Budget bites


What did stakeholders think of the 2021-22 Budget?

Pharmacy Guild: The Guild welcomed measures that it says will help community pharmacies as frontline health care providers and small businesses, while also addressing specific concerns for regional, rural and remote patients.

The National President of the Guild, Professor Trent Twomey, said the Budget was a positive move towards recovery from the COVID-19 pandemic, and recognises the role community pharmacy will play in the vaccine rollout.

Professor Twomey said the $17.7 billion boost over four years for the aged care sector was an important advance, but that an opportunity to better utilise community pharmacists in support of at-home care needed to be pursued.

“The Guild has urged the Government to commit to greater funding for pharmacists to supply dose administration aids to ageing patients who are able to stay at home.

“This is important to help ensure medication adherence for these vulnerable patients, and we are disappointed this has not been factored into the aged care package at this stage. We will, however, continue to work with the Government on this proposal.”

The Guild was also disappointed at the Government’s lack of recognition of Australians who need a nationally consistent and affordable Opioid Replacement Therapy program. However, it is hoped that this will form part of the National Preventative Health Strategy package, the Guild says.

“They are some of the most disadvantaged patients in the country, and the divergent set of State-run programs and lack of either Federal or State funding has meant that access to this program is unaffordable for many of them,” Professor Twomey said.

He said the Guild also welcomed the Budget focus on programs for women.

“The community pharmacy profession boasts a workforce of more than 60 per cent women and this trend is accelerating with some two thirds of graduates being women.

“The Budget focus on women is long overdue and we support it wholeheartedly.”

SHPA: The Society of Hospital Pharmacists of Australia welcomed the growing focus on electronic medicines management and transitions of care for older Australians, continued focus on hospitals to support the COVID-19 vaccine program and pandemic preparedness through National Medical Stockpile investments—as well as nearly $900m for new and amended listings on the PBS.

SHPA Chief Executive Kristin Michaels says the response is an opportunity to scale and embed new clinical and service models in aged care informed by hospital pharmacy expertise and proven technological support, led by $45.4m announced to roll out electronic medication charts to improve the safe use of medicines.

“This funding will support the specialised role hospital pharmacists play liaising between hospitals and residential aged care to support the safe transition of patients,” Ms Michaels said.

“Wherever possible, our members are already using Interim Residential Care Medication Administration Charts for residents moving from hospitals back to aged care facilities to make sure they are able to take their new medicines and avoid readmission.

“We look forward to the government’s plan to implement electronic National Residential Medication Charts to help reduce the number of unnecessary medicines prescribed and dispensed per resident in aged care.

“This investment will help address an urgent need – between 2014 and 2019 hospital admissions from aged care residents increased by 20%, while emergency department (ED) admissions increased by 27% – and we reiterate our call to embed dedicated Geriatric Medicine Pharmacists as part of increasing provision of frontline care to aged care residents, to reduce medicines misuse and medication-related hospitalisations and injuries among older Australians.”

Ms Michaels welcomed a further $510.8m for the National Partnership on the COVID-19 Response for states and territories, with hospital pharmacists an essential part of the surge workforce implementing Australia’s COVID-19 vaccine program.

“The importance of hospital pharmacy expertise to pandemic preparedness is clear through tonight’s additional funding for the National Incident Centre and National Medical Stockpile,” she said.

“Our 2020 COVID-19 Preparedness survey demonstrated hospitals were not optimised to respond to the pandemic, despite their irreplaceable role in treatment and care as well as the vaccine roll-out – this funding will safeguard reliable supplies of essential PPE, pharmaceuticals and medical devices to respond swiftly to significant public health events.”

COSBOA: The Council of Small Business Organisations Australia said the Budget provides sound foundations needed for small business owners to rebuild and grow jobs.

COSBOA CEO Peter Strong said, “This budget delivers substantial benefits for small business owners in five key areas, namely: business tax relief, simplifying compliance with Australia’s IR laws, encouraging continued investment in digital commerce, and creating a national agency to accelerate recovery from ever-frequent natural disasters”. 

He said tax relief measures including the reduction in the SME Company Tax rate from 27.5% to 25% from 1 July 2021, the extension of the Instant Asset Write-Off provisions to 30 June 2023 and a one-year extension of the temporary loss carry back to include the 2022-2023 financial year, are very welcome.

“But it is a little disappointing that these budget tax relief measures do not extend to sole trader businesses, particularly the significant number of sole trader businesses that employ staff. We would have rated this budget an 8.5/10 had the Government not left out sole traders,” he said. 

Mr Strong said that Australia’s industrial relations system has become “complex” and that “The $134.6M investment in deregulation includes an investment in a new reg tech system to simplify IR compliance which is both welcome and overdue”.

COSBOA also welcomed measures to cut the cost of childcare, which it says will give women entrepreneurs more time to focus on their businesses.

“This budget measure provides a powerful impetus to economic growth as Australia rebuilds its economy post COVID-19.” 

MedAdvisor: MedAdvisor CEO Robert Read said that, “Improving access to healthcare and medication, no matter where you live in Australia, is a theme which underpins the healthcare initiatives in this budget and something MedAdvisor applauds”.

“Specific investment in technology, including MyGov and My Health Record initiatives are aimed at improving the digital delivery of government services and is something that will drive medication adherence and improve healthcare outcomes.

“The additional home care packages are key for older Australians to age well in their home. Medication management is critical to help people stay in their home safely and MedAdvisor can assist with this challenge.

“We are also lucky as a country that we don’t have the challenges present globally with COVID.”

RACP: The Royal Australasian College of Physicians said that the $17.7 billion to aged care may not be enough to address the recommendations of the Royal Commission.

RACP spokesperson and President of the Australian and New Zealand Society for Geriatric Medicine, Dr John Maddison, says the $6.5 billion investment in Home Care Packages is a positive move, but that more funding across the board may be required to achieve the big picture reform that the aged care system needs.

To achieve any realistic change, significant structural re-alignment of state and federal responsibilities are essential in the face of this shortfall, he said.

“The additional funding in the budget represents a much-needed boost to aged care. Whether it will be enough to completely address the recommendations of the Royal Commission is unclear.

“The fact is, the Royal Commission identified a $9.8b annual shortfall existing in aged care. Now we’re looking at approximately an average of $3.4b additional per year, for five years.

“Once you take out the $6.5 billion for Home Care Packages, it may not leave enough to address the issues in residential aged care which are significant.

“It’s a good start but it’s unlikely this is going to be enough to meet the current annual shortfall and address the Royal Commission’s 148 recommendations.”

AMA: The Australian Medical Association’s national president, Dr Omar Khorshid, said that, “The Government’s response to the Aged Care Royal Commission will help shore up the failing sector.

“Moving to mandate nurse-resident ratios is long overdue, but unfortunately we will have longer to wait until these measures are in place,” Dr Khorshid said.

“Additional home care packages will go a long way to clearing the waiting list of older Australians looking for support to stay in their own homes and avoid residential care longer.

“Mental health investment and suicide prevention is a step in the right direction, with the Government readily agreeing more still needs to be done.

“When our international borders eventually reopen, we will inevitably see the return of influenza and outbreaks of COVID. We’ve also been seeing growing chronic illness.

“Now is the time to be putting the health prevention and health infrastructure in place to build for the post-COVID future. It’s time to fund telehealth permanently beyond its current extension.

“Our public hospitals urgently need an additional injection of federal funding to address capacity issues that are leading to long waiting times in emergency departments and for elective surgery,” Dr Khorshid said.

RACGP: The Royal Australian College of General Practitioners said that Australia must not take a backwards step on telehealth.

“I welcome the extension to telehealth services to the end of the year because it has been embraced by GPs and patients and proven to be a valuable complement to face-to-face care,” said national president Dr Karen Price.

“The telehealth extension includes new Medicare items for reproductive health, smoking cessation, and drug and alcohol counselling.

“Helping people with alcohol and other drug concerns is core business for general practice and the new items will open up reproductive choices for women in rural and remote areas that were not previously available to them. No woman should miss out on reproductive health services and that is why the RACGP pushed so hard for these changes.

“However, some Medicare items for longer telephone consultations will be scrapped from 1 July this year, including for chronic disease management plans, health assessments for Aboriginal and Torres Strait Islander patients, and some mental health items.

“I strongly believe longer telephone consultations are a vital part of the telehealth package and must be included in the extension to the end of this year.”

AHHA: Australian Healthcare and Hospitals Association Chief Executive, Alison Verhoeven, said that, “Many of the health and aged care budget announcements made tonight had already been put on the table – and there’s been strong feedback from stakeholders that this is a good start, but this cannot just be a once-off cash splash before an election”.

“As a society, we are only as healthy as the unhealthiest amongst us – as the past 18 months have clearly demonstrated,” she said.

“The $17.7 billion commitment to aged care over five years is about half of the investment recommended as being necessary by the Royal Commission into Aged Care Safety and Quality. It will make a difference, but attention will be required to ensure this investment makes a difference to the care of older people, not just to profit margins for private providers.

“Much work is still needed to ensure aged care governance, safety and quality reforms aren’t neglected. Funding has been made available tonight to support improved regulation – this work must commence immediately.

“There have been important recommendations from successive inquiries regarding the need to ensure that people experiencing mental ill-health can access care.

“Of the $2.3 billion allocated to mental health funding… more than half ($1.4 billion) is notably to develop a network of Commonwealth-funded mental health centres, specialising in diagnosis and treatment of conditions in adults, youth and children.

“How these centres work together with Commonwealth-funded mental health programs administered by Primary Health Networks is not yet clear. It will be important to ensure that the majority of this large investment is directed at improved services and care for people with mental ill-health, and not just allocated to administration and infrastructure of new organisations.

‘Better support, in partnership with the states and territories, for people who have attempted suicide to continue to receive care and support once they leave hospital is a welcome initiative, with $298 million to be made available.”

APHA: The Australian Private Hospitals Association welcomed the Governments’ approach to Prostheses List reform announced in the Federal Budget.

APHA CEO Michael Roff said there was broad agreement across the sector that pricing reform of prostheses was required.

“While there is still much detail to be worked through, the pathway the Government has chosen to bring public and private sector prostheses prices into line appears sensible and is consistent with the approach advocated by APHA.

“A phased approach to pricing reform will enable necessary changes to be made in a planned and managed way, allowing continued access by doctors to a full range of technologies for their patients while minimising any shocks to the system.

“We are pleased the Government has rejected the radical DRG funding model, which would have resulted in significant cost increases for consumers, a reduction in choice of technologies and threatened the viability of many private hospitals.

“They have listened to the sector and we look forward to engaging constructively on the reform consultations.”

PSA: Pharmaceutical Society of Australia national president Associate Professor Chris Freeman said that it commended the Government on the boost for aged care, but that more must be done to safeguard residents from the harms caused by medicine mismanagement.

“The Royal Commission into Aged Care Quality and Safety is a once-in-a-generation opportunity to fix our neglected aged care system.

“The Morrison Government has laid the foundation for rebuilding our aged care system from the ground up. Person-focused care and collaborative care teams need to be at the centre of this reconstruction. 

“Residents in aged care facilities deserve to have timely and regular access to the expertise of a pharmacist if they require advice and support with their medicines and medicine management.

“Having pharmacists on the ground within aged care facilities must happen if we are serious about improving medicine management and resident safety in our aged care facilities.”

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