A lot, in short. First cab off the rank is likely the legislative mechanism to get the $7.9b Medicare investment operational.
Federal health minister Mark Butler is back in Canberra for the first parliamentary sitting since the election, and it’s likely that one of the items first up on his agenda will be passing amendments to allow the promised $7.9 billion Medicare investment to proceed.
The incoming government brief prepared by Department of Health, Disability and Ageing secretary Blair Comley and released under the Freedom of Information Act reveals the five key pillars and four ongoing initiatives that the second Albanese administration will be working on.
The first of the five pillars was strengthening Medicare, with the ministerial brief noting that the number of GP clinics which universally bulk bill has halved over the past three years to 26% of all GP clinics.
Under a subsection titled “critical next steps” the brief points out that the government will need to pass amendments to the Health Insurance (General Medical Services Table) Regulation 2021 before it is able to expand eligibility for bulk-billing incentives as promised in the lead-up to the election.
These will need to be agreed upon by early September in order to go ahead on 1 November.
According to the brief, the department deadline for legislative advice on incorporating the new Bulk Billing Practice Incentive Payment into the Health Insurance Act was 30 June.
It also alluded to a risk that the 12.5% incentive payment would not be seen as sufficient for practices and providers to join the new program and acknowledged that around one in four GP clinics would be unlikely to switch to universal bulk billing.
“Some patients will still face out-of-pocket costs,” the brief reads.
“The department estimates that 23% of clinics are unlikely to join the Program based on financial incentives.
“However, the Program may increase competition in the market and consumer demand for bulk billing, which may lead to higher uptake amongst these clinics.”
The other four pillars included securing access to cheaper medicine, scope of practice and workforce, a simpler mental health system and closing the health gap for Indigenous Australians.
On scope of practice, the brief specifically refers to the 2024 Scope of Practice Review and mentions a “coordinated reform agenda” that will be delivered in late 2025.
“A dedicated taskforce, with an external expert advisory committee, is working on this,” the briefing said.
“They aim to sequence measures to improve support distribution in areas of need and encourage multidisciplinary team-based care in the primary care sector.”
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It also said that part of this work would include looking at how to move toward a 60:40 blended payment model for general practice, wherein 60% of government funding would be fee-for-service and 40% would be block funding.
“As part of the work looking at moving to 60:40 funding arrangements, the department will be reviewing the sustainability of current funding sources,” the document said.
“This work will consider options for repurposing existing funding and phasing out obsolete payments.”
GPs fearing a loss of income and control is cited as a key challenge to implementation.
The ongoing initiatives include finalising the National Health Reform Agreement, embedding tobacco and vaping reforms, establishing the Australian Centre for Disease Control and implementing aged care reforms.
On vaping, Australians can expect the implementation of the new Public Health (Tobacco and Other Products) Act 2023, a vaping prevention campaign in schools and other activities to combat illicit tobacco and nicotine products.
For the ACDC to be functional by the target date of 1 January 2026, the government will have to draft and pass legislation to establish it as a statutory entity by the end of the spring parliamentary sittings.
The new Aged Care Act was initially meant to be implemented this month; since the incoming minister briefing was written, it has been pushed back to 1 November 2025.
Information on the ongoing NHRA negotiations was redacted.