Close examination of the Health Budget

Even when the costs of child health checks and continuation and expansion of the bowel cancer screening program are included, the Commonwealth’s new commitment to prevention amounts to only $54 million a year over the next four years.

The big loser in the Budget is mental health. Despite the huge burdens of cost and disability that mental illness imposes on society, despite a raft of reports that cogently argue for doing and spending more, and despite election commitments to make mental health a priority, the budget details reveal spending cuts of $290 million in mental health programs over the next four years.

In primary care, the growing concern is that a Medicare system that only pays GPs for services delivered if and when the patient visits their practice will not deliver in terms of better prevention, early intervention and management of chronic illnesses. The incentive payments that were introduced a decade ago to encourage GPs to do more in these areas have not had a huge take-up, and this budget sensibly cuts these incentives - but does nothing about replacing them with incentives that will work.

The rationale provided for these cuts is that the programs have historically been under-spent, and that if demand does increase in the future, then more funds will become available. However there is no commitment to examine the value of these programs, to understand why uptake rates have been less than predicted, and to invest the budget savings in innovative approaches to the delivery of mental health and primary care services.

Changing the focus of the health care system and the way in which services to keep people healthy and treat their illnesses are delivered cannot happen overnight, and needs a cohesive strategy which involves all stakeholders. We should not expect miracles in this first budget in the first six months of government, but we should expect a consistent focus on these new imperatives that will deliver the required new strategies, action plans and funding as soon as possible. The target timeline should be the 2009-10 Budget.