The first weeks of a new government are challenging for ministers and their staff as they work to get on top of their complex portfolios - there are few more complex than heath.
Minister Mark Butler has been building his personal staff and working to establish relationships with the officials that will implement the new government's policy agenda in health.
Like his ministerial colleagues, Mr Butler is also dealing with strict rules imposed on new spending ahead of the government's first budget that will be delivered in October.
The central agencies can be quite unreasonable when it comes to Budget planning, but it is hard to believe the rules in the lead-up to October have so little flexibility they are allowed to effectively force the government into reneging on it election commitments. Yet that appears to be the situation for the 'Patient Pathways' program.
In the prime minister's own words, election commitments matter.
In a recent interview with the ABC's 7.30 Report, Prime Minister Anthony Albanese said, "...one of the things that people have a right to believe, is that when a politician makes a commitment before an election, they keep it and I intend to do just that."
Mr Butler is known for having convictions but he is now at risk of being seen to renege on a publicly stated commitment to provide $2.5 million to the Patient Pathways program over three years starting from 2022-23.
The Department of Finance will never care about a small program providing support to telehealth nurses. Yet that does not make it incredibly important and, regardless, it is the prime minister's own department that ultimately sets the Budget operational rules.
The Patient Pathways program funds telehealth nurses in patient organisations. The nurses provide direct support, mostly to families with children diagnosed with rare genetic disorders.
Mark Butler rightly won significant praise and respect for Labor's commitment to a program that has had a very positive impact on over 2,700 Australian families. These are nurses providing practical health system support to families forced into the situation of dealing with the implications of a very serious diagnosis.
To be clear, Labor's commitment was unequivocal. It was not a commitment to review, implement a process or reconsider a decision taken by the former government. It was an explicit commitment to fund Patient Pathways for three years based on the pre-Budget submission of the Centre for Community-Driven Research (CCDR).
The decision to now retain a decision taken by the former government to temporarily underfund the program into virtual non-existence with around $150,000 for six months makes no sense. It is made even worse by the decision to force CCDR and its partner organisations into a highly questionable, expensive and time-consuming evaluation Mr Butler himself effectively described as a waste of time.
Presumably, Labor made its election commitment to Patient Pathways because it thought the former government was wrong to undermine the program with inaction and under-funding. Yet it has now adopted the former government's decision.
There will be practical consequences for the program and the families it serves in the form of a loss of service capability and provision.
CCDR has made it very clear to the new minister, his personal staff and officials that reduced funding for six months raises serious doubts over the viability of the program. It certainly has real consequences for the nurses it contracts to provide services.
Do officials administering these grants actually understand that non-government organisations operate within a legal and contractual framework?
Does the government seriously believe a not-for-profit organisation can wind down its operation, effectively go into hibernation while it goes through its Budget process, and then re-emerge as if nothing happened?
