Transcript of doorstop: AMA President, Dr Andrew Pesce
Druitt St, Sydney, Thurday 27 August 2009
E&OE

Subjects: Media reports of Preventative Health Taskforce report, cash payments for nurses.

DR PESCE: Thanks for coming. Some elements of the primary health prevention Taskforce report are starting to be released to the public. Doctors see the downstream effects of poor health caused by obesity, smoking, and excess alcohol in their practices and in the hospitals every day.

It's vitally important that, as a community, we do everything we can to improve the health of our community, not just through treating illness, but through preventing it in the first place.

The AMA has always had a strong policy on decreasing smoking through campaigns, to decreasing advertising, increasing the prices of cigarettes, and also has always had a policy on targeted advertising to make sure that poor health choices aren't promoted in our media.

It's very important that this continues, and the Government needs to look at ways in which it can really improve the health of the community by preventing obesity, smoking and inappropriate alcohol consumption and promoting healthy diet choices all through Australians’ lives.

QUESTION: So you're saying that there's something new in the Taskforce's findings?

DR PESCE: There is something - there are some radical suggestions in the Taskforce findings. They're talking about the Government subsidising good food choices for people through food vouchers for low-income earners, and possibly subsidising the cost of nutritious foods in remote and rural communities where the costs are prohibitively expensive.

It's a lot cheaper to buy a packet of chips in Arnhem Land than an apple, so sometimes the Government has to be proactive in making sure it makes good food choices possible for all Australians.

There's also recommendations regarding the incorporation of food manufacturers into the strategy.

Too often foods that are marketed and easily available to the population have less than healthy levels of salts, fat, carbohydrates.

We need the community to have information to make sure they know they can make healthy choices easily, and sometimes you may actually need to send price signals to make sure that those health choices are reinforced.

QUESTION: This radical suggestion, to use your own words, do you know whether or not they've been trialled in other countries, and if so, if they've been a success?

DR PESCE: Look, we know that intervening in terms of smoking and alcohol, we can improve health outcomes.

There isn't a huge amount of evidence on this yet in terms of the proportions of unhealthy foods in the diet.

There is some evidence that restricting advertising of junk foods to children during children prime time viewing does lead a measurable decrease in weight gain. So there is evidence that this can work.

QUESTION: Does the anecdotal evidence overseas, for example, from these sorts of measures to subsidise the [inaudible] increased cost of cigarettes and alcohol is going to benefit [inaudible].

DR PESCE: We know that you can decrease smoking - and so far this has been done through restrictions on advertising and pricing of cigarettes - you do improve health outcomes and it makes sense that this would work in other foods and beverages as well.

QUESTION: Do you think specifically a tax on cigarettes is an appropriate measure?

DR PESCE: Well we've had taxes on cigarettes for a long time, and I think it's an incremental pricing message that's been sent to the community.

It's not just a disincentive for people. It actually, I suppose, in a way pays for the health costs downstream which are generated by smoking.

It makes sense that if manufacturers are going to be marketing a product which costs the health system money in the future, that those costs will be recouped through taxes.

QUESTION: And do you think that the food vouchers are a positive step?

DR PESCE: I think it's an excellent step. I think it's probably good public policy in general terms in health policy.

I think that if we can encourage people to make good food choices, even if they're not so affordable for them, then that has to be of benefit for our health as a community.

QUESTION: Isn't our government, though, playing Big Brother and taking choice away from the individual to an extent?

DR PESCE: Well no, people will always have choice, but the Government has responsibility to encourage good choices, and make sure that those good choices aren't beyond the reach of normal Australians.

And it would be a terrible thing if people wanted to make healthy choices, but couldn't do it.

QUESTION: Okay, we're talking about a whole bunch of different sectors, obviously medical industry, manufacturers, you know, it's a huge thing. How effective - it's all very well to plan, but just how much will it take to implement do you think?

DR PESCE: There's no doubt this needs real consultation. The Government has to learn that it can't just decide if it wants to do things and expect that that's going to happen.

It has to consult. It has to consult with the medical profession to see what's going to work, it has to consult with the community, it's going to have to consult with the producers and manufacturers of the products that are involved, so this is only the beginning of the process.

It's going to have to put a lot of work in and engage with all of these people to make it work.

QUESTION: [Inaudible]

DR PESCE: Look, I think - I'd like to think it's going to happen.

The Government has to make a choice. It can't just make policy by public press release.

It actually does have to engage, and I know this as a matter of fact, I mean just earlier this week, the Minister for Health, Minister Roxon said doctors have to take a lead in improving health outcomes in Australia.

But that has to be a two-way thing. There has to be consultation, genuine dialogue, seeking advice from the providers, the manufacturers to make sure that the policy actually works and doesn't just remain a pie in the sky idea.

QUESTION: What's the most embarrassing part about this leak in Government do you think?

DR PESCE: I think that the Primary Prevention Taskforce has important messages. It seems to be coming out in dribs and drabs, and I think it's time that we see the report or are able discuss it fully.

QUESTION: [Inaudible]

DR PESCE: Well I think that unfortunately they are in a business with a product which is known for poor health outcomes for a lot of Australians.

I'm sorry, but as a doctor I have to focus on the patients that I see every day: the poor health outcomes that people are losing limbs because of gangrene, the people who are losing lungs to lung cancer and then die from heart disease and stroke.

I think we have to make good public policy decisions which are going to improve the health of our nation, and everyone has to bear a price and the burden of that.

QUESTION: What's your reaction to the story in The Australian today that there hasn't been a widespread take-up of the cash incentives to attract nurses back into hospitals?

DR PESCE: Well I think this demonstrates the point. It doesn't just ... good health policy doesn't come out of the good idea in just throwing some money around. 

Good health policy comes from engaging with the people who are involved, finding what it's going to take to actually really work, take our advice and talk to us.

ENDS

27 August 2009

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