According to health experts there has never been a better time to secure significant and sustained health reforms, with a particular focus on preventing the tide of chronic disease.

Todd Harper, Chief Executive Officer of the Victorian Health Promotion Foundation (VicHealth) and Professor Brian Oldenburg, Research Director at the Australian Institute of Health Policy Studies and School of Public Health and Preventive Medicine at Monash University have released a paper calling for a National Charter for Health – an agreed framework to secure the future health of all Australians.

“We all know the struggles our health system faces,” Mr Harper said.  “The current economic crisis adds further impetus to the need to tackle these issues and design a health system that not only delivers for those who are ill, but has a clear mandate to prevent many of these illnesses, that we know are avoidable.

“A reorientation of Australia’s health system towards illness prevention and health promotion would lead to a considerable reduction in the personal and community burden of avoidable disease, injury and disability.

“It would also lead to a more efficient use of resources, and generate substantial economic benefits over time, as Australia’s economic performance and productivity would also be improved by having a healthier workforce,” says Mr Harper.

 According to Professor Oldenburg, recent developments including last week’s release by the National Health and Hospital Reform Commission’s paper are encouraging.

“The momentum is building - we’re edging closer to achieving significant, sustained health reform for this country," Professor Oldenburg says.

In recent months, the National Health and Hospitals Reform Commission, the National Preventative Health Taskforce, State and Federal governments and the Council of Australian Governments’ have all released plans, position and discussion papers to chart the course of health promotion and disease prevention in Australia.

“There seems to be great optimism for a strengthened, systemic, and far-sighted approach to health promotion that has been lacking for decades,” says Professor Oldenburg.

 “Australia needs a whole-of-society approach that embraces prevention and acknowledges the crucial importance of cultural, social, economic and environmental factors in the health of all individuals and communities.

“This will only come about if prevention is elevated to a national priority, if targets for determinants of health  are identified and agreed to by all governments, and if prevention measures to achieve these targets are appropriately financed,” he explains.

In their Issues Paper A Call for a National Charter for Health, Mr Harper and Professor Oldenburg argue that Australia requires an approach to prevention that is accountable, targets the causes of poor health and that is financially supported and rigorously evaluated.

They also call for a greater financial commitment to health promotion. In the 2005–06 financial year just over $250 million was spent on health promotion in Australia, out of what the authors’ term ‘…an inadequate $1.4 billion spent on all of public health’.

“Health promotion needs to be elevated financially, once and for all, from its ‘poor cousin’ status. It requires at least 10 percent of the national health budget.

“This additional investment would be accompanied by rigorous research and evaluation so that, over time, the evidence base for health promotion can begin to resemble that of more clinical areas of medicine,” Mr Harper said.

According to Professor Oldenburg this approach would build on Australia’s past successes with tobacco control, the reduction of the incidence of road traffic trauma, prevention of heart disease and other initiatives that have shown how long-term planning and coordinated effort over many years delivers successful and cost-effective prevention programs.

About a third of the current disease burden could be prevented by controlling risk factors like smoking, low fruit and vegetable consumption, alcohol misuse and physical inactivity.

Social and economic marginalisation is also associated with each of these, which in turn has led to a significant rise in health inequalities in Australia.

“Now is the time to act. We cannot improve our health if we continue as if it’s ‘business as usual’”, Mr Harper adds.

The authors stress that such an approach will require commitment from government portfolios beyond health, as well as engagement from all three levels of government, and partnerships with the non-government and business sectors.

They cite shared targets, accountability, greater investment, evaluation and mutual responsibility as key and call for a new statutory authority or National Preventative Health Agency, to provide the leadership, technical support and program delivery capabilities.

Key components of a National Charter for Health:

• Targets for key risk factors and the determinants of improved health identified and endorsed by federal, state and territory governments and, where appropriate, also by local government and community agencies;
• Progress against the national charter reported by health ministers every three years;
• Funding for prevention increased to 10 percent of the national health budget by 2015;
• A National Preventative Health Agency established with responsibility for evidence synthesis, nationwide campaigns, program coordination, and evaluation of effectiveness, efficiency and equity outcomes.

To view the Issues Paper  A Call for a National Charter for Health