Senate Community Affairs Legislation Committee
Report on Additional Estimates 2009-2010
1.1
On 26 November 2009 the Senate referred the following documents to the
Committee for examination and report in relation to the portfolios of Health
and Ageing; and Families, Housing, Community Services and Indigenous Affairs:
- particulars of proposed additional expenditure in respect of the
year ending on 30 June 2010 [Appropriation Bill (No. 3) 2009-10]
- particulars of certain proposed additional expenditure in respect
of the year ending on 30 June 2010 [Appropriation Bill (No. 4) 2009-10]
-
Final budget outcome 2008-09
-
Issues from the advances under the annual Appropriation Acts for
2008-09.
1.2
The Committee has considered the additional expenditure of the
portfolios set out in their respective Portfolio Additional Estimates
Statements 2009-2010 (PAES). Explanations relating to the estimates were
received from Senator the Hon Joseph Ludwig representing the Minister for
Health and Ageing, Senator the Hon Chris Evans and Senator the Hon Ursula
Stephens representing the Minister for Families, Housing, Community Services
and Indigenous Affairs, and officers from the portfolio Departments at hearings
held on 10 and 11 February 2010.
1.3
The Committee also considered additional expenditure at a hearing on 12 February
2010 on cross portfolio Indigenous matters pursuant to Resolution of the Senate
of 26 August 2008.[1]
Explanations relating to the estimates were received from Senator the Hon Mark
Arbib. Officers from the following portfolio Departments and agencies were in
attendance:
Education, Employment and Workplace
Relations
Families, Housing, Community Services
and Indigenous Affairs
Health and Ageing
Australian Hearing and Centrelink
agencies (Human Services portfolio).
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 1 April 2010.
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 10 to 12 February 2010, 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 matters
1.7
To assist both the Committee and portfolio departments the Committee
conducted the cross portfolio Indigenous matters hearing in a similar 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 in coordinating portfolios
to enable the hearing to be conducted in this manner.
Public interest immunity claims
1.8
During the hearings the issue of public interest immunity pursuant to Order
of the Senate dated 13 May 2009 was not raised.
1.9
The Committee acknowledges the Departments' efforts in providing answers
to a large number of questions on notice relating to the supplementary
estimates. Both portfolio Departments, Health and Ageing (DoHA) and Families,
Housing, Community Services and Indigenous Affairs (FaHCSIA), provided
approximately half of the answers by the due date. The majority of the remaining
answers were progressively provided within the following month, and all were provided
by the commencement of the hearings, with the exception of three answers which
were provided by DoHA shortly after.
Attendance of portfolio agencies
1.10
A number of agencies had been requested to attend the hearing, including
some who had travelled from interstate, and had spent a considerable amount of
time at the hearing waiting to be called, but were not then required to answer
questions. Reasons ranged from Senators who had requested their appearance
unable to be in attendance at the time, or advice that questions would be
placed on notice, and other Senators not having any questions of these
agencies.
1.11
The Committee Chair apologised to representatives of the agencies
concerned, and with the cooperation of the Committee intends to try to prevent
this situation occurring at future hearings.
Insufficient time for questioning
1.12
The Committee regrets that for both portfolios there was insufficient hearing
time for Senators to ask all of the questions they intended, and therefore a
large number of these questions needed to be placed on notice.
Issues
Health and Ageing portfolio
1.13
Senators asked a range of questions covering corporate and cross-outcome
matters. The discussions included the National Health and Hospitals Reform
Commission's role in implementing a national plan for health reform, including
the review, consultation, reporting process, and progress with the report
recommendations. Other matters included details of contracts for Voice over Internet
Protocol (VoIP) services for DoHA's new building, purchase of leased desktop
computers and laptops, and international health experts' professional services.[2]
1.14
The Australian Institute of Health and Welfare (AIHW) was asked to
provide information relating to their contract with FaHCSIA to receive, analyse
and write up the work that FaHCSIA had commissioned for an evaluation report on
income management. AIHW informed the Committee that this was an unusual piece
of work to undertake because they did not undertake a full evaluation. AIHW did
not provide input into the design of the evaluation, however considered that:
...it was an important piece of work for us to do from the
sense of objectively looking at what the evidence was that had been collected.
AIHW
further explained that:
Obviously the design of the evaluation is a very important
factor with regard to the extent to which the data you have is comprehensive,
is useful and is analysable. That is why in our report we made strong comments
about the limitations of the evidence.[3]
1.15
Other matters discussed with AIHW included the role of their ethics
committee, new strategic plan, national minimum data sets on alcohol and other
drug treatment services, development of standards for the National E-Health Transition
Authority (NEHTA), and hospital expenditure statistics.[4]
1.16
DoHA informed the Committee about the Elective Surgery Waiting List
Reduction Plan arrangement with the states and territories, including the use
of private sector services to achieve targets, and funding arrangements.[5]
1.17
The Australian Organ and Tissue Donation and Transplantation Authority
informed the Committee in relation to the reform package for organ and tissue
donation for transplantation, including increased funding and provision of specialist
personnel for hospitals; the national professional awareness and education
program; donor family support; and organ donation rates.[6]
1.18
Senators sought information on primary care matters which included an
update on progress with the GP Super Clinic project. DoHA informed the
Committee that of the original 31 locations for Super Clinics 28 funding
agreements had been fully executed but only two are fully operational.
Information was also provided as to the number of fully and partially
operational clinics. The status of several particular clinics or proposed sites,
and the services already provided or planned were also discussed, as well as workforce
shortage, the employment of overseas trained doctors, and relocation incentives
to move to Super Clinics. Other primary
care matters discussed included proposals to consolidate Divisions of General Practice
and funding agreements with the Divisions.[7]
1.19
Private health insurance issues included the private health insurance
rebate, Medicare levy surcharge, and modelling relating to the measure overall.
The Committee was also informed that in the most recent quarter of data private
health insurance membership had increased slightly, with the current proportion
at 51.6 per cent, up from 51.4 per cent in the previous quarter.[8]
1.20
Senators questioned DoHA about hearing services provided to children
with severe hearing loss and provision of subsidies for children requiring a
direct bone conduction hearing aid device. Questions were also asked about
modelling being undertaken to assess the cost of providing support for people
over 21 to retain access to hearing services. The Committee also sought information
in relation to hearing difficulties and building design.[9]
1.21
Questions relating to pharmaceutical benefits matters included the
review of the Pharmaceutical Benefits Scheme (PBS) reforms, including the consultancy
process, and modelling; community service obligation for pharmaceuticals, the
funding pool for PBS medicines, and distribution arrangements; progress with
the fifth pharmacy agreement; and the review of the pharmacy location rules.
E-script payment for electronic prescriptions, implementation of the
chemotherapy measure, and PBS access for nurse practitioners and midwives were
also discussed. Senators also sought information in relation to new therapeutic
groups and the role of the Pharmaceutical Benefits Advisory Committee (PBAC) in
reviewing listed medicines to determine if they fit within a therapeutic group.
The Senate Community Affairs References Committee is currently inquiring into
consumer access to pharmaceutical benefits and the creation of new therapeutic
groups through the PBS.[10]
1.22
The Committee discussed aged care matters at some length with DoHA.
Included in discussions were transition arrangements from the Continence Aids
Assistance Scheme to the Continence Aids Payments Scheme and outcomes and
services for participants in the scheme; the impact of an Emissions Trading
Scheme (ETS) on aged-care facilities and the Government's Climate Change Action
Fund to provide assistance to businesses and community organisations, including
operators of aged care facilities. The stocktake of aged-care places, status of
reviews for accreditation standards, accreditation processes and the complaints
investigation scheme, and the engagements and activities undertaken by the
Ambassador for Ageing were also discussed. A number of questions were also asked
relating to the aged care approvals round and the application process, Aged
Care Funding Instrument (ACFI) review, and requirements for aged care services
to provide support and quality care to people in the LBGTI group.[11]
1.23
DoHA was also asked to provide an update on progress with assistance to young
people with disabilities to be accommodated in alternative residential care out
of aged care facilities. The Nursing Home Oral and Dental Health Plan,
evacuation procedures in aged care homes in the event of disasters such as
bushfires, the Zero Real Interest Loans Initiative, and viability of smaller
regional aged care facilities were also discussed. Aged care workforce topics
included the impact of award modernisation, aged care nursing scholarships and
Bringing Nurses Back into the Workforce program.[12]
1.24
The Aged Care Standards and Accreditation Agency (ACSAA) informed the
Committee in relation to the unannounced visits program, and compliance with
nutrition and hydration standards in aged-care facilities.[13]
1.25
Following up on the Committee's report recommendations for the inquiry
into children in institutional care titled Forgotten Australians,
Senator Siewert asked questions relating to progress with the initiative to
provide support to former children in institutional care, particularly so far
as aged care was concerned. DoHA advised that development work had commenced on
an educational package of support for 'forgotten Australians' who have now been
identified as a special needs group under the aged-care legislation through an
amendment to the Allocation Principles.[14]
1.26
Questions relating to access to medical services included take-up rates
for the Healthy Kids Check program; stakeholder input to the MBS Quality
Framework; changes to Medicare rebates for cataract surgery; review of Medicare
schedule items for joint injections and aspirations; Medicare Teen Dental Plan;
and an MRI licence for Warrnambool in Victoria.[15]
1.27
The Office for Health Protection informed the Committee of the strategies
in place to deal with emerging infectious diseases, including preparedness and
response plans. Funding and research coordination in Australia and
internationally were also discussed. Senators also sought information
concerning provision of health services for border protection agencies. A
number of questions were asked relating to the supply of H1N1 flu vaccine,
particularly with regard to the cost, uptake rate and clinical trials.[16]
1.28
Questions on sporting matters mainly related to the report of an
Independent Sport Panel, chaired by Mr David Crawford, which reviewed all
aspects of sport in Australia and its future direction, referred to as the
'Crawford report'. Panel membership was discussed, including remuneration and whether
declarations of conflicts of interest were completed before appointment of panel
members. The Crawford report recommendations were also discussed, as well as
the report's appendix I which the Committee was informed had not been publicly
released in its entirety because of commercially confidential information
pertaining to the Gemba group, the body who prepared the appendix. Other
sporting topics included the hotel contract for food and beverages for the
Commonwealth sports ministers' meeting in Beijing and the contract for the FIFA
World Cup bid negotiations.[17]
1.29
Rural health matters related to the new zoning system for regional and
remote communities, and the possible impact on communities, GPs, and overseas
trained doctors. The rural GP locum program, number of applications and
placements were also discussed, as well as the Rural Health Workforce Strategy
and provision of services for rural and remote Australians.[18]
1.30
Questions relating to the nursing workforce included recruitment targets
for nurses returning to the workforce under the Bringing Nurses Back into the
Workforce program, and abuse of nurses in the workplace. Medical education and
training matters discussed included the processes in place to ensure a balance
between the number of medical school graduates and the availability of intern
and postgraduate training places.[19]
1.31
Further information was sought from DoHA concerning midwives, including
the impact of the proposed collaborative arrangements and indemnity insurance
issues, which were matters discussed at length during the Committee's inquiry
into the Health Legislation Amendment (Midwives and Nurse Practitioners) Bill
2009 and related Bills.[20]
1.32
The Committee was provided with an update on the implementation of
E-Health, including system development, trialling, healthcare identifiers, the time-frame
for roll-out of the system, and capability across the health system.[21]
1.33
Cancer Australia agency, in response to a question relating to how
priorities are set with regard to cancer research, particularly for less
well-known forms of cancer, informed the Committee of their role and functions:
...we work with a large range of providers, both funders and
researchers, and that has been melded into the Priority-Driven Collaborative
Cancer Research Scheme. That process puts forward priorities, either for policy
or for practice, to the research community on an annual competitive merit based
program jointly with evaluation by the National Health and Medical Research
Council. Then, subsequently, Cancer Australia and its committees seek to ensure
that we are investing across the full spectrum of cancer. To that end, Cancer
Australia ... has put together a range of priorities which really are incredibly
broad in their remit and target a number of cancers that may otherwise not be
in the public eye.[22]
1.34
Discussions on mental health matters included the allocation of funding
for the COAG National Action Plan on Mental Health for phone and web-based counselling
services; and breakdowns of funding provided to organisations for stages 1
and 2 of mental health services in rural and remote areas. In relation to the
provision of ongoing treatment following attempted suicide, DoHA informed the
Committee that a project had been developed under the Access to Allied
Psychological Services program to support individuals upon discharge from
hospital.[23]
1.35
Population health matters included the consultation process, research
contracts, and preliminary work undertaken by the Preventative Health Taskforce.
Food Standards Australia New Zealand (FSANZ) agency provided information on requirements
for testing for chemical residues in frozen vegetables in Australia and
internationally.[24]
1.36
Questions asked of the Therapeutic Goods Administration (TGA) related to
the processes followed when TGA decided whether a drug should be approved for
use in Australia, and whether testing is more rigorous in relation to
prescription medicines. Processes used to approve devices such as artificial
joints were also discussed. TGA informed the Committee that the regulatory
framework for implantable devices is an internationally harmonised framework
called the global harmonisation taskforce framework for regulation of medical
devices. TGA also advised that although they have well-established processes
for investigating faulty medical devices they do not have the power to compel
healthcare professionals to refer faulty devices to them. TGA also informed the
Committee their medical device expert advisory committee investigates
orthopaedic implants as a result of reporting by the Joint Replacement Registry.
Regulatory action has been taken by this committee, including the removal of
several devices from the market.[25]
Families, Housing,
Community Services and Indigenous Affairs portfolio
1.37
The Committee sought information relating to a number of corporate
issues and matters which cross outcomes, including total staff numbers, the number
of staff having identified a disability, people with a disability employed on
the traineeship program, and the number of DLO officers attached to ministers'
offices. Contracts for the procurement of services from Disability Enterprises,
expenditure on consultancy services, advertising and marketing were discussed.
Information was sought in relation to the design of research programs and
adherence to the National Statement on Ethical Conduct in Human Research and
other ethical guidelines when data collection involves vulnerable people.[26]
This issue was further discussed later in the hearing and an explanation
provided in relation to the ethical processes followed for a particular research
project.[27]
1.38
Matters relating to seniors included the Commonwealth Seniors Health
Card concessions and eligibility thresholds, income test and changes to income
streams, number of same-sex couples declaring their relationship for pension
assessment, and pensioners with irregular incomes affected by assessment
changes.[28]
1.39
Senators discussed housing matters with FaHCSIA at length, including the
effectiveness of KPIs and COAG performance indicators in measuring outcomes in
delivery of programs and initiatives relative to the National Rental
Affordability Scheme (NRAS), National Affordable Housing Agreement (NAHA), Homelessness
National Partnership, and rent assistance. Information was sought on Housing
Affordability Fund (HAF) projects, additional housing stock, and the role and
work of the National Housing Supply Council in planning to meet housing demand.
Progress with work under the maintenance component of the Social Housing
Initiative, delivery of housing under the stimulus package, funding agreements
under HAF, and sustainability and energy efficiency benchmarks for social
housing were also included in discussions.[29]
1.40
A range of questions were asked by Senators relating to homelessness,
including the numbers of homeless people, including women and children who are
homeless due to domestic violence.
1.41
The Committee was informed by the Office for Women and Equal Opportunity
for Women in the Workplace agency (EOWA) on matters such as the consultation
process and timetable for the review of EOWA, affirmative action reporting and
compliance, particularly with regard to appointment of women to Boards. EOWA
advised that workshops were provided to assist companies with compliance and
reporting. Information was also provided on delegation representation and
progress with preparations for attendance at the Beijing +15 UN General
Assembly on women's rights. The national plan to reduce violence against women
and their children was discussed in relation to progress with implementation of
recommendations of the Time for Action report, including the Respectful
Relationships programs.[30]
1.42
A number of questions were asked relating to family matters including
Family Relationship Services Australia client identification, and Indigenous
service delivery issues. The Secretariat of National Aboriginal and Islander
Child Care (SNAICC) program was also discussed in relation to provision of
culturally appropriate services to Indigenous communities. Senators sought
information on a range of paid parental leave matters, including the scheme's consultation
process, eligibility criteria, employer responsibilities, payment options, and implementation
plans. Questions were also asked in relation to assistance available to
grandparents who care for their grandchildren, succession planning and
financial planning services.[31]
1.43
In relation to the national apology to the 'Forgotten Australians' - former
children who were in institutional care, including child migrants - FaHCSIA
informed the Committee that there had been an overwhelming positive response
following the apology. FaHCSIA also advised of progress with implementation of
the recommendations of the Lost Innocents and Forgotten Australians
reports of the Senate Community Affairs References Committee.[32]
The Committee has a long standing interest in this area and will continue to
monitor progress.[33]
1.44
The Minister
commented that:
...the department should be congratulated on what a great job
they did in managing that. It was really well done, but I also think ... we ought
to keep reminding people that it was as a result of the committee and the work
of the Senate committee that actually made this happen. That is not often
acknowledged... I think it is one of the great examples of the way the Senate
committee system can work, so I think that we ought to keep acknowledging that
is the Senate at its best in that regard and it would never have happened if it
were not for the succession of Senate inquiries and pressure.[34]
1.45
The Committee Chair, on behalf of the Committee, also acknowledged
FaHCSIA's excellent work.[35] The Committee appreciates the Minister's
acknowledgement of the role the Committee played in achieving outcomes for the former
'Forgotten Australians', now the 'Remembered Australians', and the importance
of the Senate Committee system.
1.46
Senators asked a number of questions on disability matters, including
the harmonisation of disability parking permit schemes across Australia; the
national approach to universal design in housing to provide a greater range of
homes as people age or for those with a disability; allocation of additional places
and locations under the Outside School Hours Care for Teenagers with Disability
Program; and details of procurement contracts for services purchased through
Australian Disability Enterprises. FaHCSIA provided an update on progress with operations
and locations of Autism Specific Early Learning and Care Centres. The status of
the National Autism Register, autism adviser services, and waiting time for
access to services was also discussed. Other questions related to the carer
adjustment payment, development of the National Carer Recognition Framework,
status of legislative amendments relating to Special Disability Trusts,
accommodation for young people assisted out of residential aged care facilities,
and the Personal Helpers and Mentors Program to assist people with mental
illness.[36]
1.47
Matters relating to the proposal to expand income management included the
use of the BasicsCard to access income-managed funds; BasicsCard funding and
service delivery implementation; voluntary income management; income
quarantining; participation requirements; exemption and appeals processes.
Questions were also asked about financial management assistance and provision
of financial services in the Cannington district and Kimberley region of WA, as
well as the number of people being quarantined in these areas and the processes
involved to be able to come off the scheme. The proposal to reinstate the Racial
Discrimination Act 1975 was also discussed.[37]
Cross portfolio Indigenous matters
1.48
Senators sought answers to Indigenous issues questions from various
portfolio Departments and agencies under the thematic headings detailed on the
hearing program. In response to Senators' questions concerning the Closing the
Gap initiative, the Coordinator-General for Remote Indigenous Services provided
a comprehensive overview of progress being made, priorities identified in
consultation with communities, and implementation plans for a range of initiatives
under the National Partnership on Remote Service Delivery. Governance and
leadership matters were also discussed.[38]
1.49
Matters discussed with Centrelink included income management, income
quarantining, and some difficulties experienced in relation to the BasicsCard.
Services provided by Centrelink in relation to financial counselling and
assistance with improving money management skills were also discussed.[39]
1.50
A considerable number of housing questions were asked by Senators relating
to remote Indigenous housing, the Strategic Indigenous Housing and
Infrastructure Program (SIHIP), including the number of new houses completed or
commenced, and houses refurbished and upgraded. Funding allocation for housing
in town camps, and maintenance of housing stock were also discussed, as well as
homeless Indigenous people in remote areas, State-owned and managed Indigenous
housing, and the National Policy Commission on Indigenous Housing.[40]
1.51
Employment and economic development matters included the Australian
Employment Covenant initiative to provide training and employment opportunities
for Indigenous people. Options available to employers to assist with preparing
people for employment were also discussed. DEEWR provided figures on outcomes
of key employment programs which showed an 18 per cent increase in Indigenous
job placement compared to the previous year. Progress with the placement of Community
Development Employment Projects (CDEP)
participants into the mainstream labour market was also discussed, including
the Cape York income management welfare reform trial and other employment
projects.[41]
1.52
Indigenous health issues discussed with DoHA included the size of the
health workforce under the emergency response initiative, Indigenous health
workers, and progress with the Bringing them Home and Link Up programs. The
provision of dialysis services and difficulties for people accessing services in
remote areas was also discussed. Funding for pharmaceuticals for Indigenous
people with chronic disease, and support for pharmacists and delivery of
pharmaceuticals in remote areas were also raised. A number of questions were
asked relating to hearing health, particularly the difficulties encountered by
Indigenous children with hearing loss and their involvement with the juvenile
justice system, and lack of suitable sound systems in classrooms.[42]
1.53
Questions were asked relating to the expected release date for the Central
Australian Petrol Sniffing Strategy Unit (CAPSSU) report on petrol sniffing,
and differences in payments to Board members of Divisions of General Practice
and members of Aboriginal community controlled health organisations' Boards.[43]
1.54
Other more general Indigenous matters included the Queensland
Government's wild rivers legislation and the affect this may have on Indigenous
people in that area. Senators also sought information on the recruitment
process, appointment, and early resignation of the CEO of the Aboriginal and
Torres Strait Islander Healing Foundation.[44]
1.55
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
February 2010
Navigation: Previous Page | Contents