Government funding for public health

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All sources of government funding Australian Government funding to states and territories on public health

All sources of government funding

Expenditure on public health activities in Australia was funded by the Australian Government and state and territory governments. Before the COVID–19 pandemic, funding contributions were evenly split between the Australian Government and state and territory governments. Starting in 2019–20, the Australian Government’s share began to rise – reaching 57.0% in 2020–21 and peaking at 66.0% in 2021–22 during the height of the pandemic (Figure 5, Table 6). In recent years (2022–23 and 2023–24), the Australian Government's contribution has retained a funding share above 60%. This increase in funding share during the pandemic was primarily attributed to a rise in direct Australian Government spending, mostly administered through the Department of Health, Disability and Ageing (DHDA) on public health programs.

During the pandemic, DHDA administered a range of public health programs in response to the COVID-19 pandemic including programs related to the COVID-19 vaccine, masks and personal protective equipment (PPE), rapid antigen test subsidies, primary care respiratory clinic services and mental health programs.

In 2023–24, an estimate of $5.4 billion was spent on public health activities, with $3.4 billion (63.3%) funded by the Australian Government and $2.0 billion (36.7%) funded by state and territory governments (Figure 5, Table 6).

During 2023–24, Australian Government public health spending decreased $1.4 billion (29.2%) from 2022–23 (Table 1). This was lower than the average annual real growth in the decade to 2023–24 (6.9%).

Australian Government expenditure on public health activities in 2023–24 comprised direct Australian Government spending ($2.8 billion) and grants to states and territories, including National Health Reform funding and other Federation Funding Agreements (FFA) ($0.7 billion).

Figure 5: Government funding of expenditure on public health activities, current prices, by source of funds, 2013–14 to 2023–24

The bar chart illustrates funding sources for public health activities from 2013–14 to 2023–24, highlighting contributions from the Australian Government and state and territory governments.
 Between 2013–14 and 2019–20, total government funding remained stable, ranging from approximately $2.4 billion to $3.9 billion, with balanced contributions from both the Australian Government and state and territory governments. 
 In 2020–21, funding doubled to $8.3 billion and peaked at $15.7 billion in 2021–22, driven by the Australia Government’s increased share in response to the COVID-19. State and territory governments also raised their contributions, though less dramatically.
 From 2022–23 to 2023–24, funding from both Australian Government and state and territory governments declined to $4.6 billion and $2.7 billion in 2022–23, and $3.4 billion and $2.0 billion in 2023–24, respectively. Despite the decrease, funding levels remained above pre-pandemic averages, indicating a potential new baseline for public health expenditure.

The bar chart illustrates funding sources for public health activities from 2013–14 to 2023–24, highlighting contributions from the Australian Government and state and territory governments. Between 2013–14 and 2019–20, total government funding remained stable, ranging from approximately $2.4 billion to $3.9 billion, with balanced contributions from both the Australian Government and state and territory governments.  In 2020–21, funding doubled to $8.3 billion and peaked at $15.7 billion in 2021–22, driven by the Australia Government’s increased share in response to the COVID-19. State and territory governments also raised their contributions, though less dramatically. From 2022–23 to 2023–24, funding from both Australian Government and state and territory governments declined to $4.6 billion and $2.7 billion in 2022–23, and $3.4 billion and $2.0 billion in 2023–24, respectively. Despite the decrease, funding levels remained above pre-pandemic averages, indicating a potential new baseline for public health expenditure.

Notes: 

  1. Direct Australian Government spending, mostly administered through the Department of Health, Disability and Ageing on programs for which the government has responsibility, such as the Health Protection and Emergency Response, Preventative Health, Immunisation and capital consumption.
  2. Treasury grants to states include the Commonwealth Government National Health Reform funding, Federation Funding Agreeements, and National Partnership on COVID-19 Response (NPCR).
  3. Gross expenditure sourced from the Government Health Expenditure National Minimum Dataset (GHE NMDS) data was supplied by states and territories. These gross expenditures include the Commonwealth grants provided to fund public health activities in these state and territories.

Source: AIHW Health Expenditure Database (Table 6).

In 2023–24, funding by state and territory governments from their own sources was estimated at $2.0 billion, representing a $0.9 billion real decrease (30.0%) from 2022–23 (Table 6). This was less than the average annual real growth in the decade to 2023–24 (4.1%).

Australian Government funding to states and territories on public health

During 2023–24, about one-fifth (19.5%) of Australian Government spending on public health was from Treasury grants to states and territories ($0.7 billion). Of this:

  • NHR funding on public health services was $0.6 billion.
  • the FFA – Health (mainly Organised immunisation, Selected health promotion, Communicable disease control) was $0.1 billion.

Australian Government funding to states and territories

Australian Government funding to the states and territories is through two mechanisms: the NHRA and Schedules to the FFA.

National Health Reform Agreement (NHRA)

The NHRA, originally signed in 2011, outlines the shared roles of the Australian Government and state and territory governments to work in partnership to improve health outcomes and ensure the sustainability of the health system. In addition to main funding of NHRA for public hospital system, NHRA also support public health programs under block funding. 

Federation Funding Agreement (FFA) Schedules

The Australian Government also supports state and territory government’s delivery of specific health initiatives through Schedules to the Federation Funding Agreement (FFA) – Health. While these initiatives fall under the broad category of public health, ranging from health infrastructure to the establishment and operation of health service supports (such as screening and prevention activities), it is not always possible to track funding provided through this mechanism through to the delivery of individual core public health activities. Further the initiatives may not meet the definition of public health activities used in the report.  It is relevant to note however that state and territory governments report their total expenditure on public health activities, regardless of how these activities may have been funded.

All current FFA - Health Schedules can be accessed from the Federal Financial Relations website (www.federalfinancialrelations.gov.au). 

Prior to the COVID-19 pandemic, the allocation of Australian Government grants on public health was broadly aligned with population distribution across jurisdictions, with New South Wales receiving 31% and Victoria 24% of total funding. During the same period from 2013–14 to 2018–19, these grants decreased at an average annual rate of 9.5% (Figure 6, Table 7).

During the height of the COVID-19 pandemic (2019–20 to 2021–22), these Treasury grants increased significantly, recording an average annual growth rate of 33.2%. In 2021–22, the most populous jurisdictions received the largest share of funding from the Australian Government, with New South Wales receiving $746 million, Victoria $815 million and Western Australia $434 million in current prices (Table 7). Notably, the Northern Territory was an exception, receiving special funding during 2020–21 and 2021–22 to support the Centre for National Resilience.

Total government funding through the NPCR on public health activities over the four financial years of the pandemic (2019–20 to 2022–23) was $5.7 billion. Of this $3.9 billion was for spending on communications, operations and responses to the COVID-19 outbreak. For further information on the spending relating to COVID-19, refer to Health system spending on the response to COVID–19 in Australia 2019–20 to 2022–23.

Figure 6: Australian Government grants on public health for each state and territory, current prices, 2013–14 to 2023–24

The line graph illustrates Australian government grant funding for public health across each state and territory from 2013–14 to 2023–24. While most states experienced a modest increase in funding over the period, New South Wales, Victoria, and Queensland consistently received higher levels of funding compared to smaller jurisdictions such as Tasmania and the ACT. Funding trends remained relatively flat for most regions until around 2021–22, when all states and territories saw a sharp increase. During this peak, Victoria and NSW reached the highest funding levels, with Victoria receiving $814.7 million and NSW $746.4 million. However, from 2022–23 to 2023–24, grant funding declined across all regions following the 2021–22 surge.

The line graph illustrates Australian government grant funding for public health across each state and territory from 2013–14 to 2023–24. While most states experienced a modest increase in funding over the period, New South Wales, Victoria, and Queensland consistently received higher levels of funding compared to smaller jurisdictions such as Tasmania and the ACT. Funding trends remained relatively flat for most regions until around 2021–22, when all states and territories saw a sharp increase. During this peak, Victoria and NSW reached the highest funding levels, with Victoria receiving $814.7 million and NSW $746.4 million. However, from 2022–23 to 2023–24, grant funding declined across all regions following the 2021–22 surge.

Notes:

  1. Treasury grants to states include the Commonwealth Government National Health Reform funding, Federation Funding Agreements, and National Partnership on COVID-19 Response (NPCR).
  2. During the COVID-19 pandemic (2020–21 to 2022–23), the Northern Territory received the Australian Government funding on Centre for National Resilience. 

Source: AIHW Health Expenditure Database (Table 7).

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