MEMO

To: The new Federal Health Minister
From: Professor Stephen Leeder
Re: Some tips for your new job

Dear Minister

Don’t rush. Take time to consider two things – first, what an ideal Australian health service would look like, and second, what distinctive role you, as the federal minister, can play to achieve that ideal. Find a way to show that you have left the country healthier for your term as federal minister. After all, you are accountable to the public for precisely such an achievement.

First, the ideal health system, I suggest, is one where appropriate and effective care is provided to all who need it in a timely and an efficient manner. It is a system that is much safer then the one we have now, and more accessible, a system where care for people with chronic illness is provided near or in their homes, and where public tax dollars buy public care that works in emergencies and for routine and continuing care.

High among the virtues of our health system is a commitment, embodied in Medicare, to provide universal access to necessary care without financial hindrance. In practice, less than the ideal is achieved. Subsidising private health insurance benefits those who afford it and who live close to private hospitals for elective surgery.

The billions of tax dollars that subsidise it do not benefit the poor or those living outside major capitals where there are no private hospitals. Consider carefully what this subsidy has done to universal access: downgrading the public system has created a double jeopardy for those without private insurance.

Second, you face challenges aplenty. Consider making Indigenous health a cabinet matter rather limiting it to your portfolio. With national leadership in reconciliation and consultative community development, health would improve, because society and forces beyond your portfolio determine Indigenous health. Only the prime minister can lead this effort.

The same applies to child obesity. We need the PM to meet with food industry CEOs, chief urban planners, media magnates and others to win their agreement to accept this problem as everyone’s problem, including theirs. The PM must then seek agreement from each of them to contribute by reducing kids’ TV advertising of fattening snack food, cutting back on trans fats and designing healthier cities that encourage safe walking and concourse. Indigenous health and child obesity are national problems, requiring national leadership from the highest levels of government. They cannot be solved state by state, as the determinants of these problems, like the problems themselves, are truly national.

Previous ministers expressed surprise and frustration when they find how little they can do. However, do not overlook the power of inspiration and leadership — to inspire health workers whose ideals are worn and whose imagination and creativity is suppressed. Recognise and restate in every hospital you visit and in every media interview that you do the humane mission of health care.

Peter Fray

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