Mixed reactions to $45.4bn South Australian health budget

A publicly funded IVF rebate scheme, described as the first of its kind in South Australia, will receive $18.5 million over four years.

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Reactions to the South Australian budget delivered yesterday have been mixed with mental health advocates bemoaning a lack of community-based supports and the RACGP critical of the state’s continued practice of applying payroll tax to GPs.  

Treasurer Tom Koutsantonis unveiled a $45.4 billion health budget that includes a $1.7 billion boost to frontline health services, new mental health assessment units, women’s health initiatives, regional hospital upgrades, and a publicly funded IVF rebate scheme.  

The largest health measure is an additional $1.7 billion over five years for South Australia’s public health system to meet growing demand and rising service delivery costs across local health networks.  

Mental health services – despite the complaints from the Mental Health Coalition of South Australia – received a significant boost, with $28 million over four years for a specialised mental health assessment unit adjacent to the Royal Adelaide Hospital emergency department.  

The government plans to establish additional units at Lyell McEwin Hospital and Noarlunga Hospital following implementation of the RAH model.  

Women’s health was a focus, with $10 million over four years to establish five specialised women’s health clinics within GP practices. The clinics will provide services including endometriosis and pelvic pain management, fertility and pregnancy support, menopause care, contraceptive implant services, and preventative health checks. Clinics are planned for northern, southern, and central Adelaide, as well as two regional locations.  

The government will also spend $4.6 million over four years to establish South Australia’s first virtual pelvic pain clinic and launch an endometriosis public awareness campaign.  

A publicly funded IVF rebate scheme, described as the first of its kind in South Australia, will receive $18.5 million over four years. Eligible patients will be able to claim a $2000 rebate for up to two IVF cycles and a $250 rebate for pre-IVF fertility testing.  

Regional health infrastructure featured, including $22 million for a new emergency department at Clare Hospital, $15 million for upgrades to Murray Bridge Soldiers’ Memorial Hospital and $13 million for a new medical education and training centre adjacent to Mount Gambier Hospital.  

The Murray Bridge project includes redevelopment of the maternity ward and birthing unit, increasing capacity from six to eight beds, and construction of a new renal unit that will expand treatment capacity from four to six chairs.  

The budget also allocated $16 million over four years to expand the Patient Assistance Transport Scheme, more than doubling accommodation subsidies for eligible rural patients and introducing a cumulative travel subsidy for people travelling long distances for renal and oncology treatment.  

Ambulance services will receive $13.9 million over four years for additional regional resources, including community paramedics in Ceduna, a new 12-person crew at Yorketown, a new station at Millicent, and upgrades to facilities at Yorketown and Barmera. A further $5.6 million will fund a dedicated ambulance transfer team in Murray Bridge.  

The government has also committed $13.2 million over four years to establish three additional 24-hour pharmacies in Adelaide’s west, north-east, and Mount Barker, expanding a program designed to reduce pressure on emergency departments and general practice.  

Workforce initiatives included $1 million to train an additional 120 pharmacists, doubling the number with postgraduate qualifications needed to deliver expanded scope services, and $350,000 to train 100 more GPs to diagnose and prescribe medication for ADHD.  

The budget included $3 million over two years for a business case for the proposed Greater Northern Adelaide Hospital and another $3 million for planning work to transform the current Women’s and Children’s Hospital site into a health and aged care precinct incorporating up to 600 aged care beds.  

Older South Australians were also targeted through a new $250 million no-interest aged care loan scheme intended to support construction of up to 650 aged care beds, including dementia-specific places, with the aim of reducing pressure on hospital beds.  

Other health-related measures include $2.6 million to continue specialist lung cancer nurses, $1.8 million to establish a Motor Neurone Disease Biomarker Research Centre of Excellence, $1.6 million in additional support for people living with MND, and funding to improve pain management options for IUD procedures.  

The budget papers show total health system spending will reach $45.4 billion over the next four years, while the Commonwealth was expected to provide an additional $2 billion over five years under the National Health Reform Agreement. 

The response 

The Mental Health Coalition of South Australia said the Budget had delivered “nothing for the 19,000 South Australians with severe mental illness who continue to go without the community-based mental health support they need to avoid a hospital crisis”. 

“Three years of waiting, three years of reports, three years of recommendations – and still nothing,” said Geoff Harris, executive director of the MHCSA.  

“The government had the evidence, it had the opportunity, and it had a clear ask from the sector and from its own reports. Those 19,000 South Australians are still waiting.” 

“The evidence is not in dispute. The recommendations have been made – repeatedly, by economists, clinicians, and the government’s own department. What is missing is the political will to act on them. Those 19,000 South Australians, and their families and carers cannot wait another year.” 

The RACGP commended the SA government on some key health investments including commitment to ADHD GP training and $10 million to support women’s health clinics.   

RACGP SA Chair Dr Siân Goodson explained while the government has taken some important steps towards creating the healthcare system South Australians need, “there is still a lot to be done”. 

“We are very disappointed that the state continues to apply payroll tax to GPs as every dollar raised by payroll tax on GPs comes out of patients’ pockets,” she said.  

“We also feel some key opportunities were missed when it comes to bringing more metro GPs to rural areas and supporting international medical graduates to relocate to South Australia.  

“With 22 million Australians choosing to visit a specialist GP each year, our profession forms the foundation of the healthcare system.  

“Investing in general practice leads to better health outcomes for our state’s population and takes the strain off our hospital systems.  

“We look forward to continuing our work with the government around key general practice priorities for South Australia.” 

Read the full Budget papers here.