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OUTCOME 10

HEalTH SySTEM CapaCiTy and QUaliTy

The capacity and quality of the health care system meet the needs of australians

10 Key Strategic directions for 2006–07

improved Quality and Coordination of Cancer Control

Strengthening Cancer Care

In partnership with Cancer Australia, the Department worked to reduce the burden of cancer in Australia through the Strengthening Cancer Care Initiative. It did this by supporting better coordination of cancer services, prevention and research programs, health professionals and consumers. For example, the Department provided funding through the Breast Cancer Network Australia to support those newly diagnosed with breast cancer.

Gynaecological Cancer in Australia

During 2006–07, the Department coordinated the Government response to the report of the Senate Community Affairs Committee Inquiry into Gynaecological Cancer in Australia 2006, Breaking the Silence: a National Voice on Gynaecological Cancers. Key recommendations from this report highlighted the need for a Centre for Gynaecological Cancers; increased funding for gynaecological cancer research; and an increase in education and awareness of gynaecological cancers in Australia. In response to these findings, the Department provided funding for the establishment of a Centre for Gynaecological Cancers in Australia under the auspices of Cancer Australia to increase education and awareness of gynaecological cancers among medical and allied health professionals and the community.

Support for Those Living with Cancer

The Department continued to administer the Supporting Women in Rural Areas Diagnosed with Breast Cancer Program. This initiative enables women diagnosed with breast cancer to receive supportive care and information in their local areas. Significant funding was also provided to the National Breast Cancer Centre to improve clinical practice and information relating to breast cancer, ovarian cancer, and the management of lymphoedema.

In addition, increased support for people living with cancer was achieved through funding provided to the Prostate Cancer Foundation Australia, Camp Quality, Ronald McDonald House in Forster, New South Wales and CanDo.

Outcome

Health System Capacity and Quality

Outcome 10 was managed in 2006–07 by Population Health Division, Portfolio Strategies Division, Primary and Ambulatory Care Division and the Regulatory Policy and Governance Division.

paRT 1: OUTCOME pERFORManCE REpORT

Major achievements• Supported the Asia-Pacific Economic

Cooperation Health Ministers’ Meeting, the Health Task Force and the Life Sciences Innovation Forum.

• Increased education and awareness of gynaecological cancers through the establishment of a Centre for Gynaecological Cancers.

• Improved the detection and reduction of type 2 diabetes in Australia by leading the development of Council of Australian Governments (COAG) initiatives.

• Raised community awareness of asthma and effective asthma management strategies through a national media campaign.

• Provided leadership in e-Health through the delivery of a number of initiatives, including Broadband for Health, Managed Health Networks, HealthConnect and HealthInsite.

• Enhanced Australia’s national health and medical research capacity. In 2006–07, the Department provided grants totalling $435.8 million to 14 research organisations.

• Supported continued research into adult stem cells through funding for the establishment of the National Adult Stem Cell Centre.

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139annUal REpORT 2006–07

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10implementation of the national Chronic disease Strategy and the national Service improvement Frameworks

Australian Population Health Development Principal Committee

In conjunction with State and Territory governments, the Department established the Australian Population Health Development Principal Committee in August 2006 as part of the Australian Health Ministers’ Advisory Council restructuring in order to provide better, more coordinated advice. The committee is responsible for coordinating national strategies relating to primary and secondary prevention of chronic disease. It also has carriage of implementing the National Chronic Disease Strategy and National Service Improvement Frameworks. In 2006–07, the Department provided research and secretariat support to assist the committee to finalise a work plan and establish agreed priorities. The priorities included overseeing the national implementation of the Australian Better Health Initiative (discussed in the Outcome 1 and Outcome 5 chapters) and developing an integrated approach to chronic disease.

National Diabetes Strategy

The Department continued to manage a range of activities within the National Diabetes Strategy to improve the prevention, early detection and management of diabetes in Australia. These activities included providing funding to the

Juvenile Diabetes Research Foundation for the Islet Cell Transplantation Program to help find a cure for type 1 diabetes through research and refining the islet cell transplantation procedure.

Reducing the Incidence of Type 2 Diabetes

During the year, the Department played a lead role in the development of the COAG initiative to improve the detection and reduce the risk of type 2 diabetes in Australia. Development of the package included extensive analysis of available research into diabetes best practice, reviewing existing type 2 diabetes programs and services, and seeking expert opinions regarding the most appropriate package to achieve outcomes in the field of type 2 diabetes. Announced in April 2007, the package includes the development of a new assessment tool to identify people at risk of developing type 2 diabetes and the introduction of a Diabetes Risk Plan to be used by general practitioners for eligible patients at high risk of developing the disease. It also includes the introduction of national standards and accreditation processes to ensure lifestyle modification programs that aim to reduce the risk of type 2 diabetes are safe and effective. Support enabling the Divisions of General Practice to purchase or provide accredited lifestyle modification programs was also included.

Management of Type 2 Diabetes

The Department managed the funding and contract with the International Diabetes Institute to develop and implement the Lift for Life® Program nationally. The institute designed an evidence-based training program to improve the management of type 2 diabetes in older Australians. Since the program launch in February 2007, more than 50 service providers expressed interest in the program and 53 trainers completed the Lift for Life® training program.

Asthma Awareness and Self-Management

The Department worked to improve the public’s awareness of asthma by launching a national print and radio awareness campaign in May 2007. The campaign focused on highlighting the symptoms and seriousness of asthma and encouraged people with asthma to utilise evidence-based preventative strategies. Funding was provided to continue national programs supporting consumer self-management in Australia. These included the Community Support and Community Grants Program and the Asthma Friendly Schools Program. In addition,

140 dEpaRTMEnT OF HEalTH and aGEinG

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the Department supported the development of asthma management training packages for health professionals which will be delivered nationally by the National Asthma Council of Australia.

Arthritis and Osteoporosis Awareness and Self-Management

The Department developed an implementation plan for the Better Arthritis and Osteoporosis Care Initiative and provided funding for national programs to improve community awareness and help people with arthritis and osteoporosis to self-manage their conditions. In addition, the Department engaged the Royal Australian College of General Practitioners to develop primary care guidelines for arthritis and osteoporosis and the Australian Orthopaedic Association to develop a national undergraduate musculoskeletal curriculum for health sciences.

improved provision of, and access to, Quality palliative Care ServicesA range of new and ongoing programs under the National Palliative Care Program were administered to improve access to quality palliative care. The initiatives focused on improving access to medicines and equipment, and education and awareness programs for health professionals. Improved coordination of services in rural and remote areas, and supporting patient choices were also targeted.

Support for Health Professionals

The Department continued to administer the Program of Experience in the Palliative Approach which enables health professionals to improve their skills in palliative care through workforce placements in a specialist palliative care service. Participants are able to provide better palliative care and also teach these skills to colleagues. In 2006–07, 139 primary health workers undertook placements, including 30 general practitioners and five Aboriginal Health Workers. Twenty-five per cent of all participants were from rural and remote areas.

Funding was provided for the development of a web-based national Rural Palliative Care Resource Kit. Developed by the Australian General Practice Network, the kit assisted the Divisions of General Practice to implement local integrated palliative care services in rural and remote communities to better cater for patients’ needs.

Palliative Care Initiatives

Through the Local Palliative Care Grants Program, the Department supported the development of local responses to palliative care needs. This included providing grants to develop innovative ways to improve access to appropriate palliative care services that reflect patients’ needs and support the development of services in local communities. This year, the Department advertised its fourth round of grants.

The Department also supported Palliative Care Australia to manage the National Community Education Initiative. The initiative was launched at the start of National Palliative Care Week in May 2007 and will raise awareness of palliative care options in Australia. A National Story Collection, also launched in National Palliative Care Week, will gather stories from people experiencing palliative care. The initiative will run until October 2007 and includes the national distribution of palliative care resources, radio and television advertisements.

Facilitated and promoted Electronic Clinical CommunicationsElectronic clinical communications enhance the timeliness and availability of critical health information for health care providers and so support the provision of the best possible care to people in the community.

In 2006–07, the Department provided leadership in e-Health through the delivery of initiatives including Broadband for Health, Managed Health Networks, HealthConnect, and HealthInsite. Work also continued with the National E-Health Transition Authority and in implementing COAG initiatives on clinical terminologies and health identifiers. In addition, the national direction setting through the Australian Health Information Council, National Health Information Principles Committee and the Board of the National E-Health Transition Authority was progressed.

As at June 2007, the Broadband for Health Program had subsidised business grade broadband services for 62 per cent of eligible general practices (includes 98 per cent of Aboriginal Community Controlled Health Services and Royal Flying Doctor Service sites), and 88 per cent of community pharmacies.

HealthConnect is an overarching national change management strategy to improve safety and quality in health care, by establishing and maintaining a range of standardised electronic


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health information products and services for health care providers and consumers. The Department’s support for HealthConnect resulted in significant gains in a number of states and territories. An example is the successful implementation of the HealthConnect Northern Territory Shared Electronic Health Record covering approximately 11,500 customers, all Northern Territory public hospitals and 320 health care providers. The 320 health care providers who have registered to participate in the Northern Territory’s Shared Electronic Health Record are able to create and view initial health profiles, medical event summaries and pathology results. In addition, the providers can view hospital inpatient discharge and emergency event summaries for consumers who have registered to participate.

Legislative barriers were removed from the use of electronic signatures in prescribing and established a process for approving proposals. In addition, the Department, in collaboration with HealthConnect Northern Territory, established a trial of electronic prescribing in an aged care setting which has seen savings in time for the general practitioner, streamlined administration of claiming for the pharmacy and improved medication charting in the residential facility.

australian Commission on Safety and Quality in Health CareIn 2006–07, the Department continued its strong working relationship with the Australian Commission on Safety and Quality in Health Care to promote improved patient safety and quality across the continuum of health care in Australia. The Department provided advice to the Minister for Health and Ageing in relation to the national safety and quality initiatives that the commission is leading, which include issues such as accreditation, hygiene, and medication safety. In addition, the Department played an integral role on the Inter-Jurisdictional Committee and the Information Strategy Committee by contributing to the oversight of the commission and the development of an Information Strategy.

improvements in Research CapabilitiesProviding researchers with the capacity to work on discovering cures to diseases will help ensure that Australia remains a world leader in the field of medicine. In 2006–07, the Department negotiated funding deeds with, and processed

payments totalling $435.8 million, to 14 medical research organisations. This funding went to organisations such as the Murdoch Childrens Research Institute for research into serious childhood diseases and conditions, and the University of Queensland and the Princess Alexandra Hospital to support the establishment of the southern hemisphere’s first integrated research and development facility for the development, testing and small scale production of life-saving biopharmaceuticals. This funding was for infrastructure to support health and medical research that holds out the hope of discovering cures to diseases.

The Department also provided funding to establish the National Adult Stem Cell Centre following extensive negotiations with the Griffith University. The centre will enable Australian researchers to apply adult stem cell research to diseases such as Schizophrenia, Parkinson’s disease and Motor Neurone disease.

asia-pacific Economic Cooperation Health Ministers’ ConferenceIn 2006–07, the Department supported the Asia-Pacific Economic Cooperation (APEC) Health Ministers’ Meeting, the APEC Health Task Force and the fifth Life Sciences Innovation Forum. These events required significant effort both on the logistics and policy sides. Planning for the events proceeded in close cooperation with other agencies, especially with the Department of the Prime Minister and Cabinet, the Department of Foreign Affairs and Trade, and AusAID. Close liaison with Canada, as Chair of the Health Task Force, was also critical to the success of the meetings. Particular emphasis was given to involving Health Ministers in the meeting which ensured a high level of ministerial attendance (ultimately 11 out of the 21 member economies were represented by a Minister). The Health Ministers’ Meeting was held on 6–8 June 2007 and was preceded by a meeting of the Health Task Force on 5–6 June 2007. The theme for the ministerial meeting was Building on our Investment: a Sustainable and Multi-sectoral Approach to Pandemic Preparedness and Emerging Health Threats.

The Health Ministers’ Meeting discussed ways that APEC economies can respond effectively to disease outbreaks and as far as possible maintain the cross-border movement of goods, services and people, thereby benefiting Australian businesses and travellers. Key outcomes from


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these events were a renewal of APEC Ministers’ commitment to efforts against avian and pandemic influenza, including cooperation with other international bodies such as the World Health Organization; and endorsement of projects to build capacity in the region, including an Australian project on Guidelines for Functioning Economies in Time of Pandemic. The guidelines were endorsed by APEC Leaders at their meeting in September 2007.

In addition, the APEC Life Sciences Innovation Forum in Adelaide from 19–20 April 2007 provided an opportunity for government representatives, business and academia to engage in dialogue on regional developments in the Life Sciences sector.

World Health Organization On 14–23 May 2007, 2,400 representatives of the World Health Organization’s 193 member states and non-government organisations attended the 60th World Health Assembly in Geneva, Switzerland. The Assembly elected the Department’s Secretary, Ms Jane Halton PSM, as its President.

The World Health Assembly considered a wide range of health issues, with the key theme this year being International Health Security. The Assembly adopted a record number of resolutions on public health issues and on the technical and administrative work of the World Health Organization.

In addition, the Medium Term Strategic Plan that was approved by the World Health Assembly set out the key areas of focus for the Assembly for the period 2007 to 2011. The plan will focus on 13 strategic objectives including combating HIV/AIDS, tuberculosis and malaria. Reducing both the burden of other communicable and non-communicable disease and the health consequences of emergencies and disasters are also identified priorities.

APEC Support Officers


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paRT 2: pERFORManCE inFORMaTiOn

performance information for administered items Administered Funding – Health System Capacity and Quality Programs, including:

• Chronic Disease – Treatment;

• e-Health Implementation;

• Health Information;

• International Policy Engagement;

• Palliative Care and Community Assistance; and

• Research Capacity.

Indicator Measured by Reference Point or Target

Access and quality of palliative care in the community.

Improved palliative care, including increased access to a range of medicines on the Pharmaceutical Benefits Scheme and increased number of services participating in the Palliative Care Outcomes Collaboration.

Maintain or increase the level of access from previous year.

Indicator met. An additional 16 items were listed under the Palliative Care Section of the Schedule of Pharmaceutical Benefits during 2006–07. These medicines will be provided in greater quantities at a reduced price for people receiving palliative care.

Also in 2006–07, 15 new services joined the Palliative Care Outcomes Collaboration.

Better use of evidence to inform patient treatment options.

Increased uptake of evidence-based medicine by health care providers.

Increased level of uptake from previous years.

Indicator met. Phase 2 of the National Health and Medical Research Council Palliative Care Research Program was completed and resulted in 25 research grants, 10 postgraduate scholarships and fellowships, and 2 research workshops.

In June 2007, a record number of 35,693 visits were made to the CareSearch website accessible at <www.caresearch.com.au>. This is double the number of visits made in May 2007, and a sixfold increase from July 2006.


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Initiatives that prevent type 2 diabetes or modify the prevalence of type 2 diabetes risk factors.

Initiatives will be assessed against the National Diabetes Indicators.

Increased programs/initiatives to prevent type 2 diabetes or to modify the prevalence of type 2 diabetes risk factors.

Indicator met. The National Diabetes Indicators are in the final stages of development and have not been reported against in 2006–07. A report on the National Indicators for Diabetes was developed in 2006–07 and was released in August 2007.

During 2006–07, the Department finalised contracts for the development of new National Health and Medical Research Council endorsed evidence-based guidelines for type 2 diabetes. Funding was also provided to the National Institute of Clinical Studies to develop an implementation plan for the type 2 diabetes evidence-based guidelines to assist uptake by consumers and relevant professions.

During 2006–07, the Department increased the range of programs/initiatives to prevent type 2 diabetes or to modify the prevalence of type 2 diabetes risk factors. This included seed funding for a National Walking Initiative and funding for a chronic kidney disease early detection pilot study.

Key stakeholders use electronic clinical communications to improve quality and safety in health care.

Increased implementation of relevant projects and uptake of incentives by key stakeholders.

Increased use of electronic communications by key stakeholders in the health sector.

Indicator met. The Department continued to work collaboratively with states and territories and non-government organisations, through its Broadband for Health, Managed Health Network and HealthConnect programs to provide and expand infrastructure that allows clinicians greater access to electronic clinical communications.

Broadband for Health Program take up by eligible general practices (including Aboriginal Community Controlled Health Services and Royal Flying Doctor Service sites) increased 3.6%, from 58.0% to 62.0%, and community pharmacy take up increased 8.2%, from 80.0% to 88.0%.


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Improved quality of, and access to, online health information and Government health policy by medical professionals and the Australian public.

Quality online health information is made available through the HealthInsite Program.

Improved access and quality information.

Indicator met. In 2006–07 there were over 14,000 information items on the websites of 84 Information Partners. HealthInsite Information Partners are authoritative health organisations that have gone through a quality assessment process to ensure that their sites are of the highest standard and provide reliable and relevant information.

There was approximately 18.0% growth in the use of HealthInsite from 2006 to 2007. Technical upgrades on the HealthInsite program improved user access, speed, and a clearer display of search results.

Access to broadband infrastructure to enable health care providers to better engage with state and national level activity in the implementation of e-Health initiatives (such as HIC Online).

Level of health care provider access to broadband infrastructure.

Increased access from previous year.

Indicator met. There has been a 5.0% increase in 2006–07 (from 68.0% to 73.0%) in the number of health care organisations accessing the Broadband for Health Program.

Access to the program by eligible practices has increased by 3.6% to 62.0% in 2006–07 and for pharmacies by 8.2% to 88.0% in 2006–07.

Government investment in National E-Health Transition Authority contributes to the development of priority e-Health interoperability initiatives.

Timely and quality contributions to National E-Health Transition Authority during the development of priority e-Health initiatives.

Achievement of work outlined in the National E-Health Transition Authority work program.

Indicator substantially met. In February 2006, COAG announced that the National E-Health Transition Authority would be supported to:

• accelerate the development of agreed Clinical Terminologies for health communications;

• develop an Individual Healthcare Identifier for all individuals; and

• develop a Healthcare Provider Identifier for healthcare professionals.

The Department is working closely with the authority in the implementation of this work program. The Department is represented on the authority’s Board and on a range of advisory committees that have been established to make progress in these areas.


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Effective international health policy engagement.

Feedback from international organisations.

Domestic health policy informed by international experience.

Australian contribution to health policy/programs in our region acknowledged.

Indicator met. In accordance with Australia’s domestic priorities, the Department continued to have significant input into decisions made by global organisations, such as the World Health Organization and the Organisation for Economic Co-operation and Development, in international health policy. The feedback the Department received from these organisations assisted in the development of domestic health policy, for example, avian influenza virus sharing.

The Department continued to strengthen its engagement in the region by taking a prominent role in the management of the Pacific Senior Health Officials’ Network and the Papua New Guinea-Australia Cross Border Health Issues Committee, and successfully hosted the APEC Health Ministers’ Meeting.

Effective management of Memorandum of Understanding arrangements with the World Health Organization.

Timeliness of contributions. Contributions made as per Memorandum of Understanding arrangements.

Indicator met. All payments were made on time and in accordance with Memorandum of Understanding arrangements.

performance information for departmental OutputsOutput Group 1. Policy Advice, including:

• Chronic Disease – Treatment;

• e-Health Implementation;

• Health Information;

• International Policy Engagement;

• Palliative Care and Community Assistance;

• Research Capacity; and

• 2006–07 Budget measures.


Quality, relevant and timely advice for Government decision-making.

Ministerial satisfaction. Maintain or increase from previous year.

Indicator met. Ministers were satisfied with the quality, relevance and timeliness of advice provided for Government decision-making.


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Relevant and timely evidence-based policy research.

Production of relevant and timely evidence-based policy research.

Relevant evidence-based policy research produced in a timely manner.

Indicator met. In 2006–07, the Department commissioned and completed developmental research on community awareness of asthma and best practice asthma management. This research informed the development and campaign concept for a national asthma awareness campaign launched in May 2007. The results of this research are accessible at <www.health.gov.au>.

The Department provided funding to Campbell Research and Consulting for the Community Attitudes Towards Palliative Care report in August 2006; and the subsequent National Community Education Initiative to raise awareness of palliative care in Australia which commenced in May 2007.

Output Group 2. Program Management, including:

• financial management and reporting;

• development and management of grants and contracts; and

• administration and revision of legislation as required.


Administered budget predictions are met and actual expenses vary less than 0.5% from budgeted expenses.

Percentage that actual expenses vary from budgeted expenses.

0.5% variance from budgeted expenses.

Indicator not met. Actual expenses varied from budgeted expenses by 10.0%. This variance resulted primarily from the rescheduling of contract payments to better match the funding requirements of the provider in one program.


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Stakeholders to participate in program development.

Opportunities for stakeholder participation through a range of avenues, such as surveys, conferences and meetings.

Stakeholders participated in program development eg. through surveys, conferences and meetings.

Indicator met. During 2006–07, the Department offered a wide range of stakeholders the opportunity to participate in policy and program development through a range of expert advisory committees, reference group meetings and workshops. For example the Department:

• established the Asthma Expert Advisory Committee, the Arthritis and Osteoporosis Expert Advisory Committee and the Diabetes Expert Advisory Committee to provide advice on the development and implementation of relevant programs. Subject experts, medical professionals and consumers are represented on these committees; and

• established an asthma awareness reference group to provide advice and assistance in the development of a national asthma awareness campaign in conjunction with an expert advisory group and a technical working group.

In 2006–07 the Department developed a Funding Agreement for the Consumer Health Forum, Health Consumers Network Project. This project intends to accelerate and influence government investment in the e-Health agenda by driving consumer demand for a shared Electronic Health Record and participation in e-Health initiatives.

In addition, the forum has advocated consumer representative participation in the Broadband for Health Working Groups, Australian Health Information Council, the National E-Health Transition Authority and HealthConnect. The consumer participation provides input on the strategic directions of e-Health initiatives.

The forum has also established a steering committee chaired by a member of the forum’s Governing Committee, and four or five consumers and forum representatives to support and guide the e-Health Consumers’ Network Project. In 2006–07 the project has seen:

• 5 consumer consultation sessions between March and June 2007 held in Victoria, the Northern Territory and western Sydney; and

• the development of an e-Health assessment criteria, and measures for consumer impact assessments for tools, clinical knowledge sources and health programs based on practical examples.


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performance assessment: Evaluations and Reviews

Evaluations

Evaluation: Health Information Network

Timeframe: The status of the National Health Information Network measure is ongoing and therefore an internal evaluation of the program is anticipated in 2007–08.

Reviews

Review: National Diabetes Register

Timeframe: Commencement date: November 2006

End date: February 2007

Key Strategic Direction: Implementation of the National Chronic Disease Strategy and the National Service Improvement Frameworks.


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Outcome 10 – Financial Resources Summary

(A) Budget Estimate 2006–07

$’000

(B) Actual 2006–07

$’000

Variation (Column B

minus Column A)

$’000

Budget Estimate 2007–08

$’000

Administered Expenses

Program 10.1: Chronic Disease – Treatment

Appropriation Bill 1/3/5 16,891 16,107 (784) 15,812

16,891 16,107 (784) 15,812

Program 10.2: E-Health Implementation

Appropriation Bill 1/3/5 78,972 37,408 (41,564) 40,041

78,972 37,408 (41,564) 40,041

Program 10.3: Health Information


7,300 6,996 (304) 7,544

Program 10.4: International Policy Engagement


11,575 10,538 (1,037) 11,575

Program 10.5: Palliative Care and Community Assistance

Health Care (Appropriation) Act 1998 – Australian Health Care Agreements – Provision of Designated Health Services(p) 3,014 2,946 (68) 2,861

Total Special Appropriations 3,014 2,946 (68) 2,861


22,274 21,834 (440) 28,471

Program 10.6: Research Capacity


467,439 461,596 (5,843) 32,123

Total Administered Expenses 604,451 554,479 (49,972) 135,566

Departmental Appropriations

Output Group 1 – Policy Advice 4,918 4,859 (59) 4,924

Output Group 2 – Program Management 13,206 13,049 (157) 13,223

Total price of departmental outputs (Total revenue from Government & other sources)

18,124 17,908 (216) 18,147

Total revenue from Government (appropriations) contributing to price of departmental outputs

17,618 17,489 (129) 17,661

Total revenue from other sources 506 419 (87) 486

Total price of departmental outputs (Total revenue from Government & other sources)

18,124 17,908 (216) 18,147

Total estimated resourcing for Outcome 10 (Total price of outputs & administered expenses)

622,575 572,387 (50,188) 153,713

Average Staffing Level (Number)

Department 134 133 (1) 131 (p) = Part.

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