COVID-19 has taught us the fragility of our society in the face of an unexpected threat. It has also reinforced the critical importance of a well-resourced and evidence informed public health and social care system in combatting these threats.
Most of the future threats to Australians’ health and wellbeing are not unexpected. We have known for a long time that we have an obesity epidemic, an aged care system that is no longer fit for purpose, and a broken mental health system.
Last night’s Federal budget includes some welcome items for the future health and wellbeing of Australians. The structural reforms for aged care, including major investment into workforce training and quality standards, are significant. There is also funding for some critically needed programs for eating disorders, domestic violence support and mental health.
However, there is only so far that one-off investments into chronic problems can take us. There is little to no investment in health prevention in this budget. We know prevention works and that it is far more cost-effective than treatment and cures. Imagine the many investments in the current budget into new programs and increased access to care as band-aids applied after a run through a bramble forest. Critical, and welcome. But limited in capacity and less effective than clearing a path through the forest.
In Australia we currently invest less than 2% of our health budget into prevention. It is not possible for us to efficiently reduce the harms and costs of the chronic issues facing Australians without boosting our investment in prevention. We need substantial investment in health prevention in Australia, across all levels of government.
In the UK, Prime Minister Boris Johnson responded to his country’s COVID-19 crisis by pushing through the second stage of its obesity plan, explicitly calling out the increased risk of COVID-19 associated with obesity and diabetes. COVID-19’s deadly lessons should be driving Australia to finally act on obesity, but progress on what would be our first-ever national obesity plan has stalled. It is time for the Federal government to commit ongoing, integrated funding into obesity prevention to avoid ever increasing budget investments in the future as band-aids for the outcomes of more diabetes, heart disease, joint replacements and cancer.
We also need substantial investment into evidence-led system reform for our aged care, mental health and disability systems. We are still applying money piecemeal to fix the holes as they appear. Again, the increase in investment into all these systems is badly needed and long overdue. But where is the investment in the glue that will hold these systems together, now and for the long term?
As I wrote recently for MJA Insight, we already know what is needed to fix these broken systems. Multiple parts of society need to be involved in the solution. It requires integrated actions aimed at the food system, our health care system, our schools, our communities, our workplaces, our maternal and child networks, and our social services. And we must constantly gather intelligence and continue to improve, evolving who is engaged, what the system looks like, and what change is needed next.
Our health system is not a skyscraper that requires solid laying of block after block of the same structure and layout. It is more like a complex and fragile spider’s web that we need to learn how to spin with agility and adaptation, responding rapidly to changing consumer needs and context.
The COVID-19 pandemic has shown us that if we really want to do something, we can get on and do it. It is time for us to invest in the long-term health and wellbeing of Australians – through prevention and system reform.