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As Western Australia turns towards an election, what are the critical health issues?

Ahead of the Western Australian election next year, public health advocates are signalling their determination to put climate action, criminal law reform and increased spending on prevention firmly on the political radar.

The Public Health Association of Australia (PHAA) WA Branch today releases its 2021 election platform, Striving towards a healthier Western Australia: 2021 and beyond.

This urges parties and voters to #ThinkPublicHealth and prioritise effective, evidence-based public health policies in 2021, according to the article below by Dr Elizabeth Connor, vice president of the branch, and her colleagues in the branch committee.


Elizabeth Connor and colleagues write:

The COVID-19 pandemic has shown that prevention and public health must be priorities for political parties and voters alike, to support a sustainable and effective approach to health in WA.

Following a year of unparalleled levels of support for the current Government and Premier Mark McGowan, Labor is a strong contender to win the election, to be held on 13 March 2021.

Dr Connor

The McGowan Government has been in the national spotlight and has garnered considerable local support for its approach to managing COVID-19, including tough and unapologetic border closures. It has taken a strong focus on economic recovery in the WA COVID-19 Recovery Plan and the 2020-2021 State budget released in October, with a mantra of keeping WA ‘safe and strong’.

In this context, the other major parties including the Australian Liberal Party, The Greens and the Nationals, are in for a fight – with the Liberal Party already going into election mode under the new leadership of Zak Kirkup (following the resignation of Liza Harvey).

It is likely that health will be firmly on the agenda for the coming election. How could it not be after the events of 2020?

COVID-19 and the importance of health are firmly in the collective mind of the WA public. The Opposition has committed to following the advice of the WA Chief Health Officer in relation to COVID-19, as the McGowan Government did throughout 2020 and now.

In addition, a swath of documents pepper the policy landscape in WA and nationally, pointing to the need for health sector reform and a focus on prevention; some established, including the Better Choices. Better Lives. Western Australian Mental Health, Alcohol and Other Drug Services Plan 2015–2025  (The Better Choices, Better Lives Plan) and the Sustainable Health Review Final Report and others new, including the Productivity Commission Mental Health Inquiry Report, and the WA Climate Health Inquiry Final Report.

Our 2021 Election Platform, released today, has an emphasis on protecting those groups in our community who carry a disproportionate burden of disease, and calls for urgent commitment from all political parties to actions across six key public health areas, as outlined below.

1. Increase investment in public health prevention and promotion for a sustainable future health system

This includes:

1) Increase investment in health prevention to at least five percent of the total health budget by July 2029

2) Increase investment in mental health prevention to five percent of the total Mental Health Commission budget by 2025

3) Maintain Healthway’s activities, funded at no less than the current level with indexation.

The WA health and mental health systems face enormous financial pressures, with expenditure on health in WA projected to increase to almost 40 percent of the State budget by 2026-27.

Investment in the prevention of ill health and mental ill health, including public health workforce, makes good economic sense, and ensures the sustainability of WA’s health system. Maintaining Healthway’s activities is fundamental to WA successfully implementing the strategic vision outlined in the Sustainable Health Review Final Report.

Election 2021 context: These asks should be uncontroversial, aligning directly with the recommendations made in the Sustainable Health Review Final Report and The Better Choices, Better Lives Plan.

However, we know that there is chronic underinvestment in mental health prevention in WA. There is currently no publicly available data on health prevention spending in WA. Reporting was due to commence in December 2019 as per the Sustainable Health Review Final Report, but is yet to be seen publicly.

With a renewed focus on the Sustainable Health Review implementation, and the lessons of COVID-19 fresh in our minds, it is hoped that these asks will be supported by political parties.

Towards health. Photo: supplied

2. Introduce a minimum unit price for alcohol

This should be applied per standard drink for all alcohol products and be informed by independent modelling using WA data, and regularly adjusted for inflation and supported by appropriate resourcing for support agencies.

There is a strong link between alcohol price, use, and harm. In WA, alcohol is promoted and sold at dangerously cheap prices. The World Health Organization has found alcohol taxation and pricing policies to be among the most effective and cost-effective alcohol control measures.

A minimum unit price for alcohol would set a price below which alcoholic drinks cannot be sold, and is a targeted measure that would reduce alcohol use among the heaviest drinkers, while having minimal impact on moderate drinkers.

Election 2021 context: This ask aligns with recommendations from a number of key guiding state and national strategies. In line with public comments from his office, the current WA Health Minister is open to minimum unit pricing, although no formal commitment has been made.

In October 2018, over 70 health and community organisations expressed support for the introduction of minimum unit pricing in WA. The Northern Territory has had a minimum price for alcohol for two years now, and it has resulted in reductions in a range of alcohol-related harms.

Given the policy faces opposition from some sectors of the alcohol industry, strong support from health and communities groups will be needed to keep this on the table in 2021.

3. Immediately ban advertising of unhealthy food and drink on State-owned assets

Companies use WA government (and taxpayer-funded) assets to market and boost sales of unhealthy food, alcohol, and drinks. WA children are being targeted with food marketing, with 74% of outdoor food advertising within 500m of Perth schools being for unhealthy foods.

A ban on advertising of unhealthy food and drink on all State-owned assets would support broader obesity prevention and alcohol-related harm strategies.

Election 2021 context: This ask aligns with the recommendations from a number of WA frameworks and key reports. Evidence shows that policies to remove unhealthy food advertising implemented in other jurisdictions have not had a negative impact on government revenue.

WA’s leading non-government health agencies, including PHAA WA, have expressed support for this policy in a recent Joint Statement. This advocacy, in conjunction with mounting pressure to address obesity in WA, aims to cement this issue in the political agenda in 2021.

4. Raise the minimum age of criminal responsibility to 14

Entering the justice system at a young age can have adverse life course effects, including health and social consequences.

We know that the WA Government’s ability to incarcerate children as young as 10 years has a disproportionate impact on Aboriginal and Torres Strait Islander children.

Election 2021 context: This issue has been gaining traction nationally in 2020, with the Raise the Age campaign launching in June prior to a Council of Attorneys-General (CAG) meeting where members were due to vote on raising the age of legal responsibility from 10 to 14 years.

However, the CAG delayed their decision for at least 12 months; a move condemned by many stakeholders, including the Aboriginal Legal Service of WA and the Human Rights Law Centre.

The ACT Legislative Assembly has since committed to increasing the age of criminal responsibility from 10 to 14 years, prompting strong discussion about the potential for other governments to follow suit.

The incoming WA Government has a real chance to protect our WA children from ongoing interactions with the justice system by joining the ACT as leaders in this space by committing to increasing the age.

Photo by Melissa Sweet

5. Keep the current restrictions on electronic gaming machines in WA

WA is the only jurisdiction in Australia that does not have electronic gaming machines in licensed premises or sporting clubs, resulting in fewer problem gamblers due to the physical restriction of electronic gaming machines than other jurisdictions.

By supporting a ban on electronic gaming machines, WA leads the way in minimising the uptake of gambling and the health and social impacts it has on individuals, families and the wider WA community, and not having pokies in the state is something the WA community takes pride in.  

Election 2021 context: In 2019, the WA Government passed the TAB (Disposal) Act 2019