This has been such a week of missed opportunity.
The headlines have been dominated by the Feds urging a local government spend on infrastructure – and fast.
It was a perfect opportunity for the public health crowd to highlight the importance of local government as agents of health. So much of our public debate about health focuses on the role of federal and state governments, which means there is very little attempt to make local government accountable for the many areas in which they influence the community’s health.
Where were the public health voices pushing for some accountability to maximise the health benefits of this new spending? Missing in action, I’m afraid.
So I was very interested to hear that Canada has recently appointed 15 new chairs of applied public health with a brief to do intervention research in population health (in other words, to move beyond just describing health problems and talking about the need for prevention and action on the social determinants of health – to trying to actually DO something).
They are also charged with ensuring that their research is translated into action.
Or as Penny Hawe, from the University of Calgary, told me: “They’re being funded as change agents. They’re not allowed to just sit around being gifted.”
Perhaps if we put some money and muscle into creating population health change agents in Australia, we also end up with some much more interesting and useful public discussions, including about local government’s responsibilities.
2 Comments
This is what I would DO:
Charge patients, Doctors fees, who can afford to pay. Many,many people CAN afford to pay , but wont.
If you use nicotine, you can afford to pay the Doctors fee.
If you are obese, through over-eating, you can afford to pay the Doctors fee
If you have medical side effects from an overindulgence of ANYTHING, you can afford to pay.
STOP moddycoddling the over indulgent, they are aware of what they are doing , and choose to ignore the consequences. If they can find the money for a smoke,a bun, a tipple, they can find the money for a Doctor. Will the Government get real and stop pandering to the overindulgent, and we will have more funding for those people who truly are unwell from no -choice medical conditions
Missed but not Forgotten
If you speak to the social and community workers, urban planners, environmental health officers, water and sewerage engineers they will all tell you that protecting and defending public health is part of their everyday work. They are being increasingly being asked to do this work from a shrinking resource base.
However, the recent example of the partnership built between the NSW Food Authority and Local government in NSW, which has modernized food inspection and food safety in this State, is a great example of the willingness of local government to respond to the appropriate overtures from State and Commonwealth governments.
Can local government respond to the contemporary public health challenges of obesity and hard wired sedentary lifestyles with infrastructure development, innovative urban planning and deft regulation? Yes they can. But what is needed is a commitment to genuine partnership with mutual obligations and perhaps a little less blue sky opining about what local government should do.
Here in Western Sydney we have been trying, with some success, to do this with our 9 local councils. Our experience has been that one of the enemies of success is the lure of short term funding for transient enthusiasms.
This is not to discount the need for arguments for improved transport and social infra-structure, and for bold measures to improve it, but the foundation will be a re-design of the role and authority of local government interventions in these domains.