It may be an election year, but it is highly unlikely that we will see an old-fashioned, big-spending election year Budget that is designed to buy a few extra votes in marginal seats.
The combination of minority Government and an economy under constant pressure would indicate that the Budget will be big on rhetoric, but little in terms of significant new spending.
The health reform process that commenced under Kevin Rudd has slowed to a crawl and the big picture is now much smaller. This has come about through a combination of the Gillard Labor Government having to survive with the support of Independents, the changing political hue of State and Territory Governments, the global economic downturn, policy timidity, and some bad advice in key reform areas.
Nevertheless, the Federal Government has put more money into health - through current public hospital funding under the National Healthcare Agreement, and future funding under the National Health Reform Agreement and other more targeted Agreements, all of which have been signed by all governments.
What we are now seeing, however, is retreat and reversion to the blame game between the Commonwealth and the States in regard to health policy and health funding. We have seen it all before.
It is important in this environment to get back to basics. We must protect and support the fundamentals of the health system.
The 2013-14 Health Budget must look at getting the priorities right.
If new funding is limited, then it must go towards building on the things that work.
We must build capacity in our public hospitals. Funding must be better targeted, patient-focused, and clinician-led. This will require unprecedented cooperation between the Federal and State Governments.
The complete pipeline of medical training needs to be properly funded to ensure we have a medical workforce in sufficient numbers to meet future community need. This will involve some long-term vision and planning, not stopgap year-by-year solutions.
Money should be going to GP Infrastructure Grants, not GP Super Clinics. The Grants are delivering real benefits to general practices and their local communities. The Super Clinics are a bad idea that is getting worse and wasting valuable health dollars.
Planning is needed to allow primary care, led by general practice, to cope with the growing demands of chronic disease in the community.
The Government has announced major policies in the areas of aged care and mental health. Where there is evidence that things can be done better, the Government must take the advice of clinicians at the front line and shift or re-prioritise funding accordingly.
This same principle should be applied to e-health.
The AMA supports the PCEHR – it can make a real difference to the continuity of care for patients.
But the legal framework for the PCEHR has imposed additional red tape on practices. The Government can alleviate this by assisting practices to navigate the complex pathways and requirements necessary for them to participate.
We must also proceed consultatively on the National Disability Insurance Scheme (NDIS). The priority must be on timely quality care, not litigation. The AMA has some concerns that are still to be resolved.
The Government must preserve and build on its commitment to improving Indigenous Health outcomes.
The AMA Federal Budget Submission 2013-2014 provides sensible and affordable recommendations for a stronger health system.
We may not have the environment for significant new health funding, but we have an urgent need for some smarter thinking on how precious health dollars are allocated and spent. The funding must find its way to the patient.
Dr Steve Hambleton
AMA Federal President