The Morrison Government handed down its 2021-22 Budget on Tuesday this week. A Federal Government budget will rarely, if ever, satisfy everyone. Inevitably what is reported the next day are superficial listings of winners and losers, but things are often not quite that clear cut. For those living with chronic pain, there appear to be some gains, some potential losses and some measures we will need to see more detail on before we can exercise our judgement with any certainty.
Keeping this introduction in mind, what follows is a quick review of what’s in the Budget for chronic pain.
Support for endometriosis/women’s health
The Government will invest $21.6 million to support the continuation of critical women’s health initiatives, including the Jean Hailes for Women’s Health and the Pelvic Pain Foundation of Australia for the Periods, Pain and Endometriosis Program.
PBS listing to help people living with chronic migraine
On 1 June 2021, galcanemab (Emgality®) will be available on the PBS for the treatment of chronic migraine. This will mean around 10,000 patients are not faced with out-of-pocket costs in excess of $6,800 each year.
The Government is providing funding for mental health initiatives by investing $6.3 billion in 2021-22 to improve Australia’s mental health system and ensure all Australians have access to mental health and suicide prevention services when and where they need them. Considering that people living with pain experience depression at 4 times the rate of those without pain, this may benefit people living with chronic pain.
THN Program Continuing
The Take Home Naloxone pilot program will continue for an additional year in New South Wales, South Australia, and Western Australia. Naloxone is a common medicine used in emergency settings where to temporarily reverse an opioid overdose or adverse reaction.
Potential Losses and Ambiguity
The Government will invest an additional $17.7 billion to reform aged care and respond to the Royal Commission into Aged Care Quality and Safety (Royal Commission). While additional funding for the sector is always welcomed, there wasn’t a significant focus on chronic pain in the Commission’s report, so how and where the money is spent (hopefully not just on profits and executive bonuses) and the extent of real reform in the quality of aged care will be a factor in determining its impact on the ground.
Potential cuts in pain management services
The Budget listed a potential cut in pain management services through further amendments to the MBS pain management items resulting in efficiencies of $41.5 million over three years. We are told this may be a ‘redistribution’ of MBS items, but have requested further details from the Health Department about what this means.
New MBS items for people with chronic and complex disease
New MBS items will be added for allied health professionals who participate in case conferences which are organised by a patient's GP. This is meant to support increased allied health participation in multidisciplinary, coordinated care for patients with chronic and complex disease. Again we expect this measure to significantly benefit people experiencing pain who may need access to a multi-disciplinary health care team, but we will need to see more details about how this measure will apply in practice.
Women’s health, disability support, rural and regional services, mental health and suicide and veteran’s programs have had funding allocated in the budget. While this funding will have a positive flow on impact on people living with chronic pain, there doesn’t appear to be anything that directly addresses pain management.
Of course, the devil is always in the detail and while the top line figures may appear positive, its often the finer details that will determine who really benefits from budgetary measures.
If the Government allocates funds to address chronic pain, it will reduce the $73.2 billion dollar impact of pain on the Budget bottom line. This is why spending money on pain is good economics as well as the right thing for reducing the suffering of those living with the condition.
While the handing down of the Budget represents the most important policy statement the government makes about its priorities, Painaustralia notes that in this budget the government have kept a hefty $9.7b aside in reserve for ‘as yet undisclosed programs and projects’. We can only hope the top up funds will include some practical actions to support people to manage their pain.
We’re looking to the National Strategic Action Plan for Pain Management (when finally launched) to provide real impetus and generate some direct, practical support for the 3.4 million Australians living with chronic pain. Let’s hope some dollars and sense result from the next government announcements on pain.