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Are we there yet in public health ? Not really, says Rob Moodie

Professor Rob Moodie, who’s been in the headlines recently thanks to his role as chair of the Melbourne Storm, was wearing another hat when he delivered the Sax Oration in Canberra on Wednesday night.

Public health policy consultant Margo Saunders were there and has filed this report:

“With shades of ‘Don’t mention the war!’, the great and the good of the ACT’s public health community were not going to mention the Melbourne Storm on Wednesday evening when they settled in to hear Professor Rob Moodie deliver this year’s Sax Oration, hosted annually by the ACT Branch of the Public Health Association.

But they need not have worried, as a jovial Moodie did the mentioning himself.

Speaking just 24 hours after the release of the Government’s response to the National Preventative Health Taskforce’s final report and only weeks after claims of salary cap rorting by the Melbourne football team, Moodie — who Chairs both organisations — made it clear which was the more difficult experience.

Running the Taskforce had its challenges, he said.  These included synthesising vast amounts of information on still-developing issues into coherent reports (with credit duly given to the exceptional skills of the report-writers); trying to control 9 members all wanting to rush off in different directions (with credit duly given to their passion and commitment, especially to Deputy Chair Mike Daube, whom Moodie alleges ‘never sleeps’); and being called ‘health zealots’ by those from whom he expected support (names will be omitted to protect the not-so-innocent).

But all of this was easy, he said, compared to what he has been going through with the Melbourne Storm.

With that out of the way, Moodie got down to what we were all most interested in: his thoughts on, ‘Turning the rhetoric of prevention into reality’, which included his spin on the Government’s response to the Taskforce’s recommendations.  The spin was mostly positive, in a hopeful sort of way.

But if the question was, ‘Are we there yet?’, the answer was ‘no’ – but with the understanding that it was always about a staged arrival rather than an immediate one.

Moodie gave us a quick overview of key public health issues – tobacco, alcohol, obesity, as well as road safety – to illustrate how behavioural changes have corresponded to health initiatives. (Perhaps sadly for an ACT audience, the chart showed the advent of ‘smoke-free dining’ at about 2001-02, with no mention of the ACT’s landmark smoke-free public places legislation which started the ball rolling when it took effect half a decade earlier.)

Moodie then explained that the Taskforce’s 136 sub-recommendations and 35 key action areas were deliberately presented as ‘staged’ initiatives that could be implemented over the coming decade, rather than in ‘take it or leave it’ terms.

He noted that the Government rejected only 4 recommendations; indicated that 15 were matters for State and Territory Governments; and flagged the others as appropriate for either immediate action or for further development by the still non-existent Australian National Preventive Health Agency (for which, Moodie stressed, an independent and cross-sectoral advisory council would be essential).

Moodie welcomed specific initiatives, including initiatives on obesity, tobacco and alcohol; funding for the Australian Health Survey and for a national men’s longitudinal health survey, previously announced as part of the National Male Health Policy; and funding for more nurses in general practice, which he believes will help change the culture in favour of more health promotion.

He also pointed out where the Government’s response fell short, including the failure to act on ‘moral imperatives’ such as establishing a minimum floor price for alcohol.

He wants to see much more done to acknowledge and address the economic drivers of obesity, and a solid approach to discovering ‘what works’ at the community level.  He believes that workplaces, with interest from health insurers and other sectors, are ‘the new frontier’ for health promotion and disease prevention.

Moodie’s to-do list also includes food labeling; effective social marketing (‘needs the best research and the best minds’); reform of alcohol taxation; continual improvement of jurisdictional liquor control regulations; removal of alcohol from National Competition Policy; and the systematic phasing out of the marketing of energy-dense, nutrient-poor foods and beverages.

While he echoed the sentiments expressed by Taskforce Deputy Chair Mike Daube in claiming that the Government has not closed the door on some of the tough measures proposed in the Taskforce Report, Moodie was clearly disappointed in the response to a number of recommendations, including the Government’s argument that it was not willing to consider reforming alcohol tax in the midst of a ‘wine glut’ – a situation, Moodie pointed out with some amusement, which would seem to support the call for immediate rather than delayed reform.

He also believes that a collaborative relationship with the alcohol industry has its limitations, especially around advertising and promotion.

And the public health challenge about which Moodie is least confident?  Reducing, or even stabilising, obesity.”

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