Terry Slevin, PHAA CEO
Last weekend’s dramatic Western Australian state election has returned the McGowan Government with the strongest parliamentary majority in Australian history.
Public support for the Government, which has just completed its first 4-year term, is at extraordinary levels: Premier Mark McGowan’s Labor won 69% of the two-party vote at the election, demolishing the previous national, state or territory record of 64%.
The Labor government’s legislative agenda will be unfettered by the upper house of state Parliament, which it has control over for the first time since federation.
The result is largely because of the state Government’s performance on a public health issue – specifically, their stern and effective approach to pandemic management. There have been economic costs, and many of those costs have been picked up at the federal level (Australia’s governments have cooperated well on economic management during the past year). But perhaps never in Australian history has public health management resulted in such a clear and overwhelming show of support for a government.
So it’s timely to check in on what other public health commitments the McGowan Government made in the campaign, or during its last term.
The Government already had established reasonably clear policy credentials, with its Sustainable Health Review (SHR), released in mid-2019, clarifying policy directions on many subjects. The Government has made repeated public statements that it largely accepts the Review’s many recommendations.
Premier McGowan also provided PHAA WA Branch with a 5-page letter setting out its record and its future commitments.
PHAA WA Branch President Hannah Pierce welcomed the Government’s future commitments, which addressed the state Branch’s 2021 state election platform.
“The PHAA WA Branch was pleased to receive a comprehensive response from the Labor Party in the lead up to the WA state election that included a number of important public health commitments,” said Pierce.
“There are several crucial evidence-based documents developed during the WA Government’s last term, including the final reports from the Sustainable Health Review and the Climate Health Inquiry, that provide a blueprint for the Government when it comes to progressing action on key public health issues.”
“Once the dust has settled on the election landslide, the PHAA WA Branch look forward to working with the WA Government to see its commitments become a reality.”
On healthy food and obesity, the state Government has certainly made a real effort. According to the Premier, the SHR:
“sets the target for WA to have the highest percentage of population with a healthy weight of all States in Australia within a decade, a target endorsed by the McGowan Government. As outlined in the SHR, priority will be placed on halting the rise in obesity and reducing harmful alcohol levels, which are risk factors for many chronic conditions.”
“The McGowan Government has ensured the continued funding of the LiveLighter campaign and a re-elected McGowan Labor Government will continue this home grown campaign that has now been adopted in most Australian states and territories and is recognised internationally as an exemplar for public health campaigns.”
The Premier committed to the following:
“A re-elected McGowan Labor Government will:
- continue to implement the Healthy Weight Action Plan 2019-2024,
- establish a cross-government working party to consider the issue of advertising of unhealthy foods and beverages on WA Government assets, and
- develop a Walking Strategy, with the aim of helping to address a range of risk factors for ill health including unhealthy weight, which will also complement the McGowan Government s WA Cycling Strategy.”
On alcohol policy, the Premier cited his Government’s previous “call for tax reforms on alcoholic beverages, so that these products are taxed on a volumetric basis, which is an effective means to reduce levels of alcohol consumption and related problems including deaths, crime and traffic accidents.”
While this call is welcome, in truth this is a little bit of “duck shoving”. The tax applied to alcohol is a federal issue, not a lever in the hands of the state government. A lever the state government can pull, but has failed to commit to, is the establishment of Minimum Unit Pricing (or MUP), which has been successful in the Northern Territory. We need to continue to press this important reform, which was also a recommendation of the SHR.
The 2019 SHR had stated that it was WA Government policy that “a key preventative health priority is reducing harmful alcohol levels, which are risk factors for many chronic conditions. The McGowan Government endorsed the SHR recommendation to reduce harmful alcohol use by 10 percent by July 2024.”
The Premier goes on to state that:
“A re-elected McGowan Labor Government will maintain a comprehensive approach to reducing the level of alcohol-related harm in WA, including continued support for:
- the successful Alcohol. Think Again campaign,
- school-based education,
- the ban on alcohol advertising on State-government operated transport,
- support for community based AOD prevention coordinators, and prevention research.”
The Premier also committed to “focus attention on preventing Fetal Alcohol Spectrum Disorder (FASD) with a commitment to Aboriginal Youth Wellbeing and actions that include education and training to address alcohol and pregnancy among Aboriginal Youth.”
McGowan’s commitments also included maintaining funding for WA’s health promotion agency, Healthway: “A re-elected McGowan Labor Government will maintain Healthway’s activities, funded at no less than the current level with indexation.”
Other commitments include:
- Rather weakly, in regard to justice-system drivers of health the Government will only “continue to work through the Council of Attorneys-General Age of Criminal Responsibility Working Group, which was established in February 2019 to examine whether the minimum age of criminal responsibility should be raised from 10 years of age.”
- More positively, on gambling harm policy the Government will “not support expansion of gambling to include keno or pokies” in Western Australia.
- On climate policy, the Government says it will have a focus on “…the health impacts of climate change. In December 2020, the McGowan Government released the Climate Health WA Inquiry Final Report and endorsed its recommendations in principle.”
But perhaps McGowan’s most important commitments were in relation to overall preventive health strategy. In recent years his Government became the first in Australia to adopt a commitment to a minimum of 5% of health expenditure being directed to disease prevention programs. His commitment statement repeated the policy: “the McGowan Government supports the SHR recommendation for five per cent of total health expenditure to be spent on prevention by 2029.”
“My Government endorsed [the Sustainable Health Review’s] eight enduring strategies and 30 recommendations for change in the Western Australian health system. These recommendations will drive a cultural shift to focus on prevention and community care supported by a modern hospital system.”
In the very same week McGowan re-committed to the 5% target, the Commonwealth Government released the final public draft for its National Preventive Health Strategy, which also declared in favour of the 5% target being met at national level by 2030.
The policy commitment that a minimum of 1 health dollar in 20 should be dedicated to preventive health is now bipartisan, and is supported at both federal and state level. This is a great outcome for Australia’s future.
Terry Slevin is the CEO of the Public Health Association of Australia, and is also Adjunct Professor in the School of Psychology at Curtin University and Adjunct Professor in the College of Health and Medicine at the Australian National University.