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Community Affairs Legislation Committee
Department of Health

Department of Health


Senator WATT: Do you mind if I ask a couple of other mental health related things?

CHAIR: Okay.

Senator WATT: In terms of the government's recent announcements regarding headspace funding, could you provide a breakdown of the announcement over the forward estimates by each component. My understanding is that the funding was announced partly to continue the existing eheadspace for another two years. There was partly a top-up or an extension of existing base funding, and there was a one-off funding allocation for relocation or upgrades. Is that correct? Is that pretty much how it breaks down?

Dr Morehead : Yes. The funding announcement on 14 October was for $51.8 million over four years for headspace. That is broken down into $33 million over four years to support the existing national network of headspace services; $6 million over three years from 2019-20 to support capital works improvements for the existing headspace network, such as refurbishing or relocating premises; and then $12.8 million over two years from 2019-20 for headspace national to, as you say, continue to operate eheadspace in 2019-20 and 2020-21.

Senator WATT: Have you got a document there you could table, Dr Morehead, that breaks that funding down over the forward estimates for each of those three components?

Ms Edwards : We probably can't table that document, but we can get it to you now.

Senator WATT: If you could, that would be great. Thanks. Where did that funding come from?

Dr Morehead : That is new funding.

Senator WATT: New funding that wasn't ever within the—

Dr Morehead : It hasn't come out of the existing mental health—nothing has been saved within mental health in order to put it there.

Senator WATT: What about within the health budget overall?

Dr Morehead : It was a government decision, so the government decision was to have that as money coming in, and that—

Senator WATT: From outside the health portfolio all together?

Dr Morehead : It was new money, yes.

Senator WATT: That's your understanding, Ms Beauchamp, as well?

Ms Beauchamp : As I have said earlier, the budget involves ons and offs all over the place. There's not such a thing as hypothecation. The bottom line budget, as we went through with Dr Di Natale, shows that on every program funding has gone up over the forward estimates, and similarly in this program there's been additional funding provided for mental health services in the order, I think, at last budget of $374 million or something—

Ms Edwards : It was $388 million at the budget but this money is in addition to the mental health program that we have previously talked about.

Senator WATT: There's the eheadspace funding and then there's $39 million in base funding and infrastructure funding for existing physical headspace services?

Dr Morehead : Yes. Six million for actual capital works and then $33 million just to be given out to the existing headspace services on top of their normal funding. So it's a funding boost to the existing headspace services—for services; not for capital works.

Senator WATT: That's one of the things I was going to ask. With this $33 million, they already had funding in the budget for the next four years to operate and this extra money is on top of that?

Dr Morehead : Correct.

Senator WATT: For the next four years. So, that does mean that there will be genuinely additional services provided? It won't just be a continuation of however many they're providing now?

Ms Edwards : It's responding to demand.

Senator WATT: The minister's press release on this said that it would provide for around 14,000 additional services. Are you able to explain how that 14,000 figure was derived?

Ms Gleeson : Yes. We looked at the number of the services that are currently provided through headspace centres and we modelled what the number of services provided was, so then we could extrapolate out to calculate what the additional funding would provide. The headspace funding model is a bit complicated in that there are two sources of funding that come through to headspace centres. They get a grant, which is what we're increasing here, but they can also access MBS items—Better Access—and that's a demand-driven component. So there are actually two streams of funding that go through. So 14,000 is an estimate of additional services, but it might be more depending on access to the demand-driven MBS items.

Senator WATT: My understanding is that this money will be provided to headspace and they will allocate the money to particular services, or is the department saying, 'This service gets this much and this service gets this much.'

Dr Morehead : It is done through the 31 PHNs, or the PHNs will give that money out to the headspace services. The PHNs are the ones who commission the headspace services, so they will get the money and it will go through them via a deed of variation.

Senator WATT: There's no money for new headspaces in this is there?

Dr Morehead : No. Not in that particular allocation, no.

Senator WATT: Do you have a list of the existing headspace centres and what the financial impact on each of them will be from this announcement?

Ms Gleeson : We're working on that as the moment. We intend to provide that shortly, as soon as we finish the calculations.

Ms Beauchamp : In a general sense, I think all centres will receive funding. I think it averages out to about eight per cent additional funding for each headspace.

Senator WATT: Is any extra funding that's being provided, whether to headspace overall or to individual centres, going to be contingent on additional services being provided?

Ms Gleeson : No.

Senator WATT: Has any thought been given to that?

Ms Gleeson : The funding is provided for the purpose of centres increasing their capacity to deliver services. It could involve increases to the available workforce, which will support increased service provision.

Senator WATT: Do the PHNs get an equal share of the extra funding?

Ms Edwards : No. A component of the $33 million will go to them just to operationally hand—you know, give this money out to the existing headspace services.

Senator WATT: How is it being decided which PHN gets what?

Ms Gleeson : It's based on the number of centres that currently exist. There are three more due to open shortly. We know the locations of all of those and we will calculate the amount of money per PHN based on the number of centres in their region.

Senator WATT: Each centre, effectively, will get an equal share?

Ms Gleeson : On average, eight per cent. I think it works out to 8.135 per cent.

Senator WATT: Of the overall bucket?

Ms Gleeson : Of the current allocation.

Dr Morehead : Of the 33 million. Added to their—

Senator WATT: So, if one PHN has three headspaces it will get three times as much as a PHN with only one headspace?

Ms Gleeson : It depends on the size of the service. Headspace centres are funded at slightly different levels across the country.

Senator WATT: Depending on the number of people they're servicing and that kind of thing?

Ms Gleeson : Yes, and what round they were established in. For example, a service in Bondi gets about $1 million per year for a grant, whereas there's an outpost service in Devonport that gets $350,000 per year.

Senator WATT: I heard what you said, that you're currently preparing a list of which centre will get what. Can you take that on notice and provide that to the committee when that's finalised?

Dr Morehead : Yes.

Senator WATT: In terms of the process of making this decision, did the department advise the minister that a funding increase to eheadspace was a good idea?

Ms Gleeson : Eheadspace is delivered by headspace national. We knew that the funding agreement was due to expire, so—

Ms Edwards : Senator, we provided lots of advice to the minister about headspace, eheadspace and everything. We wouldn't normally tell you the content of that advice, but it's certainly a topic which we provide advice about regularly, as do stakeholders, who approach the minister or write to us and so on. It's an issue which has been live in the department and among the service.

Senator WATT: When was the final advice provided to the minister about this funding announcement prior to the announcement?

Ms Edwards : We'll have to take that on notice.

Senator WATT: Okay. Who made the decision? Was it just the minister on his own?

Ms Edwards : We got a decision from the minister.

Senator WATT: So, advice was provided to the minister about headspaces and he or his office advised you that the minister wanted to do this? Is that—

Ms Edwards : That's right.

Senator WATT: a phone call from the minister's office or—

Ms Gleeson : We talk about these issues on a regular basis.

Ms Edwards : There'd be some sort of paper trail, but I'm not sure what it was.

Senator WATT: Can you tell me when the decision was actually made to provide this extra funding.

Ms Edwards : Well, we wouldn't normally disclose the to and froing of advice. You know the date it was announced. It was a decision by the minister. It was communicated to us. We're not aware of whether the minister talked to anybody else.

Senator WATT: You can tell us the date that a decision was made.

Ms Beauchamp : We'll take that on notice. I haven't got it in front of me.

Senator WATT: Do you know if it was very long before the announcement was made?

Senator McKenzie: I think the officials have taken it on notice.

Senator WATT: I know, but that's the precise date. I'm just asking in general terms.

Ms Edwards : I'm not sure exactly how it happened. We'll have to take it on notice for you.

Senator WATT: Was headspace national consulted about this decision prior to it being made?

Ms Gleeson : Yes, they were.

Senator WATT: When, roughly, were they consulted?

Ms Gleeson : We've been consulting with them over a number of months in regard to issues relating to demand, waiting lists and workforce. Prior to the announcement, we let them know that the announcement was proceeding.

Senator WATT: We've only got one other mental health topic. Is it convenient for us to knock that over and for Senator Siewert to keep going on mental health after that.

CHAIR: Yes. As long as you're within time.

Senator SINGH: I want to go to some of the mental health data issues in relation to the survey of health and wellbeing. Can the department confirm there are currently gaps in nationally consistent mental health data? Is that correct?

Ms Gleeson : I don't know that I would characterise it as gaps. The AIHW provide a number of data across mental health. We collect PHN data through a minimum data set. The survey of adult mental health and wellbeing was conducted by the ABS in 2007. There's also a survey of young people called young minds matter, which was conducted, I think, in around 2011 or 2012.

Senator SINGH: You don't think there are gaps?

Ms Gleeson : I'm not sure what sort of gap you'd be referring to.

Ms Edwards : We think we need to continuously improve it. Data generally across health is something we're on. Yes, there is a way to go to have better data. As Ms Gleeson says, whether there are gaps gives an impression there's a particular—we think we can do better, and we're working on it.

Senator SINGH: As you know, there have been two national mental health surveys for the adult population by the ABS. The first was in 1997 and the second was in 2007. The AIHW has stated the need for the survey to proceed. You would think it's fairly overdue in that sense, of looking at those two dates. What are the reasons that the survey still has not gone ahead?

Dr Morehead : Each portfolio agency, of course, would love there to be more data. We all make calls on the ABS and wish that they would do our particular subject matter and have more data. It has been a long time, since 2007, for that. There are some other ABS surveys that can gather some information on mental health, but there is no decision of government at this stage to do another survey.

Senator SINGH: Isn't there? Okay.

Dr Morehead : To do another ABS survey.

Senator SINGH: Because it's, kind of, a year late if you look at those dates. There should have been one in 2017.

Dr Morehead : Yes. You can look on the ABS site and see what surveys they run and when they're coming out, and there isn't another one booked in.

Senator SINGH: Are you in correspondence with the minister about this? I mean, there lies the gap. I think that's the answer, really, to the first question. What kind of correspondence are you engaged in with the minister or the ABS on this?

Ms Gleeson : Nothing that I'm aware of at the moment, Senator. I guess I would make the comment that, while those two surveys were 10 years apart, they weren't established to occur on a regular basis. Surveys are very expensive, and so no decision has been taken to do another one 10 years after the last one.

Senator SINGH: The Department of Health hasn't done any kind of scoping on this survey?

Ms Edwards : I think we're going into what the ABS program of work is. We, of course, would love to have more data. As Dr Morehead says, all agencies are always asking the ABS to run lots of things. It's a matter for them. You really have to direct the questions about their programming and scheduling to the ABS.

Senator SINGH: I asked whether the Department of Health has done any scoping on this survey.

Ms Edwards : Scoping of what the ABS should do?

Senator SINGH: Yes.

Ms Edwards : No.

Dr Morehead : We do meet with the ABS and discuss with them various pieces of data. We might say to them, 'In one of your household surveys or the census data, for example, we could look at that.' There's a lot of call, for example, on the next census. A lot of portfolio agencies are now saying, 'Could you please put in one question on something or other.' Obviously, we would love them to have a mental health question there, but these are all matters for the ABS as to what to decide on. There has not been a decision by our portfolio to fund the ABS to run a specific mental health survey nationally by the ABS.

Senator SINGH: Well, I asked specifically about scoping. I think, Ms Edwards, you may want to correct the record, because, in October last year—this time last year—in estimates, the department told us that scoping studies were being done to go out to market towards the end of 2017 or early 2018.

Ms Edwards : I'm happy to be corrected. I'm not aware of any.

Dr Morehead : We have consultations with the ABS. I can state quite categorically that we are not planning to fund a survey by the ABS on mental health at the moment.

Senator SINGH: Right, because I understand you were talking about funding it this time last year.

Ms Edwards : I think the ABS would scope its own studies, which was the point of my answer, rather than us doing it for them. We can take on notice what was said previously by other officers. Perhaps they know stuff we don't know. We're happy to take that on notice and correct it if needed. We'd have to go back and have a look.

Ms Beauchamp : The focus of the department is on making sure we've got access to good data across the states and territories and the Commonwealth. There are many people involved in the provision of mental health services, and marrying up NBS data with PHN data and other data from our grants, for example, is a real focus of where we need to put efforts to get better information about mental health.

Senator SINGH: From the answer you gave a year ago, it just sounds like the department, and therefore the government, is now walking away from this survey, and indeed funding it, compared to the answer that was given last year.

Ms Edwards : It would be good to have the reference to what was said now, if you could provide it directly, so we can have a look. Perhaps we need to go and talk to other officers. If I've made an error then I'm happy to correct it, but there's certainly nothing to indicate the government doing anything. It's simply a matter of perhaps we're not aware of things that have happened before. I think the safest thing to do is for us to examine that record, talk to other officers who may have been here previously and come back to you on notice with the position. As far as we're aware at the moment, we do meet with the ABS; we are pushing for extra collection of data. We haven't done scoping of what the ABS might do, but if there's previous work done then we'll dig it out and report back to you.

Senator SINGH: Okay. I know there was a letter that shadow minister Collins sent to the minister on 25 September in relation to the progress of this survey. Are you aware of that? Has the department given any advice to the minister relating to that letter?

Dr Morehead : Yes. If we could, we'll take that on notice. I do know the letter that you are referring to; I just can't find it here in front of me. But I am aware of the letter that you're referring to. So it has come to the department for response, for us to consider the response to that. I'm aware of the correspondence, but if I could take on notice the exact—

Senator SINGH: So it's still in the department's cogs at the moment?

Dr Morehead : Yes, that's right.

Senator SIEWERT: I just want to clarify something around telehealth as it relates to the delivery of mental health services. I'm aware of the change that was made to not require face-to-face any more, and it was announced particularly in relation to services for farmers during the drought. Is that now a permanent change? It won't revert back?

Dr Morehead : Yes; that's correct.

Senator SIEWERT: It is a permanent change?

Dr Morehead : Yes, it is.

Senator SIEWERT: Can I go back to the psychosocial $80 million?

Ms Edwards : Yes.

Senator SIEWERT: As I understand it the states have all now agreed?

Ms Edwards : Yes.

Senator SIEWERT: So what I want to know is: when will the bilaterals be completed with each of the states?

Ms Edwards : I asked exactly this question in anticipation of your question. Apparently we're very close. We would try to have a good answer for you, but certainly in the next week or so we're hopeful that we'll be able to publish. It's taken some effort because we had to get agreement across all the jurisdictions and so on. We'll certainly take it on notice, and I think we can provide you all that very shortly.

Senator SIEWERT: When you say 'take on notice', you mean when they will be published?

Ms Edwards : The bilateral information will be published on soon.

Senator SIEWERT: Okay.

Unidentified speaker: It's today.

Ms Edwards : My notes say by Wednesday, 24 October, which I thought couldn't be right. But my colleague tells me, yes, it is; it's going up.

Senator SIEWERT: That's the second announcement that's been made today. Geez, we should have estimates more often!

Senator McKenzie: And the room groans!

Senator SIEWERT: Well, we seem to get announcements around estimates. It's fantastic. Okay. I haven't checked that area of the website today. They're up on the website. Thank you.

Ms Edwards : So I'm informed.

Senator SIEWERT: Will they also tell me how much each state and territory is receiving and what they're spending it on?

Ms Jarvis : The web page that has gone live today includes the links to what jurisdictions are planning to fund; however, only the Northern Territory and Victoria have provided those links at this stage. As the other departments provide the links, we will publish them as they come through.

Senator SIEWERT: Do they contain the bilaterals themselves?

Ms Jarvis : It contains the clauses of the bilaterals that are common across the jurisdictions.

Senator SIEWERT: So my excitement was premature? It sounds like the common things the states have agreed to have been published, but not what individual states and territories are doing and what they're spending. Is that correct?

Ms Jarvis : We're linking to the jurisdictions' web pages around what they're doing. At this stage, only the Northern Territory and Victoria have provided those links. The others should be coming through shortly.

Senator SIEWERT: Is it anticipated that the variations across the states and territories, what they're doing differently, will eventually be published? What they are doing and have committed to under the bilaterals, is it intended that those variations that aren't common will be published?

Ms Jarvis : The intention is that what they're each doing will be on their own websites, which we will then link to. We won't have a consolidated—

Senator SIEWERT: What's the reason for not putting it on the federal website, given that they're bilaterals with the states and territories?

Ms Jarvis : We'll have to take that on notice.

Senator SIEWERT: Could you take that on notice? Services and communities in the states would quite like to know what is being committed to. Could you take on notice what is the Commonwealth going to do if the states don't publish it?

Ms Jarvis : Sure.

Senator SIEWERT: Thank you. Can I go back to the front door process?

Ms Edwards : Before we go there, I'd like to go back to Senator Singh's questions. I have a question on notice—

Senator SINGH: I have the Hansard for you as well.

Ms Edwards : In the Hansard, Ms Cole apparently referred, in oral testimony, to some 'scoping studies'. A QON was then put in that clarified the position, which said that the department was undertaking work to progress the initial development and design phase of a potential third adult general population national survey of mental health. That is more correct in terms of exactly what we're doing, which is working with the ABS and having some ideas. That sort of explains the discrepancy—that is, we are pressing for better data across the ABS, AIHW and so on, but we wouldn't scope that sort of thing in a technical sense. That's SQ18-000793. You might want to look at that. We'll still take on notice what we did before, but I just wanted to clear up that it's not as unclear as I had feared.

Senator SINGH: I haven't got that QON in front of me, but I think the exchange between Senator O'Neill and Ms Cole, specifically about the ABS—they were talking about the ABS survey—was around whether it would go ahead. Was there a guarantee about it going ahead? And Ms Cole said last year it took two years.

Ms Edwards : I appreciate that, but I just wanted the context that there actually was a follow-up QON that went to it. It's a bit clearer that it was more a, 'We're looking at it, but there's no decision at the moment about whether such a survey would go ahead.'

Dr Morehead : As I was saying, we do consult with the ABS quite regularly. Like other departments, obviously the department would like to have a survey on its topic, because we love to have more data. We do talk to the ABS about it; we do talk about ways that we could collect more mental health data. It is something that we discuss with them fairly regularly. As I said, there has been no decision by the health portfolio to fund the ABS to do another survey. That's the status of where it is at the moment.

Senator SINGH: But it is funded by the health portfolio, isn't it?

Dr Morehead : The ABS itself funds only a few core surveys. If other portfolios do want surveys to be done, they provide the money to the ABS to run further surveys. So the work of the ABS is its core surveys—

Senator SINGH: We're talking about this survey; I'm not talking about any other survey, but this survey.

Dr Morehead : We would need to fund the ABS to do it.

Senator SINGH: Yes, that's the evidence that was provided a year ago by Ms Cole.

Dr Morehead : Yes. A decision has not been made by the health department or the portfolio to fund the ABS to do that survey, but we do consult regularly with the ABS to talk about what we could do to get more data on mental health.

Senator SINGH: Who makes that decision?

Dr Morehead : That's a decision for government.

Senator SINGH: For the minister?

Dr Morehead : Yes.

Senator SINGH: Have you given any advice to the minister on the basis of making that decision?

Dr Morehead : The minister's office would know that we consult with the ABS, I presume. We would talk about—

Senator SINGH: Don't try to find a way to answer the question if you don't want to. I'm just trying to understand. There is a gap now in the data. We had 1997; we had 2007; we should have had 2017, but we don't. Nevertheless, we are trying to ascertain whether this mental health survey is going to happen in the forward years. Is the money allocated in the forward estimates for it?

Dr Morehead : No.

Ms Edwards : At this point there is no decision to have a survey. I want to clarify that what was said in testimony actually was followed up. It was looked at in context. We will come back to you, as we said we would, on notice.

Senator SIEWERT: I want to clarify a question in relation to whether I should ask it here or later. It relates to mental health and it relates to GPs. One of the issues that we've heard—we've been on the road with the rural, regional and remote mental health inquiry—is GPs actually refusing to deal with mental health. If you look at the General Practice: Health of the Nation 2018 report, they report mental health as one of the main reasons people go see your GP. I'm sure you're aware of that. Should we be asking questions around some of the payments here, in terms of indexation, or take that—

Ms Edwards : If it's about MBS items, it probably should be—

Senator SIEWERT: And GPs.

Ms Edwards : What we'll do, just in case you get to that thing and there are some questions that are asked, we will keep monitoring and make sure we can come and answer if needed at that point. I expect those questions to be primarily for outcome 4.

Senator SIEWERT: That's what I thought you'd say. I wanted to make sure someone was around just in case, so that I'm not being told later on that I should have asked it here. Also, your area of expertise is mental health.

Ms Edwards : Absolutely. Perhaps if you ask it early on in that outcome we can make sure we have the right people.

Senator SIEWERT: I take that on board. Have you had discussions with that area in terms of the issue and how it's playing out and the way GPs are able to address mental health?

Ms Edwards : We work with them very closely on any issue that comes up in relation to MBS scheduling that affects mental health—that and many other issues. Yes.

Senator SIEWERT: I will leave it there. I want to go back to the PHNs' front door. Has there been additional funding provided to the PHNs for the front door?

Ms Edwards : Yes. There has.

Senator SIEWERT: How much is that?

Ms Edwards : It's $19.1 million in this financial year only.

Senator SIEWERT: It's just a 2018-19 initiative?

Ms Edwards : It's an injection to help them set up arrangements.

Senator SIEWERT: Can you point me somewhere where I can go and find out more detail about it?

Ms Edwards : I can tell you a bit about it. It's support for establishment of the continuity of support arrangements—obviously PIR, Day to Day Living and PHaMs. It's also to strengthen the interface between the mainstream service system and the NDIS. It's that idea that you can turn up wherever and be directed to the right place. We are still working out the detail of it. I think there's a workshop in early November where we're getting in the PHNs and the sector to talk about how we do that best.

Senator SIEWERT: Obviously I'm going to be asking NDIA tomorrow, but I'm struggling to understand where it fits in with the new LAC process, the new path or the new psychosocial stream—the new process of planning and people being put in the local area coordinator offices.

Ms Edwards : You should follow this up with DSS tomorrow, but my understanding is that it is primarily about the fact that PHNs obviously have a whole stack of new functions, both the continuity of support functions and the psychosocial functions. They are also getting people who will be new clients, where rather than sticking them straight into a psychosocial program, you might say, 'You should knock on the door of the NDIA and check whether you're eligible for a package.' It's to cater for that interface. We're aware that when funding starts on that day, we want them to be streamlined and assisted. It's to do that sort of thing. It's primarily in relation to the psychosocial, the continuity of support, but we're making sure we have a way for clients to move back and forth between the NDIS and our one. We'll have to come back to you on the exact detail of that. It is still being worked out.

Senator SIEWERT: PHNs aren't supposed to be service providers.

Ms Edwards : No.

Senator SIEWERT: It sounds like a service to me. How do I find a service? I don't want to say—

Ms Edwards : PHNs do do quite a lot of things themselves in terms of providing support and so on. Some of them do provide services. This is about how we make that work best.

Senator SIEWERT: Will there be a person or people that do this in the PHNs?

Ms Edwards : There will be activities done in the PHN, yes.

Senator SIEWERT: How do I find my way there? How do I know to go there? Do GPs point me in that direction?

Ms Edwards : I think those pathways are part of the things they're actually designing now.

Senator SINGH: Can I have one follow-up on the surveys? What's the impact of Australia not now having this data, which we've had consistently over a number of decades, going forward, when we are looking at the various range of issues around health and wellbeing, mental health obviously being a really important issue for the country, when we don't have that 2017 or even 2018 data about the current state of Australians living with mental health issues? What's the impact of that?

Dr Morehead : We don't have that national overview picture, but there are various collections of data at lower level. In fact, when we do have a big national picture, you often can't drill right down to the local level. For example, with the drought measures that the government's announced on mental health, there was evidence available on recent surveys and studies that had been done—the University of Newcastle was one—where they had recently done a survey of several hundred farmers in New South Wales and were able to give very specific guidance to us in terms of an evidence base as to what effects drought had on people's mental health. That type of information is found around the country, and that was extremely useful for us in designing the drought measures. I guess it's more that we don't have that big national data collection, but we do have smaller amounts. Funding a gold standard large Australian mental health survey could cost upwards of around $20 million. If you said to the ABS, 'Could you go out and do a great mental health survey?' that's about the quantum of money that you would be looking at.

Senator SINGH: Is that what it cost in 2007?

Dr Morehead : I can get you the costs for 2007 on notice.

Ms Edwards : A survey like that would be rich data, but since the first one we've actually got data from all sorts of other sources.

Senator SINGH: Well, you've had to.

Ms Edwards : We have been building the data asset in all sorts of ways. We would like to have additional surveys. We would like to have a lot of things. But we do have a growing base of data and evidence in relation to mental health, which we are drawing on, which is improving. When we got back to the very beginning, we wouldn't say there are gaps; we would say it's a work in progress and we are continuing to improve data. The survey, while one potential element, is not the be-all and end-all. There is lots of other work going on.

Dr Morehead : Particularly if you want data at the granular, local level, which a lot of our funding is designed to support.

Senator DEAN SMITH: Going to Senator Siewert's point about the government's telehealth initiatives, how has that been received by the sector?

Ms Edwards : It's certainly been used a lot.

Senator DEAN SMITH: That was my second question in regard to uptake. So why don't we start with the uptake question? Then we'll come back to how the sector's responded. Can you give us a sense of the uptake in terms of quantum? Do you have that by geographical dispersion, by chance?

Ms Edwards : Not here today, I don't think. We don't have geographical here, but we do have uptake. Since 1 November 2017, to 31 July 2018 there's been a total of 2,833 services.

Senator DEAN SMITH: Do you have the 2,833 by gender or age breakdown?

Ms Edwards : We would have to take that on notice.

Senator DEAN SMITH: Do you collect that data?

Ms Edwards : We would have to take that on notice.

Senator DEAN SMITH: On eating disorders, I thought I had read somewhere that matters around eating disorders had received significant investment.

Ms Beauchamp : The minister's made a number of announcements around eating disorders. Some of those include a trial in southern Queensland of a new model of care. I think $3.26 million was provided for that. I think the government has also committed $1.5 million to establish endED Butterfly House, Australia's first residential eating disorder treatment facility. That's on top of $3 million provided to the national helpline, ED HOPE, and $2.7 million provided to the National Eating Disorders Collaboration initiative—the NEDC.

Senator DEAN SMITH: The name of the residential facility is—

Ms Beauchamp : endED Butterfly House. There's been a lot of work happening under the MBS review taskforce as well looking at investigating Medicare coverage for treatment needs of those with an eating disorder.

Senator SINGH: I want to come back to national action plans from this morning. I won't go through all the national action plans, because we would be here all day, but to recap, I listed 10 and then I was given women's health, men's health, cardiovascular and stroke diseases as extras. I understand you're preparing three additional national action plans over and above those, in the Indigenous health space. Is that correct?

Dr Studdert : We will just have to get ourselves organised, because they will be with our Indigenous health colleagues.

Senator SINGH: This is still national action plans.

Dr Studdert : Yes. In the population health and prevention and chronic disease space, there is the list you referred to this morning. I can take you through that and make sure you have the full list. But the ones in Indigenous health would be in addition to those, and we would need our colleagues.

Senator SINGH: It's in the same area—2.4.

Dr Studdert : No, it would be on Friday, in cross-portfolio Indigenous matters.

Senator SINGH: We will leave those for now then. I now have the full list from this morning.

Dr Studdert : I just want to make sure I have given you that correctly.

Senator SINGH: I mentioned 10, and you mentioned three extras. That's 13.

Dr Studdert : I think there's another one that we identified. Should I just run through them quickly to make sure you have got them?

Senator SINGH: No, to save time. There are 14?

Dr Studdert : Yes.

Senator SINGH: There is obviously one missing, though. Women's health and men's health, cardiovascular and stroke. Is that one—cardiovascular and stroke together?

Ms Soper : Yes.

Senator SINGH: There must be one more.

Ms Soper : Why don't you go through them?

Dr Studdert : Okay. Arthritis, childhood heart disease—

Senator SINGH: That's it—arthritis. I didn't have arthritis listed. So that's 14 national action plans announced in just 18 months.

Dr Studdert : Work on them is underway, and it's at various stages. Endometriosis, as you're probably aware, has been finalised and launched by the minister. Then there are others at various stages of development.

Senator SINGH: But there have been 14 national action plans announced in 18 months?

Dr Studdert : Or it has been announced that there is intention to work on them, yes.

Senator SINGH: Okay. Why has there been such a sudden flurry of announcements of national action plans?

Dr Studdert : As you would be aware, last year the government and the department finalised the National Strategic Framework for Chronic Conditions, and that was the outcome of a long and detailed piece of work with the states and territories and endorsed by COAG. Since then, we've been working with a range of stakeholders, who have identified ways they want to take forward priority actions that fall under that framework. These action plans, which are very targeted, tight pieces of work and are specific to specific conditions, have been taken on as something that the government is supporting the development of.

Senator SINGH: So is this something the department has been driving, or is it the minister?

Dr Studdert : As with all our work, it's done in consultation, but ultimately it's the minister's decision to commit those resources.

Senator SINGH: The minister wanted to announce 14 national action plans in 18 months?

Ms Beauchamp : It's been a way of bringing stakeholders together and getting alignment around developing action plans for the future on specific disease areas.

Senator SINGH: Okay. Thank you for the speech. What, then, is a national action plan?

Ms Beauchamp : I think it's looking at a work program and what we do collectively to address these key priority areas of disease.

Dr Studdert : It includes things like research.

Senator SINGH: Is that the agreed definition in the department—that it's a work program?

Dr Studdert : It's priority areas for action and investment. Not all of them are for the Commonwealth to take forward. Some of them are for clinicians to take forward. Some of them are for the states and territories. Some of them are for the advocacy groups. But it's getting everyone on the same page with a set of priorities that will advance the outcomes for patients and consumers in terms of those particular conditions. In the case of, for example, the endometriosis plan, I think that's done an enormous amount to bring attention to that condition; to have consumer voices heard, which has not often been the case to date; and to enable consumers, clinicians and researchers to agree on a way forward that will seek to improve those outcomes.

Senator SINGH: Do you anticipate that any of these national action plans will be completed before the next election, in May—if the election is in May?

Dr Studdert : I think quite a number of them will. I could go through them individually and tell you where they're up to. But, as I said, they're at various stages of development. I don't know if my colleagues can identify which ones would be finished in the coming months.

Senator SINGH: I'm happy for you to take it on notice, because there are obviously 14 of them and it will take a while to go through each one.

Dr Studdert : Yes, we'd be happy to provide you with that information.

Senator SINGH: Perhaps just some sort of table with the 14 and where each of them is up to, the dates they will be finalised and those sorts of things.

Ms Flynn : They're all due to be completed this financial year. Approximately half of them are due to be completed by December and the other half early next year, in February-March.

Senator SINGH: Okay. I just want to know: how do sufferers of these diseases actually benefit from a national action plan? Is that a bit philosophical? You're saying it's a work program for the department.

Dr Studdert : Overall, I would posit that the overarching objective of each of them is to improve outcomes for those people that are affected by the conditions or to prevent the conditions in the first place, as would be the case, say, with the cardiovascular, heart and stroke action plan.

Senator SINGH: But what about people that already have these diseases?

Dr Studdert : Yes. Again, using the example of endometriosis, consumers—and by that I mean people who are affected and suffer from the condition—are absolutely front and centre in the development of that, and their voice is what is taken as paramount in terms of understanding how to take action that will improve outcomes for them. So, absolutely, that is the key objective.

Senator SINGH: What about the funding for these 14 national action plans?

Dr Studdert : I think those will be taken on a case-by-case basis, and it depends on what the priorities are and who they fall to best taking responsibility for implementing.

Senator SINGH: Is their funding in the delivery of these?

Dr Studdert : There is funding in the portfolio for chronic disease prevention.

Senator SINGH: Is that a yes?

Dr Studdert : Yes.

Ms Beauchamp : There is funding for development of each of the action plans. In terms of the work program and outcomes from each of the action plans, it may be a reprioritisation of existing funding or better targeting of existing funding—not just at the Commonwealth level but also from the states and territories and other funders in the system around these particular areas.

Senator SINGH: There's no allocated Department of Health funding?

Ms Beauchamp : There's allocated money for some of the diseases, endometriosis being one of them, that have been focused on in terms of the action plans. There has been money allocated for the development of the action plans. This is to provide much better coordination with all the players in the area and a national approach.

Senator SINGH: You seep saying 'existing funding'. There's no new funding. You've had 14 national action plans announced in 18 months. I'm trying to find out whether there is new money associated with these, or have these just been hollow announcements by Minister Hunt?

Ms Beauchamp : As Ms Flynn mentioned, we're looking at finalising those action plans over the next six to 12 months and looking at what the actions might be out of that—to then go back either to government or key stakeholders in terms of delivering on these work plans.

Senator SINGH: Right, so no new funding. I note your comment before, I think Dr Studdert, to do with the Indigenous Health Division being here on Friday. That, as you know, only goes for one hour. I think that you should be able to answer these questions to do with these national action plans for Indigenous health now.

Dr Studdert : That's a different program area, and the staff that are responsible for that aren't here. I would be happy to talk to my colleagues and ensure that the staff are absolutely ready to deal with that.

Ms Beauchamp : Are there any particular areas you're looking at?

Senator SINGH: Yes, there are. I wanted to ask specifically around ear health, rheumatic heart disease and suicide.

Ms Edwards : It might be helpful for everyone to have a little bit in advance of Friday, when the Indigenous folk are here. There's the implementation plan in relation to the National Aboriginal and Torres Strait Islander Health Plan, which our big national plan. We don't have national action plans so-called, necessarily, in the same way, which is why we want to talk to the team a bit about it. But we do have in development what we're calling road maps in relation to rheumatic heart disease, renal, ear health and eye health—I think they're the ones, and they're in development now. We would be able to either take that on notice or answer it on Friday, if there's time, to tell you exactly where those are up to, but they're in development through Minister Wyatt. From speaking to my colleague on the phone just now, there might be other less significant—important issues to the people, I'm sure—action plans that are also around that we were going to dig out by Friday to check we had a comprehensive list. But the key ones are those four road maps.

Senator SINGH: On Friday, if you could give us the time frame for the delivery of those.

Ms Edwards : Of the four road maps, yes.

Senator SINGH: Yes, on those four road maps. What's the difference between a road map and a national action plan?

Ms Edwards : Documents often are put together in a different way, depending on the stakeholders. This is something that's being developed in collaboration with Indigenous stakeholders and other experts in the field—and that's the way it's been described, and they're moving forward with it. It will no doubt include actions, which is the key point of it.

Senator SINGH: So road maps include actions, but they're not a national action plan—and a national action plan is a work program? I'm just trying to get the definitions right.

Ms Beauchamp : There's probably not much difference.

Senator SINGH: Yes, there's probably not much difference, okay.

Ms Beauchamp : In terms of outcomes and actions, and getting key stakeholders together, there's probably not much difference.

Ms Edwards : I'm not privy to what's in the national action plans. But the road maps are about—

Dr Studdert : To a large extent, we've tried to be responsive to stakeholders and what their terminology and interests have been.

Senator SINGH: Do road maps have new funding attached to them? The national action plans don't.

Ms Edwards : The road maps are in development, and so it will depend. If we're talking about renal and RHD, you would know there's significant investments connected with those, and the road maps would help guide how we roll those out—same with eyes and ears, in fact. There are big commitments about these; we're working with stakeholders to develop a road map, which is a way of making sure the investment is actually targeted in the way that's agreed to be the best way to tackle these really difficult issues.

Dr Studdert : If I could just be clear, it's not to say there isn't money. The plans are being, as I said, dealt with case by case. In the case of endometriosis—

Senator SINGH: That's the only one you seem to be talking about.

Dr Studdert : That's the only one that's been finalised and launched.

Senator SINGH: There are 14 of them.

Dr Studdert : And there are others coming. There has been funding allocated to that, and I think the government is minded to look at each of them on a case-by-case basis and to determine—

Senator SINGH: But you will take it on notice?

Dr Studdert : Yes.

Senator SINGH: Thanks.

Dr Studdert : You asked for the dates by which they would be finalised?

Senator SINGH: Correct, and the funding as well.

Dr Studdert : To the extent that any have been finalised and decisions have been made about funding, absolutely, yes.

Senator WATT: Can I move to a different topic in outcome 2, which is the National Cancer Screening Register?

Dr Studdert : Yes.

Senator WATT: Thank you for coming today. I assume you are aware of the recent report from the Joint Committee of Public Accounts and Audit on the National Cancer Screening Register.

Dr Studdert : Yes.

Senator WATT: It is a pretty scathing report, I think you'd agree.

Dr Studdert : It certainly has a lot of advice for us.

Senator WATT: It does. What was notable to me—not being a member of the committee— was that it was a unanimous report.

Senator DEAN SMITH: No, that's not a correct characterisation.

Senator WATT: Isn't it?

Senator DEAN SMITH: I'm the chairman of that committee. The committee made a report, and Labor members of the committee made some additional comments. The additional comments are not unanimous. They were additional comments.

Senator WATT: Okay. I stand corrected.

Senator DEAN SMITH: You do.

Senator WATT: But there was a bipartisan report separate to the additional comments?

Senator DEAN SMITH: Yes. When you're asking your question, you might want to assist officials by drawing a distinction between what is in the part of the report that is agreed by the whole committee and the elements that are additional comments from Labor members of the committee.

Senator WATT: Okay.

Senator McKenzie: Thank you, Senator.

Senator WATT: My understanding is that the recommendations I'm going to be referring to are bipartisan recommendations, but I'm sure Senator Smith will help us out if that's not the case.

Senator DEAN SMITH: I will be the first to correct you if that's necessary.

Senator WATT: I'm sure you will, Senator Smith.

Senator DEAN SMITH: The second after officials!

Senator WATT: Have you had an opportunity to review those recommendations?

Dr Studdert : Yes.

Senator WATT: Do you accept those recommendations?

Dr Studdert : I think that will be a matter for government, ultimately, but we are certainly considering them carefully and preparing responses. We are considering what the responses will look like and, in some cases, would probably like to add additional information, noting that some time has lapsed since those recommendations were drafted, and quite a lot of progress has been made in that time.

Senator WATT: You will have noted that the recommendations were, if you like, addressed to the Department of Health, not to the minister. So they have been made for the department to consider. That's why I'm asking whether the department accepts them.

Ms Beauchamp : There are some recommendations that were made in the JCPAA report that obviously reflect on the prior ANAO report. Of course, once that ANAO report was provided, we did take actions, for example, around conflicts of interest—so making sure all our senior executive leadership team have filled out and declared conflicts of interests. So that was one area. Another area we've looked at is the risk profile and how we manage risk projects. That came out of the ANAO report, even though we only got one recommendation in the ANAO report. So there are certain learnings and things we have done already as a department following up on the prior ANAO report.

Senator WATT: When do you expect to be able to respond to these recommendations?

Ms Beauchamp : They are currently under consideration, and we will respond to them in the normal way that we respond to JCPAA reports.

Senator WATT: Many of the issues are things that have been raised. This has got to be my sixth hearing where I have been raising concerns about this.

Dr Studdert : And I would note that at each hearing we've been able to give you an update that shows there has been progress and there have been significant developments in implementing the register and the new HPV screening program. So I think we do progress.

Senator WATT: Okay. Turning to specific recommendations, recommendation 11, which I understand was a bipartisan recommendation, was:

… the Department of Health give consideration and report back to the Committee on:

whether, in the circumstances of such serious underperformance by Telstra Health, it may be in the Commonwealth’s interests to terminate the contract and pursue other options for either or both registers—

being cervical and bowel cancer. Do you accept the recommendation that you should reconsider the contract?

Mr Boyley : To answer that recommendation, it's important to consider where the project is up to at the moment. The short answer is that it's not my position that it's in the department's interests or the public's interests to terminate the contract currently, and I'll—

Senator WATT: It's not in the interests?

Mr Boyley : No, and I'll explain why. To explain why, it's important to understand where the project is up to today. We have had a live cervical cancer screening component of the register, since 2 July. We have migrated over 10 million cervical screening records from the eight separate state and territory registers into one register. We've been able to discover that 20 per cent of those records were duplicates, meaning that one in five of the participant records held in state and territory registers in each disparate system prior were, in fact, duplicates. That means that, when certain women attended to have screening services taken, they, in 20 per cent of the cases, did not having complete records for pathology diagnosis processes that occur after that. We have had an active call centre since 2 July that's taking an average of 817 calls per week.

Senator WATT: Mr Boyler, just in the interests of time, it looks like you're reading from something. It would be really valuable to get an update, but could I suggest you table that rather than go through it so that I can stick to some questions about the contract itself?

Mr Boyley : Senator, I'd be happy to table this document—not the entire document, but an update. Suffice to say, there's been significant delivery since the JCPAA hearings themselves, and the report recommendations don't take that into account, of course, because they weren't aware of it. It would not be in the interests of certainly the Commonwealth or the screening public, in my view, to terminate the contract at this stage, because of substantial delivery and we're on track. We have bowel screening register dates that I'm happy to share with the committee today, if you'd like those, or I can include them as part of the update. What I'm saying is that the position since March and April, when the committee met, to today is significantly different to where it was.

CHAIR: Senator Watt, we need to move to Senator Di Natale.

Senator WATT: Senator Gichuhi, I've only just started questions on this topic. Am I going to be able to resume that?

CHAIR: I'm not sure. We need to finish this at the latest 5.50, so I need to give them a bit of time.

Senator WATT: With respect, there are three senators who rolled in here 20 minutes before the end of this section.

Senator DI NATALE: Hang on, I've been here for—

Senator WATT: You've been in and out, admittedly.

Senator DEAN SMITH: To be fair, they had foreshadowed their interest in this outcome prior to today's Senate estimates, which is part of the—

Senator WATT: I understand that, but—

Senator DEAN SMITH: It's not just your committee.

Senator WATT: I know that, but three people rolled in with 20 minutes to go and expected to run the rest of the program.

Senator RICE: Come on! We came in when the outcome came on.

Senator WATT: If we could go a bit further on outcome 2, that would be a good outcome, but we do need more time here.

CHAIR: As long as we get questions for outcome 3. We can start them at 6 but will finish at 6.30—that is, sports and recreation. That way we'll be able to get 15 extra minutes for outcome 2, in which case I'll go to Senator Di Natale and then we'll get back to you. We'll come back to you when we are finished, but for now we'll go to Senator Di Natale.

Senator DI NATALE: I'm happy for Senator Griff to go first and I'll go on the back of Senator Griff.

CHAIR: In five minute, unless you put them on notice, because we can't accommodate all of them. Did you want to put them on notice?

Senator GRIFF: No, I'm not going to put them on notice.

Senator DI NATALE: That's okay. Senator Di Natale.

Senator GRIFF: How does that work?

Senator DI NATALE: You want me to go?


Senator DI NATALE: I want to ask questions firstly on DrinkWise and prevention. When did discussions with DrinkWise commence to provide funding for their alcohol and pregnancy campaign?

Dr Studdert : So your question was: what date did the discussions start with DrinkWise—

Senator DI NATALE: Yes.

Dr Studdert : about funding for that?

Senator DI NATALE: For their alcohol and pregnancy campaign.

Mr Laffan : I don't have a specific date in relation to conversations that were had with DrinkWise in relation to the funding, but I can tell you that we received an unsolicited proposal from them. I'd have to take on notice the date that was received.

Senator DI NATALE: Tell me about the process for awarding funding to DrinkWise. You got an unsolicited proposal—

Dr Studdert : And then we provide advice to the minister about that, and the decision is made by the minister.

Senator DI NATALE: So there was no tender, no open process, no—

Dr Studdert : Not in this case.

Senator DI NATALE: This is an industry-funded body. They sent you a proposal to run a campaign. And you basically just accepted it, holus-bolus?

Dr Studdert : No. We review the proposal, and, as I said, we provide advice on the basis of the proposal—the evidence that underpins it; the value-for-money proposition—and that is considered by the minister.

Senator DI NATALE: That's pretty remarkable. So the process for what is a very critical public health measure—that is, to run health promotion campaigns, and, obviously, around labelling—was an unsolicited proposal from DrinkWise. The department didn't seek to open, or had not—

Dr Studdert : To give the full picture, there are other unsolicited proposals, including in this space, that we have funded over time.

Senator DI NATALE: Talk me through the process of this specific unsolicited proposal.

Mr Laffan : As Dr Studdert has said, the proposal was received, and advice was provided by the minister, who—

Senator DI NATALE: Can you get the date from one of your officers? That should be available—

Dr Studdert : We can certainly endeavour to do that.

Mr Laffan : We can seek to do that.

Senator DI NATALE: Sorry; continue on. You received the proposal. What happened next?

Mr Laffan : We provided advice to the minister in relation to that proposal, and the minister made a decision on funding in relation to DrinkWise—

Senator DI NATALE: Tell me what—

Mr Laffan : and, at the same time, provided some additional funds to the Foundation for Alcohol Research and Education in relation to the Women Want to Know and Pregnant Pause campaigns.

Senator DI NATALE: Tell me: what were the proposals? What was the proposal from DrinkWise?

Mr Laffan : I don't have the details of the specific proposal here with me—just what the outcome of the minister's decision was.

Dr Studdert : It was an education campaign for GPs' surgeries, wasn't it?

Mr Laffan : Part of it was an education campaign. It was developing some video content, rolled out and integrated with the Red Dust Role Models education program and strong young men program in relation to educating people on FASD, and video media across a thousand regional and remote primary care sites, supplemented by resources for GPs and staff.

Senator DI NATALE: Were other health promotion organisations with perhaps a bit more experience in this space considered, to roll out those programs?

Dr Studdert : I think, as Mr Laffan mentioned, in recent times there has also been money funded to FARE, which also works in this space.

Senator DI NATALE: No, but for this specific initiative—this is a proposal, to roll out a specific intervention, by an industry-funded body; was any consideration given to saying: 'Hang on. On this intervention, we're going to consider opening this up to other people with specific expertise in this area'?

Mr Laffan : As part of the same decision, as mentioned, the Foundation for Alcohol Research and Education were funded to continue their campaigns.

Senator DI NATALE: Separately—that's a separate issue. I'm talking about this proposal from an industry-funded organisation, and you've given them more money.

Dr Studdert : But, to go back to the point I made earlier: where we provide advice to the minister, it will also include advice on what other initiatives in a similar space are funded, and whether this fills a gap that's not currently funded. That's part of the picture that is provided, and the information—

Senator DI NATALE: So can I take it that other health promotion organisations with specific experience weren't considered to roll out this program?

Mr Laffan : There was no decision to fund any additional organisations.

Ms Beauchamp : We would have assessed this proposal on its merits and provided that advice to the minister.

Senator DI NATALE: Is it fair to say that, of the campaign, one of the specific target groups is Aboriginal and Torres Strait Islander peoples?

Mr Laffan : Yes.

Ms Beauchamp : Yes, that's correct.

Senator DI NATALE: For what reasons would you choose to give money to an industry-funded body? The alcohol industry funds DrinkWise. You're giving money to run an intervention targeting Aboriginal communities. Why wouldn't you invest in NACCHO, the Menzies School of Health Research, the Ord Valley Aboriginal partnership, the Telethon Kids Institute, Health Promotion Resources or other organisations who've got a proven track record in this area, rather than giving more money to an industry-funded group with no proven track record in this area?

CHAIR: Senator Di Natale, you're coming to the end of your time.

Senator DI NATALE: I've just started.

CHAIR: I know, but the reality is: it's just five minutes each.

Dr Studdert : Would you like me to—

Senator DI NATALE: Well, it would be nice to have an answer to a question. I'm not saying it's your—

Dr Studdert : I will continue to provide the same advice, which is that, on many occasions, we get unsolicited proposals, and we provide advice to the minister.

Senator DI NATALE: So if I write to you and say, 'Give me some money because I want to run a program in an Aboriginal community,' you don't think, 'Perhaps we might give that money to somebody with a proven track record of doing it'?

Dr Studdert : That would be part of the advice that we would provide—who else is working in this space, what the other programs are and what the opportunities are.

Senator DI NATALE: So would you suggest there are other bodies that are more suitable to running or to implementing a program like this?

Dr Studdert : I couldn't say that right here and now because I don't have that information at hand.

Senator DI NATALE: Mr Laffan?

Mr Laffan : As part of the approval process, there is a clause in the contract with DrinkWise which requires that all resources developed under that funding agreement are reviewed for clinical accuracy prior to the department's approval.

Senator DI NATALE: What consultation was undertaken with Aboriginal and Torres Strait Islander peoples in the development of this resource?

Dr Studdert : That would've been part of the agreement with the organisation in developing the proposals.

Senator DI NATALE: I'm asking specifically: given that you've given money to an alcohol-funded industry group to work on interventions in Aboriginal communities, what consultation took place?

Dr Studdert : We would put it to the organisation that they would, in developing the materials and the program, work with—

Senator DI NATALE: Did they provide that as part of the proposal?

Dr Studdert : It would've been part of their proposal, I would expect, but I'd be happy to check.

Senator DI NATALE: I wouldn't expect you to give money to an industry group in this way, so just to say that you 'expect' this is what happened is not good enough. Did it happen?

Dr Studdert : I would be happy to take that on notice and get you some further advice.

Senator DI NATALE: In 2018, DrinkWise had to recall a national campaign from GPs' surgeries after groups such as the AMA and the Foundation for Alcohol Research and Education raised concerns that the campaign was misleading. Is that the sort of track record that an organisation has to have for you to be able to fund it?

Dr Studdert : That's an opinion, Senator. I don't—

Senator DI NATALE: Well, I'm asking—

Senator McKenzie: You're asking the official for an opinion. That is her answer, Senator Di Natale.

Senator DI NATALE: No, hang on. You're saying that this was an unsolicited proposal from an industry-funded lobby group. They have a track record of running misleading campaigns—so much so that posters put up in GPs' surgeries had to be recalled. And you've given them more funding?

Ms Beauchamp : We said we'd take the issue on notice. The proposal would have been assessed on its merits, and we would have provided advice to the minister, and the government has decided to fund the proposal that was provided to us.

Senator DI NATALE: Did you provide the minister with evidence—or perhaps I'll rephrase that, because you're unlikely to tell me what you've told the minister. Was the provision of dangerous health advice raised with DrinkWise prior to awarding them a quarter of a million dollars of public money?

Dr Studdert : I think, as Mr Laffan explained, it was required of them in the funding agreement that all the information that was going to be used had to be reviewed and shown to be clinically sound, and that was the agreement—that we had to review it and sign off on it before it was released.

Senator DI NATALE: They'd run a misleading campaign. The AMA said it was 'fundamentally incorrect'. We had to withdraw posters from surgeries. How does that recommend an organisation to get more government funding?

Mr Laffan : I think it's also worth noting here that the criticism in the media for the projects for those posters happened on 28 August and the funding for DrinkWise was provided prior to that.

Senator DI NATALE: The campaign was running well before the funding was withdrawn. Do you agree with that? The issue was raised well before 28 August.

Mr Laffan : Sorry, Senator—

Dr Studdert : I think we would have to take it on notice to review the time line of events there.

CHAIR: May I ask at this point, what other funding has previously been provided to DrinkWise by previous governments?

Mr Laffan : Previous funding for DrinkWise: in 2012 the Australian government contributed $600,000 for point-of-sale education material to highlight the message that it's safest not to drink while pregnant as a one-off grant. Between 2002 and 2006 the Australian government contributed $5 million to DrinkWise to develop alcohol education programs, in particular the Kids Absorb Your Drinking campaign.

Senator SINGH: I want to ask about this Roundup glyphosate situation. You're aware of the court case in the US that's triggered concerns about glyphosate as carcinogenic. I understand the food standards code—

Senator DI NATALE: Sorry, that's not here. That's FSANZ. We're doing prevention now, is that right?

Senator SINGH: It's 2.4.

Senator McKenzie: FSANZ is within the prevention, outcome 2—

Senator SINGH: Yes, it's prevention—

Senator DI NATALE: No—

Senator SINGH: It's in 2.4.

Senator DI NATALE: We were on preventive health and chronic disease sport. I thought we were leaving the FSANZ questions until later?

Senator SINGH: You keep going then, Senator Di Natale.

Senator DI NATALE: I think Senator Griff had some questions.

Senator GRIFF: Okay, I'll go. I'd like to ask questions about the National FASD Strategy 2018 - 2028, which is kind of an interesting name for a strategy when the consultation on the updated strategy concluded last year and no further information has since been released. Given we're nearer the end of 2018, when will the National FASD Strategy 2018 - 28 be finalised?

Mr Laffan : The FASD strategic action plan has been through, as you say, the consultation and other stages of development and is currently being considered by the Ministerial Drug and Alcohol Forum out of session. We hope that that FASD strategic action plan is finalised very soon.

Senator GRIFF: It concluded last year. I know certain things are out of your control, but it is a strategy for the years 2018-28, so how long is soon do you anticipate?

Mr Laffan : Of course it's up for a decision for the ministers that form part of that forum. But we would anticipate that it would be out in 2018.

Dr Studdert : I think that's a commitment they've made in previous communiques from their meetings that that was their intention.

Senator GRIFF: Are you aware if the national action plan will incorporate any of the 19 recommendations from the 2012 House of Representatives inquiry into FASD?

Mr Laffan : Certainly, the work from the 2012 inquiry's ongoing. There was an action plan that was a budget measure in 2013 in relation to FASD that picked up a lot of those recommendations. That work continued through the budget measure that was announced by government in 2016, and I would see the FASD strategic action plan as the next step in advancing that work.

Senator GRIFF: Has any new funding been attached to the delivery of the strategy?

Mr Laffan : Not at this time.

Senator GRIFF: But you believe—

Dr Studdert : You would anticipate funding to be made in the process of finalising the strategy and releasing it and that would be a matter for all governments not just federal.

Senator GRIFF: In the interests of time I'm going to skip around a couple of areas. I have a couple of questions in relation to vaping. Has there been any research undertaken to look at whether vaping by young adults is a gateway to smoking tobacco?

Dr Studdert : I believe there's a very active body of research on this, and I'm sure my colleague can talk a bit about some of the more recent pieces of research, including quite a significant piece done by the CSIRO. And, yes, certainly the impact on young people and the risk to young people is one that's a very active consideration.

Mr Laffan : In relation to the CSIRO, just as a summary, they said that evidence consistently suggests that the use of e-cigarettes by non-smoking youth predicts future smoking. Another piece of evidence from the United States National Academies of Sciences, Engineering, and Medicine that was released in January 2018 concluded that there was substantial evidence that e-cigarette use increases the risk of ever using combustible tobacco cigarettes among youth and young adults, and moderate evidence that e-cigarette use increases the frequency and intensity of subsequent combustible tobacco cigarette smoking.

Senator GRIFF: Is there any health based regulation in Australia on the flavour compounds permitted to be used in vaping products?

Mr Laffan : Not specifically in relation to e-cigarettes, no.

Senator GRIFF: So there aren't any restrictions at all on the flavour compounds that can be used in any form of vaping product?

Mr Laffan : No. The restrictions are in relation to scheduling of nicotine.

Senator GRIFF: Is the department planning on commissioning any research into the possible harms of flavoured compounds in vaping?

Mr Laffan : That was one of the recommendations of a Senate committee I think recently—that the Australian government establish a regulatory process for assessing and, if necessary, restricting colourings and flavourings used in electronic cigarettes. The department is currently preparing the response for government's consideration there.

Senator GRIFF: That's all I have for 2.4.

CHAIR: We will go to Senator Rice on food standards, then Senator Waters on food standards. Then we will come back to Senator Leyonhjelm and Senator Singh. Hopefully we'll be done by 6.15.