Queensland report, November 2018

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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 November 2018 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, November 2018

The basis used to determine NHR payments to LHNs in Queensland for November 2018 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, November 2018

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 November 2018.

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
520,326,940 520,326,940 520,326,940
Commonwealth
Block funding
42,823,393 42,823,393 42,823,393
Commonwealth
Other funding
6,749,825 6,749,825 6,749,825
Total C'wealth
funding
569,900,159 520,326,940 42,823,393 6,749,825 569,900,159
QLD
funding
396,308,954 393,074,653 0 3,200,000 396,274,653
Other state/territory funding 5,000,000 0 5,000,000 5,000,000
Total 971,209,112 913,401,593 42,823,393 11,749,825 3,200,000 971,174,812

See definitions and explanatory notes following table 1b.

Table 1b – State pool account transactions YTD – Queensland, November 2018

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 November 2018.

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
1,957,249,508 1,957,249,508 1,957,249,508
Commonwealth
Block funding
201,314,080 201,314,080 201,314,080
Commonwealth
Other funding
33,891,188 33,891,188 33,891,188
Total C'wealth
funding
2,192,454,776 1,957,249,508 201,314,080 33,891,188 2,192,454,776
QLD
funding
2,339,087,398 2,322,895,666 0 16,000,000 2,338,895,666
Other state/territory funding 25,000,000 0 25,000,000 25,000,000
Total 4,556,542,174 4,280,145,174 201,314,080 58,891,188 16,000,000 4,556,350,442

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, November 2018

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 November 2018.

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 42,823,393 42,823,393
State/territory Block funding 88,156,892 88,156,892
Total 130,980,285 130,980,285 0 130,980,285

See explanatory notes following table 2b.

Table 2b – State managed fund transactions YTD – Queensland, November 2018

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 November 2018.

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 201,314,080 201,314,080
State/territory Block funding 476,919,994 476,919,994
Total 678,234,074 678,234,074 0 678,234,074

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, November 2018

This table shows NHR funding and payments by service category on both a monthly and year-to-date (YTD) basis for Queensland for November 2018. 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 569,683,649 569,683,649 2,669,974,211 2,669,974,211
Admitted mental health 46,684,535 46,684,535 199,135,912 199,135,912
Sub-acute 52,806,136 52,806,136 227,121,221 227,121,221
Emergency department 119,052,578 119,052,578 566,148,024 566,148,024
Non-admitted 125,174,695 125,174,695 617,765,806 617,765,806
Total ABF (Pool) 913,401,593 913,401,593 4,280,145,174 4,280,145,174
Block
Small rural hospitals 60,181,283 60,181,283 322,196,218 322,196,218
Teaching, training & research 27,544,090 27,544,090 147,988,548 147,988,548
Non-admitted mental health 37,357,910 37,357,910 189,871,822 189,871,822
Other non-admitted services 5,897,002 5,897,002 18,177,487 18,177,487
Total Block (SMF) 130,980,285 130,980,285 678,234,074 678,234,074
Other
Public health funding 6,749,825 6,749,825 33,891,188 33,891,188
Overdeposit 0 0 0 0
Cross-border 8,200,000 8,200,000 41,000,000 41,000,000
Interest 34,300 0 191,732 0
Total Other (Pool) 14,984,126 14,949,825 75,082,920 74,891,188
Grand Total 1,059,366,004 1,059,331,704 5,033,462,168 5,033,270,436

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, November 2018

This table shows NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland during November 2018.

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 63,536,469 10,553,372 74,089,841
Central Queensland Hospital and Health Service 34,099,834 7,882,460 41,982,294
Central West Hospital and Health Service 0 3,646,543 3,646,543
Children's Health Queensland Hospital and Health Service 44,581,674 3,619,987 48,201,661
Darling Downs Hospital and Health Service 42,904,357 14,078,515 56,982,872
Gold Coast Hospital and Health Service 87,301,504 9,232,911 96,534,415
Mackay Hospital and Health Service 26,577,917 5,594,830 32,172,747
Mater Misericordiae Health Service Brisbane 32,517,252 988,308 33,505,560
Metro North Hospital and Health Service 179,361,016 15,143,488 194,504,504
Metro South Hospital and Health Service 163,877,174 13,845,864 177,723,038
North West Hospital and Health Service 7,421,814 2,806,004 10,227,818
Queensland Virtual LHN 8,532,616 0 8,532,616
South West Hospital and Health Service 0 5,796,481 5,796,481
Sunshine Coast Hospital and Health Service 75,220,405 5,490,996 80,711,401
Torres and Cape Hospital and Health Service 0 6,085,827 6,085,827
Townsville Hospital and Health Service 59,882,930 11,293,002 71,175,932
West Moreton Hospital and Health Service 40,134,428 10,068,659 50,203,087
Wide Bay Hospital and Health Service 44,200,480 4,754,207 48,954,686
Total 910,149,868 130,881,454 1,041,031,322

See explanatory notes below table 4b.

Table 4b – NHR contributions by local hospital network YTD – Queensland, November 2018

This table shows YTD NHR contributions (from state, territory and Commonwealth sources) made to each LHN in Queensland as at November 2018.

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 275,512,016 56,407,729 331,919,745
Central Queensland Hospital and Health Service 148,294,512 42,113,808 190,408,321
Central West Hospital and Health Service 0 19,471,511 19,471,511
Children's Health Queensland Hospital and Health Service 192,036,663 14,767,852 206,804,515
Darling Downs Hospital and Health Service 186,728,360 75,221,008 261,949,368
Gold Coast Hospital and Health Service 469,270,384 38,767,166 508,037,550
Mackay Hospital and Health Service 116,078,263 29,923,577 146,001,840
Mater Misericordiae Health Service Brisbane 187,689,366 5,349,689 193,039,055
Metro North Hospital and Health Service 868,294,784 77,340,883 945,635,667
Metro South Hospital and Health Service 764,202,253 71,745,021 835,947,274
North West Hospital and Health Service 32,689,890 14,997,716 47,687,606
Queensland Virtual LHN 22,806,019 0 22,806,019
South West Hospital and Health Service 0 30,949,412 30,949,412
Sunshine Coast Hospital and Health Service 368,796,497 28,741,211 397,537,707
Torres and Cape Hospital and Health Service 0 32,490,768 32,490,768
Townsville Hospital and Health Service 269,071,907 60,411,419 329,483,326
West Moreton Hospital and Health Service 168,719,745 53,580,864 222,300,609
Wide Bay Hospital and Health Service 191,185,579 25,419,469 216,605,048
Total 4,261,376,238 677,699,105 4,939,075,342

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, November 2018

This table shows estimated state or territory hospital activity for activity-based funding services expressed as NWAU for November 2018, 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 9,836 49,179 118,030
Central Queensland Hospital and Health Service 5,308 26,538 63,691
Children's Health Queensland Hospital and Health Service 6,504 32,520 78,048
Darling Downs Hospital and Health Service 6,763 33,817 81,160
Gold Coast Hospital and Health Service 17,632 88,160 211,585
Mackay Hospital and Health Service 4,276 21,380 51,312
Mater Misericordiae Health Service Brisbane 7,052 35,258 84,618
Metro North Hospital and Health Service 32,999 164,994 395,986
Metro South Hospital and Health Service 26,477 132,385 317,724
North West Hospital and Health Service 1,160 5,802 13,925
Queensland Virtual LHN 2,222 11,109 26,661
Sunshine Coast Hospital and Health Service 12,159 60,795 145,907
Townsville Hospital and Health Service 10,127 50,635 121,524
West Moreton Hospital and Health Service 6,075 30,373 72,895
Wide Bay Hospital and Health Service 6,911 34,555 82,933
Total 155,500 777,500 1,866,000

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.