Give and take Budget

A big injection of money into health and a possible cash grab from first-homebuyers can be revealed as two key parts of the State Budget to be handed down on Thursday.

The Weekend West understands the WA health budget is set to top a record $8 billion as the Government faces unrelenting pressure in public hospitals, including more than a million emergency department presentations in the next 12 months.

It is also believed the Government is looking at cutting stamp duty concessions for first-homebuyers in what would be a $150 million cash grab.

Industry sources, including the Australian Medical Association, are tipping health spending will rise to just over $8 billion - an increase of about 6 per cent - but argue it is still unlikely to be enough.

Last year, the health budget was set at $7.2 billion but the midyear review resulted in an extra $440 million being ploughed in, mostly for cost blowouts at Fiona Stanley Hospital.

On current trends, the number of emergency department cases is expected to reach 1,029,000 in 2014-15, while 45,000 extra out- patients will push appointment numbers to more than two million cases.

Health Minister Kim Hames told a meeting of the Australasian College of Health Service Management this week that it would be a tight budget but yesterday said the Government would continue to provide increased funding for extra demand on services.

AMA WA president Richard Choong said the record spend on health would be welcomed in the pessimistic economic environment and he hoped some would go to mental health and medical research as well as hospitals.

"However, I still have concerns if it will be enough to cope with the growth and ageing in WA's population because the activity numbers we're looking at for the next year are very big," he said.

Australian Nursing Federation State secretary Mark Olson said he wondered about the Government's ability to manage the health system when it was spending a record amount but at the same time planning to cut hundreds of front-line nursing positions. "The challenges of providing a world-class health system to the people of WA do not end when you open a few new hospitals," he said.

The WA Government wants to cut stamp duty concessions for first-homebuyers, reaping a predicted $150 million windfall ahead of the State Budget.

_The Weekend West _understands the Government is considering a reduction in the thresholds below which first-homebuyers do not pay stamp duty on homes and land.

The proposal is causing concern on the Government's backbench and there are fears across the property sector that it might crush the important first-homebuyer sector.

It is believed that one option being considered would result in the current $500,000 stamp duty-free threshold on a home being reduced to between $400,000 and $425,000.

The duty-free threshold on vacant land bought by first-time buyers would fall to about $250,000 from $300,000.

Up to $150 million could be raised by the changes, which would follow last year's decision to slash the first- homebuyer's grant for the purchase of an established home.

It would have a flow-on impact on the Government's successful and profitable Key-start program.

Earlier this week, Premier Colin Barnett said there may be some "tinkering around the edges" of stamp duty in Thursday's Budget.

Real Estate Institute of WA chief executive Neville Pozzi said changes to first-homebuyer concessions by the Victorian and NSW governments in recent years had led to a collapse in activity.

Property developer Nigel Satterley urged the Government to tread carefully when contemplating changes to stamp duty.

"We have to be cautious and hopefully the Government understands how important keeping housing affordable is across Perth," he said.

A spokesman for Treasurer Mike Nahan declined to comment.