Informed, engaged communities for health

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021

The Queensland commentaries: How NOT to defend health services

How to clear the ‘blinding fog’ of mystery on decision making in health prevention programs. Philip Darbyshire lays a challenge at the feet of those working on government public health programs in this follow-up piece on the Queensland health cuts.

As the news cycle moves on and some of the heat, perhaps momentarily, dissipates from the Queensland health cuts furore, I wonder what Croakey readers have learned over the past weeks.  More importantly perhaps, I wonder what we as health professionals have learned about how to, and perhaps how not to advocate for and defend health services.  Sadly, my view of the latter would be, ‘precious little’. 

In my contribution  I proposed four ‘killer questions’ that health professionals must able to answer if they are to advocate for and champion the value of the work that they do.  I also suggested, rather tongue-in-cheek, various ways not to respond to them.  I did not expect to find that almost every one of these would be the default position of the health promoters.

What we have read in almost every commentary (see here, here, here and here ) is a surfeit of ‘mourning’, ‘eulogies’, outrage, hand-wringing and apocalyptic visions of the doom and decline that is now sure to visit Queenslanders – to the extent that I almost expect to see the bodies mounting up along Queen Street mall any day now. 

I readily acknowledge the ‘heartfelt’ nature of the commentaries and the genuine difficulties that sacked staff will face, especially since, as Sabina Knight noted, “Generations of health professionals have not ever known job insecurity.”  Millions of other workers in the private and commercial sectors of our economy will of course have little comprehension or experience of such generational ‘job security’.  I find it hard to believe however, that such sustained emoting will have the slightest influence on government or health board thinking. 

Thus far, a tear of remorse emerging from Campbell Newman’s eye seems a more likely prospect than some kind of evidence or appreciation of outcomes being mentioned by the health professionals. What we read instead is the semi-liturgical listing of programmes and projects, each more worthily-named than its predecessor.  Who, after all could possibly NOT want to fund a programme or service as eponymously wonderful as ‘Lighten Up’, ‘Living Strong’, ‘Growing Strong’, ‘Smart Choices’, ‘A Better Choice’, ‘Get up and Grow’ and so on.  With such linguistic insulation, no wonder that defunding such programmes seems like drowning kittens.

Wonderful though these programmes may sound, we are still none the wiser from the Croakey commentaries as to whether they actually work, whether they make a demonstrably positive difference to the health and lives of the people concerned and what improvements they have made in relation to any key indicators of health and wellbeing.  For instead of even a shred of evidence, we read only about how ‘vital’ the programmes are, how wonderful the staff are, how committed they are to their work, how tireless their efforts are, how important their jobs are to them, how diligent they have been at University and how much gratitude we owe them (examples here and here).  Is this really the best we can do?

The only dissenting voice to this orthodoxy other than my own was Vern Hughes, who wrote that, “Prevention programs in these areas amount to little more than media and education campaigns that largely fail in modifying behaviours.” While Vern may well be right, so too may the health promoters, the problem is that because the discussions around the Queensland cuts and indeed the undertaking of the cuts themselves have been essentially an evidence-free zone, we simply don’t know.

This concern that the health promotion and prevention sectors see themselves as self-evidently worthy, successful and thus entitled to their share of the eternal ‘more resources’ that everyone in healthcare desires is not a new observation and others have expressed this more clearly than I. Martyn Goddard for example has argued that: “A blinding fog of ignorance and mystery surrounds the decisions being made on disease-prevention funding. Perhaps it is time we started to do the job better”. No ‘perhaps’ about it I’d say.

I am not so naive as to believe that politicians create health policy and make health funding decisions on the basis of rational thought and good evidence but I have to believe that strong evidence of positive and valuable outcomes will ultimately carry more weight than ‘heartfelt pleas’.  I would also like to believe that the public health service as a whole is not fundamentally a giant job-creation scheme existing primarily to provide gainful employment for its staff and where any proven, beneficial, health outcomes are but a fortuitous by-product.

Let’s hope that the people running all of these health promotion and public health projects, programmes and departments have been collecting good data, not only about process, and ‘inputs’ (i.e. amount of ‘work done’), but also in some way, about outcomes and identifiable benefits.  Let’s also hope that some of our university research departments are already planning the longer term ‘post-cuts’ follow up studies in Queensland that will provide a less febrile and more evidence-informed assessment of exactly what effects (positive, negative or otherwise) these policy decisions may have on Queensland and its people.

Philip Darbyshire is Professor of Nursing at Monash University, Adjunct Professor of Nursing at University of Western Sydney and Director at Philip Darbyshire Consulting Ltd. Read his blog or follow him on Twitter.

Declaration: Philip Darbyshire has undertaken paid speaking engagements for various services within Queensland Health.

Comments 3

  1. Mike Daube says:

    This piece quotes an earlier commentary from Vern Hughes from a group called Social Enterprise Partnerships in Victoria. Mr Hughes writes that “Population health and prevention programs seem to have made little impact on Australia’s epidemic of obesity or ongoing levels of alcohol abuse and tobacco-related illness. Presumably, if current programs were effective, the trends would be heading downwards”.

    Action on obesity and alcohol is light years behind that on tobacco, but where on earth does Mr. Hughes get the idea that we are not making on impact in reducing the death and disease caused by tobacco. Current programs are effective; the trends are heading downwards; and further measures such as plain packaging will ensure that these encouraging developments are maintained.

    It would be helpful if people like Mr Hughes bothered to check out what is actually happening before letting their biases get ahead of the evidence.

  2. Amanda Lee says:

    Those readers interested in the evidence that preventive health services have been effective in Queensland could access the Report of the Chief Health Officer 2008, The Health of Queenslanders- Prevention of Chronic Disease, particularly Chapter 5, available at http://www.health.qld.gov.au/cho_report/2008/documents/2008choreport.pdf – or indeed in any of the recent articles that are conveniently omitted from this piece.
    Aside from the well-documented outcomes in tobacco control, the evidence includes measured impacts and outcomes at multiple stages along the causal pathway in other areas. For example, in 2007 the rate of measured (rather than self-reported) healthy weight among children in Queensland had reached levels 2-3% higher than in other states where comparable data was available. This equates to 1,200 fewer future cases of Type 2 Diabetes per year by 2015. The multi-strategy Go for 2 and 5 fruit and vegetable promotion program resulted, at its peak, in an extra intake of 1.1 serves per person per day throughout the state. This was confirmed by objective measurement of additional turnover of $9.8 million sales of fresh produce per month in Brisbane alone. Campaign targets were exceeded resulting in a technical saving of $55 million per year to the ill-health system.
    Adult physical activity participation rates had increased by 34% since 2004. Exclusive breastfeeding rates for the first six months had quadrupled, and the proportion of infants breastfed at one and six months had increased by over 5% points to 83% and 63% respectively.
    As is the case for most interventions in a complex public health system, the evidence is that a multi-strategic approach is required for effective advocacy. By not acknowledging the need for diverse perspectives, this piece is guilty of its own criticisms in not adopting an evidence-based approach.

  3. Philip Darbyshire says:

    Thanks to Mike and Amanda for their considered responses. I feel myself coming over all Shane Crawford and wanting to say; “That’s what I’m talking ’bout”. Mike is absolutely correct about tobacco, although as Martyn Goddard explains, it might be slightly disingenuous were the health promotion lobby to claim sole credit for smoking reduction as a ‘health education’ victory.

    If I have, as Amanda suggests, missed any coherent arguments in Croakey against the Queensland cuts that were based more on evidence and demonstrated value than on outrage and indignation, then mea culpa indeed. “Conveniently” however, has nothing to do with it. I searched Croakey using key terms such as ‘Queensland’ and ‘cuts’ and cited the blogs or commentaries I found that responded to the news of these cuts. Amanda feels that I may have “omitted” something important here. I wish that this were true.

    The Queensland Health Report that Amanda helpfully cites is fascinating reading. I’m sure that it addresses some of the thorny concerns I raised about assessing the benefits of various health promotion and other awareness and education campaigns, while possibly raising others. I would not be surprised however to see some of its critics raising the Mandy Rice-Davies objection.

    One example will have to suffice. Eating more fruit and veg sounds like a wonderful idea but I’m not sure how excited the policy makers should be at the trumpeted benefits of people having an “extra intake of 1.1 serves per day”. Who knows what slips there may be ‘twixt veggies and lips? Should we worry rather than rejoice if the ‘extra serves’ of veggies were, for example, mostly fresh potatoes that were ultimately devoured as bowls of hot chips (with accompanying salt and sauce)? Or perhaps the serves were apples, that instead of inhabiting little Johnny’s lunchbox, ended up as the foundation of some mighty apple crumbles. Pertinent questions to ask one would think.

    I’m not a health economist but the bald idea that ‘sales of fresh produce’ increasing by $X million dollars translates to a health system saving of $XX million seems such a long bow to draw that Robin Hood on steroids would find it a challenge. Perhaps that’s the reason for the little ‘qualifier’ – “technical” saving. I wonder if a “technical saving” is like a “technical breach”?

    Amanda berates me for “not acknowledging the need for diverse perspectives”. I’d be wounded, if I had a clue what she meant. I cannot see a scintilla of basis for this presumption from my piece. I’m guessing that a “multi-strategic approach for effective advocacy” might mean that there are many different ways that people and communities can be helped and enabled towards better health. No argument at all from me there and by the same token, I think that there are ‘diverse’ forms of evidence, both qualitative and quantitative, that we need if we are to highlight and to demonstrate the acceptability, effectiveness and value of health programmes and services. Such diverse research approaches should also be capable of discovering the converse; what does not work and what has little demonstrable benefit. I have no difficulty at all in saying which of these services deserves to receive our hard-earned tax dollars in government funding. Here is a clue: the answer is not ‘both’.

    What I am not obliged to ‘acknowledge’, in deference to any notion of ‘diversity’, is the correctness of the ways that Amanda and others have responded to the cuts in their Croakey comments. I simply believe that their approach is wrong and have explained why. On that point we may agree to disagree.

    Amanda plays her parting shot as if it were an ace when it is barely a deuce. I criticised Queensland Health for their ‘slash and burn’ approach to these cuts that almost wilfully ignored any notion of evidence. I have called for a more ‘evidence and outcomes’ informed thinking, not only in relation to these cuts but across all of health funding. I have critiqued the predominant hand-wringing preciousness of responses that we have read to date and have cited specific examples of my concerns. I may not have joined the bandwagon of bluster but I can scarcely be guilty of “not adopting an evidence-based approach”.

    Philip Darbyshire

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Healthdirect Australia series 2019
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17