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The Australian government's latest budget injected an additional $25 billion into the public hospital network, taking the total federal spending on public hospitals to $220 billion in the next year.

The government also committed to reintroducing a Medicare-subsidized health and development check for all children at age 3 years (which had been defunded over a decade ago by the previous government) and to funding initiatives to increase childhood vaccination rates, such as text message reminders and vaccination by pharmacists. 

The budget also contains additional funding to support children with autism and their families, although the amount was dwarfed by a massive $36 billion cut from the National Disability Insurance Scheme, which supports a significant number of people with autism.

The rest of the budget received an overall lukewarm response from medical organizations, which expressed disappointment in the lack of additional funding to provide adequate remuneration for longer, more complex consultations in primary care. Some pointed to the lack of much-needed investment in rural and regional health infrastructure.

Access to Primary Care

"We hoped to see the reforms and investments that the healthcare system needs to be ready, not just for now but also for the future," said Danielle McMullen, MBBS, president of the Australian Medical Association (AMA) and a general practitioner in Brisbane. "We do think it was a missed opportunity for those reforms."

In the lead-up to the annual federal budget, the AMA had been lobbying for a range of measures, including increased access to primary care, steps to strengthen the healthcare workforce, reforms to the private health sector, and a tax on sugar-sweetened beverages. 

Instead, the budget includes a one-off commitment to fund up to six new general practice clinics in the central coast region of New South Wales, all of which would be bulk-billing-only, meaning that patients will not pay out of pocket for consultations.

"The Commonwealth clearly has its mind set on no out-of-pocket general practice costs, and, instead of looking at why there might be geographic differences in that, seems to be set on intervening in the market, as they put it, which we think is disappointing," McMullen told Medscape News Australia. 

The new bulk-billing clinics don't address systemic issues that are making it harder for vulnerable communities and groups to access affordable primary healthcare, particularly in regional areas, she said. 

Longer Consultations 

One measure that the AMA had also hoped to see in the budget, but which wasn't delivered, was an increase in the rebate that patients receive for longer consultations with a general practitioner. "With more older people, chronic disease, and complex consultations, we're seeing more longer consultations that have a poorer rebate back to the patient," said McMullen. 

Rod Martin, MBBS, a rural generalist in Armidale and president of the Australian College of Rural and Remote Medicine (ACRRM), was scathing about the lack of meaningful investment in rural healthcare infrastructure, particularly maternity services. 

"As soon as you start to lose more and more maternity services from rural areas, so many hospitals will end up closing, or they'll have their services stripped away, or they'll just become first-aid posts with a heliport," he told Medscape News Australia. "But this is what happens when you live in rural areas."

The federal government had announced earlier in the year that it was increasing the number of general practice trainees, including rural generalists. But the budget didn't include funding for the additional 180 rural generalist trainees that ACRRM had been pushing for. "We need more general practitioners, but … the real need is still premature death, unnecessary death, inappropriate and unsustainable doctor-to-patient ratios," said Martin. "And that's happening in rural Australia, it's not happening in metropolitan Australia." 

McMullen and Martin reported no relevant financial relationships.