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Ministerial reshuffle creates historic opportunities for health

In what is thought to be a first for Australia, an Indigenous Minister will take on a health portfolio, following the Federal Ministerial reshuffle announced by the new Prime Minister, Malcolm Turnbull.

Ken Wyatt, the first Indigenous Member of the House of Representatives and the Federal Member for Hasluck in Western Australia, has been appointed Assistant Minister for Health.

Sussan Ley remains as Health Minister, while Fiona Nash is now the Minister for Rural Health, and Nigel Scullion continues in the Indigenous Affairs portfolio.

Wyatt has considerable experience working in the health sector, including as the District Director for the Swan Education District and as Director of Aboriginal Health in Western Australia.

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The other significant news for those with a concern for public health is that there is a new Ministry – for Cities and the Built Environment (other reshuffle details are here.)

Time will tell whether public health advocates are able to engage effectively with the new Minister, Jamie Briggs.

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The health portfolio announcements have been generally welcomed, though there are concerns about gaps in the ministry, including the lack of specific coverage of disabilities and other areas.

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In announcing the new Ministry, the PM promised a “21st Century Government and a Ministry for the future”, as well as a focus on investing in science, and supporting start ups. There was very little focus on health matters during his media conference.

Reaction and commentary

Professor Tom Calma, social justice and human rights advocate

The new Ministry is an interesting line-up of untried and accomplished ministers and assistant ministers.  What is important in Indigenous affairs is for consistent policy and programme application.  While we might not agree with policies all the time, radical changes in policy and programmes causes mistrust, despondency, and general complacency in Indigenous affairs.  This is the major issue that retards advancement for Indigenous Australians.

Therefore it is encouraging to see ministers like Ley, Scullion and Nash holding their portfolio responsibilities.  All three have engaged with myself and colleagues to develop advancement in Indigenous health and particularly mental health, suicide prevention and social and emotional well being.  These works in development will pay real dividends if they are allowed to reach maturity that will happen in the next 12 to 18 months. Then the real work of implementation, in collaboration and leadership with Indigenous people will commence.  Ley, Scullion and Nash have witnessed the good will and partnership aspirations of the National Health Leadership Forum (Indigenous Health Peak Bodies) so hopefully their retaining their portfolios will enable the momentum to be maintained and increased over time.

Ken Wyatt’s appointment is a real winner.  Ken has a strong background in Indigenous health and health generally, and his willingness to work across portfolios and parties for sensible and real outcomes will be a big plus. I get the sense that with the flush we will see the government move away from the  retrospective approach of the former government to a futuristic vision that will not be handicapped by negative politics.  The Turnbull Government should not be constrained by the rhetoric of the Abbott ministers, who encumbered themselves to positions while in opposition then they could not divorce themselves of such public rhetoric.

***

Michael Moore, CEO of the Public Health Association of Australia

The PHAA welcomes the re-appointment of Sussan Ley as Health Minister and is pleased to see the promotion of Senator Fiona Nash to Minister for Rural Health.  Minister Ley has had an open door policy and we look forward to continuing engaging with her.

In congratulating Senator Nash it is important to recognise that, although the PHAA had a bumpy start, we have worked closely with the Senator across a wide range of issues in the preventive health area and health promotion.  There are great challenges ahead in rural health and we look forward to engaging with the Minister particularly in the areas of primary health care, alcohol and other drugs and prevention.

It is particularly exciting to welcome Ken Wyatt as Assistant Minister for Health. The greatest challenge for Australian health is in understanding and implementing change around the social determinants of health.  This has most impact for Indigenous people.  Having an Aboriginal person as the Assistant Minister with this responsibility and the type of engaging personality to reach out to other ministers is critical.  The PHAA is keen to work with Mr Wyatt to build on the work we have done with Ministers Nash and Ley.

However, there are some significant challenges that have arisen for all of the health ministers with the appointment of the new ministry.  With no ministers for housing, mental health, disabilities or climate change, a considerable extra weight of responsibility falls on all the health ministers to ensure that sensible policy continues to be developed in these areas.  Without attention to housing, mental health, disabilities and climate change a long-term approach to ensuring a healthier community will be significantly undermined.

***

Professor Lesley Barclay, former chair of the National Rural Health Alliance, and a professor of rural health, the University of Sydney

I couldn’t be more delighted – to have a minister for rural health, who lives rurally, and to have an Aboriginal man, Ken Wyatt, in the Ministry. The NRHA have just met with Minister Ley and Nash, and we were extraordinarily impressed with their responsiveness. Nash also met with the university department of rural health. Their concern and their listening are outstanding. I’m utterly delighted to work with all these ministers. Turnbull’s appointments in health have been quite outstanding, I think.

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***
Dr Lynore Geia, James Cook University

The appointment of Ken Wyatt is significant, and it’s a good move that we have an Indigenous Minister for Health, working alongside the other Ministers. He will bring the Aboriginal perspective to the Ministers with whom he will be working, and will be a valuable resource for both Sussan Ley and Fiona Nash. He will bring the importance of being inclusive of family and the holistic health of community into health services paradigms. There is no Minister for Mental Health but I would be confident Ken Wyatt could bring a mental health perspective for the Indigenous community.

The advantage of Nigel Scullion is continuity; we don’t have to get to know another person again. It gets to us, having a new minister and everyone has to go and lobby and negotiate. Consistency is important. He has had some good track record. I think he’s been a committed Minister working with communities that are affected by petrol sniffing, and that’s encouraging for us out there who are in communities. Mental health needs to be on the agenda, and disabilities and housing are all significant factors impacting on peoples’ health across all communities. I’d like to see health more on the agenda with this Government.

I hope the PM respectfully engage with Indigenous communities and genuinely sits at the table and listens to peoples’ voices, and not thinking he’s an expert in it. Just come to the community and talk to people and find solutions together.

***

Jason King, chair, VACCHO

Ken needs to start liaising with NACHHO and State Peak Aboriginal Health bodies to fully understand what is going on in health for Aboriginal services. Ken needs to remember that he can make a lot of change, should he deem it necessary, as I believe Malcolm will empower him to make it right for Aboriginal communities. Christopher Pyne must realise that his portfolio needs true leadership & he is going to need to LISTEN to his sector leaders and the fact there is no Mental Health minister shows the fact we have a prime minister in name only and he has acted too fast. Malcolm needs to return alcohol and drugs, Mental Health and social and emotional well-being issues to Health – these are health issues not Prime Minister & Cabinet.

***

Summer May Finlay, public health researcher, Croakey team member

Aboriginal and Torres Strait Islander Affairs has seen a massive upheaval in areas such as health and social services since the Coalition Government was elected. With a number of reviews also underway which will impact health, such as the Review of Federation, the Medical Benefits Scheme review, and the Senate Select Committee into health, more upheaval is likely.

Maintaining Sussan Ley and Fiona Nash in the health portfolio is welcome when there is so much uncertainty in Aboriginal and Torres Strait Islander affairs. Consultation with Aboriginal and Torres Strait Islander peak health bodies is essential.

The appointment of Ken Wyatt hopefully signifies a reinvigorated focus on Closing the Gap policy. Since the coalition’s election, there have been few Aboriginal and Torres Strait Islander policies that could be described as primary health care policies. Ken Wyatt is well respected among Aboriginal and Torres Strait Islander people, and I would expect that he would be consulting communities and Aboriginal and Torres Strait Islander peak organisations on how to progress with the Closing the Gap targets.

A Ministry of Cities and the Built Environment could bring huge opportunities. The introduction of this portfolio brings an opportunity to focus on creating more livable cities that encourage walkability and functionality. Additionally, a focus on improving areas where there are high levels of disadvantage should be a priority. Most Aboriginal and Torres Strait Islander people, like the majority of Australians, live in cities. Disadvantaged groups such as Aboriginal and Torres Strait Islander people tend to live in the most disadvantaged areas of cities.

To improve the lives of the most disadvantaged, a focus on creating built environments which improve opportunities would benefit all. Working with the states and territories to improve public transport, increase community services, improve housing affordability, and reduce the number of fast food chains in these areas are just a few examples of the improvements that would benefit the most disadvantaged.

***

Stephen Leeder, Emeritus Professor of Public Health and Community Medicine
, the University of Sydney

The new ministry is consistent with Turnbull’s statement that he was not going for radical change, but it is assuredly different and, as you would expect, its composition appeals to me.

Sussan Ley has been successful as health minister and retaining her, especially in the middle of reviews of PBS and MBS and primary care, makes excellent sense.  She has been consultative, responsive and thoughtful. Splitting rural health off may be a good thing for the Nationals, I suppose, but makes little prima facie sense, at least to me, so I hope that works out. Not sure.

Ken Wyatt is an interesting man – with his experience in Indigenous health and his heritage he should be a strong advocate in his new position.  That he comes from WA is a further advantage.

Mental health never works when it is a separate entity so having no minister specifically for it is good.  The last thing we want is another commission, committee or inquiry into mental health that comes up with a clever title (Mental as Anything, for example) for a 500 page rehearsal of all that we know and then achieves nothing.  We need action. The health triumvirate could get their boots on over mental health and make a difference – including in rural and Indigenous communities.

Good to see an assistant minister now for cities and the built environment.

Not sure what a minister for climate change would do. He or she could knacker environment and so get nothing done.  I don’t see it as a serious omission.

Dutton, who made such a fearful hash of health and seems error prone in immigration remains in immigration.  I suppose that is because he comes from Queensland there is sense in retaining him.

It is good to see the word science back in currency.

***

National Rural Health Alliance statement

Today’s announcement by Prime Minister Turnbull promises an important and very welcome boost to the Australian Government’s work to improve the health of both rural/remote and Aboriginal and Torres Strait Islander people.

Fiona Nash’s appointment as Minister for Rural Health is to be applauded.  Minister Nash has proved her commitment to better health for people in rural and remote areas and will now be able to focus more strongly on this.

It is made possible by the appointment of Ken Wyatt as Assistant Minister for Health.  Ken Wyatt will presumably have responsibility, under Minister Sussan Ley, for the health of Aboriginal and Torres Strait Islander people.

There will not be a person in the land who does not welcome the appointment of an Indigenous man with high level and direct experience of the health sector in two States as the responsible Minister for the health of Aboriginal and Torres Strait Islander people.  He will have the support and good will of everyone in his endeavours to meet Australia’s greatest unmet social challenge.

The Alliance notes the comments by Prime Minister Turnbull about the infrastructure and human capital of Australia’s cities having been, in some respects, ignored.

“That is of course what rural people feel much of the time about their national Government,” said Gordon Gregory, NRHA Chief Executive Officer.

“I am sure that the Prime Minister’s references today apply, in his mind, just as much to rural and remote people and industries as to the cities,” he said.

“Working with Minister Ley, Fiona Nash and Key Wyatt will be able to build on the Prime Minister’s views about the value of human capital and the need to integrate policies across the board for productivity and wellbeing in rural and remote areas.”

The Alliance looks forward to continuing its work with Ministers Ley and Nash and to developing a close working relationship with Assistant Minister Wyatt.

Reaction via Twitter

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