Budget highlights work still to be done
The Australian Physiotherapy Association (APA) recognises that while there are many positives in the 2018 Federal Budget, there are also omissions that will impact the profession and require further attention.
Key strategies around investment in sport and physical activities, the funding of additional aged care places, the increased spending on Aboriginal and Torres Strait Islander healthcare, and additional investment into medical research will all have positive impact.
APA National President Phil Calvert says after careful analysis of the Budget content, the APA will continue to work through the Medicare Benefits Schedule (MBS) Review to ensure that physiotherapy services are appropriately funded. Similarly, the APA will continue to seek reform on the price-setting methodology of the National Disability Insurance Scheme (NDIS), and push for adequate funding for advanced practice physiotherapy services in Commonwealth public hospitals, among other initiatives.
‘We welcome the provisions that encourage Australians to get moving; what we want to ensure is that physiotherapy is a central pillar of preventative healthcare, and not something sitting on the periphery – this is good for patients and the economy’ Phil says. ‘We will continue to work hard outside of the Budget process to make sure that physiotherapy is recognised appropriately in policy-making decisions.’
The APA sees four themes in the Budget that are relevant to physiotherapists. Phil Calvert and CEO Cris Massis will attend tomorrow’s Post-Budget Health Breakfast with The Hon Greg Hunt in Canberra, after which further updates may be made.
Theme 1: Prevention
The Government will invest $230 million in sport and physical activity initiatives over five years. This will encourage more Australians to get more active more often by promoting participation in physical activity and strengthening links between the community and sporting organisations. The APA would encourage the government to tie the provision of grant funds (e.g. infrastructure grants) to the implementation of injury prevention programs.
Theme 2: Sustainability and future-proofing
There is no mention of a lifting of the Medicare freeze on physiotherapy services. The APA continues to advocate for the freeze to be lifted. We support additional resourcing for the Medical Services Advisory Committee (MSAC) to ensure that new MBS items will be available in the near future.
The Government will provide $28.2 million over five years from 2017–18 to upgrade the e-prescribing software system used by clinicians to prescribe medicines. As physiotherapy moves to seek an endorsement to prescribe medicines within scope of practice, this sort of initiative signals the importance of investment in fit-for-purpose information systems in physiotherapy clinics.
Commonwealth public hospital funding is based on hospital service activity and the efficient price of hospital services, capped at 6.5 % annual funding growth. The arrangements maintain a commitment to activity based funding, and extend reforms under the Addendum to the National Health Reform Agreement to focus on improved safety and quality and coordinated care and health innovation.
The APA has made a submission to the Independent Hospital Pricing Authority recommending that the way in which advanced practice physiotherapy services are funded be amended to ensure that these services attract the funding necessary to make them sustainable.
Theme 3: Access and equity
Aboriginal and Torres Strait Islander Health
The APA wholeheartedly supports the Government’s investment of $3.9 billion into Indigenous health, an ongoing increase of around four per cent per year. The Government will improve Indigenous health outcomes by introducing a more transparent primary care funding model based on patient numbers, episodes of care, remoteness and need.
The Government will support the work of Aboriginal and Torres Strait Islander Health Professional Organisations (ATSIHPOs). Priorities include training and mentoring, developing leadership, strengthening cultural safety, and engaging and supporting students.
The Workforce Incentive Program will assist general practices to employ allied health professionals and support doctors to practise in non-metropolitan areas. Around 5,000 practices and more than 7,000 medical practitioners will be eligible for incentive payments under the Workforce Incentive Program.
The APA recognises that the funding is intended to strengthen multidisciplinary primary care, but we strongly support an approach that funds allied health provision directly, and not through the gateway of a GP practice where the GPs may have a conflict of interest as competing employers to well-respected physiotherapy services.
The APA continues its advocacy in support of a revision to major funding schemes (e.g. the MBS and private health insurance) to include telehealth services.
The Government will increase funding for aged care by $5 billion over five years. More than 14,000 packages are funded in this Budget, on top of 6,000 packages released in the Mid-Year Economic and Fiscal Outlook. The APA welcomes this as it responds to demand for people seeking additional support to live at home longer.
As well, 13,500 residential aged care and 775 Short Term Restorative Care places will be released through an Aged Care Approvals Round in 2018–19, with an additional $60 million capital investment to support access to residential aged care.
The APA strongly supports the role of quality and safety initiatives such as an Aged Care Quality and Safety Commission. We are concerned that about the increasing number of standards and accreditation models (e.g. in health services, the NDIS and aged care), and the potential impact on physiotherapy providers who seek to provide a range of care, especially in rural and regional communities. There needs to be a harmonisation of the arrangements.
Theme 4: Quality
The APA welcomes the Government’s investment of $150.4 million over four years into the Medical Research Future Fund to support translation of research into better patient care. Four programs will focus on health service and system research, and its direct translation into clinical practice and patients.
Hip fracture registry
The Government will build the capacity of the Australian and New Zealand Hip Fracture Registry (ANZHFR) to improve data collection, provision of data to hospitals and clinicians, and monitoring of standards to reduce deaths and complications for older people recovering from a hip fracture. The APA is keen for the ANZHFR to include data on community-based physiotherapy care, so that we can gain a much better picture of the opportunities for prevention.