Published 7 October 2020, revised 8 October 2020
Allied Health Professions Australia (AHPA) and its members have cautiously welcomed the Federal Government’s 2020 Budget announcements, with investments in some key areas representing an important step forward in relation to allied health access for consumers. However, other areas of the Budget represent significant missed opportunities. AHPA also notes that details about a range of the Budget measures are still limited and AHPA will be working closely with the Australian government and the Department of Health to gather information and to ensure that the allied health sector is involved in the implementation of these Budget measures.
Mental health
AHPA welcomes the increase in the number of annual Medicare-funded mental health sessions from 10 to 20 sessions through the Better Access program. This is a significant outcome after extensive lobbying by allied health professions. The additional annual sessions will be an important means of ensuring appropriate support for the many Australians impacted by the health, social and economic challenges presented by COVID-19.
While AHPA welcomes the increased funding for mental health professionals, we remain concerned about the lack of investment in a more holistic, multidisciplinary approach to mental health that recognises the important role of physical aspects of health and factors such as exercise, diet, environment, creative outlets, and the increased impact of chronic illnesses on people with mental health issues.
AHPA is hopeful that the Productivity Commission’s final report on mental health will result in a commitment by government to larger scale mental health reform.
Rural health
AHPA is pleased to see investment in the rural health workforce, building on the recommendations from the report from the Office of the National Rural Health Commissioner.
The funding of a new university department of rural health (UDRH) and additional funding for existing departments is welcome. Supporting health professionals to undertake their training in rural and remote setting is a key factor in growing the rural health workforce. UDRH have an important role in training health professionals, including allied health professionals, in rural and remote health. AHPA is seeking clarification on whether funding might target specific health disciplines and how that supports the need to increase access to allied health services.
AHPA is also seeking more information about the government’s proposed multidisciplinary models of primary care in rural health. We understand that a range of new models are to be trialled in NSW. However, we are keen to find out more detail about the specific models, including the extent to which they involve and support allied health. We also call for a national approach to meeting the health needs of rural Australians.
Telehealth
The extension of telehealth funding until March 2021 is a welcome commitment that will continue to support crucial access to healthcare for Australians in the context of COVID-19. However, telehealth is an essential means of improving access to allied health services beyond the specific needs arising from COVID-19. AHPA welcomes the acknowledgement by the Health Minister that an ongoing commitment to telehealth is required and that further consultation with the health sector will be undertaken. We welcome the additional commitment of $18.6M to support system changes for telehealth, and the development of tele-audiology standards as part of the hearing health initiatives, and call for engagement of the allied health sector as these are implemented. We are hopeful that this investment will support additional initiatives to support practitioners and consumers to take advantage of telehealth.
Aged care
The announcement of 23,000 more aged care Home Care Packages is a welcome further investment that will reduce waiting lists and help more older Australians to remain in the community. AHPA also welcomes a commitment to reforms in relation to the funding of community-based care. We understand that consultation will be undertaken to better assess, classify and fund the needs of older people living in the community and will be seeking a commitment to ensuring that the government works with AHPA and the allied health sector as these changes are implemented. In particular we are seeking urgent changes that better embed allied health interventions in the range of services older people are provided in the community.
The commitment to funding further testing of the Australian National Aged Care Classification (AN-ACC) assessment model is an important step towards addressing the limitations of the Aged Care Funding Instrument in residential aged care. However, AHPA and its members remain concerned that the AN-ACC model lacks focus on allied health interventions. AHPA is seeking more information about the AN-ACC implementation, particularly whether the allied health sector will be involved in supporting the trial of independent assessments, given the involvement of the allied health workforce in this process.
Private health insurance
AHPA also welcomed the government’s announcement of reforms to private health insurance. The proposed reforms will see improved access to private health insurance-funded home and community-based care for mental health and general rehabilitation services. These are slated to begin on 1 April 2021 with an initial focus on mental health and orthopaedics. AHPA has had a range of recent discussions with government and the private health insurance industry in relation to these changes and will be working to support the design and implementation of reforms. It will be crucial to ensure that these are designed with a focus on quality and with a strong focus on access to appropriate allied health services.
Missed opportunities
While this Budget provides some positive initiatives for improving access to essential allied health services for Australians, some of the key commitments, such as the extension of telehealth and additional mental health sessions under Medicare, are temporary. Other key opportunities have been missed, particularly in relation to access to preventive health and rehabilitation services delivered by allied health professionals. Equitable access to services, particularly allied health services, remains one of the biggest weaknesses of our health system and one that the Commonwealth government must address.
AHPA was disappointed to see that there is no funding allocated for a structured approach to the rehabilitation needs arising from COVID-19. Beyond the acute response, there is increasing evidence from overseas that ongoing and latent effects of coronavirus will present a significant burden on individuals and on the health system and it will be essential to ensure that services such as respiratory physiotherapy are funded.
There is also no indication of the government’s commitment to implementing changes to allied health funding as part of the long-running Medicare review. Chronic and complex conditions continue to be the biggest health threat for Australians, and allied health services play a key role in assessing, diagnosing, preventing and managing a range of health conditions. However, Medicare funding for these services through the Chronic Disease Management program remains too limited for most consumers. Services focusing on prevention and addressing diagnosed risk factors for chronic illnesses remain ineligible for Medicare funding.
AHPA welcomed both the recommendation by the Aged Care Royal Commission to increase access to allied health services and the government’s acceptance of the Commission’s recommendations. Unfortunately, that government commitment has not resulted in the allocation of additional Medicare funding for those allied health services and it is not yet clear what the timeline for implementation will be.
AHPA recognises the difficult fiscal environment we are in and the need to make tough choices. However, we cannot afford to continue disregarding the important role of allied health interventions in meeting the growing burden of chronic and complex illnesses, or the essential role of allied health professionals in supporting older Australians. AHPA will continue to advocate for the essential need to improve access to allied health services for all Australians.