Report: Federal Budget 2024-25 summary

Budget measures for osteopaths and osteopathy businesses

As with every federal budget, there are winners and losers, and sadly, neither osteopathy, allied health more generally, nor small business received great gains from this budget.

We are concerned about the lack of progress on the broader enablement of the allied health workforce in primary care. Osteopathy can play a role in current workforce shortages, if funded and recognised.  Disappointingly, a key document on the future of allied health in Australia was not mentioned or further funding - the national allied health workforce strategy.

The following key points have been taken from the budget that are indirectly influential in the practice of an osteopath working across health, aged care and disability:

• $531.4 million to release an additional 24,100 Home Care Packages in 2024–25, but the Budget does not address the worsening shortages in the allied health workforce for home care.
• We welcome the announcement of $2.2 billion to deliver aged care reforms and continue implementing recommendations from the Royal Commission into Aged Care Quality and Safety. As a part of this work, the Commonwealth Government must implement the recommendations from the Royal Commission to ensure that all aged care consumers receive the allied health services they need.
• $57.4 million in 2024–25 to continue initiatives under the Health Delivery Modernisation Program and to update My Health Record
• Aged Care: "$1.4 billion to upgrade the sector's technology systems and digital infrastructure. This includes funding to sustain current systems and to support the implementation of the new Aged Care Act."
• $8.5 billion in new investments in the health budget for things like:
  • chronic disease challenges (currently unclear what this means for osteopathy)
  • hospital interfaces with primary care, disability, aged care
• $53.6 million around women's health MRFF
• Consumers are stuck with the outdated model of 5 allied health sessions per calendar year. With a declining GP workforce and record low bulk billing rates, consumers with chronic diseases are finding it harder than ever to get into their GP. The primary care system is buckling under pressure.
• The budget allocated $23.1 million to extend the Continuous Review of the MBS but did not provide details about funding to update existing legislation and ensure it is fit for purpose. Funding is crucial for the scope of practice review to include the removal of current barriers and increase funding for osteopaths working at their full scope of practice via increased diagnostic imaging rights and direct MBS referral to a specialist.
• We are pleased to see recognition of improving the distribution of the health workforce through improved incentives for primary care doctors, nurses and allied health professionals, including through reforms to the Workforce Incentive Program.

Individuals

Individual osteopaths may benefit from:

• Stage three tax cuts aimed to deliver more support to taxpayers on middle and lower incomes.
• $1.1 billion has been allocated to pay superannuation on Government-funded Paid Parental Leave, with funding allocated to small and medium enterprises (SMEs) to support this initiative.
• Funding to several programs that will expand access to education and training, including an $88.8 million investment. 
• $350 million for fee-free, uni-ready courses to offer places to those seeking tertiary qualifications.

Businesses

For businesses, some support was offered:

• Small businesses will be eligible for a $325 energy relief payment.
• $20,000 instant asset write-off has been extended until 30 June 2025 for small businesses. This measure allows business owners to invest in their growth by claiming an immediate tax deduction after buying a new piece of equipment – a vehicle, a coffee machine, or an EFTPOS machine. Small businesses with an annual turnover of less than $10 million can immediately deduct eligible assets costing less than $20,000 until 30 June 2025.
• Continuing support for several programs introduced to help bolster cyber security among Australian small businesses.
• $22.7 billion Future Made in Australia package, which includes production tax incentives and funding for innovation, particularly in green industries, offers opportunities for small businesses to innovate and adapt to new technologies. This is unlikely to benefit osteopathy businesses

Student - Prac Payment

While we welcome the Commonwealth Prac Payment, which was announced a little over a week ago, we are deeply disappointed that it does not extend to osteopathy and other allied health professionals.

Primary care

Overall, we are disappointed to see no progress in enabling the broader role of allied health in primary care and chronic disease prevention and management.  We note the expansion of the Urgent Care Clinic program, with the announcement of $227 million of funding to support 29 more clinics. While the focus remains on general practice, some urgent care clinics include allied health staffing, and we hope to see an expansion of the allied health role in those clinics as the program expands.

• $2.8 billion to strengthen Medicare.
• $16.0 million over four years from 2024–25 (and $0.2 million per year ongoing) to implement system changes to MyMedicare, enabling the payment of incentives to general practitioners and general practices to support wrap-around primary care for frequent hospital users.
• $90.0 million to fund the implementation of the health-related recommendations of the independent review of Australia’s regulatory settings relating to overseas health practitioners (the Kruk Review) to grow and support the health workforce.  

Aged care

As part of Strengthening Medicare and the care economy, $2.2 billion has been allocated over a five-year period, to improving aged care through reforms and recommendations from the Royal Commission into Aged Care Quality and Safety.

• $87.2 million is being allocated towards workforce initiatives to bring nurses and other workers into aged care; however, there is no mention of support for the allied health workforce. Of that, $65.6 million will be allocated over four years, starting in 2024-2025, to go towards retraining aged care workers, improving data collection, and enhancing outcomes for older Australians receiving aged care services through existing workforce programs. However, it remains unclear whether this funding will cover allied health services.
• $531.4 million has been allocated for an additional 24,100 Home Care Packages in 2024–25. However, the budget fails to tackle the growing shortages in the allied health workforce in home care.

• The Government is allocating $110.9 million over four years to boost the Aged Care Quality and Safety Commission's regulatory capacity.
• $882 million has been allocated to help older Australians get medical support outside of hospitals. The funding will offer support via community outreach, virtual care and training for aged care workers. 
• $610.4 million to better support older Australians and relieve pressure on our public hospitals.

We are disappointed that the Government has not introduced new budget measures to increase access to osteopaths and the full range of allied health services for aged care clients, as recommended in our pre-budget submission.

A lack of preventative health focus in the budget is alarming and does not address the high costs associated with more intensive interventions that fall out of disease management. Fall prevention and reablement are key focal areas for osteopaths to reduce avoidable hospitalisations for older Australians.  

As part of this work, the Commonwealth Government must implement the recommendations from the Royal Commission to ensure that all aged care consumers receive the allied health services they need. Key parts of this funding include:

• reinforce the foundations and connections that underpin quality aged care
• reduce wait times for older people seeking Home Care Packages
• bolster the aged care workforce
• deliver an enhanced quality and safety regulator
• upgrade technology systems and digital infrastructure across the aged care sector.

While we acknowledge that there have been considerable improvements in nursing and personal care provision, there is still no mandatory standard for allied health, and the average number of minutes per person in residential care is now less than half the figure criticised by the Royal Commission. For these reasons, we also advocate for some of the $110.9 million over four years to support an increase in the Aged Care Quality and Safety Commission's regulatory capabilities to be used to develop strategies to ensure sufficient allied health provision.

Despite references in the Budget material to providing better support for older Australians, including via the Specialist Dementia Care Program ($32.1 million), the Budget does not contain any commitment to provide consistently available, multidisciplinary team care for people with complex care needs, whether at home, transitioning from hospital or in residential aged care.

For example, while we recognise the importance of transitioning older people with complex care needs out of the hospital system, residential aged care homes are woefully understaffed and ill-equipped to manage residents with complex medical needs.

The government also states that the Budget will promote stronger links between aged care and health systems. More detail is needed about what is envisaged and what funding is attached, if any.

New models of care will be developed for older Australians to prevent them from going to hospital unnecessarily. Virtual care technology will facilitate this.

$1.4 billion ICT upgrade across the sector to prepare for the new Aged Care Act. It is unclear when the new Aged Care Act will commence. The Government outlined in its webinar on 15 May 2024 that the new Aged Care Act feedback is being worked through, and they are committed to introducing the Act as soon as possible. A report with stakeholder feedback will be released soon.

$88.4 million will be invested to attract and retain the aged care workforce. However, there needs to be a mention of whether that workforce includes allied health staff. Some of this work will be undertaken via a biennial Provider Workforce Survey.

$37.0 million for the My Aged Care contact centre - The support at home program will take effect on 1 July 2025, as planned. It will replace home care packages and the short-term restorative pathway. In the meantime, $400 million has been committed to the Commonwealth Home Support Program (CHSP) over the next three years.

Disability

As part of strengthening Medicare and the care economy, $468.7 million has been allocated to support people with disabilities and get the NDIS back on track, compared with the $732.9 million provided in last year's budget.

• $214 million over two years to fight fraud and to co-design NDIS reforms with people with disability, announced earlier this year. 
• $23.5 million will be allocated to Services Australia to investigate fraudulent providers.
• $45.5 million will be allocated to an advisory committee to determine value-for-money supports. Allied Health must be a core piece of the committee. 
• $129.8 million will be allocated over two years to support design and consultation efforts in response to the Independent Review of the NDIS findings.
• $20 million will be allocated over two years for initial design and consultation work on reforms to aid people with disability and NDIS participants to navigate services. 
• $160.7 million to upgrade the NDIS Quality and Safeguards Commission’s information technology systems, to better protect the safety of NDIS participants, reduce regulatory burden on NDIS providers, and improve cyber security.
• $83.9 million to boost fraud detecting information technology systems at the National Disability Insurance Agency (NDIA), to further safeguard the integrity of the NDIS.
• $5.3 million for the Independent Health and Aged Care Pricing Authority to work with the Department of Social Services and the NDIA to undertake initial work to reform NDIS pricing arrangements, including reviewing existing pricing approaches and developing a pricing data strategy.

We support co-design, but allied health providers must be consulted early to develop a fair registration and assessment design approach.

We need consultative structures enabling reform rollout so providers and participants can work together on reforms enabling greater participant choice and control. We expect allied health to be represented in the NDIS Implementation Advisory Committee and the NDIS Implementation Working Group announced in the Budget. 

Will the government pay for initial assessments, as previously mooted, including those by the Senate Joint Standing Committee on the NDIS? There is nothing on this is in the Budget.

We welcome the $5.3 million in 2024-25 to begin work to establish an independent pricing authority, as recommended by the NDIS Review. An independent authority is essential to help stem the exodus of providers from the National Disability Insurance Scheme (NDIS) (who are making losses due to current losses arising from prices being set by the National Disability Insurance Agency (NDIA)).

The budget has failed to allocate funding and resources to allied health peak bodies and all allied health practitioners to provide services to support participants in the NDIS.

Rural and remote

In addition to the additional Urgent Care Clinics, we welcome the announcement of a pool of funding to support PHNs and Rural Workforce Agencies to step in where health services are at risk of closing.

• $17.4 million to boost the supply of health care in areas of shortage.  
   - Primary Health Networks and Rural Workforce Agencies will work with local communities to support people to get the care they need, close to home.
• The 2024–25 Budget provides $17.4 million to boost the supply of healthcare in areas of shortage. PHNs and rural workforce agencies will work with local communities to support people to get the care they need, close to home. This is new funding for the existing Workforce Incentive Program. 

Digital health

We suggest that funding provided to Services Australia, the Aged Care sector, and others to upgrade, simplify, and improve the integrity of digital infrastructure extend to include allied health-related systems.

• Aged Care: "$1.4 billion to upgrade the sector's technology systems and digital infrastructure. This includes funding to sustain current systems and to support the implementation of the new Aged Care Act."
• Underpinning the aged care reforms, including those dependent on the new Act, significant technology, platform maintenance, and enhancements will be funded to ensure critical aged care digital systems remain contemporary and comply with legislation ($1.4 billion). Improved systems will help older people, their families, and carers access aged care services and reduce administrative burdens for aged care providers by better integrating aged care and health systems.
• Services Australia: "Services Australia will continue to build and strengthen its technology and systems and increase digital accessibility to ensure it provides a simpler, more secure and efficient digital customer experience, and faster and more accessible services across all channels".(Reference Portfolio Budget Statements 2024-25 (dss.gov.au)
• $57.4 million in 2024–25 to continue initiatives under the Health Delivery Modernisation Program and to update My Health Record.

The budget must provide funding to support the smooth transition and access to My Health Record, which will foster understanding, engagement, cross-collaboration, and ease of sharing and viewing important patient information.

Modernising the My Health Record system to support near real-time information sharing across care settings.

Digital measures missing from the budget

An extension of digital products utilised in the Aged Care sector to enable access to allied health professionals and incorporate critical consumer information generated.

Services Australia streamline the processes for allied health professionals, particularly self-regulated professionals, to access and utilise a Health-care Provider Individual Identifier (HPI-I) number to enable faster connection with My Health Record and other digital products.

Digital products and systems are upgraded to allow interoperability between sectors for all health professionals so consumer information can be with them wherever they go.

Veteran's health

The Government will provide $59.6 million over three years from 2024-25 to continue access to health and support services for veterans and their families. Specific measures include:  

• $48.4 million to provide viability payments to providers to maintain the short-term viability of Veterans’ Home Care and Community Nursing programs.  
• $10.2 million to extend access to the Provisional Access to Medical Treatment program, which provides access to funded medical treatment for ill and injured veterans who are awaiting a liability determination on the claim they have submitted.  
• $1.0 million to extend the Veterans’ Chaplaincy Pilot Program for one year, which will provide additional time to complete the evaluation of the program.

Conclusion

In conclusion, we are deeply disappointed at the lack of acknowledgement and inclusivity of osteopathy and the wider allied health professions. This budget fails to address our key recommendations made in our pre-budget submission.

Osteopathy Australia will continue to advocate on behalf of the profession to ensure that osteopaths are recognised as a core part of multidisciplinary teams providing care to people in the health, aged care, and disability sectors.

For more information or to discuss this summary, contact Policy and Advocacy Manager, Stephanie Santos at ssantos@osteopathy.org.au or on (02) 9410 0099.