Paige Preston and Letitia Del Fabbro
With only a few days left before the October 31st Queensland state election, a record number of voters have already cast their ballots.
Queensland is transitioning to four-year fixed terms, following the 2016 referendum, and for the first time in Australia two women will contest a leadership. The incumbent Palaszczuk Labor government was elected in February 2015 and it currently holds a two-seat majority. In this election there are several seats in play.
Due to the COVID-19 pandemic, health and economic recovery is at the forefront of peoples’ minds, and there’s no doubt that the election outcome will influence policy and resourcing of public health and health services. Thus far Queensland has achieved great outcomes in the management of the COVID-19 pandemic and the message of ‘keeping Queenslanders safe’ has resounded; however there have also been criticisms of the tight border controls with vocal opponents; as well as understandable disquiet from struggling tourism and service sectors. It is also important to note that Queensland currently has the highest rate of unemployment in Australia, and this is emerging as a key concern for voters who face uncertainty as Job Keeper payments come to an end.
As we all wait with bated breath to see if Queensland can maintain our strong COVID-19 response, we need to remember that sustaining this health focus, and increasing efforts in public health – specifically preventive health – is crucial. The health commitments are again focused on hospitals, and not on preventive health policy that keeps people out of hospitals.
We know this all too well.
The recent federal budget was also missing a commitment to preventive health, highlighting an even greater need for the Queensland Government to step up and invest in public health and health promotion in Queensland.
In Queensland, the rate of health service provision to meet community demand has been growing exponentially over the last decade. This demand will put the health system under extreme pressure in the immediate future. Even before COVID-19 there was a $1.137 billion increase in Queensland Health’s operating budget. Despite this increasing spend in health, funding of preventive health in Queensland is currently well below the level needed to ensure optimal health, wellbeing and economic benefit.
The latest figures showed that Queensland spent significantly less per capita than nearly all other Australian jurisdictions in preventive health. An investment of 5% of the Queensland health budget dedicated to public health and health promotion, would bring the state closer to other OECD countries, including New Zealand and Canada, and in line with goals set by Western Australia.
The Queensland Branch of the Public Health Association Australia has joined the Queensland Branch of the Australian Health Promotion Association and the Queensland chapter of the Australasian Epidemiological Association with three key election asks.
We are advocating for all political parties to make a commitment to:
- Invest 5% of the health budget in the strategic resourcing of comprehensive preventive health.
- Reinvigorate, sustain and support a diverse and skilled public health and health promotion workforce, capable of pivoting to emerging challenges such as COVID-19.
- Invest in infrastructure and policy that enhance community wellbeing, including good urban design for safe walking and cycling, and by reducing carbon emissions.
Public health includes a diverse range of disciplines, it is necessary to have these diverse and skilled public health and health promotion disciplines ready and available to pivot to emerging public health threats – such as the global COVID-19 pandemic, bushfires and floods. Strategic workforce planning with the allocation of dedicated funding is required.
A well-resourced preventive workforce is also essential for continuing to address concerns of ongoing chronic disease (such as diabetes, mental health and cancer). The long-term strategic work of evidence based non-communicable disease planning needs to continue throughout work surges, such as the current COVID-19 pandemic.
When considering the lay of the land in terms of health funding in Queensland, it is difficult not to hark back to the dismantling of preventive health services that occurred following the 2012 election, as it did at that time in other Australian jurisdictions. Ongoing investment in public health will result in long term benefits. Examples of public health prevention programs that have demonstrated return on investment include: programs to reduce tobacco consumption, programs to reduce lead exposure, programs to reduce coronary heart disease and road safety programs.
Since its election in 2015, the Palaszczuk Government has begun to rebuild the health promotion workforce with solid investment in health and wellbeing, including the establishment of an independent Health and Wellbeing Queensland agency with a focus on obesity, and numerous other health and wellbeing strategies. These kinds of investments in health promotion and illness prevention will have significant positive impacts on population health and provide longer-term savings, including on expensive hospital care down the track.
There is enormous potential for preventive programs to improve the health and wellbeing of the community and create resultant savings for health budgets. A key factor in the success, and return on investment, of programs is the inclusion of public policy interventions.
Preventive health is important across the lifespan, from childhood (e.g. immunization, healthy food advertising and water fluoridation) to aged care (e.g. walkable streets and availability of nutritious food). Indeed Australia’s Royal Commission into Aged Care Quality and Safety has painted a grim picture, highlighting that Australia needs to do much more to protect and provide for this vulnerable group. Healthy settings for older people are healthy settings for us all. Active transport has had some media attention lately with the development of new bike ways in Brisbane but more needs to be done in other parts of Queensland to improve access to safe cycle and walking pathways. Walking improves health and cuts pollution.
One policy area that the LNP has been unwilling to engage in is that of abortion law. That an LNP government may seek to repeal the 2018 decriminalisation of abortion legislation is very concerning. This is an important women’s health and duty of care issue. Women of reproductive age must have the right to access best-practice care and the right to decide. Then there is also the recent LNP election commitment to enforce curfews for youth in certain areas, which raises many red flags.
Firearm policy is predicted to ‘play a big role’ in the upcoming Queensland state election, with marginal seats being contested by multiple candidates (some of which are advocates for the roll-back of gun reforms). Australia’s gun reforms are a public health success story and the position of candidates on this issue, especially in marginal seats, is worth consideration.
The disquiet toward Queensland voters following the 2019 federal election saw calls for Quexit. That election outcome serves to illustrates that, as a recent piece in The Conversation points out, ‘there is more than one Queensland’. However, as the election plays out this coming weekend, we implore the next Queensland Government to invest in evidence-based strategies that will protect and improve the health of all Queenslanders. Now is the time for the Queensland Government to invest in health promotion, disease prevention and wellbeing; to focus on community recovery, resilience, mental health and employment.
Paige Preston is QLD Branch Vice President of the Public Health Association of Australia, and a Senior Policy Advisor.
Letitia Del Fabbro is QLD Branch President of the Public Health Association of Australia, a PhD candidate with The Hopkins Centre: Research for Rehabilitation and Resilience and a Lecturer in Nursing at Griffith University. Follow Letitia on Twitter: @letitia_df and the PHAA Queensland branch: @PHAAQldbranch