The 2018 Federal Budget – with its focus on rural health and aged care – has been labelled “safe and steady” by the AMA, but has attracted criticism for neglecting preventive health.

Doctors’ groups have welcomed a decision not to fund the proposed Murray Darling medical school, opting instead to create a network of medical schools in the region to boost training in the bush. There are new MBS items and new PBS-subsidies for expensive medications, many that have been previously announced.

Medicare

From 1 July 2018, fees for GP and specialist consultation items will be indexed

From 1 July 2019, fees for procedures performed by specialists and allied health items will be indexed

On 1 July 2020, targeted diagnostic imaging items will be indexed for the first time since 2004

Medicare spending to increase from $22.9 billion in 2017/18 to $27.2 billion by 2020/21

New MBS item for 3D mammography test for the early detection of breast cancer

Consolidate items for thyroidectomy

Double the rebate for spirometry to $40 for GPs

New item for GPs to refer patients with high pre-test probability for moderate to severe OSA for sleep study

Expansion of the Insulin Pump Program for children with type 1 diabetes, with funding for 280 pumps up from 66

Pharmaceuticals/PBS

PBS spending to be capped: forward estimates  of $10.69 billion by 2020 (from $10.95 billion in 2017/18)

$1.4 billion for new and amended listings on PBS includes:

• Nusinersen (Spinraza) from 1 June for the treatment of spinal muscular atrophy.
• Ribociclib (Kisqali) from 1 July for the treatment of breast cancer

Reduced funding for NPS MedicineWise and National Return of Unwanted Medicines

$302.6 m in savings over forward estimates by encouraging greater use of generic and biosimilar medicines

Workforce/Training

No additional specialist training places

100 extra GP training places by 2021

New network of five regional medical schools within the Murray Darling Region in NSW. No increase to Commonwealth-supported university medical places.

Improved return of service obligations for bonded medical places – details TBA

Increase proportion of rural training done in the bush from 40% to 45% in 2020-21

Cap for visas for IMGs who want to work as GPs (2100) from 2019, does not affect specialties

E-Health

$28.2 m over five years to upgrade the e-prescribing software system used by clinicians to prescribe medicines

$5 m over two years to develop national digital baby books

Medical research

$6 billion for medical research including $500 m for genomics projects, $248 m for the rare cancer, rare diseases and unmet need clinical trials and registries program and a new $125 m chronic disease fund which will focus on diabetes and cardiac disease.

Other Budget measure items that have previously been announced:

New MBS items to fund dialysis services in very rural and remote regions

Reforms to MBS knee imaging items

PBS listing of Ocrelizumab (Ocrevus) for the treatment of relapsing remitting multiple sclerosis, Pembrolizumab (Keytruda) for the treatment of relapsed or refractory Hodgkin lymphoma and

Carfilzomib (Kyprolis) for the treatment of refractory multiple myeloma

Landmark agreement with Medicines Australia to improve access to life saving medicines for rare diseases through reforms to the Life Saving Drugs Program.