Below are snippets on the Federal legislative agenda, what Federal MPs are being told (and not told) about health and related policies, and a new Victorian health reform website.
What’s on the Federal legislative agenda for health?
Federal Parliament resumes next week, and these are some of the health-related bills on the legislative agenda:
• Australian National Preventive Health Agency Bill
Establish the Australian National Preventive Health Agency to provide evidence‑based policy advice to governments on preventive health, and to implement associated programs as tasked by Health Ministers.
• Food Standards Australia New Zealand Amendment Bill
Remove duplication of work undertaken by the Australian Pesticides and Veterinary Medicines Authority and Food Standards Australia New Zealand in developing maximum residue limits of agricultural and veterinary chemicals allowed to be present in food.
• National Health and Hospitals Network Bill
Establish the Australian Commission for Safety and Quality in Health Care and provide a framework for its establishment, including an expanded role in setting national clinical standards and strengthened clinical governance.
• Therapeutic Goods Amendment (2010 Measures No. 1) Bill
Make a range of amendments to the Therapeutic Goods Act 1989 to improve the regulation of therapeutic goods in Australia.
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What do MPs need to know about health?
The Parliamentary Library has prepared this Briefing Book, to give the new Parliament an overview of issues that might be raised over the next three years.
Some of the relevant chapters include:
• A health care system for the 21st century
This notes that Australians are less healthy than they were ten years ago, and suggests a need for fundamental restructuring of the health system towards a greater focus on primary and preventative health care.
It notes that hospitals remain the primary focus of the health debate and receive significant amounts of funding, despite evidence which suggests Australia is over reliant on hospitals and that there would be benefits if more were spent on preventative care than the mere two per cent of the health budget currently allocated.
It says there is evidence emerging from some health care providers in the US and Spain that a primary health care approach has been successful in improving health outcomes and reducing overall expenditure on health. “However, for Australia the challenge is that implementation of such an approach would require adopting a different attitude to funding, delivery and organisation to that of the current system.”
• Improving the health of all Australians: the role of preventative health
This chapter notes that preventative health, with its longer term population-based strategies to promote wellness and prevent disease, is often overlooked by both policy makers and a public more focused on personalised primary care and hospital services. Approximately 32 per cent of Australia’s total burden of disease can be attributed to modifiable risk factors that include smoking, alcohol abuse, physical inactivity, high blood pressure and blood cholesterol, low consumption of fruits and vegetables and overweight and obesity.
The books also has chapters on the challenges of an ageing population, plain packaging of tobacco products, and the section on Indigenous affairs asks: Do we need different policies or just better policy delivery?
• Questions about income management
The section on welfare notes that there are concerns about the Government’s welfare reforms, including income management. These include that evidence as to the effectiveness of these policies is limited, administrative costs are high and a question persists as to whether it is possible to encourage people to take responsibility for themselves if they do not have control over important aspects of their lives. Some critics also argue that targeting personal behaviour by withholding income payments is inconsistent with the rights-based approach to income support that has been a longstanding feature of welfare policy.
The push for income management to become a mainstream approach to welfare delivery, and for further reforms to the social security system in terms of conditionality, raise a number of questions for the new Parliament to address, including what evidence will be required to evaluate whether the new approach to welfare has been a success?; and what, if any, limits ought there to be on the nature and extent of interventions in the lives of welfare recipients?
But what about health inequities and the social determinants of health?
The book’s lack of attention to health inequities and the social determinants of health is a surprising and regrettable omission. Surely these issues are so fundamental that they deserve a chapter in themselves rather than brief mentions in passing.
Meanwhile in Victoria…
This website links to a new website on national health reform from the Victorian Health Department, and gives an overview of developments.
Preventative health is framed in a very narrow way by the major parties and, sadly, also by the Australian Greens. Working in mental health, I can tell you that my sector’s prevention agenda is largely divorced from obvious social questions.
I’ve looked at the hollowness of Australia’s preventative health agenda here: http://left-flank.blogspot.com/2010/08/worse-than-cure-hollowness-of.html