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Federal Budget (2014-15) Health Changes Compiled by Stephen Milgate, National Co-ordinator, Australian Senior Active Doctors Association on 14/5/2014 Offered in good faith by Medical Forum, without verification of accuracy and with permission of the author .

1. The government will spend $90.9m over 2 years to support the sale of Medibank Private Ltd as a private public offering in 2014. 2. The Government establish a Medical Research Future Fund on (MRFF) 1/1/2015. MRFF to receive $1b from uncommitted funds in the Health & Hospitals Fund (HHF) and amounts equal to the estimated value of health savings to be reinvested into the fund until it reaches a target capital fund of $20b in 2019/20. Net interest on the MRFF capital will be available for drawdown the following financial year. The fund is preserved in perpetuity and managed by the Future Fund Board. MRFF subject to the passage of health savings legislation. 3. $2.5m to be provided for coordinating operational phase of the 2018 Gold Coast Commonwealth Games 4. Australian Sports Commission to be redirected into the Department of Health producing savings of $22.8m 5. Australia & New Zealand Therapeutics Administration and Regulations to be harmonised. 6. $156m to be given to the QLD government to run the Australian Commonwealth Games 7. Some of the functions of the Australian Sports Commission to be moved to the Australian Department of Health. 8. Dementia research to be increased, $200m over 5 years 9. Charles Sturt University dental and health clinic developments not to be proceeded with. 10. Changes to funding arrangements with state public hospitals 11. Indexation of funding of public hospitals to be a combination of CPI and population growth (end to National Health Agreement 2011). Savings of $1.8b over 4 years. 12. Australian anti-doping arrangements to be aligned with world anti-doping code 13. Dental flexible grants program to cease, savings to be transferred to the MRFF. 14. Diagnostic imaging quality program to cease, savings to be transferred to the MRFF. 15. Australian Community Food Safety Campaign, e-health summit and implementation of clinical trial functionality into jurisdictional e-health systems, Flat Out incorporated outreach support services for criminalised women and Mental Health Better Access to Education and training programs to cease, savings of $4.4 m savings to be transferred to the MRFF. 16. Doubling of practice incentive program teaching payment for general practice to provide teaching opportunities to medical students. Payment to increase from $100 to $200 for each 3 hour session to encourage GPs to provide teaching sessions to undergraduate and graduate medical students. 17. Funding for supply of uniquely Australian anti venoms, Q fever vaccine and pandemic influenza vaccines. 18. Primary healthcare networks to replace Medicare Locals governed by Clinical Councils with significant GP presence and aligned with local hospital networks.

19. Full implementation of national bowel screening program for Australians 50-74 for biennial screening by 2019-20. Cost of $95.9m 20. General practice rural incentive programs increased by $35.4m 21. Good sports program continues to provide local sporting clubs build a culture of responsible drinking 22. Head Space program to get an additional $14.9m for young people 12-25 at risk of mental illness 23. Indexation for a number of health portfolio flexible funds will be paused for 3 years from 2015-16 to save $197.1m, savings to be transferred to the MRFF. 24. Philip Island health infrastructure to be upgraded. 25. Indigenous teenage sexual and reproductive health and young parent support program to be continued at a cost of $25.9m in 2014-15 26. Nursing and allied health workforce to receive additional $13.4m to fund 500 additional scholarships @ $30K each to target workforce shortages in rural and remote areas. 27. Dept of Health to develop a proposal with Dept of Human Services to market test the delivery of a commercially integrated health payment system. Expressions of Interest to be sought from commercial providers to gauge interest in the proposal and identical the potential alternative approaches to the delivery of health payments (cost of $0.5m 2014-15). 28. MRFF to get $276.2m over 3 years from 1/7/15 building up to $1b in 2022-23 29. Medicare rebatable eye examinations to be extended from 3 years (currently 2) for asymptomatic aged under 65 and from 2 to 1 year for patients over. 30. MBS rebate for all optometry services to be reduced from 85% to 80% from 1/1/15. 31. Reduction of the Medicare rebate from 1/7/2015 by $5 for standard GP consultation and out of hospital pathology and diagnostic imaging services and allowing providers of these services to collect a patient contribution of $7 per service. Concession card holders and children under 16 yrs, the MBS rebate will only be reduced for the first 10 services each year and then returned to current benefit levels. 32. A new low gap incentive will replace bulk billing incentives for providers of these services. 33. The low gap incentives will be paid to providers where they provide services to patients with concession cards and children under 16yrs and only charge the $7 patient contribution for the first 10 services per year or where they charge no patient contribution for additional services in that year. [currently GPs receive $6 per patient incentive payment for bulk billing, pensioners and children under 16] 34. Restriction on state and territory governments charging patients presenting to hospital emergency departments for general practitioner type attendances will also be removed. All savings to be invested into the MRFF. 35. Certain amendments to the MBS and Veterans benefits for new and amended items at a savings of $7.4m over 4 years including restrictions on the ability of doctors to claim items associated with injecting autologous blood injections 36. Full MBS rebates will be paid for services performed on newer or upgraded diagnostic imaging equipment and MBS fees reduced by 50% for services performed by older equipment. 37. The Mental Health Nurse incentive program will be continued with an extra $23.4m. Mental health nurses are engaged in community based general practice, private psychiatric

practices and similar organisations. An additional $13.6m will provided to fund the Mersey Hospital. 38. $18m over 4 years for the Orygen Youth Health Research Centre to operate a National Centre for Excellence in Youth Mental Health 39. National partnership agreement on improving public hospitals to cease from 2015-2016, savings of $201m over 3 years 40. National partnership agreement on preventative health to cease from 2014-2015, savings of $367.9m over 4 years 41. A new low cost media campaign for national tobacco prevention to be established, savings of $2.9m 42. Consolidation of the NT Medical Program with the Indigenous Transition Pathway and the NT Remote Clinical School Initiative, savings of $0.4m over 4 years. 43. Deferral of the establishment of 13 partners in Recovery organisations for 2 years, the existing 48 organisations to continue, savings of $53.8m over 2 years 44. Pausing the indexation benefit for 2 years from 1/7/14 and income thresholds for the Medicare levy surcharge and private health insurance rebate for 3 years (general practice MBS fees will be excluded and all MBS fees not currently indexed e.g. pathology and DI will not be affected), savings of $1.5b over 5 years to be transferred to MRFF. 45. Continued operation of the PCEHR while government finalises its response to the review. Cost of $140.6m. 46. Increase in co-payment for the PBS by $5 (80c for concessional payments) in 2015. 47. PBS safety net thresholds to increase each year for 4 years from 1/1/15 with general safety net thresholds to increase by 10% each year and concessional safety net by the cost of 2 prescriptions each year. Savings $1.3b to be invested in the MRFF. 48. Reduction in red tape for medical practitioners to enable paperless claiming for PBS services, medicines, dispensed from medication charts in public and private hospitals. Cost of $16.5m 49. New and amended listings to the PBS and repatriation PBS, cost of $378.7m 50. Price adjustments for certain medicine on the PBS and the repatriation PBS, cost of $8.1m 51. 300 extra GP training places per year to 1500 places in 2015 through the AGPTP and reducing AGPT funding for training registrars employed by state governments and introducing new training places for GP practices. Abolishing GPET and prevocational general practice scheme to achieve savings of $115.4m over 4 years and savings transferred to MRFF. 52. Reforming the National medical stock pile operation aimed at reducing waste and decreasing risk and increasing the surety of supply and deployment capabilities, cost of $15.4m 53. Dental health reform national partnership agreement for adult public dental services will be deferred from 2014-2015 to 2015-2016. Savings to be invested to the MRFF 54. The government will provide $95.8m over 5 years to index the current income limits for the Commonwealth Seniors health card by the CPI from September 2014. 55. Superannuation income will be included in the assessment of eligibility for the Commonwealth Seniors health card from 1/1/2015. 56. Seniors supplement for holders of commonwealth senior health card will cease from 20/9/14

57. Provide $52.5m over 3 years for 175 infrastructure grants for existing general practices in rural and remote settings to provide additional consultation rooms and space for teaching and training. Grants to be capped at $300K and successful practices required to match Commonwealth commitment. 58. Simplify the National Health & Medical Research Council grant application & assessment process, cost of $9.9m over 5 years. 59. Simplify the Medicare safety net arrangement from 1/7/16 with new safety net thresholds of $400 for concessional singles and families, $700 for non-concessional families and nonconcessional singles and $1,000 for non-concessional families who do not receive FTB-A. 60. Abolition of the Australian National Prevention Agency, savings of $6.4m over 5 years being directed to the MRFF. 61. Abolition of the Health Workforce Australia, with savings of $142m over 5 years, activities to be re-directed to the Federal Department of Health, and the clinical funding training program to be redirected to uncommitted funds in the health workforce funds. 62. A sporting schools initiative through the ASC to encourage students to participate in sport at a cost of $100.3m over 3 years. 63. New listings and amendments to the Stoma appliance scheme with savings of $0.2m over 2 years, being directed to the MRFF. 64. Additional support for the Royal Flying Doctor Service, cost of $6m in 2014-15 65. Cessation of health scholarships as part of the Tasmanian Health Assistance package for a saving of $9.9m over 4 years and savings being directed to the MRFF. 66. Funding to defend plain paper packaging litigation, no cost estimate given 67. Pharmacy Guild to administer payment functions for the professional pharmacy programs under the 5th Community Pharmacy Agreement. Agreement originally administered by the Department of Human Services. Programs to be administered include, Home Medicines Review, Residential Medication Management Review, Diabetes Medication Management Service, Medicine Use Review, Rural Pharmacy Maintenance Allowance, Section 100 Support Allowance, Pharmacy Practice Incentives Program. Cost of $2.1m over 2 years. Cost to be met from existing resources from the Department of Human Services 68. Increase funding for water safety and reduce drowning initiatives through Surf Lifesaving and Water Safety organisations at a cost of $15m over 5 years 69. Reduction in the voluntary additional contribution to the WHO, saving of $2.3 million, 2013-14

Federal Budget Health Changes