The Department of Health is responsible for purchasing and delivering integrated services that maintain and improve the health and wellbeing of Tasmanians. The Department reports to the Minister for Health, Hon Michael Ferguson MP.
The 2018-19 Budget is the first Budget for the Department of Health, which comes into effect on 1 July 2018. For more information regarding the restructure, refer chapter 1 of this Budget Paper.
The Department coordinates the delivery of public health services across Tasmania through a network of facilities, community services and home-based care.
The principal responsibilities of the Department include:
· planning and purchasing high quality, safe and efficient health services through the public hospital system; primary and community health services, including mental health, oral health and correctional health services; and ambulance services;
· delivering health protection through emergency management, environmental health, chronic diseases prevention and other health improvement services;
· funding care for Tasmanians over 65 years of age, as well as support and assistance to enable them to remain living independently in their own homes; and
· funding a network of alcohol and drug abuse prevention and treatment services.
The Department also coordinates the delivery of public hospital services and a broad range of community health services through the Tasmanian Health Service in accordance with the Tasmanian Health Service Act 2018.
The functions of the THS include:
· improving, promoting, protecting and maintaining the health of Tasmanians as required by its Service Plan;
· managing public hospitals, health institutions, health services and health support services;
· achieving and maintaining standards of patient care and delivery of services;
· providing training and education relevant to the provision of health services;
· undertaking research and development relevant to the provision of health services; and
· collecting and providing health data for reporting and research purposes.
Funding for the THS is provided by both the State and Australian Governments. Australian Government Activity Based Funding and Block Funding, and State ABF, flows through the National Health Funding Pool, which is overseen by an independent statutory office holder known as the Administrator. Block funding for some activities is paid to the THS via a State‑managed Fund. In addition to State and Australian Government funding, the THS also generates its own revenue to fund some of its activities.
This chapter provides the Department’s financial information for 2018‑19 and over the Forward Estimates period (2019‑20 to 2021‑22). Further information about the Department is provided at www.dhhs.tas.gov.au.
The National Health Reform Agreement sets out arrangements for the Tasmanian and Australian Government contributions to the provision of health services in Tasmania as primarily delivered by the THS. Under the NHRA, State and Australian Government funding is provided on the basis of activity through ABF wherever practicable. Where it is not practical, funding is provided on a Block basis.
Block funded services include smaller regional or rural hospitals and teaching, training and research, and non‑admitted mental health services. Pricing under the NHRA is determined by the Independent Hospitals Pricing Authority.
From 1 July 2014, the Australian Government has provided growth funding equivalent to 45 per cent of the efficient growth in activity under the NHRA. The IHPA determines the efficient price of ABF and the efficient cost of Block grants. From 1 July 2016, growth in Australian Government funding to the states and territories was capped at 6.5 per cent per year.
On 16 May 2018, the Tasmanian Government signed the Heads of Agreement for a new National Health Agreement. The Heads of Agreement represents an agreement between governments on the high level parameters for public hospital funding from 1 July 2020 to 30 June 2025 and identified reform areas for further development. The Heads of Agreement preserves the current arrangement of the Australian Government contributing 45 per cent of the efficient growth in ABF services, Block grants and growth in Australian Government funding capped at 6.5 per cent per annum nationally. In addition, the Heads of Agreement includes a minimum funding guarantee and a new Health Innovation Fund.
The signatories to the Heads of Agreement are now working to draft the new National Health Agreement, which will replace the current NHRA from 1 July 2020.
Table 5.1 provides a summary of the Budget and Forward Estimate allocations for key deliverables within the Department.
Table 5.1: Key Deliverables Statement
|
|
2018‑19
Budget |
2019‑20 Forward Estimate |
2020‑21 Forward Estimate |
2021‑22 Forward Estimate |
|
|
$'000 |
$'000 |
$'000 |
$'000 |
|
Election Commitments and Other Major Initiatives |
|
|
|
|
|
|
|
|
|
|
|
Tasmanian Health Service |
|
|
|
|
|
Acute Hospital Services1 |
|
|
|
|
|
180 more Nursing Graduates across Tasmania |
1 645 |
2 836 |
2 892 |
2 951 |
|
250 beds for the Royal Hobart Hospital |
.... |
.... |
16 184 |
36 796 |
|
Air Conditioning Upgrades - Statewide |
2 700 |
2 200 |
.... |
.... |
|
Eight Bed Acute Medical Unit at the North West Regional Hospital |
2 407 |
4 933 |
5 057 |
5 183 |
|
Eight Beds on Ward 4K at Launceston General Hospital |
.... |
3 627 |
3 718 |
3 811 |
|
Elective Surgery |
20 000 |
.... |
.... |
.... |
|
Launceston General Hospital Redevelopment 2018-19 |
5 462 |
12 185 |
12 533 |
12 000 |
|
Maternity Services at the North West Regional Hospital |
800 |
1 300 |
.... |
.... |
|
Mersey Community Hospital Capital Upgrades2 |
5 000 |
.... |
.... |
.... |
|
New Services and New Staff for the Mersey Community Hospital |
.... |
.... |
.... |
1 000 |
|
Planning for 250 beds and the next stage of the RHH Health Precinct |
250 |
.... |
.... |
.... |
|
Planning the next stage of the Launceston General Hospital |
250 |
.... |
.... |
.... |
|
Royal Hobart Hospital Ward Upgrades |
.... |
2 640 |
2 640 |
5 000 |
|
Ward 3D - A 32 Bed Inpatient Ward3 |
.... |
.... |
.... |
.... |
|
|
|
|
|
|
|
Community and Aged Care Services |
|
|
|
|
|
Better accommodation for health professionals on Flinders Island |
500 |
.... |
.... |
.... |
|
Better Patient Transport on Flinders Island |
30 |
30 |
.... |
.... |
|
Community Defibrillator Fund |
270 |
270 |
.... |
.... |
|
Community Rapid Response - Infrastructure |
360 |
.... |
.... |
.... |
|
Community Rapid Response |
3 237 |
5 530 |
5 670 |
1 162 |
|
Midlands Multipurpose Centre (Oatlands Hospital) Upgrade |
1 250 |
1 250 |
.... |
.... |
|
Palliative Care Clinical Nurse Educators |
400 |
400 |
.... |
.... |
|
Palliative Care Tasmania |
66 |
66 |
.... |
.... |
|
Stage 2 of the King Island Hospital Redevelopment |
1 125 |
3 125 |
3 125 |
3 125 |
|
Urgent Care Centre Feasibility Study |
240 |
.... |
.... |
.... |
Table 5.1: Key Deliverables Statement (continued)
|
|
2018‑19
Budget |
2019‑20 Forward Estimate |
2020‑21 Forward Estimate |
2021‑22 Forward Estimate |
|
|
$'000 |
$'000 |
$'000 |
$'000 |
|
Statewide and Mental Health Services |
|
|
|
|
|
25 Mental Health Beds in Southern Tasmania - Infrastructure |
6 840 |
5 000 |
.... |
.... |
|
25 Mental Health Beds in Southern Tasmania |
1 203 |
2 467 |
6 322 |
6 480 |
|
Drug and Alcohol Rehabilitation Beds in Ulverstone |
.... |
800 |
800 |
800 |
|
Eating Disorders Peer Workers Partnership |
200 |
200 |
.... |
.... |
|
Good Sports Program |
435 |
435 |
.... |
.... |
|
Holyoake Gottawanna |
50 |
50 |
.... |
.... |
|
Mental Health Peer-Workforce Strategy |
60 |
60 |
.... |
.... |
|
More Drug and Alcohol Rehabilitation Beds |
1 998 |
1 998 |
1 998 |
.... |
|
Pathways Tasmania |
100 |
100 |
.... |
.... |
|
Rural Alive and Well |
920 |
920 |
.... |
.... |
|
|
|
|
|
|
|
Ambulance Tasmania4 |
|
|
|
|
|
Aeromedical Helicopter Service - Infrastructure |
1 615 |
.... |
.... |
.... |
|
Aeromedical Helicopter Service |
.... |
9 853 |
10 100 |
10 352 |
|
Burnie and Glenorchy Ambulance Stations |
4 000 |
4 000 |
4 000 |
.... |
|
More Paramedics in Regional Areas |
924 |
2 828 |
4 807 |
6 374 |
|
Secondary Triage |
650 |
1 900 |
2 500 |
2 900 |
|
Smithton Ambulance Training Station |
500 |
630 |
.... |
.... |
|
State Operations Centre Boost |
720 |
734 |
749 |
764 |
|
Statewide Rural Hospital and Ambulance Station Upgrade Fund |
5 000 |
5 000 |
5 000 |
.... |
|
Training Equipment and Stretchers |
1 100 |
.... |
.... |
.... |
|
Volunteer Support Package |
800 |
800 |
800 |
800 |
|
|
|
|
|
|
|
Public Health |
|
|
|
|
|
A Healthy Tasmania (continued funding) |
.... |
.... |
1 100 |
1 100 |
|
Epilepsy Tasmania |
440 |
440 |
.... |
.... |
|
Stroke Foundation |
220 |
220 |
.... |
.... |
|
Tasmanian Community Health Fund |
4 300 |
2 250 |
.... |
.... |
|
|
|
|
|
|
Notes:
1. These initiatives are included in the Government’s Better Care in Northern Tasmania, Better Care in North West Tasmania and Record Boost to Health in Southern Tasmania policies.
2. Existing funding of $2.5 million for 2019-20 and 2020-21 has been brought forward to 2018-19 to achieve the Government’s objectives under the Mersey Community Hospital Capital Upgrades project. Total funding committed in the 2017‑18 Budget for this project is $35 million.
3. Funding for this project has been allocated beyond the Forward Estimates period.
4. These initiatives are included in the Government’s Investment in Ambulance Services policy.
Tasmanian Health Service
Acute Hospital Services
Building on the success of the 2014 election commitment, where transition to practice placements have increased each year, this initiative will fund an additional 30 nursing positions each year, which will see an additional 180 nursing positions offered over the next six years.
Funding of $299 million over the next six years has been allocated to boost acute care in Tasmania by fully staffing 250 new beds at the newly refurbished Royal Hobart Hospital from 2020-21. These new beds will be progressively rolled out from 2020-21. This includes 10 new intensive care unit beds and a dedicated 16 bed adolescent unit. Clinicians will determine the final mix of services and beds, but it is estimated that approximately 946 full-time equivalent staff will be recruited.
Funding of $250 000 is allocated in 2018-19 to begin planning for the immediate future of the Royal Hobart Hospital with the establishment of a Clinical Planning Taskforce which will lead planning for: the models of care and clinical planning for the 250 new hospital beds in K-Block; the potential use for the 54 bed J Block inpatient building; and to update the RHH Master Plan to guide the next stage of the Royal Hobart Hospital health precinct.
Funding of $4.9 million is provided to undertake comprehensive air conditioning upgrades at the Royal Hobart Hospital ($3 million), the Launceston General Hospital ($1.4 million) and the North West Regional Hospital ($500 000).
Funding of $17.6 million over four years is provided in the 2018-19 Budget to open eight new acute medical beds at the North West Regional Hospital, including four Emergency Department stay beds and four surgical beds for elective surgery patients who need to stay overnight.
The 2018-19 Budget provides funding, commencing in 2019-20, for eight new beds on Ward 4K at the Launceston General Hospital.
This initiative provides $20 million in 2018-19 for elective surgery. Funding for Elective Surgery in 2018-19 will be maintained at a level consistent with that provided in 2017-18 State Budget under the Government’s successful first term initiative Rebuilding Health Services ‑ Elective Surgery Program. These elective surgeries will improve the quality of life for those Tasmanians requiring surgery.
Funding of $87.3 million will be provided over six years for a major redevelopment and expansion of the LGH building, including improvements across medical, surgical, maternity, obstetric, paediatric and mental health units, with an additional $5 million of funding allocated to provide more car parking. The program of works will be subject to consultation with staff and stakeholders and is expected to include:
· refurbishment of existing wards, and the development of new single rooms;
· expansion of existing blocks to accommodate additional beds;
· a new Women’s and Children’s outpatient building on top of the proposed Ward 4K project; and
· contemporary mental health facilities.
The redevelopment will commence in 2018‑19 and will be completed in 2024.
Funding of $2.1 million is provided to construct a purpose built antenatal clinic at the North West Regional Hospital as part of the Integrated North West Birthing Service. This will provide a state‑of‑the art facility to better support mums, babies and the staff that operate the service.
The 2017‑18 Budget provided additional funding of $35 million for 2019-20 and 2020-21 to deliver a significant capital upgrade of the Mersey Community Hospital. The 2018‑19 Budget brings forward $5 million of this funding to provide a total allocation of $8.6 million in 2018-19, so a range of important improvements can commence immediately. The upgrade will support the new service profile being implemented as part of the One Health System reforms. It is expected that the redevelopment will be completed in 2021.
The Tasmanian Government is continuing to implement new services at the Mersey, Tasmania’s Dedicated Elective Surgery Centre, to deliver better health outcomes on the North West Coast and across the State as part of the One Health System Reforms. Additional funding will be provided in 2021-22 for the support of the new services and new staff as a result of the capital works to be completed in 2021.
In 2018-19, funding of $250 000 is being provided for planning of the next stage of the Launceston General Hospital, to ensure that infrastructure investment is in line with the Hospital’s Medical Services Plan.
Funding of $28.1 million is provided over five years, commencing in 2019-20, for the redevelopment of existing wards at the Royal Hobart Hospital and the Hobart Repatriation Hospital.
Funding of $21.9 million for 2023-24 was announced as a 2018 election commitment to redevelop and open a new 32‑bed inpatient ward as an additional level on the upcoming Ward 4K redevelopment and extension at the Launceston General Hospital.
Community and Aged Care Services
Funding of $500 000 is provided for the purchase of a new property, as well as refurbishments to provide better accommodation for nursing, medical and allied health professionals working on Flinders Island.
The 2018‑19 Budget provides $60 000 over two years to fund a pilot partnership program with Community Transport Services Tasmania to extend transport operations on Flinders Island.
Funding of $540 000 is provided for an additional 180 community defibrillators over the next two years.
Funding of $6.9 million is provided over six years to extend the Community Rapid Response Service pilot program in the North into a permanent part of the health system. This program supports people who need short‑term intermediate care that can be safely delivered in the community or in the home.
Funding is also provided to roll out a three year pilot program to the Greater Hobart Area ($5.6 million) and the North West Coast ($5.6 million). The 2018-19 Budget also provides funding of $360 000 in capital funding to establish these pilot programs. Evaluation of the new pilot programs will occur after two years.
Funding of $2.5 million is provided for a major upgrade of the Midlands Multipurpose Centre at Oatlands. The Government will work with the Southern Midlands Council and the local Community Advisory Committee to ensure the redevelopment is designed to best support the local community.
The Palliative Care initiatives provide funding of $132 000 to Palliative Care Tasmania and $800 000 for Palliative Care Clinical Nurse Educators over two years from 2018-19. This will enable the important work of Palliative Care Tasmania in continuing to assist families to provide a caring and supportive environment, deliver End of Life Care projects focused on staff training and development of care support models.
Funding of $10.5 million is provided over four years to build the next stage of the King Island Hospital Redevelopment. Works will include palliative care and associated family rooms, acute care and observation areas, improved emergency and after‑hours access and a kitchen upgrade. The redevelopment will also include construction of dedicated housing for nurses working and living on King Island.
The 2018‑19 Budget provides $240 000 to fund feasibility studies into establishing Urgent Care Centres in the Launceston and Greater Hobart areas, where General Practitioners, supported by hospital specialists, provide care in the community taking pressure off emergency departments. The study will look at how such centres could work with the Community Rapid Response Service and local health centres.
Statewide and Mental Health Services
Additional funding is provided to build 25 mental health beds in the South, for safe, supportive ‘step down’ care post hospitalisation; ‘step up’ care to avoid hospitalisation for those whose condition has escalated; and community mental health services. These beds will help take pressure off the Royal Hobart Hospital.
Funding of $11.8 million has been allocated in 2018-19 for infrastructure, and almost $16.5 million is provided over four years for the operation of the new beds.
The 2018‑19 Budget provides $2.4 million over three years for additional community based drug and alcohol rehabilitation beds in Ulverstone, which forms part of the boost to health in the North West.
The 2018-19 Budget provides $400 000 over two years for a trial partnership between the Government and the Butterfly Foundation (which merged recently with Tasmania Recovery from Eating Disorders). This will enable the recruitment of peer workers to support Tasmanians living with eating disorders. These peer workers will provide support to both adolescents and adults, as well as their families and loved ones.
The 2018‑19 Budget provides $870 000 over two years to the Alcohol and Drug Foundation to expand the Good Sports Program. The Program provides community sporting club volunteers with the resources, training and guidance they need to build a healthy club environment. The Program was designed as an alcohol management program ‑ a way to change the drinking culture in clubs, and has recently expanding to include components focusing on mental health and nutrition, as well as information on other legal and illegal drugs.
The 2018-19 Budget provides Holyoake with $100 000 over two years, to continue the Gottawanna program. This program provides support to clients with drug and alcohol addiction issues, including helping them to develop strategies that improve their family relationships.
Funding of $120 000 over two years will be provided to the Mental Health Council of Tasmania to facilitate a partnership with the Government to develop a Tasmanian Mental Health Peer-Workforce Strategy. This Strategy will provide an overarching framework to ensure Tasmania’s mental health and suicide prevention peer workforce is supported into the future.
As part of the record boost to Health in Southern Tasmania, the 2018-19 Budget provides $6 million of funding over three years to enable the provision of 30 additional community based drug and alcohol rehabilitation beds.
The 2018-19 Budget provides $200 000 over two years for Pathways Tasmania to expand its Transformations residential program to include a new program specifically for women, as part of the statewide initiative related to drug and alcohol rehabilitation.
The 2018-19 Budget provides $380 000 over the next two years to assist RAW to provide better outreach support, particularly focusing on older Tasmanians who are experiencing mental health concerns in regional areas. This funding is in addition to $730 000 in each of 2018-19 and 2019‑20 detailed in the Tasmanian Liberals’ Taking Agriculture to the Next Level Policy, with a total commitment of $1.8 million.
The 2018-19 Budget provides funding of $30.3 million over three years to establish a dedicated aeromedical and medical retrieval service. The funding will be used to provide additional staffing consisting of flight paramedics and specialist retrieval doctors.
In addition, funding of $1.6 million in 2018-19 has also been provided for capital costs associated with establishing a dedicated aeromedical and medical retrieval service including expanded base facilities to accommodate crew on-site and additional road vehicles so that the helicopter crew can respond by road if required.
Funding of $12 million is provided to build a state-of-the-art ambulance station on a greenfield site in Burnie ($6 million) and an ambulance super‑station on a greenfield site in Glenorchy ($6 million).
The new Burnie station will provide greatly improved facilities including dedicated staff meeting facilities, a bigger garage to ensure that service vehicles do not have to park outside, and better parking and disability access. The Glenorchy super‑station will have a specific focus on state‑of‑the‑art training facilities which will include contemporary administration, operations and staff amenities, with better garaging of vehicles and parking spaces. It is anticipated that the new stations will be completed in 2021.
The 2018-19 Budget allocates additional funding of $14.9 million over four years to recruit an additional 42 paramedics, to reduce overtime costs, increase ambulance responsiveness, and reduce fatigue in regional areas around Tasmania. These paramedics will perform 24 hour on duty coverage in those communities to better support Ambulance Tasmania volunteers.
Funding of $8 million is provided over four years to fully roll out secondary triage of Ambulance Tasmania calls. Secondary triage will ensure that patients not requiring emergency intervention or transport to an emergency department will be referred to an appropriate health service, keeping paramedic resources available for emergency calls. Once fully operational, the secondary triage service will assess almost 2 200 calls per annum and has the potential to divert up to 16 000 patients to alternate service providers.
Funding of $1.1 million is provided to construct a dedicated training room at the Smithton Ambulance Station and a new two bedroom unit for relief staff.
Additional funding has been provided for the Ambulance Tasmania State Operations Centre which will boost staffing in the Centre by employing an additional six full-time staff. These staff will help meet the growing demand for services, and are in addition to a staffing increase of five full‑time staff in 2017-18.
Funding of $15 million is provided over three years for capital improvements at Tasmania’s rural and regional hospitals. It is anticipated that $10 million will be spent on rural hospitals to provide better facilities for staff and patients; and $5 million will be spent on ambulance stations to provide better facilities for paramedics and volunteers at rural stations. Funding will be allocated based on areas with the greatest need.
Funding of $1.1 million is provided to purchase new training equipment and stretchers. The equipment will include training dummies and Smart Stretchers that will help improve patient safety.
Additional funding of $800 000 per annum is provided to enhance support for ambulance volunteers including:
· reimbursement of out‑of‑pocket expenses;
· enhanced training and coordination;
· enhanced equipment for training volunteers;
· formal recognition of skills developed, including Advanced First Aid certificates;
· reviewing operational responsibility to ensure volunteer stations have support from a Branch Station Officer; and
· increased volunteer recruitment and retention to improve the efficiency of Ambulance Tasmania and the response to patients, particularly in rural communities.
Public Health
The 2016‑17 Budget provided additional funding of $1.6 million over four years to fund initiatives under the Healthy Tasmania policy. In addition, the Department reallocated existing funding of $1 million over the same period.
This funding was reprofiled over that period to align with the implementation of initiatives identified in the Government's Healthy Tasmania Five Year Strategic Plan targeted at key areas of smoking and obesity.
The 2018‑19 Budget provides ongoing funding of $1.1 million per annum to support the Healthy Tasmania Five Year Plan from 2020‑21 after current funding ceases.
The 2018-19 Budget provides $880 000 over two years to Epilepsy Tasmania to support improved services for Tasmanians living with epilepsy. Epilepsy Tasmania will be able to increase the availability of support services, improve GP liaison and hospital avoidance, increase education and awareness of epilepsy (including through the Smart Schools program), and boost peer and family/carer support.
The 2018‑19 Budget provides additional funding of $440 000 over two years to the Stroke Foundation to enable health support on a regional basis.
The 2018‑19 Budget provides $6.6 million to establish the Tasmanian Community Health Fund which will provide grant funding to individuals and groups with ideas to improve the health of their community.
On 20 March 2018, the Government announced that, effective from 1 July 2018, the Department of Communities Tasmania will be established through the amalgamation of part of the Department of Health and Human Services and part of the Department of Premier and Cabinet. The establishment of the new Department will result in the Department of Health and Human Services ceasing on 30 June 2018, with the remaining Outputs not transferred to the new Department to form the new Department of Health.
As part of the restructure, the Tasmanian Health Service will also be brought into the Department of Health.
In accordance with the establishment of the new Department, the Department of Health and Human Services Output Groups have been allocated to the new Departments as follows:
· Output Group 1 - Health Services System Management has been reallocated to the Department of Health.
· Output Group 2 - Tasmanian Health Service has been reallocated to the Department of Health.
· Output Group 3 - Statewide Services has been reallocated to the Department of Health.
· The former Output Group 4 - Human Services System Management has been split in two and renamed Output Group 4 - Housing Services System Management; and Output Group 6 - Disability Services and Community Development System Management. Both Output Groups have been reallocated to the Department of Communities Tasmania.
· The former Output Group 5 - Human Services has been split in two and renamed Output Group 5 ‑ Housing Services; and Output Group 7 - Disability Services and Community Services. Both Output Groups have been reallocated to the Department of Communities Tasmania.
· Output Group 6 - Children Services System Management has been renamed Output Group 1 - Children Services System Management, and has been reallocated to the Department of Communities Tasmania.
· The former Output Group - 7 Children Services has been renamed Output Group 2 - Children Services and has been reallocated to the Department of Communities Tasmania.
· The former Output Group - 8 Independent Children’s and Young Persons’ Review Service has been renamed Output Group 3 - Independent Children’s and Young Persons’ Review Service, and has been reallocated to the Department of Communities Tasmania.
The 2017‑18 estimates reflect the new structure for comparative purposes.
Outputs of the Department of Health are provided under the following Output Groups:
· Output Group 1 ‑ Health Services System Management;
· Output Group 2 ‑ Tasmanian Health Service; and
· Output Group 3 ‑ Statewide Services.
Table 5.2 provides an Output Group Expense Summary for the Department.
Table 5.2: Output Group Expense Summary1
|
|
2017-18 |
2018-19 |
2019-20 |
2020-21 |
2021-22 |
|
|
|
|
Forward |
Forward |
Forward |
|
|
Budget |
Budget |
Estimate |
Estimate |
Estimate |
|
|
$'000 |
$'000 |
$'000 |
$'000 |
$'000 |
|
Minister for Health |
|
|
|
|
|
|
|
|
|
|
|
|
|
Output Group 1 - Health Services System Management |
|
|
|
|
|
|
1.1 Health Services System Management2 |
160 194 |
183 237 |
177 481 |
170 322 |
178 997 |
|
|
160 194 |
183 237 |
177 481 |
170 322 |
178 997 |
|
Output Group 2 - Tasmanian Health Service |
|
|
|
|
|
|
2.1 Admitted Services3 |
819 545 |
879 435 |
924 508 |
951 311 |
988 166 |
|
2.2 Non-admitted Services4 |
197 398 |
189 880 |
188 651 |
196 886 |
211 867 |
|
2.3 Emergency Department Services |
119 583 |
120 214 |
120 219 |
125 762 |
130 814 |
|
2.4 Community and Aged Care Services5 |
208 225 |
204 870 |
196 656 |
203 261 |
208 305 |
|
2.5 Statewide and Mental Health Services6 |
113 860 |
113 708 |
113 632 |
122 445 |
126 184 |
|
2.6 Forensic Medicine Service |
1 479 |
2 340 |
2 384 |
2 463 |
2 520 |
|
|
1 460 090 |
1 510 446 |
1 546 050 |
1 602 128 |
1 667 857 |
|
Output Group 3 - Statewide Services |
|
|
|
|
|
|
3.1 Ambulance Services7 |
74 208 |
81 865 |
95 470 |
99 171 |
103 892 |
|
3.2 Public Health Services8 |
30 201 |
25 505 |
25 894 |
25 500 |
24 615 |
|
|
104 409 |
107 370 |
121 364 |
124 671 |
128 507 |
|
|
|
|
|
|
|
|
Capital Investment Program9 |
18 340 |
.... |
.... |
.... |
.... |
|
|
|
|
|
|
|
|
Special Capital Investment Funds10 |
21 000 |
6 500 |
.... |
.... |
.... |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TOTAL |
1 764 033 |
1 807 553 |
1 844 895 |
1 897 121 |
1 975 361 |
|
|
|
|
|
|
|
Notes:
1. Agency estimates do not include the indexation impact of any variations to agency expenditure that have been made since the finalisation of the Revised Estimates Report 2017-18 (including December Quarterly Report). For further information see chapter 1 of this Budget Paper.
2. The increase in Health Services System Management in 2018-19 primarily reflects the profile of funding provided under National Partnership Agreements and additional funding for the Tasmanian Community Health Fund and More Drug and Alcohol Rehabilitation Beds.
3. The increase in Admitted Services in 2018-19 reflects: the transfer of $20 million for 2017-18 Budget initiatives previously allocated to Finance-General including for the Royal Hobart Hospital and Repatriation Hospital Support Packages and John L Grove Rehabilitation Centre; an increase in Australian Government funding to reflect growth in Activity Based Funded services and Block grants; and additional funding provided for election commitments including the Eight Bed Acute Medical Unit at the North West Regional Hospital, 250 beds for the Royal Hobart Hospital and an additional Eight Beds on Ward 4K at the Launceston General Hospital.
4. The decrease in Non‑admitted Services in 2018‑19 primarily reflects the reclassification of expenditure between Outputs to align with activity and a reduction in the forecast expenditure in relation to Hepatitis C medications on the Pharmaceutical Benefits Scheme.
5. The movement in Community and Aged Care Services primarily reflects additional funding provided in relation to the Community Rapid Response initiative, offset by a reclassification of expenditure between Outputs to align with activity.
6. The movement in Statewide and Mental Health Services primarily reflects a reclassification of expenditure between Outputs to align with activity, and the timing of additional funding provided in the 2018-19 Budget for 25 Mental Health Beds in Southern Tasmania which are due to be fully operable from 2020-21.
7. The increases in Ambulance Services primarily reflect additional funding provided in relation to the Investment in Ambulance Services policy commitment including additional funding for an Aeromedical Helicopter Service; More Paramedics in Regional Areas; Secondary Triage; Volunteer Support Package; and State Operations Centre Boost.
8. The movements in Public Health Services primarily reflect the timing of expenditure provided under the Essential Vaccines National Partnership Agreement and the delivery of initiatives under the Healthy Tasmania Five Year Plan.
9. The decrease in CIP reflects the removal of the transfer of completed assets funded under CIP from the Department of Health and Human Services to the THS. These transactions are not required under the new agency structure.
10. The decrease in 2019-20 reflects the completion of projects in SCIF.
This Output provides a number of functions including the provision of support for corporate services, policy, planning, regulation, funding, monitoring and service improvement across health services. This Output also provides support to the Secretary in establishing output priorities, including service improvement and supporting the THS to develop consistent, collaborative models of care particularly for chronic and complex conditions.
This Output includes:
· grants provided to non-government organisations in relation to mental health services, home and community health services, population health and alcohol and drugs;
· funding held centrally for health related expenses including payments to nationally funded centres, the National Blood Authority and the Post Graduate Medical Council;
· the Department’s contribution to the Australian Government for older people receiving basic community care to reflect the additional cost to the Australian Government to offset the net additional financial responsibilities taken on as part of the National Health Reform Agreement; and
· centralised functions in relation to the delivery of Statewide Mental Health Services.
Table 5.3: Performance Information ‑ Output Group 1
|
Performance Measure |
Unit of Measure |
2015-16 Actual |
2016-17 Actual |
2017-18 Target |
2018-19 Target |
|
|
|
|
|
|
|
|
Implementation of Government reform agenda goals achieved within published timeframe1 |
% |
75 |
96 |
100 |
100 |
|
Service Plan developed and administered in accordance with the THS Reform Act, and policy settings endorsed by the Minister for Health2 |
Number |
na |
na |
1 |
1 |
|
|
|
|
|
|
|
Notes:
1. The health reform goals are those specified in the Government’s Agenda 2016 and Deliverables 2017. The target of 100 per cent was not achieved due to timeframes regarding the upgrade to the Launceston Ambulance Station. Significant capital works under Stage 1 were completed, with Stage 2 to be completed in 2017-18.
2. The Tasmanian Health Service Act 2018 requires a Service Plan to be prepared by the Secretary. The Service Plan replaces the previous requirement for a Service Agreement.
This Output provides admitted acute and sub‑acute inpatient services (elective and non‑elective) provided by Tasmania’s major public hospitals to patients either admitted to a ward or in an out‑of‑hospital setting. It excludes designated mental health wards in major public hospitals.
This Output provides non‑admitted services, including ambulatory acute and sub‑acute services provided by Tasmania’s major public hospitals either on‑site or in an out‑of‑hospital setting. This includes the provision of Cancer Screening Services.
This Output provides services relating to emergency presentations at Tasmania’s major public hospital emergency departments.
This Output comprises rural hospitals, residential aged care and community health based services including:
· rehabilitation, allied health assessments and case management;
· community nursing, continence, orthotics and prosthetics services, and equipment schemes; and
· the Child Health and Parenting Service.
In addition, community palliative care services provide interdisciplinary care, support and counselling to people living with life limiting illnesses, and their families. These services are provided in a community health centre or home‑based environment.
This Output provides emergency and general oral care and dentures to eligible adults (holders of Health Care or Pensioner Concession cards) and all children under the age of 18 years, as well as a range of health promotion and prevention activities.
This Output provides services to clients and their families to treat, support and manage mental health disorders. The service also provides:
· crisis assessment and treatment, intensive support, community care and rehabilitation services;
· primary health care services in correctional facilities;
· forensic mental health services to people with mental illness who have come into contact with the criminal justice system; and
· alcohol and drug services at the individual and population level.
This Output provides forensic and medical services, forensic pathology and clinical forensic medicine.
Table 5.4: Performance Information ‑ Output Group 21
|
Performance Measure |
Unit of Measure |
2015‑16 Actual |
2016-17 Actual |
2017-18 Target |
2018-19 Target |
|
|
|
|
|
|
|
|
Admitted Services |
|
|
|
|
|
|
Admitted patients ‑ Acute Admitted Weighted Inlier Units2 |
Number |
93 814 |
101 535 |
na |
na |
|
Admitted patients - National Weighted Activity Unit3 |
Number |
na |
na |
92 840 |
93 446 |
|
Elective surgery patients seen on time4,5 |
|
|
|
|
|
|
Category 14,5 |
% |
77.1 |
78.0 |
100.0 |
100.0 |
|
Category 24,5 |
% |
43.4 |
59.0 |
98.0 |
98.0 |
|
Category 34,5 |
% |
63.0 |
81.0 |
98.0 |
98.0 |
|
Elective surgery patients ‑ average overdue wait time for those waiting beyond the recommended time4,5 |
|
|
|
|
|
|
Category 14,5 |
Days |
26.2 |
29.0 |
11.0 |
11.0 |
|
Category 24,5 |
Days |
157.7 |
10.07 |
40.0 |
40.0 |
|
Category 34,5 |
Days |
135.8 |
8.07 |
28.0 |
28.0 |
|
Elective surgery admissions4 |
Number |
19 236 |
19 205 |
17 500 |
17 500 |
|
Hand hygiene compliance5 |
% |
79.3 |
80.4 |
80.0 |
80.0 |
|
Healthcare associated staphylococcus aureus (including MRSA) bacteraemia (rate per 10 000 patient days)5 |
Rate |
1.0 |
0.2 |
<2.0 |
<2.0 |
|
Cost per weighted separation6 |
$ |
5 198 |
5 085 |
5 589 |
5 343 |
|
Table 5.4: Performance Information ‑ Output Group 2 (continued) |
|||||
|
Performance Measure |
Unit of Measure |
2015‑16 Actual |
2016-17 Actual |
2017-18 Target |
2018-19 Target |
|
|
|
|
|
|
|
|
Non-admitted Services |
|
|
|
|
|
|
Outpatient attendances7 |
Number |
523 404 |
548 034 |
564 475 |
581 409 |
|
|
|
|
|
|
|
|
Emergency Department Services |
|
|
|
|
|
|
Department of Emergency Medicine presentations |
Number |
153 524 |
156 587 |
156 174 |
161 922 |
|
Emergency Department (ED) patients who are admitted, referred for treatment or discharged within four hours5 |
% |
66.3 |
64.7 |
80.0 |
80.0 |
|
Percentage of all ED patients seen within the recommended triage time5 |
% |
66.5 |
64.8 |
80.0 |
80.0 |
|
|
|
|
|
|
|
|
Community and Aged Care Services8 |
|
|
|
|
|
|
Rural hospitals ‑ separations |
Number |
4 479 |
4 024 |
4 700 |
4 153 |
|
Rural hospitals ‑ occupancy rate9 |
% |
59.0 |
62.0 |
55.0 |
60.0 |
|
Community nursing ‑ occasions of service10 |
Number |
173 588 |
174 010 |
173 588 |
174 000 |
|
Residential aged care ‑ occupancy rate |
% |
92.8 |
91.0 |
78.0 |
90.0 |
|
Aged Care Assessment Program ‑ completed assessments11 |
Number |
4 080 |
3 999 |
4 000 |
5 000 |
|
Mothers attending the eight week Child Health Assessment |
% |
86.8 |
89.9 |
88.0 |
91.0 |
|
|
|
|
|
|
|
|
Oral Health Services12 |
|
|
|
|
|
|
Adults ‑ occasions of service ‑ general |
Number |
15 114 |
12 933 |
14 963 |
12 000 |
|
Adults ‑ occasions of service ‑ episodic |
Number |
32 402 |
31 487 |
32 078 |
33 000 |
|
Adults ‑ occasions of service ‑ dentures |
Number |
19 953 |
19 929 |
19 753 |
17 500 |
|
Children ‑ occasions of service |
Number |
65 675 |
62 122 |
63 051 |
62 908 |
|
General (adults) waiting list13 |
Number |
7 162 |
8 901 |
7 762 |
10 500 |
|
Dentures waiting list |
Number |
694 |
222 |
376 |
187 |
|
|
|
|
|
|
|
|
Mental Health and Alcohol and Drug Services |
|
|
|
|
|
|
Inpatient Separations |
Number |
2 067 |
2 044 |
2 100 |
2 100 |
|
Community and Residential ‑ active clients |
Number |
7 873 |
7 828 |
7 800 |
7 800 |
|
28 day readmission rate |
% |
14.5 |
14.3 |
<14.0 |
<14.0 |
|
Proportion of persons with a mental illness whose needs are met by the Tasmanian Mental Health Service14 |
% |
62.7 |
62.05 |
63.0 |
63.0 |
|
Average length of acute inpatient stay Alcohol and Drug Service |
Days |
10.5 |
11.3 |
11.0 |
12.0 |
|
Alcohol and Drug Services ‑ closed episodes of treatment15 |
Number |
3 840 |
3 389 |
4 000 |
4 000 |
Table 5.4: Performance Information ‑ Output Group 2 (continued)
|
Performance Measure |
Unit of Measure |
2015‑16 Actual |
2016-17 Actual |
2017-18 Target |
2018-19 Target |
|
|
|
|
|
|
|
|
Pharmacotherapy Program - total active participants |
Number |
924 |
946 |
930 |
930 |
|
Withdrawal Unit - bed occupancy |
% |
45.5 |
48.4 |
75.0 |
75.0 |
|
Withdrawal Unit - average length of stay |
Days |
6.0 |
6.67 |
7.0 |
7.0 |
|
|
|
|
|
|
|
|
Cancer Screening |
|
|
|
|
|
|
Eligible women screened for breast cancer16 |
Number |
31 696 |
31 491 |
33 597 |
33 380 |
|
BreastScreen - percentage of clients assessed within 28 days of screening |
% |
80.5 |
85.5 |
90.0 |
90.0 |
|
|
|
|
|
|
|
Notes:
1. The 2018-19 Service Plan was not finalised at the time of this Table’s preparation. Accordingly, where there is a direct alignment between performance measures in this Table and KPIs included in the 2018-19 Service Plan, targets in the final 2018‑19 Service Plan may differ from those reported in this Table.
2. The reporting of inlier weighted units as a measure of activity began in 2015-16 and ceased in 2016-17. From 2017-18, activity has been measured as a National Weighted Activity Unit to align the Tasmanian Funding Model with the National model (refer to note 3).
3. The 2018-19 target is derived from the draft 2018-19 Service Plan which was not finalised at the time of this Table’s preparation. The target in the final 2018-19 Service Plan may therefore differ from that reported in this Table. The target excludes activity delivered at the Mersey Community Hospital.
4. Figures have been revised to better reflect actual admission levels, with revised admission levels for 2016-17 reflecting the investment of additional funding provided under the Australian Government’s Tasmanian Health Assistance Package initiative. This funding ceased in May 2017.
5. The 2018-19 targets are derived from the draft 2018-19 Service Plan which was not finalised at the time of this Table’s preparation. The targets in the final 2018-19 Service Plan may therefore differ from those reported in this Table.
6. The 2016-17 actual reflects the preliminary result (not yet published) from the Round 21, National Hospital Cost Data Collection (2016-17). The 2018-19 target is based on the Round 21 preliminary result, indexed at 2.5 per cent per annum.
7. The 2017‑18 target for Outpatient attendances is a more accurate reflection of the expected 3 per cent annual increase from the 2016-15 Actuals.
8. The 2018-19 targets for occupancy measures are a reflection of 2017-18 year to date performance (as at April 2018).
9. Occupancy is an average for all facilities and calculated from the ‘beds occupied daily average’.
10. Work is currently underway to reform the community nursing service delivery model.
11. Targets are based on previous year’s data and year to date projected figures. They indicate that assessment numbers have increased to a level that was occurring in 2014-15, prior to major reforms which impacted the Aged Care Assessment Teams work processes.
12. Australian Government funding has been provided under the NPA on Public Dental Services for Adults and the Child Dental Benefits Schedule. The Australian Government has announced a commitment to the continued funding of dental services to 30 June 2019. Due to the late signing of the current NPA, meeting the 2017-18 targets will prove challenging.
13. The number of adults on the general waiting list at the end of June 2018 is estimated at 10 895. The increase reflects uncertainty caused by the later than anticipated signing of the NPA on Public Dental Services for Adults by the Australian Government.
14. This indicator is based on the estimated 3 per cent of the Tasmanian population with severe mental illness. Australian Bureau of Statistics estimation of the Tasmanian population at the end of the September quarter 2017 was 522 000, giving an estimated 15 660 people with a severe and persistent mental illness.
15. The count for closed episodes of treatment now includes treatment services provided by non-government organisations funded by the Tasmanian Government and an update of the Tasmanian Public Alcohol and Drug Services.
16. The 2018-19 target is for 6 per cent growth on the 2015-16 attendance figure which reflects growth in the demographic and an increase in participation. This target is contingent on continued Australian Government funding of screening in the 70-74 age cohort, which currently represents 12 per cent of women screened by BreastScreen Tasmania. The existing agreement for the 70-74 cohort expired in June 2017 and a project agreement for the period 2017-20 is in the final stages of negotiation.
The Tasmanian Health Service Act details the provisions for the Service Plan, the key mechanism of accountability between the Minister for Health and the THS.
The Service Plan includes:
• a schedule of services to be provided by or on behalf of the THS and the funding to be provided in relation to the provision of those services;
• performance standards, targets and measures;
• standards of patient care and service delivery;
• reporting requirements; and
• a performance management process.
The 2018‑19 Service Plan will be finalised following the delivery of the State Budget.
THS performance in relation to the Service Plan targets will be monitored by the Department of Health throughout 2018‑19.
Performance monitoring through the Service Plan process focuses on improving the efficiency and effectiveness of service delivery, and the safety and quality of care.
This Output provides integrated pre‑hospital emergency and medical services, health transport, aero‑medical and medical retrieval services to the Tasmanian community. It provides these services through a system of paramedics, doctors, patient transport officers, volunteer officers and the support and partnership of independent non‑government services around the State.
This Output protects and improves the health of Tasmanians by enabling Tasmanians to make positive health choices and live in safe environments. Public Health Services provides two service streams:
· Health Protection, which monitors and enforces legislation to manage and help prevent disease, illness and injury; and
· Health Improvement, which develops and implements evidence based policies and programs to improve health outcomes and prevent or reduce risk factors that lead to chronic conditions.
The statutory scope of Health Protection is defined by legislation including the Public Health Act 1997, Poisons Act 1971, Fluoridation Act 1968, Food Act 2003 and the Radiation Protection Act 2005. The aim of Health Improvement practice is to guide and support the health service and community service sectors in the State, particularly to work closely with key partners to implement programs and target interventions within populations that are at higher risk of poorer health outcomes. This work is closely aligned with the Government’s strategy for preventive health, the Healthy Tasmania Five Year Strategic Plan.
Table 5.5: Performance Information ‑ Output Group 3
|
Performance Measure |
Unit of Measure |
2015-16 Actual |
2016-17 Actual |
2017-18 Target |
2018-19 Target |
|
|
|
|
|
|
|
|
Ambulance Services |
|
|
|
|
|
|
Total Ambulance Responses1 |
Number |
81 409 |
83 764 |
87 115 |
90 599 |
|
Emergency Ambulance Responses2 |
Number |
49 644 |
43 064 |
44 787 |
46 578 |
|
Satisfaction with Ambulance Services |
% |
98 |
97 |
98 |
98 |
|
Median Emergency Response Times (Statewide)3 |
Mins |
12.9 |
13.8 |
11.6 |
13.8 |
|
Median Emergency Response Times (Hobart)3 |
Mins |
11.9 |
12.6 |
10.7 |
12.6 |
|
Median Emergency Response Times (Launceston)3 |
Mins |
11.7 |
12.2 |
10.6 |
12.2 |
|
Median Emergency Response Times (Devonport)3 |
Mins |
10.5 |
10.6 |
9.5 |
10.6 |
|
Median Emergency Response Times (Burnie)3 |
Mins |
10.1 |
11.0 |
9.4 |
11.0 |
|
Ambulance Services expenditure per person4 |
$ |
133.8 |
135.8 |
136.5 |
135.8 |
|
|
|
|
|
|
|
|
Public Health Services |
|
|
|
|
|
|
Radiation Protection |
|
|
|
|
|
|
Radiation Management Plan ‑ Notifying of a review5 |
% |
78.0 |
84.0 |
98.0 |
98.0 |
|
Radiation Source Certification ‑ Recertified prior to expiry |
% |
98.0 |
96.0 |
100.0 |
100 |
|
Immunisation |
|
|
|
|
|
|
Vaccine coverage in children aged 12‑15 months6 |
% |
92.9 |
93.8 |
95.0 |
95.0 |
|
Vaccine coverage in children aged 24‑27 months6 |
% |
89.7 |
92.0 |
95.0 |
95.0 |
|
Move Well Eat Well |
|
|
|
|
|
|
Primary School Program Membership |
% |
80.1 |
81.0 |
82.0 |
83.0 |
|
Primary School Program Awarded |
% |
24.0 |
26.7 |
33.0 |
34.0 |
|
Early Childhood Program Membership |
% |
84.0 |
78.0 |
90.0 |
86.0 |
|
Early Childhood Program Awarded |
% |
23.0 |
24.0 |
30.0 |
28.0 |
|
|
|
|
|
|
|
Notes:
1. The number of vehicles dispatched (responses) is one measure of the Ambulance Service’s workload and an indicator of the demand for ambulance services in Tasmania. This measure includes emergency, urgent and non‑urgent responses. This indicator is a measure of demand rather than performance. The figures presented here for 2015‑16 and 2016‑17 are actual caseload. The target figures presented here for 2017‑18 and 2018‑19 are estimated caseloads based on an expected increase in caseload of 4 per cent per annum. The 2017-18 target figure published in the 2017-18 Budget was originally reported as 97 535, this target figure has been revised to more accurately reflect the target responses for the year.
2. An emergency incident is one requiring at least one immediate ambulance response under lights and sirens. This measure is a subset of the figure reported as Total Ambulance Responses, but for emergency incidents only. The 2017-18 target figure published in the 2017-18 Budget was originally reported as 51 695, this target figure has been revised to more accurately report the target responses for the year.
3. The ambulance emergency response time is the difference in time between an emergency 000 call being received at the Ambulance Tasmania Communications Centre and the first vehicle arriving at the location to treat the sick or injured patient. The Median Emergency Response Time is the middle time value when all the response times are ordered from the shortest to the longest. The MERT can be broadly interpreted as the time within which approximately 50 per cent of the first responding ambulance resources arrive at the scene of an emergency. The target for these measures is based on the previous year’s reported figures.
4. These figures are as published in the annual Report on Government Services and may differ from those in previous reports due to statistical parameter adjustments.
5. Radiation Management Plans are required for providers who hold licences which have the dealing of ‘possession’- that is, being in control of a radiation source. The plan is approved when the licence is issued. Plans do not have an expiry date and only need re‑approving if there are changes to the licensees’ radiation safety practices. Practices are reminded to review their plans and to notify that the review has been conducted.
6. Targets for 2017-18 and 2018-19 have been revised to reflect target vaccines rates under the new National Partnership on Essential Vaccines.
There are a variety of factors which affect ambulance response times in Tasmania including:
· demand for service against the available resource base;
· the ageing population as a primary driver of demand;
· a relatively high proportion of the population living in rural and remote areas;
· hilly terrain and ribbon urban development along the Derwent and Tamar rivers; and
· a high reliance on Volunteer Ambulance Officers.
The demand for Ambulance Services in 2016-17 was 83 764 responses, an increase of 2 355 ambulance responses or approximately 3 per cent on the previous year.
The 2016-17 median emergency response time for Tasmania is 13.8 minutes, meaning that approximately 50 per cent of all Tasmanian emergency calls were responded to within that timeframe.
Ambulance response times in Tasmania are affected by the wide dispersal of the population. Tasmania has the greatest proportion of people living in rural areas of all states. According to the Australian Bureau of Statistics Estimated Resident Population by Remoteness publication, the proportion of Tasmania’s population living in rural and remote areas is three times the national figure.
Strategies to reduce the impact of demand are a high priority for Ambulance Tasmania. Initiatives being progressed include public education campaigns and community announcements, and improvements in technology.
Radiation Protection
Practices holding licences under the Radiation Protection Act 2005 are required to have a current and approved radiation management plan. Radiation sources (x-ray, laser and radioactive materials) require a certificate of compliance. Maintaining continuity of currency of management plans, and retesting and certification of radiation sources prior to expiry is a key to radiation protection. Licence holders make returns to the Radiation Protection Unit demonstrating compliance with both these requirements. This is recorded for each licence holder in the licensing and information management system.
Immunisation
Children are considered fully immunised if they have received vaccines for diphtheria, tetanus and pertussis, polio, Haemophilus influenza type b, hepatitis B and pneumococcal by 12 to 15 months; with the addition of meningococcal C and measles, mumps, rubella and varicella by 24 to 27 months.
In 2016-17, Tasmania’s 12 to 15 month age group rate increased by 0.9 per cent to 93.8 per cent which is similar to the national average of 93.6 per cent for this age group. There was a greater increase of 2.3 percent in the 24 to 27 month age group, from 89.7 percent to 92 percent.
Move Well Eat Well
The Move Well Eat Well Award Program is offered to all Tasmanian schools with a primary enrolment and all early childhood education and care services.
This program works actively with schools and early childhood services to take a sustainable and strategic approach to promoting healthy eating and physical activity as a regular part of every child’s day.
Membership of the Program includes a professional learning session for the whole school and early childhood staff. This enables staff to orientate the Program, receive available resources and arrange Program support. Schools and services then strengthen and embed health promotion requirements and messages in policies, curriculum and procedures for staff, children and families with the aim of achieving consistent and sustained healthy behaviours within the setting. Once the school or service meets the requirements of the Program criteria they receive the Move Well Eat Well Award, which is reviewed every two years.
The data in Table 5.5 show the total at end of each period and are cumulative from one reporting period to the next. Data are calculated as a percentage of the current number of Tasmanian schools with a primary enrolment as of time of reporting (with 221 schools enrolled as of 1 May 2018) and current number of Tasmanian long day care services (with 124 long day care services enrolled as of 1 May 2018). Schools and services that have been ‘closed’ at the time of reporting have been excluded from this data, regardless of their previous Move Well Eat Well membership status. During the reporting period there has been an increase in the number of Early Childhood Education Centres eligible for membership which has affected the percentages reported. Hence, although there has been new members and award services during the reporting period the percentages reported do not reflect this growth. Future predictions have been altered to allow for this discrepancy.
Table 5.6 identifies expenditure by the Department from the Government’s Special Capital Investment Funds.
Table 5.6: Special Capital Investment Fund Allocations
|
Estimated) |
2018‑19) |
2019-20) |
2020-21) |
2021-22) |
|
|
Total) |
) |
Forward) |
Forward) |
Forward) |
|
|
|
Cost) |
Budget) |
Estimate) |
Estimate) |
Estimate) |
|
$'000) |
$'000) |
$'000) |
$'000) |
$'000) |
|
|
|
|
|
|
|
|
|
Minister for Health |
|
|
|
|
|
|
|
|
|
|
|
|
|
Hospitals Capital Fund |
|
|
|
|
|
|
Mersey Hospital Upgrades |
1 900) |
1 055) |
....) |
....) |
....) |
|
|
|
|
|
|
|
|
Infrastructure Tasmania Fund - Health Infrastructure |
|
|
|
|
|
|
Kingston Health Centre1 |
6 500) |
5 205) |
....) |
....) |
....) |
|
|
|
5 205) |
|
|
|
|
|
|
|
|
|
|
|
Total SCIF Allocations |
|
6 260) |
....) |
....) |
....) |
|
|
|
|
|
|
|
Note:
1. This project was formerly known as the Kingston ‑ Tier Three Community Health Services Facility
The Hospitals Capital Fund was established in 2007‑08 to provide capital funding for hospitals around the State. In 2018‑19, $1.1 million has been allocated from the HCF for the upgrade of the Mersey Community Hospital. This is anticipated to be the final allocation from this Fund.
The Infrastructure Tasmania Fund ‑ Health Infrastructure was established in 2008‑09, to implement a series of capital investment projects. In 2018‑19, $5.2 million has been allocated for the redevelopment of the Kingston Health Centre. This is anticipated to be the final allocation from this Fund.
Table 5.7 provides financial information for the Department’s Capital Investment Program. More information on the Capital Investment Program is provided in chapter 6 of The Budget, Budget Paper No 1.
Table 5.7: Capital Investment Program
|
|
Estimated) |
2018‑19) |
2019-20) |
2020-21) |
2021-22) |
|
Total) |
) |
Forward) |
Forward) |
Forward) |
|
|
|
Cost) |
Budget) |
Estimate) |
Estimate) |
Estimate) |
|
$'000) |
$'000) |
$'000) |
$'000) |
$'000) |
|
|
|
|
|
|
|
|
|
New Infrastructure Commitments1 |
|||||
|
|
|
|
|
|
|
|
Minister for Health |
|
|
|
|
|
|
25 New Mental Health Beds in Southern Tasmania |
11 840) |
6 840) |
5 000) |
....) |
....) |
|
Aeromedical Helicopter Service |
1 615) |
1 615) |
....) |
....) |
....) |
|
Air Conditioning Upgrades ‑ Statewide |
4 900) |
2 700) |
2 200) |
....) |
....) |
|
Better accommodation for health professionals on Flinders Island |
500) |
500) |
....) |
....) |
....) |
|
Burnie and Glenorchy Ambulance Stations |
12 000) |
4 000) |
4 000) |
4 000) |
....) |
|
Community Rapid Response – Establishment |
360) |
360) |
....) |
....) |
....) |
|
Launceston General Hospital - More Car Parking |
5 000) |
2 500) |
2 500) |
....) |
....) |
|
Launceston General Hospital ‑ Redevelopment |
87 331) |
2 962) |
9 685) |
12 533) |
12 000 |
|
Maternity Services at the North West Regional Hospital |
2 100) |
800) |
1 300) |
....) |
....) |
|
Midlands Multipurpose Centre (Oatlands Hospital) Upgrade |
2 500) |
1 250) |
1 250) |
....) |
....) |
|
Royal Hobart Hospital - Ward Upgrades |
28 080) |
....) |
2 640) |
2 640) |
5 000 |
|
Smithton Ambulance Training Facility |
1 130) |
500) |
630) |
....) |
....) |
|
Stage 2 of the King Island Hospital Redevelopment |
10 500) |
1 125) |
3 125) |
3 125) |
3 125 |
|
Statewide - Rural Hospital and Ambulance Station Upgrade Fund |
15 000) |
5 000) |
5 000) |
5 000) |
....) |
|
Training Equipment and Stretchers |
1 100) |
1 100) |
....) |
....) |
....) |
|
|
|
|
|
|
|
|
Existing Infrastructure Commitments |
|
|
|
|
|
|
|
|
|
|
|
|
|
Minister for Health |
|
|
|
|
|
|
Campbell Town Ambulance Station |
2 960) |
140) |
1 180) |
1 640) |
....) |
|
Health Transport and Coordination Infrastructure |
10 000) |
4 123) |
....) |
....) |
....) |
|
Launceston General Hospital Ward Upgrades - Ward 4K Upgrades2 |
7 850) |
6 268) |
300) |
....) |
....) |
|
Mersey Community Hospital Capital Upgrades |
35 000) |
8 600) |
8 300) |
17 500) |
....) |
|
Priority Infrastructure Works ‑ Health3 |
2 000) |
1 720) |
....) |
....) |
....) |
|
Royal Hobart Hospital Redevelopment4 |
469 200) |
142 877) |
134 684) |
....) |
....) |
Table 5.7: Capital Investment Program (continued)
|
|
Estimated |
2018-19 |
2019-20 |
2020-21 |
2021-22 |
|
|
Total |
|
Forward |
Forward |
Forward |
|
|
Cost |
Budget |
Estimate |
Estimate |
Estimate |
|
|
$'000 |
$'000 |
$'000 |
$'000 |
$'000 |
|
|
|
|
|
|
|
|
Royal Hobart Hospital Pharmacy Redevelopment |
3 761 |
1 000 |
2 761 |
....) |
....) |
|
St Helens Hospital Redevelopment |
12 100 |
7 806 |
....) |
....) |
....) |
|
Statewide Hospital Critical Facility Upgrades |
10 500 |
1 710 |
6 600 |
....) |
....) |
|
Statewide Rural Health Facility Infrastructure Upgrades |
4 700 |
500 |
1 500 |
2 200 |
....) |
|
THS Infrastructure Upgrades |
1 880 |
....) |
720 |
1 160 |
....) |
|
|
|
|
|
||
|
205 996 |
193 375 |
49 798 |
20 125 |
||
|
|
|
|
|
|
|
1. A description for each of these projects is included in the Key Deliverables section at the commencement of this chapter.
2. The total cost of the LGH Ward Upgrades Project is anticipated to be approximately $10.3 million which includes funding from a range of other sources.
3. These funds are allocated to complete the Launceston General Hospital Cladding Upgrade project. Includes $280 000 for 2017‑18.
4. Funds allocated in 2019-20 include; final payments to contractors; client operational commissioning; and works on other existing buildings scheduled post K-Block completion. It is anticipated the new K‑Block will be completed in mid‑2019.
Additional funding of $3 million was allocated in 2017‑18 to construct a new Campbell Town Ambulance Station. The new Station will deliver a contemporary ambulance station on a green field site at the southern end of Campbell Town. The project will include accommodation for relieving paramedics. In 2018‑19, $140 000 has been allocated to commence the project.
Funding of $10 million was provided in the 2015-16 Budget for health transport infrastructure projects. These funds will be used for investment in improved infrastructure associated with changes to patient coordination, transport and accommodation arising from the One Health System reforms. These funds target capital upgrades to support patients that need to travel for services, staff that may need to travel to provide outreach services to patients, or strategies that limit the need for patients or staff to travel in order to provide or receive services under a single statewide Tasmanian health system.
Funding of $5 million is provided in 2018-19 to increase car parking at the Launceston General Hospital and to develop a long term car parking plan.
The 2016‑17 Budget provided $7.9 million over four years to upgrade Ward 4K at the Launceston General Hospital. This ward is the current children and paediatrics ward, which is not appropriately configured to support young people suffering from a mental illness. The expansion of Ward 4K will enable young people suffering from a mental illness to be treated in a clinically appropriate environment.
Funding of $2 million has been provided for the Launceston General Hospital Cladding Upgrade.
The $689 million Royal Hobart Hospital Redevelopment is Tasmania’s largest ever health infrastructure project and will deliver a modern health facility for future generations. This project is jointly funded by the Australian and Tasmanian Governments.
Construction of K-Block has commenced and is being built with important additions including:
· a safer construction methodology allowing key acute services to stay on site but away from the day to day disruption of construction and still have access to critical medical facilities and security;
· a fully costed decanting and refurbishment plan including the construction of the temporary facility in Liverpool Street;
· an improved design that will increase the floor area of levels 2 and 3 by an additional 1 400m², allowing increased space for mental health services including more outdoor recreational space;
· an improved design for the maternity ward that will increase the number of single bed rooms for women who have had caesareans or complex births;
· the addition of a helipad for emergency aero‑medical retrievals; and
· the accelerated replacement of the hyperbaric chamber.
It is anticipated the new K‑Block will be completed in mid‑2019.
The total $689 million cost of this project includes $469 million from the Capital Investment Program project identified in Table 5.7 and funds from the completed Special Capital Investment Fund, Women’s and Children’s Precinct and Cancer Centre phases of the project.
The 2016‑17 Budget provided additional funding of $3.8 million for the Royal Hobart Hospital Pharmacy Redevelopment project. This project will deliver a new, purpose built sterile pharmaceutical production facility at the Royal Hobart Hospital. This facility will be a contemporary, safe, high‑capacity sterile production suite that is able to meet patient throughput needs for chemotherapy and elective surgery, and other services as required.
The construction of a new St Helens Hospital, at a total cost of $12.7 million made over successive budgets, will achieve a modern and accessible environment for patients, clients, staff and community members in the Break O’Day region into the future.
Practical completion for the construction program of the St Helens Hospital Redevelopment project is anticipated in December 2018. Payments will extend beyond that period to reflect equipment purchases and final payments made following the completion of the defects period.
The 2017‑18 Budget provided additional funding of $10.5 million over three years for critical upgrades at hospital facilities across the State. This includes $2.2 million for the new dedicated Nurse Training facilities at the North West Regional Hospital, which will replace a substandard demountable facility. The new on‑site facility will support better education and skills building that is paramount to achieving excellent patient care.
The 2017-18 Budget provided funding of $4.7 million over three years for high priority infrastructure upgrades required in rural health facilities across the State. Investment will be primarily dedicated to roof upgrades and heating, ventilation and air‑conditioning units across the State that are in urgent need of upgrade and replacement.
Funding of $1.9 million is provided over two years, commencing in 2019-20, for significant infrastructure upgrades and replacements in the THS in addition to the Essential Maintenance program already undertaken.
Table 5.8: Statement of Comprehensive Income
|
|
2017-18 |
2018-19 |
2019-20 |
2020-21 |
2021-22 |
|
|
|
|
Forward |
Forward |
Forward |
|
|
Budget |
Budget |
Estimate |
Estimate |
Estimate |
|
|
$'000 |
$'000 |
$'000 |
$'000 |
$'000 |
|
Revenue and other income from transactions |
|
|
|
|
|
|
Appropriation revenue - recurrent1 |
1 010 336 |
1 072 057 |
1 124 875 |
1 136 268 |
1 182 077 |
|
Appropriation revenue - works & services2 |
132 001 |
93 322 |
138 691 |
49 798 |
20 125 |
|
Other revenue from government3 |
490 |
.... |
.... |
.... |
.... |
|
Revenue from Special Capital Investment Funds4 |
12 192 |
6 260 |
.... |
.... |
.... |
|
Grants5 |
525 488 |
599 311 |
543 848 |
497 405 |
515 642 |
|
Sales of goods and services |
200 345 |
208 118 |
211 006 |
212 032 |
212 849 |
|
Interest |
317 |
325 |
334 |
343 |
343 |
|
Other revenue6 |
47 543 |
18 698 |
20 172 |
20 803 |
21 976 |
|
Total revenue and other income from transactions |
1 928 712 |
1 998 091 |
2 038 926 |
1 916 649 |
1 953 012 |
|
|
|
|
|
|
|
|
Expenses from transactions |
|
|
|
|
|
|
Employee benefits7 |
1 076 563 |
1 171 948 |
1 196 235 |
1 240 774 |
1 284 333 |
|
Depreciation and amortisation8 |
44 353 |
39 306 |
47 470 |
41 937 |
35 955 |
|
Supplies and consumables9 |
479 640 |
458 188 |
463 074 |
478 201 |
512 152 |
|
Grants and subsidies10 |
135 970 |
110 299 |
109 665 |
106 985 |
113 066 |
|
Other expenses |
27 507 |
27 812 |
28 451 |
29 224 |
29 855 |
|
Total expenses from transactions |
1 764 033 |
1 807 553 |
1 844 895 |
1 897 121 |
1 975 361 |
|
|
|
|
|
|
|
|
Net result from transactions (net operating balance) |
164 679 |
190 538 |
194 031 |
19 528 |
(22 349) |
|
|
|
|
|
|
|
|
Other economic flows included in net result |
|
|
|
|
|
|
Net gain/(loss) on non-financial assets |
14 |
14 |
13 |
13 |
13 |
|
Total other economic flows included in net result |
14 |
14 |
13 |
13 |
13 |
|
|
|
|
|
|
|
|
Net result |
164 693 |
190 552 |
194 044 |
19 541 |
(22 336) |
|
|
|
|
|
|
|
|
Other economic flows - other non-owner changes in equity |
|
|
|
|
|
|
Changes in physical asset revaluation reserve |
22 965 |
23 619 |
37 721 |
38 578 |
51 980 |
|
Other movements taken directly to equity |
(5 230) |
(3 288) |
(8 386) |
(7 393) |
(43 459) |
|
Total other economic flows - other non-owner changes in equity |
17 735 |
20 331 |
29 335 |
31 185 |
8 521 |
|
|
|
|
|
|
|
|
Comprehensive result |
182 428 |
210 883 |
223 379 |
50 726 |
(13 815) |
Notes:
1. The increase in Appropriation revenue ‑ recurrent primarily reflects additional funding provided in the 2018-19 Budget for initiatives detailed in Table 5.1 Key Deliverables Statement.
2. The movements in Appropriation revenue ‑ works & services reflect movements in capital project funding from CIP. The most significant item in this profile is the RHH Redevelopment project.
3. Other revenue from government in 2017-18 reflects the utilisation of funds carried forward under Section 8A(2) of the Public Account Act 1986.
4. Revenue from Special Capital Investment Funds reflects funding associated with SCIF projects which will be completed in 2018‑19.
5. The movements in Grants primarily reflect increased Australian Government funding to reflect growth in activity based funded services and Block grants, and the final Australian Government payments under the Health and Hospitals Fund Redevelopment Royal Hobart Hospital National Partnership Agreement.
6. The reduction in Other Revenue from 2018-19 is a result of a change in the treatment for charges between the former Department of Health and Human Services and the Tasmanian Health Service now treated as an internal charge which are offset with the THS forming part of the Department of Health.
7. The movements in Employee benefits primarily reflects an increase in staffing as a result of election commitments, including 250 beds for the Royal Hobart Hospital; 180 More Nursing Graduates across Tasmania; initiatives under the Record Boost for Mental Health Care policy (including 25 Mental Health Beds in Southern Tasmania) and the Investment in Ambulance Services policy; and the transfer of 2017-18 Budget initiatives which were previously allocated to Finance‑General.
8. The movements in Depreciation and amortisation primarily reflect the Department’s anticipated depreciation schedules based on current asset balances and anticipated purchases of non-financial assets over the Budget and Forward Estimates period.
9. The movements in Supplies and consumables reflect a reduction in the forecast expenditure in relation to essential vaccines and Hepatitis C medications on the Pharmaceutical Benefits Scheme, and a reclassification of expenditure to Employee benefits, offset in the Forward Estimates by an increase in operating expenditure as a result of election commitments.
10. The movements in Grants and subsidies primarily reflect the allocation of funds for election commitments including for the Drug and Alcohol Rehabilitation Beds in Ulverstone; time limited funding for the Rural Alive and Well initiatives; Epilepsy Tasmania and the Stroke Foundation; and the Tasmanian Community Health Fund.
Table 5.9: Revenue from Appropriation by Output
|
|
2017-18 |
2018-19 |
2019-20 |
2020-21 |
2021-22 |
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|
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Forward |
Forward |
Forward |
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Budget |
Budget |
Estimate |
Estimate |
Estimate |
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$'000 |
$'000 |
$'000 |
$'000 |
$'000 |
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Notes:
1. The increase in Health Services System Management in 2018-19 primarily reflects the provision of additional funding for Drug and Alcohol Rehabilitation Beds in Ulverstone and time limited funding for Rural Alive and Well and the Tasmanian Community Health Fund.
2. The increase in Admitted Services in 2018-19 primarily reflects additional funding provided for initiatives detailed in Table 5.1 Key Deliverables Statement including 250 beds for the Royal Hobart Hospital; Eight Bed Acute Medical Unit at the North West Regional Hospital; and Eight Beds on Ward 4K at the Launceston General Hospital.
3. The increase in Emergency Department Services in 2018-19 primarily reflects a reclassification of expenditure between Outputs to align with activity and the provision of funding in the 2017-18 Budget originally allocated to Finance-General for Health initiatives.
4. The increase in Community and Aged Care Services in 2018-19 and 2019-20 primarily reflects additional funding for election commitments including Community Rapid Response, Palliative Care initiatives and 180 More Nursing Graduates across Tasmania.
5. The increase in Statewide and Mental Health Services in 2019-20 primarily reflects funding allocated for initiatives under the Record Boost for Mental Health Care policy, including 25 Mental Health Beds in Southern Tasmania.
6. The increase in Ambulance Services in 2018-19 primarily reflects additional funding provided for election commitments for the Investment in Ambulance Services policy commitment including additional funding for an Aeromedical Helicopter Service; More Paramedics in Regional Areas; Secondary Triage; Volunteer Support Package; and State Operations Centre Boost.
7. The decrease in Public Health Services in 2018-19 primarily
reflects the completion of 2014 election commitment funding.
Table 5.10: Statement of Financial Position as at 30 June
|
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|
Notes:
1. The variations in the 2019 estimates of Cash and deposits, Receivables, Payables and Other liabilities reflect more accurate estimates based on the 30 June 2017 outcome.
2. The decrease in Inventories in 2019 reflects the expiry of the current Essential Vaccines NPA and associated inventories funded by the program.
3. The variations in Property, plant and equipment over the Budget and Forward Estimates period reflects the timing of anticipated expenditure in key capital projects, including the Royal Hobart Hospital Redevelopment Project.
4. The decrease in Infrastructure in 2019 reflects completion of the Health Transport and Coordination Infrastructure project.
5. The decrease in Employee benefits in 2020 reflects the impact of the 27th pay that will occur in that year.
6. The movements in Accumulated funds primarily reflects the
completion of CIP projects predominantly associated with the Royal Hobart
Hospital and Launceston General Hospital Redevelopments and Mersey Community
Hospital Capital Upgrades.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Notes:
1. The increase in Appropriation receipts ‑ recurrent primarily reflects additional funding provided for initiatives detailed in Table 5.1 Key Deliverables Statement.
2. The movements in Appropriation receipts - capital, Receipts from Special Capital Investment Funds and Grants reflect movements in capital project funding from CIP and SCIF, including those components of CIP that are funded by the Australian government.
3. The increase in Sales of goods and services in 2018-19 primarily reflects increases in the level of chargeable activities.
4. The movements in Employee benefits primarily reflects an increase in staffing as a result of election commitments including 250 beds for the Royal Hobart Hospital; 180 More Nursing Graduates across Tasmania; initiatives under the Record Boost for Mental Health Care policy and the Investment in Ambulance Services policy; and the transfer of 2017-18 Budget initiatives previously allocated to Finance‑General.
5. The movements in Grants and subsidies primarily reflect the allocation of funds provided for election commitments including Drug and Alcohol Rehabilitation Beds in Ulverstone; time limited funding for the Rural Alive and Well initiatives, Epilepsy Tasmania and the Stroke Foundation; and the Tasmanian Community Health Fund.
6. The movement in Payments for acquisition of non-financial assets primarily reflects the anticipated timing of expenditure on major capital projects, including the Royal Hobart Hospital Redevelopment project.