Details of the Financial Framework (Supplementary Powers) Amendment (Health Measures No. 5) Regulations 2017
Section 1 - Name
This section provides that the title of the Regulations is the Financial Framework (Supplementary Powers) Amendment (Health Measures No. 5) Regulations 2017.
Section 2 - Commencement
This section provides that the Regulations commence on the day after registration on the Federal Register of Legislation.
Section 3 - Authority
This section provides that the Regulations are made under the Financial Framework (Supplementary Powers) Act 1997.
Section 4 - Schedules
This section provides that the Financial Framework (Supplementary Powers) Regulations 1997 are amended as set out in the Schedule to the Regulations.
Schedule 1 - Amendments
Item 1 - In the appropriate position in Part 4 of Schedule 1AB (table)
This item adds two new table items to Part 4 of Schedule 1AB to establish legislative authority for government spending on certain activities administered by the Department of Health.
New table item 241 establishes legislative authority for government spending on the General Practitioners Healthy Heart Partnership (the Partnership).
The Partnership is part of the Government's Healthy Heart Initiative, announced in the 2017-18 Budget, which will give people the right tools and information to live active and healthy lives through establishing partnerships with general practitioners (GPs) and the National Heart Foundation.
The Government will provide grant funding of $5 million to the Royal Australian College of General Practitioners (RACGP) to develop education and training material for GPs and their patients to support Australians to achieve a healthy lifestyle through increased physical activity and better nutrition. The education and training will enhance the knowledge and skills of GPs to more effectively work with their patients and, in particular, ensure that GPs have the resources to support overweight or obese patients. Information will also be provided to patients to help them better manage their own weight.
The Partnership will target the Australian community, including those in remote, rural and regional areas, people from lower socioeconomic backgrounds, and Aboriginal and Torres Strait Islander people. It is expected to lead to a reduced cost to the health system to support people with chronic conditions, as it will over time reduce the number of people that have chronic conditions. In particular, the education and training material will be directed at supporting treatment by GPs of patients who are overweight, obese or at risk of, or managing, diabetes mellitus.
The RACGP will be responsible for the development of education and training material for GPs and their patients. The resources and tools will be available electronically. GPs and their patients will be able to access them via an online portal, which integrates with the general practice clinical software.
The RACGP will manage the Partnership and use part of government funding to assist GPs with the administration and monitoring required for their patients. These activities will be designed to fit in with a patient's usual, clinically appropriate consultation cycle with their GP, without involving additional consultations under Medicare. Between consultations, the patient will receive support which may include:
* access to mobile phone applications (to be developed by the RACGP) that will send regular affirming messages;
* reminders to attend physical and other lifestyle modification activities; and
* the ability to record their weight through self-reporting and have this information provided to their GP without the need to visit the GP.
The full range of monitoring approaches will be determined by the RACGP. The information recorded by the patient through self-reporting will be reviewed by the GP at the patient's next regular consultation to determine any adjustments required for the patient's weight control or reduction plan.
The online portal will provide tips and tools for GPs when having difficult conversations to encourage patient behaviour change. The training material and resources for GPs will include information about local lifestyle modification activities such as local Heart Foundation Walking groups and community-based exercise classes. GPs will be able to provide this information to their patients to assist them in achieving their weight goals.
GPs will also be able to advise their patients where they can obtain further information on achieving weight loss, including in relation to nutrition and physical activity. Patients may also be referred to other health and behavioural change professionals, such as dietitians, psychologists and life coaches, to assist them in reaching their weight loss goals.
The Partnership will also include a reward program for patients who may receive awards and certificates when their target weight has been achieved.
The Partnership will be delivered using a staged approach over four years from 2017-18. The RACGP will establish a Steering Committee (and other relevant working groups) to provide governance and broad oversight of the Partnership, as well as input into its design and implementation. There will be close linkages between the Partnership and the Prime Minister's Walk for Life Challenge, which is also part of the Healthy Heart Initiative.
Funding of $5 million for the Partnership was included in the 2017-18 Budget under the measure 'Healthy Heart Initiative - targeted activities' for a period of four years commencing in 2017-18. Details are set out in Budget 2017-18, Budget Measures, Budget Paper No. 2 2017-18 at page 111.
The Department of Health will provide grant funding to the RACGP through a direct source arrangement. The Commonwealth Grants Rules and Guidelines will apply to the grant process. The grant decision will be made by the delegate of the Secretary of the department and reported at www.health.gov.au.
The department will enter into a grant funding agreement with the RACGP, which will be responsible for the program delivery. The RACGP may engage subcontractors, for example, to develop a mobile phone application. Consideration will be given to whether applications currently available on the market could be adapted.
The provision of funds to the RACGP to administer the Partnership is not considered suitable for independent merits review because the expenditure is one-off, time-limited and non-competitive.
The direct source arrangement is considered appropriate because the RACGP is the only peak body for Australian GPs. Given the RACGP has the appropriate capability, the specific expertise required and established infrastructure, they are considered to be the most appropriate organisation to deliver this program.
To reconsider this decision under merits review would substantially delay implementation of the program in a market environment where there are no alternative providers with similar capacity to access Australian GPs.
Funding for this item will come from Program 2.4: Preventive Health and Chronic Disease Support, which is part of Outcome 2. Details are set out in the Portfolio Budget Statements 2017-18, Budget Related Paper No. 1.10, Health Portfolio at page 70.
Noting that it is not a comprehensive statement of relevant constitutional considerations, the objective of the item references the following powers of the Constitution:
* the external affairs power (section 51(xxix));
* the social welfare power (section 51(xxiiiA)); and
* the communications power (section 51(v)).
External affairs power
Section 51(xxix) of the Constitution empowers the Parliament to make laws with respect to 'external affairs'. The external affairs power supports legislation implementing treaties to which Australia is a party. Australia has obligations regarding the right to health under Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights. In particular, these Articles require States Parties to take steps necessary for 'the prevention, treatment and control of epidemic, endemic, occupational and other diseases'.
The materials to be developed under this program will:
* assist GPs to treat patients who are overweight, obese and/or suffering from diabetes mellitus; and
* support and encourage patients who are overweight, obese and/or suffering from diabetes mellitus to manage, monitor and implement their GP's treatment recommendations related to preventing and/or treating that health condition.
Social welfare power
Section 51(xxiiiA) of the Constitution empowers the Parliament to make laws with respect to the provision of various social welfare benefits and services, including medical services.
The materials to be developed under this program will improve the quality and effectiveness of Commonwealth-funded medical services.
Communications power
Under section 51(v) of the Constitution, the Commonwealth has power to legislate with respect to 'postal, telegraphic, telephonic and other like services'.
Some materials (for example, mobile phone applications) to be developed under this program will operate on, or rely on, electronic communications services such as the internet.
New table item 242 establishes legislative authority for government spending on the Prime Minister's Walk for Life Challenge (the Challenge).
The Government will provide funding of $10 million to the National Heart Foundation (Heart Foundation) for the Challenge, which is also part of the Government's Healthy Heart Initiative announced in the 2017-18 Budget.
The Challenge will improve community participation in physical activity and raise community awareness of the value of physical activity and its role in preventing chronic diseases. It will also increase access to walking and other physical activity programs, including for children in schools, and promote innovative uses of technology to support increased physical activity.
The Challenge will consist of two parts:
* the Innovative Physical Activity Challenge; and
* the Step Challenge.
The Innovative Physical Activity Challenge
The Innovative Physical Activity Challenge will encourage schools, universities and community groups to develop and implement innovative ideas that encourage physical activity in the school, university and community environments. These activities will be administered by the Heart Foundation and undertaken in partnership with other organisations or programs.
The Heart Foundation will engage a social marketing agency to support the social marketing and education campaign and program design of both parts of the Challenge. The campaign will promote a national conversation on the benefits of physical activity and the consequences of physical inactivity. The social marketing agency will be responsible for the development and distribution of the promotional material and will encourage people to participate in the Innovative Physical Activity Challenge to encourage innovative physical activity ideas in the school, university and community environments. The agency will also assist with the design of incentives to support participation.
The Innovative Physical Activity Challenge will run for two years from 2017-18, with participation open to all schools, universities and communities of any size. Participating schools, universities and community groups will be encouraged to research the benefits of physical activity and submit ideas on how to create a more physically active culture. A number of proposals will be selected and awarded with prizes to assist in their implementation (for example, sporting equipment). Prizes will be awarded in each state and territory. The social marketing agency will also be responsible for purchasing and distributing the prizes to winning entrants. These prizes will differ depending on the target group.
The Innovative Physical Activity Challenge is designed to build national momentum and identify potential private sector partners for future activities. Innovative ideas developed through this challenge will be considered for national initiatives in future years. The Heart Foundation will establish a Steering Committee (and other relevant working groups) that will assess the applications and develop a report for the Department of Health, including recommendations for future funding activities.
Information about the Innovative Physical Activity Challenge, including guidelines, eligibility and assessment criteria, will be made available on the Department of Health's website. Advertising will also occur through the Heart Foundation's website.
The Step Challenge
The Heart Foundation will be responsible for the development of the Step Challenge, which will leverage off the existing successful Heart Foundation Walking program. It will use the Heart Foundation's infrastructure to scale up the number of walking groups supported by the Heart Foundation. The Step Challenge will run for two years from 2017-18, with participation open to all adults, especially hard-to-reach groups. Participation in the Step Challenge will be promoted through the social marketing and education campaign.
The Department of Health will request the Heart Foundation to develop new models of engagement and program delivery to further encourage participation of disadvantaged groups in the Step Challenge. The initiatives are expected to focus on actions across multiple settings and consider at risk population groups, such as the Aboriginal and Torres Strait Islander people, culturally and linguistically diverse groups, people experiencing socioeconomic disadvantage, people with chronic conditions, and people who are residing in remote, rural and regional locations.
A step tracking mobile phone application and an online portal will be developed as part of the Step Challenge to promote individual 'virtual' walking, that is, walks taken but not with a walking group. The Heart Foundation may subcontract an organisation to develop the application by utilising existing step tracking applications in the market.
The mobile phone application is expected to help participants track their progress and identify walking group sites supported by the Heart Foundation's Walking program. The application could also include features to help people with behavioural change through:
* appropriately timed reminder messages to motivate or reward an activity;
* a platform for goal-setting that aligns short-term goals with long-term outcomes and includes anchoring, or referencing to appropriate personal targets;
* relevant feedback on participants' progress;
* opportunities to make a commitment to an activity; and
* engaging friends and social networks to maintain a commitment.
When a participant's steps reach a '1 million steps' milestone, they will receive a certificate from the Prime Minister and then become eligible to enter into a prize draw for sporting equipment.
The same Steering Committee established for the Innovative Physical Activity Challenge is expected to oversee the Step Challenge. Additional working groups may also be established.
The Heart Foundation will also engage an independent organisation to evaluate and guide the development of both parts of the Challenge. The evaluation will include the development of a monitoring and evaluation plan, including performance indicators, and the collection of data to assess progress against program objectives. For example, the Innovative Physical Activity Challenge will be evaluated based on the participation rates and the applications received. The Step Challenge will be evaluated based on the number of participants, steps achieved and awareness of the campaign.
Funding of $10 million for the Challenge was included in the 2017-18 Budget under the measure 'Healthy Heart Initiative - targeted activities' for a period of four years commencing in 2017-18. Details are set out in Budget 2017-18, Budget Measures, Budget Paper No. 2 2017-18 at page 111.
The Department of Health will provide grant funding to the Heart Foundation through a direct source arrangement. The Commonwealth Grants Rules and Guidelines will apply to the grant process. The grant decision will be made by the delegate of the Secretary of the department and reported at www.health.gov.au.
The department will enter into a grant funding agreement with the Heart Foundation, which will be responsible for the program delivery. The Heart Foundation may engage subcontractors, for example, to develop a mobile phone application.
The provision of funds to the Heart Foundation to administer the Challenge is not considered suitable for independent merits review because the expenditure is one-off, time-limited and non-competitive.
The direct source arrangement is considered appropriate because the Heart Foundation is the peak body in Australia for cardiac disease. The Heart Foundation has previously funded medical and scientific research and public education; promoted lifestyles that improve cardiovascular health; developed clinical guidelines; and conducted programs that improve heart health. The Heart Foundation has the appropriate capability, the specific expertise required and established infrastructure to deliver this program.
To reconsider this decision under merits review would substantially delay implementation of the program in a market environment where there are no alternative providers with a similar capacity.
Funding for this item will come from Program 2.4: Preventive Health and Chronic Disease Support, which is part of Outcome 2. Details are set out in the Portfolio Budget Statements 2017-18, Budget Related Paper No. 1.10, Health Portfolio at page 70.
Noting that it is not a comprehensive statement of relevant constitutional considerations, the objective of the item references the external affairs power (section 51(xxix)) of the Constitution.
Section 51(xxix) of the Constitution empowers the Parliament to make laws with respect to 'external affairs'. The external affairs power supports legislation implementing treaties to which Australia is a party.
Australia has obligations regarding the right to health under Articles 2 and 12 of the International Covenant on Economic, Social and Cultural Rights. In particular, these Articles require States Parties to take steps necessary for 'the prevention, treatment and control of epidemic, endemic, occupational and other diseases'.
Australia also has obligations regarding the rights of the child under Articles 4, 24 and 29 of the Convention on the Rights of the Child. Article 4 requires States Parties to 'undertake all appropriate ... measures for the implementation of the rights recognised' in the Convention. Article 24, in particular, requires States Parties to take appropriate measures 'to ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition'. Article 29 provides, in particular, that 'States Parties agree that the education of the child shall be directed to' '[t]he development of the child's personality, talents and mental and physical abilities to their fullest potential.'
The program will improve community participation in physical activity, and raise community awareness of the value of physical activity and its role in preventing chronic disease. It will increase access to walking and other physical activity programs, including for children in schools, and promote innovative uses of technology to support increased physical activity across the population.
Commonwealth Numbered Regulations - Explanatory Statements