The Best and Worst in Health

The Rudd Government’s first year has brought a mixed record in health policy – a grab-bag of small, uncoordinated initiatives have been announced, but major election commitments to reform remain unfulfilled, awaiting reports from a raft of advisory groups.

The Best
The best health policy initiative from the Rudd Government this year was its commitment to spend $90.3 million over the next five years on Indigenous child and maternal health services.  This will contribute to closing the gaps on mortality, morbidity and literacy and, if done well, could provide valuable learning back into white Australian society about the importance and contribution of the extended family in establishing a healthy and rich cultural life of children.

However, this endorsement comes with caveats: the policy proposal will only work if it is sustainably funded; if staff with appropriate health and cultural training are supported in their efforts; if welfare, health and development problems uncovered are addressed; and if the Commonwealth can work in effective partnerships with the states and territories and Indigenous communities.

This new commitment, which will incorporate a program based on the Nurse Family Partnership, pioneered in the US by Professor David Olds, must be integrated with current commitments such as Health @ Home Plus, Healthy for Life, Family Centred Primary Health Care, and state and territory programs. The risk? We could too easily end up with a series of different programs all trying to do the same thing, diluting the investment of scarce resources, effort and goodwill.

The Worst
The most deeply disappointing policy decision (or more correctly non-decision) was that which led to no change in the advertising of food on children’s television.  We were used to Mr Abbott’s view that, if there was a problem with what was on children’s TV, parents should simply switch it off.  Strength of character and parental presence was all that was needed.

After considerable prevarication, Health Minister Roxon has ended up adopting the same position. The immense political power of the food manufacturing giants cannot have had any impact on the decision, can it, although their analysis of the research data unsurprisingly supported the conclusion of no impact from advertising?  The food industry’s investment in such advertising is thus incomprehensible – unless, of course, the wrong research data were entered into the debate.

Indeed that is the case.  Sales data, never made public, probably hold the appropriate evidence.  Many forms of evidence influence policy, of which health research metrics is but one, occasionally applied.

The proposition "no we won’t restrict advertising because there is no conclusive proof that it affects consumption" bears an eerie, almost plagiarised, similarity to the arguments made last century against controlling tobacco advertising.  Nevertheless we got rid of tobacco advertising.  Now the evidence is visible for all to see – tobacco consumption rates in Australia are among the lowest (17 per cent) in the world, with falling lung cancer, heart disease, and emphysema death rates.

Inevitably the public – sick of being fat, concerned about childhood obesity and diabetes – will drive food companies to change their behaviour and drive our politicians to change their position as well.  In the meantime, this is a disappointing policy cop-out with substantial health consequences.


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