Radiation Oncology: 2016 Review of the Radiation Oncology Health Program Grants (ROHPG) Scheme

Last updated: 3/02/2016

Written submissions as part of the ROHPG Scheme review are currently being invited.

On 22 April 2015, the Minister for Health, Aged Care and Sport, the Hon Sussan Ley MP, announced a programme of work to deliver a Healthier Medicare and announced that a Medicare Benefits Schedule (MBS) Review Taskforce would be established to consider how existing MBS items can be aligned with contemporary clinical evidence and practice.  The MBS Review Taskforce released two consultation papers on 27 September 2015.

Commonwealth funding for radiation oncology is provided through the MBS for medical services and the ROHPG Scheme.  The ROHPG Scheme, which was introduced in 1988, provides a contribution towards capital costs incurred by radiation oncology providers for major radiation oncology equipment and has not been formally reviewed since 1999.

The Australian National Audit Office is also conducting a performance audit of the ROHPG Scheme.

Given the linkages between radiation oncology MBS items and the ROHPG Scheme, the Department is initiating a review of the ROHPG Scheme and is seeking stakeholder input.  Some of the areas of interest the Department wishes to invite feedback on (although this list is not exhaustive) include: 

•	The benefits and limitations of the scheme
•	Its purpose
•	Potential alternative funding models
•	Determining eligible equipment
•	Workforce considerations
•	Linking funding to quality measures (rather than throughput)
•	Billing practice complexity, and
•	Existing supply/potential saturation of services.

Written submissions as part of the ROHPG Scheme review are currently being invited. The written submission process closes on 4 March 2016.  If you wish to submit a submission or would like further information about the review please email the Department at radiation.oncology@health.gov.au.  Please note: written submissions will be made publicly available.  If you wish your submission to be confidential please advise the department when providing your submission.

More information and background about Australian Government funding of radiation oncology services is available below.

Radiation Oncology in Australia

Radiotherapy is one of the main treatment modalities in cancer management, often used in combination with other treatments such as surgery or chemotherapy.  Approximately 40% of cancer cures are attributed to radiotherapy.  There is evidence from an overview of the published literature that around 48.3% of patients with cancer would benefit from radiotherapy at some stage during the course of their illness.

Over the years there has been a deliberate increase by the Australian Government in radiotherapy investment.  Australian Government funding for radiation oncology is provided through a range of funding measures including Medicare Benefits Schedule (MBS) funding for medical services, the Radiation Oncology Health Program Grants (ROHPG) Scheme funding for high-cost equipment and one‑off funding grants for the construction of new and improved radiotherapy facilities.

In 2014-15 the Australian Government provided approximately:
•	$68 million in capital reimbursement funding under the ROHPG Scheme; and
•	$342 million in funding through the MBS for around 1.9 million radiotherapy services.

A report from the Australian Institute of Health and Welfare Radiation Therapy Waiting Times was released in November 2015, revealing that most patients who receive radiotherapy wait less than two weeks for treatment and that almost all emergency cases begin their treatment on the same or next day.

ROHPG Scheme

The ROHPG Scheme was introduced in 1988 under Part IV of the Health Insurance Act 1973 as an alternative method for funding the capital cost of expensive radiotherapy equipment, which was formerly funded through Medicare arrangements.

Payments are in addition to Medicare rebates that patients receive for radiotherapy services.  The Scheme is open to public and private providers who are recognised as an ‘approved health service’ (at a specific location) under the Act.  More information about the Scheme can be found here.

National allocation of radiation therapy equipment (private and public) is outlined below.

State	% of Australian population	% of linear accelerators*	% of facilities	No. of linear accelerators	No. of facilities	
NSW	32%	30%	34%	60	26	
Vic	25%	23%	24%	45	18	
Qld	20%	23%	21%	46	16	
SA	11%	8%	8%	15	6	
WA	7%	10%	8%	20	6	
Tas	2%	3%	3%	5	2	
ACT	2%	2%	1%	4	1	
NT	1%	1%	1%	2	1	
TOTAL	100%	100%	100%	197	76	
*Linear accelerators are the main treatments machines used to deliver radiation treatment.

The Scheme has not been formally reviewed since 1999 but has been subject to investigation as part of the broader 2002 Baume Inquiry into radiotherapy services and an audit of the Scheme conducted by the Australian National Audit Office, due to be tabled in Parliament in 2016.