Queensland Budget Submission 2015 – 2016 The Heart Foundation is calling for five budget actions to save lives from heart disease, build a healthier Queensland and reduce pressure on health budgets. We welcome the commitment of a further $46 million to preventive health made by the Labor Government in A Healthier Queensland. Cardiovascular disease is the most expensive disease in Queensland, costing 10% of total allocated recurrent health expenditure at $2.01 billion in 2011-12. It results in more than 100,000 hospitalisations here every year. Two thirds of Queenslanders are in danger of developing cardiovascular disease as they have at least one of the following risk factors - high blood pressure, high cholesterol, obesity or diabetes. Action on Cardiovascular Disease Investment 1. Increase investment in preventive health to tackle obesity, smoking, early detection and education. $680m annually (5% of $13.6b health budget); including $46m extra 2. Increase investment in active travel to help more people walk, cycle and use public transport. $540m annually (10% of $5.4b transport budget) Equity 3. Fund Queensland’s Better Cardiac Care Strategy for Aboriginal and Torres Strait Islander peoples. $10m over 3 years Treatment 4. Invest in improved access to cardiac rehabilitation services, and measures to improve referral and completion rates. $1.26m commitment; plus $5m for HHSs annually Research 5. Invest in a Queensland Cardiovascular Research Network to attract and retain the best and brightest research minds. $300,000 over 3 years Prevention Prevention 1.Increase investment in preventive health to tackle obesity, smoking, early detection and education The Heart Foundation warmly welcomes the priority given to preventive health and the commitment of an additional $46 million in Labor’s A Healthier Queensland. We will work with the Queensland Government to support the implementation of these commitments: Health Promotion Commission: • Establish a state-wide Queensland Health Promotion Commission (QHPC) ($7.5 million investment over four years). • Set up a Select Parliamentary Committee to review and guide the QHPC. Legislation: • Legislate for kilojoule menu labelling at fast food chains and commit at least $530,000 for a two year community and industry awareness campaign. -- The Heart Foundation recommends a greater investment of $7.5 million over three years for consumer education, compliance monitoring, uptake by consumers and industry support. • Invest $500,000 over two years to support local government participation in the enforcement of tobacco control strategies. -- The Heart Foundation recommends that legislation also be extended to include state-wide smoking bans at pedestrian malls, bus and ferry stops and taxi ranks; as well as removing designated outdoor smoking areas (DOSAs) in pubs and clubs; and banning smoking inside premium gaming rooms. Programs and campaigns: • Invest $3 million over four years to partner with the Heart Foundation to implement complementary primary, secondary and tertiary prevention programs including: -- $1.4 million for Heart Foundation Walking and the Central Queensland University 10,000 Steps program over four years. • Invest $5 million over three years in the “Go for 2 & 5” or similar campaign, to increase fruit and vegetable consumption. -- The Heart Foundation recommends an additional $15 million over three years for comprehensive social marketing campaigns to also increase physical activity and reduce smoking. • Invest $27 million for the Life! diabetes, heart disease and stroke community-based prevention program, addressing risk factors for major chronic diseases. Why? Investment: Queensland’s health budget takes up more than a quarter of the total state budget. This is unsustainable. Chronic diseases (heart disease, stroke, cancer and diabetes) cause 89% of all deaths and cost Queensland $7.7 billion. $680 million annually (5% of the $13.6b health budget); including Labor’s additional $46 million commitment We must prevent chronic diseases as well as help people with chronic disease stay as healthy as possible by investing in prevention. Government funding to prevention falls well short of best practice at less than 2%. New Zealand spends 7%, Canada 6.5% and Slovakia 5%. QUEENSLAND BUDGET SUBMISSION 2015 – 2016 2 Prevention 2.Increase investment in active travel to increase cycling, walking and public transport The Heart Foundation welcomes the Queensland Labor commitment in its 2014 State Policy Platform to a transport system that is well planned, sustainable, affordable, accessible, integrated and safe. The Heart Foundation recommends these budget proposals to support the implementation of the 2014 State Policy Platform on transport: Infrastructure and planning: • Continue to collect regular household travel survey data, including connector trips, to inform future transport planning and investment. • Plan and build more connected infrastructure to make cycling, walking and public transport an easier choice. • Invest in a solution to the SEQ commuter and freight gridlock, like Cross River Rail. Active travel investment (cycling, walking and public transport): • Fund ongoing social marketing campaigns to encourage active travel. • Further increase frequency of all public transport services to make it easy to use. • Create more affordable public transport systems including transport discounting. • Continue to fund proven behaviour change programs like the Healthy Active School Travel (HAST) and Active Towns. • Fund innovative incentive schemes to encourage people to cycle to work. • Fund the full implementation of the Queensland Cycle Strategy. Legislative solutions: • Evaluate the cycling law trial requiring a one metre (or 1.5 metre over 60km/h) minimum passing distance to make cycling safer. • Legislate for safer neighbourhoods for all road users including 30 km/h zones to improve pedestrian and cyclist safety. Why? Investment: We need a greater investment in active travel because of its health and economic benefits. It is one of the most cost effective ways of increasing physical activity. Physical inactivity is associated with obesity and is responsible for $1.5 billion a year in healthcare costs across the country. One quarter of this cost is due to coronary heart disease. Queensland has the highest rate of adult obesity in Australia; and 65% of adults and 28% of children are either overweight or obese. $540 million annually (10% of the $5.4b Transport budget) People who use public transport walk at least 30 minutes more a day than people in cars, however: • Only 30% of Queensland adults walk for transport at least five days a week. • Only 6% of Queensland adults cycle at least one day per week. • Only one-third of children actively travel to school. • 40% of our car trips are less than three kilometres and could be cycled or walked. QUEENSLAND BUDGET SUBMISSION 2015 – 2016 3 Equity 3.Fund Queensland’s Better Cardiac Care Strategy for Aboriginal and Torres Strait Islander peoples The Heart Foundation wants the Queensland Government to adequately fund and implement the Queensland Better Cardiac Care Strategy for Aboriginal and Torres Strait Islander peoples. This is an identified priority under the Australian Health Ministers’ Advisory Council with all States working cooperatively with the Federal Government to develop a robust plan for each State and nationally. The Queensland Better Cardiac Care Strategy aims to deliver sustained improvements across the continuum of care from prevention, primary care, emergency services and hospital care to rehabilitation for Aboriginal and Torres Strait Islander peoples. This includes the need for more cardiovascular risk assessments and management in general practice so that heart disease risk can be detected early and managed before damage has set in. This is even more important in regional areas where emergency services are less accessible. The Heart Foundation supports the next stage which is to identify actions that need new funding commitments to implement the Strategy. This includes resourcing needs for rheumatic heart disease, the State-wide Cardiac Clinical Network, Hospital and Health Services (HHSs) and Heart Foundation quality Indigenous resources to supply HHSs including My heart, my family, our culture and Living every day with my heart failure. Why? Investment: Coronary heart disease is the single biggest contributor to the gap in life expectancy between Indigenous and non-Indigenous peoples. People living in our regions and Aboriginal and Torres Strait Islander peoples are experiencing higher levels of cardiovascular disease than those in urban areas. $10 million over 3 years Coronary heart disease death rates are 40% higher in remote areas than in major cities, and 54% higher for Indigenous Queenslanders than non-Indigenous. For coronary heart disease and stroke, the death rates for Indigenous Queenslanders were two to three times the non-Indigenous rates. Risk factors are greater amongst Indigenous peoples with higher rates of obesity, smoking, higher blood pressure and cholesterol. QUEENSLAND BUDGET SUBMISSION 2015 – 2016 4 Treatment 4.Invest in improved access to cardiac rehabilitation services The Heart Foundation welcomes Labor’s commitment in A Healthier Queensland to partner the Heart Foundation to boost cardiac rehabilitation by an additional $1.26 million for programs, including: • $100,000 for State Government improvement of Queensland’s Cardiac Rehabilitation Directory with links to Google Maps to build the capacity for online referrals. This will assist clinicians and patients to more easily find and access rehabilitation services. • $250,000 for a State Government/NGO Partnership to develop an electronic version of My heart, my life to improve patient access to this post-heart attack support resource. • $910,000 additional funds to leverage My heart, my life resources in HHSs where cardiac rehabilitation referrals are low. With this funding every patient discharged from a public hospital after a heart attack will be provided a tailored cardiac rehabilitation program including a follow-up plan with their GP and outpatient cardiology service. Cardiac rehabilitation will be funded within existing HHS service agreements with the potential for Quality Improvement Payments (QIP) to accelerate compliance in targeted HHSs. -- The Heart Foundation recommends a $5 million annual investment to fund this QIP for cardiac rehabilitation to incentivise HHSs to embed referral and completion into the discharge process. Why? Investment: A greater investment in cardiac rehabilitation is crucial because the total economic cost of just one heart attack is $281,000. Repeat heart attacks are costing Queensland $1.6 billion every year and make up more than 30% of hospital admissions for heart attack. Repeat heart attacks are projected to increase by over 40% by 2020, requiring an extra 4,000 hospital beds and costing an extra 1,400 lives each year. $1.26 million for cardiac rehabilitation in A Healthier Queensland; plus Cardiac rehabilitation boosts recovery, saves health costs and reduces repeat heart attacks. It can reduce hospital admissions by up to 45% in the first 12 months and mortality by 25%. And yet, more than half of Queensland heart attack patients are leaving hospital without a referral to cardiac rehabilitation or access to quality self-management tools. The Heart Foundation’s My heart, my life publication is recognised as the highest quality self-management tool to support patients after a heart attack. We know that people need support to make lifestyle changes from our Heart Attack Survivor Survey 2013 because: • One in four had not been able to return back to the workforce. • More than one in two continued to smoke after their event. • One in six were not regularly taking their medication. QUEENSLAND BUDGET SUBMISSION 2015 – 2016 5 $5 million annually for a QIP for cardiac rehabilitation Research 5.Invest in a Queensland Cardiovascular Research Network The Heart Foundation is establishing an independent Queensland Cardiovascular Research Network (QCVRN). We’re seeking a co-funding commitment from the Queensland Government to boost cardiovascular research projects in Queensland through this Network. The QCVRN will directly support Labor’s Advance Queensland policy to create well-paid, knowledge-based jobs of the future and to improve collaboration between researchers and industries. By better coordinating cardiovascular disease research, we will be able to secure more funds for the future, develop research solutions to health problems experienced in Queensland and internationally. We want to retain Queensland’s best researchers and attract new minds from around the world. Why? Investment: Queensland researchers have told the Heart Foundation they often feel isolated from other cardiovascular researchers. Without a Network or Institute, there is limited pooled knowledge about other research projects or the availability of research facilities, services and expertise. This causes duplication and gaps, and leads to researchers leaving our State. Contribute $300,000 over 3 years ($100,000 annually) Queensland is not achieving its potential in cardiovascular research, despite our many quality researchers. Cardiovascular researchers in Queensland are missing out on opportunities to collaborate on innovative projects because we don’t have a coordinating body. For further information contact: Alison Durham Advocacy Manager Heart Foundation PO Box 442 Fortitude Valley QLD 4006 07 3872 2527 alison.durham@heartfoundation.org.au QUEENSLAND BUDGET SUBMISSION 2015 – 2016 6
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