6 February 2025

Tough decisions: Steel flags pain as health puts budget into freefall

| Ian Bushnell
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Treasurer Chris Steel says all measures are on the table to make the budget sustainable. Photo: Ian Bushnell.

Treasurer Chris Steel has warned of tough decisions ahead after announcing a revised Budget deficit of almost $1 billion, fed by an “unsustainable” increase in demand for Canberra’s health services.

Mr Steel said that while no decision had yet been made on measures to rein in the deficit, both those on the revenue and spending sides were on the table ahead of the 2025-26 Budget being handed down in June.

In a bid to support the beleaguered health system, spending across the government has been tightened for this financial year with a freeze on the hiring of non-essential staff and the delay of some non-essential programs and payments.

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The Mid-Year Budget review shows a deterioration in the ACT’s bottom line from a deficit of $624.1m to a record $971.7m, most of which stems from a $227 top-up for the health system to cope with an unanticipated 16 per cent increase in patient visits.

Other factors include $105 million less under the National Health Reform Agreement, a $22 million drop in own source taxation and a $24 million allocation to out-of-home care.

Despite this, the Budget Review continues to project a return to surplus of $176.7 million by 2027-28.

It also forecasts a billion-dollar turnaround in revenue for the 2025-26 budget, from $7.976 billion to $8.889 billion.

Mr Steel made it clear that getting health spending under control and getting to the bottom of the surge in presentations at ACT hospitals, Walk-in Centres and clinics was crucial to achieving this.

“It is not sustainable to have double-digit increases in healthcare expenditure year on year,” he said.

“We simply cannot sustain that in a budget where healthcare already makes up 34 per cent of the entire expenditure across government.

“So in order to deliver all of the other government services … we do need to look at what we can do to put the budget and healthcare expenditure on a more sustainable footing.”

Canberra Hospital emergency building

Mr Steel said the ever-increasing demand at Canberra’s hospitals cannot continue. Photo: Michelle Kroll.

Mr Steel said the were tough decisions ahead that would require strong economic management.

Assisting that will be a strong economy growing at more than 3 per cent a year with full employment, falling inflation and interest rate cuts on the horizon.

But Mr Steel said Canberra Health Services was looking at savings across the system beyond those announced last week by Health Minister Rachel Stephen-Smith.

The ACT would also be negotiating with the Commonwealth for a better deal on health funding and with the states, particularly NSW, to pay their way on interstate patients being treated in Territory hospitals.

The Budget Review does not include an extra one-off payment of $50 million from the Commonwealth, announced on Wednesday as part of a one-year rollover of the National Health Reform Agreement.

Carefully avoiding words such as tax increases or cuts, Mr Steel would not rule anything out or in, but the government would be looking “right across the board” at existing programs.

The government was still committed to delivering on its election commitments, but Mr Steel said the government would have to look right across the budget to make sure it was sustainable to deliver them.

Its $8 billion infrastructure program, including the new Northside Hospital, appears to be safe, with Mr Steel saying a growing city needed these projects, and “we can’t step back from that”.

Asked if more land sales were possible to boost the coffers, Mr Steel said there was already a strong land release program, but he planned regulatory and zoning changes to unlock more housing, especially along transport corridors, to increase economic activity.

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Net debt has also increased by $173 million and is expected to grow over the next four years to nearly $13 billion, reflecting the infrastructure program, but Mr Steel said the government was in a good position to service and manage that debt.

He said the infrastructure investments would benefit future generations.

“They’re important investments that we need to make that will benefit people for the long-term, but there’s no doubt that there’s work ahead to support a sustainable budget as well,” he said.

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Incidental Tourist9:57 pm 08 Feb 25

They introduced GP tax recently and GP fees have increased. Opposition was saying loud and clear that this GP tax would result in more hospital presentations and higher hospital costs. Now we read Steel saying “unanticipated 16 per cent increase in patient visits”. But incompetence is half of the problem. Another half is arrogance. Even if they realise the root cause of health cost blow out they will never remove GP tax.

As I read it, the GP tax was just a re-interpretation of the existing PRT laws. This meant levelling the playing field and now the GPs suffer the same pain that the other SMEs and businesses in town do. If you think the GP tax is unfair, then how about lobbying to get PRT fixed for all.

@Incidental Tourist
“They introduced GP tax recently …”
No – the exemption, for GP practices, from payroll tax expired.

If you need to spruik a lie, that it was a “GP tax”, to make your argument, then you have no argument.

Unbelievable that money for Health is in trouble while money for the TRAM is still forthcoming.

I am not surprised about increased presentations. With the huge failures in both My Aged Care & NDIS many have no choice but to attend CHS with aggravated conditions especially for mental health services

GrumpyGrandpa5:32 pm 07 Feb 25

If I can paraphrase Mr Steele, I think what he is saying:

“We are broke, but hopefully, the Commonwealth will help bail us our of health debt, and future land sales along LR 2B will save our bacon”.

Did I miss anything?

…. and, the stupid lifting of London Circuit!!

Self inflicted. The billion dollar (& counting!) TRAM!!

Ian De Landelles3:40 pm 07 Feb 25

I remember more than 20 years ago, Jon Stanhope telling a monthly meeting of the ALP Mt Rogers sub-Branch, that he didn’t want to be in government in 2030, as he didn’t know the health bill would be paid.
Jon and I are among the baby boomer generation that’s consuming an ever increasing proportion of the funds allocated to health, and all governments, of all political persuasions, have, or should have known, this runaway freight train has been gathering momentum for many years.

Jon and I often disagree on policy matters, however, on this issue, we are in furious agreement.

No mention of how much money is being sucked up by Barr’s white elephant tram.

I’m becoming increasingly convinced that Ian Bushnell is the ACT government PR person. He reports what he’s told by them rather than getting the facts as investigative journalists do by seeking out different perspectives on the issues.

Once again ACT budgets have shown that this place (and the NT) should never have had self government forced on them. Canberra is the national capital and should be funded as such, overseen by an updated NCA peopled by members with the appropriate knowledge and skills – not by retired lawyers and public servants.

And people think Barr is a dill, well he is but what a great handball “treasurer” straight down Steels throat.

A billion dollar deficit in the ACT, you’ve got to be kidding. Though with the reckless rubbish that the government spends our money on it’s no surprise. For every $7 they collect, they spend $8. Debt is $9 billion, it’s simply unsustainable. Stop wasting our money.

Audrey Gilrain1:06 pm 07 Feb 25

And yet they were voted in again….

Yes, go figure. Is there a sense of Stockholm Syndrome involved ?

It’s not as if the massive amount of money put into health care is actually delivering quality. Health care was massively better in the 80s and 90s. Then you could actually see a family doctor who knew you and your lifestyle. Today you’re lucky to get 15 minutes with someone who actually speaks English and is more competent than a pill dispensary.

Capital Retro9:14 am 07 Feb 25

Andrew Barr has given Steel the best hospital pass ever seen outside the NRL.

Australia is about a decade behind the rest of the world in public service administration management, the golden rule is to ‘make hay while the sun shines’, or in other words transform from a position of strength, not weakness.
They have missed that chance and now there will be years of uncovering and hand wringing anxiety as the underlying debt position becomes even clearer, which usually results in severe urgent cuts because you missed the chance to do it sustainably by running a tight ship with strong risk management and a dedicated eye to making yourselves efficient enough to weather future storms with lesser impact.
On the other hand it’s human nature to keep pushing the line out until somebody stops you out of necessity. Is it really that much of a shock?

Audrey Gilrain1:08 pm 07 Feb 25

There was a necessity, and we had the chance in October last year to stop it, and yet we didn’t.

“The foundation of delivering all of the high levels of government services that Canberrans expect is a sustainable budget position.”
This is what needs to explained and understood. Because everything else is not.

HiddenDragon10:55 pm 06 Feb 25

Look across the federation and, with exception for the time being of WA, there are similar problems in all of the sub-national jurisdictions.

The ACT government are deplorable managers of public finances, but they are in good company, with the Australian political class as a whole in deep denial about the fiscal realities facing the nation.

It is well past time for a serious shake up of how the federation is financed and run. The answer is not an even higher overall tax take, it is much more efficient use of those funds, with much less waste, churn and duplication – so that governments and their bureaucracies are very clearly a means to an end, not (as too often happens) an end in themselves.

As part of that, the conspicuous diseconomies of scale faced by the smallest jurisdictions would need to be dealt with. Geography limits the options for Tasmania and the NT, but in the case of the ACT there would clearly be more efficient forms of governance for delivering public services to the people of this city.

Well said Hidden Dragon!

Capital Retro10:28 pm 06 Feb 25

What’s the latest with the unfunded public service pensions that we took over with “self-government”?
How many billions has it blown out to this time?

Capital Retro10:24 pm 06 Feb 25

“Mr Steel said the were tough decisions ahead that would require strong economic management.”
Hopefully those decisions are made by an Federally appointed administrator.

Anyone that believes the forecast improvements to the budget position is kidding themselves.

These are the exact outcomes that many people have been predicting for a number of years but far too many voters have been incapable of seeing beyond their noses, with dreams that we can afford anything and that proper economic analyses of spending decisions are unnecessary.

Absolutely correct. Sadly, people ignore what they don’t want to see. That way they feel able to blame other people, saying it was unanticipated or unexpected. Yeah right.

Kybosh the tram. Way too expensive white elephant and plough the money into health. The ACT has the lowest bulk billing rates in the country, there’s your overpresentation at A& E for issues that could be treated by a GP as a start.

It is a doctor’s choice not to bulk bill. Nurse-led walk-in centres were created to take load off both.

Crime n Punishment7:10 pm 06 Feb 25

Questions for the Health Minister;
Does the $227m top-up for the health system account for the entire increase in services, or are there cost blow outs in specific areas unrelated to increased demand ?

Question for the Treasurer;
Why did the blow out become so big before you were notified, and if you were notified, why did you not act sooner to bring spending back in line with budgets?

Question for the Canberra community;
Does this increased debt burden really improve future generations, and Canberra’s livability?

Is this the same Chris Steel who was skiting back in 2021, that ““debt has never been this cheap” and that the government would be foolish not to go into debt to get the goodies it wanted?

And where is our former treasurer and current Chief Minister in all of this? Whistling and looking at his shoes?

Yes, it’s all obviously the fault of those naughty inter-state patients.

We all know it will be another excessive rate rise, because these clowns can’t stop wasting money on virtue signalling nonsense.

If there was bulk billing for a Doctors appointment and a reasonable time to see them, then the system would not be overloaded and the cost would come down. Having said this, isnt it common sense.

GrumpyGrandpa7:52 pm 06 Feb 25

You are 100% right Mick, however, Medicare is funded by the Federal Government. The ACT Government doesn’t really control bulk-billing levels.
The ACT Government is however responsible for the extra $7 being charged by your GP, due their decision to charge Payroll Tax on private GPs.

“Overloaded” means supply is insufficient for demand. How would more bulk billing and implied longer consultation times fix that?

0% knowledge.

Amateur town planner Chris Steel is starting to demonstrate his lack of experience and inadequacy almost daily. Good job.

Went to emergency for a detacted retina, was sent away and told to go immediately to Sydney Eye Hospital for emergency surgery. Apart from the stress of the situation and having to find my own way to the centre of Sydney, it cost me $1500. I was able to claim $260 back from the government. That’s how they are saving money !!

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