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Tuesday, 19 August 1980
Page: 149

1978-79

Actual

1979-80

Actual

1980-81

Estimate

Change

S million $ million $ million

S million

Medical Services and Benefits - Medical Benefits . Diagnostic Services Veterans and Dependants

528.9 18.4 57.8

621.0 20.4 71.5

681.0 22.5 80.6

+ 60.0 + 2.2 + 9.1

Total

605.1

712.9

784.1 + 71.2

Eligibility for Pensioner Health Benefit (PHB) Cards

Subject to an income test limit of $40 a week for a single person or $68 a week for a married couple (the limits are higher where there are children), a person in receipt of one of the following pensions, benefits or allowances is eligible to receive a PHB Card: age, invalid, widow's and service pensions, supporting parent's benefit, and sheltered employment and rehabilitation training allowances. Tuberculosis allowees are also eligible for PHB Cards.

Holders of PHB Cards and their dependants are entitled to the following Commonwealth 'health' benefits without charge: the provision, with the agreement of doctors, of Schedule medical services (see under "Medical Benefits"), Schedule optometrical services, pharmaceutical benefits, and hearing aids and batteries (provided by the National Acoustic Laboratories).

Currently, a disability pension paid to a veteran is regarded as income for the purposes of the PHB income test. The Government has decided that, from 1 January 1981, 50 per cent of any disability pension- received by a service pensioner will be excluded from the PHB income test. This extension of eligibility is estimated to add $0.4 million to outlays by the Department of Health in 1980-81 and $1.0 million in a full year and $2.5 million to outlays by the Department of Veterans' Affairs in 1980-81 and $3.8 million in a full year.

The Government has decided also that from November 1980 eligibility for PHB Cards will be extended in appropriate cases to sickness beneficiaries who meet the income test limit.

The extension of supporting parent's benefit to cover the first six months of sole parenthood is estimated to add $3.1 million in 1980-81 and $4.9 million in a full year to outlays on Health. (See 'Social Security and Welfare' for details.)

The cost of the three decisions on eligibility for PHB Cards will be reflected mainly in increased outlays on medical benefits and pharmaceutical benefits.

The estimated number of eligible pensioners and their dependants at 31 December 1979 was 2.02 million. These numbers are expected to increase by about 9 per cent during the year to 31 December 1980. about half of the increase being attributable to the above mentioned decisions.

Medical Services and Benefits

Medical Benefits

In 1980-81 the Commonwealth's contribution towards the costs of medical benefits will continue to be as follows: pensioners (and their dependants) covered by Pensioner Health Benefit entitlements: 85 per cent of Schedule fees, subject to the gap between the benefit and Schedule fee for a service not exceeding $5; disadvantaged patients, as classified by their doctors: 75 per cent of

Schedule fees for all services regardless of cost; and the rest of the population: that part, if any, of the Schedule fee in excess of $20 for each service.

Commonwealth medical benefits for some 85 per cent of services rendered to eligible pensioners and all services rendered to disadvantaged persons are paid directly by the Commonwealth under bulk-billing arrangements. In respect of the rest of the population (including the balance of eligible pensioners and dependants), registered medical benefits organisations act as agents for the Commonwealth and pay Commonwealth medical benefits.

Outlays on Commonwealth medical benefits are estimated to increase by $60.0 million in 1980-81 to $681.0 million. The increase comprises: a part year increase of $43 million ($85 million for a full year) resulting from an average increase in Schedule fees of 9.7 per cent from 1 November 1980; $9 million reflecting the net effect of changes in the level of medical benefits from 1 September 1979, the increase in Commonwealth medical benefits arising from the Schedule fee increases applying from 1 November 1979 and 1 January 1980 for medical and optometrical services respectively and the 1 November 1979 extension of eligibility for Pensioner Health Benefit entitlements; $7 million ($11 million for a full year) resulting from decisions, as announced in the Budget Speech, to extend eligibility for PHB Cards from November 1980 to eligible sickness beneficiaries and to eligible supporting parents during the first six months of sole parenthood, and from 1 January 1981 to veterans in receipt of disability pensions who qualify under a liberalised income test; and $1 million ($3 million for a full year) for the estimated cost of extending the Medical Benefits Schedule from 1 January 1981 to include items associated with orthodontic treatment required by children with cleft lip and cleft palate conditions.

Diagnostic Services

This item relates to the running of health laboratories operated by the Commonwealth, including pathology laboratories, which provide services to hospitals and medical practitioners. The $2.2 million increase in 1980-81 reflects the fullyear effects of administrative cost increases.

Treatment and Allowances for Veterans and Dependants

The Commonwealth meets the costs for eligible persons of specialist, local medical officer, paramedical and dental services, the provision and maintenance of surgical aids and travelling expenses incurred in obtaining medical treatment. The increase of $9.1 million arises from increased fees for professional services, an increase in demand for treatment, and the Government's decision to extend eligibility for free treatment of disabilities not related to service to Australian mariners who were prisoners of war and to all veterans who have suffered servicerelated amputations or loss of vision.

Hospital Services and Benefits

Hospital Payments

Under the Health Insurance Act 1973 the Commonwealth: meets half the approved net operating costs of State and Northern Territory public hospitals 'recognised' under the Hospital Cost-Sharing Agreements. Payments in 1980-81 are estimated to increase by $152.8 million to $1291.9 million; meets half the approved net operating costs of 'recognised' hospitals in the Australian Capital Territory under arrangements similar to the Agreements with the States. Payments in 1980-81 are estimated to increase by $2.3 million to $24.2 million. (The other half of approved net operating costs is met from the provision under the appropriation for the Capital Territory Health Commission); and makes payments to private hospitals of $16 a day for each occupied bed. Payments in 1980-81 are estimated to increase by $1.3 million to $71.0 million.

Hospital net operating costs represent the aggregate residual operating deficits of 'recognised' hospitals after patient fees and other hospital revenues have been taken into account. Commonwealth payments in 1979-80 were on the basis of maintaining the overall level of hospital services at their 30 June 1979 level. Estimated payments in 1980-81 are again designed to maintain the same overall level of services as in 1979-80. Charges for insured inpatients are to remain at $50 a day for shared-room accommodation, and $75 a day for single-room accommodation. Eligible residents without hospital insurance will continue to be entitled to free hospital-provided treatment and services without means test in public hospitals. The Budget estimates provide for escalation due to price and wage increases, including prospective increases to 30 June 1981, except for the ACT for which the provision is based on current prices. The estimates also provide for some increase in the proportion of uninsured inpatients following the trend perceived by hospitals in 1979-80. The estimates include an amount of $7.5 million related to previous years' hospital expenditures. After adjustment for this amount, Commonwealth expenditure for 'recognised' hospitals will increase by an estimated 12.0 per cent in 1980-81.

The Hospital Agreements with the States and the Northern Territory are to be varied to allow charges to be levied in respect of nursing-home type patients in 'recognised' hospitals as provided in the Health Insurance Act 1973 - as follows : where the patient is not a hospital insured person, the charge will be the patient contribution being paid by nursing-home patients in State Government homes in the relevant State; or where the patient is a hospital insured person and/or private patient, the charge will be the total of the patient contribution and the Commonwealth nursing-home benefit payable in the relevant State.

Concurrent with the introduction of the above arrangements, insured nursinghome type patients in private hospitals will be required to pay, as part of their fees, an amount equal to the statutory nursing-home patient contribution, which will be uninsurable. Hospital benefits will be payable, but the benefit level could be reduced if the fee payable by the patient is less than the benefit plus the patient contribution.

Hospital Agreements with four States (New South Wales, Victoria, Queensland and Western Australia) and the Northern Territory are presently on the basis of annual extension until the Commission of Inquiry into Hospital Efficiency and Administration has reported and decisions have been taken on its report. Agreements with South Australia and Tasmania run until 30 June 1985. The Commission of Inquiry has among its terms of reference the question of existing and possible Commonwealth-State arrangements for meeting hospital operating costs. The Inquiry, which brought down an interim report in early July 1980, is expected to submit its final report by 31 December 1980.

Hospital Benefits Reinsurance Trust Fund

Under the provisions of the National Health Act 1973, the Commonwealth subsidises private health funds by sharing deficits that arise in reinsurance accounts required to be maintained by registered hospital insurance organisations. The deficits occur from paying benefits to high risk and chronically ill members. Reflecting the Government's earlier announced decision to increase its contribution to the Fund by $75 million a year from 1 August 1980, the Commonwealth's contribution to the Fund in 1980-81 will be $117 million, $67 million higher than in 1979-80. The amount for 1980-81 makes provision for advance payments of 50 per cent of the Commonwealth contribution each quarter. Unspent balances of $2.4 million at 30 June 1979 were applied during 1979-80.

Other Hospital Benefits

Expenditure on other hospital benefits is estimated at $0.6 million compared with $2.6 million in 1979-80 and $6.8 million in 1978-79. The decrease is mainly attributable to the abolition on 1 November 1978 of the subsidy payable to registered health insurance organisations in respect of the contribution rates for basic 'hospital only' insurance. Almost the whole of the estimated expenditure in 1980-81 represents residual hospital insurance subsidy payments.

Repatriation Hospitals

Hospitals and clinics are maintained in each State for the treatment of eligible veterans and their dependants; to a limited extent repatriation hospitals also treat non-repatriation patients, while some use is made of private and State public hospitals for repatriation patients where this is appropriate. The estimated increase of $6.5 million in 1980-81 reflects higher wages and salaries and operational costs associated with the running of repatriation institutions.

Mental Health Facilities and Services

Expenditure on mental health facilities and services is estimated at $10.4 million in 1980-81. Of this amount, $9.8 million relates to medical care and treatment for eligible veterans and their dependants in State mental hospitals. Assistance for non-residential mental health facilities is provided under the Community Health Program.

Launceston General Hospital

The Commonwealth is meeting 50 per cent of the approved cost of Stage I of the re-development of the Launceston General Hospital, including the fittingout of a pathology laboratory. The Commonwealth's share of the total estimated cost is $22 million of which $14.5 million has been paid, leaving $3.7 million to be paid in 1980-81 and $3.8 million in 1981-82.

Health Program Grants

Health Program Grants, authorised under the Health Insurance Act 1973, are payable to eligible organisations to meet the cost, or such proportion of the cost as the Minister may determine, of approved health services, including contract medical services, provided outside of hospitals by medical practitioners employed on a salaried or sessional basis. Eligible organisations impose charges, where appropriate, for services.

Health Program Grants are also available for projects that develop and test new forms of health care delivery systems (eg health maintenance organisations) .

The increase of $1.4 million reflects, particularly, increased provision for Aboriginal medical services.

Pharmaceutical Services and Benefits

Pharmaceutical Benefits - General and Pensioners

Except for a flat charge of $2.75 per prescription payable by persons other than Pensioner Health Benefit (PHB) Card holders and their dependants, the Commonwealth meets the cost of a wide range of drugs supplied on doctors' and dentists' prescriptions. PHB Card holders and their dependants are eligible for benefits without charge.

Outlays on pharmaceutical benefits (general and pensioners) are estimated to increase by a net $49.4 million in 1980-81 to $324 million. The net increase comprises: a part year increase of $9.5 million ($19 million for a full year) resulting from the across-the-board increase announced in the Budget Speech of 20 cents in drug prices per benefit item; the full year effect ($16 million) of the decision in 1979-80 to extend eligibility for PHB Cards to supporting parents and their dependants and to increase the basic income test limit; $3.9 million ($6.7 million for a full year) resulting from decisions announced in the Budget Speech to extend eligibility for PHB Cards from November 1980 to eligible sickness beneficiaries and to eligible supporting parents in the first six months of sole parenthood; and from 1 January 1981, to veterans in receipt of disability pensions who qualify under a liberalised income test; expected increases in the volume of prescriptions dispensed and an increase in the average benefit prescription price ($24.8 million); and reductions of $1 million ($2 million for a full year) resulting from the Government's decision to remove certain low priority items from the list of pharmaceutical benefits and of $3.8 million from a decrease of 4 cents per prescription from 1 May 1980 in the dispensing fee paid to chemistSr'-

Pharmaceutical Benefits - Veterans and Dependants

The Commonwealth meets the full cost of drug and medicinal prescriptions supplied on doctors' prescriptions for eligible veterans and their dependants. The increase of $3.7 million to $42.7 million in 1980-81 reflects the expected full-year effect of increased costs and increased demand for pharmaceuticals.

Nursing Home and Domiciliary Nursing Care Services and Benefits

Nursing Home Benefits and Payments

Under the National Health Act 1973, benefits are paid by the Commonwealth for all patients in approved nursing homes who are not insured with a registered hospital benefits fund. Current benefits are:

Ordinary Extensive care care patients patients

S a day $ a day

15.30 21.30

22.70 28.70

13.85 19.85

20.55 26.55

13.85 19.85

15.85 21.85

New South Wales and Australian Capital Territory

Victoria

Queensland

South Australia and Northern Territory Western Australia ..... Tasmania

The benefits are reviewed annually and were last adjusted on 8 November 1979. Benefits are set so that together with the statutory minimum patient contribution (currently $8.25 a day) they cover fees charged to 70 per cent of patients in non-government nursing homes approved in each State under the National Health Act 1973 at the time of the review. The patient contribution is set at 87.5 per cent of the single pension plus supplementary assistance. The levels of benefit are to be reviewed during 1980-81 after a survey of nursing home fees, with new benefit levels to apply from the first pension pay day in November.

Under the Nursing Homes Assistance Act 1974 the Government meets approved operating deficits (after receipt of patient contributions and of benefits for patients insured with a hospital benefits fund) of eligible private non-profit nursing homes that participate in arrangements authorised by the Act.

Expenditure on nursing home benefits is estimated to increase by $50.6 million in 1980-81 to $278.0 million, while expenditure on the financing of deficits of eligible nursing homes is estimated to increase by $35.0 million to $120.0 million. These increases reflect a 10 per cent increase in bed days for which benefits are paid and a 20 per cent increase in bed days in those nursing homes whose deficits are met, the effects of higher benefits, and an allowance for cost increases.

There are indications that the supply of nursing home beds will further increase substantially in 1981-82, mainly as a result of the greater availability of funds provided under the Aged or Disabled Persons Homes Act 1954, but that the rate of increase will slow in 1982-83.

Domiciliary Nursing Care Benefits

The Commonwealth currently pays a benefit of $2 a day to approved persons who provide adequate nursing care for approved patients at home as an alternative to institutional care. The approved patients must be aged 16 or over and require professional nursing care to an extent that would otherwise justify admission to an approved nursing home.

As announced in the Budget Speech, legislation will be introduced to increase the benefit to $3 a day with effect from 4 September 1980. The cost of the benefit increase is estimated to be $4.7 million in 1980-81 and $5.5 million in a full year. Reflecting the benefit increase and the full-year effect of reducing the age eligibility to 16 years from 1 November 1979, which partly explains an estimated increase in patient numbers of 1350 to 15 100, estimated expenditure in 1980-81 is $15.7 million, $5.9 million higher than in 1979-80.

Nursing Care for Veterans and Dependants

The Commonwealth meets the full cost of nursing home accommodation required by veterans for service-related disabilities. For certain categories of veterans and war widows, it also meets the cost of nursing home care for disabilities not related to service, subject to payment by the patient of the patient contribution prescribed for other nursing home patients in the community. Free domiciliary care services are provided to these groups as required.

Home Nursing Services

The Commonwealth /-extends subsidies, estimated to cost $13.5 million in 1980-81, to approved non-profit organisations providing home nursing services. The Commonwealth subsidy to any organisation may not exceed that paid to the organisation by the relevant State or local government organisations.

The rate of subsidy was increased with effect from 1 July 1980. For organisations established before 30 September 1956, the annual Commonwealth payment for each nurse who attracts a subsidy was increased from $10 800 to $11 680. For organisations established after that date, the annual subsidy for each nurse employed was increased from $5400 to $5840. These increases are estimated to cost $1.07 million in 1980-81.

Community Health Facilities and Services

Commonwealth assistance is provided to the States, Northern Territory, local government authorities and other eligible organisations for the provision of community-based health services. In 1980-81 an estimated $67.5 million will be provided as follows: up to $55.0 million in block grants for capital and operating costs of community health services in the States and the NT on a $ for $ basis. In 1979-80 funds were provided for 721 projects including community health centres, day hospitals, rehabilitation and counselling services and health education projects; $3.8 million for capital ($ for $ basis) and operating ($3 for $1 basis) costs of women's refuges; currently 96 refuges are approved for receiving assistance; $1.3 million for the cost of programs based on the recommendations of the Review of Post-Arrival Programs and Services for Migrants (Galbally Report) concerning ethnic health workers and interpreters and translators in health services; in 1979-80 the Commonwealth met the full costs of these programs and in 1980-81 the cost will be shared with the States on a $3 for $1 basis. $6.45 million for 'national' projects that have an Australia-wide application and are fully funded by the Commonwealth (e.g. the Family Medicine Program, a vocational training program, which has 1650 trainees, for medical graduates wishing to enter general practice; and the secretariats of national non-government health organisations); and $0.9 million for health care planning and research in the form of grants to the States and the NT (on a $ for $ basis) and to institutions and persons.

Treatment of Tuberculosis

The provision of $1.5 million in 1980-81 is for the payment of allowances to persons (and their dependants) suffering from tuberculosis. The increase of $0.3 million reflects mainly the intake of refugees from South East Asia.

Dental Services for School Children

In co-operation with the States and the NT, assistance is provided for an Australia-wide school dental scheme to provide a free dental service to all primary school children. The children receive comprehensive dental care at local school clinics at regular intervals by either a dentist or dental therapist, and the scheme emphasises prevention and dental health education. At 30 June 1980, 9 training schools for dental therapists were operating and 573 school clinics (static and mobile) had been provided under the scheme. This represents a substantial addition to the 183 clinics operating in the States and the NT before the commencement of the scheme. Personnel employed under the scheme numbered 2618 at 30 June 1980. At that date a further 72 clinics were being developed.

The Commonwealth will provide amounts up to a ceiling of $23.3 million, the same amount as in 1979-80, to the States and Northern Territory in 1980-81 as its 50 per cent share of approved operating and capital costs of the scheme.

Health Services in the Territories, nec

Since 31 December 1978, outlays under this heading relate only to the Australian Capital Territory. The Commonwealth provides or subsidises health services in the ACT of the type provided elsewhere by State and local government authorities. These include three hospitals (expected to have 909 operative beds and 44 nursing home beds in 1980-81), public health activities, ambulance services, school health services, 9 community health centres, 2 nursing homes (260 beds), 5 residential care hostels for the mentally ill and the handicapped (90 beds) and a centralised health services supply centre.

During 1980-81 a new central health laboratory will be occupied, Stage I of a new radiotherapy facility will be provided and the construction of an additional health centre and a hostel for the handicapped (40 beds) will be commenced. Approval has also been given for the provision of 20 beds within the hospitals for the profoundly intellectually handicapped and of a short-term accommodation service for intellectually handicapped young adults.

Net expenditure by the Commonwealth under this heading in 1980-81 on recurrent and capital costs of health services in the ACT is estimated at $48.3 million, $1.7 million more than expenditure in 1979-80. (A further $24.2 million - half the net operating costs of recognised hospitals in the ACT - is included under the heading 'Hospital Payments'.)

Health Services for Aboriginals

This item relates to outlays by the Department of Aboriginal Affairs under its grants-in-aid program ($5.96 million in 1980-81) and its State grants program ($13.58 million) to improve the standard of Aboriginal health. Under these programs, funds are provided for the prevention and control of alcohol abuse; to develop Aboriginals' responsibility for, and involvement in, the improvement of their own health through participation in the delivery of medical/health services; and for the development, through training, of Aboriginal expertise in all aspects of health care and administration.

A program effectiveness review of Aboriginal health was completed in 1979-80. The review is under consideration in the light of the Parliamentary Standing Committee's Reports on Aboriginal Health and Alcohol Problems of Aboriginals and the Report of the National Trachoma and Eye Health Program.

Other Health Services

Medical Research Grants

The Commonwealth provides financial assistance for medical research through the Medical Research Endowment Fund. Disbursement of the funds is made by the Minister for Health on the advice of the National Health and Medical Research Council, acting, where necessary, in accordance with the conditions of gifts or bequests made to the Fund. Assistance is provided to universities and other institutions such as the Howard Florey Institute of Experimental Physiology and Medicine and the Walter and Eliza Hall Institute of Medical Research, and to individual research workers or trainees, and may also be provided to Commonwealth and State Government departments. Reflecting mainly the Government's decision to increase funding of medical research in real terms in 1980-81, the provision for medical research programs in 1980-81 is $18.0 million, an increase of $4.4 million over 1979-80 expenditure.

Commonwealth Serum Laboratories

The Commonwealth Serum Laboratories Commission produces and sells pharmaceutical products as approved by the Minister for Health. Under amendments to the Commonwealth Serum Laboratories Act 1961 operative from 1 July 1980 the Commonwealth meets the full cost of those activities undertaken in the national interest at the request of the Minister for Health, whereas previously the Commonwealth, in the event of an overall net loss, met the costs or the net loss of CSL operations, whichever was the less. The national interest activities include research, the maintenance of production facilities and the holding of stocks of pharmaceutical products. The estimated cost of these activities in 1980-81 is $3.6 million. In addition, a further $6.1 million is being made available for capital works that commenced in 1978. The total estimated cost of these works is $12.3 million, $2.1 million of which is estimated to remain to be met in 1981-82.

Commonwealth Institute of Health

This facility, formerly the School of Public Health and Tropical Medicine, was renamed the Commonwealth Institute of Health on 3 March 1980 in recognition of the greater emphasis to be placed on health services research, preventive medicine and health surveillance, and occupational and environmental health. The Institute continues the School's basic functions of teaching, medical research and consultation.

The amount of $3.9 million to be provided to the Institute for 1980-81 includes its recurrent and capital costs ($3.1 million, or S0.7 million higher than in 1979-80), an amount of $0.75 million for the commencement of a special epidemiological study into the effect of herbicides and other chemicals on Vietnam veterans, and $0.05 million towards the establishment of a malaria and other insectborne diseases monitoring station in Torres Strait. The station will be built in 1981-82 at an estimated cost of $1.0 million.

Aids and Appliances

The Commonwealth meets the cost of supplying and maintaining hearing aids (and batteries) for children, eligible pensioners and supporting parents in receipt of an allowance from the Department of Social Security. It also meets the cost of supplying artificial limbs and stoma appliances to those civilians who require them.

The provision of $10.3 million in 1980-81 represents an increase of $3.0 million on the previous year, and includes the following: the supply and maintenance of hearing aids and batteries ($6.55 million); the supply of stoma appliances ($2.05 million); the supply of artificial limbs ($0.95 million); and 0 the provision, from April 1981, on specialist medical prescription, of essential aids to disabled persons who are not eligible for assistance under current arrangements so as to reduce their dependency on others in the home or in the place of employment. Included among the aids will be the widening of doorways, provision of access ramps for wheelchairs, grip rails, home aids, wheelchairs (on loan), and orthoses (including surgical footwear and walking aids) etc. The scheme is estimated to cost $0.7 million in 1980-81.

Blood Transfusion Service and Products

The annual operating costs of the Red Cross Society's Blood Transfusion Service in the States are shared by the States (60 per cent), the Society (the lower of 5 per cent of operating costs or 10 per cent of its previous year's income from donations) and the Commonwealth (the balance). In the Northern Territory the Commonwealth provides similar assistance. Approved capital costs are shared between the Commonwealth and the States and the Northern Territory on a $ for $ basis.

Blood collected by the Transfusion Service is processed by the Commonwealth Serum Laboratories Commission and blood products are supplied, free of charge, to hospitals and approved pathologists for use in medical treatment and analysis. The Commonwealth reimburses the Commission for the cost of processing the blood. The Commonwealth contributions are estimated to increase by $1.7 million in 1980-81 to $13.6 million.

Isolated Patients Travel and Accommodation Assistance Scheme

Under arrangements introduced with effect from 1 October 1978, and liberalised in June 1979, the Commonwealth provides financial assistance to persons (and, if necessary, escorts/attendants) who live in country areas and are referred for specialist medical treatment not available locally. To be eligible for assistance a patient must reside outside the metropolitan areas of Sydney, Melbourne, Brisbane, Adelaide and Perth and reside more than 200 kilometres from the nearest place of specialist medical treatment; persons residing on certain specified offshore islands are exempt from this requirement.

From 1 October 1980, the Commonwealth will meet the approved travel costs per return journey of all eligible patients, escorts and/or attendants less a total contribution of $20 regardless of whether the patient is escorted or not. Present arrangements provide for a $20 contribution by both patients and escorts or attendants. The rates used to determine the cost of journeys for which private motor vehicles are used will be reduced from 1 October to ensure that any reimbursement will be more closely related to private vehicle operating costs. An accommodation benefit of up to $20 per night ($15 at present) per person in respect of each approved overnight stay will also be payable.

Largely because of greater use, the cost of the scheme is expected to increase by $1.9 million in 1980-81 to $4.2 million.

Educational Campaigns

Assistance is provided through the National Drug Education Program to support State, Northern Territory and national programs of education against the abuse of narcotics and other drugs of addiction. Arising from the emphasis given to the importance of such programs by the Australian Royal Commission of Inquiry into Drugs and the Senate Standing Committee on Social Welfare, the 1980-81 allocation for the Program has been increased by $0.6 million to $1.8 million.

Quarantine Services

Human, plant and animal quarantine measures are enforced to prevent the introduction of exotic diseases into Australia. By arrangement, the States and the Northern Territory administer animal, plant and certain human quarantine operations in their respective areas and the costs they incur on the Commonwealth's behalf are reimbursed. Human quarantine control measures at ports of entry are administered by the Commonwealth.

The provision of $27.4 million for net outlays for quarantine services in 1980-81 (an increase of $2.1 million) reflects, in addition to general cost increases, the following factors: payments of $3.0 million to the States and the Northern Territory for animal, plant and human quarantine operations, including $1.6 million for new arrangements for seaport waste disposal; the quarantine component of coastal surveillance in Northern Australia ($0.3 million); costs associated- with the opening of the Cocos Island animal quarantine station ($0.5 million) ; a national quarantine publicity campaign designed to increase public awareness of the economic and social importance of keeping Australia free from exotic diseases and pests ($0.8 million); and a net reduction of $2.5 million in respect of capital expenditure on animal quarantine stations; the reduction mainly reflects the completion in 1979-80 of the station at Wallgrove (NSW) at a total cost of $4.2 million and reduced expenditure on extensions to the Fairfield Infectious Diseases Hospital which are due for completion in 1980-81 at a total cost of $2.1 million.

The off-shore animal quarantine station on Cocos Island will be virtually completed by 30 June 1981, at a total estimated cost of $6.4 million. A start is to be made in 1980-81 on a new animal quarantine station at Guildford, Perth, $0.9 million being the total estimated cost, to replace the present station at Bicton.

Medibank Private - Payment

The outlay of $11 million in 1978-79 represented a 'once-only' grant to Medibank Private to enable it to undertake its future operations on a sound actuarial basis.

Other

This category includes the Commonwealth subsidy of $3.5 million to the Royal Flying Doctor Service, grants to the States and the Northern Territory for the Australian Encephalitis Eradication Campaign, and expenditure related to the administration of public health and the Therapeutic Goods Act 1966. Expenditure in 1979-80 reflected a test program costing $0.5 million designed to persuade people to adopt healthier lifestyles. The results of the program are being evaluated. Also included in 1979-80 was a grant of $0.1 million to the Walter and Eliza Hall Institute of Medical Research towards the cost, to be shared equally by the Commonwealth and Victorian Governments, of a feasibility study of a new building program.

General Administrative Expenditure

Expenditure under this heading comprises the general administrative and capital expenses of the bulk of the Department of Health. Included for 1980-81 is §3 million which represents final payments in respect of the winding up of the former general function of the Health Insurance Commission. The estimated cost in 1980-81 of the service fee payable to registered medical benefit funds for the cost of registering uninsured persons and paying Commonwealth medical benefits to them is $3.5 million, $0.9 million less than in 1979-80; this reduction mainly reflects the full year effects of the 1 November 1979 revised health insurance arrangements. Provision of $92.5 million is made for expenditure on capital works (nec) including the National Acoustics Laboratory, Chatswood, and the National Biological Standards Laboratory, Canberra, the estimated total costs of which are $12 million and $27.6 million respectively.

Recoveries

Recoveries shown under this heading are in respect of charges met by certain countries for treatment given to their veterans through Repatriation facilities, charges made on departments and authorities for the use of the Department of Health's computer facilities, and other miscellaneous receipts.







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