28th September 2020.

Development of the National Preventative Health Strategy.

Australian Patients Association Response to Consultation Paper September 2020.

Responses were required to be provided online via a question and answer format.

Below is APA’s response to the specific questions asked.

  1. Are the vision and aims appropriate for the next 10 years? Why or why not?

The vision should be tied to the delivery of wellness and a focus on the quality of life of Australians.  A move away from intervention.

The vision and aims are appropriate for what they cover.

However the focus of health should be on the promotion of wellness and the role of Governments at all levels in the delivery of wellness. Polices and funding across all levels of governments should have embedded in them a wellness test. Every policy should be tested against the impact on Australians.

Health needs to move towards a vision of an Australia where every person is given the best opportunity to be the best human being they can be. A vision of an Australia where people are given real choices about their health and the quality of life they lead in an environment that is supportive of wellness and values them as human beings.

  1. Are these the right goals to achieve the vision and aims of the Strategy. Why or why not? Is anything missing?

The goals of the Vision and Strategy should focus on the delivery of whole of person care. Care that is focused on Quality of life.

The delivery of wellness through:

  • Promoting resilient mental health. refer to ABS ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 29/04/2008 refer to table 310 for general health. Refer to table 3.11 for psychological distress
  • Food security as well as Water security
  • Adequate housing, the built environment and access to the natural environment and parks.
  • Education opportunities not just on health but promoting the benefits of employment. Improved education leads to improved health outcomes. While it relates specifically to Aboriginal and Torres Strait Islanders the information in this document (refer to ABS Paper 4704.0 – The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples, 2008) applies to all Australians.

The above are all socioeconomic factors. Improving them leads to better heath & better health outcomes. Refer to AIHW report Australia’s Health 2016, 5.1

  1. Are these the right actions to mobilise a prevention system?

Health and wellness are life choices so health is not one size fits all model, quality of life should be the Nation’s top priority.

A preventative health model it should focus on delivering services to patients in a timely manner, focused on the level of intervention required to ensure a patient is treated with dignity, given access to the healthcare needed to allow patients to remain engaged in society and thus be a productive member of society. Quality of life should be a shared goal between government, healthcare providers and patients.

Waiting lists for public access to healthcare results in acute conditions becoming chronic.  Health Insurance is expensive and the gap in payments is so large that many forgo treatment due to expenses.  Unless the equation is turned around preventative health action remains out of reach for many.

To implement preventative health requires a Public Health approach that draws on the skills and strengths across all strategies developed by government, non-government organisations and communities, combining efforts to effectively and efficiently implement solutions.

The first interaction Australians have with the ‘health system’ should be through education on better choices, not presentation at a healthcare provider seeking help.

The system needs to move away from prevention to one that is proactive in the promotion of whole of person wellness.

  • The promotion of a resilient population that is supportive of each other.
  • The delivery of localised health and wellness education through community-based organisations.
  • The education of Australians in what contributes to wellness and a fulfilling life.
  • The delivery of tools and services that promote the skills of Australians to make better life and health choices.

The actions that need to be taken to move forward are:

  • A top down approach to determine what individuals need to make better health & life choices decisions.
  • Development of a strategy to encourage individual engagement with their healthcare as a whole of life daily activity.
  • Implementation of a framework that encompasses all areas of a persons life journey that encompasses all level of governments and departments.
  • Embedding in every policy decision a ‘wellness’ test. Every policy decision should be evaluated as to its impact on Australians & their quality of life.
  • Focus on building a mentally resilient population.

 

  1. Where should efforts be prioritised for the focus areas?

As a minimum the focus areas need to be broadened to include chronic health & health insurance reform. The role of health insurance needs to be tested & a plan implemented to move from the current system to one that delivers transparency and value to patients. This needs to be done in conjunction with Medicare reform.

Affordability of accessing Healthcare is a luxury for most, the Medicare Gap rebates need to be revised and caps placed on out-of-pocket expenses. Campaigns have a purpose but without affordable and equitable access there will be no change.

It is well researched and documented that once a patient develops one chronic condition, they are more likely to develop additional illnesses.  Currently 11 million Australians have at least one Chronic Condition. This should be a high priority area of focus. The impact of COVID-19 on the populations mental health clearly demonstrates a healthy society starts with strong mental health. Programs need to be developed to encourage it. Face to face interaction, not advertising of brochure. Implementation of strategies and supports that motivate people to make lasting change. Campaigns have a purpose but without affordable and equitable access there will be no change.

The current Medicare scheme needs to be updated and aligned to the wellbeing of society.

  • For example, Mental Health is critical to physical health.  Capping Mental Health plans to maximum 10 per year (if lucky) does not ensure continuous continuity of care.  At a minimum, patients should get able to engage with Psychologists fortnightly if they have Mental Health or Chronic Health conditions. The Government needs to support this through Mental Health plans and subsidies.  The cost will be clearly outweighed by the benefits that well supported patients will be able to function in society.
  • The same should apply to Physical Therapy e.g. Physiotherapy, Remedial/Myotherapy Massage, Rehabilitation programs etc.
  1. How do we enhance current prevention action?

By looking after the wellbeing of people, we will ultimately reduce the long-term costs on our healthcare system. By being proactive rather than reactive, the investment up-front reduces the higher cost of treating patients when their health has deteriorated to the point whereby chronic conditions require higher intervention and a patient can no longer be a productive in society.  Mobilisation requires a change to funding and policies from the top down, without this support the actions proposed will not eventuate, despite the best of intentions.

  1. Any additional feedback/comments?

The delivery of health services & therapies need to be evidence based, safe and of high quality. The actions of the TGA in fining both Pete Evans and Lorna Jane are ones that need to be applauded & acknowledged.

The National Disability Insurance Scheme was a once in a generation change that valued the humanity of people with a disability.

Australia is faced with a choice to make a once in a century change to the lives of Australians or to continue to deliver health services in the current system.

The current system:

  • focuses on interventions.
  • it treats symptoms.
  • it doesn’t address the underlying causes of health issues.
  • Focuses on illness not wellness.

Housing, built environment, access to natural environment and parks, transport, employment opportunities, education, financial literacy, community involvement, food and water security, quality food, physical and mental health and financial security impact on the health and wellness of Australians.

Structural change is needed to move from a narrow definition of health focused on sickness and interventions to one focused on whole of person wellness and quality of life.

To download a copy of the consultation paper click here NPHS Consultation Paper – PDF

To download a copy of APA’s response click here 20200928 APA Submission National Preventive Health Strategy Web