The background paper intended to guide health discussions at the 2020 Summit is now available here, and the news is not encouraging.

The consensus, from a quick survey of some of the country’s leading public health and policy buffs (including some who will be at the Summit), is that the paper is more than a touch disappointing.

Its professed goal is to stimulate discussion about the main challenges and opportunities facing the country’s health, but it does a good job of glossing over or omitting the nitty gritty issues that should be central to such discussions.

The document describes the Australian health system as “a sophisticated public-private and federal-state blend” which “gives rise to a mixed model of service provision and accountabilities”.

It would have been much more accurate to say our system is inefficient, wasteful, inflexible, too often fails to meet the needs of patients and the broader community, is too often driven by political and professional imperatives, and is also characterised by poor morale among often disillusioned service providers.

The document promotes the benefits of private health insurance without acknowledging there are widespread concerns that the current funding arrangements promote inequity and inefficiency.

I also spluttered at the heading “the Australian medical workforce will face many challenges in meeting future demand”. Why focus on doctors? The Rural Doctors Association of Australia estimates that at least 16,000 more health professionals are urgently needed in rural areas to ensure even basic access to care. This figure includes 1,000 doctors, 5,400 nurses, 600 midwives, 1,000 Aboriginal health workers, 1,700 dentists, and more than 6,100 allied health professionals.

And some of the document’s content – putting sport forward as the solution to inactivity and obesity – is just bizarre, being so far removed from what the evidence base suggests might help us to be more physically active and healthy. Where is the mention of transport and town planning policies, for example?

Generally the document fails to acknowledge the importance of the social and structural determinants of health – noting merely that “lifestyle risk factors” are more common in disadvantaged sectors of society, for example.

If I had to rate the usefulness of this paper, in terms of its ability to stimulate meaningful discussions about the real health challenges facing us, it might just scrape in with a pass.

Perhaps the health Summiteers would be better advised to have a look at this Productivity Commission report and this Medical Journal of Australia article on how citizen’s juries can contribute to health policy.

They might also want to have a look at the discussion paper for a National Prevention Summit being held in Melbourne tomorrow, which gives a much more coherent overview of the key issues.

It will be available here from tomorrow.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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