The Australasian College for Emergency Medicine (ACEM; the College) acknowledges significant commitments towards healthcare contained in this year’s Australian federal budget.
In an initial analysis of the budget, the College notes some positive elements of the government’s mental health and aged care packages, as well initiatives aimed at building the rural and regional specialist medical workforce.
“While many of the initiatives announced in the budget are promising, as always, it will be important to ensure that implementation contributes to genuine whole-of-system improvements, particularly where state and federal initiatives may intersect,” said ACEM President Dr John Bonning.
“The College acknowledges the ongoing significant pressures the response to the COVID-19 pandemic continues to place on hospitals and health systems and associated budgets. ACEM stresses the importance of ensuring hospitals and health systems across the country are properly funded and supported by federal and state jurisdictions to deliver the care Australians need and deserve.
“This is particulary pertinent in light of the immense pressures on emergency departments and acute hospital access crises being experienced across the country.
“The College is eager to see greater cohesion and coordination between state and federal jurisdictions which ultimately contribute to better healthcare systems and outcomes for people seeking emergency care when they most need it. This should include the defining of clear goals and expectations in terms of desired outcomes and improvements stemming from all budget initiatives.”
Mental health
ACEM notes the announced expansion of up to 57 additional mental health treatment centres and satellites for adults, youth and children. While such centres may assist in providing additional support and non-emergency department options for people needing mental health support – particularly in rural and regional areas – it will be important to ensure the rollout is matched with a commensurate focus on training and retaining staff. This is a major area of need and an ongoing challenge currently facing Australia’s mental healthcare system. The College looks forward to hearing further details about how and when this rollout will occur.
The College also welcomes announced investments in prevention and early intervention for mental health, as well as a significant suicide prevention package, to include follow-up services for Australians discharged from hospital. The College has long supported follow-up services for all patients leaving hospital after seeking mental health support, and would like to see such services further extended.
ACEM urges the Commonwealth Government, in implementing its budget measures, to take a lead role in ensuring the co-ordination of state and federal initiatives and responsibilities, which have remained an historic area of disfunction and inconsistency across the country’s mental health system.
This needs to include the setting of clear goals and expectations in terms of desired outcomes, and improvements in the care provided to, and outcomes for, people most needing mental health support.
Hospital funding arrangements
The College notes that relative ot the 2020-21 budget papers, funding for ‘hospital services’ under National Health Reform funding has decreased across jurisdictions for that financial year. While this has been offset somewhat by allocations to public health and hospital responses to COVID-19 in this, and next financial year, this amounts to less funding overall being allocated to some jurisdictions over that period.
While the College understands and supports ongoing investment in the response to the pandemic, ensuring hospital and health services are properly supported and funded to provide the highest standard of care to the community must remain a key focus. This is particularly important in light of the major acute hospital access crises being experienced across Australian jurisdictions.
The College emphasises that this is another area where state and federal jurisdictions have an opportunity to work together to achieve the hospital and healthcare systems and reforms which Australians need and deserve.
Building the rural and regional workforce
The College welcomes the budget commitment to re-invest $29.5 million over four years from the Specialist Training Program into a new innovative funding pool for non-GP medical specialist training.
The College looks forward to engaging with the Department of Health to learn more about this announcement, particularly how the investment may supplement current efforts and programs seeking to ensure regional and rural communities have greater access to necessary specialist emergency medicine expertise.
ACEM hopes this commitment will help to build on existing government and College efforts and initiatives to help address the maldistribution of the specialist medical workforce and improve health equity in rural and regional areas. This remains a significant challenge facing Australia’s healthcare system and requires ongoing focus.
Aged care
The College notes significant investment in Australia’s aged care system, however, observes that further commitments will be needed to secure the genuine, systemic reform and improvement identified as necessary by the recent Royal Commission.
In response to the Royal Commission’s final report the College emphasised the importance of ensuring older people have access to timely, affordable, appropriate and high-standard healthcare. Where feasible and appropriate, this should be delivered in the environment of their choice – be it their own home, hospital, or residential aged care facility.
ACEM notes some positive commitments in the budget, including $365.7 million to improve access to primary care, including the transition of senior Australians between aged care and health care settings and improved medication management.
The College also welcomes the commitment to ensuring the continued operation of My Aged Care, as well as funding to help transition aged care into a digital system that will integrate with My Health Record to make safer and more efficient transitions between aged care, hospitals and other health facilities.
Though the budget contains some welcome commitments as part of efforts to improve aged care, ongoing focus will be needed to ensure older people have the improved access to the healthcare they need, when and where they need it.
Family violence
ACEM recognises the unacceptable rates of violence against women in Australia and the rights of women to be safe at home, at work and anywhere else in society. Emergency clinicians in the course of their work often encounter the tragic aftermath of domestic and family violence, and the College is supportive of initiatives that may help to address this scourge on society.
The College notes the budget commitment to provide an additional $1.1 billion for women’s safety measures, by building on previous and current commitments to protect and assist victims of family violence. ACEM notes that the need for ongoing commitment and focus on the substantial work is still required to ensure women and children can live lives free from violence.
Background:
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au