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Corporate Plan 2018-2019

Our operating environment

Health statistics reflect both the success of the Australian health system and the pressures on it. Australians today live approximately 30 years longer than they did a century ago. According to the Organisation for Economic Co-operation and Development (OECD), Australia has the 6th highest life expectancy rates in the world — 84.5 years for women and 80.4 years for men.

While we may be living longer than ever before, half of us are living with at least one chronic condition

A particular challenge is improving the health of Aboriginal and Torres Strait Islander people whose burden of disease is 2.3 times the rate of non-Indigenous Australians.

Foresight and action are required to meet the challenges and, at the same time, realise the opportunities to build a more sustainable health system that is more tailored to individual needs. We need to respond to, anticipate, and be open to change. This includes taking advantage of technology; embracing the power of genomics and personalised medicine, and; better using data analytics, including a national digital health record system – My Health Record – to support better care for patients and decision making by doctors. We start with a solid foundation – a mix of public and private health, supported by our universal health insurance scheme Medicare, which ensures all Australians have access to a wide range of health and hospital services, including medicines, at little or no cost.

The graphic below illustrates the complexity and interaction of the health system and the determinants of health.

The Australian health system is a complex matrix of services, providers and structures involving all levels of government and the private sector.

A mixed model of balanced private and public health services is integral to providing accessible, high quality, and affordable health care services for all Australians.

As a successful and integral part of Australia’s health system, Medicare is designed to be complemented by a private health care system, as well as funding through a private health insurance system. This insurance system is partially subsidised by the Australian Government.

In this way, all Australians have both universal access to health care services, as well as a choice of health care alternatives.

A key feature of the health system is our skilled and motivated health workforce. Under a new rural health workforce strategy, our medical and health workers will be better distributed across the nation to bridge the city–country divide that has historically denied people living outside major cities and towns access to the health services they need, when they need them.

Our health system continues to have very strong regulatory oversight for medicines and medical products, vaccines, the health workforce, health services, and the quality and safety of health care. There are also effective health information systems in place to ensure that government policy is well informed and that there is an established health technology assessment system to inform decisions about public and private health care funding for health interventions and technologies.

Sport has helped shape Australian culture and our way of life. It provides a key source of identity, a focus for national pride and community engagement. Participation in sport plays a significant role in health and wellbeing, including preventing chronic conditions, improving mental health and supporting personal development.

To maximise the various health, economic, social and cultural benefits sport provides, it is critical sport is conducted on a level playing field, and embodies the values of fair play, commitment, and sportsmanship. To this end, the department is committed to safeguarding the integrity of sport in Australia and globally from threats such as doping, match-fixing and illicit drug use.

Health Portfolio budget

1 the detailed amounts are rounded which may result in discrepancies between totals and the sum of components

2 A further $8.7 billion is allocated for a range of health services and programs including, but not limited to: 

  • medical research;
  • immunisation;
  • digital health;
  • drug and alcohol programs; and
  • child dental benefits.

In 2018-19, the Health Portfolio is budgeted to spend is $92.8 Billion1 for health and aged care, with allocation of:

  • $24.0 billion to Medical Benefits Schedule;
  • $11.3 billion to Pharmaceutical Benefits Scheme;
  • $1.7 billion to primary care, including mental health; 
  • $18.6 billion to Aged Care; 
  • $21.2 billion to hospitals;
  • $8.7 billion to Other2;
  • $0.9 billion to indigenous health;
  • $6.2 billion to private health insurance rebate; and
  • $0.4 billion to sport.

The challenges

Australia’s health system currently faces many challenges.

Ageing population

Many health conditions and associated disabilities become more common with age, and older Australians are higher users of health services than younger Australians. For example, while people are living longer and healthier lives, the prevalence of health conditions associated with ageing, such as dementia, is projected to increase.

Impact of technology

Advances in medical science, and genomics in particular, have seen a growth in genomic testing services, including in Australia. Genomic testing has the potential for early diagnosis, or avoidance, of a range of health conditions and diseases. Genomic testing services pose many ethical and legal issues for consideration, including the high cost to consumers, the extent to which tests actually inform treatment options, and the impact on a healthy person of discovering a predisposition to a certain disease.

Technology is also having an impact on health and medical services – from digital health technologies through to medical artificial intelligence for diagnostic testing. These technologies may provide efficiencies and improvements for the health system, but could also create tension between consumer demand for early access to new products and ensuring products meet requirements for quality, safety and effectiveness.

Chronic conditions

Most illness and deaths in Australia are caused by chronic conditions. Chronic conditions place a high burden on individuals, their families and carers, and the health system.

Expectations

Consumers are more informed and aware of developments in health and aged care, particularly in relation to choice and access to care, service design, and the safety and quality of health services. There is a trend towards people more actively participating in their own and their families’ health care – a trend strongly encouraged by the department. Clinicians, too, have increasing expectations around patient care, including ensuring the the Medicare Benefits Schedule (MBS) aligns with best practice, and the need for new ways of delivering and funding primary care.

A sustainable, affordable health system

As people live longer and the incidence of chronic disease increases, so does the cost for governments and the community. Without new models of care and earlier intervention strategies, health care costs will continue to rise.

Improvements to the health system

We are committed to supporting a culture across the health system that includes collaboration, discovery, testing/trialling, and embracing new technologies that will help us to respond quickly and effectively to policy, program and service delivery challenges. This will enable us to be better positioned to drive change and deliver benefits to citizens, business and government. The Government continues to commit to strengthening links, both at home and abroad, with industry, to collaborate on medical breakthroughs and research and development in healthcare.

We will build upon our previous work in the areas of behavioural insight, health data analytics and use of statistical techniques to further increase our ability to deliver benefits to citizens. 

The Therapeutic Goods Administration is driving reforms aimed at delivering efficient, best practice regulatory outcomes. It supports small to medium enterprises, researchers and those unfamiliar with therapeutic goods regulation to better understand regulatory requirements.

The $20 billion endowment Medical Research Future Fund, the $500 million public-private Biomedical Translation Fund, and ongoing support through the National Health and Medical Research Council, are set to improve health outcomes, and will continue to fuel new ideas and discoveries with potential to transform health care.

Health challenges for Australia

1 AIHW Australia's Health 2018 page 94 – ABS 2015

2 AIHW Australia's Health 2018 page 223 – ABS 2015

3 AIHW Australia's Health 2018 page 223 – ABS 2015

4 AIHW Australia's Health 2018 page 318

5 AIHW Cancer in Australia 2017 page ix

6 AIHW Australia's Health 2018 page 245

Infographic icon and text relating to the challenges for Australia include:

  • 1 in 4 have two or more chronic conditions1,
  • 63% of adults2 and 20% of children3 are overweight or obese,
  • ~10 years life expectancy gap between Indigenous and non-Indigenous4,
  • cancer accounted for about 3 of every 10 deaths (31%) registered in Australia5,
  • 1 in 3 adults have high blood pressure6.

Rural GP training and working

The Stronger Rural Health Strategy measures incentivise and support doctors to increase their qualifications, and work in rural and remote settings. For example:

Joanne is an Australian trained doctor who is interested in becoming a specialist GP in a rural town. The More Doctors for Rural Australia Program will enable her to access MBS rebates for GP services in rural and remote community practice settings. This gives Joanne the opportunity to work in a private practice in a rural town, treating patients and gaining valuable primary care skills with GP supervision.

If Joanne wants to continue to work as a GP she can apply through The Royal Australian College of General Practitioners or Australian College of Rural and Remote Medicine to enter a training pathway. While she is training, her patients receive the highest MBS benefits and her rural practice may also be eligible for supervision and practice support payments if she is training on a Commonwealth Supported GP Training Place.

Joanne will continue to provide services in rural Australia while working towards fellowship with her selected College.

Last updated: 
25 September 2018