Intouch Public Health

Adjunct Professor Terry Slevin

If this is a ‘health election’, it is missing a vital puzzle piece. Our major parties are throwing billions at promises to treat health problems, but are offering virtually nothing to keep us healthy in the first place.

The national budget for health expenditure is one of the government’s enduring headaches. We spend around $250 billion each year on ‘health’, but only three percent of that is on preventive efforts to preserve good health.

This expenditure is growing uncontrollably – five years ago, it was only around $200 billion – and it still doesn’t meet public demand.

Every jurisdiction, every health service, and the professionals who treat every condition are constantly crying out for more funding, and they’re right to. When we or the people we love are sick, we want (them) to get better, fast.

Labor wants this to be seen as a ‘health election’, and has led the way on health portfolio promises, with a variety of major health announcements in the past six months including:

• $7.9 billion in budget funding to encourage more GP bulk-billing
• $1.8 billion in additional funding to the states for public hospitals
• $2.6 billion to boost pay rates for aged care nurses
• A $793 million package of women’s health initiatives
• $657 million for more ‘urgent care clinics’
• $663 million in training funding for GPs, nurses, and midwives
• $689 million additional subsidisation for pharmaceuticals at point of purchase
• A new medical school at QUT
• Over $780 million capital spending for new health service infrastructure at Rouse Hill, South Adelaide^[1], Midland in WA, and Burnie
• $1 billion for more free mental health services

The Coalition, keen to avoid a partisan ‘mediscare’ from emerging, has rapidly declared that it will ‘match’ all these ideas.

The Coalition have also engaged meaningfully in some aspects of mental health care; commendably, their policy manifesto specifically mentions enhanced attention to suicide prevention.

Yet out of all the spending that is made on ‘health’, both major parties invest hardly anything in initiatives that would keep us in good health. The vast majority of government funding goes toward treating us once we are in poor health.

It’s not just a social failure; it’s a national financial fiasco. It is the failure to invest in prevention that renders the national health budget financially unsustainable.

Yet practical, and surprisingly cheap solutions are everywhere, just waiting for politicians to pick them up. Examples include:

• A combination of investments and policies to reduce our weight, from regulation of junk food advertising to children, to promoting and teaching healthy eating, supporting chances to be more physically active, better food labelling, and more
• Programs to reduce alcohol consumption and abuse
• New and boosted campaigns to reduce smoking and vaping
• Improving uptake of proven and safe screening and immunisation programs

When the next government is formed, the spending on treatment commitments promised by Labor and matched by the Coalition will start to roll out.

But the underlying drivers of disease will remain stationary.

Millions of Australians will continue to develop preventable diseases.

The primary care sector will continue to be under-resourced to engage in health promotion and preventive care.

The GP sector will never have enough capacity to meet the community’s need for daily attention.

State health ministers will continue to expect unsustainable pressure on hospitals and their staff. The whole national economy will continue to be diminished by loss of productivity and economic vitality.

And the tragedy is that this unhealthy default scenario costs governments and families more that it would take it to prevent it.

Let’s also reflect on the extraordinary phenomenon of “pandemic amnesia”.

A short five years ago, the world was brought to its knees.

Are we better placed to respond to the next pandemic? No.

Labor is offering an Australian Centre for Disease Control. But during the campaign, the Coalition confirmed that it does not support the establishment of the Australian CDC.

That’s the irrational health future politicians are currently choosing. The promises made so far in this ‘health election’ are simply not giving us a healthy future. It’s a “treating more sick people” future.

Do we want a future where people in their 50s, 60s, and 70s are spending more of their time in pain and discomfort, restricted in their capacity to contribute to their families, communities, or workplaces due to the ravages of chronic disease?

Or do we want to see them happy, fulfilled, and productive? That is our stark choice.

This election cycle, we asked major political parties to articulate their policies in seven priority areas of public health. We published a Scorecard, assessing their answers. For those who want to Vote For Public Health, you can view our ratings of Labor, the Coalition and the Greens here.

We can change politicians’ minds if we speak loud enough to convince candidates and parties to get aboard a robust national agenda for disease prevention – not just treatment.

Adj Prof Terry Slevin is CEO of the Public Health Association of Australia.

 Image: Australian Electoral Commission.