Introduction by Croakey: During the federal election campaign, health policy analyst Alison Verhoeven has been sifting the wheat from the chaff in search of meaningful election commitments that offer significant benefits for our health.
Labor’s childcare policy, which includes a $1 billion fund to build and expand around 190 childcare centres over four years, deserves more attention because of its wide-ranging health impacts, she writes below.
Verhoeven, a director of Croakey Health Media, also identifies several key questions that warrant some answers over the remaining days of the campaign.
Alison Verhoeven writes:
In the race between political parties to outspend each other as they vie for power on 3 May, there have been few truly transformative and innovative policies put forward which will genuinely make a difference to people’s lives.
With three-year political terms, there is little room for the hard slog required to develop and implement policies which are likely to have medium to long-term gains. So it’s not surprising to see the major parties focused on price cuts at the petrol bowser for the next 12 months, a rebate on a power bill, or some tinkering with tax cuts.
Health policies announced by the ALP are underpinned by three years of incremental reforms and aim to progress this work, albeit at a much slower pace than many health advocates would like to see.
The Coalition, all too aware that health is their Achilles heel, particularly noting the past performance of their leader when he was an unpopular Health Minister, have been too timorous to do anything other than say they will match the ALP’s proposed health investments.
The Greens have wheeled out their proposal for a universal dental scheme yet again, and the independents have been largely silent on health policy (although Croakey will be publishing more on this in coming days).
We’ve had to put up with Trump-lite copycat nonsense, not only from the usual suspects like Clive Palmer’s big-spending Trumpet of Patriots, but also from Liberal senators Jacinta Nampijinpa Price and Jane Hume who want to get rid of public servants (even possibly closing down the National Indigenous Australians Agency) and make those few who are left work full-time in the office (or not, seeing this proposal was not well received in the opinion polls).
Policies related to environmental determinants of health are big news, mostly for the wrong reasons. Peter Dutton’s throwaway line that he was not a scientist when asked about climate change will no doubt enter political history alongside Scott Morrison’s statement that he didn’t hold a hose when asked about his Hawaii holiday during the 2019 bushfires.
There’s also been little focus on the social determinants of health other than housing.
The cash splashes for first home buyers are unlikely to do much other than further drive up house prices according to most housing market experts. However, the ALP’s proposed investment to increase housing supply has received cautious approval. Renters have been totally ignored, despite some efforts by The Greens to highlight solution for renters.
Genuine reform
But, hidden amongst the generally tame and uninspiring election rhetoric, has been one policy which gives some hope for genuine reform and which unfortunately hasn’t received the airtime it deserves.
I’m talking about the ALP’s childcare policy which proposes a $1 billion fund to build and expand around 190 childcare centres over four years. This comes on top of their recently-legislated change to remove the childcare activity test, meaning that from 2026, every family will receive at least three days of subsidised care each week, regardless of their work, study or volunteering status.
The Coalition’s approach of mirroring ALP social policy announcements hasn’t quite kept up on childcare, with an unspecified amount potentially being committed to expand childcare in regional areas only through the proposed Regional Australia Future Fund. This promise may enhance access to childcare, although it is silent on policy to ensure care is affordable.
Childcare affordability is a major contributor to cost-of-living challenges for families. Likewise, the activity test has been a significant obstacle to universal access to early childhood education, particularly for First Nations families and children from low-income and disadvantaged households.
The peak body for Aboriginal and Torres Strait Islander children, SNAICC, described the changes as a “game changer for our babies”.
In its 2019 Position Statement on Early Childhood, the Royal Australasian College of Physicians (RACP) recommended investment in early childhood education as part of a suite of strategies to better support all children to achieve healthy outcomes and to address intergenerational disadvantage.
As noted by the RACP, the links between children’s early years and longterm health conditions and health inequity are significant.
Aside from longterm outcomes including higher educational qualifications and higher income, several randomised controlled trials have shown that children from disadvantaged backgrounds who attend quality early childhood education and care have a reduced likelihood of involvement in the criminal justice system and better physical and mental longterm health outcomes (see here and here).Â
The opportunity for promoting healthy behaviours among young children and improving health literacy are important. Educators are able to work with parents and support them in making choices about immunisation and accessing health services such as screening programs and dental care.
Without access to affordable quality early childhood care, the ability of carers (the majority of whom are women) to participate in the workforce is limited, with longterm consequences including lower wages, poorer career progression, loss of skills and less superannuation in retirement. This is very evident in the female-dominated health and aged care workforces.
Education policy more broadly also has a significant role in shaping the social determinants of health, in ensuring we have the capability and numbers we require in our health workforce, and in ensuring Australians have the capacity to make positive and informed decisions about the way they want the country governed. Â
With the clock moving rapidly forward to the 3 May election, there’s not much time left for major education policy announcements. We may have already seen all that’s on the table.
The ALP’s announcements include restructuring HECS debt repayments, investments in vocational education, and highlighting its recent agreement with the states and territories to ensure more equitable funding for public schools.
In addition to vocational education investment, the Coalition has flagged cuts to ‘wasteful’ spending on education, with the Commonwealth Department of Education in its sights. Among the Department’s priorities are its work on the early years strategy, the public schools funding agreement with the states and territories, and the Universities Accord, which aims to increase tertiary education attainment from 60 percent to 80 percent of the workforce by 2050.
It is not clear which of these areas might be the target of Coalition cuts, although the Opposition leader has focused on what he described as a “woke agenda” that has “come out of universities” during a recent Sky New Live appearance. According to the Coalition’s election policy platform, it will match dollar-for-dollar agreements already in place for schools funding.
Looking for answers
Will social policy in its broadest sense continue to be more or less ignored in the run up to 3 May?
Will we hear anything about rental assistance, unemployment benefits, or investment in legal aid programs?
Will any of the announcements on aged care or disability services focus on making these critical social supports more affordable and accessible?
Or will we continue to hear measured but cautious offerings from the ALP?
Will the Greens and independents provide more constructive details about how they might negotiate with a minority government should that eventuate?
Will the Coalition continue its increasingly defensive statements, including the very worn-out accusation that PM Albanese is a liar?
Social and economic reforms to ensure all Australians can share equally in our wealth require courage, diligence in policy making, and the ability to communicate and explain the importance of reforms in a convincing way to the electorate.
Unfortunately there has been little evidence of that during this election campaign and we will all be the poorer for it.
Author details
Alison Verhoeven is a director of Croakey Health Media. She was previously an Adjunct Professor with the Institute for Health Transformation, Deakin University; and a Visiting Fellow at Queensland University of Technology. She was formerly Chief Executive of the Australian Healthcare and Hospitals Association, the independent peak membership body and advocate for the Australian healthcare system and a national voice for universally accessible, high quality healthcare in Australia. Her professional affiliations include membership of the Australian Institute of Company Directors and the Australian Institute of Management. She has broad experience in health, education, corporate governance and communications, and has worked in both the private and public sectors in Australia, the Asia-Pacific region, and Europe. She is a member of the George Institute Australia Community Advisory Group.
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