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A rallying call for public health to refocus efforts, on building government for the public’s good

Introduction by Croakey: Public health professionals and organisations have been urged to do much more to promote good government as the fundamental determinant of planetary health and survival of the human species.

In a keynote presentation to the recent Australian Public Health Conference, Dr Peter Tait said getting good government that prioritises the public interest, rather than the “corporatocracy”, should become a central focus for the Public Health Association of Australia and the broader public health movement.

His presentation is published below, including a suggestion to get yourself in front of a new documentary, Big Deal.


Peter Tait writes:

In opening, I want to acknowledge the Indigenous nations on whose countries we are attending this conference, and pay my respects to those peoples.

I would also acknowledge that beneath these Indigenous lands are the ecosystems that protect, provision, support and sustain us; and to also pay our respects to the other beings who share the Earth’s ecosystems with us. Without them, in functioning ecosystems, neither a well society nor well people are possible.

Third, I want to acknowledge Stephen Boyden, his pioneering work and the Frank Fenner Foundation whose logo I have adapted to use here to capture the primary message that underlies planetary health; a well planet holds a well society and both support well people, and are all connected.

I also acknowledge that the Indigenous approach to caring for and healing country is a parallel process that teaches that we respect the environmental foundations of the human project.

There are two parts to this talk: first, to define Planetary Health and some of the elements that sit under its umbrella; second, and more importantly, answer the question: what must the public health community do to protect and promote our planet’s health?

What is planetary health?

The Lancet Commission, who promotes the term, defines Planetary Health as “… the health of human civilisation and the state of the natural systems on which it depends”.

That is, we are not referring to the health of the inanimate rock that is hurtling around the sun; but to the planet’s physical, chemical and ecological systems which enable life, and human civilisation.

The Commission acknowledges that while humanity is the wealthiest it has ever been, this has come at the cost of destroying the fabric of the natural systems on which we depend.

Their third important point is that this is entirely due to human behaviour. It is what we are doing, collectively and individually; it is us.

This is not to ignore that this is also a systems issue; as individuals we are caught up in our political economic system. But as individuals we have a role in either maintaining or changing that system. I will return to this point.

One Health, environmental health, human ecology, eco-health, are all aspect of planetary health. All important in their own way.

As a planetary community, we are in strife. The February 2021 UN Environment ­Program report, Making Peace with Nature, is blunt: “Humanity’s ­environmental challenges have grown in number and severity … and now represent a planetary emergency.”

The first installment of the IPCC’s Sixth Assessment Report on the climate catastrophe is the climate science community politely saying ‘guys, ACT NOW or we are all effed’.

Our planet is not well; our society is not well and people and other species are not well.

What are the implications for public health?

In brief, survival of our species (and many other species). And avoiding immeasurable suffering along the way to extinction.

What are we to do?

There are three steps: identifying the situation, responding appropriately as public health professionals and responding appropriately as individuals.

Identify the situation accurately

To use a clinical analogy, to correctly treat the problem, one must have an accurate diagnosis. I am using a political economic diagnostic lens here because I think this most accurately frames the situation we find ourselves in and therefore what action we have to take.

In summary, leaving out most of the nuances, one can summarise the cause of our unwell planet as:

the adverse effects of the behaviour of large, poorly regulated corporations; consequent to government failure; brought about by the influence of said large unregulated corporations promoting a politico-economic ideology of neoliberalism/capitalism (to name rather than describe), that shapes our expectations, beliefs and behaviour, individually and collectively.

So, governance failure is deliberately created by the active influence of the corporations; the so-called corporatocracy.

We now are operating in a political system where the rules of the game have been changed.

Politics has become about winning office to not govern for the public good.

We can see politics is blatantly about buying influence to get elected: sports rorts, carparks, premiers shredding documentation and unselfconsciously saying rorting is to be expected, the recent attempt to chill charities out of advocacy, and so on, all show that the MPs, however well-meaning they might have started out, are caught up in this corrupt system.

We see this when neither major party supports, and indeed votes against, many of the provisions for good government. MPs are constrained to vote along party lines.

Our political leaders’ responses to COVID and climate disruption show science is always bent to corporate needs not for the public good and the public’s health. MPs choose when they will accept the science and when they won’t.

Some of the COVID pandemic response, JobKeeper, robodebt and the NT Intervention shows that when they want to, politicians will act.

The Uluru Statement from the Heart, funding an adequate public health workforce and addressing the climate catastrophe show that when they don’t want to, they don’t.

These decisions are corporate, not community driven, and for corporate not community benefit.

No longer is presenting evidence or being a critical friend sufficient to get the policy and legislative outcomes we want for a healthy planet.

In playing the game only this way, we are losing.

An important note of caution: how we talk about the situation is vital to understanding and getting the outcome we want. If we talk about government as the problem, we sing from the corporatocracy’s hymn sheet.

The corporatocracy aims to trash government; we cannot afford to contribute to the trashing of government by repeating their language and the narrative that disparages and sidelines government. As public health people we realise that we need and want good government to deliver on its promise to protect and promote wellbeing.

Instead, we need to consciously promote a narrative of good government for the public’s good.

We need to talk about a political system being run by and for the corporatocracy and identify that it is the politicians, the Members of Parliament who are the ones are behaving badly. It is the MPs who have become unaccountable, dishonest, lost integrity, and are serving the interests of big business. We need to identify that this is driven and abetted by the mouthpieces of the corporatocracy, the news media (in the Anglosphere especially News Corp).

We need to demand good government and MPs with integrity who are accountable to their communities.

Our situation is both a systemic issue and a human behaviour issue; the system is built to deliver outcomes that advantage the corporates and destroy the planet’s health, through our elected representatives AND it is the behaviour of the MPs co-opted by this system, that allows these detrimental outcomes.

And it is our behaviour as people, community members and citizens that either allows this system to continue or to change.

What to do?

We transform our political-economic system so it works for us. But how?

We need to act in our personal and professional capacities at the community and societal domains.

The main game, personal and professional, must be political, because only political action can change the system to create structures that ensure good governance for the public’s good.

To paraphrase Richard Denniss, the response to neoliberalism is democracy. So effective political action is about strengthening democracy.

The two aspects of strengthening democracy are:

  1. Work with other organisations to improve the institutional structures supporting and promoting good governance, such as integrity commissions, caps on donations and election spending, and
  2. Improving representation in parliament by promoting active community participation in electing MPs who will govern for the public good.

I am focusing on these actions because both are immediate, practical and focused action that we can all take as citizens, personally and professionally, to change the system within the very short time we have left to rescue our planet’s health.

I like the analogy used by Hendricks and co-authors in their recent work Mending Democracy. One of their themes might be paraphrased: our system is tattered but functioning; best option is to mend our system, not spend more time and diverting effort to make a new one.

Actions

Action 1 – Improving the infrastructure of government

It’s not like we don’t know what to do. The Public Health Association of Australia (PHAA) now has a policy that sets out action PHAA can take. Indeed, we already are.

Action 2 – Improving representation as the way to improving good governance.

I want to spend the remainder of the presentation discussing why good representation is important and how we can achieve that with personal and professional action.

The theory of change behind this approach.

It is MPs in parliaments who make the decisions that determine our future.

So, getting the ‘right’ MPs into parliament is a practical and immediate means to mend the current representative electoral political system, to change how parliament and government work, making it work for the public good.

The right MP is one who:

  • has the necessary skills and knowledge to undertake the job of an MP,
  • demonstrates the necessary integrity to hold the position,
  • votes for measures that structurally strengthen good government,
  • actively works with and is directly and personally accountable to their electorate communities, and
  • systematically seeks input from their electorate communities on policy and law making.

At a personal level

The key to getting the right MP is for us to become active citizens. This can range from being part of an electorate group that regularly meets with the MP to discuss and advise them, through to voting tactically at election time, informed not only by party policy positions, where these exist anymore, but more importantly by the quality of the candidate.

Our power as voters rests in who we vote for and how we assign our preferences. This is a new way of thinking about how to vote. It is about thinking of candidates as job applicants coming for interview, not as political party faces.

A tool for seeing how your sitting member is working for you is the They Vote for You web site where you can discover how your local MP votes, to assess if they are voting for the public good, or not.

Being an active citizen is about communities taking back the power to choose the representative who will work in their collective best interest and then working with this representative for outcomes that enhance the public good.

This is not saying we get rid of political parties. It puts pressure on parties and candidates to change how they approach and work with the community.

So part of the answer to how do we get good government and policy that addresses the public good, rather than corporations’ interests, is to elect and work with these ‘right’ MPs.

In parallel we need to advocate for structural change and promulgate to our families, neighbourhoods and workplaces this new narrative about how politics can work.

At a professional level

At the professional level, we can act through our professional associations such as PHAA.

If PHAA and other health organisations are to be effective in achieving our vision of well people in a well society on a well planet, we have to change how we play the game. Humanity is at a crossroads. Doing more of the same alone isn’t going to cut it. We must do differently.

Good government needs to become a central focus for PHAA and the broader public health movement. Getting good government is the unifying principle in achieving all our objectives for tacking obesity, substance use, road safety, climate disruption, diabetes, heart disease, other non-communicable diseases, biodiversity loss … the list goes on. If human civilisation collapses, most of that becomes irrelevant.

So as our professional organisation, I am inviting PHAA to put more resources into campaigning and advocating for better democratic institutions as a core component of public health action – enacting our new policy. And we need to promote the new story of how a democratic society can work.

I acknowledge this presents some difficult choices for PHAA’s leadership and members. It means changing our priorities and operating strategy.

But this coming decade, it comes down to deciding if we want to keep losing our habitable planet and seeing the public’s health trashed, or whether we accept the difficult and indeed courageous challenge to help change the way politics is played in Australia, and indeed internationally, to ensure a well future for our species.

PHAA members, Board and staff need to have a conversation to work out if and how we can do this.

If you think that the ideas presented here are fanciful, then consider that over 30 electorates around Australia already have “Voices for” groups. They demonstrate that people want and are prepared to work for a community selected MP who is responsive and accountable to the local electorate and to vote them in over a party selected candidate.

Numerous groups are working for community selected independents for the House of Representatives and Senate. Active Democracy Australia is looking to support these and establish a network of Active Democracy Groups across electorates in Australia to get existing MPs and community working together.

PHAA needs to see if and how to promote and support these initiatives.

To return to some personal action.

The Australian Democracy Network has set up the #OurDemocracy campaign, which PHAA has signed on to, to push for stronger regulation of corporations in our politics.

With other groups they are promoting the Craig Reucassel documentary, the Big Deal, to raise awareness about corruption in Australian politics and support for the electorate-based democracy movement.

You can register to hold a local screening of the Big Deal, or watch it on the ABC on October 19 or on iView.

Change the game

In the current political economy, we are losing; that is failing to adequately protect and promote the public’s and the planet’s health.

To stop losing, we have to ‘change the game’.

Game change means to put more resources into changing the political system so it delivers good government for the public good.

The two means for change are:

  • To strengthen the institutions of good government, and
  • To help communities realise their power to select and work with MPs who will work with them for good governance and the public good.

Time is short. We need good government now for planetary health. This is our supporting and re-energising the public health agenda. Over to you.

Dr Peter Tait is a GP, a Clinical Senior Lecturer in Population Health at ANU Medical School and active with many public health and democracy organisations.


Meanwhile, here’s a trailer


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