Melissa Parke (Fremantle, Australian Labor Party, Shadow Assistant Minister for Health) Share this | Hansard source

I rise today to speak against the proposed abolition of the Australian National Preventative Health Agency. It was at the recommendation of the health experts who comprised the National Preventative Health Taskforce, and with support from, among others, the Royal Australian College of Physicians, the National Heart Foundation and the Public Health Association that the Labor government created this agency for the purpose of improving the health of Australia's people in the long term and reducing costs to the health system.

In everyday life we often use the phrase 'prevention is better than the cure' metaphorically, but of course this axiom is the literal explanation of why preventative health measures, both for individuals and for national health outcomes, are so valuable.

By focusing on some of the biggest health challenges we face, tobacco use, excessive alcohol use and obesity, the agency was building its strategy for a comprehensive and coordinated attack on preventable conditions. For a modest cost, this agency would deliver far greater savings to future health budgets and, most importantly, would prevent people from becoming ill in the first place. Unfortunately, it does not appear to matter to this government that prevention is far preferable and less expensive than a cure.

The government's approach to agencies that work to minimise the harm done by chronic health problems was first seen with the abolition of the Alcohol and Other Drugs Council. Now, in the context of this health-slashing budget, we see preventive health removed in the name of short-term savings, while the personal and long-term systemic costs are left to lie where they fall. And one suspects this government sees no problem with disregarding expert advice or ignoring the potential for positive health outcomes if it means posturing against government involvement or intervention in areas of health, like obesity and addiction, where the ultra-liberal view is that individuals should be entirely responsible for avoiding such health impacts. With this bill and its swag of other budget cuts to health, the Abbott government has set about destroying the very foundation of affordable and universal public health care in this country. Left on this trajectory, we will certainly see a two-tiering of the health system and a disproportionate representation of poor health among our poorest and most vulnerable citizens.

In the 2010 legislative debates that led to the creation of the Australian National Preventive Health Agency, coalition participants appeared to support a greater focus on preventive health in this country. Indeed, the speakers at that time noted and appreciated the ultimate cost-benefit merits of funding preventive health initiatives. Speaking to the point that 32 per cent of Australia's disease burden stems from modifiable risk factors, Senator Fierravanti-Wells said:

Investing time and energy into preventing chronic life-threatening disease will obviously assist. The coalition believes preventive health should be on the national agenda because treating people with chronic preventable diseases leads to a substantial reduction in economic and social costs. Chronic disease is a significant burden on our healthcare system. This leads to substantial economic and social costs for all Australians. If we can manage these costs then it will raise a significant burden from Australia's healthcare system—a system that is already under a lot of pressure. Increased focus on preventive health—keeping people healthy and out of hospital—is a very important goal for any government. Of course, we agree with provisions to this effect.

And Senator Barnett made the following contribution:

We need a total paradigm shift in this country in supporting health prevention measures. I am pleased to say that this bill goes some way to starting that effort and making a difference.

Senator Birmingham had this to say:

The coalition are supporting the passage of this legislation because we recognise that there is more work to be done in the area of educating people and ensuring a greater understanding by all Australians of what we should engage in to live a healthy lifestyle.

Deputy Speaker, of course you would be hard-pressed to find anyone in this place disagreeing with the benefits of preventive health programs and measures. Yet in this very bill the government demonstrates its disregard for preventive health strategy, coordination and program assessment. In doing so it is ignoring the fact that the community, and especially stakeholders in the health arena, expect governments to lead, to coordinate, and to assist in tackling the very significant health challenges facing our nation. This government and its members talk about the value of preventive health while ripping away the key statutory agencies and funding that actually work to help make that change. It is frankly appalling that expert advice which recommended a focused, concentrated, educational approach is being cast aside. Instead, we will see the targeted effort subsumed within the broad health portfolio and no doubt weakened and diluted within a prevailing atmosphere of funding cuts and uncertainty. Preventive health will not be on the front-burner; it will not be prioritised to help make a paradigm shift in society; and people will continue to suffer from preventable chronic diseases, with all the individual and health system burdens these bring.

In its short life, the National Preventive Health Agency has already demonstrated ingenuity and contemporary relevance in its social marketing approach. Its free My QuitBuddy app, designed to help smokers beat their addiction, has proved to be an innovative and effective tool in the war against smoking, receiving a gold medal at the Association for Data-driven Marketing awards. As previous speakers have mentioned, we have today seen the health minister attack this, and other preventive health measures. The reality is that the ANPHA funded promotion of the My QuitBuddy app through the Summernats events was undertaken precisely because it attracts over 100,000 people, with the large majority being 25- to 40-year-old men. This is a core target audience for the National Tobacco Campaign and the promotion was undoubtedly a success, with 55,000 downloads of the app in the month of January, when Summernats occurred, compared with 19,000 in December. That is virtually a 300 per cent increase from one month to the next—and it is exactly what a smart and well-designed promotional campaign should deliver.

In its final report, handed down this month, the agency explored the often canvassed idea of placing a minimum price on alcohol to reduce harmful consumption. Contrary to the intuitive reasoning that stands behind minimum pricing, the report concluded that such an approach was not advisable. It said:

As Australia's alcohol distribution and retail systems are fully private, a regulated minimum price increase (as distinct from a tax) would lead to profit increases flowing to the private sector from the monopoly rents created. This significantly reduces the available public benefits which could be used to further reduce or treat alcohol-related harm or be redistributed by government for other purposes.

I am not sure that I entirely agree with that conclusion—and I am aware that experts in this area believe that a minimum floor price, along with other measures, including a comprehensive recasting of the current inconsistent excise arrangements, does have a role to play in reducing the severe impact of alcohol-related harm. But the report nonetheless demonstrates the critical and valuable role the agency is performing, and the value of its independent input into the public policy process. With its dedicated focus, the agency is equipped to respond quickly and specifically to issues as they arise. The agency's Be the Influence—Tackling Binge Drinking campaign has successfully connected with its young target audience; it is amongst the most popular government social media pages with 189,000 Facebook likes. This campaign also has a presence within 16 national sporting organisations to help reduce the exposure to alcohol imagery and break the links between sport and alcohol. Under this government, disappointingly, the funding for Be the Influence is about to disappear. The funding of campaigns and the examination of questions like those I have just mentioned need to be sustained. This critical area of work must be continued and expanded if we are to achieve the aim of reducing the prevalence and impact of preventable chronic disease in this country.

Increasing the cost of visiting the doctor in order to create 'new' medical research funds while at the same time cutting perfectly functional and forward-looking programs and agencies, and acting to strip future hospital funding, is simply topsy-turvy nonsense. In The Age on 16 May, economics editor Peter Martin pondered the government's health priorities as follows:

Imagine for a moment the government is serious about reining in health costs. What should it do? Should it invest heavily in preventive health, trying to change lifestyles so more people don't get ill in the first place, or should it amass billions for medical research?

A government concerned about pay-offs will do the first. Or it may decide to do both, investing in preventive health while also putting aside funds for medical research. What it won't do is shut down existing attempts to prevent illness in order to fund research. That's if it is serious.

Sadly, this government is not serious about sensible, balanced, long-term health policy—and its abolition of the Australian National Preventive Health Agency is yet another example of this nation being put into reverse gear with barely a glance in the rear-view mirror for the dire health consequences that await.

See this speech in context