Ministry for the Public's Health the Way Forward for Disease Prevention in Australia
Public health challenges such as the obesity epidemic have prompted an Australian public health physician to call for a Ministry for the Public's Health distinct from the Ministry for Health, to take responsibility for disease prevention. Similar dedicated public health agencies have been created in Canada, Sweden and the United Kingdom.
In the current issue of the Medical Journal of Australia, Dr Stephen Corbett, acting Director of the Centre for Population Health at the Sydney West Area Health Service, outlines the case for a Ministry for the Public's Health with a budget and accountability to Parliament separate from the Health Minister.
Dr Corbett says the new Ministry would be better placed than current health departments to develop and implement health, rather than health care, policy.
"We have a medical and hospital system, rather than a health system that places proper weight on primary care, prevention and hospital avoidance programs," Dr Corbett says.
The new Ministry would also be better able to build partnerships across tiers of government, and present the health and economic arguments for disease prevention to State and Federal treasuries.
"Achieving health improvements will require whole-of-government action across a range of portfolios, including environment, education, water supply, police and health," Dr Corbett says.
"To prevent chronic disease we should, at the very least, be examining carefully the cardiovascular impact of macroeconomic decisions in agriculture, food production and marketing, and tobacco control.
"The Ministry would be best placed within State and Territory governments, as it is at this level that partnership building and whole-of-government cooperation would have the greatest impact," Dr Corbett says.
Dr Corbett outlines five issues for initial focus of a new agency.
- Whole-of-government action for health
- Effective partnerships supported by executive authority
- Implementation of health policy
- Securing investment in health
- Meeting the macroeconomic challenge of chronic disease prevention
He says major obstacles in Australia to such a model include scepticism from elected officials and the public, the need for authority within and outside government, and finance.
"The rapid population-wide increase in obesity is a particularly urgent and complex public health challenge," Dr Corbett says.
"Lessons learnt from tobacco control could be applied to improving diet and physical activity on a global scale.
The lessons include assertion of collective responsibility, a precautionary approach to evidence, the development of broad coalitions, modest well spent funding programs, political leadership, and a comprehensive rather than narrow approach to risk reduction.
Dr Corbett argues these lessons are an excellent starting point for a vision and modus operandi for a proposed public health ministry and bureaucracy.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT Dr Stephen CORBETT 0411 207 545
Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471