OK, so the recent post on why Health Ministers should insist on health equity impact statements for all policy recommendations may have revealed me as a hopelessly tragic idealist. And that’s not all. On reflection, I was also being a bit simplistic.
Of course, if we really care about health equity, health ministers would probably not be at the top of the list of people we should be chasing.
Prime ministers, premiers, treasurers, education ministers, even transport ministers may be just as important when it comes to policy decisions with health equity implications. Besides, many people seem to think that it’s Rudd (or at least his office) who is running the Government’s health reform agenda (whatever that may be…)
The Rural Doctors Association certainly gave this impression in a enthusiastic statement released after the PM’s visit to Bridge Clinic in Murray Bridge, South Australia, on Wednesday. They were delighted the PM gave them an hour of his time when just 15 minutes had been scheduled.
“Pleasingly, after hearing RDAA’s concerns, Prime Minister Rudd invited us to also work directly with his Office in combating the key issues fuelling the continuing health workforce crisis in rural and remote Australia,” said Dr Peter Rischbieth’s statement.
“We came away from the meeting with a great feeling that the Prime Minister now clearly appreciates the wide scope of work that rural doctors undertake in their communities and the additional workload they carry—from providing general practice-based primary care right through to being the emergency doctor at the local hospital.”
Well that’s wonderful. It does make you wonder though why it has taken so long for the PM to gain this appreciation. How long is it now that the problems of rural health have been in the headlines and at the forefront of health policy challenges? Probably easier to measure it in decades than years.
No doubt the PM’s office, with their keen interest in health reform, read this oped from the Business Council of Australia (in the Oz on Tuesday in case you missed it, as I initially did), arguing that health reform is too important to be left to the warring stakeholders. It’s an argument that John Menadue has made powerfully on many occasions.
I only hope they are also familiarising themselves with the mountains of evidence suggesting that health equity impact statements should be a critical part of health reform planning.
I’d suggest that health equity impact statements might be inadequate for the task required. We only need to look at family impact statements to see how a health equity impact statement could devolve into a back-of-the-envelope exercise.
There are already existing approaches such as equity focused health impact assessment that would be more useful. A evidence-informed process is required, not yet another check-box statement.
Are there any other suggestions for getting health equity into the mainstream dialogue? I know that it’s a hot topic for some health industry insiders but I don’t think it’s anywhere near top-of-mind in mainstream health debates. Perhaps not even anywhere near bottom-of-mind…