Online version of the 2014-15 Department of Health Annual Report
My arrival as Secretary, in October 2014, coincided with a period of external and internal reviews of the Department. These reviews have identified opportunities to improve our capability, to match the challenges currently facing the Australian health system.
We have already made significant progress in addressing the recommendations of these reviews and change continues. Organisational re-alignment and improvements in business processes are ensuring that we are best placed to tackle our new strategic agenda.
The executive leadership team and I will continue to focus on building our capability in terms of people leadership, strategic policy, effective governance, proportionate risk management and active stakeholder engagement, while recognising that our people’s skills are essential to success. This focus is reflected in the Department’s new Corporate Plan 2015-2016.
We are also working hard to fulfil our role as the pre-eminent health and sport policy adviser to Government, with the aim of strengthening and preparing the health and sport systems for future generations.
We will continue to identify opportunities for innovation and improvement to ensure that we are well placed to respond to the continually changing health landscape.
While implementing these changes within the Department, we have continued to deliver against the Department’s key programmes and initiatives, to support the Government, and improve the health and wellbeing of Australians.
Rebuilding the primary health care system
During 2014-15, the Department undertook the task of implementing a new structure for primary health care, to replace the national network of Medicare Locals. This resulted in a smooth transition from Medicare Locals to 31 Primary Health Networks (PHNs) on 1 July 2015. The PHNs will guide and enable positive changes in primary health care. They will work closely with GPs, other primary health care providers, secondary care providers and hospitals to improve and better coordinate care for patients across the local health care system. They will particularly assist patients at risk of poor health outcomes and those with complex needs, ensuring they receive the right care in the right place at the right time. PHNs will also use flexible funding and innovative methods to address national and local health priorities.
Improving the sustainability of Medicare
The Medicare Benefits Schedule (MBS) is one of the key ways that the Australian Government supports access to health services. In 2014-15, more than $20 billion was spent on MBS rebates for patients.
During 2014-15, two new expert groups, comprising highly respected health professionals and consumer representatives, were set up to work closely with the Government to improve the operations of Medicare. The Primary Health Care Advisory Group is investigating options for improving primary care, especially in relation to patients with complex and chronic illness, and the treatment of mental health conditions.
The MBS Review Taskforce is undertaking the first comprehensive review of the MBS, which lists more than 5,500 services that are eligible for Medicare subsidies. The Taskforce will work to identify how Australians can receive better value from the health services supported by the MBS, through aligning them with contemporary clinical evidence to improve health outcomes for patients.
Reviewing mental health
In 2014-15, the Department worked towards creating a more effective and efficient mental health system by establishing an Expert Reference Group to provide advice to the Department and the Minister on key system issues identified by the Review of Mental Health Programmes and Services. The Group brings together experts in mental health with extensive experience in primary care, youth mental health, service integration and other key areas. In 2015-16, the Department will hold targeted consultations with a broad range of stakeholders to further inform its advice to the Government on a response to the Review.
Providing high quality essential health services for Indigenous Australians
Closing the gap in health outcomes experienced by Aboriginal and Torres Strait Islander peoples, compared to non-Indigenous Australians, remains a priority for the Department. While the Closing the Gap Report released in February 2015 noted ongoing challenges in relation to life expectancy, there has been a significant improvement in chronic disease mortality (down 19 per cent between 1998 and 2012), and child mortality (35 per cent reduction in the gap between Indigenous and non-Indigenous children from 1998 to 2013).
The Indigenous Australians’ Health Programme, established in July 2014, consolidated four existing funding streams, including chronic disease funding. This change enabled better alignment of high quality essential services with need, a greater focus on tangible outcomes, and a reduction in red tape. As part of this, the Tackling Indigenous Smoking Programme was redesigned to make it more effective in reducing the health damage caused by smoking.
Negotiating the Sixth Community Pharmacy Agreement
This year has been a busy year for the Pharmaceutical Benefits Scheme (PBS). The Department undertook extensive and broad-ranging negotiations across the pharmacy and pharmaceutical sectors, other health professional groups and consumers, which culminated in the signing of new five year agreements with both community pharmacy and the generic medicines industry.
The Sixth Community Pharmacy Agreement represents a significant investment ($18.9 billion over five years) in supporting community pharmacies across Australia to deliver both affordable medicines and related professional health care services.
This Agreement is significant in bringing a change to the way in which pharmacists are paid for dispensing PBS medicines. The Agreement will also support an expanded health care role for community pharmacy and pharmacists, which will contribute to patient health outcomes and improve the quality use of medicines in the community. The Agreement also provides efficiencies which ensure that important new medicines can continue to be listed on the PBS. It is a lasting achievement for the Department in assuring the future sustainability of the PBS for all Australians.
Implementing the new Health Star Rating system
With overweight and obesity now serious health issues, the Department has been active on many fronts to help Australians to adopt better lifestyle habits. The Health Star Rating food labelling system, developed through more than two years of collaborative negotiations, makes it easier for shoppers to choose healthier food options by rating the nutrition of packaged foods from half a star to five stars.
In 2014-15, the Department supported implementation of the Health Star Rating system, including through a public education campaign on how to use it. In the first year, the system has been adopted on more than 1,000 products, with more being added each week.
Adopting a new direction for electronic health records
We are working with stakeholders to implement the recommendations from the review of the Personally Controlled Electronic Health Record (PCEHR) in order to maximise the benefits of eHealth to the Australian community. The Review strongly supported maintaining and improving the system.
The recommendations were targeted to deliver the necessary increased usage to deliver tangible benefits and include: renaming the PCEHR to My Health Record; the formation of a new governing body – the Australian Commission for eHealth; improvements to usability and clinical content of the records; better targeted communication; training for healthcare providers; trials of participation arrangements, including ‘opt-out’; and a review of incentive payments for use of the system. Planning and delivery of the recommendations is currently underway.
Supporting GP training
Supporting and growing our health workforce is critical to the delivery of effective primary health care services across Australia, particularly in rural and remote communities. The closure of General Practice Education and Training Ltd and Health Workforce Australia, provided the opportunity to evaluate and reform the delivery of GP training to meet increasing demand, and improve health workforce distribution while lowering costs. The Department worked closely with the medical profession to align training regions with PHN boundaries, and ensure a mix of urban, regional and rural training opportunities are provided within each region. The changes have freed up resources to be used to provide additional GP training places.
Delivering world class sporting events
In sport, 2014-15 was a busy year for the Department on and off the field. The Office for Sport played a critical role in coordinating and delivering whole-of-government support to the Asian Cup 2015 and the Cricket World Cup 2015. These major events received significant public support, notably in bringing Australia’s diverse cultural groups together through sport. Australia’s reputation as a successful host of international sporting events was also showcased, and opportunities to boost tourism, trade and investment outcomes were maximised. Moreover, the success of Australia’s national teams in both events has provided a foundation to encourage young people to participate in sport and to lead an active lifestyle.
Reducing regulatory burden and cutting red tape
We are contributing to the Government’s priority of reducing the impact of regulation and red tape on business, community organisations and individuals, while maintaining desired health outcomes and upholding public health and safety protections.
In 2014, our actions contributed more than $152 million towards the Government’s target of $1 billion in red tape reductions. Benefits from these reforms are already being felt by our key stakeholders. Applications for assistance with hearing aids, from vulnerable people with hearing loss, are now being processed in minutes through the Hearing Services Online portal, compared to up to six weeks previously, and reduced application and reporting requirements for health grants are saving considerable time and effort for many organisations. Opportunities to further streamline and simplify systems for consumers and the health sector will continue to be identified across the Portfolio.
For both the Department and Australia’s health system, 2014-15 was a significant year in which foundations were laid for reform and ongoing change and improvement in structures, systems and processes.
These ongoing changes are designed to position the Australian health system to maintain its world-class reputation and deliver high quality health care to Australians now and for future generations.
The changes within the Department will enable us to fulfil our roles as key adviser to Government on health issues, and chief steward of the nation’s health system. We are now better equipped to address future challenges in the health environment and to fulfil our vision of ‘better health and wellbeing for all Australians, now and for future generations’.
Martin Bowles PSM