The 2021–22 Budget has been handed down with few changes impacting eye care.
A snapshot of the long term national health plan shows:
• $121.4 billion in 2021–22 for health, aged care and sport,
• $36 billion additional funding for health, aged care and sport over four years from 2021–22 to 2024–25,
The Australian Government has announced it will invest $503 million to transform digital health in Australia, resulting in a modern, integrated health system
• $17.7 billion additional for respect, care and dignity in aged care,
• $2.3 billion additional for Mental Health,
o $820.1 million for Adult, Youth and Children’s treatment centres
• $125.7 billion over four years for Medicare,
o $3.6 billion total investment in telehealth to date
• $4.1 billion over 4 years for Prioritising Aboriginal and Torres Strait Islander Health,
• $43 billion for life changing medicines over four years
o PBS New and Amended Listings
• $135.4 billion for National Health Reform Funding over 5 years
• $6.7 billion over four years for life-saving medical research
• $492 million additional for preventive health and sport
• Over $25 billion on total COVID expenditure since March 2020
o $7.2 billion for vaccines
The My Health Record system plays a central role in health service delivery, with more than 23 million Australians, or more than 91% of all eligible patients, holding an MHR. More than 89% of all MHRs contain critical healthcare data.
The Australian Government has announced it will invest $503 million to transform digital health in Australia, resulting in a modern, integrated health system.
Investments will include:
• $301.8 million for the next wave of My Health Record (MHR), leveraging the connections already in place and ensuring a more coordinated healthcare future for Australia while also stimulating economic recovery from COVID-19,
• $87.5 million for operational funding for the Australian Digital Health Agency, with a focus on implementing lessons learnt from the COVID-19 pandemic to help improve system preparedness and responsiveness,
• $32.3 million for continued funding for the 2018–2022 Intergovernmental Agreement on National Digital Health (IGA). This will ensure interoperability within Australia’s national digital health infrastructure to deliver improvements to health system quality and safety, accountability, transparency and patient- centred healthcare,
• $45.4 million to roll out electronic medication charts in residential aged care facilities, drive utilisation and integration of MHR, and establish digital support for transitions between aged care and hospital settings, and
• $36 million for streamlining reimbursement approvals for health products through the Health Products Portal (HPP). This change will allow the sector to digitally manage applications to the Pharmaceutical Benefits Advisory Committee (PBAC), Medical Services Advisory Committee (MSAC), and the Prostheses List. This will create a streamlined application process and faster patient access to new therapies and treatments.
Medicare Benefits Schedule
The Medicare Benefits Schedule (MBS) is a critical element of the Australian Health System which evolves to meet societal challenges such as the growing burden of chronic disease, an ageing population, workforce pressures and inequities in health outcomes and access.
An investment of $711.7 million was announced for new and amended MBS items, including $14.2 million for new MBS items for allied health professionals who participate in case conferences which are organised by a patient’s GP. This will support increased allied health participation in multidisciplinary, coordinated care for patients with chronic and complex conditions.
$3.2 million will be delivered to introduce a continuous review mechanism for the MBS, which aims to provide Australians with affordable access to universal health care, a key pillar of Australia’s Long Term National Health Plan. The Medical Services Advisory Committee (MSAC) is responsible for assessing the safety, effectiveness and value-for-money of medical services and technologies proposed for public funding. The MBS Review Taskforce was established to consider how the more than 5,700 items on the MBS could better align with contemporary clinical evidence and practice, and improve health outcomes for Australians.
The continuous review will:
• provide clinician-led, independent advice to drive value for the patient and taxpayer,
• deliver program assurance across the $125.7 billion in MBS expenditure over the forward estimates by reviewing thematic issues across the MBS and identifying opportunities to improve how services are funded,
• ensure the MBS continues to provide high value care, remains flexible and contemporary, and provides value for money for patients and taxpayers, and
• enable consideration of critical issues relating to health financing and affordable access to clinical care, particularly where existing assessment pathways such as the Medical Services Advisory Committee (MSAC) are not suitable.
The Australian Government will also provide $3.8 million to enhance data-matching activities through the National Health Funding Body to compare public hospital activity data and MBS claims data. This project will identify any instances where the Guaranteeing Medicare – Updating the Medicare Benefits Schedule.
An investment of $133.8 million will be made to primary health care including:
• $71.9 million for the Primary Health Network’s (PHN) After Hours Program to commission after hours services and improve service integration in communities around the country
o This will also improve access to after-hours services for residents of aged care facilities, rural and remote communities, women and children, homeless people, people with disability, people with mental illness, and Aboriginal and Torres Strait Islander people, who may not have regular access to GP services.
• $50.7 million to continue to develop an ICT system that enables a voluntary patient registration (VPR) initiative, to be known as MyGP, which will improve health outcomes, and lift the quality of services delivered to Australian patients through continuity of care.
• $5.5 million to expand the National Health Call Centre Network, Healthdirect, to include Victoria.
• $5.7 million to modernise the Hearing Services Online (HSO) portal, which supports the Hearing Services Program and helps hearing service providers deliver care to Australians who have hearing loss. This funding will ensure the ongoing viability of the portal and improve service delivery data collection, guaranteeing the program’s client-focused approach.
The Australian Government is investing an additional $204.6 million to support continued access to universal telehealth for all Australians, building on previous investment of $3.6 billion since March 2020.
Medical Benefits Schedule (MBS) items will be extended until 31 December 2021 for allied health and:
• general practitioner (GP)
• midwifery, and
• allied mental health attendances.
Rural Workforce Support
The Australian Government will invest $123 million in an effort to alleviate workforce shortages, extend investment in rural training and help to build a sustainable health service in regional, rural and remote Australia.
Key measures include:
• $65.8 million to progressively increase the Rural Bulk Billing Incentive to doctors working in rural towns and remote areas (see separate fact sheet, Guaranteeing Medicare – Improved patient care through Rural Bulk Billing Incentives).
• $12.4 million through the John Flynn Prevocational Doctor Training Program to almost double the number of rural primary care rotations for prevocational doctors (see separate fact sheet, Guaranteeing Medicare – John Flynn Prevocational Doctor Program).
• $9.6 million to expand the Allied Health Rural Generalist Pathway (AHRGP) to attract and retain allied health professionals in rural and remote communities through an additional 90 workplace training packages, including up to 30 packages for Aboriginal Community Controlled Health Organisations. This will also include incentives for practices to employ and train up to 30 rural allied health assistant trainees.
• $300,000 to develop a new streamlined program to support rural generalist GPs to maintain their range of advanced skills and encourage them to practice in rural and remote communities. This work will explore options to streamline the Rural Procedural Grants Program (RPGP) and the Practice Incentives Program (PIP) Procedural GP payments.
• $29.5 million for an innovative funding pool for non-GP medical specialist training from 1 January 2022. This will fund activities such as trials of networked training models, supervision models, and transition of junior.
Rural Access to Medical Care
In an effort to attract doctors to rural and remote areas, $65.8 million will be invested to implement a progressive incentive schedule that increases bulk billing payments. This measure aims to offset higher operating costs, smaller patient populations, increased complexity in patient care, and the greater burden of responsibility for the healthcare needs of people living in these communities. Additionally, it is anticipated that bulk billing incentives will encourage doctors to bulk bill vulnerable patients, including children under 16 years old and concession card holders, leaving them with no out-of-pocket costs.
From 1 January 2022, the Rural Bulk Billing Incentive (RBBI) will progressively increase from the current rate of 150% of the incentive in metropolitan areas as classified under the Modified Monash Model (MM) to:
• 160% of MM 3–4 , large (population 15,000 to 50,000 residents) and medium (population 5,000 to 15,000) rural towns
• 170% in MM 5, small rural towns (population up to 5,000)
• 180% in MM 6, remote areas, and
• 190% in MM 7, very remote areas (up to $12.35* per consultation).
The geographic eligibility for claiming bulk billing incentives for after-hours services will be updated to use the Modified Monash Model.
*Based on metropolitan bulk billing incentive rate as at May 2021.
Pathology tests play a vital role in more than 70% of medical diagnoses in Australia and inform many clinical decisions related to patient care.
The Australian Government will invest $667.1 million towards increasing pathology services for Australians, including extending the Medicare subsidies for COVID-19 testing until 31 December 2021. This builds on previous investment, totalling $1.8 billion since the start of the pandemic. The inclusion of new pathology related procedures and tests to the MBS means more Australian patients are able to access these critical diagnostic and monitoring tests, with lower out-of-pocket costs.
The pathology services funded in the budget include:
• $2.1 million for point of care quantitation of HbA1c for the monitoring of diabetes in diagnosed patients. Expected to fund around 47,000 tests a year
• $41,000 for amendments to the Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS), items to help manage patients with multiple comorbidities. Expected to benefit 662 patients over 4 years, and
• $375,000 for diagnostic testing for neuromyelitis optica. Expected to benefit 40,000 patients.
The Australian Government will invest $37 million to modernise diagnostic imaging by replacing outdated equipment, improving the patient journey for those in need of radiology services, and continuing to support private radiology oncology providers.
Among these modernisation measures include:
• a one-off funding pool of $20.7 million over two years will be established to assist private diagnostic imaging providers to replace older diagnostic imaging equipment in rural and remote areas with up to 50% of the cost to replace older equipment,
• $7.2 million over two years to fund development of a streamlined electronic referral solution, which will assist in the determination of the need for diagnostic imaging,
• $3.1 million to make enhancements to the diagnostic imaging register location specific practice number to improve data integrity and granularity, and
• $6 million over four years for continued support through the Radiation Oncology Health Program Grants (ROHPG) for private radiation oncology providers to assist with high-cost cancer treatment equipment.
The Federal Government has responded to the Royal Commission into Aged Care with a five year – five pillar aged care reform plan addressing:
1. Home care – at home support and care based on assessed needs,
2. Residential aged care services and sustainability – improving service suitability that ensures individual care needs and preferences are met,
3. Residential aged care quality and safety – improving access to and quality of residential care,
4. Workforce – growing a bigger, more highly skilled, caring and values based workforce; and
5. Governance – new legislation and stronger governance
The response include $365.7 million to improve access to primary care for senior Australians, including the transition of senior Australians between aged care and health care setting and improved medication management.
The Australian Government is investing $6.7 billion in medical research over the next four years, including:
• The Medical Research Future Fund (MRFF) ($2.6 billion)
• National Health and Medical Research Council (NHMRC) ($3.6 billion)
• Biomedical Translation Fund ($500 million).
Among 69 research projects to commence in 2020-21, funded with grants totalling $128.1 million through the MRFF and NHMRC, (full table further below) will be:
$10 million to the Menzies School of Health Research for a National First Nations Research Network. Led by Indigenous people for Indigenous people, the Network will nurture culturally safe environments, connect expertise, and catalyse research methods, training and development.
The Australian Government will invest $6 million over four years to continue the Encouraging More Clinical Trials in Australia program which supports collaboration with jurisdictions to grow the number of clinical trials run in Australia, while also removing red tape for industry and states and territories from the process. KPMG estimates that every dollar invested in medical research returns an average benefit to the Australian population of $3.90, based on their 2018 report. Clinical trials contribute an estimated $1.1 billion a year to the economy and the sector has been identified as a key potential growth area for Australia.
The investment is in addition to the $614 million Clinical Trials Activity under the Medical Research Future Fund (MRFF), which includes the Rare Cancers, Rare Diseases and Unmet Need (RCRDUN) initiative and the International Clinical Trial Collaborations (ICTC) initiative.