Report on Additional Estimates 2008-2009


Report on Additional Estimates 2008-2009

1.1        On 4 December 2008 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 additional expenditure in respect of the year ending on 30 June 2009

  • particulars of certain proposed additional expenditure in respect of the year ending on 30 June 2009

  • Final budget outcome 2007-08

  • Advance to the Finance Minister as a final charge for the year ended 30 June 2008.

1.2        The Committee has considered the additional expenditure of the portfolios set out in their respective Portfolio Additional Estimates Statements 2008-2009 (PAES). Explanations relating to the estimates were received from Senator the Hon Jan McLucas, Parliamentary Secretary to the Minister for Health and Ageing and Senator the Hon Chris Evans, Minister for Immigration and Citizenship representing the Minister for Families, Housing, Community Services and Indigenous Affairs, and officers from the portfolio Departments at hearings held on 25 and 26 February 2009.

1.3        The Committee also considered additional expenditure at a hearing on 27 February 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 Chris Evans, Minister for Immigration and Citizenship and Senator the Hon Joseph Ludwig, Minister for Human Services. Officers from the following portfolio Departments were in attendance:

Attorney-General's

Education, Employment and Workplace Relations

Environment, Water, Heritage and the Arts

Families, Housing, Community Services and Indigenous Affairs

Health and Ageing

Human Services

Prime Minister and Cabinet.

1.4        The Committee expresses its appreciation for the assistance of the Ministers; Parliamentary Secretary; 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 8 April 2009.

1.6        The Committee discussed many of the expenditure proposals and information contained in the PAES. These discussions are detailed in the Committee’s Hansard transcripts of 25, 26 and 27 February 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.

1.7        At the conclusion of the Health and Ageing hearing the Parliamentary Secretary, Senator McLucas, and the Committee Chair, Senator Moore on behalf of the Committee, joined with the Departmental Secretary, Ms Halton, in acknowledging the huge contribution made by Professor John Horvath as Chief Medical Officer and also Mr Philip Davies, Deputy Secretary and wished them all the best for their future endeavours.[2]

Procedural matters

Cross portfolio Indigenous issues

1.8        To assist both the Committee and portfolio departments the Committee conducted the cross portfolio Indigenous issues hearing in accordance with a new program format which listed themes and issues for consideration across portfolios. The Committee acknowledges and appreciates the assistance of FaHCSIA in coordinating portfolios to enable the hearing to be conducted in this manner.

1.9        The major themes/issues format proved to be very effective and greatly assisted the Committee's deliberations; however, due to restrictions in Ministerial availability there was a limitation of time which prevented a range of issues being considered as fully as Committee members would have preferred. To gain extra time for the hearing it was agreed that it would start at 8.00am. When the hearing commenced a procedural motion was successfully passed to extend the hearing time to that originally scheduled. The hearing eventually ran from 8.00am to 2.45pm.

Provision of answers relating to Supplementary Budget Estimates 2008-09

1.10      The Committee is pleased to acknowledge the Departments' efforts in providing answers to a large number of questions on notice relating to the supplementary budget estimates. DoHA provided approximately half of the answers by the due date, and the remaining answers were provided progressively by early February.

1.11      Although FaHCSIA did not provide any answers to questions on notice by the due date, the majority were provided a few days later, with the remaining answers being provided in early February.

Medibank Private – appearance at estimates hearings

1.12      The issue of which Committee Medibank Private should appear before during the consideration of estimates was raised at the budget estimates, and detailed in the Committee's budget estimates report of June 2008. The Committee agreed that as the responsibility for Medibank Private is with the Minister for Finance and Deregulation it is appropriate that Medibank Private only appear before the Finance and Public Administration Committee for questions on any issues relating to a range of health and insurance matters, in addition to financial and administrative issues.

Attendance of portfolio agencies

1.13         The Committee noted in its previous report that some agencies, including a number that had travelled from interstate, had been requested to attend the hearing but were not then called to answer questions. The procedures instigated by the Committee have improved the situation with all agencies requested to attend the hearing being asked questions at the hearing.

Issues

Health and Ageing portfolio

1.14      The Committee sought information relating to a number of corporate issues and matters which cross outcomes. Included in discussions were the efficiency dividend, staffing numbers, consultancies, replacement of capital items, stimulus package, and the Health and Hospital Reform Commission.[3]

1.15      A considerable amount of time was spent on questions concerning population health issues, particularly with regard to alcohol behaviour and misuse, risk, alcohol reduction programs, and hospitalisation data for alcohol-related harm and the use of statistics. The information provided by DoHA is also of assistance to the Committee in its consideration of Bills referred for inquiry and report, which relate to the impact of tax on ready-to-drink alcoholic beverages, known as 'alcopops'.[4] The Access Economics report Trends in alcohol related hospital use by young people was discussed in some detail as to the use of data in support of their conclusions.[5]

1.16      Other matters relating to population health included obesity rates, and initiatives and programs in place to improve these rates. Harm minimisation and the provision of prevention initiatives, drug treatment services to combat illicit drug use and naltrexone implants were also included in discussions, as well as exemptions from smoke-free workplace laws, level of tobacco excise, and nicotine replacement therapy.[6]

1.17      Cancer Australia informed the Committee regarding the advantages and operation of a collaborative cancer research scheme that the agency is administering in conjunction with a number of funding partners. Questions were also asked relating to genetic testing of breast cancer samples and patenting of DNA tests, which is the subject of the Committee's inquiry into gene patents.[7]

1.18      The Australian Sports Anti-Doping Authority (ASADA) was asked to explain why their annual report had not included a reference to the Privacy Commissioner's response relating to privacy issues involved in a pilot program to cross-reference medical records with lists of banned substances. The privacy issues had previously been raised at the Committee's budget estimates hearing. ASADA assured the Committee that their next annual report would include details of their progress with implementation of the Privacy Commissioner's recommendations. The Committee also asked ASADA regarding reviews being conducted.[8]

1.19      A range of questions were asked of DoHA and the Australian Sports Commission (ASC) agency relating to the Crawford review of sport.[9] Funding to national sporting organisations, the National Pathways Plan, issues relating to loss of accreditation by Taekwondo Australia, and the interrelationship between the sports system as overseen by the ASC and university sport were also discussed.[10]

1.20      The Committee sought information from DoHA with regard to emergency response and biosecurity provisions, as well as arrangements in place to deal with potential health emergencies such as the stockpile for pandemics.[11]

1.21      Aged care matters were the subject of much debate over a wide range of issues, including aged care homes eligibility to apply for insulation under the Energy Efficient Homes Package; delays with construction of aged care facilities; financing of projects; bed licences; allocation and take-up of aged care places; capital grants allocation. Also included in discussions were the status of aged care allocations older than five years, including the proposed Evans Head aged care facility and reasons for the lengthy delay. Sanctions imposed on aged care facilities; the aged care workforce; and the funding application process for an ageing and dementia research centre were also discussed.[12]

1.22      The Committee asked DoHA to provide an overview of the new insulin pump subsidy program. The level of the co-payment required to be paid and other matters relating to juvenile type 1 diabetes was also discussed in some detail. Further pharmaceutical questions related to reduced estimates for pharmaceutical benefits, the Fourth Community Pharmacy Agreement, and the provision of consumer medicines information.[13]

1.23      Eligibility to access Medicare benefits included questions relating to general anaesthetics administered by dentists in Tasmania, and services undertaken by private nurse practitioners and midwives. Indexation of MBS data and Medicare compliance audits were also discussed. The setting up of diagnostic imaging services by groups of specialists who have a financial interest in the practice, and the number of diagnostic imaging services attracting a Medicare payment were also included in discussions.[14]

1.24      A range of questions were asked by Senators relating to the progress with planning and roll-out of superclinics in various States and Territories. Rural health questions included an update of the National Rural and Remote Health Infrastructure Program and the role of the Office of Rural Health. The Committee was also informed on matters relating to the National Blood Agreement, blood collection and distribution.[15]

1.25      The Committee asked DoHA and the Private Health Insurance Administration Council a number of questions concerning private health insurance, including premium increase applications and the approval process; rebates; reforms; funds' capital reserves; membership levels; and prostheses items covered by private health insurance which were subject to a gap payment.[16]

1.26      DoHA informed the Committee regarding progress in relation to eHealth and the Department's and the National E-Health Transition Authority's role and focus in the provision and delivery of e-health technology. Some of the complexities involved in setting up this IT capability were outlined to the Committee.[17]

1.27      Mental health matters discussed included the Australian Suicide Prevention Advisory Council; the National Suicide Prevention Strategy; and crisis support services. Details of early and on-going provision of primary mental health care support services to people affected by the recent bushfires in Victoria were outlined to the Committee.[18]

1.28      Senators sought information covering health workforce issues, including the status of the National Registration Accreditation Scheme, and the uptake by nurses returning to work under the bringing nurses back into the workforce program.[19]

Families, Housing, Community Services and Indigenous Affairs portfolio

1.29      The Committee asked a range of questions covering corporate and cross-outcome matters which included advertising and communications relating to the Economic Security Strategy payments; staff training programs; the efficiency dividend; staff numbers; consultancies; and media monitoring.[20]

1.30      Support for the aged discussions included details relating to the administration of the pension review and the progress made; age pension projections; Commonwealth Seniors Health Card; national seniors reciprocal transport concessions; and the pension loans scheme.[21]

1.31      The Committee asked a wide range of disability support questions concerning the National Disability Agreement, particularly with regard to progress with finalisation of the implementation plans for service delivery, and COAG arrangements regarding disability funding and indexation. Funding and delivery of community-based care, and the consultation process were also included in discussions.[22]

1.32      Senators sought an update of information on progress with possible changes being considered to Special Disability Trusts by the Department and the Disability Investment Group who are reviewing funding. FaHCSIA advised the Committee with regard to the Committee's report recommendations on Special Disability Trusts that:

Of the 14 recommendations that were made, the majority have both budgetary and legislative implications, so those considerations within government are still ongoing. The Disability Investment Group is also considering broader issues around private investment in disability support. They are currently finalising their report ... we are expecting that report to government in the near future.[23]

1.33      Further disability matters raised by the Committee included work being undertaken around succession planning to assist people with disabilities. Progress with the establishment of national autism centres and eligibility for services for children under the Helping Children with Autism package, the number of autism advisers and recruitment process to increase adviser positions, and workshops to assist and support families were also discussed, as well as funding and other aspects of the younger people with disability in residential aged care program.[24]

1.34      A number of questions were also asked regarding the assessment process for places to be offered across a number of sites under the Personal Helpers and Mentors Program and the evaluation process. The Committee was also provided with details of young people with disabilities who had been moved out of residential aged care facilities into a variety of settings, such as into their own homes, or to supported accommodation. FaHCSIA also advised that enhanced services were being provided to those who remain in residential aged care. Some difficulties experienced by ageing employees in Australian disability enterprises were also discussed.[25]

1.35      With regard to support for carers Senators sought information about funding arrangements for carer advocacy organisations, publishing timelines for research reports relating to young carers, and the primary school kit for young carers.[26]

1.36      A considerable amount of time was spent by the Committee questioning FaHCSIA on a range of housing issues. Included in discussions were the stimulus package, social housing, national rental affordability scheme, housing affordability fund, homelessness, and public housing dwellings.[27]

1.37      Family support matters canvassed by the Committee related to the School Enrolment and Attendance through Welfare Reform Measure (SEAM), voluntary income management, BasicsCard, Family Relationship Centres, adult survivors of child abuse, and the new family support program.[28]

1.38      FaHCSIA informed the Committee concerning data which was being collated relating to child support payments following the reforms. Financial counselling programs, services and funding were also discussed.[29]

1.39      Included in some community-based matters canvassed with FaHCSIA were the Communities for Children program; projects transferring into Family Support; evaluation of the Stronger Families and Community Strategy program; administration of contracts; volunteer grants; Community Response Taskforce; the Victorian Bushfire Reconstruction and Recovery Authority; broadband for seniors; and the national compact.[30]

1.40      Matters discussed by the Committee with FaHCSIA in relation to support for women included the timeframe for the National Council to Reduce Violence Against Women and their Children in developing the national action plan; domestic violence and sexual assault laws; funding for new research into international best practice models for working with perpetrators of violence; the National Rural Women's Summit; paid parental leave; Commission on the Status of Women; and the structure of the Office for Women.[31]

Cross portfolio Indigenous issues

1.41      The Committee sought answers relating to Indigenous issues questions from various portfolio Departments 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 Closing the Gap initiative. A large number of housing questions were asked by the Committee under the housing and land heading, but which principally also fitted under the 'umbrella' of the above two themes.

1.42      Questions which were asked relating to the welfare reform theme mainly covered income management and school attendance trials. The Central Land Council was questioned in relation to their annual report financial statements. Health matters included an update of the trachoma screening and treatment program.[32]

1.43      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

March 2009

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