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| 2023 Health Funding Agreement | |
|---|---|
| Name | 2023 Health Funding Agreement |
| Date signed | 2023 |
| Location | Canberra |
| Parties | Commonwealth of Australia; State and Territory Governments |
| Subject | Health funding reform |
2023 Health Funding Agreement
The 2023 Health Funding Agreement restructured financial arrangements between the Commonwealth of Australia and the States and Territories of Australia to address hospital funding, primary care, and aged care reforms. It sought to reconcile funding commitments following national reviews such as the Royal Commission into Aged Care Quality and Safety, the National Health and Medical Research Council recommendations, and lessons from the COVID-19 pandemic in Australia and the 2022 Australian federal election. The accord connected federal fiscal settings such as the Australian Treasury frameworks with state health implementation through institutions like the Australian Institute of Health and Welfare, the Australian Commission on Safety and Quality in Health Care, and the Productivity Commission.
Negotiations were framed by prior agreements and inquiries including the National Health Reform Agreement 2011, the Council of Australian Governments reforms, and high-profile reports such as the Murray Review and the Haydon Review. Fiscal pressures from the Global financial crisis aftermath, demographic trends noted by the Australian Bureau of Statistics, and pandemic stresses evidenced during the COVID-19 pandemic pushed health portfolio ministers from the Australian Health Ministers' Conference and premiers of New South Wales, Victoria, Queensland, Western Australia, South Australia, Tasmania, Australian Capital Territory, and the Northern Territory into intensive talks. Influential stakeholders included unions like the Australian Nursing and Midwifery Federation, peak bodies such as the Australian Medical Association, and patient advocacy groups referenced by the Consumers Health Forum of Australia.
Intergovernmental bargaining involved leaders including the Prime Minister of Australia, state premiers such as the Premier of New South Wales, and treasurers from jurisdictions that cite fiscal precedents like the Intergovernmental Agreement on Federal Financial Relations. Negotiations used evidence from agencies like the Productivity Commission and expert panels convened by the National Cabinet, with mediation influenced by actors including the Commonwealth Grants Commission and stakeholders such as the Royal Australasian College of Physicians. Public consultations mirrored processes used in inquiries like the Royal Commission into Victoria’s Mental Health System and drew input from institutions such as the Grattan Institute, Australian Healthcare and Hospitals Association, and university research centres at University of Melbourne, University of Sydney, and Australian National University.
Major provisions addressed hospital funding formulas similar to those in the National Health Reform Agreement 2011, commitments to elective surgery targets inspired by the Australian Institute of Health and Welfare benchmarks, and emergency department performance measures likened to metrics from the Australian Commission on Safety and Quality in Health Care. The Agreement incorporated initiatives for aged care reforms recommended by the Royal Commission into Aged Care Quality and Safety, mental health expansions referencing the National Mental Health Commission, and primary care enhancements echoing the Medical Benefits Schedule review. It specified accountability via reporting to bodies such as the Council of Australian Governments, the Australian National Audit Office, and parliamentary committees like the Senate Community Affairs References Committee.
Funding mechanisms combined block grants administered via the Commonwealth Grants Commission with activity-based funding models used in New South Wales Health and Victorian Department of Health. Allocations referenced demographic modelling from the Australian Bureau of Statistics and cost benchmarks from the Independent Hospital Pricing Authority. The Agreement linked payments to performance indicators used by the Australian Institute of Health and Welfare and required matched investments by states drawing on precedents from the National Partnership Agreement on Preventive Health and the Healthcare Homes pilots supported by the Department of Health and Aged Care.
Phased implementation followed timetables similar to rollout plans of the National Disability Insurance Scheme and vaccination programs under the Australian Technical Advisory Group on Immunisation. Short-term milestones targeted emergency department wait times and elective surgery backlogs with quarterly reporting cycles to the Australian Commission on Safety and Quality in Health Care and annual reviews by the Productivity Commission. Longer-term reforms for aged care and primary health networks paralleled transition timelines used by the Aged Care Quality and Safety Commission and regional planning frameworks in Primary Health Networks.
Responses ranged from support by professional bodies such as the Australian Medical Association and the Australian Nursing and Midwifery Federation to criticism from state treasurers and opposition figures including those aligned with the Liberal Party of Australia, the Australian Labor Party, and minor parties like the Australian Greens. Health consumer groups including the Consumers Health Forum of Australia and aged care advocates referencing the Royal Commission into Aged Care Quality and Safety pressed for stronger accountability, while think tanks such as the Grattan Institute and the Lowy Institute offered independent analyses.
Early outcomes reported by the Australian Institute of Health and Welfare and the Productivity Commission included moderated elective surgery waitlists, adjusted emergency department throughput, and investments in aged care workforce measures noted by the Aged Care Workforce Strategy Taskforce. Ongoing evaluation by parliamentary committees like the Senate Finance and Public Administration References Committee and audits from the Australian National Audit Office continue to track fiscal sustainability, service quality, and intergovernmental cooperation patterns exemplified historically by the Council of Australian Governments.
Category:Health finance in Australia