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    Dr Harry Hemley, President AMA Victoria

    I’m looking forward to reading this in greater detail. One point that did jump out at me was the bariatric surgery option. A couple of years ago AMA Victoria called for a trial of bariatric surgery in public hospitals in this state, as obesity is more prevalent in lower socio-economic groups, but only about 10 per cent of bariatric surgery is carried out in public hospitals. A significant proportion of the Victorian population who would most benefit from the treatment currently miss out. You can see more of what we said at

    [Dr Harry Hemley is President, AMA Victoria]

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    I too look forward to reading the whole report, which will no doubt raise lots of interesting questions. For many of us, the fundamental questions revolve around individual behavioural vs structural/regulatory approaches, so it will be interesting to see what can be concluded about this. There are other important issues about how you slice up the population to determine which strategies work with which groups. Gender, for example, has not received the attention that it deserves in the prevention literature. It also goes without saying that a large part of the problem with ‘lifestyle interventions’ are that they exist in a world in which commercial marketing still runs rings around social marketing, and where ‘regulation’ is still considered a 4-letter word of last resort.

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    I am not an academic and I have yet to read the full report. However, my initial reaction is one of despair about the failure of Public Health in Australia, due undoubtedly to insufficient commitment and investment, and the proposal now for Secondary Prevention measures to deal with what are really Primary Health problems.

    My feeling is that a tax on junk food might work if the proceeds were sufficient to
    1. subsidize healthy food so that it is affordable and
    2. large enough to fund a social marketing campaign to make junk food unsexy.
    I doubt that 10% will be sufficient.


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