The ANAO has already reported on the PHN delivery system, now it’s looking for some other DoHAC fish to fry.
The Australian National Audit Office has released its list of proposed audits for 2024-2025 and the Department of Health and Aged Care is firmly in its sights.
Already this year, the ANAO has turned its gaze to primary health networks’ administration of Commonwealth funding, with its 27 February report finding that the DoHAC had failed to demonstrate that PHNs delivery model was achieving its objectives.
Top of the list in the next 12-24 months for the eagle-eyed auditors are Medicare urgent care clinics, mental health funding, and the management of medicines supply.
The federal government set up 58 UCCs between the 2023-24 May Budget and 31 December with allocated funding of $358.5 million over five years.
“This audit would examine the stand up and early implementation of the UCCs, including the selection of locations and providers for UCCs, and the establishment of performance measures and monitoring arrangements to enable the DoHAC to ensure UCCs are achieving their intended outcomes,” said the ANAO.
Given the UCCs were set up in order to reduce pressure on hospital emergency departments by diverting urgent but not life-threatening care, so far the evidence for that outcome has been a mixed bag, with critics arguing that it is bed block rather than non-urgent cases causing the backlog in EDs.
The coordination and targeting of mental health funding is also proposed as a review topic by the ANAO, with the effectiveness of the DoHAC’s administration of funds – including $765.8 million directed to headspace, $487.2 million to establish a network of eight Head to Health adult mental health centres and 24 satellite centres, $278.6 million to expand and enhance headspace youth mental health services, $54.2 million to help establish child mental health and wellbeing hubs to provide multidisciplinary care and preventative services, and $117.2 million to establish a national database on service delivery, performance and outcomes across the mental health system and conduct longitudinal studies on the mental health of children and Aboriginal and Torres Strait Islander Australians – under the microscope.
The audit will also look at the effectiveness of the National Mental Health and Suicide Prevention Agreement, in which the federal government acknowledged its joint responsibility for “supporting better integrated mental health service planning and care coordination at a regional level, accompanied by accountability mechanisms and reporting”.
Medicine shortages have been in the headlines since the covid pandemic disrupted supply chains.
“In 2021 the Australian Government concluded strategic agreements with entities in Australia’s medicines industry to introduce a Medicines Supply Security Guarantee,” said the ANAO.
“From 1 July 2023, minimum stockholding requirements applied, where manufacturers were required to hold a minimum of either four or six months’ of stock in Australia for certain PBS-listed medicines.
“This audit will examine the effectiveness of the department in ensuring compliance with the minimum stockholding requirement, as well as broader administration of equitable medicines access and medicines shortages.”
Linked to that would be an audit of the DoHAC’s management of sovereign health capabilities, including procurement and contract management of antivenom and vaccines of national significance.
“Following the privatisation of the Commonwealth Serum Laboratories in 1994, the Australian Government has relied on commercial contracts with the private sector to ensure that Australians have access to products of national significance,” said the ANAO.
“These products include antivenoms for Australian venomous creatures, Q-Fever vaccine, and pandemic vaccines.
“On 16 November 2020 the Prime Minister [Scott Morrison] announced the Australian Government had concluded a $1 billion manufacturing agreement with Seqirus, a wholly owned subsidiary of CSL Ltd, which committed Seqirus to the continued supply of products of national significance until 2036 and the development of a new manufacturing facility.”
The effectiveness of the Professional Services Review Scheme will come in for some attention as well said the ANAO. While the director of the PSR is independent of the DoHAC, he or she reports directly to the Minister for Health.
Other health-related audits proposed by the ANAO for 2024-25 include the effectiveness of the DoHAC’s administration of the Australian National Preventive Health Agency Act 2010 and delivery of the National Preventive Health Strategy; the effectiveness of the DoHAC’s administration of the Commonwealth Home Support Program; assessment of whether Sport Integrity Australia had delivered a coordinated national response to sports integrity issues; a cross-entity audit that would assess the effectiveness of actions by the DoHAC and the National Disability Insurance Agency to achieve Australian Government targets for reducing the number of younger people entering or remaining in residential aged care, and the Department of Social Services’ oversight and evaluation of actions taken; and, the effectiveness (including cost-effectiveness) of joint stewardship of the support worker workforce, including the coordination of workforce strategies for support workers.
The ANAO’s proposed program of audits is open for public consultation. Submissions close at midnight on 19 April. The full program can be found here.