Queensland report, June 2019

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In this report

This report includes the following tables:

This report is issued by the Administrator of the National Health Funding Pool under section 240 of the National Health Reform Act 2011.

This report is prepared on a cash basis. It shows monthly and year-to-date (YTD) National Health Reform (NHR) funding and payments for Queensland for June 2019 as part of the National Health Reform Agreement.

Local hospital networks and National Health Reform

A local hospital network (LHN) is an organisation that provides public hospital services in accordance with the Agreement. An LHN can contain one or more hospitals, and is usually defined as a business group, geographical area or community. Every Australian public hospital is part of an LHN.

Note: The term ‘local hospital network’ is a national term. Some states and territories use their own terminology to describe these networks, such as local health districts, health organisations, and hospital and health services.

Under the Agreement, LHNs receive funding for the following public hospital services:

  • All admitted and non-admitted services
  • All emergency department services provided by a recognised emergency department
  • Other outpatient, mental health, sub-acute services and other services that could reasonably be considered a public hospital service.

Note: LHNs also receive funding from other sources, including the Commonwealth, states and territories, and third parties for the provision of other specific functions and services outside the scope of the Agreement, for example dental services, primary care, home and community care, residential aged care and pharmaceuticals. For further information on total funding to a particular LHN, contact the Queensland Department of Health to view the service agreement for that LHN.

Basis for National Health Reform payments – Queensland, June 2019

The basis used to determine NHR payments to LHNs in Queensland for June 2019 was advised by the Queensland Department of Health to be as follows:

Service agreements between the Department of Health and each Hospital and Health Service (HHS) are based on the Department’s funding and purchasing models. In broad terms, the funding model determines the price at which the department purchases services from HHSs, and the purchasing model determines the volume of services that are purchased.

In terms of the funding model:

36 of the largest public hospitals are funded through the Queensland Activity Based Funding (ABF) model, which sets prices at a disaggregated level for each type of public hospital service. The Queensland ABF model is based largely on the national ABF model, but includes a number of modifications to reflect Queensland priorities.

83 public hospitals, predominantly small regional and rural hospitals, and 4 specialist mental health facilities are funded through block funding arrangements which take account of hospital size and location. These are based on 2017-18 reported expenditure (net of depreciation) indexed to 2018-19 levels.

Most non-hospital services (e.g. preventive health, primary and community health) are funded based on historical funding levels. However, some services, such as oral health and breast screening, are funded based on a price per unit of output.

The purchasing model determines the volume and value of services that the Department agrees to purchase from each HHS through the service agreement. The model reflects key priority areas for investment which is informed through a range of planning models, growth projections and performance objectives for each HHS.

Reference information

The financial information outlined in the following report is categorised as:

  • NHR funding – when the Commonwealth or state or territory government pays NHR funding into a state pool account or state managed fund.
  • NHR payments – when NHR funding that has been deposited into a state pool account or state managed fund is paid out of the state pool account by the Administrator, or is paid out of the state managed fund by the state or territory.

State pool account transactions

Table 1a – State pool account transactions – Queensland, June 2019

This table shows funding paid into the Queensland state pool account by the Commonwealth, Queensland or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Queensland Department of Health or the state pool accounts of other states/territories for June 2019.

NHR funding by source Paid into state pool account Paid out of state pool account
To Local hospital networks To State
Managed Fund
To state
health department
To state pool (other State) Total paid out
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
403,976,588 403,976,588 403,976,588
Commonwealth
Block funding
45,305,090 45,305,090 45,305,090
Commonwealth
Other funding
6,405,161 6,405,161 6,405,161
Total C'wealth
funding
455,686,839 403,976,588 45,305,090 6,405,161 455,686,839
QLD
funding
501,549,184 498,318,083 463,183 3,200,000 501,981,265
Other state/territory funding 5,000,000 0 5,000,000 5,000,000
Total 962,236,023 902,294,670 45,305,090 11,868,344 3,200,000 962,668,104

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Queensland, June 2019

Following on from table 1a, this table shows year-to-date (YTD) funding paid into the Queensland state pool account by the Commonwealth, Queensland or other states/territories, and payments out of the state pool account to LHNs, the state managed fund, the Queensland Department of Health or the state pool accounts of other states/territories as at June 2019.

NHR funding by source Paid into state
pool account
Paid out of state pool account
To Local hospital
networks
YTD
To State
Managed Fund
YTD
To state health
department
YTD
To state pool (other State)
YTD
Total paid out
YTD
($) ($) ($) ($) ($) ($)
Commonwealth
ABF funding
4,663,022,215 4,663,022,215 4,663,022,215
Commonwealth
Block funding
495,720,037 495,720,037 495,720,037
Commonwealth
Other funding
80,251,782 80,251,782 80,251,782
Total C'wealth
funding
5,238,994,034 4,663,022,215 495,720,037 80,251,782 5,238,994,034
QLD
funding
5,588,495,820 5,549,632,637 463,183 38,400,000 5,588,495,820
Other state/territory funding 60,000,000 0 60,000,000 60,000,000
Total 10,887,489,854 10,212,654,852 495,720,037 140,714,965 38,400,000 10,887,489,854

Commonwealth ABF funding represents Acute admitted, Non-admitted, Emergency department, Sub-acute, and Admitted mental health service categories, which are funded by the Commonwealth through the state pool account and subsequently paid to LHNs.

Commonwealth Block funding represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted categories, which are funded by the Commonwealth and paid to the state managed fund.

Commonwealth Other funding represents other amounts funded by the Commonwealth, transacted through the state pool account and subsequently paid to state or territory health departments. This currently represents the Commonwealth contribution to public health.

QLD funding represents funding contributions paid by Queensland into its own state pool account, and subsequently paid to LHNs within the state, to the Queensland health department and/or to other state pool accounts.

Other state/territory funding represents contributions paid to Queensland by other states and territories for cross-border activity.

Note: The grey shaded areas in these tables reflect cells that are not applicable for a particular 'paid out' column. For example, Commonwealth block funding is only paid to state managed funds and not to local hospital networks or state or territory health departments.

NHR funding and payments shown in these tables include GST where applicable.

State managed fund transactions

Table 2a – State managed fund transactions – Queensland, June 2019

This table shows funding paid into the Queensland state managed fund by the Commonwealth and Queensland, and payments out of the state managed fund to LHNs and other provider organisations for June 2019.

NHR funding by source Paid into state managed fund Paid out of state managed fund
To local hospital networks To Other Total paid out
($) ($) ($) ($)
Commonwealth Block funding 45,305,090 45,305,090
State/territory Block funding 84,560,574 84,560,574
Total 129,865,664 129,865,664 0 129,865,664

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Queensland, June 2019

Following on from table 2a, this table shows year-to-date (YTD) funding paid into the Queensland state managed fund by the Commonwealth and Queensland, and YTD payments out of the state managed fund to LHNs and other provider organisations as at June 2019.

NHR funding by source Paid into state
managed fund
YTD
Paid out of state managed fund YTD
To local hospital
networks
YTD
To Other
YTD
Total paid out
YTD
($) ($) ($) ($)
Commonwealth Block funding 495,720,037 495,720,037
State/territory Block funding 1,121,938,005 1,121,938,005
Total 1,617,658,042 1,617,658,042 0 1,617,658,042

Block funding represents Non-admitted mental health, Small rural hospitals, Teaching, training & research, and Other non-admitted categories.

Commonwealth Block funding represents Commonwealth block funding contributions paid into the state managed fund from the state pool account, and block payments out of the state managed fund to LHNs and other provider organisations.

State/territory Block funding represents Queensland block funding contributions into the state managed fund, and block payments out of the state managed fund to LHNs and other provider organisations.

Note: The grey shaded areas in these tables reflect that these block payments cannot at this stage be identified by source of funding (state, territory or Commonwealth contribution).

NHR funding and payments shown in these tables include GST where applicable.

NHR funding and payments by service category

Table 3 – NHR funding and payments by service category – Queensland, June 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Queensland for June 2019. NHR funding and payments are separated into the following service categories – activity-based funding (ABF), block funding, and other funding.

Service category NHR
funding
NHR
payments
NHR
funding YTD
NHR
payments YTD
($) ($) ($) ($)
ABF
Acute admitted 580,975,725 580,975,725 6,401,645,341 6,401,645,341
Admitted mental health 41,548,358 41,548,358 511,971,525 511,971,525
Sub-acute -11,796,850 -11,796,850 527,784,010 527,784,010
Emergency department 76,397,776 76,397,776 1,284,174,071 1,284,174,071
Non-admitted 215,169,661 215,169,661 1,487,079,905 1,487,079,905
Total ABF (Pool) 902,294,670 902,294,670 10,212,654,852 10,212,654,852
Block
Small rural hospitals 59,755,016 59,755,016 771,555,135 771,555,135
Teaching, training & research 28,925,236 28,925,236 352,583,571 352,583,571
Non-admitted mental health 39,509,927 39,509,927 459,796,454 459,796,454
Other non-admitted services 1,675,484 1,675,484 33,722,884 33,722,884
Total Block (SMF) 129,865,664 129,865,664 1,617,658,042 1,617,658,042
Other
Public health funding 6,405,161 6,405,161 80,251,782 80,251,782
Overdeposit 0 0 0 0
Cross-border 8,200,000 8,200,000 98,400,000 98,400,000
Interest 31,102 463,183 463,183 463,183
Total Other (Pool) 14,636,263 15,068,344 179,114,965 179,114,965
Grand Total 1,046,796,597 1,047,228,678 12,009,427,859 12,009,427,859

Total ABF (Pool) is an aggregate of both Commonwealth and state or territory NHR funding and payments for activity-based funding (ABF) which is transacted through the state pool account.

Total Block (SMF) is an aggregate of both Commonwealth and state or territory NHR funding and payments for block funding which is transacted through the state managed fund (SMF).

Total Other (Pool) represents other funding and payments transacted through the state pool account, including public health funding, overdeposits, cross-border funding and payments, and interest.

State and territory cross-border payments can either be:

  • Paid to the relevant state or territory's LHNs - included within ABF and/or block payments in the above table, or
  • Reimbursed to the relevant state or territory where the state or territory's LHNs are already being funded for the cost of treating cross-border patients - shown in the Cross-border row under Other in the above table.

NHR funding and payments shown in these tables include GST where applicable.

NHR contributions by local hospital network

Table 4a – NHR contributions by local hospital network – Queensland, June 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during June 2019.

NHR contributions to LHNs are separated into an activity-based funding (ABF) component and a block component.

Local hospital network (LHN) ABF component
(ex GST)
Block component
(ex GST)
Total NHR payment
(ex GST)
($) ($) ($)
Cairns and Hinterland Hospital and Health Service 67,057,633 9,226,697 76,284,330
Central Queensland Hospital and Health Service 28,528,430 8,129,718 36,658,149
Central West Hospital and Health Service 0 3,659,136 3,659,136
Children's Health Queensland Hospital and Health Service 39,835,416 1,828,459 41,663,874
Darling Downs Hospital and Health Service 38,750,165 14,371,679 53,121,844
Gold Coast Hospital and Health Service 104,873,996 7,733,932 112,607,928
Mackay Hospital and Health Service 23,997,635 5,733,331 29,730,967
Mater Misericordiae Health Service Brisbane 38,689,826 1,039,915 39,729,741
Metro North Hospital and Health Service 183,308,123 15,123,935 198,432,058
Metro South Hospital and Health Service 161,874,017 14,170,759 176,044,776
North West Hospital and Health Service 7,241,060 2,837,538 10,078,599
Queensland Virtual LHN 4,156,103 0 4,156,103
South West Hospital and Health Service 0 5,826,385 5,826,385
Sunshine Coast Hospital and Health Service 78,322,584 5,659,813 83,982,396
Torres and Cape Hospital and Health Service 0 6,133,608 6,133,608
Townsville Hospital and Health Service 52,150,450 11,597,762 63,748,213
West Moreton Hospital and Health Service 32,988,081 11,718,604 44,706,685
Wide Bay Hospital and Health Service 36,652,168 4,970,401 41,622,569
Total 898,425,688 129,761,672 1,028,187,360

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – Queensland, June 2019

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at June 2019.

NHR contributions to LHNs are separated into an activity-based funding (ABF) component and a block component.

Local hospital network ABF component YTD
(ex GST)
Block component YTD
(ex GST)
Total NHR payment YTD
(ex GST)
($) ($) ($)
Cairns and Hinterland Hospital and Health Service 651,778,851 133,922,218 785,701,068
Central Queensland Hospital and Health Service 349,131,689 99,992,540 449,124,229
Central West Hospital and Health Service 0 46,236,099 46,236,099
Children's Health Queensland Hospital and Health Service 451,615,858 28,511,538 480,127,396
Darling Downs Hospital and Health Service 445,520,944 178,599,030 624,119,974
Gold Coast Hospital and Health Service 1,144,685,827 91,642,032 1,236,327,859
Mackay Hospital and Health Service 274,185,458 71,036,809 345,222,267
Mater Misericordiae Health Service Brisbane 434,136,499 12,676,020 446,812,519
Metro North Hospital and Health Service 2,098,144,592 181,619,634 2,279,764,226
Metro South Hospital and Health Service 1,820,877,246 169,078,732 1,989,955,978
North West Hospital and Health Service 82,970,534 35,607,440 118,577,974
Queensland Virtual LHN 64,395,220 0 64,395,220
South West Hospital and Health Service 0 73,491,784 73,491,784
Sunshine Coast Hospital and Health Service 886,535,896 67,878,831 954,414,728
Torres and Cape Hospital and Health Service 0 77,153,188 77,153,188
Townsville Hospital and Health Service 641,273,110 143,408,853 784,681,962
West Moreton Hospital and Health Service 378,872,106 145,188,336 524,060,442
Wide Bay Hospital and Health Service 445,117,372 60,347,357 505,464,729
Total 10,169,241,202 1,616,390,440 11,785,631,643

NHR contributions in this table are GST exclusive to enable comparability of NHR payments in each LHN report.

Note: This table excludes GST.
The majority of government funding to LHNs is not subject to GST. However in some cases hospital funding to non-government entities does attract GST, for example, denominational hospitals, privately and commercially owned health facilities, or any other non-government third party provider of health services or related supplies.

Estimated monthly, YTD and annual activity

States and territories provide service volume estimates at the start of each financial year, and if required, can continue to refine these estimates during the course of the year. These estimates form the basis of monthly reporting of service volumes until actual service numbers become available. These estimates are expressed as National Weighted Activity Units (NWAU).

States and territories provide estimated annual NWAU to the Administrator as a basis for determining the Commonwealth activity-based funding. Current month NWAU estimates accumulate through the year-to-date (YTD) NWAU, to be equal to the annual NWAU at the end of the financial year.

States and territories may also provide activity information relating to the delivery of other public hospital functions funded.

Table 5 – Estimated monthly, YTD and annual NWAU by local hospital network – Queensland, June 2019

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for June 2019, the associated cumulative year-to-date (YTD), and total estimated annual NWAU for each LHN in Queensland.

Local hospital network (LHN) Estimated NWAU delivered in current month Estimated NWAU delivered YTD Estimated annual NWAU 2018-19
Cairns and Hinterland Hospital and Health Service 13,170 121,612 118,300
Central Queensland Hospital and Health Service 5,737 64,311 63,899
Children's Health Queensland Hospital and Health Service 7,396 78,940 78,048
Darling Downs Hospital and Health Service 8,291 82,688 81,160
Gold Coast Hospital and Health Service 15,366 209,318 211,585
Mackay Hospital and Health Service 6,521 53,557 51,312
Mater Misericordiae Health Service Brisbane 8,575 86,242 84,727
Metro North Hospital and Health Service 35,648 398,635 395,986
Metro South Hospital and Health Service 39,843 331,090 317,724
North West Hospital and Health Service 1,850 14,973 14,316
Queensland Virtual LHN 2,222 26,661 26,661
Sunshine Coast Hospital and Health Service 10,256 144,081 145,991
Townsville Hospital and Health Service 9,952 121,059 121,208
West Moreton Hospital and Health Service 5,915 72,831 73,000
Wide Bay Hospital and Health Service 8,680 84,702 82,933
Total 179,421 1,890,701 1,866,851

An NWAU is a measure of health service activity expressed as a common unit. It provides a way of comparing and valuing each public hospital service, whether they are admissions, emergency department presentations or outpatient episodes, by weighting them for their clinical complexity. The average hospital service is worth one NWAU - the most intensive and expensive activities are worth multiple NWAU, the simplest and least expensive are worth fractions of an NWAU.

Monthly NHR payments relate to the cash needs of public hospitals and do not necessarily reflect the volume of services to be delivered in the month.