Budget Review 2021–22 Index
Amanda Biggs, Rebecca Storen and Elliott King
Overview
Funding the ongoing public health response to the COVID-19 pandemic
remains a high priority of the Australian Government, with the cost of the health
response now estimated
at over $25 billion since March 2020. According to the Treasurer’s
Budget speech, the 2021–22 Budget provides a further $1.9 billion for the
vaccine rollout and another $1.5 billion for other COVID-19 related health
services, giving an estimated total of $3.4 billion. The Portfolio
Budget Statements 2021–22: Budget Related Paper No. 1.7: Health Portfolio
(p. 15) and the Health
Portfolio 2021–22 Budget Stakeholder Kit (DoH Budget Kit, p.
[1]) both state that the total is $1.9 billion for the vaccine rollout and $1.1
billion for the COVID-19 health response, suggesting a total of approximately
$3.0 billion. The different basis for these figures is unclear on the
information available.
Budget
Measures: Budget Paper No. 2: 2021–22 includes three measures under the
COVID-19 Response Package:
- $1.9 billion over five years from 2020–21 to distribute and
administer COVID-19 vaccines (Budget
Paper No. 2, pp. 108–109), including:
- $777.8
million over two years for the COVID-19 Vaccination Program
- $510.8
million over two years for the National Partnership on the COVID-19 Response
for the states and territories to administer vaccines.
- $879.0 million over two years from 2020–21 to extend Medicare and
access to medicines (Budget
Paper No. 2, pp. 105–106), including:
- $557.1
million to extend temporary Medicare Benefits Schedule (MBS) pathology items
for the testing and detection of COVID-19
- $204.6
million for the extension of the temporary telehealth MBS items from 1 April
2021 to 31 December 2021, with revised billing arrangements from 1 July 2021.
- $845.3 million over two years from 2020–21 to extend the
government’s emergency response, including:
- $487.0
million to expand quarantine services in the Northern Territory
- $271.5
million to extend activities under the National Partnership on the COVID-19
Response.
Budget Paper No. 2 notes partial funding for the
first two measures has already been provided for by the Government.
The cost of advance purchase agreements for the Pfizer
BioNTech vaccine and provisions to purchase additional vaccines including mRNA
vaccines is not reported as these agreements are commercial-in-confidence.
Further detail on selected measures is provided below.
Vaccines
Vaccine administration
The Budget provides $777.8 million over two years from
2020–21 for the COVID-19 Vaccination Program. This funding expands the capacity
of the surge workforce to assist with the provision of vaccine services to
priority populations, including people living in residential aged care, disability
accommodation and remote and Indigenous communities (DoH
Budget Kit, p. [56]). This builds on the announcement
in January 2021 to engage an additional vaccine workforce to provide high
throughput and in-reach vaccination services. This funding also includes:
Under the National
Partnership on COVID-19 Response the Commonwealth is committed to providing
a 50% contribution towards the cost of public health activities undertaken by
the states and territories to manage COVID-19. The Budget provides $510.8
million over two years from 2020–21 for the state and territory governments to
administer the vaccine (Budget
Paper No. 2, p. 108). The Vaccination
Program Delivery Package factsheet states this will be for a new Vaccines
Schedule, for which the Commonwealth will make a 50% contribution towards the
agreed price for each vaccine dose delivered (p. [56]).
The Budget also provides funding for other programs and
initiatives to support the COVID-19 Vaccination Program, including:
Storage, distribution, monitoring
and manufacturing
The Budget provides $358.8 million over five years from
2020–21 for the implementation, monitoring and reporting of the vaccine rollout
(Budget
Paper No. 2, p. 107). This may include funding for data and digital
capabilities and solutions that manage and monitor the performance of the
Program, such as the Vaccine Data Solution software which monitors coverage and
logistics for COVID-19 vaccines and the National COVID-19 Vaccine Eligibility
Checker (DoH
Budget Kit, p. [57]). Notably this measure extends over a five-year period,
unlike most of the other vaccine budget measures which are for two years.
Funding of $233.8 million over two years is provided for the
safe distribution of vaccines, including for cold chain storage, logistics and
the supply of vaccine consumables (DoH
Budget Kit, p. [57]).
Research
The Australian Government announced a new Medical Research
Future Fund funding round of $15 million over three years from 2021–22 for
COVID-19 Health Impacts and Vaccination Schedules grants, across three streams (DoH
Budget Kit, p. [191]). This grant
opportunity opened on 12 May 2021.
mRNA vaccine manufacturing
There is also a related budget measure COVID-19
Vaccine Manufacturing Capabilities reported under the Industry, Science,
Energy and Resources portfolio (p. 134) which is to develop an onshore mRNA
vaccine manufacturing capability in Australia, discussed elsewhere in this
Budget Review. Funding for this is not for publication due to
commercial-in-confidence sensitivities.
Medicare
Extension of temporary MBS items
The Guaranteeing
Medicare and access to Medicines – extension measure provides funding to
extend several temporary MBS items and dispensing arrangements for medicines
(pp. 105–106).
Temporary MBS pathology items have been extended, with $557.1
million provided for the continued testing and detection of COVID-19 (Budget
Paper No. 2, p. 105). This funding includes:
- $493.5 million for the COVID-19 microbiology test for the general
population and items associated with testing for some essential workers
- $63.6 million for the extension of the dedicated ‘in-reach’
pathology service for residential aged care facilities (DoH
Budget Kit, p. [60]).
An additional $204.6 million is provided for the extension
of 300 temporary telehealth services until 31 December 2021, for the
following types of services: specialist, GP, nursing, midwifery, allied health
and allied mental health consultations. Some changes will be implemented to provide
exemptions from the requirement to have a pre-existing relationship with a
doctor to access telehealth for certain consultations, including smoking
cessation and pregnancy counselling (DoH
Budget Kit, p. [79]).
The Budget provides $11.5 million to extend the Home
Medicines Service, which was first offered in March 2020. This home
delivery service for Pharmaceutical Benefits Scheme (PBS) and Repatriation
Pharmaceutical Benefits Scheme (RPBS) prescriptions is available for people in
home isolation or for vulnerable patients wishing to limit their potential
exposure to COVID-19 (Budget
Paper No. 2, p. 105). The Home Medicines Service has enabled more than
2.4 million deliveries of medication to patients’' homes (DoH
Budget Kit, p. [59]).
In addition, $11.2 million is provided to continue the
remote response to COVID-19 in regional and remote Indigenous communities (Budget
Paper No. 2, p. 106). The Point of Care Testing for remote communities
will continue until the end of 2021 (DoH
Budget Kit, p. [58]).
Respiratory clinics
$87.5 million is provided to extend the operation
of 150 GP-led Respiratory Clinics (GPRCs) that treat patients (p. [58]).
The GPRCs, which cover 99.6% of the population, have conducted more than one
million assessments and one million tests for COVID-19. The extension of GPRCs
is intended to keep pressure off hospitals and GPs during the pandemic by
seeing patients with mild to moderate respiratory ailments.
Other measures
Quarantine
Budget
Paper No. 2 states that $487.0 million is being provided over two years
from 2020–21 to expand quarantine services for returning Australians at the Howard
Springs facility (also known as the Centre
for National Resilience) in the Northern Territory (p. 107). The cost will
be partially recovered from people who quarantine at the facility.
Federal
Financial Relations: Budget Paper No. 3: 2021–22 (p. 34) states that $513.5
million will be provided to the Northern Territory Government over two years
from 2020–21 for increased capacity at the Centre for National Resilience,
including the capital expenditure, health services and operational costs to
accept Australian repatriations.
According to the Portfolio
Budget Statements 2021–22: Budget Related Paper No. 1.7: Health Portfolio,
$581.8 million has been provided to ‘support the safe quarantine of returning
Australians at the Howard Springs Quarantine Facility’ (p. 17). This includes
funding provided in the 2020–21 MYEFO measure ‘COVID-19 Response Package – quarantine
arrangements in the Northern Territory and Tasmania for people returning from
overseas’.
National Medical Stockpile and
National Incident Centre
The Budget provides $86.8 million over two years from
2020–21 to expand the activities of the National Incident Centre and support the
National Medical Stockpile (Budget
Paper No. 2, p. 107). The National Medical Stockpile acquires, stores
and distributes medical supplies including ventilators, face masks, gloves,
goggles, gowns, hand sanitiser and medicines. Additional funding of $29.9
million will allow for the commencement of the first phase of work to enhance
the long-term capability of the National Medical Stockpile (DoH
Budget Kit, p. [86–87]). The Portfolio
Budget Statements 2021–22: Health Portfolio note an investment of $63.7
million for the National Incident Centre to continue its work monitoring and
responding to the COVID-19 pandemic year (p. 17); it is unclear if this
includes funding provided for by the Government prior to the 2021–22 Budget.
Mental health
The Budget allocates $7.1 million to continue mental health
support provided through Beyond
Blue’s Mental Wellbeing Support Service (p. [154]). This is in addition to
the $10 million provided over 2019–20 and 2020–21 and allows the program to continue
until 31 December 2021. The Support Service offers 24/7 professional mental
health counselling, a web chat service, self-help tools, and advice on navigating
the mental health system and is designed to minimise the impact of high levels
of mental distress associated with the pandemic and prevent more serious mental
illness. Since April 2020, 60,000 services have been provided.
Stakeholder responses
Funding for the extension of temporary Medicare services
such as telehealth has been generally welcomed, although as noted in the separate
Health Overview Budget Review, some stakeholders continue to call for the
temporary services to be made permanent. The president of the Rural Doctors
Association of Australia (RDAA) said in a
statement ‘RDAA will continue to work with other peak bodies and the
Government to develop a long-term, sustainable telehealth model that provides a
high quality and safe service to meet the needs of rural and remote patients,
with an announcement anticipated in the Government’s December MYEFO statement’.
The Royal Australian College of GPs also welcomed
the extension of telehealth services, the continued role of GPs in vaccinations
and news that GP clinics will also be delivering the Pfizer vaccine. President
of Australian Pathology (representing private pathologists) Mark Neeham welcomed
the commitment and ongoing Commonwealth support for COVID-19 pathology testing.
Some have criticised the absence of funding for new
quarantine facilities. Both Queensland
and Victoria have reportedly expressed disappointment there was no money
forthcoming in the budget for new quarantine facilities. The Australian
Medical Association has called on the National Cabinet to introduce interim
measures to improve existing quarantine arrangements and to establish dedicated
quarantine facilities to manage the ongoing risks of COVID-19.