoHA); and the officers who appeared before it.
1.3 In accordance with Standing Order 26, the Committee has agreed that the date for submission to the Committee of written answers or additional information relating to the expenditure is 28 July 2006.
1.4 The Committee discussed many of the expenditure proposals and information contained in the Portfolio Budget Statements. These discussions are detailed in the Committee's Hansard transcripts of 29, 30, 31 May and 1 June 2006, copies of which will be tabled in the Senate. Hansard transcripts of the estimates proceedings are also accessible on the Committee's website at http://www.aph.gov.au/senate_ca. Volumes of Additional Information received by the Committee containing answers to questions taken on notice and tabled documents relating to the Committee's hearings will also be tabled separately in the Senate and may also be accessed from the Committee's website.
Procedural matters
Conduct of the hearings
1.5 As noted in the Committee's previous report, the hearings continue to be conducted in a cooperative manner with goodwill from all participants. At the conclusion of both the FaCSIA and DoHA hearings, the respective Ministers, Senator the Hon Rod Kemp and Senator the Hon Santo Santoro, congratulated Senators on how well the hearings had been conducted and thanked Departmental officers for their performance.[1]
1.6 The Committee Chair also expressed his thanks to everyone involved in the hearings, commenting that:
I think it has been a committee inquiry which has been conducted with a measure of civilised behaviour which reflects well on the dignity of the Senate. So I thank the members of the committee for having contributed to that environment.[2]
1.7 Senator McLucas expressed concern that Minister Santoro had not been present for lengthy periods during two days of the hearings, including the outcomes for ageing for which he was directly responsible. She believed this had led to a disruption in questioning and a delay to the proceedings as the Minister had to return to issues later in the hearing.
Revised Portfolio Structure and Outcomes
1.8 Significant changes to the Portfolio Structure and Outcomes for both portfolios, compared to the previous budget year, provided for some operational and administrative challenges.
1.9 Administrative Arrangements Orders issued on 27 January 2006 resulted in significant changes to the FaCSIA portfolio. The Department assumed responsibility for Indigenous affairs through the transfer of the Office of Indigenous Policy Coordination (OIPC) and its responsibilities from the former Department of Immigration and Multicultural Affairs, including responsibility for two agencies and a number of land councils. FaCSIA's revised Outcome structure now consists of four Outcomes.[3]
1.10 The Committee sought information regarding the lines of responsibility between OIPC and FaCSIA. The Secretary explained to the Committee:
We have revised our governance arrangements so that the OIPC and the old FaCS executive are part of the key decision-making body in the department. We have consolidated our corporate services areas so that the corporate areas now provide services to both the former OIPC and the old FaCS.
We have also moved to make some other changes in policy areas. The Indigenous policy branch that was in the old FaCS has been changed so that some of those functions have gone to OIPC and others to the Social Policy Group. The OIPC remains as a separate entity within FaCSIA. It has responsibilities for coordinating the whole-of-government approach to Indigenous affairs; providing the secretariat for the secretary's meetings, the taskforce and the National Indigenous Council; and reporting on whole-of-government issues. It relates directly to the minister on whole-of-government issues. The FaCSIA department still retains responsibility for key programs in Indigenous affairs, including the Community Housing and Infrastructure Program, family violence programs and other mainstream programs that provide assistance to Indigenous Australians.[4]
1.11 Health and Ageing portfolio's revised outcome structure increased to 15 Outcomes. The new outcomes include mental health and health workforce, and separate outcomes for pharmaceutical services and medical services. Cancer Australia is an additional agency.[5]
1.12 In response to the Committee's request for an explanation as to the reasons for the changed outcome structure the Secretary responded:
Firstly, we have taken on some additional responsibilities. We now have an Office of Health Protection that you would be aware of. We have also had a significant additional injection of funding. The increasing complexity and size of the outcome that previously combined pharmaceutical and medical has meant that we decided for the purposes of clarity it was better to disaggregate, if you like, the programs in the portfolio. Essentially, particularly medical and pharmaceutical had become so large that for the purposes of accountability we had decided – and with the agreement of Finance – it would be better if we disaggregated things a little more.
... Essentially there has been some realignment. As you would well understand, as policy moves on and issues develop, the question of where things are best aligned is something we have been spending a bit of time looking at. There has been some move in some of the components of programs, as there will be in terms of which divisions manage them.[6]
1.13 The Committee was assisted in more easily finding where programs were now located in both portfolios by FaCSIA tabling a list of all programs with their corresponding outcome/output group and DoHA providing in advance of the hearings a listing of a large number of rural health programs, some of which cross several outcomes, as well as mapping the 2006-07 with the 2005-06 outcome structures.
Provision of answers relating to Additional Estimates 2005-06
1.14 The Committee asked FaCSIA why their previous excellent record of achievement in providing answers to questions on notice by the due date was not maintained for the answers relating to the additional estimates held in February 2006. The Secretary, Dr Harmer, advised the Committee that the deadline could not be met on this occasion for a number of reasons. In particular, work on the budget coincided with a large amount of disaster recovery work. This work also coincided with substantial machinery of government changes, particularly the integration of OIPC into FaCSIA. These changes also resulted in the Department now having three Ministers rather than one. Dr Harmer further explained that delays in providing answers were also because one new Minister had specific requirements and commented that every effort would be made to provide much more timely answers now that the Department was aware of the Minister's preferences for estimates answers:
The minister has a very clear preference for succinct answers, he has a preference for paragraphs rather than dot points and he has a very strong preference that we refer to published material where we can, rather than repeat it.[7]
1.15 FaCSIA was asked why an answer to a question on notice stated that although the data requested had been provided this type of information would not be made available in the future. The Secretary explained:
When we put some of these questions to the new minister, given how busy the department is, we were asked whether it is readily available, and the answer is no. We compiled them specifically for the answer. Given that we had already done it, he was quite happy to let it go through. But he said, 'Look, if there is a significant diversion of resources, we ought to signal that we are not prepared to divert those resources to that sort of exercise again, given how long it takes.'[8]
1.16 The Committee is very pleased to note that DoHA substantially improved its record of provision of answers for additional estimates. Approximately 50 per cent of the answers were provided by the due date, with the bulk of the remaining answers being provided in the next three weeks. The final answers, including some 'follow-up' answers providing information that had recently become available, were answered prior to the budget hearings. The Committee acknowledges DoHA's efforts in achieving this improved performance.
Issues
Families, Community Services and Indigenous Affairs portfolio
1.17 During the FaCSIA hearings Senators sought information on a wide range of topics. Included in discussions was the implementation of access cards, departmental research projects and contracting for executive coaching. Fraud activity within FaCSIA and savings from compliance measures were also discussed in some detail.[9]
1.18 FaCSIA was asked to provide information relating to the implementation of new family relationship services, particularly with regard to contractual arrangements, selection of the location of centres, premises and service provision.[10]
1.19 Questions were asked relating to health care cards with regard to the increased threshold and estimation of income, and the value of the card. The effect of changes to Family Tax Benefit B (FTB B) was discussed, as well as funding and services under the Communities for Children program.[11]
1.20 Issues concerning the implementation of the child support reforms were discussed at length, particularly as to how these changes would impact on families and the effect of the compliance measures.[12]
1.21 A number of child care matters were raised with FaCSIA, including the in-home care program, family day care, long day care, outside of school hours care, the national childcare quality system, accreditation, validation processes, compliance, child care benefit, unmet need and oversupply of child care places.[13]
1.22 Senator Evans again sought information relating to the one-off grants in the 2004 election commitments that had been transferred to FaCSIA, particularly as to how the funding was allocated and the approval process. Questions were also asked concerning volunteer small equipment grants.[14]
1.23 FaCSIA was asked to provide information on a number of housing support matters, including housing provision, rent assistance, homelessness services, SAAP services, community housing, public housing dwellings and research. The Commonwealth State Housing Agreement was also discussed.[15]
1.24 Information was given about the assistance provided by the Department to a large number of North Queensland and Northern Territory residents following severe damage over wide areas as a result of recent cyclones.[16]
1.25 A considerable amount of time was spent discussing Indigenous matters with FaCSIA and OIPC – particularly with regard to the whole-of-government approach to Indigenous affairs. Progress with the implementation of various family violence and child abuse prevention programs and projects, as well as other initiatives introduced to assist in addressing these issues, were discussed at length. The consultation processes with Indigenous communities in relation to these matters were also discussed.[17]
1.26 Senators sought information on the progress and effectiveness of the COAG trials. Of particular focus was the Wadeye trial site and the problems encountered because of community unrest and violence in that area, including the impact on the housing situation at Wadeye. The Committee also discussed the COAG trial site in the Balgo area, Shared Responsibility Agreements (SRAs) and the location and responsibilities of Indigenous Coordination Centres and their staff.[18]
1.27 A range of questions was asked concerning Indigenous housing including funding, adequate provision, suitability and appropriateness of housing design, construction and maintenance and other necessary infrastructure. Matters relating to improvised dwellings and 'town camps' were also included in the discussions.[19]
1.28 Senator Evans again pursued questions at these hearings concerning funding to the Indigenous Land Corporation (ILC). When questioned as to what their expectation was with regard to the amount of funding they might receive from the Indigenous Land Fund the ILC stated that they were aware the change in the way they were funded would have some impact but, based on their calculations, their expectation was that they would receive approximately $45m to $50m per annum from the land fund, whereas they had received $4m in 2004-05 and $23m in 2005-06.[20]
1.29 FaCSIA advised that the large reduction in funding was due to the ILC no longer receiving a direct appropriation from Government as it was now funded from the realised real return of investments of the Indigenous Land Fund. FaCSIA further explained:
There is a combination of reasons as to how we calculate the return from the land fund for payment to the ILC. The issue that impacts on that most is the implicit price deflator for gross non-farm product. That is the measure of inflation that is defined in the act, so we have no choice but to apply that to the calculation.[21]
1.30 In response to Senator Evans seeking further clarification FaCSIA advised that the matter was complex and the way in which the return from the Land Fund was calculated was currently being reviewed.
One of the things that is not defined in the act is realised real return and, because it is not defined in the act, it is open to interpretation. We do want to have a look at that and see how it is applied and whether its current application properly reflects the intentions.[22]
1.31 Matters discussed with Aboriginal Hostels Ltd agency included temporary hostel accommodation; accommodation for people who were approved for the Patient Assisted Travel Scheme (PATS); student accommodation and Indigenous residential aged care services.[23]
1.32 Some other topics to be canvassed with FaCSIA included the one-off bonus to older Australians, utilities allowance, pensioner concessions, seniors health card, and the pension bonus scheme. Questions were also asked in relation to the extension of the carer payment to carers of severely disabled children, business services, and funding to reduce the number of young people in nursing homes.[24]
1.33 Discussions on women's issues included progress with projects and programs funded through the Women's Safety Agenda and research funding.[25] Youth issues included the National Youth Roundtable, National Indigenous Youth Leadership Group, Australian Forum of Youth Organisations and the Youth Advisory and Consultative Forum and National Youth week funding.[26]
Health and Ageing portfolio
1.34 DoHA provided information to the Committee on a wide range of topics during the hearings. Matters relating to pharmaceutical services and the Pharmaceutical Benefits Schedule (PBS) were discussed at some length, including the estimates for savings to the PBS due to the 12.5 per cent generics policy, drugs affected by the policy, industry response, and the 20-day rule for pharmacists dispensing repeat prescriptions.[27] The Committee was also advised that the growth rate for the PBS had been revised down to 2.8 per cent for the current year. Applications to the Pharmaceutical Benefits Advisory Committee (PBAC) were also discussed in some detail. The change over time of doctors' prescribing habits was outlined to the Committee.[28]
1.35 Senators asked a range of questions relating to medical services, including Medicare Benefits Schedule (MBS) expenditure; safety net expenditure and the number of registrations, and bulk billing. DoHA was also asked to provide information relating to the implementation of Medicare funded pregnancy counselling services and why some professionals had been excluded from access to a rebatable Medicare item for their patients. Radiation oncology services and funding for pathology training positions provided for in the MOU were also discussed.[29]
1.36 The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) informed the Committee on matters relating to the National Directory for Radiation Protection and the codes of practice, and progress with the implementation of the ANAO report recommendations. A nuclear waste repository in the Northern Territory and standards covering radiation emission levels from mobile phone towers were also discussed.[30]
1.37 With regard to private health insurance matters the proposed sale of Medibank Private was discussed in some detail. Issues relating to informed financial consent, out-of-pocket expenditure for privately insured patients, and health funds' services were discussed with DoHA and the Private Health Insurance Ombudsman provided information with regard to consumers' concerns.[31]
1.38 Senators sought answers to a wide range of questions on aged care issues. Topics included in discussions were the rate of indexation applied to residential aged care subsidies, the issue of police checks for volunteers under the Community Visitors Scheme (CVS), and the CVS review. The numbers and cost of police checks required for staff working in aged care facilities were also discussed, as well as the revision of estimates for aged care subsidies.[32]
1.39 The Aged Care Standards and Accreditation Agency (ACSAA) informed the Committee of the processes involved when an accreditation audit is undertaken and when sanctions are imposed for non-compliance.[33]
1.40 Information was sought from the Commissioner for Complaints on a number of matters, including the comments he had made about the need for change to the model under which the Complaints Resolution Scheme operates. The Commissioner responded that a group of complainants and some providers considered that the alternate dispute resolution model on which the scheme is currently structured had some limitations, explaining that:
There was a strong view amongst both groups that the scheme would be enhanced if we embraced a more investigatory model, so that the first initial contact would be trained to establish the facts around the particular complaint and establish whether or not there had been a breach on the provider's part. So I have advocated that I think that would be an improvement.
Secondly, because the scheme is managed through state and territory offices – we currently have eight intake points – I have argued that, for consistency and providing even better support to those complainants wanting to lodge matters with the scheme, if the scheme operated with a central intake it would enable more experienced staff to be used and, at the first point of contact, if you like, to establish much more detail around the experience about which the complainant is complaining. They are the two major changes that I have suggested would improve the scheme.[34]
1.41 The processes involved in the way the CRS deals with complaints and the resolutions procedures were also outlined to the Committee.[35]
1.42 The Committee was informed of the progress being made to prevent further abuse in aged care facilities, including the Minister's consultations with his advisory group and the establishment of a task force to deal with matters relating to abuse. Funding had been provided for a significant increase in the number of visits to aged care facilities by ACSAA, including unannounced visits. Quality control and the approach taken to ensure consistency between assessors, matters relating to the complex issue of mandatory reporting of abuse, fire safety compliance, a number of workforce issues, and the response to the Hogan review were other aged care topics discussed at length.[36]
1.43 The Professional Services Review (PSR) informed the Committee that the planned organisational review would include a retrospective look at the effect of the 1999 changes to the scheme and their effectiveness, as well as a current assessment of the PSR and the direction it should be heading in the future. The large reduction in staff numbers resulting from a significant downturn in the number of referrals to PSR for investigation was also discussed.[37]
1.44 DoHA was questioned about data on GP workforce numbers, bonding arrangements for the 400 medical places provided to assist the medical workforce shortage in particular districts, and clinical training support for nurses. The Committee was also informed in some detail with regard to organ donation. The Blood Fractionation Review was also discussed.[38]
1.45 A number of questions were asked relating to mental health issues, including the review of the national mental health policy and the evaluation of the National Mental Health Plan and the COAG process. Workforce issues, implementation plans relating to mental health nurses' placement with psychiatrists and GPs in certain circumstances, psychology services and educational programs were also discussed.[39]
1.46 Indigenous health matters included program expenditure on the APY lands, funding allocations and expenditure for various Indigenous health programs and initiatives. DoHA also provided answers relating to the trachoma surveillance unit and other eye health matters, asthma spacers and funding allocation against SRAs.[40]
1.47 Senators asked questions relating to a wide range of population health issues, including the Department's response to an indication in provisional figures of increases in HIV diagnoses, implementation of the National Bowel Cancer Screening Program, and evaluation of BreastScreen Australia. A number of matters were raised relating to pregnancy counselling services, including the telephone helpline, allocation of funding for services, and whether the tender criteria requirement that non-directive pregnancy counselling services are to be provided is being met.[41]
1.48 Questions were asked of the Therapeutic Goods Administration (TGA) concerning the approval process for the granting of authorised prescriber status for RU486 and its use according to a specific protocol, and the importation of Mifepristone under the Special Access Scheme.[42]
1.49 The approval process for the importation of blood plasma fractionation products and the role of the National Blood Authority in the process were advised to the Committee. The testing of blood products was also discussed.[43]
1.50 In response to questions relating to ADHD drugs the TGA advised that post-market issues were constantly monitored. Because of concerns about ADHD drugs the TGA had conducted a review and sought information from the sponsors of these products regarding international occurrence of adverse events. TGA's expert advisory committees would consider the review and advise if any further action needed to be taken.[44]
1.51 Questions were asked about the Q fever vaccine production and supply situation. The Committee was advised that CSL had suspended the manufacture of the vaccine and was working towards the release of some new batches. A rationing strategy had been implemented by CSL to ensure people who are most at risk have access to the vaccine.[45]
1.52 Research funding was discussed with the NHMRC, particularly the budget allocation for biomedical research, funding for research into ovarian cancer, and funding for the adult stem cell research centre.[46]
1.53 With regard to disaster management DoHA informed the Committee that they considered Australia has a very well equipped and robust health system that is prepared to respond to major health emergencies. The Department works through the Australian Health Protection Committee to coordinate with State and Territory health ministries to ensure they can respond to any particular health emergency. This preparedness had recently been demonstrated with the East Timor emergency and earthquake in Indonesia.[47]
1.54 Some other matters discussed included the smartcard initiative in Tasmania, HealthConnect, progress with the establishment of Cancer Australia, chronic disease management program funding, Medicare support for people with type 2 diabetes, the National Health Call Centre network, practice nurses, the Rural, Remote and Metropolitan Areas (RRMA) classification system review, and allied health services in rural and remote areas. Hearing services and devices were also discussed.[48]
1.55 In addition to the above issues a number of administrative and process matters involving both portfolios were raised during the estimates discussions and are detailed in the Hansard transcripts of evidence.
Senator Gary Humphries
Chairman
June 2006
Additional Comments from Labor Senators
At the Senate Estimates of 31 May and 1 June 2006, there was a significant amount of time when the Minister representing the Minister for Health, the Minister for Ageing, Senator Santoro, was not present in the hearings.
This concern was raised with the Chair at the close of the hearings and responded to at 1.7 of the Chair's report. It is the view of Labor Senators that the Chair's comments do not adequately address the concerns raised.
Principally, Labor Senators’ concern about the non-attendance of the Minister is that it is difficult, if not impossible, to gain any answer if the departmental official advises that the decision was a policy decision of Government. It is not appropriate for Departmental Officials to comment on the policy deliberations of the Government but it is appropriate for the Minister to provide some commentary on why a Government has made a decision. In fact, Privilege Resolution 1(16 ) says:
An officer of a department of the Commonwealth or of a state shall not be asked to give opinions on matters of policy, and shall be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister.
Further, there were a number of occasions, particularly when questioning in Outcome 4, "Aged Care and Population Ageing" the Minister's own area of responsibility, when questioning Senators had to re-schedule their order of questioning because the Minister was not present. In fact, the time notionally allocated to the Outcome had to be extended to accommodate the Minister's non-attendance.
Of particular concern was one of the Minister's defences that as he was the Minister for Ageing, he could not answer for the Minister for Health. Labor Senators are not unreasonable and do not expect that Ministers representing other Ministers would be across all the detail, but it is reasonable to expect that a representing Minister might at least attempt to answer policy questions.
Further, Labor Senators are concerned that the Minister indicated that it was on departmental officers ' advice that he not attend sections of the hearing.
The Community Affairs Estimates Committee has operated, as the Chair rightly says, in a co-operative and relatively convivial manner. The members have accepted that from time to time Ministers do have to leave the room to attend to urgent matters. Previous Ministers did leave for short periods, usually took phone calls in the corridor and their short absences were accommodated.
However Labor Senators feel compelled to highlight this Minister’s non-attendance and his response to our raising of the issue.
Senator Jan McLucas
ALP, Queensland
Senator Claire Moore
ALP, Queensland
Senator Michael Forshaw
ALP, New South Wales
Senator Helen Polley
ALP, Tasmania
Senator Trish Crossin
ALP, Northern Territory
Senator Carol Brown
ALP, Tasmania
Senator Ruth Webber
ALP, Western Australia
For further information, contact:
Estimates Officer
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600
Australia