Queensland report, May 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 May 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, May 2019

The basis used to determine NHR payments to LHNs in Queensland for May 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, May 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 May 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
380,523,755 380,523,755 380,523,755
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
432,234,006 380,523,755 45,305,090 6,405,161 432,234,006
QLD
funding
420,175,440 416,948,101 0 3,200,000 420,148,101
Other state/territory funding 5,000,000 0 5,000,000 5,000,000
Total 857,409,446 797,471,856 45,305,090 11,405,161 3,200,000 857,382,107

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Queensland, May 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 May 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
4,259,045,627 4,259,045,627 4,259,045,627
Commonwealth
Block funding
450,414,947 450,414,947 450,414,947
Commonwealth
Other funding
73,846,621 73,846,621 73,846,621
Total C'wealth
funding
4,783,307,195 4,259,045,627 450,414,947 73,846,621 4,783,307,195
QLD
funding
5,086,946,635 5,051,314,555 0 35,200,000 5,086,514,555
Other state/territory funding 55,000,000 0 55,000,000 55,000,000
Total 9,925,253,831 9,310,360,182 450,414,947 128,846,621 35,200,000 9,924,821,750

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, May 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 May 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 84,396,856 84,396,856
Total 129,701,947 129,701,947 0 129,701,947

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Queensland, May 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 May 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 450,414,947 450,414,947
State/territory Block funding 1,037,377,432 1,037,377,432
Total 1,487,792,379 1,487,792,379 0 1,487,792,379

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, May 2019

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Queensland for May 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 498,716,988 498,716,988 5,820,669,616 5,820,669,616
Admitted mental health 40,334,875 40,334,875 470,423,167 470,423,167
Sub-acute 46,198,033 46,198,033 539,580,860 539,580,860
Emergency department 103,379,648 103,379,648 1,207,776,295 1,207,776,295
Non-admitted 108,842,312 108,842,312 1,271,910,244 1,271,910,244
Total ABF (Pool) 797,471,856 797,471,856 9,310,360,182 9,310,360,182
Block
Small rural hospitals 59,678,294 59,678,294 711,800,118 711,800,118
Teaching, training & research 28,925,236 28,925,236 323,658,334 323,658,334
Non-admitted mental health 39,509,927 39,509,927 420,286,527 420,286,527
Other non-admitted services 1,588,490 1,588,490 32,047,399 32,047,399
Total Block (SMF) 129,701,947 129,701,947 1,487,792,379 1,487,792,379
Other
Public health funding 6,405,161 6,405,161 73,846,621 73,846,621
Overdeposit 0 0 0 0
Cross-border 8,200,000 8,200,000 90,200,000 90,200,000
Interest 27,339 0 432,081 0
Total Other (Pool) 14,632,500 14,605,161 164,478,702 164,046,621
Grand Total 941,806,302 941,778,964 10,962,631,262 10,962,199,181

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, May 2019

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during May 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 48,947,251 9,226,697 58,173,948
Central Queensland Hospital and Health Service 27,836,101 8,129,718 35,965,819
Central West Hospital and Health Service 0 3,659,136 3,659,136
Children's Health Queensland Hospital and Health Service 33,615,053 1,664,741 35,279,794
Darling Downs Hospital and Health Service 34,167,800 14,371,679 48,539,479
Gold Coast Hospital and Health Service 89,436,479 7,733,932 97,170,411
Mackay Hospital and Health Service 21,168,329 5,733,332 26,901,660
Mater Misericordiae Health Service Brisbane 33,581,731 1,039,915 34,621,646
Metro North Hospital and Health Service 170,018,247 15,123,935 185,142,182
Metro South Hospital and Health Service 138,072,839 14,170,759 152,243,598
North West Hospital and Health Service 6,864,740 2,837,538 9,702,279
Queensland Virtual LHN 4,935,516 0 4,935,516
South West Hospital and Health Service 0 5,826,385 5,826,385
Sunshine Coast Hospital and Health Service 68,303,410 5,659,813 73,963,222
Torres and Cape Hospital and Health Service 0 6,133,608 6,133,608
Townsville Hospital and Health Service 51,360,316 11,597,762 62,958,078
West Moreton Hospital and Health Service 31,141,889 11,718,604 42,860,493
Wide Bay Hospital and Health Service 34,663,983 4,970,401 39,634,384
Total 794,113,683 129,597,955 923,711,638

See explanatory notes below table 4b.

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

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at May 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 584,721,218 124,695,521 709,416,739
Central Queensland Hospital and Health Service 320,603,259 91,862,822 412,466,080
Central West Hospital and Health Service 0 42,576,963 42,576,963
Children's Health Queensland Hospital and Health Service 411,780,442 26,683,079 438,463,522
Darling Downs Hospital and Health Service 406,770,778 164,227,351 570,998,129
Gold Coast Hospital and Health Service 1,039,811,831 83,908,100 1,123,719,931
Mackay Hospital and Health Service 250,187,823 65,303,477 315,491,300
Mater Misericordiae Health Service Brisbane 395,446,673 11,636,105 407,082,779
Metro North Hospital and Health Service 1,914,836,470 166,495,699 2,081,332,168
Metro South Hospital and Health Service 1,659,003,229 154,907,973 1,813,911,202
North West Hospital and Health Service 75,729,474 32,769,902 108,499,376
Queensland Virtual LHN 60,239,117 0 60,239,117
South West Hospital and Health Service 0 67,665,399 67,665,399
Sunshine Coast Hospital and Health Service 808,213,313 62,219,019 870,432,331
Torres and Cape Hospital and Health Service 0 71,019,581 71,019,581
Townsville Hospital and Health Service 589,122,659 131,811,090 720,933,750
West Moreton Hospital and Health Service 345,884,024 133,469,732 479,353,756
Wide Bay Hospital and Health Service 408,465,204 55,376,956 463,842,161
Total 9,270,815,515 1,486,628,768 10,757,444,283

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, May 2019

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for May 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 9,858 108,442 118,300
Central Queensland Hospital and Health Service 5,325 58,574 63,899
Children's Health Queensland Hospital and Health Service 6,504 71,545 78,048
Darling Downs Hospital and Health Service 6,763 74,397 81,160
Gold Coast Hospital and Health Service 17,632 193,952 211,585
Mackay Hospital and Health Service 4,276 47,036 51,312
Mater Misericordiae Health Service Brisbane 7,061 77,667 84,727
Metro North Hospital and Health Service 32,999 362,987 395,986
Metro South Hospital and Health Service 26,477 291,247 317,724
North West Hospital and Health Service 1,193 13,123 14,316
Queensland Virtual LHN 2,222 24,439 26,661
Sunshine Coast Hospital and Health Service 12,166 133,825 145,991
Townsville Hospital and Health Service 10,101 111,107 121,208
West Moreton Hospital and Health Service 6,083 66,916 73,000
Wide Bay Hospital and Health Service 6,911 76,022 82,933
Total 155,571 1,711,280 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.