The Health Wrap: Conflict on the menu, closing the gap, the price of disadvantage, policy conundrums

By Kellie Bisset

Conflict on the menu

Conflict of interest has featured heavily on the health agenda this past fortnight and the story of the hour is the controversy over Assistant Health Minister Fiona Nash’s office pulling down a government-approved healthy food rating website just hours after it went live.

Central to the debate is Nash’s chief of staff Alastair Furnival, who resigned after it was revealed he had links to the food industry through his involvement in the companies Australian Public Affairs and Strategic Issues Management. Gary Sacks covers the issue of Big Food and government influence in this piece posted on both Croakey and The Conversation. And this article by SMH health reporter Amy Corderoy claims the companies also have links with the alcohol industry. The story questions what role Furnival had in the recent decision to defund the Alcohol and other Drugs Council of Australia (ADCA) after 46 years of operation. The Guardian also looks at the issue of Furnival’s association with both companies and a further SMH piece explores his links with Cadbury and a government funding deal to upgrade one of its factories.

Public Health Association of Australia CEO Michael Moore told AM and the SMH that ADCA should be reinstated and the healthy food  website should be returned to give consumers a fighting chance to make sound judgements about what’s in their food. And writing in the SMH, Professor of Health Policy at Curtin University Mike Daube argues that the spotlight will now be on Fiona Nash and her performance in helping to reduce the huge toll from tobacco, alcohol and obesity. The Greens and Labor will be keen to keep the issue running – the SMH reports they plan to pursue Senator Nash in Senate Estimates hearings next week.

The Conversation looks at public-private partnerships more broadly with this perspective on relationships between government and the food industry.

And you can read a statement from Australian Public Affairs here. It says Furnival had resigned as chairman when he took up the position with Fiona Nash and was in the process of divesting his shares. Furnival has denied any suggestion he acted improperly.

The story follows on the heels of publicity over a $15 m partnership deal between La Trobe University and the Swisse vitamin company to help establish  complementary medicine research centre. The deal saw La Trobe academic Dr Ken Harvey resign in protest. See a summary in the last Health Wrap here. Since then, The Conversation ran this article about the need for alternative medicine research to be publicly funded.

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Sugary drinks and the question of cost  

More interesting food news comes from California, where a bill has been proposed to put label warnings on sugary drinks. This article on townhall.com gives an overview, though it describes the proposed legislation as a nanny state bill. 

In New Zealand, health researchers are calling for a 20% tax on sugary beverages, which is interesting in light of new research from the American Journal of Public Health showing higher prices for healthy food are associated with higher blood glucose levels in people with diabetes.

Controversy over a research paper on the ‘Australian sugar paradox’ has also emerged. Australian Food News reports the University of Sydney has launched an inquiry into the paper, which contended that sugar intake declined in Australia at the same time as obesity levels had risen. Data used in the paper has been questioned and was the subject of a recent ABC Background Briefing report.

The latest issue of Harvard Magazine meanwhile, reports on a meta-analysis from its researchers published late last year in BMJ Open, which shows that a healthy diet, while out of reach for a proportion of people, is not as expensive as some might think.

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Closing the Gap report released 

Repeatedly stating our commitment to progress – and measuring our lack of it – does not actually make that progress happen, writes Elizabeth Strakosch for The Conversation. Her comments come in the wake of the latest Closing the Gap report, and she asks whether Prime Minister Tony Abbott will be able to “walk the walk” in addressing the issue of Indigenous health disadvantage. Michelle Grattan asks some similar questions.

New Matilda meanwhile, looks at the PM’s speech on the report, arguing that his focus on school attendance rates is a much easier issue to highlight than the national shame of Indigenous incarceration rates.

The NACCHO website carried a piece from Angela Webb, from the Secretariat of National Aboriginal and Islander Child Care, which said that to make real progress in closing the gap requires action to be taken when the gap first appears.

And Croakey collected a series of resource links – available here – including a Guardian opinion piece from Closing the Gap Co-chairs Mick Gooda and Kirstie Parker, which called for sustained political commitment.

Just days later, Padriac Gibson, also writing in The Guardian, chronicled recent federal government cuts to Indigenous specialist services – a move he said would directly impact on the health of Aboriginal children.

Criticism was also directed at a new federal parliamentary inquiry inquiry into harmful alcohol use in Aboriginal communities. Inquiry chair Sharman Stone told the ABC that Indigenous people were not being singled out as the only group to be affected by harmful alcohol behaviours, despite initial plans for the inquiry to be far ranging and related to all sections of the community. However, there is hope in some quarters that the inquiry will yield some positive results. NACCHO Chair  Justin Mohammed told SBS that the  inquiry was a good opportunity to examine what policy approaches have and haven’t worked at combating alcohol abuse in Indigenous communities.

Meanwhile, ANU has launched National Centre for Indigenous Genomics, which aims to help improve health outcomes by analysing the role of genetics. Aboriginal and Torres Strait Islander social justice commissioner Mick Gooda will chair the governance board of the centre, which will work collaboratively with Indigenous communities, the ABC reports.

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The price of disadvantage 

The seemingly small amount of $5 would represent an insurmountable barrier to healthcare services for some patients, the Senate Inquiry into the Commission of Audit has heard. This article on Croakey from Jennifer Doggett discusses a Consumers Health Forum survey on co-payments in the health system that was presented to the inquiry.

Croakey also highlighted a new report by Sharon Friel and Richard Denniss Unfair economic arrangements make us sick, which looks at the link between financial inequities in Australia and health outcomes.

Internationally, the Independent reports that UK GPs are referring an increasing number of people to foodbanks — and research funded by the Wellcome Trust shows men who are unemployed for more than two years show signs of faster ageing in their DNA.  Harvard Professor of Public Health David R. Williams is giving a series of talks to physicians in Canada about the impact of discrimination on health. Evidence shows discrimination has emerged as a major risk factor for disease, he told Canada’s The Chronicle Herald.

And an interesting story on Medical News Today discusses a joint commission from The Lancet and Norway’s University of Oslo, which finds that global power imbalances are failing to protect public health and must be reformed.

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Policy conundrums

Health Minister Peter Dutton has signalled major changes are on the way to curb healthcare spending costs, floating the idea of patient co-payments as one potential option to meet future financial challenges. Jennifer Doggett outlines some of Croakey’s take-home messages from the Minister’s speech to the Committee for the Economic Development of Australia conference.

The Grattan Institute’s Stephen Duckett argues that asking the rich to pay more for their healthcare is not necessarily the best answer. In another piece for The Conversation, he says the government’s shaky start on health does not bode well for reform.

Whether any of the predicted government savings will come from Medicare Locals still has the health community talking. Croakey features this piece looking at the public relations battle ahead for Medicare Locals in the face of opponents determined to paint them as a bureaucratic waste of taxpayer dollars.

Stories of on-the-ground success – such as this example of regionally driven health reform from the Hunter – continue to emerge. How much traction they get and with whom will be central to driving the discussion forward. 

On the subject of regional solutions, Dr Jennifer Bowers, from the Australasian Centre for Rural and Remote Mental Health, has spoken out about the importance of the National Mental Health Commission review focusing on the specific challenges faced by rural communities. Access to medical care would be a good start. From the primary care perspective, both the AMA and the Rural Doctors’ Association of Australia have called for an urgent review of the geographically based classification system that dictates doctor:patient ratios in rural areas.

Discussion over the stance the government will take on funding prevention continues, and this article in The Conversation by Professor Jane Hall, explores just how the government’s Commission of Audit might view spending efforts on prevention to date and suggests it should consider not just the costs but the value that organisations like the Australian National Preventive Health Agency Bring to the table.

Looking at the evidence for what works is a subject that is increasingly occupying the minds of those charged with devising policy solutions. But the trajectory of evidence as it winds its way down various policy paths is not always predictable or guaranteed. And barriers in the research world as well as the policy making sphere come into play. These issues are highlighted by a new book, Beyond Evidence-Based Policy in Public Health: The Interplay of Ideas, reviewed here on the London School of Economics website by social policy lecturer Lee Gregory.

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