Senate Community Affairs Legislation Committee - Report on Budget Estimates 2009-2010
1.1
On 12 May 2009 the Senate referred the following documents to the
Committee for examination and report in relation to the portfolios of Families,
Housing, Community Services and Indigenous Affairs; and Health and Ageing:
- particulars of proposed expenditure in respect of the year ending
on 30 June 2010
- particulars of certain proposed expenditure in respect of the
year ending on 30 June 2010.
1.2
The Committee has considered the budget expenditure of the portfolios
set out in their respective Portfolio Budget Statements 2009-2010 (PBS).
Explanations relating to the estimates were received from Senator the Hon Jan
McLucas, Senator the Hon Penny Wong, and Senator the Hon Mark Arbib representing
the Minister for Families, Housing, Community Services and Indigenous Affairs and
Senator the Hon Jan McLucas, Parliamentary Secretary to the Minister for Health
and Ageing and officers from the portfolio Departments at hearings held from 1
to 4 June 2009.
1.3
The Committee also considered budget expenditure at a hearing on 5 June
2009 on cross portfolio Indigenous issues pursuant to Resolution of the Senate
of 26 August 2008.[1]
Explanations relating to the estimates were received from Senator the Hon Jan
McLucas. Officers from the following portfolio Departments were in attendance:
Attorney-General's
Education, Employment and Workplace
Relations
Families, Housing, Community Services
and Indigenous Affairs
Health and Ageing
Human Services
Prime Minister and Cabinet
Treasury.
1.4
The Committee expresses its appreciation for the assistance of the Ministers,
Departmental Secretaries and the officers who appeared before it.
1.5
In accordance with Standing Order 26, the date for submission to the
Committee of written answers to questions or additional information relating to
the expenditure is 30 July 2009.
1.6
The Committee discussed many of the expenditure proposals and information
contained in the PBS. These discussions are detailed in the Committee’s Hansard
transcripts of 1 to 5 June 2009, 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. Answers to questions
taken on notice and tabled documents relating to the Committee's hearings will
be tabled separately in the Senate. Consolidated volumes of this additional
information may be accessed from the Committee's website.
Cross portfolio Indigenous issues
1.7
To assist both the Committee and portfolio departments the Committee
conducted the cross portfolio Indigenous issues hearing in a similar but
slightly more streamlined program format to the previous hearing. Themes and
issues were again listed for consideration across portfolios and this approach has
proven to be a satisfactory way for Senators to seek information on cross
portfolio matters. The Committee acknowledges and appreciates the assistance of
the Department of Families, Housing, Community Services and Indigenous Affairs
(FaHCSIA) in coordinating portfolios to enable the hearing to be conducted in
this manner.
Public interest immunity claims
1.8
On several occasions during the hearings the issue of public interest
immunity was raised or implied, and the question taken on notice for further
investigation as to whether the information requested could be provided. The
Committee will be keeping a close watch on the responses that are provided to
ensure that they are in conformity with the Order of the Senate dated 13 May
2009 relating to public interest immunity claims.
Provision of answers
relating to Additional Estimates 2008-09
1.9
The Committee acknowledges the Departments' efforts in providing answers
to a large number of questions on notice relating to the additional estimates. The
Department of Health and Ageing (DoHA) provided approximately two-thirds of the
answers by the due date, and the majority of the remaining answers during the
following month.
1.10
FaHCSIA was not able to provide any answers to the very large number of
questions on notice by the due date, however the majority of answers were progressively
provided from the end of April to mid May. Most of the few remaining answers
were provided in the weeks leading up to the budget estimates hearings, and the
remaining two answers post hearings.
Revisions to Portfolio Structure and Outcomes
2009-2010 from 2008-09
1.11
As outlined in the portfolios' PBS, from the 2009-10 Budget, all General
Government Sector (GGS) entities will be reporting on a program basis, which
replaces the former output group structure. Some revisions to portfolio Outcomes
were necessary following the Operation Sunlight Outcome Statements Review.
1.12
The 15 Outcomes within the Health and Ageing Portfolio Structure were
unchanged from the previous year, although there were some minor changes in
Divisional responsibility. Two new agencies were established, the Australian
Organ and Tissue Donation and Transplantation Authority and the National Breast
and Ovarian Cancer Centre.
1.13
Significant changes were made to the Families, Housing, Community
Services and Indigenous Affairs Portfolio Outcome structure. The four outcome
structure was replaced with a seven outcome structure. This involved a considerable
number of changes which were detailed in a transition table in FaHCSIA's PBS.[2]
The Committee was also provided with a clearly set out Outcomes and program
structure translator which mapped the former output groups to the program
structure and was of considerable assistance to Senators. FaHCSIA advised the
Committee on the rationale behind the change and the advantages of the new
seven-outcome structure over the former four outcomes. The seven outcomes were
now more closely linked with the way FaHCSIA engages with clients, and allows
for greater transparency and management efficiencies.[3]
1.14
During the hearings the Committee Chair called the programs within
Outcomes which assisted Senators to focus their questioning on matters within
the programs. Generally, the revised PBS structure provided for a more
streamlined approach to consideration of the budget estimates and the hearing
process.
Issues
Families, Housing, Community Services and Indigenous Affairs portfolio
1.15
The Committee asked a range of questions covering corporate and
cross-outcome matters which included staff numbers, staff superannuation
schemes, paid parental leave, ex-gratia payments, media-monitoring service,
consultancies, national agreements and national partnership agreements.[4]
1.16
Discussions covering a wide range of housing matters spanned a large
amount of the hearing time. The majority of Senators' questions related to
affordable housing, housing assistance and prevention of homelessness. Under
these thematic headings matters discussed included the National Rental
Affordability Scheme, Housing Affordability Fund, homeless people in regional
and rural areas, social housing, housing designs and standards, rent
assistance, partnership agreements, and supported accommodation.[5]
1.17
Senators sought information on a number of issues relating to women. The
Equal Opportunity for Women in the Workplace Agency (EOWA) provided answers to
questions relating to leadership and development programs, funding and grants.
Questions were also asked of the Office for Women which covered the women's
safety agenda, respectful relationships programs, helpline and other support
initiatives, and measures to reduce violence against women. Parental and
maternity leave were also discussed.[6]
1.18
The Committee's inquiry into children in institutional care, titled Forgotten
Australians, and the recent report of the Commission to Inquire into Child
Abuse in Ireland was discussed. FaHCSIA was asked what work was being
undertaken 'around overseas experience and current practice in Australia in
terms of institutions and the development of same'. The Committee was informed
that overseas reports and other research material of this nature were used to
build up a research and analytic base for use in briefing government.[7]
1.19
Questions relating to family support included the family relationship
services program; communities for children program; paid parental leave scheme;
family tax benefit; payments under the Economic Security Strategy; parenting
payment; child support payment; protecting Australia's children initiative, and
the responding early assisting children program.[8]
1.20
Senators sought information on matters relating to seniors that covered
income support, allowances, concessions and services. Issues concerning age
pensioners which were discussed at length included the Economic Security
Strategy bonus, reciprocal social security agreements, pension reform package,
indexation, taper rates, transitional safety net, pension bonus scheme, work
bonus, increase in age eligibility for a pension, possible impact on the
disability support pension (DSP) as a result of increase in the pension age, impact
of loss of investment income due to the economic crisis, and the pension review.
The Committee was also informed with regard to a number of supplements such as
the utilities, telephone and pharmaceutical allowances, Commonwealth seniors
health cards, and the self-funded retirees' supplement. Questions were also
asked in relation to the national reciprocal transport agreement, eligibility
for seniors' cards varying between States, and the broadband for seniors
program.[9]
1.21
In relation to disability and carer matters FaHCSIA answered a number of
questions concerning the DSP and carer payments, and Australian disability
enterprises. Programs and services relating to the helping children with autism
package and young people in residential aged care were also canvassed in some
detail. Disability trusts were discussed at length, particularly with regard to
the Government's response to recommendations in the Committee's report titled Building
trust: supporting families through disability trusts. Senators sought
detailed information on progress being made with some of the responses to the
recommendations, as well as clarification of some aspects of the Government's
response. Further matters discussed included a national disability insurance
scheme, outside school hours care for teenagers with a disability, the national
companion card, disability parking scheme, print disability services program,
personal helpers and mentors program, carers assisted through the community-based
program and mental health issues in rural areas.[10]
1.22
Senators also asked questions regarding national compacts with the
not-for-profit sector, volunteer management and volunteer grants programs, income
quarantining trials in Western Australia, social inclusion, and Victorian
bushfire assistance and recovery.[11]
Health and Ageing
portfolio
1.23
The Committee sought information relating to a number of corporate
issues and matters which cross outcomes, including the organisational structure,
staffing numbers, the number of people with disabilities employed, parental
leave, and superannuation entitlements. Media monitoring, FOI requests,
performance of State hospitals, the National Health and Hospitals Reform
Commission, Health and Hospitals Fund, and human gene patenting were also
included in discussions.[12]
1.24
A range of questions were asked by Senators relating to sporting
matters. The Australian Sports Commission (ASC) informed the Committee
regarding action being taken to encourage more people into sport to improve
their physical and mental health, which included Indigenous sport and
recreation programs. A number of questions were asked concerning the Crawford
review, active after-schools communities program, sport and recreation
facilities grants, programs and funding for women in sport. Senators also
sought an update on the status of Taekwondo Australia and discussed the impact
and uncertainties of this sport currently not having a recognised body.
Questions were also asked regarding sports funding, codes of behaviour and
community leadership. The Australian Sports Anti-Doping Authority (ASADA)
provided information on funding and anti-doping programs and measures.[13]
1.25
Private health insurance matters were discussed at length. Included in
debate were the current levels and forward estimates for private health
insurance membership, proposed changes to the private health insurance rebate,
Medicare levy surcharge thresholds and lifetime health cover, and future
premium increases. The possible impact on the public hospital and public dental
system and allied healthcare providers of people dropping or downgrading
hospital or general treatment cover was also discussed. The Private Health
Insurance Administration Council (PHIAC) provided information concerning the private
health insurance industry.[14]
1.26
The Chief Medical Officer (CMO) and officers involved with biosecurity
and emergency response matters provided the Committee with a comprehensive and
informative overview of the H1N1 influenza 09 (Swine flu) infection outbreak
and response. This included detailed information relating to the outbreak,
virulence of the organism, and measures activated under the National Action
Plan for Human Influenza Pandemic to contain and control the spread of the
virus. Testing for swine flu, quarantine measures, severity, and treatment
options were also discussed. The Committee was also informed regarding the
status of the national medical stockpile, agreements for further supply of
influenza vaccine, including an order for a human swine flu vaccine being
development by CSL. Answers were also provided to a number of concerns that were
raised by Senators in relation to the pandemic. The Minister, Senator McLucas,
and the Committee Chair commended and thanked the CMO and officers, who were
also managing the operation of the 24-hour a day national incident room, for
attending at such a busy time to inform the Committee and public of the current
situation and the procedures actioned.[15]
1.27
Population health matters discussed included the public health education
and research program; funding for preventative health and treatment; Preventative
Health Taskforce; initiatives to lower tobacco use and to reduce obesity levels;
marketing campaign to combat obesity; gastric banding; the Australian Better
Health Initiative; bowel, breast and cervical screening programs; the National
Binge Drinking Strategy; national immunisation strategy; and Naltrexone
implants.[16]
1.28
Senators asked questions of the Therapeutic Goods Administration (TGA)
relating to complementary medicines, the baseline assessment survey, audits of
drug manufacturers that are approved for imports into Australia, and evaluation
of applications to extend the shelf-life of drugs.[17]
1.29
Food Standards Australia New Zealand (FSANZ) provided answers relating
to Bisphenola A (BPA) found in polycarbonate plastic products such as baby
bottles. Food labelling and labelling on wine bottles and other alcoholic
beverages were also included in discussions.[18]
1.30
Matters discussed under Acute Care programs included details of Treasury's
responsibility for funding and policy arrangements for Special Purpose Payments
(SPPs) and DoHA's responsibility for the national healthcare agreement. Questions
also covered the Health and Hospitals Fund, hospital accountability and
performance programs, elective surgery waiting lists, public dental services in
rural and remote areas, Commonwealth Dental Health program, teen dental
program, review of the national blood arrangements, improving transfusion
services, and indemnity for midwives.[19]
1.31
The National Blood Authority provided information on initiatives to
improve the appropriateness of blood usage and reduce wastage, including
programs for the education of practitioners working in the blood area and
programs for improving communications with practitioners to improve the sharing
of knowledge and to stimulate best practice. The new blood manufacturing site
which will provide fresh blood products to Victoria and Tasmania was also
discussed, as well as the plasma fractionation and product distribution
contract with CSL.[20]
1.32
The CEO of the recently established Australian Organ and Tissue Donation
and Transplantation Authority provided details of the establishment, structure
and operation of the Authority, appointment of the advisory council and
Authority staff. Further answers were provided regarding organ donation and the
importance of family awareness and consent to the donor's wishes, funding for
community awareness and marketing, and access to the patient assisted travel scheme
for donors and recipients.[21]
1.33
A large number of questions were asked relating to aged care matters, including
the continence aids assistance scheme, level of care being provided to
residents of aged-care facilities, funding for an increase in numbers of
high-care residents, ratio of staff to residents, increased cost of care, and funding
for nursing staff. Matters raised in the Senate inquiry into residential and
community aged care were also discussed as well as the complaints investigation
scheme, expenditure on palliative care, review of the allocation process, aged
care approvals process, and the aged care workforce.[22]
1.34
Cancer Australia agency was asked to provide an overview of staffing and
operation of the agency. The linkages between Cancer Australia and other cancer
organisations were discussed as well as the likely long-term impact on the cost
of research relating to gene patent issues, and the cancer prevalence and
survival data published jointly with the Australian Institute of Health and
Welfare (AIHW).[23]
1.35
The National Breast and Ovarian Cancer Centre also provided the
Committee with an outline of their organisation's operations and outcomes, including
current projects. The Centre reported that they were very pleased with the
improvement in awareness of ovarian cancer, and the evidence had been reviewed
in relation to best practice in follow-up for a woman who had been diagnosed
with breast cancer.[24]
1.36
Senators sought information from the National Health and Medical
Research Council relating to their research funding and the guidelines and
system used for allocating grants. The review of the public health research
funding, and Naltrexone implant clinical trials were also included in
discussions.[25]
1.37
Information was sought from DoHA relating to implementation of the
national e-health strategy, funding for diabetes research, Lift for Life strength
training program for people with diabetes, and the National Partnership for
Health Infrastructure.[26]
1.38
Discussions relating to mental health issues included the demand and
provision of mental health services in rural areas, the national suicide
prevention strategy, National Mental Health Youth Foundation providing mental health
services for young people, funding for mental health services, the mental
health workforce, including the mental health nurse incentive program. Other
mental health issues discussed included the Victorian bushfires mental health
response package, the status of the Government response to the Committee's
recommendations in the report of the inquiry into mental health services,
action taken to combat stigma in mental health, and the alleged use of
electroconvulsive therapy on teenagers.[27]
1.39
Health workforce questions covered the number of GPs, general surgeons
and dentists per head of population in rural and regional areas, RAMUS Scheme
graduates, initiatives to overcome the shortage of rural workforce health professionals,
specialist medical services in rural areas, and overseas trained medical
practitioners. The national men's health strategy, nurses re-entering the
workforce under the Bringing Nurses Back into the Workforce program, the
General Practitioner Rural Incentive Program, the remote areas classification
system, and allied health professionals were also discussed.[28]
1.40
Senators sought information on a range of pharmaceutical matters. The
more efficient use of chemotherapy drugs, payment of benefits, and the
consultation process was discussed in some detail. PBAC approval process for
listing of Avastin on the PBS, limitation of palliative care drugs on the PBS.
Progress with the Fifth Community Pharmacy Agreement, customer medicine
information, fee for dispensing of medicines in Aboriginal communities, PBS
cost recovery, insulin pumps, Improving Maternity Services Package and eligible
midwives' access to the PBS were also included in discussions.[29]
1.41
With regard to access to medical services, questions were asked relating
to Medicare Benefits Schedule fees for cataract surgery, Positron Emission
Tomography (PET) services and location of scanners, Magnetic Resonance Imaging
(MRI) services in Tasmania, cancer support services for Launceston Hospital,
training and education for a range of professions involved in radiation
oncology.[30]
1.42
The Professional Services Review agency informed the Committee about
Medicare compliance audits and issues relating to medical practitioners' inappropriate
practices.[31]
1.43
Primary care questions included the GP Assist (Tasmania) program,
progress being made with Super Clinics becoming operational and their locations,
and the Practice Incentives Program for general practice. The General Practice
Education and Training agency confirmed to the Committee that all funded
training places to address workforce shortages had been filled. The program
also included training in Indigenous health.[32]
1.44
Rural health matters which were discussed included proposed changes from
the RRMA classification system to ASGCRA which may impact on the Gawler, SA and
Sunshine Coast, Qld areas. The consultation process is continuing so as to
allay concerns. Senator Adams was advised that the Australian Health Ministers
Advisory Council taskforce had not yet reported on the Patient Assisted Travel
Scheme (PATS). The Committee was also informed on the development of a
replacement to the Healthy Horizons initiative for improving the health of
rural, regional and remote Australians; and progress being made with the
Medical Specialist Outreach Assistance program, and the Rural Women's GP
Service.[33]
Cross portfolio Indigenous issues
1.45
Senators sought answers to Indigenous issues questions from various portfolio
Departments and agencies under the thematic headings detailed on the hearing
program. The majority of questions were on a wide range of issues relating to
the Northern Territory Emergency Response and the Closing the Gap initiative, which
included the consultation process for future directions for the Response, conformity
with the Racial Discrimination Act, and welfare reform matters such as income
quarantining, CDEP, and school attendance trials. The Indigenous Business
Australia agency informed the Committee with regard to home loans and home
ownership on Indigenous lands, the Outback Stores subsidy and evaluation of
stores.[34]
1.46
Many housing questions were asked by Senators relating to remote
Indigenous housing, the Strategic Indigenous Housing and Infrastructure Program
(SIHIP), land tenure and leasing, and the Alice Springs town camps.[35]
1.47
Indigenous health matters discussed included life expectancy data,
dental services, foetal alcohol syndrome, petrol sniffing, trachoma, asthma, and
dialysis.[36]
1.48
A range of Indigenous employment services were discussed, including the
new Community Employment Development Projects (CDEP) which will be implemented
in remote areas and the community support program operating in regional and
urban areas.[37]
1.49
Senators asked questions relating to education matters, including the Improving
School Enrolment and Attendance through Welfare Reform Measures (SEAM) project
in the NT, children and family centres, and funding for Indigenous children from
the NT to attend boarding schools in Perth.[38]
1.50
Other more general Indigenous issues discussed included establishment of
the Indigenous Healing Foundation, exposure to asbestos across the Wallaga Lake
community, the suicide prevention project at Narrogin, and income management in
the Cape York area.[39]
1.51
Questions relating to law and justice matters covered demands being
placed on legal service providers in the NT and the impact on the justice
system, police presence and provision of police stations, native title claims
and native title bodies.[40]
1.52
In addition to the above issues a number of administrative and process
issues were discussed during the estimates hearings and these are detailed in
the Hansard transcripts of evidence.
Senator Claire Moore
Chair
June 2009
Navigation: Previous Page | Contents