It is surprising and disappointing that health has largely flown under the election radar, despite the ongoing impacts of the COVID pandemic and the challenges ahead, writes health policy analyst Alison Verhoeven.
She delivered this presentation to Croakey Health Media’s final election webinar on 15 May; it is essential reading for incoming MPs.
Alison Verhoeven writes:
Five weeks of electioneering have seen health politics largely flying under the radar, despite the efforts of health leaders to raise critical issues such as the close-to-desperate straits being experienced in public hospitals, primary care, aged care and disability services.
After three years of bushfires, floods, a damning Royal Commission report on the aged care sector, and a pandemic which continues to dominate our lives (and our deaths), you’d think health might have been front of mind for all political players.
There was finally a glimmer of serious policy intent on Saturday 14 May with Labor’s announcement of a $1 billion investment in Medicare, including support for general practice.
But the limited understanding so many candidates and parties vying for election seem to have of the inextricable relationship between the economy and health remains concerning.
A trip to my local supermarket this week highlighted the reality of this relationship.
It may also explain why so many voters are disgruntled with the major parties and are looking for alternative options as they cast their vote.
For transparency, the supermarket I visited is in suburban Canberra, not in a remote Aboriginal community or a small rural town where matters are worse by orders of magnitude.
I entered the store via the fruit and veggie section, where there is clear evidence of the impact of inflation. It’s not only lettuces that have become luxury goods. So too are capsicums at $24 a kilo, strawberries at $6 a punnet, and Tony Abbott would be disappointed at the cost of raw onions which have seen an unseasonal price increase to between $3 and $4 a kilo.
Next stop was the deli section, but there was no joy to be had there. The display cabinets were covered with plastic sheeting with signs explaining the section was closed due to Covid-related staff shortages.
As I was making my choice in the bakery aisle, an unsolicited conversation with an elderly man highlighted the very real impact inflation is having on the daily lives of so many people in our community. Home-branded bread had disappeared from the shelves, leaving only more expensive brands, and this shopper worried that he couldn’t afford a $6 loaf.
At the check-out, the cashier thanked me for wearing a mask, something which she noted many shoppers no longer did. She said she was grateful because almost all her fellow-workers had had Covid, some of them becoming extremely unwell. So far, she’d managed to stay safe but she expected she’d soon be having to take time off work for illness, which she couldn’t afford as a casual.
With inflation at its highest in two decades and expected to continue increasing, rising interest rates, spiralling house prices and rents, no commitment to increase Jobseeker rates from any of the major parties, and a Prime Minister who thinks a $1 per hour increase in the minimum wage is unreasonable, it is no surprise that many people are having to make choices between purchasing fruit and vegetables, heating their homes, or filling their car with petrol to drive to their second job.
It’s a relief that at least the Labor Party is supporting an increase to the minimum wage in line with inflation, but disappointing that they will not extend a commitment to increasing the Jobseeker rate.
The role of the social determinants of health in our ability to achieve good health outcomes has been very evident during the COVID pandemic.
Who, apart from our politicians seemingly, can forget the Aboriginal communities in many parts of Australia that were unable to isolate in safe, uncrowded housing during a COVID outbreak?
Or the residents of the Melbourne housing towers who suffered so disproportionately as they struggled to receive health information, and access the care and support they needed?
Or the elderly and disabled who have become nothing more than statistics as Australia’s COVID death rates climb?
Or those people now lingering on public hospital elective surgery waiting lists who can’t afford to ‘go private’ and can expect to see their wait grow even longer as neither major party makes a formal commitment to address the funding and structural issues facing both primary and acute care.
As more Australians face financial challenges and declining social and economic well-being, we also face crunch time on a number of other key areas that influence our ability to achieve good health.
Our health, aged care and disability workforce is stretched to its limits, sparse on the ground in many places – particularly in rural and regional Australia, and experiencing considerable burn out.
We’ve de-funded the university and research sector (or seen ministerial interference and funding commitments to favoured groups and causes without robust decision-making processes).
The lack of transparency and accountability in government procurement is plaguing the health sector, just as it is so many other parts of our economy. A federal independent anti-corruption commission as supported by Labor and many of the Independents is a much needed reform.
Our head remains in the sand when it comes to understanding and dealing with the cultural determinants for the huge gaps experienced by Aboriginal and Torres Strait Islander peoples across all aspects of their lives, including their health. Support for the Uluṟu Statement is a starting point, with Labor having committed to this.
Climate change is real, already impacting our health, and getting worse – with the timeline for addressing this narrowing by the minute. The Teals, Labor and the Greens provide a glimmer of hope that we may be able to move forward, even if slowly, in the next term of government.
Another pandemic may be just around the corner, and we seem to have given up on managing the current pandemic in any meaningful way, or even having sufficient insight to be able to learn from the things that have worked and those that haven’t over the past two years.
And this election campaign seems to have completely overlooked addressing key issues and gaps in our health care, such as reducing out-of-pocket costs and low value care, improving access to mental health care, or affordable oral health care (with the Greens being an exception here).
The 47th Parliament and an incoming health minister have a big job ahead of them to ensure a healthy economy, a healthy country and healthy residents.
While the parties and candidates seeking our votes haven’t been very vocal during this campaign as to how they will address these challenges, they should be aware that Australians care about their health and their political choices are influenced by this.
• Alison Verhoeven is a director of Croakey Health Media and Adjunct Professor, Institute for Health Transformation, Deakin University.
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