Footnotes
Membership of the Committee[1]
[1]
Membership arrangements for previous phases of this inquiry can be found in
earlier interim reports.
Hospital funding quotes[1]
[1]
Full citations may be found at the beginning of each chapter.
Chapter 1 - Introduction
[1]
Journals of the Senate, 25 June 2014, pp 996–998.
[2]
Public hearing details can also be accessed via the committee's website:
www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Public_Hearings.
[3]
The submissions received by the committee can be accessed via the
committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Submissions.
[4]
The submissions received by the committee can be accessed via the
committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Additional_Documents.
[5]
Journals of the Senate, 2 December 2014, p. 1948. The report can
be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/First_Interim_Report.
[6]
Journals of the Senate, 24 June 2015, p. 2809. The report can be
accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Second_Interim_Report.
[7]
Journals of the Senate, 17 September 2015, p. 3158. The report
can be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Third_Interim_Report.
[8]
National Commission of Audit, Phase One Report, paragraph 10.1
and recommendation 57.
[9]
Commonwealth of Australia, 2014-15 Budget, Budget Paper No. 2,
Budget Measure: Smaller Government—scoping studies for four operations of
government, May 2014, p. 117.
[10]
Senator the Hon Mathias Cormann, Minister for Finance, media release, 'Further
Consultation on Future Ownership Options for Australian Hearing', 8 May 2015.
[11]
Journals of the Senate, 12 October 2015, p. 3175. The report can be
accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Fourth_Interim_Report.
[12]
Journals of the Senate, 2 May 2016, p. 4165. The report can be
accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Fifth_Interim_Report.
[13]
Journals of the Senate, 4 May 2016, p. 4238. The report can be
accessed at: https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Sixth_Interim_Report
[14]
Committee Hansards can be accessed via the committee's website: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Public_Hearings.
Chapter 2 - Background to hospital funding reform
[1]
Department of the Prime Minister and Cabinet, Reform of the
Federation White Paper 2014: Roles and Responsibilities in Health, Issue
Paper 3, December 2014, pp 1–3 and 21–25.
[2]
Amanda Biggs, Parliamentary Library, Health in Australia: a quick
guide, November 2013, pp 1–2; Council of Australian Governments, National
Healthcare Agreement 2012; and Department of the Prime Minister and
Cabinet, Reform of the Federation White Paper 2014: Roles and
Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.
[3]
Amanda Biggs, Parliamentary Library, Health in Australia: a quick
guide, November 2013, pp 1–2; Council of Australian Governments, National
Healthcare Agreement 2012; and Department of the Prime Minister and
Cabinet, Reform of the Federation White Paper 2014: Roles and
Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.
[4]
Amanda Biggs, Parliamentary Library, Health in Australia: a quick
guide, November 2013, pp 1–2; Council of Australian Governments, National
Healthcare Agreement 2012; and Department of the Prime Minister and
Cabinet, Reform of the Federation White Paper 2014: Roles and
Responsibilities in Health, Issue Paper 3, December 2014, pp 1–3 and 21–25.
[5]
Department of Prime Minister and Cabinet, Reform of the Federation
White Paper 2014: Roles and Responsibilities in Health, Issue Paper 3,
December 2014, p. 21.
[6]
Greg Lewis, Public Health and Commonwealth-State Relations,
Department of the Parliamentary Library Information and Research Services,
1998, p. 1.
[7]
House of Representatives Standing Committee on Health and Aging, The
Blame Game: Report on the inquiry into health funding, November 2006.
[8]
Sidney Sax, A Strife of Interests – politics and policies in
Australian Health Services, George Allen and Unwin, Sydney, 1984, pp 26,
36, 42 and 58; Anne-marie Boxall & James A. Gillespie, Making Medicare:
The Politics of Universal Health Care in Australia, UNSW Press, Sydney,
2013, pp 15–22.
[9]
This was through SPPs as the Commonwealth had no constitutional power
over health services. Although the scheme stopped in 1949, Queensland continued
to fund free hospital care; Sidney Sax, A Strife of Interests – politics and
policies in Australian Health Services, George Allen and Unwin, Sydney,
1984, p. 52, 56, 58; Anne-marie Boxall & James A. Gillespie, Making
Medicare: The Politics of Universal Health Care in Australia, UNSW Press,
Sydney, 2013, pp ix–x and 22–35.
[10]
Anne-marie Boxall & James A. Gillespie, Making Medicare: The
Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013,
p. 27.
[11]
This was articulated as Section 51(xxiiiA) of the Constitution.
[12]
The Pharmaceutical Benefits Scheme was enacted under the Pharmaceutical
Benefits Act 1948. Another scheme had been already in operation in early 1945
(the Pharmaceutical Benefits Act 1944), but it was declared unconstitutional in
1946. Parts of the 1948 Act would also prove to be unconstitutional in 1949;
Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of
Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp ix-x, 22–35;
Scotton, Richard, B, Medibank: from conception to delivery and beyond,
MJA Vol 173, 3 July 2000, pp 9–11.
[13]
Anne-marie Boxall & James A. Gillespie, Making Medicare: The
Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013,
pp ix–x and 22–35.
[14]
Anne-marie Boxall & James A. Gillespie, Making Medicare: The
Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013,
pp ix–x and 22–35.
[15]
Anne-marie Boxall & James A. Gillespie, Making Medicare: The
Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013,
pp 52–63; Amanda Biggs, Medicare Background Brief – E-Brief, October
2004 www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/Publications_Archive/archive/medicare
(accessed 1 March 2016).
[16]
Anne-marie Boxall & James A. Gillespie, Making Medicare: The
Politics of Universal Health Care in Australia, UNSW Press, Sydney, 2013,
p. 56; Amanda Biggs, Medicare Background Brief – E-Brief, October 2004.
[17]
The medical side of Medibank was effective nationally from 1 July 1975; Richard
B, Scotton, Medibank: from conception to delivery and beyond, Medical Journal
of Australia ,Vol 173, July 2000, pp 9–11.Amanda Biggs, Medicare Background
Brief – E-Brief, October 2004.
[18]
Amanda Biggs, Medicare Background Brief – E-Brief, October 2004;
Anne-marie Boxall & James A. Gillespie, Making Medicare: The Politics of
Universal Health Care in Australia, UNSW Press, Sydney, 2013, pp 78–89.
[19]
This inquiry was established in 1979 to find ways of containing hospital
costs and improving efficiencies. In doing so it looked at health insurance
arrangements and the roles of the Commonwealth and states in the health sector.
It reported in December 1980. Anne-marie Boxall & James A. Gillespie, Making
Medicare: The Politics of Universal Health Care in Australia, UNSW Press,
Sydney, 2013, pp 78–89.
[20]
Stephen Reynolds, Australian Health Insurance Arrangements 1969-81: the
roles of public and private health insurance, Legislative Research Service,
Department of Parliamentary Library, Basic Paper No.4, 1981; Anne-marie Boxall
& James A. Gillespie, Making Medicare: The Politics of Universal Health
Care in Australia, UNSW Press, Sydney, 2013, p. 89.
[21]
Relevant legislation introduced or amended included the Health
Legislation Amendment Act 1983, Health Insurance Act 1973, National Health Act
1953 and the Health Insurance Commission Act 1973; Amanda Biggs, Medicare
Background Brief – E-Brief, October 2004.
[22]
Amanda Biggs, Medicare Background Brief – E-Brief, October 2004; Richard
B, Scotton, Richard, B, Milestones on the road to Medibank and Medicare,
Medical Journal of Australia, Vol 173, July 2000, pp 5–7; Richard B, Scotton, Medibank:
from conception to delivery and beyond, Medical Journal of Australia,Vol
173, 3 July 2000.
[23]
Senate Community Affairs Committee, First Report: Public Hospital
Funding and Options for Reform, July 2000, pp 33–34.
[24]
Senate Community Affairs Committee, First Report: Public Hospital
Funding and Options for Reform, July 2000, pp 33–34.
[25]
The gap is the amount paid for medical or hospital charges, over and above
the rebate from Medicare or private health insurance.
[26]
Amanda Biggs, Medicare Background Brief – E-Brief, October 2004.
[27]
This is a practice that continued with all subsequent Medicare and AHCA
agreements; Senate Community Affairs Committee, First Report: Public
Hospital Funding and Options for Reform, July 2000, pp 34–35.
[28]
'Casemix' is a method of classifying the number and types of patients
using hospital systems. Casemix funding is when hospitals are funded on the
basis of their output, rather than on the level of funding provided from the
previous year. This means that such funding is on the basis of how much each
jurisdictions is prepared to pay for the care and treatment the casemix not
actually how much it costs to care for and treat a particular mix of patients;
Senate Community Affairs Committee, First Report: Public Hospital Funding
and Options for Reform, 2000, p. 39.
[29] Subsection
26(2), Medicare Agreements Act 1992.
[30] Subsection
26(2), Medicare Agreements Act 1992.
[31] Subsection
26(2), Medicare Agreements Act 1992.
[32] Bonus Pool A
was to be distributed to States and Territories for additional public bed-days
above a benchmark proportion of 51.5 per cent of total bed-days. Bonus Pool B
was to be distributed to States and Territories that increased their share of
public bed-days over the public share in 1990-91; Senate Community Affairs
Committee, First Report: Public Hospital Funding and Options for Reform,
2000.
[33]
Senate Community Affairs References Committee, First Report: Public
Hospital Funding and Options for Reform, 11 July 2000, pp 35–37.
[34]
Senate Community Affairs References Committee, First Report: Public
Hospital Funding and Options for Reform, 11 July 2000, pp 35–37.
[35]
Senate Community Affairs Committee, First Report: Public Hospital
Funding and Options for Reform, July 2000, p. 37; P. Mackey, Health Care
(Appropriation) Bill 1998, Bills Digest, 1998 http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;orderBy=customrank;page=0;query=health%20care%20appropriation%20Bill%201998%20mackey;rec=1;resCount=Default
(accessed 5 April 2016).
[36]
Senate Community Affairs Committee, First Report: Public Hospital
Funding and Options for Reform, 11 July 2000.
[37]
This meant that the funding was no linger compose of only 'direct' funding
to the states and territories but also indirect funding; P. Mackey, Health
Care (Appropriation) Bill 1998, Bills Digest, 1998.
[38]
P. Mackey, Health Care (Appropriation) Bill 1998, Bills Digest,
1998.
[39] PM, COAG
Walkout – Transcript www.abc.net.au/pm/content/2003/s935154.htm
(accessed 6 April 2016); House of Representatives Standing Committee on
Health and Ageing, Review of Auditor-General’s Report No. 19 (2006-2007:
Administration of State and Territory Compliance with the Australian Health
Care Agreements, August 2007.
[40]
Stephen J Duckett, The Australian Health Care Agreements 2003-2008,
Australia and New Zealand Health Policy , 2004, p. 2; House of Representatives
Standing Committee on Health and Ageing, Review of Auditor-General’s Report
No. 19 (2006-2007): Administration of State and Territory Compliance with the
Australian Health Care Agreements, August 2007.
[41]
House of Representatives Standing Committee on Health and Ageing, Review
of Auditor-General’s Report No. 19 (2006-2007): Administration of State and
Territory Compliance with the Australian Health Care Agreements, August
2007, p. 3; House of Representatives Standing Committee on Health and Aging, The
Blame Game: Report on the inquiry into health funding, November 2006, p.
20.
[42]
House of Representatives Standing Committee on Health and Ageing, Review
of Auditor-General’s Report No. 19 (2006-2007): Administration of State and
Territory Compliance with the Australian Health Care Agreements, August
2007, p. 2.
[43]
House of Representatives Standing Committee on Health and Ageing, Review
of Auditor-General’s Report No. 19 (2006-2007): Administration of State and
Territory Compliance with the Australian Health Care Agreements, August
2007, p. 20.
[44] House of
Representatives Standing Committee on Health and Ageing, Review of
Auditor-General’s Report No. 19 (2006-2007) : Administration of State and
Territory Compliance with the Australian Health Care Agreements, August
2007, p. 3; see also Minister’s foreword, Department of Health and Ageing, The
state of our public hospitals, June 2006 report, Commonwealth of Australia,
2006, p. iii.
[45]
National Health and Hospitals Reform Commission, A Healthier Future For
All Australians – Interim Report, December 2008, www.health.gov.au/internet/nhhrc/publishing.nsf/Content/BA7D3EF4EC7A1F2BCA25755B001817EC/$File/NHHRC.pdf
, p. 23, (accessed 6 April 2016).
[46]
National Health and Hospitals Reform Commission, A Healthier Future For
All Australians – Interim Report, December 2008, p. 23.
[47]
National Health and Hospitals Reform Commission, A Healthier Future For
All Australians – Final Report, Introduction, June 2009, www.health.gov.au/internet/nhhrc/publishing.nsf/content/1AFDEAF1FB76A1D8CA257600000B5BE2/$File/INTRODUCTION.pdf
(accessed 6 April 2016).
[48]
National Health and Hospitals Reform Commission, A Healthier Future For
All Australians – Final Report, Recommendations, June 2009.
[49]
Council of Australian Governments, Communique, Melbourne, 20
December 2007.
[50]
Council of Australian Governments, The Federal Financial Relations
Framework, www.coag.gov.au/the_federal_financial_relations_framework
(accessed 6 April 2016).
[51]
Council of Australian Governments, Communique, Melbourne, 20
December 2007.
[52]
Council of Australian Governments, The Federal Financial Relations
Framework.
[53]
Council of Australian Governments, The Federal Financial Relations
Framework; Council of Australian Governments, National Healthcare
Agreement 2012.
[54]
Council of Australian Governments, National Healthcare Agreement 2012.
[55]
Council of Australian Governments, Communique, Canberra, 29
November 2008.
[56]
Council of Australian Governments, Communique, Canberra, 29
November 2008.
[57]
Council of Australian Governments, Intergovernmental Agreement on
Federal Financial Relations, 2008, www.federalfinancialrelations.gov.au/content/intergovernmental_agreements.aspx
(accessed 6 April 2016).
[58]
Council of Australian Governments, Intergovernmental Agreement on Federal
Financial Relations, 2008.
[59] Under the
Intergovernmental Agreement on Federal Financial Relations, National
Partnership payments to the States are facilitated by the following types of
agreements:
- National Partnerships,
which support the delivery of specified projects, facilitate reforms or reward
those jurisdictions that deliver on nationally significant reforms;
- Implementation Plans,
which are not required for all National Partnerships, but may be required where
there are jurisdictional differences in context or approach to implementation,
or where information additional to the National Partnership is required to
increase accountability and transparency; and
- Project Agreements,
which are a simpler form of National Partnership, used for low value and/or low
risk projects.
Council of Federal Financial
Relations, Agreements, www.federalfinancialrelations.gov.au/content/npa/default.aspx
(accessed 6 April 2016).
[60]
Council of Australian Governments, Communique, Canberra, 29
November 2008.
[61]
R de Boer & J Tomaras, Bills Digest- National Health and Hospitals
Network Bill 2010, 2011, p. 4; R deBoer & R.Webb, Bills Digest –
Federal Financial Arrangements Amendment (National Health and Hospitals
Network) Bill, 2010, p. 3.
[62]
R deBoer & R.Webb, Bills Digest – Federal Financial
Arrangements Amendment (National Health and Hospitals Network) Bill, 2010.
[63]
R deBoer & R.Webb, Bills Digest – Federal Financial
Arrangements Amendment (National Health and Hospitals Network) Bill, 2010.
[64]
Council of Australian Governments, National Healthcare Agreement 2012.
[65]
Administrator, National Health Funding Pool, National Health Reform
Agreement summary, www.publichospitalfunding.gov.au/national-health-reform/agreement,
(accessed 11 March 2016).
[66]
Council of Australian Governments, National Health Reform Agreement 2011,
Schedule D.
[67]
Block funding is for teaching and research and to fund small and regional
hospitals.
[68]
Public health funding is paid by the Commonwealth to the states and
territories for population health activities.
[69]
Clause A2, National Health Reform Agreement 2011.
[70]
Efficient growth consists of : a) the national efficient price for any
changes in the volume of service provided; and b) the growth in the national
efficient price of providing the existing volume of services; Council of
Australian Governments, National Health Reform Agreement 2011.
[71]
Clause A3, National Health Reform Agreement 2011.
[72]
'Efficient cost will be determined annually by the Independent Hospital
Pricing Authority, taking account of changes in utilisation, the scope of
service provided and the cost of those services to ensure the LHN has the
appropriate capacity to deliver the relevant block funded services and
functions', Clause A4, National Health Reform Agreement 2011.
[73]
Clause A4, National Health Reform Agreement 2011.
[74]
Clause A5, National Health Reform Agreement 2011.
[75]
The requirements are articulates in Schedule B of the National Health
Reform Agreement 2011; also see Clause A8, National Health Reform
Agreement 2011.
[76]
Administrator of the National Health Funding Pool, The Role of the
Administrator, www.publichospitalfunding.gov.au/administrator
(accessed 8 April 2016).
[77]
National Health Funding Body, Welcome from the CEO, www.nhfb.gov.au/ (accessed 8 April 2016).
[78]
The NEP is a major determinant of the level of Australian Commonwealth
Government funding for public hospital services and provides a price signal or
benchmark for the efficient cost of providing public hospital services.
Independent Hospital Pricing Authority, What we Do, www.ihpa.gov.au/what-we-do
(accessed 8 April 2016).
[79]
National Health Performance Authority, About Us, www.nhpa.gov.au/internet/nhpa/publishing.nsf/Content/About-us
(accessed 8 April 2016).
[80]
Australian Commission on Safety and Quality in Health Care, Governance,
www.safetyandquality.gov.au/about-us/governance/
(accessed 8 April 2016).
[81]
Administrator, National Health Funding Pool, National Health
Reform funding flows, www.publichospitalfunding.gov.au/national-health-reform/funding-flows
(accessed 11 March 2016).
[82]
Administrator, National Health Funding Pool, National Health
Reform funding flows.
Chapter 3 - Commonwealth hospital funding
[1]
Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee
Hansard, 4 November 2015, p. 1.
[2]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7.
[3]
See the committee's first and second interim reports for further
discussion of these policies.
[4]
AMA, Public Hospital Report Card 2015, April 2015, p. 2.
[5]
AIHW, 25 years of health expenditure in Australia: 1989-90 to 2013-14,
5 February 2015, www.aihw.gov.au/publication-detail/?id=60129554398
[6]
OECD, Country Note: How does health spending in the United States
compare?, 7 July 2015, www.oecd.org/unitedstates/Country-Note-UNITED%20STATES-OECD-Health-Statistics-2015.pdf
[7]
OECD, Country Note: How does health spending in Canada compare?,
7 July 2015, www.oecd.org/els/health-systems/Country-Note-CANADA-OECD-Health-Statistics-2015.pdf
[8]
OECD, Country Note: How does health spending in the United Kingdom
compare?, 7 July 2015, www.oecd.org/unitedkingdom/Country-Note-UNITED%20KINGDOM-OECD-Health-Statistics-2015.pdf
[9]
OECD, Health at a Glance 2015: How does Australia Compare?, p. 1.
www.oecd.org/australia/Health-at-a-Glance-2015-Key-Findings-AUSTRALIA.pdf
[10]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7.
[11]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7.
[12]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7.
[13]
Australian Government, 'Part 2 Expense Measures', Budget measures:
budget paper no.2: 2014-15, www.budget.gov.au/2014-15/content/bp2/html/bp2_expense-14.htm
(accessed 5 April 2016); Administrator, National Health Funding Pool, Basis
of Commonwealth NHR Funding, www.publichospitalfunding.gov.au/national-health-reform/reporting-basis-commonwealth
(accessed 11 March 2016).
[14]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7. The $57 billion figure was used at the Senate Economics
Committee Estimates hearings in 2014, while the $56 billion figure was
calculated by the PBO, based on information in the NHRA.
[15]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7. In the graph, the green line of the 'old spending arrangement'
represents the NHRA funding, while the blue line represents the indexed funding
arrangements in the 2014-15 Budget.
[16]
Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee
Hansard, 4 November 2015, p. 1.
[17]
Commonwealth of Australia, 2014-15 Federal Budget Overview, May
2014, p. 7.
[18] Source:
Parliamentary Budget Office, Submission 191, Table 1, p. 5. Under the
previous government, hospital funding was to be provided under the 2011
National Health Reform Agreement. The government policy introduced in the
2014-15 Federal Budget would have indexed funding by CPI and population growth
from 2017-18 to 2024-25. Dollar amounts in the above diagram have been rounded.
[19]
Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee
Hansard, 4 November 2015, p. 1.
[20]
Dr Stephen Duckett, Director Health Program, Grattan Institute, Committee
Hansard, 4 November 2015, p. 1.
[21]
Professor Mike Duabe, Professor of Health Policy and Director, Public
Health Advocacy Institute of Western Australia, Curtin University; Director,
McCusker Centre for Action on Alcohol and Youth, Committee Hansard, 10
October 2014, p. 27.
[22]
Department of Prime Minister and Cabinet, Reform of Federation White
Paper: Terms of Reference, website, https://federation.dpmc.gov.au/terms-reference
[23]
Department of Prime Minister and Cabinet, Reform of Federation White
Paper: Terms of Reference.
[24]
Phillip Coorey, Australian Financial Review, Leaked proposal suggests
states may lose $18b healthcare funding, 22 June 2015, www.afr.com/news/politics/leaked-proposal-suggests-states-may-lose-18b-healthcare-funding-20150621-ghu001;
Dan Conifer, ABC News Online, Federal Government plays down discussion
paper's 'secret plan' to strip billions in hospital funding from states and
territories, 23 June 2015, www.abc.net.au/news/2015-06-23/states-and-territories-could-lose-billions-in-health-funding-an/6565810
[25]
Department of Prime Minister and Cabinet, Reform of Federation White
Paper: Discussion Paper, website, https://federation.dpmc.gov.au/publications/discussion-paper
[26]
COAG, 11 December 2015, Communique, www.coag.gov.au/node/529
[27]
Eliza Borrello, ABC News Online, Malcolm Turnbull scraps federation
white paper after $5 million work, 28 April 2016, www.abc.net.au/news/2016-04-28/malcolm-turnbulls-$5-million-tax-white-paper-scrapped/7367204
[28]
Department of Prime Minister and Cabinet, Reform of Federation White
Paper, website, https://federation.dpmc.gov.au/
[29]
Liz Jackson, ABC Radio PM Program, Thousands will go untreated in SA
public hospitals under current funding: report, 29 March 2016, www.abc.net.au/pm/content/2016/s4433224.htm
[30]
Lenore Taylor, The Guardian Australia, Turnbull looks to income
tax-raising powers for states to fix school and hospital funding, 30 March 2016,
www.theguardian.com/australia-news/2016/mar/29/states-offered-5bn-hospitals-funding-income-tax-raising-powers
[31]
COAG, 1 April 2016, Communique, www.coag.gov.au/sites/default/files/COAG_Communique.pdf
[32]
COAG, 1 April 2016, Communique.
[33]
Heads of Agreement 1 April 2016, www.coag.gov.au/sites/default/files/Heads%20of%20Agreement%20between%20the%20Commonwealth%20and%20the%20States%20on%20Public%20Hospital%20Funding%20-%201%20April%202016_0.pdf
[34]
COAG, 1 April 2016, Communique.
[35]
Lenore Taylor, The Guardian Australia, Malcolm Turnbull promises states
hospital funding in budget after Abbott cuts, 24 February 2016, www.theguardian.com/australia-news/2016/feb/24/malcolm-turnbull-promises-states-hospital-funding-in-budget-after-abbott-cuts
[36]
Parliamentary Budget Office, Submission 191, p. 5.
[37]
Ms Skye Jacobi, Director, Intergovernment Relations and Ageing, Department
for Health and Ageing, South Australia, Committee Hansard, 11 June 2015,
p. 21.
[38]
Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human
Services, Committee Hansard, 4 November 2015, p. 39.
[39]
Ms Kathleen Forrester, Deputy Director-General, Strategy, Policy and
Planning Division, Department of Health, Queensland, Committee Hansard,
16 November 2015, p. 14.
[40]
Ms Kathleen Forrester, Deputy Director-General, Strategy, Policy and
Planning Division, Department of Health, Queensland, Committee Hansard, 16
November 2015, p. 15.
[41]
Ms Kathleen Forrester, Deputy Director-General, Strategy, Policy and
Planning Division, Department of Health, Queensland, Committee Hansard, 16
November 2015, p. 14.
[42]
Chief Minister, the Hon Adam Giles MLA, 'Territory Health and Education
Funding Under Threat', media release, May 2014, www.chiefminister.nt.gov.au/media-releases/territory-health-and-education-funding-under-threat
[43]
Oxford English Dictionary
Chapter 4 - Impacts on New South Wales hospitals
[1]
Dr Andrew McDonald, private capacity, Committee Hansard, 23 March
2016, p. 39.
[2]
Parliamentary Budget Office, Submission 191, p. 5.
[3]
Charis Chang and Mal Farr, News.com.au, Federal Budget 2014 cuts to
health and education spending sparks talk of GST increases,14 May 2014, www.news.com.au/finance/economy/federal-budget-2014-cuts-to-health-and-education-spending-sparks-talk-of-gst-increases/story-fn84fgcm-1226917445787
[4]
Charis Chang and Mal Farr, News.com.au, Federal Budget 2014 cuts to
health and education spending sparks talk of GST increases,14 May 2014.
[5]
Professor Bradley Frankum, Vice President, Australian Medical
Association (NSW), Committee Hansard, 27 November 2015, p. 17.
[6]
Professor Bradley Frankum, Vice President, Australian Medical
Association (NSW), Committee Hansard, 27 November 2015, p. 17.
[7]
Professor Bradley Frankum, Vice President, Australian Medical
Association (NSW), Committee Hansard, 27 November 2015, p. 17.
[8]
Dr Andrew Pesce, and Dr Antony Sara, Councillors, Australian Medical
Association (NSW), Committee Hansard, 27 November 2015, p. 19.
[9]
Dr Andrew McDonald, private capacity, and Dr Karuna Keat, private
capacity, Committee Hansard, 23 March 2016, pp 33–34.
[10]
Dr Karuna Keat, private capacity, Committee Hansard, 23 March 2016,
p. 34.
[11]
Dr Andrew McDonald, private capacity, and Dr Karuna Keat, private
capacity, Committee Hansard, 23 March 2016, pp 36–37.
[12]
Dr Andrew McDonald, private capacity, Committee Hansard, 23 March
2016, p. 39.
[13]
Professor Bradley Frankum, Vice President, Australian Medical Association
(NSW), Committee Hansard, 27 November 2015, pp 24–25.
[14]
In this context "ramp" refers to an ambulance waiting with a
patient until the patient can be received by the Emergency Department.
[15]
Mr Jeff Andrew, Vice President, Australian Paramedics Association,
Committee Hansard, 11 March 2015, p. 43.
[16]
Mr Jeff Andrew, Vice President, Australian Paramedics Association,
Committee Hansard, 11 March 2015, p. 43.
[17]
Mr Jeff Andrew, Vice President, Australian Paramedics Association,
Committee Hansard, 11 March 2015, p. 45.
[18]
Mr Gil Wilson, clinical nurse specialist, private capacity, Committee
Hansard, 15 September 2014, p. 7.
[19]
Mr Gil Wilson, clinical nurse specialist, private capacity, Committee
Hansard, 15 September 2014, p. 7.
Chapter 5 - Impacts on Victorian hospitals
[1]
Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human
Services, Committee Hansard, 4 November 2015, p. 38.
[2]
Parliamentary Budget Office, Submission 191, p. 5.
[3]
Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human
Services, Committee Hansard, 4 November 2015, p. 38.
[4]
Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee
Hansard, 4 November 2015, pp 21–22.
[5]
Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee
Hansard, 4 November 2015, p. 23.
[6]
Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human
Services, Committee Hansard, 4 November 2015, p. 38.
[7]
Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human
Services, Committee Hansard, 4 November 2015, p. 40.
[8]
Ms Frances Diver, Deputy Secretary, Health Service Performance and
Programs, Victorian Department of Health and Human Services, Committee
Hansard, 4 November 2015, pp 39–40.
[9]
Ms Kym Peake, Acting Secretary, Victorian Department of Health and Human
Services, Committee Hansard, 4 November 2015, p. 46. These impacts
result from the cessation without review of the National
Partnership Agreement on Improving Public Hospital Services and the expectation
that ongoing funding would be rolled into the National Health Partnership Agreement
(see p. 47).
[10]
Victorian Department of Health and Human Services, Answer to question
on notice, 4 November 2015, received 1 December 2015.
[11]
Victorian Department of Health and Human Services, Answer to question
on notice, 4 November 2015, received1 December 2015.
[12]
Ms Annie Butler, Assistant Federal Secretary, Australian Nursing and
Midwifery Federation, Committee Hansard, 5 November 2015, p.
21.
[13]
Ms Lee Thomas, Federal Secretary, Australian Nursing and Midwifery
Federation, Committee Hansard, 5 November 2015, pp. 18–19. See
also Dr Anthony Bartone, President, Australian Medical Association Victoria, Committee
Hansard, 4 November 2015, pp 23–24.
[14]
Ms Alison Verhoeven, Chief Executive, Australian Healthcare and Hospitals
Association, Committee Hansard, 4 November 2015, p. 58.
Chapter 6 - Impacts on Queensland hospitals
[1]
Ms Bronwyn Nicholson, General Manager, Queensland, I-MED Radiology
Network, Committee Hansard, 27 April 2016, p. 8.
[2]
Parliamentary Budget Office, Submission 91, p. 5.
[3]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 14.
[4]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 14.
[5]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 14.
[6]
Mr Paul McGuire, Senior Director, Funding Strategy
Unit, Strategy, Policy and Planning Division, Department of Health, Queensland,
Committee Hansard, 16 November 2015, p. 18.
[7]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 14.
[8]
Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland
Hospital and Health Service, Committee Hansard, 16 November 2015, p. 6.
[9]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 14.
[10]
Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland
Hospital and Health Service, Committee Hansard, 16 November 2015, p. 5.
[11]
Mr Paul McGuire, Senior Director, Funding Strategy Unit, Strategy, Policy
and Planning Division, Department of Health, Queensland, Committee Hansard,
16 November 2015, p. 19.
[12]
Dr Jill Newland, Chief Executive, Torres and Cape Hospital and Health
Service, Committee Hansard, 16 November 2015, p. 4.
[13]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 16.
[14]
Dr Tash Coventry, President, Rural Doctors Association of Queensland, Committee
Hansard, 16 November 2016, p. 48.
[15] Queensland
Health, Projected impact of Commonwealth funding cuts on the public hospital
system, p. 2, www.health.qld.gov.au/publications/system-governance/health-system/comm-funding-cuts-impact-budget.pdf
(accessed 3 May 2016).
[16]
Ms Robin Saunders, private capacity, Committee Hansard, 27 April
2016, p. 1.
[17]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 16.
[18]
Ms Kathleen Forrester, Department of Health, Queensland, Committee Hansard,
16 November 2015, p. 15.
[19]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 15.
[20]
Ms Robin Saunders, private capacity, Committee Hansard, 27 April
2016, pp 1–2.
[21]
Dr Oscar Whitehead, Director, Medical Services, Queensland Section, Royal
Flying Doctor Service, Committee Hansard, 16 November 2015, p. 29.
[22]
Ms Robin Saunders, private capacity, Committee Hansard, 27 April
2016, p. 4.
[23]
Ms Robin Saunders, private capacity, Committee Hansard, 27 April 2016,
p. 4.
[24]
Ms Robin Saunders, private capacity, Committee Hansard, 27 April
2016, p. 5.
[25]
Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland
Hospital and Health Service, Committee Hansard, 16 November 2015, p. 6.
[26]
Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland
Hospital and Health Service, Committee Hansard, 16 November 2015, p. 6.
[27]
Dr Edward Strivens, Clinical Director, Older Persons Health Services, Committee
Hansard, 16 November 2015, p. 3.
[28]
Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland
Hospital and Health Service, Committee Hansard, 16 November 2015, p. 2.
[29] Dr Mark
Wenitong, Public Health Medical Adviser, Apunipima Cape York Health Council, Committee
Hansard, 16 November 2015, p. 39.
[30]
Ms Julie Hartley-Jones CBE, Chief Executive, Cairns and Hinterland
Hospital and Health Service, Committee Hansard, 16 November 2015, p. 2.
[31]
Queensland Nurses' Union, Submission 44, p. 5; Public Hospitals
Health and Medicare Alliance of Queensland, Submission 15, p. 4.
[32]
Queensland Nurses' Union, Submission 44, p. 5; Public Hospitals
Health and Medicare Alliance of Queensland, Submission 15, p. 4.
[33]
www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2015-ley151.htm
[34]
Ms Bronwyn Nicholson, General Manager, Queensland, I-MED Radiology Network,
Committee Hansard, 27 April 2016, p. 8.
[35]
Ms Bronwyn Nicholson, General Manager, Queensland, I-MED Radiology Network,
Committee Hansard, 27 April 2016, p. 11.
[36]
The Hon Cameron Dick, Minister for Health and Ambulance Services,
Queensland Government, Canberra cuts a sick blow to our health system,
Media release, 15 December 2015, http://statements.qld.gov.au/Statement/2015/12/15/canberra-cuts-a-sick-blow-to-our-health-system
(accessed 3 May 2016).
[37]
Queensland Government, Managing the Queensland Health System: Budget,
www.health.qld.
gov.au/system-governance/health-system/managing/budget/default.asp (accessed
3 May 2016).
[38]
Ms Kathleen Forrester, Department of Health, Queensland, Committee
Hansard, 16 November 2015, p. 13.
Chapter 7 - Impacts on Western Australian hospitals
[1]
Dr Stephanie Trust, General Practitioner, Kununurra Medical Centre, Committee
Hansard, 28 April 2015, p. 13.
[2]
Parliamentary Budget Office, Submission 191, p. 5.
[3]
Stephanie Dalzell, ABC News Online, WA hospital funding cuts
criticised by health minister, 22 May 2014, www.abc.net.au/news/2014-05-21/perth-hospitals-to-lose-24300m-over-four-years/5468844
[4]
Stephanie Dalzell, ABC News Online, WA hospital funding cuts
criticised by health minister, 22 May 2014.
[5]
Stephanie Dalzell, ABC News Online, WA hospital funding cuts
criticised by health minister, 22 May 2014.
[6]
Australian Medical Association, 'Public Hospital Report Card 2016',
January 2016, pp 21–23.
[7]
Charlotte Hamlyn, ABC News Online, WA hospitals cannot afford cuts,
Australian Medical Association says, 28 January 2016, www.abc.net.au/news/2016-01-28/wa-public-hospital-system-cannot-afford-cuts-ama-says/7121264
[8]
Australian Associated Press, The Guardian Australia, Western
Australia to cut 1,100 jobs in south Perth hospitals, 3 January 2016, www.theguardian.com/australia-news/2016/jan/03/western-australia-to-cut-1100-jobs-in-south-perth-hospitals
[9]
Professor Mike Daube, Professor of Health Policy and Director, Public
Health Advocacy Institute of Western Australia, Curtin University; Director,
McCusker Centre for Action on Alcohol and Youth, Committee Hansard, 10
October 2014, p. 21.
[10]
Dr Stephanie Trust, General Practitioner, Kununurra Medical Centre, Committee
Hansard, 28 April 2015, p. 13.
Chapter 8 - Impacts on South Australian hospitals
[1]
South Australian Government, Submission 24, p. 6. See also, the
Hon. Jay Weatherill, Premier, South Australian Government, Committee
Hansard, 28 August 2014, p. 1.
[2]
Parliamentary Budget Office, Submission 91, p. 5.
[3]
South Australian Government, Submission 24, p. 6. See also, the
Hon. Jay Weatherill, Premier, South Australian Government, Committee
Hansard, 28 August 2014, p. 1.
[4]
Mr Steven Archer, Deputy Chief Executive, Finance
and Business Services, Department for Health and Ageing, South Australia, Committee
Hansard, 9 October 2014, p. 1.
[5]
South Australian Government, Submission 24, p. 10.
[6]
South Australian Government, Submission 24, p. 6. See also, the
Hon. Jay Weatherill, Premier, South Australian Government, Committee
Hansard, 28 August 2014, p. 1.
[7]
South Australian Government, Submission 24, p. 9. See also South
Australian Government, Federal cuts hurt – the facts, http://www.federalcutshurt.com.au/the-facts/
[8]
South Australian Government, Submission 24, p. 8.
[9]
South Australian Government, Submission 24, p. 2.
[10]
The Hon. Jay Weatherill, Premier, South Australian Government, Committee
Hansard, 28 August 2014, p. 2.
[11]
The Hon. Jay Weatherill, Premier, South Australian Government, Committee
Hansard, 28 August 2014, p. 3.
[12]
South Australian Government, Submission 24, p. 8.
[13]
South Australian Government, Submission 24, p. 8.
[14]
South Australian Government, Submission 24, p. 8.
[15]
South Australian Government, Submission 24, p. 7.
[16]
South Australian Government, Submission 24, p. 2.
[17]
South Australian Government, Submission 24, p. 2.
[18]
South Australian Government, Submission 24, p. 2; Australian
Workplace Innovation and Social Research Centre (WISeR, University of Adelaide)
for the Department of Premier and Cabinet, Impacts of the 2014-15 Federal Budget
Measures on South Australia (2014), p. 43, http://federalcutshurt.com.au/wp-content/uploads/2014/08/fed-budget-oct2014-n.pdf
(accessed 2 May 2016).
[19]
South Australian Government, Submission 24, p. 15.
[20]
South Australian Government, Submission 24, p. 14.
[21]
Health Consumers Alliance of SA, Submission 92, p. 3.
[22]
Health Consumers Alliance of SA, Submission 92, p. 3.
[23]
South Australian Government, Submission 24, p. 9. See also South
Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/
(accessed 2 May 2016).
[24]
South Australian Department of the Premier and Cabinet, Public Health
Expenditure and Distribution of Benefits – Technical Note (Ernst & Young,
2016), p. 4.
[25]
South Australian Department of the Premier and Cabinet, Public Health
Expenditure and Distribution of Benefits – Technical Note (EY), p. 3.
[26]
The Hon Jay Weatherill, Premier, South Australian Government, 'Report
highlights dire consequences of Fed health cuts, Media release, 29 March 2016, www.premier.sa.gov.au/index.php/jay-weatherill-news-releases/321-report-highlights-dire-consequences-of-fed-health-cuts,
(accessed 6 May 2016).
[27]
South Australian Government, Submission 24, p. 11.
[28]
South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/
(accessed 2 May 2016).
[29]
South Australian Government, Submission 24, p. 11.
[30]
South Australian Government, Submission 24, p. 9. See also South
Australian Government, Federal cuts hurt – the facts, http://www.federalcutshurt.com.au/the-facts/
[31]
South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/
(accessed 2 May 2016).
[32]
South Australian Government, Submission 24, p. 11.
[33]
South Australian Government, Federal cuts hurt – the facts, www.federalcutshurt.com.au/the-facts/
(accessed 2 May 2016).
[34]
The Hon Jay Weatherill MP, Premier, South Australian Government, 'Report
highlights dire consequences of Fed health cuts', Media release, 29 March 2016,
www.premier.sa.gov.au/index.php/jay-weatherill-news-releases/321-report-highlights-dire-consequences-of-fed-health-cuts,
accessed 6 May 2016.
[35]
Australian Medical Association, Public Hospital Report Card 2016,
p. 25.
Chapter 9 - Impacts on Tasmanian hospitals
[1]
Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery
Federation, Tasmanian Branch, Committee Hansard, 29 April 2016, p. 21.
[2]
Parliamentary Budget Office, Submission 191, p. 5.
[3]
Emma Hope, The Tasmanian Mercury, Premier Will Hodgman hits out at
Federal Government's health cuts,19 May 2014, www.themercury.com.au/news/tasmania/premier-will-hodgman-hits-out-at-federal-governments-health-cuts/story-fnj4f7k1-1226922051939
[4]
Emma Hope, The Tasmanian Mercury, Premier Will Hodgman hits out at
Federal Government's health cuts,19 May 2014.
[5]
Lucy Shannon, ABC News Online, Tasmania's health sector to bear brunt
of 'tough love' federal budget, 19 May 2014, www.abc.net.au/news/2014-05-19/tasmania27s-health-sector-to-bear-brunt-of-27tough-love27-fe/5461224
[6]
Dr Pauline Marsh, Policy Officer, TasCOSS, Committee Hansard, 3
November 2014, p. 29.
[7]
Professor Tim Greenaway, President, AMA Tasmania, Committee Hansard,
3 November 2014, p. 37.
[8]
Professor Tim Greenaway, President, AMA Tasmania, Committee Hansard,
29 April 2016, p. 1.
[9]
Professor Tim Greenaway, President, AMA Tasmania, Committee Hansard,
29 April 2016, p. 2.
[10]
Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery Federation,
Tasmanian Branch, Committee Hansard, 4 November 2014, p. 14.
[11]
Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery
Federation, Tasmanian Branch, Committee Hansard, 29 April 2016, p. 21.
[12]
Mrs Neroli Ellis, Branch Secretary, Australian Nursing and Midwifery
Federation, Tasmanian Branch, Committee Hansard, 29 April 2016, p. 22.
[13]
Mr Stephen Hayes, Social Worker, Tasmanian Health Service, Committee
Hansard, 29 April 2016, pp 16–17.
Chapter 10 - Impacts on ACT and NT hospitals
[1]
ACT Treasurer, Mr Andrew Barr MLA, Australian Capital Territory Budget
2014-15 Budget in Brief, pp 2–3, http://apps.treasury.act.gov.au/__data/assets/pdf_file/0014/601115/Budget-Paper-2-Budget-in-Brief.pdf
(accessed 30 April 2016).
[2]
Mr John Paterson, Chief Executive Officer, Aboriginal Medical Services
Alliance Northern Territory, Committee Hansard, 27 April 2015, p. 25.
[3]
Parliamentary Budget Office, Submissions 191, p. 5.
[4]
Australian Medical Association, Public Hospital Report Card 2016,
January 2016, p. 32.
[5]
ACT Treasurer, Mr Andrew Barr MLA, Australian Capital Territory
Budget 2014-15 Budget in Brief, pp 2–3, http://apps.treasury.act.gov.au/__data/assets/pdf_file/0014/601115/Budget-Paper-2-Budget-in-Brief.pdf
(accessed 30 April 2016).
[6]
National Hospitals Performance Authority, 'Costs of acute admitted
patients in public hospitals from 2011-12 to 2012-14', April 2016, p. 4, www.myhospitals.gov.au/docs/default-source/our-report-pdfs/cost-of-acute-admitted-patients/april-2016/hp_costsofacuteadmittedpatients_2011-12_to_2013_14_rpt.pdf?sfvrsn=8
(accessed 1 May 2016).
[7]
Parliamentary Budget Office, Submission 191, p. 5.
[8]
Chief Minister, the Hon Adam Giles MLA, 'Territory Health and Education
Funding Under Threat', media release, May 2014, www.chiefminister.nt.gov.au/media-releases/territory-health-and-education-funding-under-threat
[9]
Chief Minister, the Hon Adam Giles MLA, 'Territory Health and Education
Funding Under Threat', media release, May 2014 http://www.chiefminister.nt.gov.au/media-releases/territory-health-and-education-funding-under-threat
[10]
Australian Medical Association, 'Public Hospital Report Card 2016',
January 2016, p. 11. See also Harriet Alexander, The Sydney Morning Herald, Hospital
Performance getting worse and now facing budgetary 'black hole', says AMA,
28 January 2016, www.smh.com.au/national/health/hospital-performance-getting-worse-and-now-facing-budgetary-black-hole-says-ama-20160127-gmf8xg.html
[11]
Northern Territory Government, Submission 148, p. 14.
[12]
Mr Michael Kalimnios, Chief Operating Officer, Top End Health Service,
Northern Territory Department of Health, Committee Hansard, 8 October
2015, p. 10.
[13]
Mr Michael Kalimnios, Chief Operating Officer, Top End Health Service,
Northern Territory Department of Health, Committee Hansard, 8 October
2015, p. 13.
[14]
Ms Joy McLaughlin, Senior Project Officer, Danila Dilba Health Service, Committee
Hansard, 27 April 2015, p. 18.
[15]
Mr John Paterson, Chief Executive Officer, Aboriginal Medical Services
Alliance Northern Territory, Committee Hansard, 27 April 2015, p. 25.
Appendix 1 - Witnesses who appeared before the committee[1]
[1] www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Public_Hearings.
Appendix 2 - Submissions received by the committee[1]
[1]
www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Submissions.
Appendix 3 - Tabled documents, additional information, correspondence and answers to questions on notice[1]
[1] Tabled documents,
additional information, correspondence and answers to questions on notice can
be accessed at: www.aph.gov.au/Parliamentary_Business/Committees/Senate/Health/Health/Additional_Documents