The politics of health Vernon Collins Oration The Royal Children s Hospital Melbourne
|
|
- Adrian Blair
- 5 years ago
- Views:
Transcription
1 The politics of health Vernon Collins Oration The Royal Children s Hospital Melbourne John Daley Chief Executive Officer, Grattan Institute 15 October 2015
2 What would Vernon do? Research matters but so does running the hospital Staffing Holistic approach to welfare and care of children Modern medical records system Accountable in public on ethical issues Vernon was the man who was a little more politically aware, and knew how to use the system to achieve the best results Don Kinsey So what would the well-rounded hospital director, who is politically aware, do today? 2
3 The politics of health Australian government budgets are under pressure The mining boom and financial crisis masked ongoing Commonwealth deficits Capital accounts masked increasing State deficits Health is the largest budget pressure Health costs are large, and growing much faster Increased costs are due to increased servicing, not ageing Health outcomes are improving Reform will require some difficult decisions Governments are hoping for slower spending growth Australian spending on health is relatively efficient by global standards Victorian government spending on health is already less than other States A more systematic approach is required to cost management, and treatment choice Hospital professionals must choose: either reform, or have reform imposed 3
4 The Commonwealth s structural deficits was masked by GFC and mining boom Commonwealth budget balance per cent of nominal GDP 3% 2% Cash balance Structural balance Cyclical impacts Terms of trade 1% 0% -1% -2% -3% -4% -5% f 2017f 2019f Financial year ending Note: Cash balance is equal to receipts minus payments, minus Future Fund income, (under 0.25 per cent of GDP) Source: Grattan Institute, Fiscal Challenges for Australia 4
5 Long term spending increased while revenue fell Commonwealth expenditures and revenues per cent of nominal GDP 27% Forecast 26% Revenue 25% 24% 23% Expenditure 22% 21% 20% Source: Grattan Institute, Fiscal Challenges for Australia Financial year ended 5
6 State operating budgets balanced, but their capital expenditure did not State net debt and operating balance $2013 bn Net operating balance Forecast Interest and depreciation increased from 7% to 10% of State government revenue Fiscal balance (inc capital works) E 2017E Source: Parliamentary Budget Office, National Fiscal Trends (2015) 6
7 The politics of health Australian government budgets are under pressure The mining boom and financial crisis masked ongoing Commonwealth deficits Capital accounts masked increasing State deficits Health is the largest budget pressure Health costs are large, and growing much faster Increased costs are due to increased servicing, not ageing Health outcomes are improving Reform will require some difficult decisions Governments are hoping for slower spending growth Australian spending on health is relatively efficient by global standards Victorian government spending on health is already less than other States A more systematic approach is required to cost management, and treatment choice Hospital professionals must choose: either reform, or have reform imposed 7
8 Health is a material component of all government expenditure Combined government expenditure % = $545b Everything else 26% Climate change Foreign affairs and environment Economy and finance Government operations Debt management Other Seniors Family support Workforce Welfare 22% Disability Carers Industry Ageing, community & disability 6% Criminal justice Disability services Ageing and aged care services Community services Infrastructure 7% Defence 6% Schools Education 16% Hospitals Primary care & medical services Health 16% Source: Grattan Institute, Budget Pressures
9 Health is over a quarter of Victorian government spending Disability services Ageing and aged care services Community services Climate change and environment Industry Other Hospitals Health 27% Government operations Everything else 38% Economy & finance Health - other Primary care and medical services Health - NFS Criminal justice Infrastructure, transport & planning 13% Infrastructure, transport and planning Education - NFS Skills Early childhood Note: Other includes legal, arts and sport, housing, emergency services, water and employment. Source: Grattan Institute, Budget Pressures Schools Education 24% 9
10 Health is the biggest pressure on government budgets overall Change in Australian governments expenditure $ bn relative to CPI Real growth Growth at GDP Crim justice Health Education Infrastructure Industry Defence Welfare Other Social Debt mgt services Government Source: Grattan Institute, Budget Pressures
11 Health is driving Vic expenditure growth Change in Victorian recurrent expenditure, to Real change in expenditure, 2003 to 2014, $2013 bn Real growth Growth if revenue a constant % of GDP 0 Health Edu & Infra., research transport & planning Other Social services Crim. justice Industry Govt & econ Note: Other comprises all expenditure not elsewhere included. Social services comprises ageing and aged care services, disability services, and community services. Govt & econ comprises government operations and economy and finance. Source: Grattan Institute Budget Pressures 2014 Supporting Materials 11
12 Hospitals are the biggest driver of increases in health costs Change in Australian governments expenditure $ bn relative to CPI 20 Real growth Growth at GDP Hospitals Primary care Source: Grattan Institute, Budget Pressures 2014 Private health insurance Pharmaceuticals Other 12
13 Health cost growth is driven by servicing, not population ageing Real increase in health expenditure ($2012 billion) More, improved, and new services per person GDP growth Source: Grattan Institute, Budget Pressures 2013 Health inflation >CPI Population ageing Population growth 13
14 Government health spending increased the most for the over 70s Government health spending per person, $2010 $16,000 $14,000 $12,000 $10,000 $8,000 $6,000 $4,000 $2, $0 0s 10s 20s 30s 40s 50s 60s 70s 80+ Source: Grattan Institute, The Wealth of Generations 14
15 Medical research spending tripled in a decade NHRMC grants to universities, $2011 m NH&MRC grants NH&MRC grants if growing at GDP Source: Grattan Institute, Mapping Australian Higher Education 2013, p.46 15
16 As health spending increased, life expectancy improved Life expectancy at 65 years of age years 90 Expected life quality for 65-year-old years Women Men Severe or profound core activity limitation Nonsevere disability Free of disability Source: Grattan Institute analysis of ABS (2008) cat no Table Men Women Source: AIHW (2012), Figure 13 16
17 As health spending increased, health improved Amenable mortality deaths per 100,000 population 250 Self-reported health status Percentage of population in lowest two categories ( fair or poor ) Fair Poor Source: AIHW Source: ABS 17
18 The politics of health Australian government budgets are under pressure The mining boom and financial crisis masked ongoing Commonwealth deficits Capital accounts masked increasing State deficits Health is the largest budget pressure Health costs are large, and growing much faster Increased costs are due to increased servicing, not ageing Health outcomes are improving Reform will require some difficult decisions Governments are hoping for slower spending growth Australian spending on health is relatively efficient by global standards Victorian government spending on health is already less than other States A more systematic approach is required to cost management, and treatment choice Hospital professionals must choose: either reform, or have reform imposed 18
19 Governments are counting on health spending falling Real annual growth in government health spending 6 Historical Projections Population increase Ageing Demographic growth 2 1 Nondemographic growth 0 IGR (2010) 1985 to 2008 PC (2013) 1991 to 2011 Grattan 1994 to 2013 IGR (2010) IGR (2015) PC (2013) 2010 to to to 2028 Source: Grattan Institute, The Wealth of Generations; Treasury, Intergenerational Report (2015) 19
20 Helath isn t the only spending forecast that relies on wishful thinking Commonwealth real annual spending growth, per cent Historical spending growth to Forecast spending growth to Age Pension Defence Aged Care MBS Schools Hospitals DSP Carer support Child care Family Benefit PHI Rebate Higher ed Newstart Pharmaceuticals Source: PBO (2014), Projections of Government spending over the medium term 20
21 Australia already gets relatively good value for money in health spending Life expectancy at birth, years, OECD countries, 2008 or latest available Japan Australia Switzerland U.S ,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 Total expenditure on health per capita (US$ PPP) Source: OECD Health care systems: getting more value for money 21
22 Victorian government spending on health is relatively low Larger State government expenditure/resident $ per capita, ,000 8,000 6,000 4,000 2,000 Infrastructure, transport & planning Other Industry Criminal justice Govt & economy Education Health 0 Source: Grattan Institute, Budget Pressures 2014 Vic NSW Qld WA 22
23 Costs are someone else s problem Views on own network relative to average Victorian network Proportion of board members of Victorian LHNs, 80% 60% Overall quality of health care Safe and skilled workforce Responding to health care incidents 40% 20% 0% Worse About the same Better or much better Note: n = 233, 70% response rate, 96% of networks included Source: Grattan Institute, Questionable care: avoiding ineffective treatment 23
24 Variation in the cost of specific operations is difficult to explain away Cost of hip replacement, unadjusted, Range Median ACT TAS QLD SA WA VIC NSW $0 $5,000 $10,000 $15,000 $20,000 $20,000 $25,000 $30,000 $30,000 $35,000 $40,000 Note: I03B, the less complicated DRG category for the procedure Source: Grattan Institute, Controlling costly care 24
25 Overall variation in public hospital costs is very hard to explain away NSW VIC QLD WA SA TAS ACT NT Hospitals Average level of unexplained costs Avoidable costs unexplained costs above the average level Unexplained costs above the lowest level in each state ($ per admission) Hospitals with the lowest unexplained cost in each state = 0 Note: Some small hospitals (total admissions < 4,000 p.a.) not shown Source: Grattan Institute, Controlling costly care 25
26 Grattan identified 5 do-not-dos and 3 donot-do routinely treatments Based on NICE, MSAC and Prasad Do-not-dos: Vertebroplasty for osteoporotic vertebral fractures Arthroscopic lavage or debridement for OA of the knee Laparoscopic uterine nerve ablation for chronic pelvic pain Removing healthy ovaries during a hysterectomy HBOT for a range of conditions (inc. osteomyelitis, cancer, and non-diabetic wounds and ulcers) Do-not-do routinely: Fundoplication for gastro-intestinal reflux Episiotomy for spontaneous vaginal births Amniotomy to augment a normal delivery Patients with legitimating diagnoses are excluded 26
27 Grattan found patterns that are difficult to explain away Proportion of relevant patients getting do-not-do procedure 80% 60% 40% 20% 0% Hospital Average Proportion of relevant patients getting do-not-do routlnely procedure 50% 40% 30% 20% 10% 0% Hyperbaric Arthroscopy Vertebroplasty Ovary removal Nerve ablation Source: Grattan Institute, Questionable care: avoiding ineffective treatment Amniotomy Episiotomy Fundoplication 27
28 A system for improving practice Continuously improve measurement Linked records pathology, MBS, PBS, hospitals Identify poor treatments Payoff relative to cost Bottom up AND top down Clinical reviews Start local Escalate for investigation and sanctions Report on outcomes System level, by hospital Peer visibility Source: Grattan Institute, Questionable care: avoiding ineffective treatment 28
29 Clinical reviews with consequences how a system might work Identify outliers Inform outliers that they are being closely monitored No No further action Yes No further action Yes No further action Are they still outliers after one year? Does clinical review support practices? Are targets met? Yes State to initiate external clinical review No Set clear targets for improvement No Financial and/or governance sanctions Source: Grattan Institute, Questionable care: avoiding ineffective treatment 29
30 The politics of health Australian government budgets are under pressure The mining boom and financial crisis masked ongoing Commonwealth deficits Capital accounts masked increasing State deficits Health is the largest budget pressure Health costs are large, and growing much faster Increased costs are due to increased servicing, not ageing Health outcomes are improving Reform will require some difficult decisions Governments are hoping for slower spending growth Australian spending on health is relatively efficient by global standards Victorian government spending on health is already less than other States A more systematic approach is required to cost management, and treatment choice Hospital professionals must choose: either reform, or have reform imposed 30
Balancing budgets in difficult times. John Daley Urbis, Brisbane 4 February 2014
Balancing budgets in difficult times John Daley Urbis, Brisbane 4 February 214 Overview Australian government budgets are in trouble The Commonwealth has had a structural deficit for over 7 years Spending
More informationFair tax and welfare for older workers. Older Australians at work summit John Daley Grattan Institute 24 February 2015
Fair tax and welfare for older workers Older Australians at work summit John Daley Grattan Institute 24 February 215 Fair tax and welfare for older workers Government budgets are unsustainable: spending
More informationMaking sense of the budget crisis. ACOSS National Conference John Daley Grattan Institute 11 June 2014
Making sense of the budget crisis ACOSS National Conference John Daley Grattan Institute 11 June 2014 Overview What sort of budget crisis do we have? Australia s debt levels are relatively manageable However,
More informationBUDGET #2014BudgetBriefing
2014 BUDGET BRIEFING @ipaawa #2014BudgetBriefing Budget Strategy in Tougher Times John Daley Chief Executive Officer Grattan Institute @ipaawa #2014BudgetBriefing Overview Budgets are under pressure, and
More informationFinancial Implications of an Ageing Population
Financial Implications of an Ageing Population Presentation to Aged & Community Care Victoria s State Congress and Trade Exhibition Saul Eslake Chief Economist ANZ Flemington Racecourse Melbourne 25 th
More informationBudget repair and the size of Australia s government. Melbourne Economic Forum John Daley, Grattan Institute December 2015
Budget repair and the size of Australia s government Melbourne Economic Forum John Daley, Grattan Institute December 2015 Budget repair and the size of Australia s government Attitudes to the best approach
More informationAustralian welfare spending trends: past changes and future drivers Brotherhood of St Laurence lunchtime seminar
Australian welfare spending trends: past changes and future drivers Brotherhood of St Laurence lunchtime seminar John Daley CEO, Grattan Institute 8 August 213 Overview Stable overall spending conceals
More informationBudget repair and the changing size of Australia s government. Crawford Australian Leadership Forum John Daley, Grattan Institute June 2016
Budget repair and the changing size of Australia s government Crawford Australian Leadership Forum John Daley, Grattan Institute June 2016 Commonwealth expenditure is high relative to history; revenue
More informationOptions to reduce pressure on private health insurance premiums by addressing the growth of private patients in public hospitals
Options to reduce pressure on private health insurance premiums by addressing the growth of private patients in public hospitals This paper seeks public feedback on reducing pressure on private health
More informationBudget pressures on Australian governments 2014
May 2014 Budget pressures on Australian governments 2014 John Daley and Cassie McGannon Grattan Institute Support Grattan Institute Report No. 2014-7, May 2014 Founding members Program support Higher Education
More informationTHE IMPORTANCE OF PRODUCTIVITY GROWTH AS A DRIVER OF VICTORIA S ECONOMY
THE IMPORTANCE OF PRODUCTIVITY GROWTH AS A DRIVER OF VICTORIA S ECONOMY PRESENTATION TO MEMBERS OF THE PARLIAMENT OF VICTORIA MELBOURNE 24 TH NOVEMBER 2016 Victoria s economy is picking up after under-performing
More informationTrends in Australian government health funding by age: a fiscal incidence analysis
Trends in Australian government health funding by age: a fiscal incidence analysis Alan Tapper and John Phillimore Final draft Accepted by Australian Health Review Abstract: Government health expenditure
More informationThe 2015 Intergenerational Report A snapshot
www.pwc.com.au The 2015 Intergenerational Report A snapshot Last week, the Australian Government delivered the fourth Intergenerational Report (IGR). PwC's snapshot outlines the main findings of the IGR
More informationAn analysis of Victoria s labour productivity performance
An analysis of Victoria s labour productivity performance Presentation to a forum hosted by Victorian Department of Innovation, Industry and Regional Development Melbourne 14 th April Saul Eslake Program
More informationPoverty in Australia 2018: Methods, Findings and Implications
Poverty in Australia 2018: Methods, Findings and Implications Peter Saunders Social Policy Research Centre University of New South Wales Presented to the 2018 ACOSS Rise to the Challenge National Conference
More informationCatholic Health Australia National Conference Jennifer Doggett August 2014
Catholic Health Australia National Conference 2014 Jennifer Doggett August 2014 Stinging rain fall down afternoon time Rosella Namok Our Medicare system is unsustainable. Australia's health spending is
More informationGovernment health expenditure and tax revenue
Health Expenditure Government health expenditure and tax revenue 21 16 $ The Australian Published May 218 Government spent 27.% of taxation revenue on health in 21 16 This report looks at how health expenditure
More informationAustralia s productivity performance
Australia s productivity performance Seminar Presentation to Australian Treasury Canberra, 22 nd September 2010 Saul Eslake Grattan Institute Australia s productivity growth has slowed over the last five
More informationIs the high Aussie dollar really bad for the Australian and Victorian economies? Professor John Daley August 20, 2012
Is the high Aussie dollar really bad for the Australian and Victorian economies? Professor John Daley August 2, 212 Messages Three factors have pushed up the real exchange rate High Australian incomes,
More informationIncreasing participation among older workers: The grey army advances. Report prepared for the Australian Human Rights Commission
Increasing participation among older workers: The grey army advances Report prepared for the Australian Human Rights Commission Susan Ryan Age Discrimination Commissioner Australian Human Rights Commission
More informationLong-term Funding of Health and Ageing
Long-term Funding of Health and Ageing The Rising Pressure on Commonwealth and State Budgets 50 % of total government expenditure of the jurisdiction 40 30 Projected increase in government expenditure
More informationPoverty Lines: Australia
MELBOURNE INSTITUTE Applied Economic & Social Research Poverty Lines: Australia June Quarter 2017 Melbourne Institute of Applied Economic and Social Research POVERTY LINES: AUSTRALIA ISSN 1448-0530 JUNE
More informationPoverty Lines: Australia
MELBOURNE INSTITUTE Applied Economic & Social Research Poverty Lines: Australia March Quarter 2018 Melbourne Institute: Applied Economic & Social Research POVERTY LINES: AUSTRALIA ISSN 1448-0530 MARCH
More informationWhy is understanding our population forecasts important?
% Population Growth per annum Population Why is understanding our population forecasts important? Understanding the ACT s population growth and its demographic trends, is fundamental to longterm strategic
More informationValuing Medical Innovation Perspectives matter. Lara Verdian 10 September 2015
Valuing Medical Innovation Perspectives matter Lara Verdian 10 September 2015 1965 1967 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
More informationTax background paper. National Reform Summit John Daley, Grattan Institute August 2015
Tax background paper National Reform Summit John Daley, Grattan Institute August 215 Summary Budget repair should include some tax increases Australia has small government by international standards Using
More informationThe Victorian economy and government financial position
The n economy and government financial position Presentation to n Council of Social Service 26 Congress Saul Eslake Chief Economist ANZ RACV Centre Melbourne th August 26 4 th www.anz.com/go/economics
More informationELECTION FORUM. Sydney, 7 June 2016
ELECTION FORUM Sydney, 7 June 2016 A Campaign of 5 Reforms to address housing affordability, generate new affordable housing and halve homelessness A National Housing Strategy to deliver: 1. Dedicated
More informationPoverty Lines: Australia
MELBOURNE INSTITUTE Applied Economic & Social Research Poverty Lines: Australia September Quarter 2017 Melbourne Institute of Applied Economic and Social Research POVERTY LINES: AUSTRALIA ISSN 1448-0530
More informationTHE TASMANIAN GOVERNMENT S BUDGET
THE TASMANIAN GOVERNMENT S BUDGET PRESENTATION TO A COMMUNITY ORGANIZATIONS MASTER CLASS SPONSORED BY THE AUSTRALIA INSTITUTE (TASMANIA) HOTEL GRAND CHANCELLOR HOBART 12 TH JUNE 218 C O R I N N A E C O
More informationStamp Duty on Transfers of Land
Stamp Duty on Transfers of Land New South Wales NON-FIRST HOME BUYER - STAMP DUTY PAYABLE - NSW $0 - $14,000 $1.25 for every $100 or part of the dutiable value $14,001 - $30,000 $175 plus $1.50 for every
More informationPublic Infrastructure Spending
kpmg Public Infrastructure Spending The Australia Institute Conference 17 October 2018 Show me the money Government has a crucial role in providing and maintaining public good infrastructure in society
More informationIncome Inequality and Tax-Transfer Policy: Trends and Questions
Income Inequality and Tax-Transfer Policy: Trends and Questions Ann Harding & Quoc Ngu Vu Presentation to the Making the Boom Pay Conference, Melbourne 2 November 2006 National Centre for Social and Economic
More informationDisability Support Pension. Historical and projected trends DRAFT. Report no. 01/2018
Disability Support Pension Historical and projected trends DRAFT Report no. 01/2018 Commonwealth of Australia 2018 ISSN 978-0-6482138-1-9 (Online) This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs
More informationResearch Note: Household Energy Costs in Australia 2006 to
Research Note: Household Energy Costs in Australia 2006 to 2016 1 Ben Phillips ANU Centre for Social Research and Methods February 2017 1 This work was funded by News Corp Australia. The author would like
More informationReview of TAC Victoria Schedule of Fees for Physiotherapy Services (Private) Presented to the Transport Accident Commission (VIC) May 2013
Review of TAC Victoria Schedule of Fees for Physiotherapy Services (Private) Presented to the Transport Accident Commission (VIC) May 2013 Authorised by: Bridget Shaw Victorian Branch President Australian
More informationSensis Business Index December 2018
Sensis Business Index ember 20 A survey of confidence and behaviour of Australian small and medium businesses Released February 2019 OPEN www.sensis.com.au/sbi Join the conversation: @sensis #SensisBiz
More informationNumber: 072/18 6 pages in total FOR INFORMATION. Below is the breakdown of sector specific school funding provided in the Budget.
Circular ABN 83 005 118 927 12 Thesiger Court Deakin ACT 2600 PO Box 324 Deakin West ACT 2600 Telephone: 02 6282 3488 Facsimile: 02 6285 2926 Email: isca@isca.edu.au Website: www.isca.edu.au Number: 072/18
More informationSuperannuation account balances by age and gender
Superannuation account balances by age and gender October 2017 Ross Clare, Director of Research ASFA Research and Resource Centre The Association of Superannuation Funds of Australia Limited (ASFA) PO
More informationAUSTRALIA Overview of the tax-benefit system
AUSTRALIA 2007 1. Overview of the tax-benefit system The Australian social security system is funded from general taxation revenue and not from employer or employee social security contributions. The system
More informationPOVERTY IN AUSTRALIA: NEW ESTIMATES AND RECENT TRENDS RESEARCH METHODOLOGY FOR THE 2016 REPORT
POVERTY IN AUSTRALIA: NEW ESTIMATES AND RECENT TRENDS RESEARCH METHODOLOGY FOR THE 2016 REPORT Peter Saunders, Melissa Wong and Bruce Bradbury Social Policy Research Centre University of New South Wales
More informationExtrapolated returns from investment in medical research future fund (MRFF) Australian Society for Medical Research
Extrapolated returns from investment in medical research future fund (MRFF) Australian Society for Medical Research 17 October 2014 This report was proudly supported by independent and unrestricted grants
More informationMultinational Comparisons of Health Systems Data, Roosa Tikkanen The Commonwealth Fund
Multinational Comparisons of Health Systems Data, 217 Roosa Tikkanen The Commonwealth Fund Health Care Spending HEALTH CARE SPENDING Health Care Spending per Capita, 2 216 Adjusted for Differences in Cost
More informationBudget Analysis May 2012
Budget Analysis 2012-13 10 May 2012 The information in this presentation is of a general nature and does not represent advice. Forecasts are subject to unavoidable statistical variation. This presentation
More informationBaby Boomers and Housing Markets. Presentation by Clare Wall, SGS Associate 7 th National Housing Conference October 2012
Baby Boomers and Housing Markets Presentation by Clare Wall, SGS Associate 7 th National Housing Conference October 2012 This report has been prepared on behalf of 7th National Housing Conference. SGS
More informationEmerging Issues for Community Sector Leaders. #EmergingIssues2018
Emerging Issues 2018 for Community Sector Leaders #EmergingIssues2018 Rebecca Cassells Principal Research Fellow, Head Research Impact & Engagement Bankwest Curtin Economic Centre BANKWEST CURTIN ECONOMICS
More informationAustralian Economy April Julie Toth Chief Economist Australian Industry Group
Australian Economy April 2018 Julie Toth Chief Economist Australian Industry Group No recession in 26 years (since 1991) but we re still quite slow and fragile. Real GDP grew by only 2.4% in Q4 of 2017
More information16 November 2018 AUSTRALIAN ECONOMIC DEVELOPMENTS
16 November 2018 AUSTRALIAN ECONOMIC DEVELOPMENTS Australia s labour market continues to expand strongly in 2018. Jobs growth seems to be stronger than had been anticipated by the RBA, Government and financial
More informationEmployment Outlook for. Public Administration and Safety
Employment Outlook for Contents INTRODUCTION... 3 EMPLOYMENT GROWTH... 4 EMPLOYMENT PROSPECTS... 5 VACANCY TRENDS... 8 WORKFORCE AGEING... 11 EMPLOYMENT BY GENDER AND FULL-TIME/PART-TIME... 13 HOURS WORKED...
More informationSUBMISSION: Inquiry into the decision to award Serco Australia the contract for the. Fiona Stanley Hospital
Inquiry into the decision to award Serco Australia the contract for the provision of nonclinical services at Fiona Stanley Hospital OCTOBER 2011 Infrastructure Partnerships Australia is a national forum,
More informationFinal Report. Cost/Benefit Analysis Relating to the Implementation of a Common School Starting Age and Associated Nomenclature by 1 January 2010
Final Report Cost/Benefit Analysis Relating to the Implementation of a Common School Starting Age and Associated Nomenclature by 1 January 2010 Volume 3 Appendices Report submitted to the Australian Government
More informationStrengthening the financing of aged care in Australia
Strengthening the financing of aged care in Australia Dr Anna Howe, Brunswick, VIC and Mr Hugh Sarjeant, Cumpston Sarjeant Pty Ltd, Melbourne, VIC Paper presented at Productivity Commission Conference
More informationSensis Business Index September 2016
Sensis Business Index September 20 A survey of confidence and behaviour of Australian small and medium businesses Released 13 October 20 OPEN www.sensis.com.au/sbi Join the conversation: @sensis #SensisBiz
More informationSensis Business Index March 2017
Sensis Business Index March 2017 A survey of confidence and behaviour of Australian small and medium businesses Released 28 April 2017 OPEN www.sensis.com.au/sbi Join the conversation: @sensis #SensisBiz
More informationState of the States October 2016 State & territory economic performance report. Executive Summary
State of the States October 2016 State & territory economic performance report. Executive Summary NSW, VICTORIA AND ACT LEAD How are Australia s states and territories performing? Each quarter CommSec
More informationCatch us when we fall: an analysis of the Medicare Safety Net
CAER WORKSHOP SYDNEY 1 and 2 February 2006 Catch us when we fall: an analysis of the Medicare Safety Net Kees van Gool, Elizabeth Savage, Rosalie Viney, Marion Haas and Rob Anderson, Centre for Health
More informationThe wealth of generations
December 2014 The wealth of generations John Daley and Danielle Wood Grattan Institute Support Grattan Institute Report No. 2014-13, December 2014 This report was written by John Daley, Grattan Institute
More informationThe Federal Budget
The 22-3 Federal Budget Presentation to a BRW / Ernst & Young breakfast Saul Eslake Chief Economist ANZ Bank Sofitel Hotel Melbourne 16 May 22 E-mail: eslakes@anz.com or economics@anz.com Internet: http://www.anz.com
More informationNEW ZEALAND PATHOLOGIST WORKFORCE STUDY 2018
New Zealand Pathologist Workforce Study 2018 NEW ZEALAND PATHOLOGIST WORKFORCE STUDY 2018 WORKFORCE PROFILE AND TRENDS The New Zealand Pathologist workforce has shown significant growth between 2011 and
More informationThe Big Picture. Long-Term Trends in Global Infrastructure Investment and Commodity Prices. Warren Hogan. Chief Economist.
The Big Picture Long-Term Trends in Global Infrastructure Investment and Commodity Prices Warren Hogan Chief Economist May 212 Outline Global Infrastructure Spending Trends Catching up for the industrialised
More informationMultinational Comparisons of Health Systems Data, 2016
Attachment F Multinational Comparisons of Health Systems Data, 216 Dana Sarnak The Commonwealth Fund Health Care Spending per Capita, 198 214 Adjusted for Differences in Cost of Living Dollars ($US) 9,
More informationBANKWEST CURTIN ECONOMICS CENTRE INEQUALITY IN LATER LIFE. The superannuation effect. Helen Hodgson, Alan Tapper and Ha Nguyen
BANKWEST CURTIN ECONOMICS CENTRE INEQUALITY IN LATER LIFE The superannuation effect Helen Hodgson, Alan Tapper and Ha Nguyen BCEC Research Report No. 11/18 March 2018 About the Centre The Bankwest Curtin
More informationState of the States January 2019 State & territory economic performance report. Executive Summary
State of the States January 2019 State & territory economic performance report. Executive Summary NSW & VICTORIA SHARE TOP SPOT How are Australia s states and territories performing? Each quarter CommSec
More informationFY17 Results Presentation. Chris Sutherland, Managing Director 24 May 2017
FY17 Results Presentation Chris Sutherland, Managing Director 24 May 2017 Important notice and disclaimer The information contained in this presentation is for information purposes only and does not constitute
More informationOverview of the COMPARE Project
MONASH MEDICINE, NURSING & HEALTH SCIENCES Overview of the COMPARE Project Professor Alex Collie Director, Insurance Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University
More informationUBS Australasia Conference 14 November Mark Fitzgibbon Managing Director & Chief Executive Officer
UBS Australasia Conference 14 November 2017 Mark Fitzgibbon Managing Director & Chief Executive Officer An inconvenient truth Healthcare spending across the entire OECD continues to grow at a per annum
More informationMultinational Comparisons of Health Systems Data, 2010
1 Multinational Comparisons of Health Systems Data, 21 Gerard F. Anderson and Patricia Markovich Johns Hopkins University November 21 Support for this research was provided by The Commonwealth Fund. 2
More informationWages and prices at a glance. Wage Price Index (WPI) September - 0.7% 3.6%
Wages Report Issue 1, November 2011 In late 2010 and early this year, employer groups began to claim that Australia was on the verge of an unsustainable wages breakout, with real wages rising faster than
More informationHealth Economics Group 2016
Introduction to CostEffectiveness Analysis in Health Health Economics Short Course For more information and course dates, please visit our website: http://go.unimelb.edu.au/8eqn Or email us: health-economics@unimelb.edu.au
More informationHEALTH AND WELLBEING: AGEING WORKFORCE
HEALTH AND WELLBEING: AGEING WORKFORCE DR NATHAN LANGSLEY BMEDSCI, MB BS, MRCPSYCH, MPHIL Welcome My details Scope of the talk Apologies for terminology eg older or ageing Apologies that some stats (eg
More informationIntroducing the Healthcare Property Trust
Introducing the Healthcare Property Trust The Healthcare Property Trust opened in 1999 to capitalise on Australia s ageing population and growing demands for healthcare. Over the last 13 years, the Trust
More informationBeing 50 and up in Australia today An investigation into the Cost of Living Pressures for the Over-50 s in Australia
Being 50 and up in Australia today An investigation into the Cost of Living Pressures for the Over-50 s in Australia September 2015 Message from Christopher Zinn The cost of living is a potent phrase much
More informationSubmission to the Review of the Conditional Adjustment Payment
28 August 2008 Submission to the Review of the Conditional Adjustment Payment "#$%&''&()$*+,,-''.,()(%&,'/0*1&%&0-23(4 Baptist Care Australia Catholic Health Australia Uniting Care Ageing NSW & ACT 5-6&-7(308-9()2&0&():;+2
More informationColonial First State Global Asset Management. Stephen Halmarick Head of Investment Markets Research. 28 September 2009
Colonial First State Global Asset Management Implications of massive sovereign debt issuance Stephen Halmarick Head of Investment Markets Research Colonial First State Global Asset Management 28 September
More informationVictorian Economic Outlook
Thursday, November 1 Victorian Economic Outlook Summary The Victorian economy has been through difficult conditions over the past few years. GSP grew by.% in 11-1, easing from growth of.7% in 1-11, and
More informationOverview - State Tax Review Discussion Paper
Overview - State Tax Review Discussion Paper FEBRUARY 2015 WWW.YOURSAY.SA.GOV.AU Why Are We Reviewing Our State Tax System? South Australia is already a great place to live and we value that as a community.
More informationCommonwealth Budget : what does it mean? Economic Society of Australia (Victoria) Danielle Wood, Fellow Grattan Institute 16 May 2017
Commonwealth Budget 2017-18: what does it mean? Economic Society of Australia (Victoria) Danielle Wood, Fellow Grattan Institute 16 May 2017 Commonwealth Budget 2018 Budget repair recedes over the horizon
More informationWorkforce participation of mature aged women
Workforce participation of mature aged women Geoff Gilfillan Senior Research Economist Productivity Commission Productivity Commission Topics Trends in labour force participation Potential labour supply
More informationKey statistics for Sensis Business Index (September 2018) SM B confidence: National average +42 7
Key statistics for Sensis Business Index (September 2018) The Sensis Business Index is a quarterly survey of 1,000 small and medium businesses, which commenced in 1993. Note: This survey was conducted
More informationSpring Statement 2018: The lost decade
Thomas Pope Wednesday 14 th March 2018 2015-16 2016-17 2017-18 2018-19 2019-20 2020-21 2021-22 2022-23 2007 08 =100 Very small improvement in the growth forecast yesterday 120 118 116 114 112 110 108 106
More informationAn Economic Portrait of Eastern Riverina
An Economic Portrait of Eastern Riverina compared with NSW September 2013 The residents Working residents Economic indicators Industries The Eastern Riverina workforce The nature of local jobs The labour
More informationEmployment Outlook for. Administration and Support Services
Employment Outlook for Administration and Support Services Contents INTRODUCTION... 3 EMPLOYMENT GROWTH... 4 EMPLOYMENT PROSPECTS... 6 VACANCY TRENDS... 9 WORKFORCE AGEING... 11 EMPLOYMENT BY GENDER AND
More informationSensis Business Index September 2018
Sensis Business Index September 20 A survey of confidence and behaviour of Australian small and medium businesses Released 27 November 20 OPEN www.sensis.com.au/sbi Join the conversation: @sensis #SensisBiz
More information20 April 2018 AUSTRALIAN ECONOMIC DEVELOPMENTS. IMF upgrades forecasts for Australian economic growth
20 April 2018 AUSTRALIAN ECONOMIC DEVELOPMENTS This week the RBA reiterated its view that there is no case for a near-term adjustment in the cash rate but that eventually it is likely that the next move
More informationFederal Budget May 2014
Federal Budget 2014 14 May 2014 On the 13th of May 2014, the Federal Government delivered its 2014/15 Budget. Summary: 2013/2014 predicted deficit of $49.9 Billion 2014/2015 - predicted deficit of $29.8
More informationAnalysing Australia s Ageing Population: A Demographic Picture
National Centre for Social and Economic Modelling University of Canberra Analysing Australia s Ageing Population: A Demographic Picture Ann Harding Paper presented to Australia s Ageing Population Summit
More information7 Intergovernmental financial relations
7 Intergovernmental financial relations Features The 2016 17 Commonwealth Budget provided additional interim short term funding for health and education. However, this does not fully address funding cuts
More informationTrends in Retirement and in Working at Older Ages
Pensions at a Glance 211 Retirement-income Systems in OECD and G2 Countries OECD 211 I PART I Chapter 2 Trends in Retirement and in Working at Older Ages This chapter examines labour-market behaviour of
More informationPOPULATION PROJECTIONS
2012 (BASE) TO 2101 POPULATION PROJECTIONS 3222.0 AUSTRALIA EMBARGO: 11.30AM (CANBERRA TIME) TUES 26 NOV 2013 CONTENTS Notes... page 2 CHAPTERS Main Features 3 2 Assumptions... 7 3 Projection results Australia...
More informationA guide to Australian Government payments
A guide to Australian Government payments 20 March 30 June 2015 On behalf of the Department of Social Services and the Department of Agriculture. Rates may change if there is a change in your circumstances,
More informationFEDERAL BUDGET Initial ACOSS Analysis
FEDERAL BUDGET 2011-12 Initial ACOSS Analysis May 2011 CONTACT Australian Council of Social Service Locked Bag 4777, Strawberry Hills, NSW, 2012 T (02) 9310 6200 E info@acoss.org.au www.acoss.org.au First
More information2015 Intergenerational Report
5 May 2015 The Hon Joe Hockey MP Treasurer Parliament House CANBERRA ACT 2600 Email: J.Hockey.MP@aph.gov.au Dear Treasurer, 2015 Intergenerational Report The Actuaries Institute is the professional body
More informationA guide to Australian Government payments
A guide to Australian Government payments 1 July 19 September 2016 On behalf of the Department of Social Services, the Department of Agriculture and Water Resources, the Department of Employment and the
More informationState of the States April 2015 State & territory economic performance report. Executive Summary
State of the States April 2015 State & territory economic performance report. Executive Summary NT Unemployment Housing finance The Northern Territory is pushed back into second spot in the rankings of
More informationEffects of the Australian New Tax System on Government Expenditure; With and without Accounting for Behavioural Changes
Effects of the Australian New Tax System on Government Expenditure; With and without Accounting for Behavioural Changes Guyonne Kalb, Hsein Kew and Rosanna Scutella Melbourne Institute of Applied Economic
More informationProductivity key to raising living standards
Productivity key to raising living standards Janine Dixon Centre of Policy Studies, Victoria University August, The Treasury s Intergenerational Report (IGR) paints a rosy picture of the future, projecting
More informationReference date for all information is June 30th 2008 Country chapter for OECD series Benefits and Wages (www.oecd.org/els/social/workincentives)
AUSTRALIA 2008 Table of Contents Introduction... 1 1. Overview of the tax-benefit system... 2 2. Unemployment insurance... 3 3. Unemployment assistance... 3 4. Social assistance... 9 5. Housing benefits
More informationCo-payments, Choices and Coverage: Meeting the Challenge of Health Financing for Consumers
Co-payments, Choices and Coverage: Meeting the Challenge of Health Financing for Consumers Dr Sharon Willcox, Health Policy Solutions Catholic Health Australia National Conference 27 August 2013 OUTLINE
More informationThe Local Government Workforce. Trends and Blips on the Radar
The Local Workforce Trends and Blips on the Radar 2 Workforce Program SECTOR POSITIONING WORKFORCE PLANNING & DEVELOPMENT WORKFORCE AND DEMOGRAPHIC DATA 3 National Workforce Strategy Local government requires
More informationPOLICY INSIGHT. Inequality The hidden headwind for economic growth. How inequality slows growth
POLICY INSIGHT Inequality The hidden headwind for economic growth Economists often talk of headwinds the swirling oppositions and uncertainties that may hamper economic growth. We hear of the slowdown
More information