2021-2022 SA Budget Delivered
“… together with a focus on creating jobs and growing the economy, the government’s other major priority in this budget is another significant increase in spending on hospitals and health services and in particular mental health services.” Hon. Rob Lucas, South Australian Treasurer
“SACOSS welcomes the continued deficit spending strategy in the 2021-22 State Budget to stimulate the economy, but maintains our concerns that much of the spending is not well-targeted to assist vulnerable and disadvantaged South Australians.” South Australian Council of Social Service
The Bottom Line
The Marshall Government has brought down a pre-election Budget aimed at reasserting its claims to sound economic management. While steering a course towards a post-pandemic surplus, it simultaneously seeks to address Labor’s traditional edge over healthcare by committing to a new Women’s and Children’s Hospital in Adelaide and by significant investments in existing health services and mental health.
Treasurer Rob Lucas, who is retiring at the next election, announced a return to surplus by 2022-23, and contrasted this with the budget deficits forecast to run into the distant future in Labor states Victoria and Queensland.
While last year’s budget predicted the South Australian economy would contract by 0.75 per cent, it has in fact grown by 2.25 per cent, while a surprise $926 million GST windfall has also helped slash the 2020-21 deficit to $1.8 billion, a significant sum but still down from the $2.6 billion estimated last year.
The deficit will drop to $1.4 billion in 2021-22, with money set aside for any pandemic-related contingencies, but after that the stimulus spending ends and the budget returns to surplus in 2022-23.
The Budget is also notable for a significant infrastructure spend, much of it in electorates the Liberal Government needs to retain at next year’s election, and for investment in the space program, which is based in the state.
The total health spend for the next financial year is $7.4 billion, which Mr Lucas noted is almost $900 million more than Labor spent in its last year in power before losing the 2018 election.
The South Australian election is scheduled for March 2022.
Health and Hospitals
This Budget commits $1.95 billion, including $814 million over the forward estimates, to build a new Women’s and Children’s Hospital in Adelaide. The project will increase the capacity of the current hospital by 13% and is estimated for completion in 2026, with the first patients to be admitted in 2027.
The Marshall Government has also allocated $6 million over 3 years to fund planning and land acquisition for a new Barossa Hospital, a purpose built health care facility to meet projected population growth in the area. This funding will support a detailed business case, acquisition of suitable land and for early works to commence delivery of the project
$45.1 million over 4 years to fund an additional 74 emergency operational staff for the SA Ambulance Service, including 24 staff in regional stations. This also includes $2 million in 2021-22 to purchase additional ambulances and for fit-out works at ambulance stations to accommodate the additional crews.
Initiatives to increase emergency department capacity:
- $110 million to fund 140 new treatment spaces in emergency departments and Emergency Extended Care Units from Lyell McEwin Hospital in the north to the Southern Fleurieu Health Service in the south, increasing capacity by 65 per cent at these sites.
- Flinders Medical Centre – South Australia’s busiest emergency department – is to become its largest, growing by 30 treatment spaces to a total of 86 spaces. The Lyell McEwin Hospital will grow from 39 to 72 treatment spaces.
- The Queen Elizabeth Hospital will receive an additional 15 emergency department treatment spaces, as part of the $314 million redevelopment of the hospital.
- Emergency departments in Modbury, Mount Barker, Murray Bridge, Gawler and the Southern Fleurieu Health Service in Victor Harbor will grow by 45 treatment spaces.
Initiatives to address increased demand for emergency departments, by creating alternative service delivery options:
- Four Priority Care Centres, providing community based health care and treatment, including diagnostic and pharmacy services;
- My Home Hospital delivering hospital care to people with certain conditions in their home;
- Adult Mental Health Centre (which will be expanded to a 24 hour model), which provides high-engagement support in a calm ‘lounge room like’ space;
- New 16 bed Mental Health Crisis Stabilisation Centre in the northern suburbs;
- Placing medic nurses in custodial facilities; and
- Assigning mental health specialists with paramedic crews across the metropolitan area.
Initiatives to improve capacity in public hospitals by creating more accommodation options:
- Additional housing to be made available for people with a mental health disability;
- A Transition to Home: Step Down program – additional short-medium term accommodation beds to be made available for NDIS eligible patients awaiting longer term supports;
- Expanded state-wide hospital Criteria Led Discharge to help patients return home as soon as possible;
- Transferring metropolitan patients to peri-urban hospitals for ongoing care in times of peak demand; and
- Development of a new 20 bed older person mental health unit at Modbury Hospital replacing Woodleigh House.
South Australians seeking urgent and ongoing mental health care will be supported by a $163.5 million package of measures in the 2021-22 State Budget, which also aims to ease the pressure on the state’s emergency departments.
Initiatives to be funded under the package include:
- The construction of a new $48 million 20-bed older person’s acute mental health unit at Modbury Hospital. This investment aims to significantly enhance services in the north and north-eastern suburbs. (The current older person’s mental health unit at the Lyell McEwin Hospital will transfer to the new Modbury facility, and mental health services at Woodleigh House will transfer to fit-for-purpose facilities at the Lyell McEwin Hospital.);
- $20.4 million to build, and $8.5 million per annum by 2024-25 to operate a new 16-bed Crisis Stabilisation Centre in the northern suburbs for mental health consumers. This will provide acute crisis care based on a recovery model, with mental health staff and peer workers in a safe, therapeutic setting;
- $12 million to create additional Psychiatric Intensive Care bed capacity in the hospital system, including additional drug and alcohol services, child and adolescent services, forensic mental health services and support for adults with mental health conditions, including post-traumatic stress disorder;
- $8.4 million per annum (indexed) to support mental health services in the community and reduce the number of people presenting to hospitals;
- $7.3 million to continue mental-health related supports specifically related to the COVID-19 pandemic, including increased in-reach support to vulnerable communities, as well as increased access to phone and other counselling services over the next 12 months;
- A $5 million investment to provide additional housing for people with mental health disability, which will help provide greater capacity for hospitals to discharge patients who no longer need acute medical attention but require support to return to the community;
- $5 million over two years to support the immediate needs of the mental health workforce, including increased training to help fill immediate positions and to provide greater opportunity for the existing workforce to build their skills in mental health treatment; and
- $4.5 million per annum (indexed) to expand the delivery of urgent mental health care to the community, including an expansion of the Adelaide Urgent Mental Health Care Centre to a 24-hour model. This will significantly expand the number and type of patients who can be assisted by the Centre, further easing pressure on our emergency departments.
The 2021-22 South Australian Budget includes funding of $500,000 to develop a new safeguarding app for people living with disability and their supporters. The app will enable people to access wellbeing checks, emergency help and the right referrals in one easy-to-use platform.
Funding of $150,000 in 2021-22 will implement telephone voting for South Australian electors living with disability and electors who reside overseas.
$4.6 million over four years will support the ongoing voluntary out-of-home care initiative, which prevents children with disability and exceptional needs from unnecessarily entering statutory care services by funding accommodation and living costs along with case coordination costs where needed.
Funding of $4.7 million over four years has been committed to ensure the Department of Human Services can continue to fund the Disability Access and Inclusion Directorate, established to build greater access and inclusion for people living with disability. The directorate provides strategic leadership, management and expert advice to inform the national disability agenda.
The 2021-22 South Australian Budget includes funding $18.2 million over 7 years ($9.7 million over the Forward Estimates) to establish the Newpin program. Newpin is an intensive therapeutic centre-based family reunification program and is expected to support more than 200 families with children aged six years and under in care on a temporary care order, where reunification has been identified as an appropriate goal. The initiative will be funded through a social impact bond.
Funding of $11.3 million over six years will establish the Resilient Families program, an intensive home-based family support intervention program that will be delivered by the Benevolent Society.
Funding of $1.3 million over two years aims to help divert children who are at risk of being remanded into custody due to lack of accommodation and support services by connecting them with appropriate supports.
$1.3 million over two years will fund the development and licensing costs of three ICT projects to support the SA Government’s new Child and Family Support System which aims to achieve better outcomes for the state’s most vulnerable families.
Funding of $3.7 million over four years will establish family group conferences as an ongoing program. Family group conferencing provides an opportunity for children and young people, family and community workers to make informed and timely decisions about care arrangements.
$2.7 million over 3.5 years will support the pilot of a Stability Post Care Program, supporting young people up to the age of 21 years with complex needs leaving care who are at risk of homelessness and housing instability.
Indigenous South Australians
Initiatives aimed at reducing the rate of Indigenous reoffending and over representation in the criminal justice system include $10 million over four years to enable more participants to complete the Violence Prevention Program for Aboriginal Men, and Domestic and Family Violence Prevention Program for Aboriginal Men.
Additional funding of $4.2 million over four years will support the establishment of the position of Commissioner for Aboriginal Children and Young People. The position will have the same legislative powers as the Commissioner for Children and Young People.
$2.9 million over four years will fund a new Aboriginal Engagement Reform model that includes the creation of an elected Aboriginal Engagement Body to ensure that Aboriginal voices are better represented in government decision-making.
Funding of $933 000 over four years will ensure increased resources for the Aboriginal Legal Rights Movement to deliver an Aboriginal justice advocacy service in South Australia.
$5.5 million over two years to fund the rollout of the Residential Aged Care Enterprise System – electronic aged care management system – to the remaining 25 regional sites and to increase the existing functionality of the system to include medication management accessed via mobile devices, supporting data entry at the point of care. The State Government anticipates this initiative will improve the safety of clients and administrative efficiency of the services.
This is in addition to significant funding for aged care announced in the 2021-22 Federal Budget. OTA’s analysis of the Federal Budget can be accessed on the OTA website here.