The Australian Dental Association (ADA), Australian Medical Association (AMA), Optometry Australia (OA), Pharmaceutical Society of Australia (PSA), Royal Australian College of General Practitioners (RACGP), The Society of Hospital Pharmacists of Australia (SHPA), and Royal Australian and New Zealand College of Psychiatrist (RANZCP) have made pre-budget submissions for the year 2018 – 2019.

Dentistry

In the report submitted by the ADA, inability to afford private dental services, long waiting times for public dental service, extremely limited access to private dental treatment currently provided through Medicare, and limited state and federal government funding for public sector dental services were listed as factors that contribute to the poor oral and dental health of about 7 million Australians.

Additionally, the ADA highlighted the great need for increased Federal Budget funding for two patients groups such as the aged and children or adults under general anaesthesia.

Recognizing dental caries, periodontal diseases, and untreated decay as culprits of poor oral and dental health among socio-economic groups in Australia, the ADA has proposed solutions to provide optimal oral and dental care:

• Better access to oral and dental health care for the low-income aged population and aged care residents
  • The oral and dental health of aged care residents is of higher concern
    • Workforce issues in residential aged care
    • The need to involve dental practitioners in oral health assessments and Care planning on admission 
    • Affordability and accessibility of dental treatment for residents
  • The indirect costs of poor oral health amongst older Australians
  • Addressing affordability barriers: Aged Pensioner Dental Benefits Schedule APDBS
    • Funding the APDBS
  • Additional budget measures to support better oral and dental health care in residential aged care facilities
• Funding to improve affordable access to dental treatment under general anaesthesia for children and special needs adults
  • The number of Australians who need dental treatment under GA is growing
  • Funding and affordability-related barriers to dental treatment under GA are growing too
    • Medicare and private health insurance funding of dental treatment under GA
    • Access to dental services under GA through public dental services or public hospitals

Medicine

While ADA’s submission centres on additional funding for the aged and children or adult under general anaesthesia, AMA President Dr Michael Gannon’s report hopes for constructive health reforms and responsible investment.

“The conditions are ripe for a new round of significant and meaningful health reform, underpinned by secure, stable, and sufficient long-term funding to ensure the best possible health outcomes for the Australian population.

“The 2018-19 Budget provides the Government with the perfect opportunity to reveal its health reform vision, and articulate clearly how it will be funded.” Dr Gannon said.

The AMA Pre-Budget Submission 2018-19 covers:

• General Practice and Primary Care;
• Public Hospitals;
• Private Health Insurance;
• Medicare Benefits Schedule (MBS) Review;
• Preventive Health;
• Diagnostic Imaging;
• Pathology;
• Mental Health and the NDIS;
• Medical Care for Older Australians;
• My Health Record;
• Rural Health;
• Indigenous Health;
• Medical Workforce;
• Climate Change and Health; and
• Veterans’ Health. 

RACGP has called for the increased transparency of investing the Federal Budget into Medicare. Additionally, with RACGP President Dr Bastian Seidel’s belief in the importance of long consultations of patients to their GPs, RACGP endorses for the government’s commitment to general practice by increasing medical rebate for longer consultations.

He said, “Patients want to spend more time with their GP,”

“The Federal Government can really make a difference to the quality of care GPs are able to provide Australians, by increasing this rebate.

“Every minute we spend with our patients allows us to obtain more information about their life, concerns, fears and expectations.”

The Royal Australian and New Zealand College of Psychiatrist’s submission formed through consultations with Fellows and Internal committees across the country, advocates for the funding of mental health services commensurate for the 2018-19 Budget. Likewise, it advocates for the reconceptualization of mental health-care spending in Australia with hopes to improve the efficiency of the economy.

Dr Kym Jenkins, President of RANZCP said, “Mental Health disorders are a leading cause of disability burden in Australia. The burden of disease from mental illness could be greatly reduced through improved health promotion, prevention, early intervention, treatment and support. In fact, mental health and well-being are central to all aspects of health care.”

The psychiatric workforce, substance use disorder, Aboriginal and Torres Strait Islander mental health, military and veteran mental health, and suicide prevention are the listed key topics for funding initiative prioritisation.

Optometry

Believing that access to quality optometric care is a key component of an effective, efficient and sustainable eye care system which is vital to maintaining vision and eye health for Australian citizens, Optometry Australia (OA) estimated a $20 million budget would realize these goals in 2018-2019. OA recommended a budget of $9 million in 2018 – 2019 alone to achieve affordable access to primary care for all Australians, $10 million annually for timely eye care for middle-aged Australians, and $1 million in 2018 – 2019 for preserving eye care access for veterans.

Pharmacy

PSA has targeted the training of its practitioners. Dr Shane Jackson PSA National President said, “I encourage the government to invest in pharmacists and the pharmacy profession to deliver better medication use in Australia.”

Dr Jackson added that, “Two specific programs designed to utilise the skills, expertise and training of pharmacists have been put forward. The first is embedding pharmacists within the general practice environment, the second utilising the skills of the community pharmacist and the established infrastructure of community pharmacy to deliver a structured minor ailments program.”

Considering the context of the Government’s existing health reform agenda, PSA recommends the Federal Government to make provision for the following key points:

• $1.2 million for a discrete project to develop quality indicators for pharmacist practice in Australia
• a large scale implementation project integrating pharmacists in general practice, to determine the best approach to implementing an evidence-based model in the Australian context, and the value of this model to the health system
• $5 million for a pilot of a structured and collaborative pharmacist-delivered minor ailments service through community pharmacies
• $3 million for a pilot project to investigate a structured service model for pharmacists to support people living with mental health conditions
• $1.5 million for the development and implementation of training and practice support tools, to support pharmacists to better utilise My Health Record to improve consumer health outcomes through effective medication management
• funding for pharmacy student placements and post registration experiential training in non-traditional settings.

The Society of Hospital Pharmacists of Australia (SHPA) also provided its own recommendations centralized on the idea of focusing on the outcomes for patients more than delivery of pharmacy care services. The organization added that unnecessary duplication and poor implementation of pharmacy care from the hospital and community care contributes to the budget’s expense. The report can be outlined as:

• Support compliance and maximise return on investment in high cost PBS medicines
• Reduce harm caused by opioid use initiated in hospitals
• Bridge the gap for high-risk patients leaving hospital and returning to care in the community
• Provide additional funding to support seven-day clinical pharmacy services in hospitals as part of National Health Funding Reform Agreements for Public Hospitals beyond 2020
• Address safety and quality concerns in aged care by embedding pharmacists in Commonwealth facilities and home nursing services
• Improve antimicrobial stewardship in all Australian healthcare facilities to address the threat of antimicrobial resistance
• Fund hospitals to provide Closing the Gap Pharmaceutical Benefits Scheme Measure (‘the Measure’) services to Indigenous people
• Develop a national pharmacy workforce reform strategy

Photo by Fabian Blank on Unsplash

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