What's being said about the 2021 federal Budget?

GPs

The Royal Australian College of General Practitioners (RACGP) has welcomed many of the Budget’s primary care measures but encouraged the federal government to go further in supporting quality GP patient services.

The Budget included:

• $1.8 billion in primary healthcare funding, including support for the continued role of general practice in COVID-19 vaccinations and news that GP respiratory clinics will now be delivering the Pfizer vaccine.
• $17.7 billion investment in aged care, including $42.8 million to double the GP Aged Care Access Incentive from 1 July this year.
• $204.6 million for the continuation of telehealth in general practice including new items for smoking cessation, reproductive health and drug and alcohol treatment.
• More than $65.8 million from 1 January 2022 to boost bulk billing rebates and provide more affordable health care for patients in regional, rural and remote areas.
   

RACGP President Dr Karen Price welcomed many primary care budget measures, but said more investment was needed for broader general practice reform.

“In December last year, Health Minister Greg Hunt promised that 2021 would be the year of the GP,” she said. “If we want to make that a reality, we need to give general practice a much-needed shot in the arm. The $1.8 billion figure is welcome; however, it is unclear how much of this will flow through to frontline GP patient services.

“We are working closely with the government to develop a model for meaningful investment in general practice care and this will continue. Supporting general practice will improve the health and wellbeing of patients from all walks of life and reduce the need for more expensive secondary care.

“On the aged-care front, the new funding measures are welcome and overdue. General practice has been drawing attention to shortfalls in the aged-care system for many years and the doubling of the incentive for GPs who provide care to people in aged-care facilities is an important first step.

“I will be taking a magnifying glass to the $365.7 million allocated to improving access to primary care and other health services in residential aged care because the finer details will make all the difference.”

Dr Price also said that Australia must not take a backwards step on telehealth and iterated that assisting rural and remote GPs was a high priority and that more investment was needed.

“I support the expansion of the allied health rural generalist pathway, and establishing the John Flynn Prevocational Doctor Program to provide additional rural primary care training rotations for junior doctors is crucial — the RACGP will be keeping a close eye on that program. Any increase in funding for rural general practice needs to be part of a broader, more comprehensive and holistic policy response.

“I also strongly back the allocation of $22.6 million to redesign the Practice Incentives Program — Indigenous Health Incentive. We will not close the gap and improve Aboriginal and Torres Strait health outcomes without measures such as this.

“Many of the measures announced tonight [11 May 2021] amount to a solid beginning for the support of vulnerable patient groups in Australia. It is very welcome after such a tough 12 months for many general practices and patients nationwide.”

Aged care

The Australian Government announced a commitment of $17.7 billion to the aged-care sector in this year’s Budget, which includes $229.4 million in funding to dementia, a move welcomed by Dementia Australia.

Dementia Australia CEO Maree McCabe said the record investment will provide the impetus for systemic change required in the aged-care industry.

“Elevating the capability and capacity of the workforce is a focus of this Budget. Dementia must be core business for aged care,” McCabe said.

Key measures in the Budget relating to dementia include:

• Enhanced early support for people living with dementia in the community, their families and carers, through an expansion of the National Dementia Support Program.
• An additional outreach capability for the National Dementia Helpline.
• More support at diagnosis for people to access the services they need.
• Dementia training throughout the sector.
• Improvement in aged-care regulation — transparency of performance, restraint and dementia-friendly building practices.
• The introduction of a nationally consistent worker screening register and code of conduct for all care-sector workers including aged-care workers.

Nurses

The Australian College of Nursing (ACN) welcomed the $17.7 billion investment into the aged-care sector, especially the $216.7 million investment in nursing scholarships, transition-to-practice programs and additional support for dementia and palliative care training for the workforce.

ACN CEO Adjunct Professor Kylie Ward FACN said the upgrade and support for the sector is welcomed, and showed the federal government was engaging closely with how best to support the aged-care sector.

The broader investment into aged care was also welcomed, but with a careful note on the future of home care and ensuring that a quality workforce supported older Australians who want to continue to stay in their own homes.

“An additional 80,000 places in home care is a massive investment which will have real and immediate impacts for older Australians, but the quality of care is crucial in ensuring we do not simply move the problems from residential aged care into home care,” Adjunct Professor Ward said. “The investment in home care needs to ensure that we have the workforce to deliver the quality of care Australians expect in their own homes.

“We look forward to seeing the detail and working with the government to have the nursing voice heard in supporting the delivery of quality home care packages for Australians.”

Additionally, the government’s support for victims/survivors of domestic violence was welcomed by Adjunct Professor Ward.

Mental health

Dr Sebastian Rosenberg, Senior Lecturer, Brain and Mind Centre University of Sydney, commented on budget commitments to mental health.

“We have established that for mental health to begin to gather the resources required to address demand, around $1 billion is required each year for several years. This Budget provides around half this — an improvement on recent, more meagre, years.

“The Budget also focuses on the development of regional and digital solutions, using new centres and services. A national and universal after-care service, following an attempted suicide is both sensible and welcome. How all these models evolve needs close scrutiny. A full government response to the Productivity Commission is yet to emerge. However, and while the scale of the investment is not optimal, the overall directions and key themes are to be supported,” Dr Rosenberg said.

“The mental health budget papers refer to ongoing work to establish a new agreement between the federal and state governments. While this is welcome, Minister Coleman referred to the need for structural reform in mental health. For me, this means revisiting the intent of the very first national mental health strategy, back in 1992. Specifically, it means diminishing the ever-increasing role (and cost) of hospital-based mental health care, instead shifting our collective focus and investment on alternatives, earlier intervention, psychosocial care, hospital avoidance and genuine accountability for progress.”

Pharmacists

The Society of Hospital Pharmacists of Australia (SHPA) welcomed the government’s growing focus on electronic medicines management and transitions of care for older Australians, continued focus on hospitals to support the COVID-19 vaccine program and pandemic preparedness through National Medical Stockpile investments, and nearly $900m for new and amended listings on the Pharmaceutical Benefits Scheme (PBS).

SHPA welcomed the government’s record $17.7 billion response to the Final Report into the Royal Commission into Aged Care Quality and Safety, 22% of which is aimed at increasing frontline care to aged-care residents.

SHPA Chief Executive Kristin Michaels said the response is an opportunity to scale and embed new clinical and service models in aged care informed by unique hospital pharmacy expertise and proven technological support, led by $45.4 million announced to roll out electronic medication charts to improve the safe use of medicines.

“This funding will support the specialised role hospital pharmacists play liaising between hospitals and residential aged care to support the safe transition of patients.

“Wherever possible, our members are already using Interim Residential Care Medication Administration Charts for residents moving from hospitals back to aged-care facilities to make sure they are able to take their new medicines and avoid readmission. We look forward to the government’s plan to implement electronic National Residential Medication Charts to help reduce the number of unnecessary medicines prescribed and dispensed per resident in aged care.

“This investment will help address an urgent need — between 2014 and 2019 hospital admissions from aged-care residents increased by 20%, while emergency department (ED) admissions increased by 27% — and we reiterate our call to embed dedicated Geriatric Medicine Pharmacists as part of increasing provision of frontline care to aged-care residents, to reduce medicines misuse and medication-related hospitalisations and injuries among older Australians.”

Michaels also welcomed a further $510.8 million for the National Partnership on the COVID-19 Response for states and territories, with hospital pharmacists an essential part of the surge workforce implementing Australia’s COVID-19 vaccine program.

“Having supported the establishment of over 500 vaccine clinics in major hospitals from Phase 1a, hospital pharmacists have taken the lead in setting up and operating state-run high-throughput vaccination clinics across the country as the rollout grows dramatically in scale.

“The importance of hospital pharmacy expertise to pandemic preparedness is clear through tonight’s [11 May 2021] additional funding for the National Incident Centre and National Medical Stockpile.”

The SHPA also welcomes $878.7 million for new and amended listings on the PBS, and indicative PBS investment totalling approximately $43 billion over the next four years.

Image credit: ©stock.adobe.com/au/Nuthawut