PHAA’s “Great Election Public Health Debate and Dinner”

A Speech made to the Public Health Association of Australia’s “Great Election Public Health Debate and Dinner” – Canberra, Tuesday 10th August, 2010.

Thank you. I’m Darren Churchill, Australian Democrats Senate candidate for the ACT.

I must say it’s good to hear people finally addressing plain wrap packaging for cigarettes and tobacco products. The Australian Democrats have been at the forefront of the campaign against tobacco advertising. And this issue in particular is something Dr Arthur Chesterfield-Evans of the NSW Democrats has been hopping up and down about for a long time.  So, an Australian Democrats achievement there.

The Australian Democrats regard the highest priority for public health attention at the national level over the next term of government as being: Mental health – particularly early intervention and social supports; Prevention – particularly diet related; and Dental Health – particularly for middle to low income earners.

Australia’s focus has always been too much on acute care and too little on healthy lifestyles. Governments can do much more in education, public information, labeling of food and alcohol products and tighter regulation of advertising to discourage junk food and alcohol use.

For General practice we aim to address the Schedule Fee shortfall for standard and long consultations, which is a big cost the Medicare levy is not covering and has led to doctors shortage, particularly noticeable in Canberra and region. The GP Superclinics are not the answer with their patients as clients model and revolving door attitude to health care which is incongruent with GP’s being able to provide the frontline of preventative services in both physical and mental health services.

The Democrats have been at the forefront of calling for volumetric taxation on alcohol. We advocate: more explicit labeling on the alcohol content of drinks, on the health risks to minors and on safe levels of consumption; tax all alcohol products according to alcohol content and introduce the same tax and excise treatment to low and mid strength Ready To Drink beverages and wine as is applied to low and mid strength beer.

For programmes designed to improve health outcomes for disadvantaged groups, we recognise that women are a disadvantaged group in many ways and most particularly because of the impact on them of family violence. Our Women’s health policy calls for: increased funding for violence prevention, including public education campaign to challenge and eliminate violence-supportive attitudes and behaviour and to promote respectful relationships; teacher training in providing programmes for sexual health and respectful relationships, mental health and wellbeing, bullying, body mage, self harm and depression.

(Spontaneous applause occurred here)

Thank you.

For the disabled we call for: funding of annual comprehensive health checks for all Australians with a long term disability and encourage greater expertise in the medical profession in dealing with people with disabilities; establishing a national disability insurance scheme; substantially increase funding to in supported accommodation, respite and personal attendant services, using a population-based benchmark approach; a National Equipment Strategy to ensure people with disabilities can afford and access disability aids and equipment; ratifying and incorporating into law the UN Convention on the Rights of Persons with Disabilities.

People with mental illness are arguably the most disadvantaged in society. Our comprehensive mental health policy calls for $3-4 billion a year more to be spent in mental health to more closely reflect its prevalence and: Primary and early intervention with a national system of community-based mental health centres staffed by psychiatrists, psychologists, GPs and psychiatric nurses; training for clinicians in screening for co-occurring substance use and mental health disorders and in evidence-based treatments; programmes in schools and in the community to promote mental health and wellbeing and to address bullying, violence against women and children, alcohol use, body image, self harm and depression.

For Youth: a doubling of HeadSpace youth mental health clinics providing specialist consultations; and a national system of mental health centres for young people with emerging serious mental illness and substance problems providing: integrated assessment, crisis response, outpatient case management, inpatient care, group based treatments, mentoring, counselling and employment assistance

We advocate case management for at least 12 months after discharge from acute care; more secure extended care units and community based care units for those at very high risk; as well as universal screening of prisoners for mental illness, treatment while in prison, and release to supported accommodation; and among other things to guarantee consumers’ rights to be consulted on treatment and services; first aid training in mental health for those routinely in contact with people who may have mental health problems, especially teachers and police; ongoing programmes to destigmatise mental illness, identify early symptoms and treatment options and provide hope for living well with mental illness.

We want A National Institute for Mental Health with a quarantined budget.

For Indigenous Health: Better pre-service training and support for nurses in very remote Aboriginal communities and a minimum of 2 nurses in each clinic; improved availability in outback and remote Indigenous stores of affordable, nutritious food; breakfast and lunch provided at very low cost in all schools; support for Indigenous communities to tackle family violence and substance abuse, eg sexual assault services, outreach centres, safe houses, and legal aid; expanded sexual health education and awareness programmes; increase oral health promotion activity and targeted oral health services; comprehensive health services for the prison population; and better accommodation and transport options for Indigenous patients.

Dental Health. A national public dental health programme that is free for concession card holders and special needs groups, and which includes a full dental check-up and basic dental treatment every two years; outreach services for special need groups, particularly Indigenous Australians; and a programme of research into oral disease prevention and the effect of changing diet patterns on oral health.

Here are our plans for responding to climate change (which we have acknowledged does affect health) and our position on a carbon tax

We support an emissions trading scheme with all the watering down changes negotiated with the Coalition reversed and all permits auctioned by 2015.

The money raised in selling permits should be re-invested in major solar, wind and geothermal power generation and extending the power grid to reach these new projects; a home insulation programme with strict safety standards, ramped up over the next 8 years, allowing sustainable industry growth; and a prohibition on new coal-fired power generators and closure of the worst polluting generators over next 5 years using tight emissions standards.

Should government proceed to a carbon tax, we suggest: a carbon tax of $20/tonne until emissions trading commences; a tax on coal exports of $5/tonne, using revenue ($600m) to fund 60,000 household PV grants/year; national feed in tariffs set to allow the cost of household solar PV panels to be recouped within 5 years; and compliance with European standards of energy efficiency in vehicles, and grants for natural gas and electric vehicle refuelling infrastructure.

The Australian Democrats say the following principles should apply in designing a carbon tax:

•It should apply to CO2 emissions from the consumption of all fossil fuels and industrial processes such as oil refining and those using chemical reactions such as chemical fertiliser and cement production;

•It should be revenue neutral with the revenue raised rebated to households at a flat rate low income earners and/or to fund programs supporting greenhouse emission reduction opportunities not adequately captured by the carbon tax such as public transport;

•The price should start in 2011 at $20/tonne and be ramped up at $5/yr to $45/tonne in 2016 as a firm recommendation. This rate of increase would be expected to continue up to $70/tonne in 2021 but with a review each year after 2014;

•Imports should be subjected to an equivalent charge;

•Australia should press for a global system of carbon taxes in which each country levies an internationally harmonised carbon price or carbon tax on emissions.

Thank you.

(This is a refined and edited version of the speech actually given. I was not actually invited to participate in the debate. However, I thank PHAA’s CEO, Michael Moore, for allowing me the time to speak and present the Australian Democrats’ position.)

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