Those who followed the period leading into the 2020 Summit may have thought that the agenda would focus on the big challenges ahead and not just the obvious dysfunction of our 1984 “universal” health system.

Repeated in-depth evaluations of community health priorities indicate that indigenous health, mental health and children’s health and well-being (with large emphasis on obesity and mental health) are at the top of the list.

Just prior to the Summit the Prime Minister’s announcement on coordination of early childhood care, education and health services provided the perfect opportunity for a proactive health summit response. The media preoccupation with the central role of a new mother and child could have been woven into a new comprehensive emphasis on the urgent need to invest in health and well-being for all future Australians.

Sadly, this great opportunity was largely missed by the narrow responses proposed by the health participants. The health sector listens to the health industry and, consequently, is increasingly disconnected from those other areas of social, community and professional life from which real solutions leap forward.

Fortunately, there were real health visionaries at the 2020 summit. They were distributed among those debating indigenous Australia, social inclusion, productivity and education, rural communities, creative arts, governance, regional security, sustainability and the economy.

All of those other areas raised substantive issues, that now need to be linked openly to the promotion of better health and well-being. We need to know: that health is a social and economic investment and not simply a cost; that an ageing population is an economic and social opportunity and not just a fiscal threat (personally, I loved the motion to abolish retirement!); that resolving health inequalities at home and in our region stabilises the region and reduces both biological and social threats; and, that promoting better mental health and reducing violence delivers more productive, educated, functional and socially cohesive communities.

Each time a substantive mental health, child or indigenous health issue arose, some over-arching word-processing program pressed the delete button. If you read the official outputs of the health stream (at least at this early stage), you’ll find that mental health first aid for all Australian teenagers – a key idea from the earlier Youth Summit – became physical “first aid” for no particular health problem. The regional ASEAN-like body proposed to deal with common mental health and other chronic health problems and health inequalities associated with economic development in our region was narrowed back to the threat of infectious diseases and preventing bioterrorism. A new preventative health body could be reduced to delivering fresh fruit or opening stairwells. The potentially very large impact of new brain science research was reduced to the concept of developing a bionic eye.

While one expects that the media and communication business, and the daily grind of real world politics, will always reduce complex issues to two-word headlines, we really should try a little harder. We are at the top of community priorities, right alongside education and the economy. At the end of the day, the health group seemed more intimidated by the “new idea” reductionism than any other group. Fortunately, the Prime Minister’s brief address to the group recognised both the community and political importance of real health reform and the urgent need to get it right. It’s not about abolishing the states – it really is about investing in our future so that those who follow us can really lead productive and socially-inclusive lives.

If we allow others to keep deleting mental, indigenous and child health, we are unlikely to make any real progress. As I discussed with my Indigenous colleagues, we in mental health have been added to the “preamble” to health reform (that’s the place you get parked while money and effort go elsewhere). Interestingly, the one politician present who made it clear that he was really interested in mental health reform was the Premier of NSW.

Let’s hope that others in key government and professional positions soon develop a similar understanding. The Prime Minister’s early childhood agenda is now leaving the station – let’s hope child, indigenous and mental health can get on board!