Tasmania has launched its Healthy Tasmania strategy, aiming to become Australia’s healthiest population by 2025.
Currently, compared to the national average, Tasmanians are more likely to be overweight or smoke, and they experience the highest burden of disease and injury outside of the Northern Territory. Around 46 per cent have a physical disability, compared to the national average of 36 per cent.
In the article below, drawn from her presentation to the recent 2015 Population Health Conference in Hobart, Healthy Tasmania committee member Siobhan Harpur talks about the transformational change in thinking that will be required and is being harnessed to pursue the agenda.
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Siobhan Harpur writes:
I have a leadership role in a long-term agenda for a Healthy Tasmania, with the current ambition of making Tasmania the healthiest population by 2025. In the contemporary state of austerity on steroids – especially for action on health promotion – we need, more than ever, to be forging new break-throughs in health-in-all-policies.
Healthy Tasmania is the Tasmanian Government’s strategic policy direction to build good health and reduce avoidable inequities, in collaboration with communities. It is supported by all three political parties as well as independent members. Tasmania faces higher levels of poverty and locational disadvantage than other Australian jurisdictions, and strong community advocacy has driven the policy focus to what can be done to keep Tasmanians well and in control of what matters to them. We have the perfect storm of an opportunity and we invite the world to not only to watch us, but also to join us in every way that you can!
Here in Tasmania we have an appetite for renewal, and a strong history of innovation. We have a relatively stable population, a temperate climate, an extraordinary wilderness and some exceptionally creative people. We don’t have big scale anything, and with some of the highest levels of intergenerational poverty and food and income insecurity, we have everything to gain from working more strongly with a shared vision for a Healthy Tasmania.
In consideration of the task to improve and protect our health, we find the tiers of government are complicated with overlapping functions and entry points, and the health and community sector is broad and deep and highly varied in its capacity and capability. As officers within the public service we can find ourselves paralysed by our own accountabilities and processes, at the same time that we are asked to be agile, flexible and responsive to opportunity. Contrary to the popular view, ideology is crucial in public service, because we cannot just analyse facts unless we have clear values or conviction, and preferably both.
The popular discourse is to see things simply, or at least to describe them as so, and that there is a simple causal model that ‘a’ follows ‘b’, if only we could lay our hands on the right solution for the intractable challenges of poverty, homelessness and family violence. In public health we know that these complex issues need emergent thinking and learning through action, observation and innovation.
However, we need to be prepared to translate this, and make it work for everyone. Weed to be open minded, tobuild in innovative experimentation and keep drawing conclusions for what’s working, and do different things when they are not.
Our real job is about stripping out the complexity and creating governance that works for local communities. Yes, it’s a challenge and we need to build capacity in demand as well as supply, and to unleash what is already there in spades. It’s beyond any individual part of government or indeed any single sector, but government needs to come with us – and the responsibility of public servants like me is to establish and maintain understanding, find our feet on common paths and gather up the stories of success and shine a light on them.
Most people can solve their own problems, but we cannot simply transfer the risk to communities inappropriately. The risks are public, and each of has a stake in the future we want to establish. It is the dynamic boundaries and the relationships between organisations, between people, professions and places that we know will make a difference. We need to be professional and personable, and we cannot separate the self. More than ever we need to be conscious of our relationship to power, and to fairness, to the values we work with and from, and to civil society writ large.
Marx reminded us that societies are not the owners of the globe. They are – he said – ‘its temporary beneficiaries’ and must hand it down to future generations in a better condition. So when we speak now of being the stewards and the custodians of our work in policy and practice, we need to understand what this means. As public health advocates, workers, servants and leaders – we must find the points of leverage for change and mobilise the underrepresented majorities. We need matters of substance in order to genuinely engage. History shows us that social movements are the source of what’s needed for political energy.
We need a common cause, a change of heart, a renewal of social bonds, a reform of public life. We need to move beyond the primacy of technical and economic knowledge and randomised control trials. We need to stop doing harm where we have all of the evidence that we need to know there are absolutely avoidable inequities. We can shift the emphasis to structural and systems thinking.
Without stronger voices, public authorities are overburdened and markets don’t work. Without moral commitment people act without consideration for each other. We cannot be indifferent to community or society at large, and we cannot continue to harm people when we know the damage of inequality. The social webs that we experience in our neighbourhoods and at work, in clubs and associations, help create our civic order socially and morally. Each of us needs to commit to invest more of ourselves in one another.
So we are at the tipping point of change here in Tasmania with a genuine appetite for positive health and wellbeing that is gathering a head of steam. We will be starting that conversation publically in the weeks ahead, to embrace the change that we can be. Watch this space!
Siobhan Harpur is CEO, Public Health Services, at the Department of Health and Human Services in Tasmania. She tweets at @SharpurSiobhan.
This is a brilliant analysis by a kind, caring , competent, insightful public servant.
Siobhan says ” As officers within the public service we can find ourselves paralysed by our own accountabilities and processes……”
There are many reports which echo this concern, however nothing seems to improve. Maybe it will this time. I hope so.
I think of the wonderful public servants I know and have worked with over the years who have tried so hard to do the right thing, but their efforts have been stymied by excessive iterative over-consultation, complex committee systems, with no outcomes or results.
If public servants are to be innovative and creative they need to be encouraged and mistakes have to be tolerated by governments, not scapegoating individuals, but supporting them to strive to do new and clever things. Assigning blame and stifling innovation in the name of media spin or parochialism will never lead to good outcomes for the Tasmanian community.
Well said Siobhan. Good luck in your endeavours.