Malcolm Baalman, PHAA
As happens at every federal election, several long-serving Members of Parliament have retired. Two in particular have influenced public health in Australia. Today we profile the Hon. Greg Hunt, former Member for Flinders, and Minister for Health 2016-2022.
Elected to the House of Representatives in 2001, Hunt became a minister in 2013. And in December 2021, he announced his retirement from Parliament.
“When I think back to the fear and the concern of this House and this country in February and March , and I look at that which has occurred around the world and the lives that have been saved here by comparison, I’m so proud of this government, of this parliament and of this nation and all the things that have been done to save lives,” Hunt told Parliament.
On some issues a relatively progressive thinker in the Liberal party, Hunt supported same-sex marriage, and in a non-party vote in Parliament in 2005 supporting removing the ban on the abortion drug RU-486 (Mifepristone). His role and legacy as Environment Minister are omitted from this profile.
He became Minister for Health after the 2016 election, and throughout his early years, he generally pacified the health portfolio as a political issue.
“Hunt used the resources, advice, and funds available to him to reasonable effect,” recalls former PHAA CEO, Dr Michael Moore AM. “He chose to focus on treatment concerns by regularly approving new drugs for registration on Australia’s national pharmaceutical benefits subsidy scheme (PBS), and he had the advantage of a steady stream of research funding announcements as the national Medical Research Future Fund, established in 2015, began to provide funding to the sector.”
“But his emphasis on regular drug approvals revealed an underlying issue: Hunt was overly focused on treatment compared to prevention, protection and health promotion.”
“This meant his Budgets were generally very thin on public health initiatives. He repeated that prevention would be the ‘third tranche’ of his plan, and then the ‘next budget’ would see a focus on prevention. Hunt got to oversee six health budgets, and it never happened.”
Moore said as an outsider, he did not know if this was because the Treasurer or Cabinet overruled Hunt, or if prevention was never proposed.
“The most agreeable parts of dealing with Greg Hunt as Minister were his strong intellect and his willingness to listen to evidence, to understand, and to take seriously proposals that were being put to him.”
Current PHAA CEO Adjunct Professor Terry Slevin agrees that prevention policies were not enacted. “Hunt showed an understanding of the health policy issues– including prevention. One of his final major health policy statements, the National Preventive Health Strategy, was excellent and has been adopted and accepted by the ALP as a legitimate national direction for the next decade. His policy directions and political decisions on tobacco and vaping were also very sound, albeit many lamented the lack of financial commitment to tobacco control.
“The main deficit was in implementation. He never did get to any significant delivery of preventive health programs or policies we were advocating. We rated his sixth and final budget as an “F” for health, because of that failure.”
Slevin also noted that Hunt’s “policies on alcohol regulation were a mess, thanks to incessant industry lobbying.”
Hunt presided over a drawn-out, unsatisfactory result regarding pregnancy warning labels on alcohol.
“This should have been a simple issue – evidence based consumer advice for women about the health and safety of their babies over any industry desire to sell more alcohol to pregnant women,” Slevin said.
“But the lobbying was relentless, and several of the state governments, initially on the right track, wobbled. Hunt could have showed more leadership, but he left the matter largely to junior Minister Colbeck. In the end, an outcome was secured without the Commonwealth Health ministers showing leadership. The lesson is – this is just not how public health decisions should be made.”
By contrast, former PHAA President Emeritus Professor Mike Daube AO said Hunt “deserves credit for taking a strong and principled stand on countering the influence of the tobacco industry, and resisting pressures from the industry and industry-funded organisations to popularise e-cigarettes.”
Hunt will be most remembered for the COVID-19 pandemic, in which he became a regular news presence.
Health Minister Greg Hunt and CMO Prof Paul Kelly providing #omicron update in Canberra. Hunt has asked ATAGI to review booster shot timeline (currently six months). “We will not hesitate to take additional steps if the medical evidence is that more are required,” he says. pic.twitter.com/mZ043GzFDI
— Clare Armstrong (@ByClare) November 29, 2021
“Hunt was consistent, calm and steady during some enormous challenges. It was doubtless a testing and grueling time to be a Health Minister,” said Slevin.
“It deserves historical recognition that … Hunt was highly influential in his role, ensuring that the federal government took health advice. The Chief Medical Officer and the Chief Health Officers were politically backed at all levels to exercise their powers. The pandemic saw the first major use of the very substantial legal powers under the national Biosecurity Act, which were deployed to protect the whole population as they were meant to.”
“And it matters that the nation’s strong expertise in the public health community was drawn on to make some good decisions about key issues such as quarantine necessities, virus transmission risks, vaccines, and a host of other urgent questions.”
Criticism came later. The vaccine acquisition and rollout seemed to fall behind schedule, emergency institutional arrangements became complex, and hitches occurred in international traveler quarantine arrangements.
The public mood on the pandemic has overall supported much of the action by the national, state and territory governments, although there are some lasting grievances, and no doubt lessons to be learned.
“Everyone expects that at some point some royal-commission style examination of events will occur,” said Slevin. “If that comes, our hope is that it will be solutions-focused, rather than blame-focused.”
“But no-one is significantly faulting Hunt’s own performance, and certainly not his dedication, application, and effort.”
Debate about reform and preparation for future pandemics is underway. The broad calls for the creation of a national Australian Centre for Disease Control and Prevention (CDC), to bolster and streamline public health emergency responses, and chronic disease prevention, have reinforced that policy for the new Labor Government.
“Progressing a CDC was recommended by a parliamentary inquiry several years ago, but the former government was opposed to change,” Slevin said, adding that in March 2022 he received a letter from Hunt that said the Coalition Government would not support creating one.
“It’s now an opportunity for the new government to deliver it.”
“Overall,” Slevin concluded, “as one of only a handful of national health ministers who served for five years, Hunt should be acknowledged for his contribution to Australia’s health.”
“There remains one final service he could deliver – not taking a job in an industry he has just been regulating. It would send all the wrong signals, because we do need to end the revolving door between government and industries.
Slevin encouraged Hunt to instead write an insider’s memoir of the national pandemic response.
“That would certainly be of interest, and perhaps even of some historical value.”