Terry SlevinAs a nation, we are facing an enormous and anticipated wave of chronic disease that will cost us in the long term.
An aging population and unhealthy lifestyles – where the most disadvantaged experience the worst health outcomes – are sending a tsunami of non-communicable disease our way.
Currently, Australia spends over $170 billion each year on health, of that spend, less than two per cent is invested in population and preventive health.
Prevention is the foundation of good health policy as it is always better than cure. We need a rational economic response to the ever-growing national costs of illness treatment.
Given that, I’m delighted that this new group of parliamentary backbenchers will be active in dealing with public health issues during this term of parliament, aiming to keep health prevention top of mind for decision makers.
The Public Health Association of Australia (PHAA) is proud to support the establishment of the new Parliamentary Friends of Preventive Health to bridge a gap between evidence that supports cost-effective prevention and health policy that remains skewed to high-end clinical care.
The cross-bench group was launched at Parliament House in Canberra on 2 December 2019, by three co-chairs who together have experience in primary health care and public health research: The Hon Dr Kate Allen (Liberal Member for Higgins), the Hon Dr Mike Freelander (Labor Member for Macarthur) and the Hon Dr Helen Haines (Independent Member for Indi).
The co-chairs each spoke of the importance of preventative health on the day of the launch:
Dr Haines said that “Preventative health starts at preconception, throughout pregnancy and the early years when a child is given the best start in life with breastfeeding and through her parents avoiding smoking, excessive alcohol and maintaining a healthy weight through good nutrition and exercise.
“Preventative health continues right through to old age by practising these same healthy habits established in childhood. Education is paramount to preventative health as is social inclusion and a global awareness of environmental factors such as climate change, gender equality, civil unrest and poverty.”
Dr Freelander said pressure on the health budget can be eased if more health prevention measures are adopted:
“Governments of all persuasions have neglected public health in the past, and it is vitally important that our public health care system is supported with sounds preventative health policies for the sake of future generations. “Early intervention, through policies such as the First 1000 Days program, is key to improving the health outcomes of Australian children into the future, and it is my hope that this group will play a significant role in championing initiatives such as this.”
Dr Allen said, “As a population health scientist I understand the need to raise awareness about preventive health to curb non-communicable diseases. It’s groups like these that can really make a difference to policy and legislation.”
The co-chairs said they were honoured to assist in the group’s formation and that they seek to make a difference to reduce chronic disease and optimise the health for all Australians with a holistic approach to prevention.
Parliamentary Friends of Preventive Health, which has a membership of 18 parliamentarians, will be a forum for sharing information and solutions about ways of preventing all forms of illness across the Australian community.
Pivot to prevention
PHAA has also released a Pivot for Prevention vision statement which recommends a framework for prevention at the federal level.
We are recommending the following:
1. Five Percent for Prevention
We are recommending that one in every twenty dollars spent in health is invested in prevention. We have had a range of successes, with progress on tobacco, immunisation, SunSmart screening and more. With a greater commitment to prevention we can achieve more with the goal of making Australians the healthiest people on earth. To do that we need to build prevention into our health system as a central pillar of activity.
2. Mechanism to assess the best prevention investment
Just as the Pharmaceutical Benefits Advisory Committee (PBAC) plays the role of independent expert advice to government – assessing the efficacy and cost effectiveness of proposed drugs – an expert, evidence driven entity is needed to guide decisions on the best investments in preventive health. At this point the decisions about investment can be made through the all important equity lens, with the aim of reducing, not increasing, the gap between those with the best health and those with the worst outcomes.
3. Infrastructure to fund prevention effort in an ongoing way
We have the Pharmaceutical Benefits Scheme (PBS) to administer the investment in drugs. We have the Medical Benefits Scheme to guide and fund our use of medical services and programs. We have the NHMRC and the Medical Research Future Fund (MRFF) to steer our commitment to research. We have no established embedded structure to commit long term to preventive health efforts. Drawing on the best advice, machinery is needed to ensure continued and reliable resourcing of preventive health efforts. The benefits are largely long term. So too should be the thinking and mechanisms to lead our preventive health efforts.
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