When Croakey contributors were asked to identify the most significant health news this past year, many nominated the change of Federal Government.
The recently announced Federal funding cuts – outlined in the Midyear Economic and Fiscal Outlook Statement – suggest this will likely also be the dominant health story for 2014.
The Australian Healthcare and Hospitals Association (AHHA) says the cuts threaten critical infrastructure and clinical service improvement programs across Australia: “There are particular concerns for the people of western Sydney as funds destined for Westmead and Nepean Hospitals have been cut. Funding commitments for the Millennium Institute and Children’s Medical Research Institute, also in western Sydney are gone.”
This statement from NACCHO outlines the changes to programs affecting the health and wellbeing of Aboriginal and Torres Strait Islander peoples.
Of course, it is not only cuts to health services and programs that will affect our health. Dugald Murray, the Australian Conservation Foundation’s senior economist, has given an overview of environmental setbacks. Although he doesn’t specifically address the health implications, some of these are raised in the compilation post from Croakey contributors below.
Q: What was the most significant health news nationally this year? Why was it so significant?
Sharon Friel, Professor of Health Equity, ANU: Australia’s roll back on climate change policy and action. The lack of action on climate change will undermine human wellbeing and social equity.
Dr Brad Farrant, UWA Adjunct Research Fellow: The failure of both major parties to support the increase greenhouse gas emission reduction targets put forward by the Climate Change Authority. This is extremely irresponsible and disappointing because it will cause massive ill-health effects in the future. If a wealthy country like ours with massive historical emissions and the biggest current per capita emissions isn’t prepared to do its fair share how can we expect anyone else to?
The change of government was nominated by Professor Guy Marks (University of Sydney), Luke van der Beeke (Marketing for Change) and public health advocate Rosemary Stanton. Stanton said the change of government is “significant because it is likely to undo many years of work getting the community to think more of preventative health rather than patching up problems”.
Alison Verhoeven, chief executive of the AHHA said, “The change of government has brought national health reform back into the spotlight, through the review of Medicare Locals, the PCEHR and the work of the Commission of Audit. There is significant potential for political and fiscal responses to reshape health reform, and while the goal might be efficient use of Commonwealth funds, a service and policy vacuum may eventuate where state governments have already disinvested.”
On the change of government, Sydney GP Dr Tim Senior said: “Looking back from the end of 2013, it looks like this is a moment that will change a lot of direction in health policy across many areas. Initially it was characterised by uncertainty. What would happen to Medicare Locals? Who would be responsible for Aboriginal and Torres Strait Islander Health, with the PM making himself partially responsible and dissolving OATSIH? There was a long period of silence for a while. Sadly, things are becoming clearer with the abolition of many advisory councils including the Drug and Alcohol advisory council, many of the mechanisms for reducing climate change impacts, and speculation about the National Preventive Health Authority, and the de-funding of The National Congress of Australia’s first peoples.”
Gemma Carey, from the Centre for Excellence in Intervention & Prevention Science in Melbourne, nominated the mooted defunding of the Australian National Preventive Health Agency. She said: “The rational for this move revealed a profound level of ignorance by the current government concerning the role and importance of independent research. In particular, I am referring to the comments that ANPHA monies were being wasted on research projects that were politically unpalatable to both sides of politics (eg the feasibility of fat taxes). This does not bode well for health or science under the current government.”
Meanwhile, Sebastian Rosenberg, Senior Lecturer, Brain and Mind Research Institute, Sydney Medical School, nominated the election of the Abbott Government promising reviews of mental health, Medicare Locals and more. “Could this be a genuine opportunity to really assess what is working in health care and what is not?” he asked.
Associate Professor Peter Sainsbury, University of Sydney nominated “Labor’s staunch defence of plain packaging of cigarettes”, while UNSW’s Professor Ric Day also said plain packaging was the standout news story.
Professor Tarun Weeramanthri, Chief Health Officer, WA Department of Health, said: “The most significant news, health or otherwise – the passing of Nelson Mandela, first President of a free South Africa. One of his many quotes ‘Education is the great engine of personal development. It is through education that…a child of farm workers can become the president of a great nation’.”
Ross Green, a public health advocate in Melbourne, said the most significant story of the year was: “Our immigration policy and its effects on asylum seekers. Around we go again.” (On related, don’t miss this story at The Guardian today re doctors’ outrage over standards of care on Christmas Island).
Q: What was the highlight for health and health policy?
Tobacco plain packaging was nominated by many (including Sharon Friel, Ginny Barbour, Guy Marks, Peter Sainsbury, Alison Verhoeven, Ric Day, Brad Farrant, and Tarun Weeramanthri).
Rosemary Stanton nominated the final release of the Dietary Guidelines and Infant Feeding Guidelines.
For WA, Professor Tarun Weeramanthri said the highlight for public and population health was that the second phase of Livelighter campaign targeting soft drinks was met by heavy counter-promotion by soft drink industry, suggesting the campaign was hitting its mark. “Expect more controversy/debate in the obesity space,” he predicted.
Alison Verhoeven, from the AHHA, said: “A highlight has been the commitment of the Coalition Government to honouring and potentially further expanding the oral health program commitments established under the Gillard/Rudd Governments.”
Gemma Carey’s highlights were the focus on the social determinants of health, driven by the Senate inquiry and the establishment of the Social Determinants of Health Alliance.
Public health advocate Ross Green said the highlight for public and population health was: “The fabulous high-quality research that is going on in public and population health all over Australia. We really are lucky to have world-leading researchers in so many areas of public and population health. Too many to mention and too hard to narrow down to just one highlight, but it’s worth highlighting the wonderful research being done and being thankful for having such skilled researchers.”
GP Dr Tim Senior said: “The highlight was the development of the 10 year plan for Aboriginal and Torres Strait Islander Health, setting out the priorities and requirements needed to close the gap. Significantly, the plan was developed with the lead Aboriginal Health Groups, including NACCHO, AIDA and the National Congress of Australia’s First Peoples. The new government are considering it at the moment.”
Q: What was the lowlight in health and health policy?
Professor Peter Sainsbury, University of Sydney: Labor and Coalition governments’ eagerness to enter trade deals with the USA that threaten health in Australia and neighbouring developing nations. The ongoing failure of all Australian governments to impose any restrictions on the promotion and sale of alcohol and unhealthy foods.
Sydney GP Dr Tim Senior: The lowlight was the abolition of the Climate Commission, for both its practical and symbolic value. It sent a clear signal that the government didn’t want to do anything on the greatest threat to Australia’s health. It also sent a signal about the new government’s attitude to independent advice, and since then we have had the abolition of the Advisory Panel on Positive Aging and the Alcohol and Other Drugs Council, cuts to CSIRO and talk of reviewing the National Congress of Australia’s First Peoples. Though the subsequent crowdfunding of the Climate Council was a successful development, that is not going to be a model to restore all important advisory bodies.
Professor Tarun Weeramanthri, WA: The failure to address rising problems from alcohol, not just in young people, but across society, including role of major sports.
Dr Brad Farrant, UWA Adjunct Research Fellow: The failure to implement traffic-light food labelling.
Professor Ric Day, UNSW: Welching on poker machine reform
Professor Sharon Friel, ANU: The public sector funding cuts – the demise of public health and health equity.
Ginny Barbour, Editorial Director, PLOS, Chair, COPE: Lowlight was news on how many children are living in poverty – currently 1 in 10 I believe
Professor Guy Marks, University of Sydney: I think the slow pace of development of the eHealth agenda is a great disappointment.
Alison Verhoeven, AHHA: The lack of response by both major parties to the Senate Inquiry report on Australia’s domestic response to the WHO Social Determinant of Health agenda is a lowlight, particularly as there is strong evidence to suggest that social determinants contribute significantly to the burden of disease, even in a country as wealthy as Australia. The potential move away from Commonwealth engagement in health prevention and promotion is a lowlight.
Rosemary Stanton: The lowlight was the axing of several advisory committees (drug and alcohol policy, marketing in Australia of infant formula) and the moves by sections of the food industry to stymie the star health rating front of pack labelling system that has been in development for two years.
Dr Brad Farrant, UWA: Lowlights include failure to implement traffic-light food labelling; planned scrapping of climate change policies that are working in favour of ones which the overwhelming majority of scientists and economists think won’t work.
Gemma Carey: The removal of tax rebates for chronically ill people who spend thousands on out of pocket medical expenses. The threatened de-funding of ANPHA, or maybe the cold shoulder from the NHMRC for population health initiatives.
Sebastian Rosenberg, University of Sydney: Lowlight is the continued governance confusion in relation to which level of government is going to take responsibility to develop community mental health care in Australia – the current void is quite debilitating.
Ross Green: Lowlight – where to start?!! If I have to pick just one, it’s the effect our immigration policy has on the health, particularly mental health, of asylum seekers.