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After the Victorian election, some expert advice for Premier Daniel Andrews and colleagues

Introduction by Croakey: The decisive Victorian election result – following media predictions of a hung Parliament or a minority Labor Government – has raised questions, yet again, about how mainstream media covers election campaigns.

Writing in The Conversation, senior journalism academic Dr Denis Muller suggested that the Herald Sun had acted throughout the election campaign “as a propaganda arm of the Liberal Party”.

Alison Barrett surveyed health and community leaders in Victoria for their foremost suggestions for Premier Daniel Andrews and his Government.


Alison Barrett writes:

Victorian health and community leaders have urged the re-elected Labor Government to do much more to address the social determinants of health, including critical justice concerns, to invest more in prevention, and to ensure equitable access to healthcare.

Labor’s election campaign, including a “positive plan for health”, was big on announcements for new or redeveloped hospitals, and included free nursing and midwifery training, expanded eligibility for free IVF and new women’s health clinics.

However, many health policy analysts were concerned ahead of the election that Labor’s health election promises lacked focus on substantive health policy reform or initiatives to reduce inequities.

According to Victorian health and community leaders surveyed by Croakey, much more can be done to ensure equitable access to healthcare, to reduce impacts from the climate crisis and improve the mental and physical health and wellbeing of Victorians.

As outlined below, they have called for the Labor Government to increase investment in addressing the social determinants of health and to raise the age of criminal responsibility to 14.

They also have some pointed suggestions for media organisations.


Improve health messages and political critique

Dr Tess Ryan, academic and writer

Q: What is a key short term ask for the new Government for health and health equity?

There needs to be recognition of the inequities in the health system currently as access has been further diminished due to COVID for many marginalised groups. GPs are hard to come by, waiting lists are long and costs are rising. Then the action needs to follow of more training, a bigger budget and better infrastructure to support health services in diverse communities.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

I believe there needs to be better communication processes that come from government towards the sector. We saw from previous ‘lost in translation’ health messages from 2020 that the government needs to communicate more effectively with the community sector. They should first ask the sector what needs must be addressed before anything else. Then the community sector needs to be conveying those messages towards a ‘fit for purpose’ message for their communities. For instance, ACCHOS take what directives are given and translate the policy into something that will resonate with that community. Other parts of the sector could really take direction from them as an example.

Q: What messages would you like the media to take from the election result?

It would be so refreshing in this era to see media agencies recognise that the loudest voices aren’t necessarily speaking for many. There was such a focus with this current election on the “Anti-Dan” movement, and yet that was only a vocal minority. This suggests that the media aren’t giving genuine critique to either side of politics, which further destroys the ability of those in the general public to choose. We should all be in a phase of trying to rebuild through what has changed in society since COVID, so I’d like to see more of a focus on that.


Aboriginal health in Aboriginal hands

Jill Gallagher, CEO at Victorian Aboriginal Community Controlled Health Organisation (VACCHO)

Q: What is a key short term ask for the new Government for health and health equity?

In Victoria, more Aboriginal people have died in custody in the last five years than the previous 25. There is no greater inequity than that suffered by Aboriginal people in jail, exacerbated by the Commonwealth Government withholding Medicare.

The Victorian Government is the only state government that contracts a private company to provide healthcare in prisons. This has to stop.

When an Aboriginal man died in a Canberra prison, the Government did something about it – it funded Winunga Aboriginal Health to provide services inside the jail. Not one Aboriginal person has died in custody since.

The new Government must fund Aboriginal health services to provide health care in prisons.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

Before the election, the Victorian Government and VACCHO signed an Aboriginal Health and Wellbeing Partnership agreement to improve the care Aboriginal people receive in mainstream health services and to grow Aboriginal-controlled health services.

We can only achieve this if the Government and our partners in hospitals, community health services, mental health and family services fully commit to reforms and increasing resources in the Aboriginal health sector. Putting Aboriginal Health in Aboriginal Hands must drive the public policy agenda.

Q: What messages would you like the media to take from the election result?

The Victorian Aboriginal Community Controlled Health Organisation (VACCHO) congratulates Daniel Andrews and the Labor Party on their re-election over the weekend and calls on the Government to continue to place Aboriginal health and wellbeing in Aboriginal hands.

VACCHO has been pleased to partner with the State Government to deliver positive health and wellbeing outcomes for Aboriginal and Torres Strait Islander communities in Victoria and looks forward to continuing to tackle the systemic injustices that have maligned Community for far too long.

The State Government was bold and brave in putting Treaty on the agenda. Now the State Government must be bold and brave in putting Aboriginal health in Aboriginal hands.

VACCHO look forward to working in close collaboration with the State Government to address the glaring disadvantages that continue to have a devastating impact on the health and wellbeing of Community.

Despite the challenges, Aboriginal Community Controlled Health Organisations continue to be beacons of light and hope – that provide holistic, wrap-around health and wellbeing care for a community that are largely doing it tough.

I implore the re-elected Victorian Government to prioritise properly resourcing Aboriginal organisations – meaningful commitments that go beyond election cycles.

If Government invests in putting Aboriginal health in Aboriginal hands, we will create vibrant, self-determining communities and our Boorais will grow up to shape the future for Aboriginal and Torres Strait Islander people in Victoria.


Elevate lived experience

Simon Katterl, Mental health and human rights consultant

Q: What is a key short term ask for the new Government for health and health equity?

The Victorian Government must get the appointments for the forthcoming Mental Health and Wellbeing Commission right. The current Mental Health Complaints Commissioner has failed, and the reform agenda rests on an effective systems leader and regulator. That regulator needs to more effectively work with, while also holding to account, mental health services and the Victorian Government. The Victorian Government’s legacy on mental health reform will depend on these appointments and the success of the Commission.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

The health and community sector need to develop new and innovative ways to ensure lived experience leadership in their organisations. Services have historically been funded and governed on pre-formulated understandings of what people want and need. With the introduction of the National Disability Insurance Scheme and reforms in the mental health landscape, there’s an understanding that this power relationship needs to be inverted. In markets that still receive substantial “block” funding (as opposed to the NDIS model of individual contracting through care packages), organisations and systems need to develop meaningful mechanisms to drive new models of care and culture change. Advisory groups that don’t adequately pay members and aren’t authorised to make real change are proving increasingly dated. New inter and intra-organisational governance mechanisms are needed.

Q: What messages would you like the media to take from the election result?

The news cycle on state politics appears to be focused on very physical and tangible items: level-crossings, electricity commissions, trains and hospitals. These things are of course, very important. However, that focus on things can come at the expense of long-term investments in public health and addressing the social and corporate determinants of mental health. Because these topics lack a physical embodiment, they are less “sticky” in the community’s minds and the news cycle.

One way I hope that cycle can be changed is through greater elevation of people with lived experience. People’s individual stories invite readers into their world, and importantly, they often have a different story of the world that needs to be better understood. I participated in a round-table prior to the election period to assist a news outlet to set their agenda. It was a useful one-off event, but a deeper understanding for media organisations about the issues that matter come from fostering trusting relationships of dialogue with communities, as Croakey has done recently with the #SpeakingOurMinds series. It’s something for other outlets to consider to be able to elevate different stories at the next election.


Build on current programs, community engagement and workforce

Dr Ruth De Souza, Vice-Chancellor’s Fellow at RMIT University

Q: What is a key short term ask for the new Government for health and health equity?

Given our collective experiences/witnessing of the health inequities that were laid bare during the pandemic (which continues) and the impacts on the health system and workforce:

Improving trust and confidence in the health system, particularly around health communication with racialised groups and avoiding carceral responses. Plus, community engagement in setting priorities, that would also involve developing health literacies and cultural safety.

Building on “soft” infrastructure (rather than hospitals and big building projects). In order to activate the incredible networks and constellations across Victoria with organisations that have specialised skills and capabilities in inter-cultural, multi-lingual communication and health literacy. There’s already work that is happening that could also be trialled and scaled up elsewhere, for example the Paving the Way Forward (PTWF) initiative which aims to find better ways of working alongside residents at the Flemington and North Melbourne public housing estates.

Retaining the current workforce: At RMIT, a group of us organised an exhibition of Nurses and Midwives’ experiences of the pandemic. Art was an incredible way to capture their experiences. We matched them up with art students and produced wonderful exhibition and public events. The key thing that came up for the Nurses and midwives, was how tired they all were. I know that there’s significant investment happening in terms of increasing numbers and creating incentives for them to remain in Victoria to work. But I’d like to see some kind of retention strategy for experienced staff.

Can we implement cultural safety training for mainstream organisations? Cultural safety using an intersectional lens across axes of difference including ethnicity, disability, sexuality etc.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

I think this sector already punches above its weight but I would add something about relationships with media and social media.


Focus on justice and inclusive policies

Julie Edwards, CEO at Jesuit Social Services

Q: What is a key short term ask for the new Government for health and health equity?

We welcome the re-elected Victorian Government’s social reform agenda which aims to give every adult and child in the state the opportunity to flourish.

In line with this, we are calling on the Victorian Government to raise the age of criminal responsibility from 10 to 14 years in 2023. Other parts of Australia such as the ACT and Northern Territory are making progress towards this (the NT has committed to raising the age to 12), and it is vital that the Victorian Government follows their lead to keep children and the broader community safe.

Children who have contact with the justice system at a young age are among the most vulnerable in our community and we know that children detained between the ages of 10 and 14 are more likely, compared to those at older ages, to have sustained contact with the justice system in adulthood.

Children belong in the classroom, not in prison – Victoria must raise the age and adequately fund restorative justice, family-centred and therapeutic approaches to respond to children under 14 who come into contact with police.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

This year, Jesuit Social Services celebrates its 45th anniversary. Since 1977 we have engaged in action and advocacy in support of a just society, and our organisation will continue to advocate for an inclusive Victoria that meets the needs of people and communities on the margins.

An area where we’ve seen particular progress relates to our Gender Justice work and, building on achievements due to the Royal Commission into Family Violence, engaging men and boys in violence prevention. The reasons for violence and other harmful behaviours are multi-faceted although the evidence suggests rigid adherence to stereotypical masculine norms are a key risk factor.

We call on the Victorian Government to continue to invest in this critical work with men and boys including scaling workforce capacity building, investing in research to understand underlying attitudes and behaviours, as well as supporting sector development and knowledge sharing.

In addition, we ask that the Victorian Government better address a critical early intervention opportunity by committing to recurrent funding for adolescent family violence programs aligned with restorative principles including Jesuit Social Services’ RESTORE and the Family Assisted Adolescent Response program which we have developed in partnership with Victoria Police.

Q: What messages would you like the media to take from the election result?

The Andrews Government’s resounding victory has made it clear that the majority of Victorians support action on climate change, fair access to education and training and an increase in social and affordable housing. For 45 years, Jesuit Social Services has advocated for policies and investments that work for all people, not just some. We are optimistic that significant progress towards a more inclusive Victoria can be made over coming years.

Read Jesuit Social Services media statement in response to the Victorian election here.


Invest in public health and disease prevention

Mariam Hachem, President of the Public Health Association of Australia Victoria branch

Q: What is a key short term ask for the new Government for health and health equity?

An immediate short-term ask is simple. Continue an active dialogue with public health professionals and communities. We need to ensure our voices are heard and responded to. This will translate to designing and importantly implementing health policies that are community driven and led.

By understanding the issues faced by public health professionals and communities, the new government can work towards addressing health equity gaps, particularly for those Victorians who have more complex health needs due to their marginalised situations. If we are to be serious about the health of Victorians, the new government must also be serious about ways to increase government investment in preventive health.

We know that intervening early has the potential to stop health complications and hospital admissions and further government spending, with every $1 dollar invested returning $14 dollars of cost-saving. The time to act is now, there is an opportunity to shift the focus of the health system to prevention, and to stem the unsustainable trend of ever-increasing treatment-focused expenditure and ever-increasing demand for hospital services.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

Advocate through your local health or community sector organisation (such as being part of the PHAA), engaging with local MPs individually and using the PHAA resources to ensure that we as Victorians are part of the public policy making process, so that we can live and work within a system that responds directly to our needs.

Q: What messages would you like the media to take from the election result?

Prevention focused policies need to be at the forefront. This is lacking. There is an opportunity to start addressing key public health priority areas now. The Victorian election scorecard highlights the key areas for improvement that the Labor government needs to respond to; increase in total government expenditure for preventive health to five percent by 2030, commit to five-year funding for Local Public Health Units for promotion, protection and prevention, develop a Victorian Public Health Officer (PHO) training program, invest five percent of total government mental health expenditure on prevention by 2030, support the self-determination of Aboriginal Community Controlled Health Organisations and to establish a state-based Victorian Sustainability Health Unit.

The PHAA will always be ready to collaborate with Victorian political parties and MPs to provide expert advice on public health policymaking whenever required and looks forward to further developing key political relationships (across the spectrum) on the back of the recent election advocacy campaign.


Create a positive legacy

Marie McInerney, Croakey editor

Q: What is a key short term ask for the new Government for health and health equity?

Victorian Premier Daniel Andrews is unlikely to seek election again and, given Victoria has fixed four-year terms, he has great opportunity to do major legacy work, as he has sought to lead on family violence and mental health system reform in past two terms.

Legacy reforms could include: raise the minimum age of criminality to 14 and turn around ‘tough on crime’ approaches to juvenile justice issues, take a stand on asylum seekers, really dig into issues around precarious work, given it was such a huge issue in the pandemic, and, given his added authority in Labor ranks, campaign federally for a rise in JobSeeker and tax reform. Fund more social housing (Victoria’s Big Housing Build is good but not enough to address years of neglect), invest five percent of total health spending on preventive health and wear a mask in line with CHO recommendations, to underline that, after all Victorians went through, the pandemic is not over.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

Campaign big on the need for social and affordable housing, which is causing so much distress now in the community. Act on issues raised at #HEAL2022 on the health sector “putting its own house in order’” in terms of reducing carbon emissions.

Q: What messages would you like the media to take from the election result?

To read this by Denis Muller: Media go for drama on Victorian election – and miss the story and apply it beyond the polling issues.


Be ambitious on climate action

Dr Mike Forrester, paediatrician, Victoria Branch of Doctors for the Environment Australia Chair and Clinical Lead of the sustainable healthcare network at Deakin University’s Institute for Health Transformation.

Q: What is a key short term ask for the new Government for health and health equity?

DEA appreciates the progress that is being made in Victoria, particularly regarding improved renewable electricity targets, ‘Rewiring the Nation’ plans and the commitment under VRET2 to supply all public sector infrastructure with 100 percent renewable electricity from 2025.

However, we need much more ambitious emission reduction, including our exports.

Climate change is the most important public health challenge and opportunity we face.

It is also a global and intergenerational equity issue with developing nations being the most vulnerable to climate risks, and we have a moral obligation to intergenerational equity as any further delay locks in the consequences for generations to follow.

In Victoria, we will need to be part of a global movement to transition much faster to a decarbonised and regenerative model, as on current policies we are heading towards 3 degrees of mean global heating. This combined with the breaching of planetary boundaries such as biodiversity loss, will lead to a broad range of risks.

Direct impacts will include deaths from heat stress, fire, flood and other extreme weather, and indirect impacts include crop failure and starvation, an expected one billion climate refugees by mid-century, increasing zoonotic pandemic risk,  and more.

To mitigate against the worst effects of climate change, we need to legislate an interim emissions reduction target (ERT) for Victoria of at least 80 percent by 2035, commit to 100 percent renewable electricity state-wide by 2030, develop policies to help Victoria transition off fossil fuel entirely, and towards electric vehicles for public transport, private transport and freight.

Q: What can the health and community sector do to promote healthier public policy in Victoria?

The health sector can lead action on climate by putting its own house in order.

We can establish a State Sustainable HealthCare Unit to oversee a transition of the health sector to a carbon-zero system by 2040 as exemplified by the Greener NHS plan. There will be room for all to become engaged in this process.

We can push climate risk mitigation policy as core public health policy- healthcare professionals can become engaged in the policy debate, write submissions, and talk to their state (and federal) MPs.

For those wanting to talk to their local members about these issues- Please follow the link for a summary of Vic DEA’S five key policy asks to move our state towards a decarbonised and sustainable system which includes energy policy, decarbonising the health sector, protecting native forests and delivering justice for First Nations peoples to protect health and country.

Please also consider joining DEA, CAHA, your college or representative body working group to become involved.

Working with others who care about this issue is the best antidote to the climate change distress many of us feel.

Q: What messages would you like the media to take from the election result?

It is vital that we help people understand that responding to the demands of climate risk is vital for the health and wellbeing of our children and future generations. Organisations such as DEA are working to make this message much clearer.

The population overwhelmingly supports an increase in the rate of response to these challenges.

In the Federal election, nearly half of voters who switched to independent candidates did so because of climate fears.

The citizen sentiment behind the swing towards climate policies in the federal and Victorian state elections was detailed in the recent, showing that 75 percent of Australians are concerned about climate change (with 42 percent very concerned) and a majority of Australians (57%) support Australia following the International Energy Agency pathway, to not approve any new gas, coal or oil projects (and 64 percent opposing any new coal mines).

The CSIRO has advised that while the world is at a mean temp increase of 1.1 degree, Australia has already reached almost 1.5 degrees. We are one of the most vulnerable continents on the planet, but we are renewable energy resource-rich, which means that if we join the global push towards renewables in the next few years, we can reap huge public health benefits from a rapid transition to a zero-emissions economy.

Doctors for Environment Australia asks for the new State government and all political parties to commit to the following:

  1. Accelerate pathways for ambitious emissions reduction, to protect human health
  2. Ban new coal, oil and gas projects, to protect global health
  3. Establish a State Sustainable Healthcare Unit and reduce the healthcare sector’s carbon footprint
  4. Protect Native Forests to protect human health and biodiversity
  5. Deliver justice for First Nations peoples to protect health and Country

Read their full policy platform here.


From Twitter

Tweet by @VCOSS

Watch video here.


See other articles in Croakey’s coverage of the Victorian election 2022.

 

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