Could our political leaders develop economic policies aimed at achieving better health, social and environmental outcomes?
Could we develop a food system based on principles of health and environmental sustainability?
Could the next Federal Government make one of their first announcements the appointment of an Indigenous person as Minister for Aboriginal Affairs?
Could we reform health services so that those in greatest need – for dental care, for example – have best access?
Could we ensure safe and secure housing is available to all people discharged from health services, especially those with mental illness?
Could Australians voting this weekend think of the health and wellbeing of future generations, rather than just their own hip pockets?
These and other transformative possibilities were flagged by participants in the recent #AusVotesHealth Twitter festival, as outlined below in our final report from the event. The article below follows the order of the Twitter festival program, and includes contributons from Professor Fran Baum, Professor Stephen Duckett, Dr Simon Judkins, Professor Sharon Friel, Associate Professor James Ward, Dr Lesley Russell, Kate Colvin, Professor Marc Tennant, Dr Ewen McPhee, Professor Melissa Haswell, Senator Richard di Natale, Paul Dutton, and others.
See our previous reports here.
Governing for Health
Professor Fran Baum AO, Matthew Flinders Distinguished Professor of Public Health and Director of the Southgate Institute of Health, Society and Equity at Flinders University.
@baumfran, @crehealthequity
Today I’ve been meeting with Rumbalara community controlled health service and again so impressed by what they do. Massive investment needed in NACCHO services.
My book Governing for Health includes a Manifesto for Wellbeing – a guide for any political party which wants to govern for health of the planet & people rather than profit for corporations.
Public not private services are usually cheaper and provide better service.
Next point of Manifesto we need to see taxation as investment in our collective health and wellbeing and crucially in equity.
Don’t believe those who say low taxation if good because it is good only for those at the very top!
What are the major policies promising on health this election?
Professor Stephen Duckett, the Grattan Institute @stephenjduckett, @grattaninst.
Read more.
Those acknowledgements of country should not be simply issues of rote, but should remind us of the continuing disadvantage faced by Indigenous Australians, see here.
Overall Australia has a good health system, however you measure outcomes.
Here at the Grattan Institute, we’ve done our priorities for a new government in an Orange Book to parallel the Red and Blue books developed in the public service. We had to prioritise, partly based on where the direction for change was clear.
One really important area where reform direction is not clear is primary care. The evidence is mixed, but clearly we probably need payment reform and new ways of delivering services, and yes, more $$. See here.
We’ve just released a report on dental care – one of the big gaps in health care provision… Really pleasing that Labor has announced a big investment here, so too the Greens. More than two million Aussies miss out on dental care because of cost.
Primary Health Networks have a big role in the social determinants of health. What we said in Orange Book ‘Empower & instruct Primary Health Networks to work more closely with their local communities to change factors which contribute to ill health’. Drawing on this, see here.
Rural and remote is a big issue, partly driven by Indigenous status. The answer is to work with communities to address the causes and the causes of causes. Marmot’s work is a place to start.
Social justice – it’s a health issue
Dr Simon Judkins, Australasian College for Emergency Medicine
@JudkinsSimon, @acemonline
Patients presenting to regional, rural or remote Emergency Departments (EDs) have the same right to timely care as city patients. EDs have a strong role to play in delivering of specialist emergency care
ACEM works across Australia to develop, strengthen and support a skilled and confident workforce of emergency doctors in rural, regional and remote areas through the EMET Program, EMC/EMD training and the IRTP initiative.
EMET provides education, training and supervision to GPs, nurses, paramedics and allied health workers to develop their skills in treating critically ill or complex trauma patients. EMET training saves lives.
Each year more than a quarter of a million people seek help from an ED for their mental health.
People who present in mental health crisis are the group most likely to wait more than 24 hours for admission to a mental health ward.
Aboriginal and Torres Strait Islander people are over-represented in populations presenting to EDs seeking support in a mental health crisis
The national shortage of psychiatric beds and mental health services exacerbates the wait for access to appropriate care.
ACEM has released its Mental Health in the ED Consensus Statement to improve mental health care. Read it. Sign it.
“Consumptagenic” threats to health
Professor Sharon Friel, Director, School of Regulation and Global Governance (RegNet) and Professor of Health Equity, ANU College of Asia and the Pacific
@SharonFrielOz
We cannot improve health inequities through the health system alone. Trade, social, labour, education, planning, infrastructure policies each affect physical and mental health inequities.
Who benefits and who loses? Can all politicians ask themselves that question when deciding on policy. It matters for health equity. But of course it assumes they care.
For what purpose? When developing economic policies ask if they will achieve better health, social and environmental outcomes. No more perpetual economic growth as the end goal.
Great to see the political campaign focus on climate change. Remember that climate change, inequality and health inequities are tightly interconnected.
To address health inequities means addressing climate change, which means addressing the common underlying drivers – consumptagenic systems.
Consumptagenic systems are the institutions, policies, and values that are responsible for the exploitation of natural resources, excess production and hyperconsumerism that are harmful to the planet, entrench social inequalities and cause poor health.
Consumptagenic systems rely on people wanting to consume what the system produces, otherwise economies will not grow and wealth will not be accumulated. This creates excessive consumerism.
We need to talk about food systems – not as production and export machines but as a powerful way to improve human and planetary health.
the industrial food system and the influence of food and beverage corporations have profoundly altered what and how food is produced, distributed, and marketed within and between countries.
In Australia we now have an excess availability of foods to consume that are high in refined sugars, refined fats, and red meats. This is not good for NCDs.
Not only is it risky for NCDs. The industrial food system contributes globally to around 25 percent of all GHG emissions.
Politicians, lets ensure our food system is based on principles of health and environmental sustainability. Currently it is not.
Every politician should read @KateRaworth’s book, Doughnut Economics. To achieve social, health and environmental justice, we must operate within a Social and Planetary Boundaries Framework. Sounds like a good whole of government policy framework to me!
When asked, “Where should politicians begin: how do we get that fundamental shift rather than tiny steps?”, Friel replied: “Politicians, let’s ensure our food system is based on principles of health and environmental sustainability. Currently it is not.”
What do we want, when do we want it by? The first 100 days
Associate Professor James Ward, SAHMRI
@researchjames
Day 1 – First things first – how about an Aboriginal Minister to run Aboriginal Affairs-imagine that!! So overdue -we’re almost in the 2020s.
At day 5 – Genuine commitment to Close the Gap; include not only conditions that cause early death but all the conditions that make us sick. First step, all our health matters be put back in the health department.
Day 90 – EYYYAH— all us black fullas finally get our free car, house, scholarship, dog and One Nation is gawn, Tony Abbott’s gaaaawn, Nigel’s gawn, Izzy’s fully redeemed and @wildblackwomen make it big on the global stage!
Wrapping the election health news
Dr Lesley Russell, health policy analyst, contributing editor at Croakey News
@LRussellWolpe
In my segment, keen to explore, not details of individual policies, but the bigger picture – what is needed to get meaningful action on health/healthcare reform. Writing policies on paper is easy (I know, I’ve done that). Delivering them at the coal face is hard.
From my perspective, Labor has a suite of policies, the Coalition promises more of the same with narrow focus on hospitals, prescription drugs, biomedical research. Professor Stephen Duckett summed it up well for The Conversation.
Lots of room to point out what has not been offered to date policy-wise – will we see more health policies in tonight’s leaders’ debate? Also valid criticisms about the policies that have been offered to date – too much focus on hospitals.
Concerns that more must be done on prevention and primary care – that would help relieve burden on hospitals.
Fingers crossed Labor will push for innovation and sustainable investments in big reforms via Australian Health Reform Commission.
Coalition is just promising more of the same. 2019 Budget had Health Care Homes 2.0 – but have you heard Health Minister talk about this? Maybe as doomed to failure as HCH1.0? In fairness, ALP has promised more funds for HCH but not promoted this.
Things I would like to see analysed, discussed, policies, actions from next Government: Out of Pocket (OOP costs); social determinants of health (especially housing) in health policies; what’s fair government subsidy for aged care for wealthy Aussies; how to integrate mental health, substance abuse into primary care; workforce planning.
Where is workforce in election? Crucial to expanding dental care and mental health services, addressing rural disadvantage; quality and safety in aged care. Appropriately trained people working to full scope of practice keep costs down, help with burnout, improve access.
Best thing in this election campaign? ALP putting respect, honour, recognition for First Nations Australians and commitment to partnerships to address their issues and needs up-front at their campaign launch. Plus promise of Pat Dodson to Indigenous Affairs.
That’s the sort of vision, leadership I want to see in health. That’s what will really help the solve the issues.
In terms of getting things done on health/healthcare my exemplar is Dr Neal Blewett. There was a Minister for Health who could deliver on multiple fronts – and he had support from PM and Treasurer of the day. Vision, leadership, innovation, commitment.
Keep tweeting and retweeting and pushing for the very best in health / healthcare policy. (Don’t let the perfect be the enemy of the good.)
Everybody’s Home
Kate Colvin, Spokesperson for the Everybody’s Home campaign, and Manager – Policy and Communications, Council to Homeless Persons
@ColvinKate, @CHPVic
I’m tweeting from Wurundjeri and Boonerung country. I’d like to acknowledge the traditional owners of these lands and elders past, present and emerging.
It’s common misconception that homelessness is primarily caused by mental illness. Research shows that homelessness precedes mental ill health more than following from it.
Children who experience prolonged homelessness are especially susceptible to repeated experiences of homelessness later in life. That’s why rapid rehousing is so important for homeless families.
Delivering #HousingFirst (housing plus support) to people who have been homeless long-term results in better health – and fewer hospitalisations and emergency visits!
Housing instability and homelessness in early life has negative consequences for child development and mental health. That’s why we need to deliver housing families can afford!
Check out what the major parties are offering around homelessness. There are some crap things, some good things, and some that would be good if they were not so teeny tiny! I’m sorry to say that so far the Liberal policy to deliver social housing and reduce homelessness looks a lot like this!
But I have hope, there are 10 more days. Please can we have a plan to end homelessness.
Snaps to Australian Labor for committing to this big housing plan for 250,000 affordable rentals – if the states add in extra money to make it social housing, it will be the change we need.
Neither the Liberals nor Labor have committed enough to house women and children fleeing family violence, though the Labor commitment is a lot bigger. Check them out – Liberals statement; Labor’s statement.
Talking Teeth
Professor Marc Tennant, UWA
@MarcTennant
I have spent three decades working in and around dental health/public health and innovation in Australia and other places.
We are a team of many, many people from all over earth – there is more than 100 people working on things with us; from Jeddah to Utah and everywhere in-between.
We have graduate students focused on addressing inequality and building systems to reform health care in Australia and across the world.
A big focus of our effort is Aboriginal health. We are one of the early teams to work on addressing issues of rural and remote dental health care access for Aboriginal people.
A crazy (in today’s thinking) simpl