Page 3015 - Week 07 - Wednesday, 30 June 2010
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policy, for, either way, the budget will be paid and it will be paid by taxpayers. It is therefore unfortunate that governments have not had the actual debate about whether it is acceptable for the health budget to continue to grow at a rate of some nine per cent per annum.
Big health organisations, including the AMA, and health experts, academics and policy makers have expressed disappointment in the direction that the health debate has taken and the missed opportunities to invest in preventative and primary health care, as well as mental health and dental health. The heightened focus on acute services almost serves for its demise as, while the focus is on investing more money in the hospital system, we can still expect to see the same or a greater level of demand for its services.
It is the acute end of our health system that attracts the most attention, as it is where we typically see the crisis occurring—or the pointy end of health problems. We know, as each of those peak groups and experts do, that, while investment in preventative health is required to address growing demands, it does not show immediate effects and can be more difficult to quantify—as can be done with waiting lists. Investment in preventative health is more difficult to sell politically and does not attract media attention, which is very unfortunate, because it is where the real difference can be made and where investment must increase if we are to address the ever-increasing demands on the hospital system. The focus on the acute end can lead to those health problems that are more hidden—and inequities within our health system—not being addressed. It is often people who experience the greatest inequities who have the smallest voice.
When approaching health policy, there is much to be said for greater utilisation of the equity models, such as the social determinants of health, as there are strong links between income and health outcomes. The Greens do acknowledge that our hospital capacity needs to expand, but in doing this it is important that there is a view beyond the outputs and boxes which can so neatly attribute moneys and accountabilities. Many of the accountability indicators say very little about outcomes, and we need to know if the programs being funded are making a difference to the lives of those people they are intended for.
With regard to output 1.2, mental health services, the Greens continue to call for greater investment in this area, especially for services provided by non-government organisations. The parliamentary agreement calls on the government to move towards allocating 12 per cent of the health budget to mental health. In the first year of this Assembly, there was some movement on this issue, as funding went from 7.8 per cent in 2008-09 to 7.7 per cent in 2009-10. However, in 2010-11 the figure appears to have dropped down to 6.96 per cent. The minister claimed in estimates hearings that mental health funding had moved to eight per cent, but it is unclear how the government calculated this figure. This may include funding from departments other than ACT Health, but it would be good to have clarification on this figure.
The Greens acknowledge that we cannot get to the 12 per cent figure overnight, but each year we need to see a reasonable level of funds appropriated to mental health from the new moneys that are allocated to health generally. Last year $2 million was provided and was split fifty-fifty between ACT Health and non-government
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