climate change

Sep 4, 2013

Election wrap : the Coalition is not leading the field, in health policy anyway

Well, it's election week, and it's time to make a decision.  Disappointingly, the discussion around population health and health policy has been frustratingly brief this election. John

Well, it's election week, and it's time to make a decision.  Disappointingly, the discussion around population health and health policy has been frustratingly brief this election. John Dwyer has reminded us that there is so much more we hoped for. In the words of Tony McBride from the Australian Health Care Reform Alliance:
"While there are some valuable initiatives from both sides, they fail to add up to a genuine effort to address the scale of the current health system problems. There is insufficient action to address serious inequities in health and healthcare or longer term problems - they have taken their eye off the ball."
In order to help you review what has and hasn't been discussed, we have provided some quick links to analysis of some major public and preventative health issues. (Note: we have tried to be as comprehensive as we can if any major policy announcements or analyses have been missed please get in touch through our comments section) **** Climate change and its impact on health The Climate and Health Alliance have done an analysis of 6 parties against their top priorities, namely:
  • Stronger emissions targets for Australia
  • Removal of fossil fuel subsidies and redirection of funds to renewable energies
  • Expand the renewable energy target to 60% by 2020
  • Put a moratorium on coal seam gas
  • Develop a national plan for climate, health and wellbeing
  • Establish a federal agency to oversee climate and environmental health issues
  • Establish a sustainable health unit within the federal Department of Health
Not surprisingly, no single party scored full marks on CAHA’s ambitious score card. However, the results do show that against these measures only the Greens (scoring 6.5 out of 7) could be considered as taking the issue seriously. Sadly the next highest score was 1 and that was the Katter party. Full results here. The Australian Healthcare & Hospital Association has also backed the Greens' plan to establish a Health Sustainability Unit to reduce the healthcare system's environmental footprint. **** Approaches to effective and sustainable services for those in regional and rural areas The National Rural Health Alliance set seven key priorities in their election charter:
  1. Local health needs must determine rural service planning and delivery.
  2. There must be an integrated rural training pathway for rural and remote health professionals.
  3. In aged and disability care, government should build on reform to enable rural people to live better.
  4. There must be continued support and resourcing for the Close the Gap Campaign.
  5. Funding must provide equitable education and health choices for rural people.
  6. Government should lead development of fixed and mobile connectivity for rural prosperity and health.
  7. Government should build the economic future of rural communities.
According to their extremely nifty score card on the major parties, the ALP and Greens get full marks of 35/35 while the LNP scores 11 out of 35. For further detail click here. (The above tally was current at 3pm on 4 Sept). Much has been made of the NBN’s role in the further growth and progression of telehealth.  It has been hard to know who to believe in terms of claims made in the IT stakes. Fortunately the Conversation stepped in and provided a number of handy analyses including this comparison of policies and this review of value for money. **** Closing the gap in Aboriginal and Torres Strait Islander health There has been a notable lack of discussion around ways to continue Closing the Gap for Aboriginal and Torres Strait Islanders. In an open letter to the political parties, The National Congress has called on the major political parties to:
  • fully support the new Aboriginal and Torres Strait Islander Health Plan including implementation that includes communities,Governments and health organisations to ensure the most effective roll out and monitoring of the Plan,
  • Continue support for achievements through Closing the Gap Initiatives and investment in ATSI health outcomes, and
  • renegotiate a National Partnership Agreement on Closing the Gap in Indigenous health that ensures full roll out of the Health Plan
Responses from each of the major parties can be found here. The Australian Healthcare and Hospitals Association  (AHHA) summarises the major parties positions thus: "Labor has committed to a new National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. The Greens support maintaining investment in Closing the Gap initiatives including a stronger focus on hearing health. The Coalition health policy makes no mention of Aboriginal health issues." Perhaps the most succinct statement comes from NACCHO: Complacent parties taking their eye of the ball in Aboriginal health.
**** Priority for prevention The Australian Health Promotion Association has also put together a score card of 17 areas of prevention and health promotion including amongst others oral health, indigenous health, tobacco, obesity prevention and mental health. Full results here. In their pre-election summary, the AHHA states: "Labor will continue to support the work of the Australian National Preventative Health Agency (ANPHA). The Coalition will fast-track the implementation of the National Bowel Cancer Screening program and establish a National Diabetes Strategy but will review the role of a range of agencies including ANPHA . The Greens support an ongoing and expanded role for ANPHA and support improved food labelling, warnings on alcohol products and restrictions on junk food and alcohol advertising". The LNP have also pledged significant funding to GP's for teaching and training - a policy supported by the AMA. Today the ALP announced funding for a Preventative Health Research Centre. The Foundation for Alcohol Research and Education (Fare) have also put together a score card regarding their election platform 10 Ways to Reduce Harm. the ALP, the Nationals, the LNP and the Greens all responded to nine questions. Again the Greens scored 9/9 points, the LNP scored 2 points, the Nationals 4 points and Labor 1. *** Who understands the impact of the social determinants of health? “Having 2.2 million people living below the poverty line, including nearly 600,000 children, is unacceptable. If we don’t take action to reverse this trend now, it will be more damaging and costly down the track.” So says the ACOSS plan for the next governments first 100 days in office. What is on the agenda for tackling poverty and other social determinants of health? The lack of focus on the social determinants of health by the major parties has been lamented by groups across the sector. Poverty: The Greens have explicitly addressed poverty as a problem. Neither of the other parties have mentioned poverty directly. Housing: Both the Greens and Labor discuss housing affordability in their plans Early education: The Gonski reforms introduced by Labor see schools receive higher funding determined by the needs of their population. The coalition also have a plan for improving education, this is based on encouraging further independence of schools. The Greens plan to increase school funding further. *** Equity in health care for the most vulnerable Asylum seeker health has been a major concern for many in the health field. To date only the Greens have made any statement on this proposing an independent health advisory panel to oversee asylum seeker health care. This initiative is supported by the AMA. *** Mental health reform The LNP and ALP have both pledged to increase funding to headspace and EPPIC, the youth metal health programs championed by former Australian of the Year Pat McGorry.  The Greens point out access issues for rural people and support expansion of the mental health nurse incentive program, telepsychiatry and outreach to support this. Kate Carnell, CEO of beyondblue had the following response to the major parties policies:
"In the lead up to the Federal election on September 7, I am very pleased that the ALP, the Coalition and the Greens have all released mental health policies. This recognises that political parties see mental health as a very important part of the health system that requires dedicated allocation of funds. With more than three million Australians experiencing depression or anxiety at any one time, this is an important issue for beyondblue and people with mental health problems and their families. I am particularly pleased that the ALP made a specific commitment to extend funding to beyondblue’s National Workplace Strategy– and I urge the Coalition to do the same. I welcome the commitment of both major parties to focus on the mental health needs of young people; however I am disappointed that neither party has addressed the ongoing needs of new mothers, their babies and partners by allocating funds to the proposed Centre of Perinatal Excellence (COPE)."
In responding to the major parties' announcements, the Mental Health Council of Australia stressed the need for systemic ongoing reform, as has an alliance of 46 mental health sector organisations and stakeholders. Croakey readers may find this detailed election analysis - a rural mental health nurse perspective - by Rhonda Wilson useful. As well as analysing policy commitments, she explains the reasons for how she is going to vote. Health research Research Australia has put together a comparison of the parties' commitments to health and medical research funding. All three parties have made commitments to different areas of funding, see the details here. If there is not enough policy reading here for you, you can find each of the major parties' health policies at the links below: LNP:  The Coalition Policy to support Australia's health system Greens:  Standing up for what matters   ALP:  Labor is for better health • See here for Croakey's election coverage   

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