Commonwealth Budget 2014-15
Written by Fitness Australia CEO Lauretta Stace
On 13 May 2014, Fitness Australia was invited by the Department of Health to attend the Budget 2014-15 briefing in Canberra. It was an interesting experience and one that I was pleased to be involved with, as it is the first time that Fitness Australia, as the fitness industry peak body, has received an invitation to attend a Budget ‘lock-up’.
Many of the announcements were not unexpected, and given the reaction in the polls conducted over the weekend some of the measures are unlikely to be legislated in the Senate so I have not spent too much time reiterating them in this article. My focus is on the key points around the preventive health agenda and what this may mean for the fitness industry and the health and fitness of the nation. It probably poses more questions than answers, but hopefully these thoughts will generate some interesting discussions.
Budget 2014-15 winners:
- $200 million to boost dementia research;
- $96 million over four years to implement the National Bowel Cancer Screening Programme;
- Significant investment in youth mental health, including an additional $14.9 million to fund expansion of the Headspace network.
- Savings achieved across the health portfolio will be used to set up a $20 billion Medical Research Future Fund (MRFF).
Budget 2015 Question-Marks:
- The Future Fund will target ‘medical’ research. The use of the word ‘medical’ is very deliberate. What does this mean for population health research for example research into obesity and physical inactivity?
- GP visit co-payment. This is likely to create problems for the most vulnerable and disadvantaged in Australia, who are also often the least healthy. It marks a strong ideological shift away from universal health care to more of a ‘user-pays’ system. These changes to the Medicare system will be challenged in the Senate where the Government does not have a majority.
- $156 million is being invested in the 2018 Gold Coast Commonwealth Games. Whilst this is good news for the local economy, organisers, sporting aficionados and athletes, one has to wonder if this is money well spent in this era of fiscal rectitude. Wouldn’t this level of funding be better spent on preventive health programs?
- The new Sporting Schools initiative will replace the Active After-school Communities programme, from 2015. Whilst the policy to continue investing in children’s sport is laudable, the financial investment will provide an average of only $1,700 per school. It’s difficult to understand how this will have a substantial impact on childhood inactivity and obesity.
Budget 2015 Losers:
- Medicare Locals, set up by the previous government, will be replaced by a smaller number of Primary Health Networks (PHNs). This signals a return to a more ‘medical/GP-centric’ model of health and a shift away from the more community-based, collaborative model that Medicare Locals were set up to provide. It also means that treatment of illness, rather than primary prevention, will continue to be the dominant paradigm in Australia.
- The Australian National Preventive Health Agency and Health Workforce Australia will be closed and essential functions will be transferred to the Department of Health.
- Funding under the national partnership on preventive health will cease in 2015-16.This will mean that programs, such as Lift for Life, that received funding from the Healthy Communities Initiative will need to look elsewhere for funding.
- A number of health-related government agencies will be closed or merged.
Consequences, Impact & Commentary
- The clear focus of the Abbott Government is to use fiscal and economic measures to reduce the Budget deficit as soon as possible. As a result, government will become smaller and many existing services and functions will disappear or be outsourced to the private and not-for-profit sectors. This will potentially generate more of a ‘user-pays’ health system.
- The absence of discussion on preventive health in the Budget and the closing of the Preventive Health Agency signals a shift away from government intervention in population health and primary prevention towards an emphasis on a ‘treatment-centric’ model. The ideology of individual responsibility for health will dominate as will the notion that doctors are at the centre of primary care. The pharmaceutical industry will continue to be the primary beneficiaries of this model and potentially the major beneficiaries of the $20 billion MRFF presuming the Government can steer its funding through the Senate.
- The Commonwealth has signalled that it wants to shift responsibility for health and education to the State and Territory Governments. The potential negative impact of this model will be an absence of a nationally coordinated strategy or approach to population health and primary prevention.
- Medical research organisations and academia will benefit from the establishment of the Medical Research Fund and the knowledge and understanding of disease treatment and management will be enhanced. However, the research is unlikely to be focused on preventative health measures.
What does this mean for the fitness industry and/or Fitness Australia?
The ‘user-pays’ health system and the decline in health-related government programs and services will herald an increasingly important role for the private sector in health. Private Health Insurance providers are likely to introduce more services and support. They will also take a stronger role in educating their members about health and wellness, and influencing behaviour change to achieve longer-term health outcomes and lower insurance claim costs.
The business sector is also likely to take more interest in health, lifestyle and wellbeing issues. In the absence of government programs or assistance,
key population settings such as schools, workplaces, community clubs and lifestyle/retirement villages will increasingly look to deliver services to help educate and improve the health and wellbeing of their employees and/or clients.
The fitness industry will benefit from greater levels of engagement with these settings to assist with the delivery of services as this trend gathers momentum.
Fitness Australia’s advocacy strategy with the Commonwealth Government will focus on very specific and targeted campaigns, such as the extension of the Fringe Benefits Tax exemptions for fitness services and the delivery of evidence-based physical activity programs to disadvantaged communities or those at risk of or managing a chronic disease.
Our advocacy program will also need to extend further with State and Territory Governments, as they increasingly take more responsibility for population health-related issues.
Advocacy efforts will also be re-directed to major settings such as workplaces, through business associations and employer groups, to help encourage more Australians to be active, fit and healthy.
The argument that broad based changes to the Medicare or taxation systems to help address population health issues through economic incentives, and thereby generate longer-term health savings through primary prevention, will not be easy to sell to a government that embraces individual responsibility for health, despite the inherent logic of this argument.
Every idea put forward to government will have to comprise a strong economic argument and a coherent and cost-effective solution before it is even considered. Lobbying efforts will take many years to yield an outcome and patience and perseverance will be critical for ultimate success.
In 2009, the National Preventative Health Taskforce prepared the National Preventative Health Strategy – the roadmap for action. The Strategy was presented to the Australian Government with the direct intention of reaching the goal of Australia being the healthiest nation by 2020. The initial key target areas for urgent action were on obesity, tobacco and excessive consumption of alcohol. In the obesity area, there were ten very clear goals/recommendations made by the Taskforce.
Fast forward to 2014.
It is clear that the former Australian Government has made some inroads into the implementation of this strategy. As an example, the tobacco reforms led by the former Minister for Health, Nicola Roxon, have yielded some outstanding results. However, the statistics indicate that Australia is far from being the healthiest country in 2014 and the clock is still ticking towards the 2020 deadline.
As concerned citizens and as an industry that is interested in improving the health and wellbeing of the nation, we need to keep the Australian Government accountable for these goals and this strategy. It is too important and too costly to ignore.
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