Review of the Radiation Oncology Health Program Grant Scheme, Australian Government Department of Health and Aged Care
The Radiation Oncology Health Program Grant (ROHPG) provides a contribution to the capital funding of high-cost radiotherapy equipment (i.e. linear accelerators) to ensure equitable access to radiotherapy services across Australia. Given the changing context of radiotherapy in Australia, the Australian Government Department of Health and Aged Care engaged HMA to assess the effectiveness of the ROHPG Scheme against the objectives of the program, including the impact of revised arrangements introduced in 2017.
The review process was undertaken from August to November 2020 and focused on four key review areas the ongoing appropriateness of the ROHPG, the effectiveness of the Scheme in meeting the program’s objectives, the efficient and effective administration of the ROHPG Scheme, and appropriate accountability for ROHPG Scheme funds.
The review included consultation with public and private radiotherapy facilities that receive ROHPG funding, the Department, jurisdictional departments of health (or equivalent), peak bodies and colleges, safety and quality agencies, consumer advocacy groups, and linear accelerator vendors. In addition, the review process considered published literature and policy and program documentation, analysis of ROHPG funding and equipment data, Australian Institute of Health and Welfare cancer incidence and radiotherapy data, and Medicare service and benefits paid data.
Ongoing appropriateness
HMA found the objectives of the ROHPG remain relevant, as radiotherapy continues to be a major component of cancer treatment, contributing to favourable outcomes in a range of high prevalence cancers. However, the review found that the process of setting priority areas by jurisdictions is not operating as intended and needs further consideration. A trade-off analysis assessed the relative advantage of the current ROHPG Scheme (status quo) against other potential funding options but did not find any of the alternative mechanisms to be more advantageous in their entirety.
Effectiveness
HMA found that the ROHPG made a significant financial contribution to the fleet of linear accelerators in Australia, supported growth in linear accelerator numbers, and promoted timely turnover of linear accelerators in the fleet. However, there was no evidence that private facilities have a higher throughput average than public facilities (per linear accelerator per annum).
Efficient and effective administration
HMA found that the $3 million contribution to linear accelerator capital costs is a significant contribution to the current costs of base-level linear accelerators but does not cover the full costs of add-ons required for newer treatment regimes, or advanced equipment. The full impact of the changes to ROHPG funding (including no longer funding non-linear accelerator equipment) may not be evident until equipment funded under the transition period arrangements and linear accelerators funded under the new arrangements require replacement. The removal of brachytherapy from the ROHPG Scheme could result in fewer facilities providing this treatment option in future. However, the ROHPG Scheme only provides a contribution to high-cost equipment and alternative funding options will need to be sourced by radiotherapy facilities.
Appropriate accountability
HMA noted several areas where the ROHPG Scheme administration could be strengthened to increase transparency and provide assurance of the appropriate use of Australian Government funds.
Download the report here.
Tags: Cancer, Radiotherapy, Evaluation, Funding