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#Tasvotes: Milestones in the journey to getting social determinants, health & wellbeing on the political agenda

In a second Croakey post for Saturday’s Tasmanian election, Graeme Lynch, CEO of the Heart Foundation in Tasmania, describes the results of concerted advocacy campaign over the past five years in Tasmania to convince political parties to address the social determinants of health.

Lynch believes the campaign has generated a paradigm shift in thinking towards a health in all policies approach in Tasmania – from each of the three main parties.

Below he describes the milestones in the campaign, including the creation in 2012 of a Joint Parliamentary Select Committee to examine the causes of poor health and wellbeing in Tasmania – which unfortunately did not report its findings before tomorrow’s election.

See also the tables below which list each party’s commitments – at key points in the campaign cycle – to a Health in All Policies approach.

***

Graeme Lynch writes:

Prior to the 2009 Tasmanian state election, a group of non-government organisations collectively called for a fairer Tasmania, and action on the social determinants of health under the banner of the Tasmanian Council of Social Service’s Our Island Our Voices campaign.

As a result of this campaign, statements of tri-partisan support from the three Tasmanian political parties were obtained (see Table 1), in varying degrees of specificity to:

  1. adopt a paradigm shift in thinking towards a Health in All Policies approach
  2. establish a Health in All Policies taskforce
  3. invest further in the funding of health and well-being and chronic disease prevention.

Following the election, the Health in All Policies (HiAP) Collaboration was established to continue advocacy on these actions. The HiAP Collaboration noted at this time the significant work being undertaken internationally in this area, but also the Health in All Policies work occurring closer to home in South Australia, which – interestingly too, heads to the polls this weekend.

Members of the HiAP Collaboration include:

  • Tasmanian Council of Social Services
  • Tasmanian Branch of the Public Health Association Australia
  • Members of the Tasmanian Chronic Disease Prevention Alliance:
    • Heart Foundation (Tasmania)
    • Cancer Council Tasmania
    • Diabetes Tasmania
    • National Stroke Foundation (Tasmania)
    • Arthritis Tasmania
    • Asthma Foundation (Tasmania)
    • Kidney Health Australia (Tasmania)

Subsequent to the 2009 election, all parties and independents in the Tasmanian Parliament have continued to engage with the HiAP Collaboration around Health in All Policies approaches.

The HiAP Collaboration’s advocacy efforts resulted in the Tasmanian Government initiating the Fair and Healthy Tasmania Strategic Review, which led to the release of A Healthy Tasmania: setting new directions for health and wellbeing and subsequently, to the establishment of the Ministerial Health and Well Being Advisory Council in Tasmania. Appointed by the Tasmanian Health Minister, the Council’s  purpose was to provide advice to the Tasmanian Government and the broader community on the best ways to improve health outcomes and reduce health inequities in Tasmania. The Council has since provided its final report to the Minister, with the Tasmanian Government providing its response in February 2014.

The HiAP Collaboration saw the establishment of this time-limited Advisory Council as positive; however it continued to call for an ongoing model for intersectoral action to address the social determinants of health in Tasmania.

In April 2012, the HiAP Collaboration (supported by Catholic Health Australia), hosted a forum for Tasmanian state and federal members of parliament, their advisors, heads of departments and senior staff, elected mayors of local government, as well as members of the business community. International experts on the social determinants of health provided an overview of their current thinking of what could and should be done.

Following the forum, participants were encouraged to:

  1. call on the Tasmanian Parliament to support the establishment of a joint parliamentary select committee to examine the causes of poor health and well being in Tasmania; and
  2. call on the Federal Parliament to support a Senate Committee inquiry at a national level.

As a result of this advocacy work, the Tasmanian Parliament established the Joint Parliamentary Select Committee (after amendment in the Upper House of the original motion). Snippets of the positions of each political party on the issue can be seen in Table 1. The Committee has since received both written and oral submissions and was due to report its findings prior to the 2014 election; however this unfortunately has not occurred.

In the tables below, we have tried to capture the responses of all three parties along the different stages of our advocacy work, though they obviously cannot capture everything. What they really don’t adequately show is what I have been able to witness over the last four and a half years of advocacy in this space. That is, that there appears to have been a definite paradigm shift in thinking towards a health in all policies approach in Tasmania (whether it be called that, or another name), with all parties agreeing that you don’t get health and wellbeing from the health department – it is what is achieved when a whole-of-government approach is taken.

Just a few weeks ago, the Heart Foundation again called on the three major political parties to respond (among other things) to an increase in investment to the prevention of ill-health. Their responses again, can be found in Table 1 below.

Whilst it is unknown what the outcome of Saturday’s election will be, it is clear that all three major parties now know what social determinants of health are, and that whole-of-government action is required to improve the health and wellbeing of Tasmanians.

For more more reading on the South Australian and Tasmanian elections to be held on 15 March, see:

Tasmania: Joining the dots to find anything resembling a social determinants of health policy
South Australia: We want to control health costs but we’ll keep feeding the beast that fuels them

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