Leslie Massey
The National Health Act 1953 is an Act of the Parliament of Australia that administers pharmaceutical, sickness and hospital benefits, as well as medical and dental services. The Act was passed in 1953 under the Fifth Menzies Ministry and, as of 2014, provisions in the Act relating to the Pharmaceutical Benefits Scheme are still part of Australian law. The Australian health system is jointly run by the federal, state, territory, and local governments, providing safe and affordable healthcare for all Australians. Medicare, the universal healthcare scheme, covers the cost of public hospital services and some other health services, while private health insurance gives patients choice outside the public system.
| Characteristics | Values |
|---|---|
| Year of passing | 1953 |
| Administers | Pharmaceutical, sickness and hospital benefits, medical and dental services |
| Regulates | Medicines and medical devices |
| Provides | Safe and affordable health care for all Australians |
| Covers | Australian and New Zealand citizens, permanent residents in Australia, and people from countries with reciprocal agreements |
| Includes | Medicare, public hospital system, private health insurance |
| Medicare covers | All of the cost of public hospital services, some or all of the costs of other health services, services provided by GPs and medical specialists, physiotherapy, community nurses, basic dental services for children |
| Pharmaceutical Benefits Scheme (PBS) | Makes some prescription medicines cheaper, lists brand name, generic, biologic and biosimilar medicines |
| Medicare Benefits Schedule (MBS) | A list of all health services that the Government subsidises |
| COVID-19 Vaccines and Treatments | Provision of COVID-19 vaccines and treatments |
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What You'll Learn
Pharmaceutical benefits
The Pharmaceutical Benefits Scheme (PBS) is governed by the National Health Act 1953 and the National Health (Pharmaceutical Benefits) Regulations 1960. The PBS was established in 1948 as a limited scheme, offering free medicines for pensioners and a list of 139 'life-saving and disease-preventing' medicines at no cost for other community members. The PBS is part of the Australian Government's National Medicines Policy, which aims to meet medication and service needs to achieve optimal health outcomes and economic objectives.
The PBS provides Australians with timely, reliable, and affordable access to necessary medicines. The Australian Government subsidises the cost of medicines for most medical conditions. The PBS Schedule, managed by the Department of Health and Aged Care and administered by Services Australia, lists all the medicines available at a government-subsidised price. The Schedule is now online and updated monthly. The PBS is available to all Australian residents with a current Medicare card. Overseas visitors from countries with a Reciprocation Health Care Agreement (RHCA) with Australia are also eligible to access the PBS.
Under the PBS, patients pay a 'co-payment' for their medicines, and the government covers the remaining cost. The co-payment was introduced in 1960, and in 2023, the general co-payment was reduced to $30 for the first time since the inception of the PBS. The out-of-pocket amount for some medications has increased since 1960, but safety nets were introduced in 2000 to limit the total patients would pay annually. Additionally, increased subsidies for concession holders began in 1983.
PBS medications are mainly supplied by approved pharmacists from approved pharmacy premises. These pharmacists are approved under Section 90 of the National Health Act 1953 and are issued with a unique PBS Pharmacy Approval Number for each approved premises. Other suppliers include approved doctors, usually in isolated areas, Friendly Society pharmacies, and approved hospitals. All suppliers are issued with approval numbers and should follow the procedures outlined in the Explanatory Notes.
The National Health Act provides alternative ways to deliver medicines when the usual supply through community pharmacies is unsuitable, such as cost, storage, or patient access constraints. These medications must still meet listing criteria, including clinical and cost-effectiveness.
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Sickness and hospital benefits
The National Health Act 1953 (Cth) is an Act of the Parliament of Australia that provides for sickness and hospital benefits, as well as pharmaceutical, medical, and dental services. The Act was passed in 1953 under the second Menzies government, with the then-Minister for Health, Earle Page, as its "chief architect".
The Act's provisions relating to sickness and hospital benefits are designed to ensure that individuals have access to the medical services and attention they need in the event of sickness. This includes coverage for hospital services, as well as other health services such as GP visits, medical specialists, physiotherapy, community nurses, and basic dental services for children.
In Australia, the cost of health services is shared by the government, individuals, and private health insurance. The Australian government usually funds most of the spending for medical services and subsidised medicines. Medicare, for instance, is available to Australian and New Zealand citizens, permanent residents in Australia, and people from countries with reciprocal agreements. It covers all of the costs of public hospital services and some or all of the costs of other health services.
The National Health Act's provisions for sickness and hospital benefits are intended to reduce the financial burden on individuals and ensure that they have access to the necessary medical care when they are sick. This includes ensuring that individuals do not face barriers to accessing health services due to cost, which is a challenge that Australia shares with other countries around the world.
In addition to the National Health Act, other legislation in Australia also addresses sickness and hospital benefits. For example, the Health Insurance Act 1973 underpins the Medicare scheme by providing for payments for medical benefits and hospital services. Together, these pieces of legislation form part of the framework that governs access to health services and financial support for individuals in Australia.
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Medical services
The National Health Act of 1953 in Australia covers a range of provisions related to medical services. These provisions are designed to ensure access to healthcare and protect the privacy of individuals seeking medical care.
One of the key components of the Act is Medicare, which has been Australia's universal healthcare scheme since 1984. Medicare provides free or low-cost access to a range of health care services, including those provided by general practitioners (GPs) and medical specialists. It also covers the full cost of public hospital services. Medicare is available to Australian and New Zealand citizens, permanent residents of Australia, and individuals from countries with reciprocal agreements.
The Pharmaceutical Benefits Scheme (PBS) is another important aspect of the Act. The PBS helps to make medicines more affordable for Australians. It lists brand name, generic, biologic, and biosimilar medicines, with over 5,200 products included. The costs of PBS medicines are shared between the individual and the Australian government, with individuals enrolled in Medicare paying a portion of the cost. The PBS Safety Net helps to keep costs down for those who spend a significant amount on medicine.
The Act also addresses the provision of certain medical and dental services, as well as the supply of medical and surgical aids and appliances. This includes arrangements with states for the provision of surgical aids and appliances, as well as the Continence Aids Payment Scheme.
Additionally, the Act covers the provision of vaccines, with the Commonwealth government playing a role in buying vaccines for the national immunisation program. The Therapeutic Goods Administration (TGA) is responsible for regulating medicines and medical devices, and the Act includes provisions for the disclosure of therapeutic goods information to the Chief Executive of Medicare.
To protect the privacy of individuals, the Act outlines privacy rules that must be followed by prescribers and approved suppliers. This includes maintaining secrecy regarding Medicare numbers and expiry dates provided for pharmaceutical benefit scheme purposes.
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Dental services
Australia has a National Oral Health Plan 2015–2024, which sets out priorities for improving the oral health of all Australians. The Australian Government Department of Health and Aged Care recognises the importance of healthy teeth, mouth and gums for an individual's general health and wellbeing.
The Child Dental Benefits Schedule (CDBS) is a legislative scheme that covers part or all of the costs of basic dental services for eligible children aged 0-17 years. It was established in 2014 as a national, means-tested programme, administered under the Dental Benefits Act 2008 and the Dental Benefits Rules 2014. The CDBS provides a capped benefit of up to $1,132 over two calendar years for basic dental services, including preventive dental care and treatment services. The Fifth Review of the Dental Benefits Act, tabled in Parliament in August 2023, made recommendations to improve oral health outcomes for vulnerable populations, including First Nations children, children in rural and remote areas, and children with disabilities. These recommendations are being considered in the context of improving the utilisation of the CDBS and have been referred to the Dental Clinical Advisory Committee (DCAC) for further clinical advice.
The Australian Government works closely with Services Australia, which is responsible for delivering administrative services under the CDBS, including benefit payments. Services Australia provides information on the CDBS for dental service providers and patients, including eligibility criteria and consent forms. The CDBS aims to improve access to dental services for children, particularly those from lower-income households, who have a higher incidence of poor oral health.
The Australian Institute of Health and Welfare (AIHW) has conducted surveys and studies on the oral health status of Australians and their use of dental services. The National Child Oral Health Study 2012-2014 found that most children aged 5-14 had made their first dental visit before the age of five, with the majority first visiting for a check-up rather than a specific problem. The study also found that the proportion of children who last visited a dental professional for a check-up varied by household income, with higher-income households more likely to have made a recent dental visit.
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COVID-19 vaccines and treatments
The National Health Act 1953 (Cth) is an Act of the Parliament of Australia that administers pharmaceutical, sickness, and hospital benefits, as well as medical and dental services.
During the COVID-19 pandemic, the Australian Government Department of Health and Aged Care established the COVID-19 Vaccines and Treatments for Australia – Science and Industry Technical Advisory Group. This advisory group provided advice to the Australian Government on the purchasing and manufacturing of COVID-19 vaccines and treatments. The advisory group's work included:
- Providing advice on the scientific validity of research into the safety and effectiveness of potential COVID-19 vaccines, tests, and treatments.
- Assisting with purchasing decisions for COVID-19 vaccines, tests, and treatments for Australia.
- Exploring options for manufacturing and packaging COVID-19 vaccines and treatments within Australia.
- Addressing distribution and logistics concerns related to potential COVID-19 vaccines.
- Advising on other technical matters connected to COVID-19 vaccines and treatments.
The advisory group concluded its work on December 31, 2023.
In terms of specific COVID-19 vaccines and treatments, Australia has approved the Pfizer COVID-19 bivalent (COMIRNATY Original/Omicron BA.4-5 COVID-19) booster dose vaccine. This vaccine has received provisional approval for individuals aged 12 and older, with an AusPAR report indicating its approval for those aged 5 and older as well. The vaccine combines 5 micrograms of famtozinameran, targeting the Omicron variants BA.4 and BA.5, and 5 micrograms of tozinameran, targeting the original SARS-CoV-2 strain. The decision to approve this vaccine was based on expert advice from the Advisory Committee on Vaccines, an independent committee with expertise in scientific, medical, and clinical fields. The Australian Technical Advisory Group on Immunisation (ATAGI) will provide further advice to the government on the potential use of this vaccine in the national COVID-19 vaccination program.
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Frequently asked questions
The National Health Act 1953 is an Act of the Parliament of Australia, which administers pharmaceutical, sickness and hospital benefits, alongside medical and dental services.
The Act covers the provision of COVID-19 vaccines and treatments, the establishment of the Pharmaceutical Benefits Advisory Committee, and the regulation of medicines and medical devices through the Therapeutic Goods Administration (TGA).
The National Health Act applies to Australian and New Zealand citizens, permanent residents in Australia, and people from countries with reciprocal agreements.
The main purpose of the National Health Act is to provide safe and affordable healthcare for all Australians, including free or low-cost access to public hospital services and other healthcare services.
The National Health Act is administered by the Australian Government Department of Health and Aged Care, which works jointly with federal, state, territory, and local governments to provide healthcare services.
