NSW Left activist, Elly Howse, writes about a Labor vision on preventative health policy
The Labor Party in Australia has a long history of driving policies and investment in health. Most famous of these policies is the development of the Medicare universal healthcare scheme – the envy of many across the world. But Labor has been successful in other key areas for health too, for example the recent achievement of plain packaging of cigarettes by the Gillard Government in 2012.
While many in Labor continue to laud and emphasie the importance of protecting Medicare during the election (which is important given ongoing attacks on it by the Coalition) most of us have forgotten that the health of our people is about much more than a healthcare system based primarily in hospitals and medical centres run by doctors, nurses, and allied health professionals. In fact, simply looking at and measuring hospital or GP visits as a measure of success in health only tells a part of the story. Providing a reactive, disease-based model that only engages people once they are sick is expensive and sometimes very ineffective.
What’s much more powerful is looking at ways to prevent people from getting sick or experiencing ill health in the first place.
Australia’s greatest health challenge, now and for years to come, is the rapidly growing issue of chronic disease – this term includes heart disease, stroke, heart failure, chronic kidney disease, lung disease, type 2 diabetes, as well as other conditions such as Alzheimer’s. An ageing population that is experiencing unprecedented rates of chronic disease means greater strain on our health system and worse outcomes for people and communities.
We know too that those who experience higher rates of chronic disease and associated conditions are those who can least afford it - Aboriginal and Torres Strait Islander peoples; people with a disability; and low income Australians.
Health inequality is alive and well in Australia. But what is really shocking is that most of the chronic diseases outlined earlier are preventable if we take appropriate action on the four big risk factors: alcohol, tobacco, poor diet and physical inactivity.
This is where Labor must act.
Since 2013, the lack of federal funding invested in preventive health efforts to counter chronic disease has been scandalous. Labor in 2010-11 set up the Australian National Preventive Health Agency (ANPHA) – an agency that no longer exists thanks to the first term of a Coalition Government, which promptly cut all funding and subsumed ANPHA into the Department of Health & Ageing.
ANPHA was essential in driving big picture, uncomfortable policy discussions that aimed to put the health of people first, especially before the profits of big companies and industry. Their reports on how to address alcohol, tobacco and obesity in Australia have been scuttled by governments afraid of the evidence underpinning it and the actions required, such as reigning in the big three: Big Tobacco, Big Food, and Big Alcohol.
For example, no one likes to admit that simply educating people about healthier choices when it comes to food, exercise and alcohol has limited success and is also inequitable. That’s of course why industry promotes education and strategies directed at individuals – they know it doesn’t work, and it won’t ultimately affect their bottom line.
This is why Labor members must sign up to and support the first ever national prevention campaign Prevention 1st, run by the Foundation for Alcohol Research and Education (FARE). This campaign asks specifically for investment in preventive health strategies in Australia. Importantly, it says we can’t do this by targeting individuals; instead we have to have necessary and difficult conversations about the commercial and vested interests driving people’s poor health.
It’s worth asking; why are discretionary or ‘junk’ food items like soft drinks still so heavily promoted and easily available in our convenience stores and supermarkets, yet plenty of Australians can’t afford or access foods for a healthy diet, particularly people on low incomes? Why is State of Origin plastered in alcohol advertising? Why do we spend so much on car and road infrastructure in our cities and spend little on cycling and public transport except in higher income, inner city areas?
Prevention 1st is calling for the Australian government to look at:
- Implementing taxation to encourage healthier choices (for example along the lines of sugar taxes in Mexico and the UK);
- Improving labelling for alcohol, food and tobacco;
- Regulating the promotion and marketing of products that are associated with harm;
- Providing supportive and safe environments that support healthy decisions by individuals and communities; and
- Committing to increase federal expenditure on preventive health - in other words, refunding ANPHA and other associated organisations.
It’s important to note that governments can’t and shouldn’t just pick and choose from this list – they need to do all of them. It’s absolutely essential for governments to ensure that any initiatives that may have a negative or disproportionate impact on vulnerable individuals and communities have programs and funding in those communities to support access to healthy environments and appropriate health services.
For example, removing alcohol sponsorship from local sporting teams is one part of the picture; the other part is ensuring governments and local councils provide more funding for kids and adults to participate in sport and exercise in their community. This could be in the form of facilities, fields and courts for organised sport, and free programs for older Australians to keep active and healthy.
Similarly, if you don’t work to improve access and subsidies to fresh nutritious foods in low income communities, a ‘sugar tax’ may disproportionally affect disadvantaged Australians. This is particularly the case if the GST is applied to fresh foods (http://www.smh.com.au/comment/a-gst-on-fresh-food-is-a-bad-idea-how-about-a-higher-tax-on-junk-food-instead-20151111-gkwjfh.html). Sugar and junk taxes can be effective and do have the greatest benefit for low income people considering we know the processed food and beverage industry deliberately target and make money from them. But we need to make sure that the barriers to a healthy diet are also addressed.
We can and should do both.
Labor and its members share a vision about what it means to be in a just, healthy and equitable country. We agree that governments have a clear role to play in building and shaping this vision so as to benefit all Australians. Only Labor has the capacity and foresight to act on chronic disease and support preventive health measures in Australia.