4     Department of Health

Agency Outlines

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 and Minister for Mental Health and Wellbeing, Hon Jeremy Rockliff MP.

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, correctional health services and ambulance services;

·       delivering health protection through emergency and pandemic management, environmental health, chronic disease prevention and other public health and health improvement services; 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 2023‑24 and over the Forward Estimates (2024‑25 to 2026‑27). Further information about the Department is provided at www.health.tas.gov.au.

National Health Reform Agreement

The National Health Reform Agreement sets out arrangements for the Tasmanian and Australian Government contributions for the provision of health services in Tasmania, as primarily delivered by the THS.

In May 2020, the Australian Government and all states and territories signed the current NHRA, which applies from 1 July 2020 to 30 June 2025. The current NHRA provides for a continuation of existing public hospital funding arrangements.

Under the NHRA, State and Australian Governments provide ABF wherever practicable. Where ABF is not practical, funding is provided on a Block basis. Block funded services include smaller regional or rural hospitals; teaching, training and research; and non‑admitted mental health services.

The Australian Government’s funding contribution in each year is its prior year contribution plus 45 per cent of the efficient growth in the price and volume of activity under the NHRA. The Independent Hospital Pricing Authority determines the efficient price of ABF and the efficient cost of Block grants. Growth in Australian Government funding to the states and territories is capped at 6.5 per cent per year. The NHRA is a cost‑sharing arrangement and the amount of funding to be received through the Agreement is dependent on the annual level of activity.

The National Partnership Agreement on COVID‑19 Response, which shared eligible COVID‑19 costs on a 50:50 basis with the Australian Government, ceased on 31 December 2022.

Key Deliverables

Table 4.1 provides a summary of the Budget and Forward Estimates allocations for key deliverables being undertaken by the Department.

Table 4.1:         Key Deliverables Statement

 

2023‑24

 

Budget

2024‑25

Forward

Estimate

2025‑26

Forward

Estimate

2026‑27

Forward

Estimate

 

$'000

$'000

$'000

$'000

 

 

 

 

 

Aeromedical Support

300

300

....

....

Allied Health Scholarships

675

....

....

450

Ambulance Tasmania workforce ‑ post COVID‑19 demand

12 000

14 000

14 000

16 000

Australian Breastfeeding Association ‑ Tasmania Branch1

55

55

....

....

Beds and Demand ‑ Major Hospitals2

63 600

93 400

102 000

115 000

Burnie and Glenorchy Ambulance Stations3

5 596

2 787

....

....

Community Mental Health ‑ Addressing Increasing Demand1

1 200

....

....

....

Community Transport Services Tasmania4

350

350

350

....

Digital Health Transformation5

40 000

40 000

40 000

60 000

District Hospital Masterplan6

....

500

....

....

Doctors4Doctors1

50

50

....

....

Enabling High Quality Mental Health Reforms7

8 335

12 500

12 750

12 750

Extending Public Health Response

6 000

4 000

....

....

Holyoake Gottawanna Program

310

310

310

....

Launceston General Hospital Helipad

15 000

....

....

....

Men’s Table

25

25

....

....

Mental Health and Alcohol and Other Drug Lived Experience Voice7

200

225

250

250

Mental Health Integration and Reform8

3 280

3 300

....

....

Mental Health Training and Development Hub7

225

225

....

....

Pathway Shed7

50

50

....

....

Residential Rehabilitation Beds

4 300

4 300

....

....

Richmond Fellowship Homelessness Outreach - North and North West7

190

....

....

....

Royal Flying Doctor Service ‑ Regional Oral Health Support

300

300

300

300

Royal Hobart Hospital Pharmacy Redevelopment3

4 000

12 000

....

....

Salvation Army Street Teams

200

200

200

....

Statewide Rural Hospital and Ambulance Station Upgrade Fund3,9

2 800

2 800

....

....

St Johns Park Health Precinct Masterplan (RHH Stage 3)6

1 000

1 000

....

....

Supporting Access to Cutting Edge Treatments for Children with Cancer

....

300

....

....

Sustainable access to public endoscopy services

9 500

9 500

9 500

9 500

Tasmanian Eating Disorder Service

3 000

5 000

7 000

9 000

 


 

Table 4.1:         Key Deliverables Statement (continued)

 

2023‑24

 

Budget

2024‑25

Forward

Estimate

2025‑26

Forward

Estimate

2026‑27

Forward

Estimate

 

$'000

$'000

$'000

$'000

 

 

 

 

 

Transforming Public Outpatient Care, Musculoskeletal and Pain Services10

10 000

10 000

....

....

Virtual Care including COVID@homeplus

18 000

23 000

....

....

 

 

 

 

 

Notes:

1.    This initiative will be funded from within the Department’s existing resources.

2.    Beds and Demand - Major Hospitals reflects the current funding profile of this existing 2021‑22 Budget initiative.

3.    This reflects additional funding for an existing project which is included in the Capital Investment Program section of this chapter.

4.    The 2023‑24 and 2024‑25 allocations for this initiative were funded in the 2021-22 Budget. Funding for 2025‑26 is provided in this Budget.

5.    The 2023‑24 to 2025‑26 allocations for this initiative were funded in the 2022‑23 Budget. Funding of $60 million in 2026‑27 is provided in this Budget, including $10 million from within the Department’s existing resources.

6.    Funding for this initiative will be provided through the Structured Infrastructure Investment Review Process within Finance‑General.

7.    These items collectively total to the funding to be provided in relation to the broader Enabling High Quality Mental Health Reforms initiative, reflected in the Policy and Parameter Statement in chapter 4 of The Budget Budget Paper No 1.

8.    The 2023‑24 allocation for this initiative was funded in the 2022‑23 Budget. Additional funding for 2024‑25 is provided in this Budget.

9.    Additional funding is provided for upgrades to the Longford and Oatlands Ambulance stations.

10.  Funding for this initiative includes $5 million from within the Department’s existing resources.

Aeromedical Support

Funding is provided to develop a statewide Helipad Masterplan to guide future regional aeromedical infrastructure investment, including helipads at St Helens and Dover. The Masterplan will ensure that future facilities are developed, implemented and maintained in a strategic manner to support helicopter aeromedical retrieval and transport services across the State, ensuring ongoing compliance with the updated Civil Aviation Safety Authority’s helicopter landing site design and operation guidelines.

Allied Health Scholarships

Funding is provided to target students across a range of allied health professions completing their final year of study in 2023 to either stay in the State after graduating or relocate and work in Tasmania. This initiative will see up to 45 allied health professionals added to the Tasmanian Health Service from 2023‑24 providing an immediate workforce boost in areas that are currently experiencing workforce shortages. The scholarships will be paid in two instalments, the first when the recipient is a final year student and the second after three years of employment in the THS.

Ambulance Tasmania workforce ‑ post COVID‑19 demand

Funding is provided to make permanent the 97 Ambulance Tasmania positions initially established in response to the COVID‑19 pandemic. The initiative will allow Ambulance Tasmania to retain this additional workforce to meet current and projected demand across the State, as identified in data analysis and predictive modelling being undertaken for the current Ambulance Tasmania master planning work. The Master Plan will inform the placement of resources to optimise ambulance service delivery models and response times.

The additional resources will be deployed to functional areas including frontline care to meet operational demand, community paramedicine, operational leadership and support, clinical services, critical care and retrieval, emergency management, and corporate governance.

Australian Breastfeeding Association ‑ Tasmania Branch

Funding is allocated over two years to provide mothers with evidence‑based breastfeeding support services and information that covers establishing breastfeeding, the introduction of solid foods and weaning. The initiative provides parental support through a 24‑hour helpline, live chat, mum2mum app, local support groups, print and digital resources and health professional education.

Beds and Demand ‑ Major Hospitals

Funding has been brought forward into 2023‑24 to recognise the early opening of beds across major hospitals and through public‑private partnerships to meet sustained demand following the COVID‑19 pandemic. This funding supports the Government’s long‑term commitment to open 298 beds by 2023‑24. A total of 228 beds are expected to be open by 30 June 2023, with an additional 70 beds to be open by 30 June 2024.

Burnie and Glenorchy Ambulance Stations

Additional funding is allocated towards increased construction costs for the new Burnie Ambulance Station and the new Glenorchy Ambulance Station. Construction costs have been affected by market conditions, design changes to incorporate separate “hot” and “cold” zones as a result of lessons learned through the COVID‑19 pandemic and site selection.

Additional site costs have been incurred for the Burnie Ambulance Station in order to mitigate impacts on neighbouring properties on Brickport Road. Construction of the Burnie Ambulance Station began in October 2022 and is due for completion in the first half of 2024.

The new Glenorchy Ambulance Station will be constructed at a greenfield site at 11 Timsbury Road, Glenorchy. Tenders to construct the Glenorchy Ambulance Station were invited in December 2022, and construction is expected to begin in mid‑2023.

Community Mental Health ‑ Addressing Increasing Demand

Funding is allocated to boost community mental health services to meet increasing demand. This initiative includes Rural Alive and Well, Baptcare’s Choices program and the Butterfly Foundation, extending a two‑year commitment announced in the 2021‑22 Budget.

Community Transport Services Tasmania

Additional funding is provided in 2025‑26 for Community Transport Services Tasmania and its 400 volunteers to continue to support Tasmanians to access care. This initiative extends a four year commitment announced in the 2021‑22 Budget.

Digital Health Transformation

Additional funding is provided in 2026‑27 to continue the Department’s 10‑year Digital Health Transformation. It is anticipated that more than $475 million will be allocated to this project over the 10 years 2022 to 2032.

Digital Health will allow for increased care to be provided at home and across Tasmania’s geographically dispersed population. It will deliver a fully integrated patient‑centric healthcare system that will securely share critical health information across clinical and organisational boundaries.

The Digital Health Transformation Program’s goal is to empower consumers and healthcare professionals to deliver better patient outcomes through system‑wide, digitally enabled technologies across three key horizons:

·       Horizon 1 (2022 ‑ 2024): Building digital foundations and targeted investments in modernising clinical information systems across the State;

·       Horizon 2 (2025 ‑ 2027): Deployment of a statewide Electronic Medical Record including enhanced diagnostic and decision support capabilities; and

·       Horizon 3 (2028 ‑ 2032): Realisation of benefits with a modern, highly integrated, patient centric service.

The Request for Proposal for an Electronic Medical Record with Electronic Medication Management capabilities and Ambulance Electronic Patient Care Record closed in March 2023.

Work has commenced in preparation of the anticipated release of the Request for Tender for these systems by the end of July 2023, with a successful tender/s contract announcement expected by June 2024.

District Hospital Masterplan

Funding is provided to deliver a masterplan for district hospitals and community health centres in line with the place‑based approach to rural health service planning outlined in the Long‑Term Plan for Healthcare in Tasmania 2040.

Acute hospitals are supported by 13 district hospitals and 23 community health centres, many of which are in rural and remote communities across Tasmania. The capacity to provide local healthcare services is dependent on key resources such as health infrastructure and workforce.

District hospitals and community health centres are important health infrastructure assets that can provide a “hub” for delivering a range of local health care services, particularly in locations with limited access to non‑government primary healthcare infrastructure. Master planning will also consider the digital connection of District Hospitals and community health assets with statewide specialist virtual care services to provide increased support for patients to remain, or return earlier to, rural and remote communities.

Doctors4Doctors

Funding is allocated in 2023‑24 and 2024‑25 to support Doctors4Doctors to establish a local service in Tasmania aimed at promoting the health and wellbeing of doctors and medical students.

Enabling High Quality Mental Health Reforms

Funding is provided to address priority areas in the Tasmanian Mental Health Reform Program, including the permanent establishment of the Acute Care Team, the General Practice Liaison Clinician, the Lived Experience Workforce, the commencement of a workforce development team to ensure future demand can be met, and the implementation of the new Tasmanian Suicide Prevention Strategy. Funding will also support a two‑year trial of a Mental Health Emergency Response Service in the North West until 30 June 2025. Future year increases include funding for these initiatives to be extended statewide.


 

In addition, funding is provided for the following mental health related initiatives:

Mental Health and Alcohol and Other Drugs Lived Experience Voice

This initiative will enhance the lived experience voice through increased funding for existing mental health representative services (Flourish and Mental Health Family and Friends) to ensure consumers, carers and families have input into reforms occurring statewide. Funding also includes support for the establishment of an alcohol and other drugs consumer representative service as part of the Government’s Reform Agenda for the Alcohol and Other Drugs Sector in Tasmania. This continues work already underway by the Alcohol, Tobacco and Other Drugs Council.

Mental Health Training and Development Hub

The Mental Health Council of Tasmania is funded jointly by the Tasmanian Government and Primary Health Tasmania to train and support the development of lived experience workers, in line with the broader Tasmanian Mental Health Reform Program initiative to increase the number of lived experience workers across the sector.

Pathway Shed

Funding is provided to support the Pathway Shed in East Devonport to coordinate access to services and activities in the local area, promoting positive mental health and wellbeing at the grassroots level in the community.

Richmond Fellowship Homelessness Outreach Program ‑ North and North West

Funding is provided in 2023‑24 for the Richmond Fellowship Mental Health Homelessness Outreach Program in the North and North West to ensure a statewide service. This program is a mental health recovery focused program supporting people who are experiencing or are at risk of homelessness.

Extending Public Health Response

Funding is allocated over 2023‑24 and 2024‑25 to ensure that resources are available to support the continued Public Health response to the COVID‑19 pandemic and ensure capability to deal with notifiable diseases within the Tasmanian community.

Holyoake Gottawanna Program

Funding is provided over three years for the Holyoake Gottawanna Program to deliver counselling and support for individuals dealing with alcohol, drug and other addictions. This initiative extends the two‑year commitment announced in the 2021‑22 Budget.

Launceston General Hospital Helipad

Funding of $15 million is provided in 2023‑24 for the construction of a new state‑of‑the‑art rooftop helipad to replace the Ockerby Gardens facility that is no longer suitable for modern aeromedical retrieval services. The Helipad will be located on the top level of the Cleveland Street car park, providing additional flight paths to enable operation in varying weather and operational conditions and more direct access to the Launceston General Hospital’s Emergency Department, Intensive Care Unit and theatres.

Men’s Table

Funding is provided over two years to support the Men’s Table community organisation. The Men’s Table is currently expanding the number of local “Tables” (groups) around the State. This funding will support a grassroots men’s mental health and suicide prevention initiative.

Mental Health Integration and Reform

Additional funding is provided in 2024‑25 to address priority areas in the Tasmanian Mental Health Reform Program as identified in the 2020‑21 Budget. This funding allows for the continuation of the Reform Program Team and continues funding for a series of pilot reforms through to evaluation, such as Southern continuing care Teams, lived experience workforce in mental health facilities, and improving the coordination of services for people with severe and complex mental illness.

Residential Rehabilitation Beds

Additional funding is provided to continue the Residential Rehabilitation Beds initiative for a further two years. This funding supports the Salvation Army, City Mission and Pathways Tasmania to deliver 65 residential rehabilitation beds across the State for those seeking to detox and receive counselling and education.

Royal Flying Doctor Service ‑ Regional Oral Health Support

Additional funding is provided for the Royal Flying Doctor Service to provide oral health care in regional Tasmania. This initiative continues the funding commitment made in the 2021‑22 Budget.

Royal Hobart Hospital Pharmacy Redevelopment

Additional funding is provided to 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 additional funding addresses escalating construction costs associated with market conditions and resolving issues with the existing infrastructure that have become evident during site investigations and throughout the COVID‑19 pandemic.

Tenders closed in April 2023, with construction due to commence in late 2023 and be completed in 2025.

Salvation Army Street Teams

Additional funding is provided for the Salvation Army over three years to continue to provide support and help to those in need on Friday and Saturday nights. This service helps to alleviate unnecessary pressure on Tasmania Police and Tasmanian hospitals. This initiative continues the funding commitment made in the 2021‑22 Budget.

Statewide Rural Hospital and Ambulance Station Upgrade Fund

Additional funding is provided to continue the program of upgrading Ambulance Stations across Tasmania. The funding provided in the 2023‑24 Budget will enable the progression of stations at Longford and Oatlands.

The current funding profile and descriptions of upgrades funded through prior year Budget allocations for the Fund are included in the Capital Investment Program section of this chapter.

St Johns Park Health Precinct Masterplan (RHH Stage 3)

This initiative provides funding to continue the development of the St Johns Park Health Precinct Masterplan and initial planning for early projects within the masterplan.

The St Johns Park Health Precinct Masterplan will provide a 20‑year blueprint for the heritage sensitive revitalisation of this historic precinct into a contemporary health care campus to meet the public health needs of Tasmanians. The campus will include mental health, alcohol and drug services; sub‑acute, rehabilitation, and older persons/geriatric evaluation, treatment, and care; palliative care, and complementary community health services.

Redevelopment of the St Johns Park precinct allows progressive delivery of healthcare facilities in a community‑based environment and will progressively replace and grow sub‑acute services currently provided at the Repatriation Hospital and Roy Fagan Centre as Stage 3 of the Royal Hobart Hospital redevelopment. Building at St Johns Park allows for the replacement of outdated facilities without the need for decant of staff and patients or limitation in service.

The next stages of master planning will include community consultation and detailed health services planning for this Southern Sub‑Acute Care Service Hub that will seek to restore St Johns Park to ensure a further 100 years of health service to the community.

Supporting Access to Cutting Edge Treatments for Children with Cancer

Funding is provided in 2024‑25 to ensure continued local access to clinical trials for Tasmanian children with aggressive forms of cancer. This allocation supplements the existing funding provided for 2023‑24 in the 2022‑23 Budget.

Sustainable access to public endoscopy services

Ongoing funding is provided to utilise the full capacity of the health care system to deliver an additional 22 000 endoscopy procedures by 2027 and reduce the waiting time to receive endoscopies to within clinically recommended times. This initiative includes the refurbishment and upgrading of endoscopy facilities at all four major hospitals and the upgrading of equipment. This funding is in addition to funding provided in the 2021‑22 Budget for the Elective Surgery ‑ additional funding ‑ Surgeries + Endoscopy initiative.

Tasmanian Eating Disorder Service

Ongoing funding is provided to operate the Tasmanian Eating Disorder Service. TEDS is a new statewide service within Statewide Mental Health Services that will deliver specialised care and a suite of evidence‑informed programs for Tasmanians of all ages experiencing and impacted by an eating disorder.

The Australian Government provided $10 million to construct a residential Eating Disorders Treatment Centre located at St Johns Park. The Eating Disorder Treatment Centre will include eight beds in a residential style setting with consulting and treatment areas. Construction is scheduled to commence in 2023.


 

Transforming Public Outpatient Care, Musculoskeletal and Pain Services

Funding is provided over two years to address growing outpatient care demand and reduce waiting times for public outpatient services, which will provide immediate action to address long wait times, by implementing nurse led clinics, so that those who have been waiting the longest can access outpatient services as soon as possible. This funding will also increase access to evidence based musculoskeletal care pathways and implement multidisciplinary pain and rheumatology services. This initiative will help develop and implement alternative, evidence‑based and costeffective care pathways and address known service gaps to the current, traditional medical and surgical models of care available in Tasmania.

Virtual Care including COVID@homeplus

This initiative provides funding over two years to expand existing successful virtual care programs such as COVID@homeplus and develop central virtual care hubs and specialised response teams to keep care in the community as long as possible. Virtual Care support for specific conditions or types of patients will help to reduce unnecessary trips to hospital or can safely support earlier discharge from hospital to free up acute care beds to meet growing demand. Use of home‑based models of care such as “Hospital in the Home” will aid the health care system’s ability to cope with increased demand and provide improved accessibility to services, flexibility and choice for patients, families and clinicians.

Output Information

Outputs of the Department of Health are provided under the following Output Groups:

·       Output Group 1 ‑ System Management; and

·       Output Group 2 ‑ Health Services.

Table 4.2 provides an Output Group Expense Summary for the Department.

Table 4.2:         Output Group Expense Summary

 

2022‑23 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

 

 

Forward 

Forward 

Forward 

 

Budget 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Minister for Health

 

 

 

 

 

 

 

 

 

 

 

Output Group 1 ‑ System Management

 

 

 

 

 

1.1 System Management ‑ Health1

171 994 

165 654 

158 570 

158 662 

158 897 

 

171 994 

165 654 

158 570 

158 662 

158 897 

Output Group 2 ‑ Health Services

 

 

 

 

 

2.1 Admitted Services2

1 346 821 

1 480 053 

1 578 145 

1 636 676 

1 666 018 

2.2 Non‑admitted Services3

278 423 

318 058 

329 775 

314 348 

316 110 

2.3 Emergency Department Services

196 020 

205 990 

211 528 

215 630 

215 813 

2.4 Community Health Services4

266 538 

285 964 

293 942 

283 170 

287 002 

2.6 Ambulance Services5

142 812 

163 896 

167 487 

171 587 

176 835 

2.7 Public Health Services6

30 941 

38 585 

35 732 

29 329 

29 320 

 

2 261 555 

2 492 546 

2 616 609 

2 650 740 

2 691 098 

 

 

 

 

 

 

Capital Investment Program

.... 

300 

300 

.... 

.... 

 

 

 

 

 

 

Minister for Mental Health and Wellbeing

 

 

 

 

 

 

 

 

 

 

 

Output Group 1 ‑ System Management

 

 

 

 

 

1.2 System Management ‑ Mental Health and Wellbeing7

38 612 

45 893 

43 668 

38 055 

38 224 

 

38 612 

45 893 

43 668 

38 055 

38 224 

Output Group 2 ‑ Health Services

 

 

 

 

 

2.5 Statewide and Mental Health Services8

171 025 

192 801 

201 475 

202 217 

206 660 

 

171 025 

192 801 

201 475 

202 217 

206 660 

 

 

 

 

 

 

TOTAL

2 643 186 

2 897 194 

3 020 622 

3 049 674 

3 094 879 

 

 

 

 

 

 

Notes:

1.    The decrease in System Management ‑ Health in 2023‑24 and 2024‑25 primarily reflects an internal reallocation between Departmental outputs to more accurately reflect anticipated expenditure, and the funding profile of Budget initiatives.

2.    The increase in Admitted Services from 2023‑24 primarily reflects an update of expenditure under the National Health Reform Funding Agreement to align with forecast activity and the expenditure profiles of prior year initiatives including 250 beds for the Royal Hobart Hospital, Ward 3D ‑ A 32 Bed Inpatient Ward and Beds and Demand ‑ Major Hospitals.

3.    The increase in Non‑admitted Services in 2023‑24 and the variation across the Forward Estimates primarily reflects additional funding for initiatives including Virtual Care including COVID@homeplus, Transforming Public Outpatient Care, Musculoskeletal and Pain Services, and Sustainable access to public endoscopy services.

4.    The variation in Community Health Services primarily reflects the profile of funding for Virtual Care including COVID@homeplus and Enabling High Quality Mental Health Reforms, together with the expenditure profile of prior year Budget initiatives for Home and Community Based Palliative Care.

5.    The increase in Ambulance Services from 2023‑24 primarily reflects additional funding for the Ambulance Tasmania workforce ‑ post COVID19 demand initiative and an internal reallocation between outputs to more accurately reflect anticipated expenditure.

6.    The increase in Public Health Services in 2023‑24 and 2024‑25 primarily reflects additional funding for the initiative Extending Public Health Response.

7.    The increase in System Management ‑ Mental Health and Wellbeing in 2023‑24 primarily reflects additional funding for Enabling High Quality Mental Health Reforms and Residential Rehabilitation Beds, and an internal reallocation of grant payments between Departmental outputs. The decrease in 2025‑26 primarily reflects the profile of funding for the Residential Rehabilitation Beds initiative.

8.    The increase in Statewide and Mental Health Services from 2023-24 primarily reflects additional funding for the Tasmanian Eating Disorder Service, the profile of Australian Government funding allocations and prior year Budget initiatives including the Mental Health Hospital in the Home Pilot and Older Persons Mental Health Services (Roy Fagan Centre Review).


 

Output Group 1:    System Management

1.1 System Management ‑ Health

This Output provides specialist clinical advice on health professional, policy, regulatory and clinical issues impacting the Tasmanian health system; the management of intergovernmental relations; and core health services system management functions of strategy and planning, purchasing, monitoring, performance management, analysis, evaluation and reporting.

1.2 System Management ‑ Mental Health and Wellbeing

This Output provides specialist clinical advice on mental health and wellbeing professional, policy, regulatory and clinical issues impacting the Tasmanian health system; the management of intergovernmental relations; and core mental health and wellbeing services system management functions of strategy and planning, purchasing, monitoring, performance management, analysis, evaluation and reporting in the context of mental health and wellbeing.

Table 4.3:         Performance Information ‑ Output Group 1

Performance Measure

Unit of

Measure

2020‑21 Actual

2021‑22

 Actual

2022‑23 Target

2023‑24 Target

 

 

 

 

 

 

System Management ‑ Health

 

 

 

 

 

Implementation of Government reform agenda goals achieved within published timeframe1

%

100

100

100

100

Service Plan developed and administered in accordance with the THS Act, and policy settings endorsed by the Minister for Health2

Number

1

1

1

1

 

 

 

 

 

 

System Management ‑ Mental Health and Wellbeing

 

 

 

 

 

Implementation of Government reform agenda goals achieved within published timeframe1

%

100

100

100

100

 

 

 

 

 

 

Notes:

1.    The reform agenda goals for 2020‑21 and 2021‑22 are those specified in the Government’s First 100 Days Plan. The targets for 2022‑23 and 2023‑24 are based on action areas outlined in the Long‑Term Plan for Healthcare in Tasmania 2040, Our Healthcare Future ‑ Advancing Tasmania’s Health, actions from the Healthy Tasmania Five‑Year Strategic Plan 2022‑2026 and actions to be delivered by the Department under Rethink 2020: A state plan for mental health in Tasmania 2020‑2025.

2.    The Tasmanian Health Service Act 2018 requires a Service Plan to be prepared by the Secretary of the Department.

Output Group 2:    Health Services

2.1 Admitted Services

This Output provides services to acute, sub‑acute and non‑acute admitted patients (inpatients) through Tasmania’s major public hospitals. It excludes admitted services provided by designated mental health wards in major public hospitals (Output 2.5 Statewide and Mental Health Services) or district hospitals (Output 2.4 Community Health Services).

2.2 Non‑admitted Services

This Output provides services to non‑admitted patients through Tasmania’s major public hospitals. It includes services provided in outpatient clinics, as well as a number of other health services provided by Tasmania’s major public hospitals, including forensic medicine services, that are neither admitted services nor emergency department services.

2.3 Emergency Department Services

This Output provides services relating to emergency presentations at Tasmania’s major public hospital emergency departments.

2.4 Community Health Services

This Output provides community health services, hospital services and aged care services to patients and residents outside Tasmania’s major public hospitals. These services are provided through a broad range of service centres, including community health centres, child health centres, parenting centres, dental clinics, district hospitals and multi‑purpose centres.

2.5 Statewide and Mental Health Services

This Output supports a wide range of clients including people experiencing complex and chronic disease, severe mental illness, alcohol and drug issues and people within the corrections and justice system. Services include the provision of inpatient, hospital‑based and community‑based services, with many provided in partnership with community sector organisations.

2.6 Ambulance Services

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.

2.7 Public Health Services

This Output provides public health services that improve and protect the health of all Tasmanians by enabling Tasmanians to make positive health choices and live in safe environments. This is achieved through an integrated network of practice and programs led by public health specialist practitioners, doctors and scientists, with the support of local government, other agencies of government and non‑government organisations.


 

Table 4.4:         Performance Information ‑ Output Group 2

Performance Measure

Unit of

 Measure

2020‑21 Actual

2021‑22 Actual

2022‑23 Target

2023‑24 Target

 

 

 

 

 

 

Admitted Services1

 

 

 

 

 

Admitted patients ‑ National Weighted Activity Unit2,3

Number

123 310

133 479

139 850

143 650 

Elective surgery patients seen on time4

 

 

 

 

 

Category 1

%

64.0

63.9

100.0

100.0

Category 2

%

36.2

42.2

50.0

55.0

Category 3

%

35.2

65.8

70.0

75.0

Elective surgery patients ‑ average overdue wait time for those waiting beyond the recommended time4

 

 

 

 

 

Category 1

Days

105.6

91.0

0.0

0.0

Category 2

Days

231.0

270.0

100.0

90.0

Category 3

Days

273.0

283.0

80.0

70.0

Elective surgery admissions4,5

Number

18 313

20 314

20 600

20 600

Hand hygiene compliance

%

80.1

77.9

≥80.0

≥80.0

Healthcare associated staphylococcus aureus (including MRSA) bacteraemia (rate per 10 000 patient days)

Rate

0.8

1.1

≤1.0

≤1.0

Cost per weighted separation6

$

6 317

6 768

na

na

 

 

 

 

 

 

Non‑admitted Services1

 

 

 

 

 

Outpatient attendances7

Number

590 395

576 923

591 000

591 000

 

 

 

 

 

 

Emergency Department Services1

 

 

 

 

 

Emergency Department presentations8

Number

170 287

173 276

173 000

175 000

ED patients who are admitted, referred for treatment or discharged within four hours3,9

%

57.7

55.2

≥90.0

≥90.0

Percentage of all ED patients seen within the recommended triage time3,9

%

58.4

53.4

≥80.0

≥80.0

 

 

 

 

 

 

Community Health Services1

 

 

 

 

 

District hospitals ‑ separations

Number

3 934

3 549 

4 150

4 150

District hospitals ‑ occupancy rate

%

49.2

45.8

≥60.0

≥60.0

Community nursing ‑ occasions of service

Number

177 928

164 969

173 000

173 000

Residential aged care ‑ occupancy rate

%

88.3

85.4

≥90.0

≥90.0

Aged Care Assessment Program ‑ completed assessments10

Number

4 634

4 693

4 700

4 700

Mothers attending the eight‑week Child Health Assessment

%

89.5

94.0

92.0

92.0

 

Table 4.4:         Performance Information ‑ Output Group 2 (continued)

Performance Measure

Unit of

 Measure

2020‑21 Actual

2021‑22 Actual

2022‑23 Target

2023‑24 Target

 

 

 

 

 

 

Oral Health11

 

 

 

 

 

Adults ‑ occasions of service ‑ general

Number

3 283

5 946

10 900

8 600

Adults ‑ occasions of service ‑ episodic

Number

32 211

31 129

32 300

31 000

Adults ‑ occasions of service ‑ dentures

Number

14 760

13 958

15 400

12 600

Children ‑ occasions of service

Number

50 555

50 617

60 050

52 000

General (adults) waiting list

Number

17 518

15 377

14 400

15 000

Dentures waiting list

Number

759

609

150

400

 

 

 

 

 

 

Statewide and Mental Health Services1

 

 

 

 

 

Inpatient Separations

Number

2 292

2 307

2 300

2 300

28‑day readmission rate

%

15.9

16.0

≤14.0

<14.0

Average length of acute inpatient stay

Days

12.2

13.7

12.0

12.0

Community and Residential ‑ active clients

Number

8 531

8 177

8 600

8 800

Proportion of persons with a mental illness whose needs are met by the Tasmanian Mental Health Service12

%

74.9

73.2

70.0

70.0

Alcohol and Drug Services ‑ closed episodes of treatment

Number

3 406

3 143

4 000

4 000

Pharmacotherapy Program ‑ total active participants

Number

844

857

900

900

Withdrawal Unit ‑ bed occupancy

%

46.5

79.5

75.0

75.0

Withdrawal Unit ‑ average length of stay

Days

5.5

6.0

7.0

7.0

 

 

 

 

 

 

Ambulance Services

 

 

 

 

 

Total Ambulance Responses13

Number

105 327

121 443

128 381

133 516

Emergency Ambulance Responses13

Number

50 579

59 149

64 568

67 151

Satisfaction with Ambulance Services14,15

%

97.0

97.0

98.0

98.0

Median Emergency Response Times (Statewide)15,16

Mins

14.0

14.3

14.6

14.6

Median Emergency Response Times (Hobart)15,16

Mins

13.8

14.7

14.8

14.8

Median Emergency Response Times(Launceston)15,16

Mins

12.4

12.2

12.7

12.7

Median Emergency Response Times (Devonport)15,16

Mins

10.8

10.0

9.8

9.8

Median Emergency Response Times (Burnie)15,16

Mins

11.1

10.0

10.1

10.1

Ambulance Services expenditure per person17

$

251.55

262.11

na

na

 

 

 

 

 

 


 

Table 4.4:         Performance Information ‑ Output Group 2 (continued)

Performance Measure

Unit of

 Measure

2020‑21 Actual

2021‑22 Actual

2022‑23 Target

2023‑24 Target

 

 

 

 

 

 

Public Health Services

 

 

 

 

 

Eligible women screened for breast cancer18

Number

35 995

34 020

36 750

37 240

BreastScreen ‑ percentage of clients assessed within 28 days of screening19

%

89.8

82.4

90.0

90.0

 

 

 

 

 

 

Radiation Protection

 

 

 

 

 

Radiation Management Plan ‑ Notifying of a review20

%

80.0

90.0

95.0

95.0

Radiation Source Certification ‑ Recertified prior to expiry

%

94.0

98.0

95.0

95.0

 

 

 

 

 

 

Immunisation

 

 

 

 

 

Vaccine coverage in children aged 5 years21

%

95.0

94.6

95.0

95.0

 

 

 

 

 

 

Move Well Eat Well22

 

 

 

 

 

Primary School Program Membership

%

83.3

84.0

83.0

85.0

Primary School Program Awarded

%

27.1

27.4

28.0

28.0

Early Childhood Program Membership

%

78.6

77.1

80.0

80.0

Early Childhood Program Awarded

%

35.7

35.4

36.0

36.0

 

 

 

 

 

 

Notes:

1.    The 2023‑24 Tasmanian Health Service ‑ Service Plan will be finalised following the release of the 2023‑24 Budget. Performance measures and associated targets included in the Service Plan will supersede those included in this chapter and will be included in future Budgets.

2.    National Weighted Activity Units are measured differently each year and are not directly comparable between years. The 2022‑23 target has been revised, primarily reflecting increased activity levels associated with new bed openings. This growth is expected to continue with an increased target in 2023‑24. The 2023‑24 target is preliminary and may change following the finalisation of the 2023‑24 Service Plan.

3.    The 2020‑21 actual figures reflect the final end of year result.

4.    The Statewide Elective Surgery Four‑Year Plan 2021‑2025 outlines strategies to achieve a sustainable elective surgery wait list by 2024‑25. These targets show an uplift in admissions as outlined in the Plan, as well as improvements in seen on time and average overdue wait time targets, reflecting progressive achievement towards a sustainable elective surgery wait list by 2024‑25. The 2023‑24 targets are preliminary and may change following the finalisation of the 2023‑24 Service Plan.

5.    The 2022‑23 target has been updated to reflect the 2022‑23 Service Plan target.

6.    The 2020‑21 actual outcome has been revised to the preliminary figure for the Round 25 National Hospital Cost Data Collection. The 2021‑22 actual is preliminary and will be revised after the completion of the Round 26 National Hospital Cost Data Collection. Targets are not set for this indicator as historical costs do not provide a good indicator of future costs.

7.    Outpatient attendances included attendances at specialist clinics, and other activities such as radiation and oncology services that are managed separately. This data reflects counting rules for national reporting, with some occasions of service reported as a single attendance. The Transforming Outpatient Care initiative includes the design and delivery of models to increase clinic capacity and reduce waiting times. The 2023‑24 target is preliminary and may change following the finalisation of the 2023‑24 Service Plan.

8.    The Emergency Department presentations targets are a projection of expected demand, they are not a measure of performance.

9.    Emergency Department data has been updated to match national reporting rules.

10.  Data is sourced from Australian Government ‑ My Aged Care and measures performance against contract.

11.  For the Oral Health performance measures, 2020‑21 and 2021‑22 activity was impacted by the COVID‑19 pandemic, and services are continuing to recover from the impacts of the pandemic. The 2023‑24 targets have been set based on the projected actuals for 2022‑23 and reflects the completion of funding associated with the 2021‑22 Budget initiative Oral Health - One‑off Funding Injection.

12.  This indicator is based on the estimated three per cent of the Tasmanian population with severe mental illness. The Department of Treasury and Finance’s population projection for Tasmania in 2023 is approximately 573 000, giving an estimated 17 190 people with a severe and persistent mental illness in 2023‑24.

13.  Total Ambulance Responses include emergency, urgent and non‑urgent responses. This indicator is a measure of demand not performance. The estimate for 2021‑22 has been replaced with a final full‑year figure. The 2022‑23 target has been revised and is calculated by extrapolating seven months of data out to June 2023 and assumes the same rate of caseload increase will continue through to the end of the period. Target figures for 2023‑24 are calculated using four per cent expected growth on the previous year’s figures.

14.  A Patient Satisfaction Survey is undertaken in May/June each year. The results for 2022‑23 will be available in October 2023.

15.  The 2021‑22 preliminary estimate has been revised to reflect the final end of year result.

16.  The ambulance emergency response time is the difference in time between an emergency Triple Zero 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 2022‑23 MERT figures are calculated on year‑to‑date performance as at 20 February 2023.

17.  Ambulance Services expenditure per person is as published in the Productivity Commission’s Annual Report on Government Services. The Productivity Commission adjusts the time series financial data to current year dollars each year. Figures are as published in the RoGS and may differ from those in previous reports due to statistical parameter adjustments. Targets are not set for this indicator as historical expenditure does not provide a good indicator of future expenditure.

18.  The 2022‑23 and 2023‑24 targets for eligible women (aged 40 and over) screened for breast cancer are based on incremental growth in screening required to achieve 65 per cent biennial participation of women in the 50‑74 years target age group by 2024‑25. The 2021‑22 actual reflects the impacts of service closures in response to the COVID‑19 pandemic.

19.  The 2021‑22 actual percentage of clients assessed within 28 days of screening has been updated with a final full‑year figure and reflects the impacts of service closures in response to the COVID‑19 pandemic.

20.  In 2020‑21, there was a reduction in businesses notifying that they had reviewed their Plan due to closures in response to the COVID19 pandemic.

21.  Vaccine coverage indicates the proportion of fiveyearold children (aged 60‑63 months) who have been immunised against Diphtheria, Tetanus, Pertussis (Whooping Cough) and Polio due at four years of age. Data presented for 2020‑21 relates to children turning five years of age between 1 January 2020 and 31 December 2020. Data for 2021‑22 relates to children turning five years of age between 1 January 2021 and 31 December 2021. Targets for 2022‑23 and 2023‑24 are based on nationally agreed performance measures.

22.  Award and Member percentages for Early Childhood and Primary School fluctuate due to variance in the pool of eligible services and schools. In the 2022 reporting period, there was an increase in the number of Child and Family Centres, which make up one component of Early Childhood Services resulting in a slight decrease in Early Childhood membership.

 


 

Capital Investment Program

Table 4.5 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 4.5:         Capital Investment Program

 

Estimated 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

Total 

 

Forward 

Forward 

Forward 

 

Cost 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

New Projects

 

 

 

 

 

 

 

 

 

 

 

Minister for Health

 

 

 

 

 

Aeromedical Support1

600 

300 

300 

.... 

.... 

Launceston General Hospital Helipad1

15 000 

15 000 

.... 

.... 

.... 

 

 

 

 

 

 

Existing Projects

 

 

 

 

 

 

 

 

 

 

 

Minister for Health

 

 

 

 

 

Air Conditioning Upgrades ‑ Statewide2

5 900 

538 

.... 

.... 

.... 

Burnie and Glenorchy Ambulance Stations1

28 915 

18 650 

2 850 

.... 

.... 

CHHP Acute Care facility NWRH2

10 000 

2 300 

6 946 

.... 

.... 

CHHP Kings Meadows Community Centre2

10 000 

3 259 

6 148 

.... 

.... 

Digital Health Transformation1

210 000 

40 000 

40 000 

40 000 

60 000 

Hospital Equipment Fund2

20 000 

3 995 

.... 

.... 

.... 

Kingston Health Centre ‑ Stage 22

30 000 

1 000 

8 000 

11 000 

10 000 

Launceston General Hospital Redevelopment ‑ Stage 12

87 331 

1 732 

14 962 

14 962 

.... 

Launceston General Hospital Redevelopment ‑ Stage 2 (including Mental Health Precinct) 2

580 000 

8 000 

12 000 

32 000 

31 700 

Maternity Services at the North West Regional Hospital2

5 800 

587 

.... 

.... 

.... 

Mersey Community Hospital ‑ Expanded Redevelopment2

20 000 

1 000 

9 300 

9 700 

.... 

Mersey Community Hospital Capital Upgrades2

37 386 

14 276 

.... 

.... 

.... 

Midlands Multipurpose Health Centre Upgrade2

3 500 

1 950 

.... 

.... 

900 

New Ambulance Vehicles and Equipment2

9 000 

3 991 

.... 

.... 

.... 

North West Regional Hospital ‑ Mental Health Precinct2

40 000 

3 000 

16 800 

20 060 

.... 

North West Regional Hospital Upgrade2

20 000 

1 750 

.... 

750 

10 500 

Regional Health and Ambulance Facilities Fund2

10 000 

6 754 

.... 

.... 

.... 

Royal Hobart Hospital ‑ New Angiography Suite and Equipment Upgrade2

7 000 

5 600 

1 000 

.... 

.... 

Royal Hobart Hospital Pharmacy Redevelopment1

21 861 

8 815 

12 000 

.... 

.... 

Royal Hobart Hospital Redevelopment

469 200 

2 508 

.... 

.... 

.... 

Royal Hobart Hospital Redevelopment ‑ Expanded Stage 22

110 000 

13 249 

52 500 

36 860 

7 391 


Table 4.5:         Capital Investment Program (continued)

 

Estimated 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

Total 

 

Forward 

Forward 

Forward 

 

Cost 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Royal Hobart Hospital Stage 2 Redevelopment2

91 080 

30 504 

.... 

.... 

.... 

Rural Hospital Equipment Boost2

5 000 

1 490 

.... 

.... 

.... 

Statewide Hospital Critical Facility Upgrades2

6 990 

250 

253 

.... 

.... 

Statewide Rural Hospital and Ambulance Station Upgrade Fund1

21 035 

2 800 

2 800 

.... 

.... 

 

 

 

 

 

 

Minister for Mental Health and Wellbeing

 

 

 

 

 

27 New Mental Health Beds in Southern Tasmania2

20 740 

4 700 

3 827 

.... 

.... 

CHHP St Johns Park Eating Disorders Treatment Centre2

10 000 

3 300 

6 084 

.... 

.... 

 

 

 

 

 

 

Total CIP Allocations

 

201 298 

195 770 

165 332 

120 491 

 

 

 

 

 

 

Notes:

1.    Further information on this project is included in the Key Deliverables section of this chapter.

2.    Funding profiles over the Budget and Forward Estimates have been revised to reflect a more accurate expenditure profile.

Air Conditioning Upgrades ‑ Statewide

The 2023‑24 Budget reflects the continuation of the program of comprehensive air conditioning upgrades at the Royal Hobart Hospital, Launceston General Hospital and North West Regional Hospital, which commenced in 2018‑19.

Community Health and Hospitals Program

The Australian Government provided $92 million to support better health care for all Tasmanians. Capital investment initiatives announced in this program include:

·       $10 million to improve the Acute Care Facility at the North West Regional Hospital. This project will replace the Heating, Ventilation, and Air Conditioning system in the operating theatres and day surgery units. Work is underway and will be completed in late 2024;

·       $10 million for the Kings Meadows Community Centre ‑ project planning and scoping is underway with delivery of the project expected in 2025; and

·       $10 million for a new residential eating disorder clinic in Hobart, to be co located at St Johns Park with the 27 New Mental Health Beds in Southern Tasmania project. Construction is expected to commence in 2023, with the new facility operational by the middle of 2025.


 

Hospital Equipment Fund

This initiative has replaced and upgraded critical hospital equipment across Tasmania, including diagnostic imaging and surgical equipment. Equipment purchased includes $3.1 million for a new Magnetic Resonance Imaging machine at the Royal Hobart Hospital and Surgical equipment totalling $11 million in response to the Statewide Elective Surgery Four Year Plan.

Funding of $500 000 has been allocated to the development of a Medical Equipment Management Framework to provide a strategic approach for the management of equipment across the Department.

Kingston Health Centre ‑ Stage 2

The Kingston Health Centre will provide increased community health facilities for this growing region, with Stage 2 to be located at Kingston Park.

Planning commenced in 2022‑23. Consultation, including with the Kingborough Council, will be completed during 2024‑25 with construction scheduled to commence in 2025‑26.

Launceston General Hospital Redevelopment ‑ Stage 1

Delivery of the $87.3 million Stage 1 of the Launceston General Hospital continued throughout 2022‑23. The dedicated Women’s and Children’s Precinct in the lutha building opened in late 2022. The Paediatric Outpatients Clinic opened in August 2022 and the Women’s health+ Clinic opened in October 2022.

The new tunapri mapali administration and learning centre, incorporating the Anne O’Byrne Education Centre, formerly known as Drysdale, opened in November 2022. Decanting of services into this facility from Anne O’Byrne Education Centre and the main LGH campus is a key element of the LGH Masterplan implementation.

Stage One of the Masterplan is now substantially progressed, with final works involving completion of the Emergency Department airlock due to be finalised in the coming months. Other projects delivered during the year include nine negative pressure beds in the Acute Medical Unit.

Planning for major redevelopment projects and smaller refurbishment projects to create space and address service and infrastructure priorities identified in the Masterplan is underway, including planning for the expansion and redesign of the Acute Care Zone on Level 3, refurbishment of Level 2, relocation of the Department of Medicine and Orthopaedic Services, expansion of Surgical Short Stay and Day Procedure units, establishment of Neurology, Respiratory and Infusion Services to provide a shared front of house and flexible consultation rooms.

Launceston General Hospital Redevelopment ‑ Stage 2 (including Mental Health Precinct)

Funding of $580 million is allocated over 10 years from 2021‑22 to deliver the next stages of the Launceston General Hospital Redevelopment Masterplan.

Planning has commenced for a new purpose‑built mental health precinct, on the current Viewpoint site at 52 Frankland Street, to replace the current Northside Unit. Construction of the mental health precinct is scheduled to commence late 2024 and be completed in 2027.

Planning for a new inpatient and outpatient tower will begin in 2023‑24 with construction due to commence in 2027.

Maternity Services at the North West Regional Hospital

A $5.8 million purpose‑built facility providing better support for mothers, babies and staff was completed in August 2022. This contemporary facility provides a range of antenatal services offered at the North West Regional Hospital as part of the Integrated North West Birthing Service. The remaining funds in 2023‑24 will be primarily used to add car parking to provide improved visitor access to the new facility and also support the planned transition of maternity services from the North West Private Hospital.

Mersey Community Hospital ‑ Expanded Redevelopment

The projects included under this funding are a new medical ward to increase bed capacity and relocation of the hospital kitchen, in addition to existing theatre redevelopment works. Mersey capital upgrade projects that are part of the expanded redevelopment are anticipated to be complete by 2026.

Mersey Community Hospital Capital Upgrades

Significant works have been completed under this program including: lift replacement; car parking expansion; rehabilitation services; and utility services relocations. Redevelopment of the theatre and outpatient facilities commenced in 2021‑22, and in October 2022 the temporary Outpatients Clinic opened to deliver outpatients services while construction is ongoing. Another milestone was reached in March 2023 with the completion of the slab for the new E Block. Construction is scheduled for completion in mid‑2024.

Midlands Multipurpose Health Centre Upgrade

The $3.5 million Midland Multipurpose Health Centre Upgrade will deliver a new wing housing eight bedrooms. The project will deliver facilities to contemporary standards to improve comfort and quality of care for residents, with better access and ensuite facilities in all rooms. Construction work is expected to commence in December 2023 and be completed in 2024. A master planning process has identified a further two stages to be considered in the future including refurbishment and extension of the Callington Wing and construction of a new palliative care facility located in a clinical area.

New Ambulance Vehicles and Equipment

The funding provides new vehicles, replaces ageing stock, provides complete ambulance fit outs and upgrades and replaces critical equipment to support paramedics. By the end of 2022‑23 financial year a total of 51 new ambulances will have been brought into service under the program. The remaining funds are allocated to continuing to deliver the fleet renewal program and a further 21 ambulances will be delivered in 2023‑24.

North West Regional Hospital ‑ Mental Health Precinct

Planning for the Mental Health Precinct adjacent to the North West Regional Hospital is continuing as part of the development of the North West Hospitals Masterplan. A consultation draft Masterplan was released for public comment at the end of April 2023, with the final Masterplan due for release in early 2023‑24.

Facility briefing and schematic design for the new service is expected to be completed during 2023‑24 and construction is expected to commence in 2024 for completion in 2025‑26.

North West Regional Hospital Upgrade

The consultation draft of the North West Hospitals Masterplan provides a blueprint and recommended staging for the North West Regional Hospital refurbishments and expansion. These proposed upgrades are planned to occur following the construction of the new Mental Health Precinct.

Regional Health and Ambulance Facilities Fund

The 2020‑21 Budget provided an additional $10 million over four years for regional health and ambulance facilities. This funding allocation, together with the Statewide Rural Hospital and Ambulance Station Upgrade initiative, is being utilised to support the ongoing construction of new ambulance stations in regional areas statewide.

Construction of the new Bridgewater, Beaconsfield and Queenstown Rural Ambulance Stations commenced in the second half of 2022. The Bridgewater Ambulance Station is nearing completion and is due to open in mid‑2023, with Queenstown and Beaconsfield stations also scheduled for completion in 2023.

Following community consultation in late 2022, a preferred site has been identified for the Bicheno ambulance station.

Additional funding is provided in this Budget to continue the program of upgrading Ambulance Stations across Tasmania. The funding provided in the 2023‑24 Budget will enable the progression of stations at Longford and Oatlands.

Royal Hobart Hospital ‑ New Angiography Suite and Equipment Upgrade

Funding is provided to build, equip and staff a second Angiography Suite at the Royal Hobart Hospital to meet increasing patient demand and support improved patient care. Construction of the new suite will commence in late 2023 and is expected to be completed in 2024‑25.

Royal Hobart Hospital Redevelopment 

The 2023‑24 funding will fund post‑K‑Block works.

Royal Hobart Hospital Redevelopment ‑ Expanded Stage 2

Funding has been provided to expand the Stage 2 Redevelopment of the Royal Hobart Hospital, including a complete refurbishment of A Block, which is due to commence in early 2024‑25 for completion in 2028. The expansion is part of a new 30 year Masterplan for the Royal Hobart Hospital precinct.

Works include the second stage of the expanded Emergency Department which is scheduled to reach completion by 2026 and relocation and upgrades of paediatric outpatient facilities, with construction to commence in 2024.

Royal Hobart Hospital Stage 2 Redevelopment

The funding for Stage 2 of the Royal Hobart Hospital redevelopment will contribute to delivering:

·       expansion of the Emergency Department to respond to growing patient demand. The first Stage of the Emergency Department expansion, including delivering an additional 28 beds, was completed in January 2023;

·       expansion of the Intensive Care Unit, providing space for an additional 12 beds in 2023, whilst retaining close physical linkage to medical imaging. This project is under construction with operational commissioning scheduled for mid‑2023; and

·       a refit of J Block to provide a contemporary space for Cardiology services which will provide additional inpatient bed capacity. The refurbishment of Ward 2J was completed in March 2023, delivering a new Cardiology unit with improved Cardiology and Cardiothoracic Services, including a doubling of capacity in the Critical Care Unit. As part of the refurbishment of 2J, a new dedicated sleep centre was established. The new sleep centre provides comprehensive sleep management services and tertiary chronic ventilation care.

Rural Hospital Equipment Boost

This project provides new and upgraded rural hospital and health facility equipment across Tasmania. Funding includes $600 000 each for the New Norfolk District Hospital and North East Soldiers Memorial Hospital and $400 000 each for the St Helens District Hospital and West Coast District Hospital. Additionally, funding of $2 million ($200 000 per hospital) has been provided to purchase new and upgraded equipment at regional hospitals and health facilities.

Equipment purchased includes an X‑Ray machine at North East Soldiers Memorial Hospital, ultrasound machines at Smithton District Hospital and King Island District Hospital, and 72 beds across various sites.

Statewide Hospital Critical Facility Upgrades

Expenditure to date has included emergency power backup at Launceston General Hospital, server upgrades at the Royal Hobart Hospital, completion of the Cambridge Kitchen site, upgrading of the LGH Level 6 Mechanical Services Switchboard to reduce risk of heating and cooling system failure and LGH Generator Replacement to improve backup power supply reliability. The remaining funds are allocated to a lift replacement program at the LGH that is due for completion in 2024.

Statewide Rural Hospital and Ambulance Station Upgrade

Current works include Mersey Community Hospital High Voltage maintenance and upgrade, North West Regional Hospital Loading Dock Upgrade and George Town Community Health Centre upgrade. Funding of $250 000 has been allocated to upgrading works in the Emergency Department at the West Coast District Hospital, supplementing the CHHP funding, with construction to commence in the second half of 2023. Funding of $450 000 has been allocated to the plant deck roof at the North West Regional Hospital. Construction of the Plant Deck Roof will commence in mid‑2023.

27 New Mental Health Beds in Southern Tasmania

The Government has committed to deliver 27 extra mental health beds, with 15 new beds to be provided at St Johns Park and 12 new beds to be provided at the Peacock Centre. Implementation of the extra beds will take pressure off the Royal Hobart Hospital.

Works at the new Peacock Centre commenced in March 2020, with delays experienced due to a deliberately lit fire, and construction completed in March 2023. The new Peacock Centre is the first of its kind in Tasmania. The innovative Centre hosts four new services providing contemporary recovery‑focused care, including the Peacock House short‑stay unit, a Mental Health Integration Hub, Safe Haven, and a Recovery College classroom.

Progress also continued towards delivering a mental health centre at St Johns Park, which is due to open in 2025. This Centre will provide a Safe Haven, 15 short‑stay beds and a Mental Health Integration Hub and will be co‑located with the statewide Tasmanian Eating Disorder Service.

CHHP St Johns Park Eating Disorders Treatment Centre

This program includes an Eating Disorders Treatment Centre co‑located with the mental health centre at St Johns Park. The Eating Disorders Treatment Centre will include eight beds in a residential style setting with consulting and treatment areas. Construction is scheduled to commence in the second half of 2023. Funding from this program will also be used to progress eating disorder community treatment program sites in the North and North West.

Detailed Budget Statements

Table 4.6:         Statement of Comprehensive Income

 

2022‑23 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

 

 

Forward 

Forward 

Forward 

 

Budget 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Revenue and other income

 

 

 

 

 

Appropriation revenue ‑ operating1

1 686 248 

1 874 966 

1 961 598 

1 969 764 

2 018 274 

Appropriation revenue ‑ capital

129 043 

179 931 

166 592 

155 332 

110 491 

Other revenue from government

18 324 

300 

.... 

.... 

.... 

Grants2

589 873 

616 603 

653 630 

656 761 

655 648 

Sales of goods and services

241 981 

250 047 

259 748 

263 563 

263 606 

Interest

39 

29 

28 

24 

24 

Other revenue3

43 967 

67 133 

68 246 

68 338 

68 681 

Total revenue

2 709 475 

2 989 009 

3 109 842 

3 113 782 

3 116 724 

Net gain/(loss) on non‑financial assets

183 

178 

221 

225 

229 

Total income

2 709 658 

2 989 187 

3 110 063 

3 114 007 

3 116 953 

 

 

 

 

 

 

Expenses

 

 

 

 

 

Employee benefits4

1 703 974 

1 928 391 

2 035 634 

2 056 497 

2 090 392 

Depreciation and amortisation

94 800 

97 278 

95 910 

95 910 

93 281 

Supplies and consumables

677 940 

717 554 

739 588 

752 696 

765 243 

Grants and subsidies5

117 388 

102 874 

96 486 

90 952 

92 032 

Borrowing costs6

288 

554 

420 

420 

247 

Other expenses

48 796 

50 543 

52 584 

53 199 

53 684 

Total expenses

2 643 186 

2 897 194 

3 020 622 

3 049 674 

3 094 879 

 

 

 

 

 

 

Net result

66 472 

91 993 

89 441 

64 333 

22 074 

 

 

 

 

 

 

Other comprehensive income

 

 

 

 

 

Changes in physical asset revaluation reserve

52 167 

51 964 

51 964 

51 964 

51 964 

Total other comprehensive income

52 167 

51 964 

51 964 

51 964 

51 964 

 

 

 

 

 

 

Comprehensive result

118 639 

143 957 

141 405 

116 297 

74 038 

 

 

 

 

 

 

Notes:

1.    The increase in Appropriation revenue ‑ operating from 2023‑24 primarily reflects 2023‑24 Budget initiatives and the profile of prior year Budget initiatives including 250 beds for the Royal Hobart Hospital, Ward 3D ‑ A 32 Bed Inpatient Ward and Beds and Demand ‑ Major Hospitals.

2.    The increase in Grants from 2023‑24 primarily reflects the profile of revenue for National Health Reform Funding and Australian Government National Partnership Agreement projects.

3.    The increase in Other revenue from 2023‑24 primarily reflects a forecast increase in own source revenue within the THS for salaries and wages recoveries, mainly relating to Specialist Medical Colleges recoveries, and workers’ compensation recoveries.

4.    The increase in Employee benefits from 2023‑24 primarily reflects 2023‑24 Budget initiatives and the profile of expenditure associated with prior year Budget initiatives including 250 beds for the Royal Hobart Hospital, Ward 3D ‑ A 32 Bed Inpatient Ward, and Beds and Demand ‑ Major Hospitals.

5.    The decrease in Grants and subsidies in 2023‑24 primarily reflects the completion of prior year Budget initiatives including Public Private Partnerships to deliver care sooner and COVID‑19 continued mental health services.

6.    The variation in Borrowing costs primarily reflects the accounting treatment for leases in accordance with AASB 16 Leases.

 


 

Table 4.7:         Revenue from Appropriation by Output

 

2022‑23 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

 

 

Forward 

Forward 

Forward 

 

Budget 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Minister for Health

 

 

 

 

 

 

 

 

 

 

 

Output Group 1 ‑ System Management

 

 

 

 

 

1.1 System Management ‑ Health1

143 797 

142 429 

143 576 

144 805 

148 130 

 

143 797 

142 429 

143 576 

144 805 

148 130 

Output Group 2 ‑ Health Services

 

 

 

 

 

2.1 Admitted Services2

846 937 

931 946 

990 852 

1 024 536 

1 052 978 

2.2 Non‑admitted Services3

147 126 

183 111 

191 747 

176 189 

177 926 

2.3 Emergency Department Services

122 954 

129 423 

133 931 

137 880 

138 055 

2.4 Community Health Services4

142 142 

159 210 

166 120 

154 879 

158 616 

2.6 Ambulance Services5

116 665 

132 817 

136 039 

140 383 

145 450 

2.7 Public Health Services6

16 512 

23 253 

21 514 

15 874 

16 205 

 

1 392 336 

1 559 760 

1 640 203 

1 649 741 

1 689 230 

 

 

 

 

 

 

Capital Investment Program

124 543 

175 231 

162 765 

155 332 

110 491 

 

 

 

 

 

 

Operating Services

1 536 133 

1 702 189 

1 783 779 

1 794 546 

1 837 360 

Capital Services

124 543 

175 231 

162 765 

155 332 

110 491 

 

1 660 676 

1 877 420 

1 946 544 

1 949 878 

1 947 851 

 

 

 

 

 

 

Minister for Mental Health and Wellbeing

 

 

 

 

 

 

 

 

 

 

 

Output Group 1 ‑ System Management

 

 

 

 

 

1.2 System Management ‑ Mental Health and Wellbeing7

35 229 

42 218 

39 466 

35 272 

35 442 

 

35 229 

42 218 

39 466 

35 272 

35 442 

Output Group 2 ‑ Health Services

 

 

 

 

 

2.5 Statewide and Mental Health Services8

114 886 

130 559 

138 353 

139 946 

145 472 

 

114 886 

130 559 

138 353 

139 946 

145 472 

 

 

 

 

 

 

Capital Investment Program

4 500 

4 700 

3 827 

.... 

.... 

 

 

 

 

 

 

Operating Services

150 115 

172 777 

177 819 

175 218 

180 914 

Capital Services

4 500 

4 700 

3 827 

.... 

.... 

 

154 615 

177 477 

181 646 

175 218 

180 914 

 

 

 

 

 

 


 

Table 4.7:         Revenue from Appropriation by Output (continued)

 

2022‑23 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

 

 

Forward 

Forward 

Forward 

 

Budget 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Department of Health

 

 

 

 

 

Total Operating Services

1 686 248 

1 874 966 

1 961 598 

1 969 764 

2 018 274 

Total Capital Services

129 043 

179 931 

166 592 

155 332 

110 491 

 

1 815 291 

2 054 897 

2 128 190 

2 125 096 

2 128 765 

 

 

 

 

 

 

Appropriation Rollover

18 324 

300 

.... 

.... 

.... 

 

 

 

 

 

 

Total Revenue from Appropriation

1 833 615 

2 055 197 

2 128 190 

2 125 096 

2 128 765 

 

 

 

 

 

 

Controlled Revenue from Appropriation

1 833 615 

2 055 197 

2 128 190 

2 125 096 

2 128 765 

 

1 833 615 

2 055 197 

2 128 190 

2 125 096 

2 128 765 

 

 

 

 

 

 

Notes:

1.    The decrease in System Management ‑ Health in 2023‑24 primarily reflects the completion of funding for the prior year initiative Tasmanian Community Health and Wellbeing Networks.

2.    The increase in Admitted Services from 2023‑24 primarily reflects prior year initiatives including 250 beds for the Royal Hobart Hospital, Ward 3D ‑ A 32 Bed Inpatient Ward and Beds and Demand ‑ Major Hospitals.

3.    The variation in Non‑admitted Services primarily reflects funding for Sustainable access to public endoscopy services, Virtual Care including COVID@homeplus, Transforming Public Outpatient Care, Musculoskeletal and Pain Services and Enabling High Quality Mental Health Reforms.

4.    The increase in Community Health Services in 2023‑24 and 2024‑25 primarily reflects additional funding for initiatives including Virtual Care including COVID@homeplus and Enabling High Quality Mental Health Reforms.

5.    The increase in Ambulance Services from 2023‑24 primarily reflects additional funding for Ambulance Tasmania workforce ‑ post COVID‑19 demand.

6.    The increase in Public Health Services in 2023‑24 and 2024‑25 primarily reflects additional funding for the Extending Public Health Response initiative.

7.    The increase in System Management ‑ Mental Health and Wellbeing in 2023‑24 primarily reflects additional funding for Enabling High Quality Mental Health Reforms and an internal reallocation of grant payments between Departmental Outputs.

8.    The increase in Statewide and Mental Health Services primarily reflects additional funding for the Tasmanian Eating Disorder Service and reflects prior year Budget initiatives including the Mental Health Hospital in the Home Pilot and Older Persons Mental Health Services (Roy Fagan Centre Review).


Table 4.8:         Statement of Financial Position as at 30 June

 

2023 

2024 

2025 

2026 

2027 

 

 

 

Forward 

Forward 

Forward 

 

Budget 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Assets

 

 

 

 

 

Financial assets

 

 

 

 

 

Cash and deposits1,2

167 639 

157 887 

134 277 

113 528 

95 531 

Receivables1

46 681 

58 200 

59 959 

61 741 

63 546 

Other financial assets

41 762 

39 337 

40 158 

40 979 

41 800 

 

256 082 

255 424 

234 394 

216 248 

200 877 

 

 

 

 

 

 

Non‑financial assets

 

 

 

 

 

Inventories

79 247 

81 154 

82 461 

83 780 

85 099 

Property, plant and equipment1

1 861 668 

2 044 919 

2 176 424 

2 279 755 

2 318 185 

Heritage and cultural assets

4 433 

4 921 

4 992 

5 063 

5 134 

Intangibles1,3

59 995 

88 780 

128 019 

167 258 

226 497 

Other assets1,4

19 813 

69 466 

63 353 

57 240 

51 257 

 

2 025 156 

2 289 240 

2 455 249 

2 593 096 

2 686 172 

 

 

 

 

 

 

Total assets

2 281 238 

2 544 664 

2 689 643 

2 809 344 

2 887 049 

 

 

 

 

 

 

Liabilities

 

 

 

 

 

Payables1

86 968 

71 503 

72 335 

73 167 

73 999 

Interest bearing liabilities1,4

9 373 

50 102 

42 910 

35 527 

28 407 

Employee benefits1

379 349 

397 883 

407 660 

417 437 

427 214 

Superannuation1,5

(3 965)

(7 602)

(7 544)

(7 486)

(7 428)

Other liabilities

45 157 

47 451 

47 550 

47 670 

47 790 

Total liabilities

516 882 

559 337 

562 911 

566 315 

569 982 

 

 

 

 

 

 

Net assets (liabilities)

1 764 356 

1 985 327 

2 126 732 

2 243 029 

2 317 067 

 

 

 

 

 

 

Equity

 

 

 

 

 

Reserves

466 327 

590 653 

642 617 

694 581 

746 545 

Accumulated funds

1 298 029 

1 394 674 

1 484 115 

1 548 448 

1 570 522 

Total equity

1 764 356 

1 985 327 

2 126 732 

2 243 029 

2 317 067 

 

 

 

 

 

 

Notes:

1.    The variation in these items in 2024 primarily reflects revised estimates based on 30 June 2022 actuals.

2.    The decrease in Cash and deposits across the Forward Estimates primarily reflects the funding of 2022‑23 Budget initiatives from within the Department’s existing resources, including Digital Health Transformation, North West Regional Hospital Domestic Services and Implementation of Our Healthcare Future Reforms.

3.    The increase in Intangibles reflects the purchase of ICT related assets; in particular, Digital Health Transformation.

4.    The variation in Other assets and Interest bearing liabilities reflects the accounting treatment for leases in accordance with AASB 16 Leases.


 

5.    The variation in Superannuation reflects a surplus balance consistent with the 30 June 2022 outcome. The State Actuary undertook a revaluation of the present value of the defined benefit obligation and the fair value of the plan assets as at 30 June 2022 using the process outlined in AASB 119 Employee Benefits. As a result of the revaluation, it was determined that the Tasmanian Ambulance Service Superannuation Scheme was in surplus by $7.7 million.

 


Table 4.9:         Statement of Cash Flows

 

2022‑23 

2023‑24 

2024‑25 

2025‑26 

2026‑27 

 

 

 

Forward 

Forward 

Forward 

 

Budget 

Budget 

Estimate 

Estimate 

Estimate 

 

$'000 

$'000 

$'000 

$'000 

$'000 

 

 

 

 

 

 

Cash flows from operating activities

 

 

 

 

 

Cash inflows

 

 

 

 

 

Appropriation receipts ‑ operating

1 686 248 

1 874 966 

1 961 598 

1 969 764 

2 018 274 

Appropriation receipts ‑ capital

129 043 

179 931 

166 592 

155 332 

110 491 

Appropriation receipts ‑ other

18 324 

300 

.... 

.... 

.... 

Grants

589 873 

616 603 

653 630 

656 761 

655 648 

Sales of goods and services

240 533 

248 599 

258 300 

262 115 

262 158 

GST receipts

110 777 

112 993 

115 253 

117 558 

119 909 

Interest received

39 

29 

28 

24 

24 

Other cash receipts

32 474 

55 376 

56 219 

56 034 

56 094 

Total cash inflows

2 807 311 

3 088 797 

3 211 620 

3 217 588 

3 222 598 

 

 

 

 

 

 

Cash outflows

 

 

 

 

 

Employee benefits

(1 506 916)

(1 702 746)

(1 792 183)

(1 801 418)

(1 832 384)

Superannuation

(187 335)

(215 922)

(233 728)

(245 356)

(248 285)

Borrowing costs

(288)

(554)

(420)

(420)

(247)

GST payments

(111 857)

(114 095)

(116 376)

(118 704)

(121 078)

Grants and subsidies

(117 388)

(102 874)

(96 486)

(90 952)

(92 032)

Supplies and consumables

(678 331)

(717 863)

(739 862)

(752 961)

(765 508)

Other cash payments

(37 289)

(38 772)

(40 543)

(40 881)

(41 083)

Total cash outflows

(2 639 404)

(2 892 826)

(3 019 598)

(3 050 692)

(3 100 617)

 

 

 

 

 

 

Net cash from (used by) operating activities

167 907 

195 971 

192 022 

166 896 

121 981 

 

 

 

 

 

 

Cash flows from investing activities

 

 

 

 

 

Payments for acquisition of non‑financial assets1

(174 067)

(212 444)

(206 162)

(177 988)

(133 087)

Proceeds from the disposal of non‑financial assets

183 

178 

221 

225 

229 

Net cash from (used by) investing activities

(173 884)

(212 266)

(205 941)

(177 763)

(132 858)

 

 

 

 

 

 

Cash flows from financing activities

 

 

 

 

 

Net borrowings2

(8 368)

(11 243)

(9 691)

(9 882)

(7 120)

Net cash from (used by) financing activities

(8 368)

(11 243)

(9 691)

(9 882)

(7 120)

 

 

 

 

 

 

Net increase (decrease) in cash and cash equivalents held

(14 345)

(27 538)

(23 610)

(20 749)

(17 997)

 

 

 

 

 

 

Cash and deposits at the beginning of the reporting period

181 984 

185 425 

157 887 

134 277 

113 528 

Cash and deposits at the end of the reporting period

167 639 

157 887 

134 277 

113 528 

95 531 

 

 

 

 

 

 


Notes:

1.    The variation in Payments for acquisition of non‑financial assets primarily reflects the anticipated timing of expenditure on major capital projects as detailed in the Capital Investment Program section of this chapter.

2.    The variation in Net borrowings primarily reflects the accounting treatment for leases in accordance with AASB 16 Leases.