Much of the media coverage of Labor’s reshuffle of two critical shadow portfolios for health has tended to focus on the political dynamics in play, including questions about the Federal Opposition’s leadership.
But what does the health sector make of the chair swap between the Shadow Ministers for Health and Ageing, and for Climate Change and Energy?
It’s a timely question as Western Australian communities face devastating bushfires amid a coronavirus lock-down, in a reminder of the intersections between health and climate portfolios.
The new Shadow Minister for Climate Change and Energy Chris Bowen advocated for a national climate and health strategy during his time as Opposition health spokesman, while the new Shadow Minister for Health and Ageing Mark Butler returns to a policy area he knows well, as a former Parliamentary Secretary for Health, Minister for Mental Health and Ageing, and Minister Assisting the Prime Minister on Mental Health Reform.
Below we hear some insights from some leaders in the health sector, noting that some others chose to reserve their judgement at this stage, preferring to “wait and see”.
Latest climate and health news
But first: there is no shortage of new reading for the new Shadow Ministers (as well as their Ministerial counterparts).
In the latest BMJ, global health researchers paint a bleak picture, writing that prevailing policies are projected to lead to the world being up to 4°C warmer than in pre-industrial times by the end of the century, “increasing the risks to health in such a way that they are difficult to predict”.
Yet only half of the countries surveyed by the World Health Organization in 2019 have national climate and health plans, while another survey found that two-thirds of cities are concerned climate change will overwhelm their public health infrastructure.
The latest edition of Australian Health Review also includes a series of calls for urgent climate action.
In ‘Reducing emissions and waste in the health sector: the long sleep is over – time for the hare to get running!’, Adjunct Professor Tarun Weeramanthri predicts that internationally there will be an increasing focus on climate and health in the build-up to the critical 26th session of the Conference of the Parties (COP 26) meeting in November this year.
In ‘Policy reflection on climate change and health’, Professor Sotiris Vardoulakis writes that “it is crucially important to shift attention to the longer-term preparedness, resilience and responsiveness of the health sector to climate change”.
In ‘What does climate change have to do with bushfires?’, Dr Bin Jalaludin and Dr Geoffrey Morgan call for “transformative thinking and action by our political leaders that builds on the Australian public and industry’s willingness to play their part”.
Rural health in focus
Meanwhile, the National Rural Health Alliance has released a new position paper: ‘Rural health policy in a changing climate: three key issues’, which warns that rural and remote communities are particularly prone to the health-related impacts of climate change.
As well, regional areas are more exposed to associated economic risks, with over half having emission-intensive employment that makes up 20 to 60 percent of total employment.
“Therefore, the economic, social and consequential health impacts of not implementing a planned transition from these industries will be significant, particularly for the most affected regions,” the paper says. (The National Party, meanwhile, continues to advocate for more coal mines).
The NRHA paper recommends that governments should:
- Act immediately to introduce policies and incentives to reduce the the nation’s greenhouse gas emissions and mitigate climate change impact
- Ensure the transition to a sustainable economy is managed and planned to support those regions and sectors of the economy most affected by climate change, through the development of regionally specific transition plans
- Prioritise and support research to assist rural, regional and remote communities to better adapt to and mitigate the direct and indirect effects of climate change on health, including the impact of extreme weather events, risks to agriculture and food security, and the potential threat of vector-borne diseases
- Address the implications of climate change in their healthcare planning in terms of prevention, early intervention, primary care, secondary care, tertiary care, crisis and trauma management, mental health service provision, and health care workforce education and training. This planning will also need to incorporate the additional costs to health care from both direct and indirect effects of climate change
- Determine how best to ensure those members of society already disadvantaged by inequitable access to health care are not further disadvantaged by the impact of climate change on health.
Health sector leaders on the Labor shuffle
Alison Verhoeven, CEO, Australian Healthcare and Hospitals Association
Mark Butler comes with a good understanding of the portfolio, particularly of mental health and ageing from his past ministerial experience – and that is really positive. Likewise for Chris Bowen, taking his economic experience and jobs experience to the climate portfolio is an interesting move. Clearly as health advocates we want to see the climate issues addressed in a way that moves the debate forward – so perhaps there’s an opportunity to move the debate forward, especially talking about jobs.
It’s really important to have good knowledge in opposition offices around mental health and aged care, because those are two very big and unaddressed areas in the health portfolios. The Government has been able to direct attention away because of the rightful focus on COVID-19, but we have damning reports on these matters, and that needs a strong and engaged response from the Opposition. Mark Butler has the expertise and experience to do that. So hopefully this is a positive move for policy debate and moving some of these discussions forward.
(Asked about potential risks for the shuffle?): We know that health is a strong point generally for Labor. At a time when the Coalition Government has probably got stronger health credentials than they’ve ever had before, because of what’s happened during COVID-19, there must be a risk to Labor if it’s seen to be changing health leadership. But I think the two people involved – Mark Butler and Chris Bowen – are going to areas where they have good skills sets.
(Asked for advice to Mark Butler): COVID-19 has dominated the agenda for the last 12 months and it’s important we continue to keep our eye on the ball. We must continue to hold government, especially the Commonwealth Government, to account for national leadership on the pandemic. But there are many other important issues in healthcare: some of them as a result of COVID and natural disasters and others that are not. We can’t let that drop while the focus is on COVID. Mustering resources to respond to aged care and mental health reports is a start. He needs to be both focused and big picture.
(Asked for advice to Chris Bowen): Take what he has learnt about the health system and the passion and commitment of health system leaders to see climate addressed as part of health policy and ensure he brings some of that vision into the climate discussion – so it’s not only about jobs but why this is good for the health of Australians. Look at what we’ve done in the past. when we moved away from the tobacco industry, the world didn’t stop turning because of the public health initiatives that we took – so thinking through job substitution and product substation and how we might be able to support industry to do things differently is important. It’s better for health outcomes to have people employed. There are broad health considerations around climate and economic policy and maybe his experience will be a conversation breaker in a way that hasn’t been achieved to date.
(Advice to health sector?): It’s really important to cultivate good working relationships with both health ministers and shadow ministers and portfolios related to health. We have to play on both side of politics and work constructively with both sides of Parliament and the cross benchers; I will be taking my own advice and getting to know Shadow Minister Butler as soon as possible and I will continue working with Shadow Minister Bowen as it relates to health and I hope my colleagues across the sector will as well.
Dr Arnagretta Hunter, Human Futures Fellow at ANU
I’ve spoken to Mark Butler and Chris Bowen about climate change and feel both of them understand the magnitude of the challenges we face in terms of climate change and both are articulate on health and climate.
We should all focus on helping, supporting and encouraging the ALP to come to terms with the need for visionary leadership on a climate change strategy. Rather than focus on politics and individuals, we should focus on policy and the potential for better policy. As an electorate, as a community of voters, we are tired of the internal political stuff, the micro focus; I think journalists have to get used to this.
We are much more keen to see a solutions framework emerge from our politicians. What matters is the policy framework they develop and how well they can articulate that. Chris Bowen can do that just as well as Mark Butler.
The commitment to climate action of senior leadership in the Biden Administration is powerful, especially their solid articulation of the threat of climate change. We can manage problems much better once we name them. When Government doesn’t even use the words ‘climate change’, it undermines our capacity for both mitigation and adaptation. I have to be optimistic that the Biden Administration presents the ALP with an opportunity to reframe and take a visionary perspective.
We can encourage them to be bold in terms of the climate strategy going forward. There has never been a greater need in Australia’s history for articulating the future, for seeing the landscape of challenge and threat that we might need to move through and how we might get to a great place.
I don’t think either side of politics is doing that. I’d love to see a solid articulation of a strategy for the next couple of decades…to create our best future.
If the ALP does release a significantly weaker climate change policy I will be the first to criticise, but until that happens we shouldn’t get ahead of the game.
Mark Butler has the potential to be a great shadow Health Minister. The fact he understands climate change policy is tremendously helpful in terms of the health portfolio; his understanding of the aged care sector is very important.
Aged care is one of the other areas where the Federal Government performance really needs to improve; having someone in that portfolio with a personal and professional interest is an advantage.
Associate Professor Lesley Russell, Menzies Centre for Health Policy, contributing editor at Croakey Health Media
Key to the ability to develop, sell, implement and manage policies in critical areas like health and climate change are the ability to have a long-term vision, to take a whole-of-government approach, to listen to what voters want and need, to have an institutional memory – and to do the hard work that is involved.
The exchange of shadow portfolios between Chris Bowen and Mark Butler has the potential to boost the Opposition’s ability to offer real alternatives and substantive critiques of current government positions.
While Bowen acquitted himself effectively in the Health portfolio (always difficult to influence from Opposition), he did not really capitalise on the ability to integrate his economic expertise into his work; he has already shown his ability to do this with respect to climate change. Butler, who has held ministerial positions in aged care and mental health might be a better fit for Health, especially with both these issues high on the agenda.
But if these two Shadow Ministers can work together inside the Shadow Cabinet, with their colleagues on the back bench and with allies outside of Parliament, then they can deliver real value in offering substantive alternatives for policies in the environment, climate change, and health.
Their combined experience and expertise can help move the focus of the Health portfolio beyond a very clinical approach focused on illness to one that addresses prevention, individual and community wellbeing, health disparities, the intrinsic links between the environments in which people live and their health outcomes, and the economic benefits that derive from this.
Gabrielle O’Kane, CEO, National Rural Health Alliance
There are growing calls from across the health sector for action on climate change.
The consequences of climate change are increasingly impacting the health of Australians, and in particular people in rural and remote communities. It’s an advantage that both Health and Climate Change Shadow Ministers share an understanding of the growing health implications of climate change. The Alliance is encouraged that the switch in portfolio responsibilities will put health and climate issues at the forefront of Opposition policy development.
This month the Alliance released a key position paper addressing three emerging health issues directly related to climate change which will affect all Australians, but will have a disproportionate impact on people living in rural and regional areas.
We’re calling for urgent action from the Government and Opposition to recognise that the cost of inaction on climate change will be much higher than the cost of action, and that inaction will have serious implications for the health of current and future generations of Australians.
Dr Tim Senior, GP and contributing editor at Croakey Health Media
The Bowen/Butler swap for climate change is interesting. I don’t think I know enough about either of them to make a judgement.
However, I suppose my lack of awareness is significant. Some of the reporting I have read includes more of the horse-race, soap-opera-style insider political reporting about who is from what faction, and how this shores up Albanese’s support, and interpretation in the light of a coming election. Of course that’s part of the story.
But I would like to know about policy outcomes – we need to reduce emissions quickly, we need to have policy that reaches and exceeds the Paris agreement, we need policy that will get us there, and we need people who can argue for those policies in a way that touches people. Whatever voters care about it will be affected adversely by not acting on climate change – health, the economy, security, the armed forces, agriculture, sport, coffee, education….
Can Chris Bowen do that? I don’t know. Apparently he’s argued for a Green New Deal, so maybe he can. That is what he will be judged on, and what Albanese will be judged on.
However, I suppose none of this matters if they don’t win an election, so to some extent that’s where the reporting of the soap opera and tactics comes in, but I do think that’s an enticing distraction.
Jennifer Doggett, Croakey editor and Fellow of the Centre for Policy Development
Labor’s reshuffle was prompted by political rather than policy concerns, primarily the need to shore up Albanese’s leadership by placating right faction concerns about emissions targets.
These political considerations are likely to dominate Labor’s agenda leading up to the next election, making it unlikely that Mark Butler will deviate from the “policy lite” approach of his predecessor Chris Bowen.
Prior to Bowen, Catherine King had performed well as shadow minister, taking a well-thought through and strongly supported policy platform to the last election. Labor’s election defeat has unfortunately damped party strategists’ appetite for undertaking major policy reforms in opposition.
This is a shame as Butler’s previous political experience (as a Parliamentary Secretary for Health and a Minister for Mental Health and Ageing, Social, Housing and Homelessness, Climate Change and the Environment) makes him ideally placed to push Labor to take on some of the major policy challenges of our time, including a greater recognition of the social and environmental determinants of health.
While this “go slow” approach is disappointing from a policy perspective, this is probably sensible politics. It’s tough for Labor to gain any traction on health in the current pandemic environment where (despite some mis-steps and far too much hand-balling to the states) the Federal Government is seen as performing well.
Aged care offers Labor the best opportunity for Butler to build his profile in this portfolio so it’s likely his initial focus as Shadow Minister will be on highlighting the clear government policy failures in this area and promoting Labor’s alternative approach.
Other reform issues are likely to be put on the back burner until after the election where a Labor win could provide the next window of opportunity for tacking the many long-overdue reforms needed in this sector.