NACCHO Aboriginal Health News Alert : Five ways that the $160m same sex plebiscite could be spent in health


PHAA chief executive Michael Moore said the money should be funnelled into areas that would benefit the community such as health and education instead.

“Essentially this is a waste of money at a time when governments are cutting health budgets – and particularly slashing prevention,” Mr Moore said.

Reporting in todays The Age

Photo Above Some in the health industry name Indigenous health as the top area worthy of investment. Photo: Michael Amendolia

The growing cost of health – powered by an ageing population and more expensive technology – presents an ongoing challenge to the federal government, but there is no shortage of people willing to offer Health Minister Sussan Ley some unsolicited advice on how to better spend her portion of the budget.

If the $160 million was diverted to health, here is where some health advocates believe it could be better invested, in no particular order.

  1. Preventative health

The latest Australian Institute of Health and Welfare report showed the proportion of health expenditure devoted to prevention had decreased to 1.4 per cent in 2013-14, down from 2.2 per cent in 2007-2008.

Although much of the preventative health dollar in that peak year went towards introducing the HPV vaccine, other evidence suggests a disinvestment in preventative health, including the termination of funding to the Australian National Preventative Health Agency [ANPHA].

Michael Moore said the re-opening of that agency and all the programs that it ran would be one good use of the funds, or campaigns on the harms associated with tobacco, alcohol or obesity.

“You could easily spend all of the money on this as we cannot hope to compete with industry bombardment,” he said.

The Heart Foundation has called for $35 million to be spent annually on addressing physical inactivity, which is estimated to cause 14,000 deaths every year.

General manager advocacy Rohan Greenland said Australia was in the bottom third of OECD nations in terms of the amount it spent on preventative health.

“While we are doing well on tobacco control, we should be putting the same, sustained effort into preventing obesity, tackling physical inactivity and addressing poor nutrition,” Mr Greenland said.

A Department of Health spokeswoman said the activities of ANPHA had been taken over by the department.

Preventative programs included projects centred on chronic conditions, a National Asthma Strategy, a National Diabetes Strategy, activities addressing healthy eating, physical activity, obesity, tobacco, alcohol, research, immunisation,  mental health initiatives and cancer screening, she said.

  1. Aged care

Nurses nominate aged care as the sector in most dire requirement of funding.

Aged care providers have long been predicting a shortage of places and qualified nurses as baby boomers move into their dotage, with lack of staffing blamed on an increase in violent incidents.

The Australian Nursing and Midwifery Federation federal secretary Lee Thomas said $160 million could replace some of the money that has been taken out of the sector in recent years.

“Currently, there is a shortage of 20,000 nurses in aged care,” Ms Thomas said.

“This needs to be fixed as a matter of urgency, given Australia’s rapidly ageing population.

“The restoration of funding for the health sector would also go toward supporting public hospitals in the states and Territories and allowing more graduate nurses to be employed.”

  1. Indigenous health

Australian Healthcare and Hospitals Association chief executive Alison Verhoeven has a wishlist that lasts pages (“Oh there’s so much you could do”) but indigenous health tops her list.

As a start, the money could be invested in closing the gap in diseases such as rheumatic heart disease and trachoma or addressing the high rates of suicide, drug and alcohol abuse.

“We could be looking beyond that at things like how we incorporate investment in safe housing and safe food supplies and ensure that kids growing up in indigenous, particularly remote and rural, communities actually get a good start in life,” Ms Verhoeven said.

  1. Chronic disease

The Heart Foundation has argued that there is an economic and social argument to address chronic disease, which cause 90 per cent of all deaths and 85 per cent of the burden of disease.

“The health minister has rightly said that chronic disease is our greatest health challenge,” Mr Greenland said.

“We need to be better at early detection of those at risk of having heart attacks, strokes or developing diabetes and kidney disease.”

The federal government unveiled in March a trial of “Health Care Homes”, whereby people with chronic disease would have all their care managed from a single GP practice, but Ms Verhoeven says the $21 million package would only cover education and training.

“It’s not enough to make a real change across Australia in the way we deliver primary care.”

A Department of Health spokeswoman said the $21 million was in addition to $93 million that would be redirected from the Medicare Benefits Schedule in 2017-18 and 2018-19 to support the management of patients with chronic conditions.

  1. Mental health

Many in the health sector are concerned that the angst caused by the plebiscite could actually contribute to its overall cost.

Michael Moore said the mental health impact of the plebiscite was estimated to cost $20 million and already there was more demand for counselling services.

The Royal Australian and New Zealand College of Psychiatrists has called for employment support for people with mental illness and improved services for people with borderline personality disorder, aged care residents, children and adolescents and Aboriginal and Torres Strait Islanders.