Transcript: Dr Omar Khorshid- Getting Australia’s Health on Track Launch - August 12th 2021

Excellent, we’re on. Thank you very much for that introduction. And good afternoon to everyone.

Before I begin, I would like to acknowledge the tradition owners of the land that I’m speaking from today here in Perth, the Whadjuk people of the Noongar nation and to pay my respect to elder’s past, present and emerging. I'd also like to extend that respect to any Aboriginal and Torres Strait Islander people who are present today.

I'm going to speak for about 10 minutes if that's OK so there should be some time for questions, and I'm really pleased to be here to help launch the Australian Health Policy Collaboration's latest report, Getting Australia's Health on Track 2021.

As you heard from the speakers before me, the report follows up from the 2016 version, measures progress on Australia's Health Tracker indicators and recommends a suite of evidence-based, effective health policy strategies to meet these targets. This report represents the best expert advice that can be provided to politicians, policymakers, doctors and of course the general population. It's going to be a really important resource and guide for us all.

Now the AMA does have a proud history of advocacy in the public health space with preventive health policy at the core. Investment in and support for preventive health programs are something that doctors are strongly in favour of. Working with patients to reduce chronic disease factors like poor diets, physical inactivity, alcohol and tobacco use is our core business as doctors.

As AMA president I take seriously the expectations from our membership and of course from the general Australian community that we are a strong voice in this space. It’s something I believe strongly in and as a surgeon I see the end results of failures in preventive health. Effective, evidence-based preventive health policies can reduce the pressure on our health system by lowering, of course, that burden of chronic disease and of course acute disease. It is us doctors who see the complications that arise when preventive health is underfunded or under recognised. Cardiovascular disease, obesity, diabetes, lung disease and of course mental ill-health.

Each of the recommendations in Australia’s getting health on track has the ability to boost population health ensuring that doctors, from primary care to emergency departments, aren't dealing with unnecessary and preventable health issues and, of course, making sure that we're not paying for that unnecessary care.

Our funding for preventive health strategies have been severely lacking in Australia for some time and as the report shows our progress on health targets has suffered as a result. On seven of the ten measurable indicators in the report there's been limited or poor progress - just not good enough. And on the three that are heading in the right direction there's certainly room for improvement.

Currently less than 2% of national health expenditure is on preventive health. The AMA, along with a number of other public health stakeholders, has called for this to be raised to 5% by 2030 and we're very excited to see this aim reflected in the Government's draft National Preventive Health Strategy. And we’re looking forward to seeing a robust plan for how this will actually be achieved and what of course the money will be spent on.

In itself the Government’s decision to pursue a new preventive health strategy is a good sign for public health, although as mentioned in the report it's a long overdue step. The AMA is pleased have been involved in the consultation process so far, and we’ve also been impressed to note the consistency in messaging from public health groups.

We are of course the strongest when we come together and support evidence-based policies with clear health benefits. And the report that we're launching today is another example of the value that a unified voice from our profession can provide.

 One of the key recommendations in Getting Australia's Health on Track is for the introduction of a 20% levy on sugar sweetened beverages. I'm pleased to say that this policy has strong support from the AMA and indeed our first public calls for such a tax go as far back as 2008 and we've continued prosecuting the case for it since. During my National Press Club address earlier this year, I released the AMA’s research paper outlining the economic case for a tax on sugar sweetened beverages. And that report demonstrates that a tax set at 40cents per 100 grams of sugar content would represent an increase in price of about 20% for sugary drinks at supermarket prices. This would reduce sugar consumption from soft drinks by between 12 and 18% and raise at least $750 million in Government revenue annually. Which of course could and should be redirected to other preventive health programs. There is clear evidence that this type of tax has worked internationally, and it actually enjoys strong support from the general public. It's heartening to see this policy supported in the report today which represents so many reputable public health stakeholders and researchers. Clear and cohesive support from the public health community is vital. Unfortunately, there is reluctance from both sides of politics to support a sugary drinks tax, so we do need to stand together and back the evidence on this one.

We all know the public health reform is a long game but as we've seen with tobacco control, sustained pressure and calls for change can have huge implications for the health of Australians. We've done it before; we can do it again.

Another central focus of the report is the treatment of mental ill-health. Nearly one in five Australians or five million people report living with mental ill-health and of those, 3.6 million report living with a chronic mental and physical condition. Life expectancy among people living with mental health conditions is around 10 to 15 years shorter and these premature deaths are mostly associated with chronic physical ill-health. It's critical that Primary Health services are supported to respond to these issues. To get Australia's Health on Track the policy report we're launching today recommends the inclusion of routine physical health checks as part of all mental health care plans. The AMA supports measures to improve integration and mental health care treatment under the care of GPs and of course psychiatrists.

In the last few decades there's been an important shift in understanding about risk factors for disease and that's the move away from individual responsibility to understanding how the environment around an individual shapes their health outcomes. We know that unhealthy industries use predatory marketing tactics to target those most at risk of harm. We know that where someone lives makes a huge difference to how and whether they can participate in physical activity safely. We know that social determinants like education and employment have a close relationship with life expectancy and health.

Whilst it’s the job of doctors to be focused of course on individual behaviour and on our clinical outcomes, it's also important that we keep getting the message to the policy makers that these bigger picture issues are just as important. Keeping Australia's Health on Track makes policy recommendations that acknowledge the important role healthy environments play. These include introducing regulation to protect children from unhealthy food and beverage marketing, investing in active travel, walking infrastructure to get people active at a local level and prioritising education and employment programs for those living with mental illness. Each of these policies aim to create an environment that empowers and supports individuals to live healthier lives.

Over the last 18 months our health system has wrestled with the biggest pandemic in a century. The Australian experience of COVID as taught us a lot of public health lessons. It's demonstrated the importance of listening to the experts on public health policy and it's brought home the reality that people already experiencing disadvantage are the most likely to be impacted by new health threats. Those on low incomes, those in insecure work, from culturally and linguistically diverse backgrounds, etc. It's shown us how the existing pressures on our health system; rising chronic disease and ageing population; how these can be exacerbated in emergency situations and the importance of acting early to address these known risks. The value of clear, targeted public health advice has been clearly demonstrated, although sometimes unfortunately by omission. Perhaps the most starkly, the current outbreak of COVID-19 in Sydney has shown us that whilst individual risk profiles vary anyone can get sick regardless of health status, their background, and their age.

The AMA has already called on governments to heed the lessons of COVID, to listen to scientists, to listen to experts when designing government policy. It is time to invest properly in preventive health, not just talk about it. The National Preventive Health Strategy, once released, must include spending commitments that will help keep Australians healthy and of course our broader health system sustainable.

There is significant community support and a strong scientific basis for many of the measures we’ve long talked about but can't seem to get over the line. Measures like sugar sweetened beverage taxes, volumetric taxes or floor pricing on alcohol. These have been well established in terms of their positive impact on health, they’re popular in the community and yet somehow, they enjoy very little political support.

Similarly, as we just heard climate change is another issue in which the science is really clear. The problem is urgent. The health and the financial impacts of inaction are profound and yet our political leaders are unable to act meaningfully. We must take the lessons from COVID to trust the science and you'll make good decisions. It is time for our political class to step up and show some leadership on preventive health, just like climate change, or we will all be paying the price for generations to come.

What can we do as a society to boost protective factors to improve health equity and to equip our health system to treat the illnesses that we can't avoid? Getting Australia's Health on Track proposes some answers to those questions and suggests a path forward that will strengthen Australia's health system. I thank the Mitchell Institute and the Australian Health Policy Collaboration for producing this report and I really look forward to working together with you to achieve better health outcomes for Australians. And as I proposed at the Press Club earlier this year to help make Australia the healthiest nation in the world. Thank you.