Key issues
2.1
This chapter outlines the key issues considered at the committee's 2018–19
Budget estimates hearings.
Health Portfolio hearing—29 May 2018
Whole of portfolio / Corporate
matters
- 2018–19 Health Portfolio Budget measures, particularly the
quantum of savings and reinvestment of savings from those measures.[1]
- Transparency of fees charged by surgeons to patients which are
not covered by private health insurance, including the response of the Ministerial
Advisory Committee on Out-of-Pocket Costs.[2]
- Funding allocated to Health Portfolio priority areas.[3]
- Implementation of the Australian Government Guidelines on the
Recognition of Sex and Gender within the Health Portfolio.[4]
- Source and quantum of funds allocated to Outcome 6: Aged Care.[5]
Outcome 1: Health System Policy,
Design and Innovation
Program 1.1: Health Policy Research
and Analysis
- Medical Research Future Fund, including: the value of
disbursements made; funding over the forward estimates; processes for making disbursements,
and specific research initiatives such as the Biomedical Translation Fund.[6]
- Particulars of the National Health and Medical Research Council
Myalgic Encephalomyelitis / Chronic Fatigue Syndrome Advisory Committee.[7]
Program 1.2: Health Innovation and
Technology
- Rollout of the My Health Record initiative, including: a large-scale
information campaign; opt-out provisions; secondary purpose data usage; arrangements
for the protection of consumers' privacy and consent; and provisions for
healthcare providers to upload data to the My Health Record system.[8]
Program 1.5: International Policy
- Department of Health's response to an Ebola outbreak in the
Democratic Republic of Congo.[9]
Outcome 2: Health Access and Support
Services
Program 2.1: Mental Health
- Processes used for determining the extension of the National
Suicide Prevention Trial, particularly the extent of the consultations
undertaken.[10]
-
Mental health services funded through the Primary Health
Networks, including mental health services for older Australians living in in
residential aged care.[11]
- Priorities for Aboriginal and Torres Strait Islander people
mental health services.[12]
- Quantum of funding allocated to mental health services, including
research-led funding priorities.[13]
-
Youth mental health services provided in educational contexts.[14]
- Continuity of psychosocial supports.[15]
- Contribution of the National Mental Health Commission to recent
government mental health initiatives.[16]
Program 2.3: Health Workforce
- Benefits of the 2018–19 Budget measure, A Stronger Rural
Health, for the recruitment and retention of doctors across rural and
remote areas.[17]
Program 2.4: Preventative Health
and Chronic Disease Support
- Progress made with developing a national strategic approach to
maternity services, including continuity of care arrangements.[18]
- Availability of Local Drug Action Teams in Tasmania and Western
Australia.[19]
- Update on the implementation of the National Cancer Screening
Register.[20]
- Intended purpose of the $40 million 2018–19 Budget measure, Support
for Alcohol and Drug Abuse Treatment.[21]
Food Standards Australia New
Zealand
- Nanohydroxyapatite chemicals in baby formula.[22]
Program 2.5: Primary Health Care
Quality and Coordination
- Performance and outcome measures of the Health Care Home trial.[23]
- Grants made by Primary Health Networks, particularly the North
Queensland Primary Health Network.[24]
- Funding allocated to the Hunter New England and Central Coast Primary
Health Network for community needs identification.[25]
Program 2.7: Hospital Services
- Government policy on the rate of the Commonwealth Government's efficient
growth funding for hospitals.[26]
- Commonwealth Government funding for Mersey Hospital, Tasmania.[27]
Outcome 3: Sport and Recreation
Program 3.1: Sport and Recreation
- Release date and potential funding methods for the National
Sports Plan.[28]
Australian Sports Commission
- Staffing levels at the Australian Sports Commission.[29]
-
Functions and costs the Australian Institute of Sport's training facility
in Italy.[30]
- 2018–19 Budget allocations for sports and physical activity
initiatives.[31]
Australian Sports Anti-Doping
Authority
- Australian Sports Anti-Doping Authority's recent anti-doping
activities.[32]
Health Portfolio hearing—30 May 2018
Outcome 4: Individual Health
Benefits
Program 4.1: Medical Benefits
- Expected outcomes of the 2018–19 Budget measure, Visas for
General Practitioners — targeting areas of doctor shortages, and the potential
savings over the forward estimates arising from fewer billings of Medicare
Benefits Schedule (MBS) listed items.[33]
- Update on the work and recommendations of the MBS Review
Taskforce, including associated implications for MBS expenditure.[34]
-
Processes by which the government issues Magnetic Resonance
Imaging licenses.[35]
- Potential MBS item for eating disorders.[36]
Program 4.2: Hearing Services
- Government response to the House of Representatives Standing
Committee on Health, Aged Care and Sport's hearing health and wellbeing of Australia
inquiry report.[37]
-
Development of a roadmap to guide improvements to the hearing
health of Australians.[38]
- Implementation plan for a $30 million budget allocation to
increase hearing health assessments.[39]
Program 4.3: Pharmaceutical
Benefits
-
Government's response to the 2015 independent Review of
Pharmacy Remuneration and Regulation.[40]
- Expenditure on the MedsCheck service.[41]
- Access to information regarding doctors certified to prescribe Mifepristone.[42]
- Particulars of the 2018–19 Budget measure, Improving access to
Medicines — additional funding for new medicines and improved payment
administration, including: statements made by the Medicines Partnership of
Australia; reduction in revenue rebates for high-cost medicines; and improved
payment arrangement for certain high cost medicines with special pricing
arrangements.[43]
- New and amended Pharmaceutical Benefits Scheme (PBS) listed
items, including: budgetary implications; recommendations of the Pharmaceutical
Benefits Advisory Committee (PBAC); and the timeframes in which medicines or
vaccines are listed on the PBS following a recommendation from PBAC.[44]
-
Special pricing arrangements for PBS listed items, principally
the eligibility of Afatinib for such an arrangement.[45]
Program 4.4: Private Health
Insurance
-
Role of the recent government private health insurance reforms in
placing downwards pressure on private health insurance premium costs.[46]
- Rates of private health insurance coverage.[47]
- Price reduction for medical devices listed on the Prostheses List.[48]
Program 4.6: Dental Services
-
Funding for dental services through the National Partnership
Agreement.[49]
Program 4.8: Targeted Assistance –
Aids and Appliances
- Application of the goods and services tax on sanitary pads and
tampons.[50]
Outcome 5: Regulation, Safety and
Protection
Program 5.1: Protect the Health and
Safety of the Community Through Regulation
-
Processing of applications for access to medicinal cannabis made
to the Therapeutic Goods Administration, and the processes pertaining to
medical practitioners applying to becoming authorised prescribers of medicinal
cannabis.[51]
Program 5.2: Health Protection and
Emergency Response
- Community support package for people impacted by Per- and
poly-fluoroalkyl substances (PFAS) in Katherine, Northern Territory.[52]
-
Government's response to an outbreak of infectious syphilis
affecting Aboriginal and Torres Strait Islander communities in Northern
Australia.[53]
- Application of the precautionary principle in the Government's
response to PFAS impacts.[54]
- Research being undertaken into the potential effects of people's
prolonged exposure to PFAS.[55]
- Particulars of the hepatitis delta virus type 1 (HDV1) in
Australia.[56]
- Responses to Lyme-like disease or vector-borne disease, including
improvements to pathology practices for more effective diagnosis.[57]
Program 5.3: Immunisation
- Rates of flu immunisation, demand for flu vaccinations and the
Commonwealth's role in facilitating vaccine supply.[58]
Outcome 6: Ageing and Aged Care
- 2018–19 Budget measures providing funding for aged care.[59]
- Government response to the Legislated Review of Aged Care 2017 report (Tune review).[60]
- Funding for additional Home Care Packages over the forward
estimates, including the number and type of packages funded, and the impact
this initiative will have on the Home Care Packages waiting list.[61]
- Adequacy of resourcing in the aged care sector, particularly in
relation to: staffing ratios; average daily spending on people in aged care; and
the homeless supplement for residential aged care.[62]
- Support services for prematurely aged homeless people.[63]
- Rates of aged care services providers returning unspent home care
package funds following the death of a receipt of a home care package.[64]
- Eligibility criteria for the dementia and cognition supplement,
and the
2018–19 Budget measures that address dementia.[65]
- Trial of aged care system navigator services to assist people in
accessing information about aged care services and making decisions appropriate
for their circumstances.[66]
Australian Aged Care Quality Agency
- Residential aged care facilities which have been found to be noncompliant
with standards following audit reviews, and subsequent processes for improving
residential aged care facilities' compliance.[67]
- Development and piloting of the Aged Care Quality Standards proposed
under the Aged Care (Single Quality Framework) Reform Bill 2018.[68]
Health Portfolio hearing—27 June 2018
Outcome 1: Health System Policy,
Design and Innovation
- Website under development by the Ministerial Advisory Committee
on Out-of-pocket costs for providing consumer transparency on aspects of
private medical practice.[69]
- Nature of the interactions between the Minister for Health and entities
of the Health Portfolio.[70]
Outcome 2: Health Access and
Support Services
Outcome 4: Individual Health
Benefits
-
Listing of Afatinib on the Pharmaceutical Benefit Scheme under a special
pricing arrangement.[73]
- Process taken in granting a Magnetic Resonance Imaging license at
the Kalgoorlie Health Campus.[74]
- Consumer complaints relating to private health insurance.[75]
- Vaccines listed on the National Immunisation Program, and state
and territory based schemes which include vaccines not listed on that program.[76]
Social Services Portfolio hearing—31 May 2018
Whole of portfolio / Corporate
matters
- Status of funding for grants made by the Department of Social
Services (DSS), particularly grants due to expire or subject to redesign.[77]
Outcome 1: Social Security
- Expected operation of the 2018–19 Budget measure, Encouraging
lawful behaviour of income support participants.[78]
- Plans to abolish the Energy Supplement, particularly the number of
people potentially affected and the associated financial impacts.[79]
- Increases to the waiting period for newly arrived residents' access
to certain social income support payments, as proposed in the 2018–19 Budget
measure, Encouraging Self Sufficiency for Newly Arrived Migrants.[80]
Program 1.1: Family Tax Benefit
- Proposed changes to Family Tax Benefit A and Family Tax Benefit B,
including the number and characteristics of the families affected, and
potential savings to government.[81]
Program 1.6: Income Support for
Seniors
-
Provisions of the 2018–19 Budget measure, More Choices for a
Longer Life – Finances for a longer life.[82]
- Changes to the assets test for age pension, as effective from 1
January 2017, including the savings to government and quantum of people
impacted.[83]
- Government policy to increase the pension age and associated
effects.[84]
- Potential effects of the provisions of the Social Services
Legislation Amendment (Payment Integrity) Bill 2017.[85]
- Particulars of the Pension Loan Scheme, including access rates
and processes by which the scheme's interest rate is set.[86]
Program 1.8: Income Support for
People with Disability
- Potential effects of the 2018–19 Budget measure, Disability
Support Pension—aligning suspension periods for imprisoned recipients.[87]
- Policy interactions between exemptions from the mutual obligation
requirements for Newstart Allowance recipients and Disability Support Pension eligibility
criteria.[88]
Program 1.10: Working Age Payments
-
Current rate of the Newstart Allowance, and consideration as to whether
the rate is adequate for recipients' living needs.[89]
-
Updated information on the proposed trail for drug testing
welfare recipients, particularly the breakdown of the services to be funded
under a $10 million treatment fund.[90]
- Number of people potentially affected by the proposal to increase
the liquid assets waiting period from 13 to 26 weeks.[91]
Social Services Portfolio—1 June 2018
Outcome 3: Disability and Carers
-
Statement made by the Secretary of DSS regarding the development
and performance of the National Disability Insurance Scheme (NDIS).[92]
- Context in which the National Disability Insurance Agency (NDIA) published
operational guidelines on its website which included incorrect information
relating to the eligibility requirements for children living with level 2
autism.[93]
- Circumstances in which a person living with an acute disability
died whilst waiting for assistive technology that had been approved through the
NDIS.[94]
-
Update on the transition to the NDIS in Western Australia,
particularly the NDIA's response to the challenges of service delivery in
remote locations.[95]
- Particulars of 'Operation Green Light', an internal NDIA project
for considering potential improvements to the consistency of decisions
regarding NDIS access.[96]
- Support for psychosocial disabilities, particularly the
continuity of support arrangements for people living with a psychosocial disability
who are transitioning from state-based services to the NDIS.[97]
- NDIA information and communication technology system outages,
particularly a recent incident of significant outage affecting the NDIA's central
customer relationship manager system.[98]
- Particulars of the draft NDIS Practice Guide – Intensive
Super Intensive Participants: Guidance for Planners, LACs and delegates, which
was released under the Freedom of Information Act 1982.[99]
-
Unscheduled reviews of participants' plans, including timeframes
for processing those reviews and the NDIA's response to related recommendations
made by Commonwealth Ombudsman.[100]
-
Outsourcing of NDIA call centre operations to a private sector operator.[101]
- Average staffing level caps applied to the NDIA, outsourcing arrangements
and consultancy expenditure.[102]
- Integrated Plan for Carer Support Services.[103]
- Specialist Disability Accommodation Provider and Investor Brief.[104]
Outcome 4: Housing
- National Rental Affordability Scheme (NRAS), including complaints
related to providers; and arrangements to support affordable housing outcomes as
the NRAS approaches a scheduled end date.[105]
- Anticipated effectiveness of recommendations made in a
Productivity Commission report, Introducing competition and informed user
choice into human services, regarding market-based approaches to social
housing.[106]
- Government initiatives that address homelessness, particularly the
consideration given by DSS to international approaches to homelessness.[107]
-
State of bilateral negotiations relating to the National Housing
and Homelessness Agreement.[108]
- Role and design of the National Housing Finance and Investment
Corporation in funding community housing.[109]
- Expected utilisation of the Pensions Loan Scheme.[110]
Outcome 2: Families and Communities
Program 2.1: Families and Communities
- Statement from the Secretary of DSS regarding the National
Redress Scheme for Institutional Child Sexual Abuse Bill 2018 and the National
Redress Scheme for Child Sexual Abuse Scheme for Institutional Child Sexual
Abuse (Consequential Amendments) Bill 2018.[111]
- Particulars of the (then proposed) National Redress Scheme,
including: provisions for counselling services; framework for determining
payment amounts; timeframes for the provision of documents or response to an
offer of redress; information protection provisions; and indexation of previous
redress payments made outside of the scheme.[112]
- Cashless Debit Card program, including arrangements for community
consultation and support services in current and future trial sites.[113]
- DSS service delivery grants which are due to expire or are subject
to redesign.[114]
Human Services Portfolio hearing—31 May 2018
- Telephony capacity of the Department of Human Services (DHS),
including: rates of busy signals; number of abandoned calls; call wait times;
and initiatives to improve customer call outcomes.[115]
- DHS' implementation of the Australian Government Guidelines on
the Recognition of Sex and Gender.[116]
-
Processes relating to the independent KPMG evaluation of the call
centre enhancement pilot.[117]
-
Performance of the NDIA call line, operated by DHS on behalf of
the NDIA.[118]
- Effectiveness of Serco contractors, engaged as part of the call
centre enhancement pilot, in delivering Centrelink call services and employment
conditions for Serco staff.[119]
- Government announcement that 1000 additional operators for DHS'
call centres will be engaged under an outsourcing arrangement.[120]
- Particulars of the DHS workforce, including: average staffing
levels caps; rates of attrition; and staffing level reductions.[121]
- Caps on deductions available to lessors using Centrepay.[122]
- Particulars of the Online Compliance Initiative, including: the
potential impact on social income recipients' tax liabilities and the number of
debt appeals made to the Administrative Appeals Tribunal.[123]
-
Administrative arrangements for managing the Child Care Subsidy.[124]
- Delivery of Centrelink services to people who are homeless.[125]
-
Update on the medical review process for people receiving
Disability Support Pensions.[126]
- Wait times for processing income support applications.[127]
- Service protocols for Centrelink shopfronts delivering in-person
client support.[128]
Program 1.2: Services to the
Community – Health
- Home and residential aged care services, including: DHS'
processes for income and means testing; annual and lifetime caps; and provider
compliance responsibilities.[129]
Program 1.3: Child Support
- Implementation of the DHS child support system upgrade project.
Senator Slade Brockman
Chair
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