PRIME MINISTER
CHECK AGAINST DELIVERY EMBARGOED UNTIL DELIVERY
SPEECH BY THE PRIME MINISTER
CONFERENCE ON " HEALTHY PUBLIC POLICYO
ADELAIDE 5 APRIL 1988
Dr Blewett,
Dr Mahler, Director-General, World Health Organisation,
Ladies and Gentlemen.
It is a pleasure to welcome you to Australia and to open the
Second International Conference on Health Promotion.
In 1988 Australians are celebrating the Bicentenary of
European settlement of this country. It is a landmark of
which we are proud, both because it encourages us as
Australians to reflect both on our achievements over the
last 200 years and on our shortcomings and because of the
opportunity which it brings for so many overseas visitors to
come to know Australia better.
Australia is becoming increasingly recognised around the
world as a tourist destination of unparalleled excellence.
Last year we played host to nearly 2 million visitors.
According to the OECD our visitor arrivals were up
27 per cent on 1986 a rate of growth nearly five times the
OECD average.
So I hope you will be able to find time apart from your
duties at this conference to travel around Australia a
little to experience for yourselves the reasons for this
great upswing in international attention.
If you do fly interstate, you will probably notice and, I
hope, notice with approval a recent initiative in
preventive health my Government has taken.
In line with the objectives of the National Campaign Against
Drug Abuse, and supported by widespread medical evidence, my
Government decided last year to ban completely all smoking
on board domestic airlines.
We believe that decision made us only the second country in
the world to impose such a ban. Through this conference,
other nations might be encouragqd to take similar steps.
As well as being our Bicentennial year, 1988 is also the
anniversary of the World Health Organisation. 0055263
In those forty years, the World Health Organisation and its
member states have, through joint planning and concerted
effort, brought about a number of significant improvements
in the health of people throughout the world.
In some cases the improvements have been dramatic, such as
the reduction in the incidence of epidemic and endemic
diseases including not least the eradication of small pox.
The WHO has also helped improve water supplies and
sanitation in developing countries, and conducted campaigns
against conmmunicable diseases.
Since the Second World War, most industrial nations have
seen considerable improvements in the health of their
people. They are better fed, enjoy better conditions of
hygiene and have seen their life expectancy substantially
extended. In particular, improvements in maternal and child health
have been remarkable, with better family planning, lower
infant mortality, widespread immunization, and significant
improvement in the nutrition of children.
But in developing nations, the vicious problems of poverty,
malnutrition, disease and despair continue. To quote just
one tragic indicator of this, infant mortality: in some
developing countries, more than 200 out of every 1000
children born die before their first birthday.
The World Health Organisation fully deserves our continuing
support in its efforts to resolve the health problems which
continue to afflict too many of our fellow human beings.
It is important however that this support should derive not
only from the variobus member states of WHO. Co-operation by
the various institutions of each nation is also required,
since there is increasing recognition that responsibility
for good health is shared by governments, industry,
education and research institutions and, of course, by
families and individuals.
In 1978 the ** Orld Health Assembly launched a global strategy
for health for all by the year 2000. In response, over the
last decade many countries have been redefining their health
policies in terms of goals and targets which could
realistically be achieved by the year 2000.
my colleague the Australian minister for Community Services
and Health, Dr Neal Blewett, will later this week present
this Conference with the Australian response to this
strategy.
While as a developed country we have good reason to be
confident in. the quality of our health care, we recognise
that there is much we can do to ensure Australia is a
healthier place by the year 2000. 005527
As a developed country we have eliminated many of the healkt,
threats our grandparents faced. But.-in their place, new
problems have arisen, problems which arise in part from our
economic well-being. 6
Health problems such as those caused by stress, diet,
failure to immunize, and catastrophic traffic injuries loom
as unresolved threats to the overall health of our nation.
In particular and it is highly relevant to note this
during our Bicentennial year the health levels of our
Aboriginal citizens are generally well below an acceptable
level.
Aboriginal infant mortality, while declining, is still about
three times the rate of the non-Aboriginal population. Life
expectancy of adult Aboriginal people is some 20 years less
than for the wider community.
This year the various State and Territory Governments, with
the Commonwealth Government, have for the first time in our
history agreed to act together to tackle this urgent task.
We have now set up a joint Commonwealth/ State Working Party
to develop a National Aboriginal Health Strategy.
It is my belief that Australians cannot adequately celebrate
the Bicentenary of European settlement without some better
acknowledgement of the Aboriginal people who inhabited this
land for more than 40,000 years before 1788.
Since poor health levels are, in many respects, a by-product
of European settlement, an important element in this
acknowledgement must be a new determination. to improve
Aboriginal health.
My Government is committed to action to improve Aboriginal
health and the working party is an essential step in that
process. In the forty years since the establishment of WHO our very
notions of what constitutes good health, and in particular
what causes it and how best to attain it, have undergone
considerable changes and developments.
Good health care policy whether conducted by Governments
or by individuals is no longer seen purely as the
treatment of pre-existing illnesses. Disease prevention and
health promotion are now regarded, rightly, as integral
elements of an overall approach.
It was in response to this broadening notion that the WHO
convened the first International Conference on Health
Promotion in Ottawa in 1986 and this, the second conference,
in Adelaide. 005528
The concept of health promotion enunciatedi in Ottawa
emphasises the needs to build healthy public policies,
create supportive environments, strengthen community action,
develop personal skills and reorient health services.
The Adelaide Conference should, and I believe will, make
further progress towards these goals. The repretentation of
so many countries and the broad range of expertise brought
to this Conference will help lead to the development of
healthy public policy throughout the world.
Ladies and gentlemen,
The decision to hold the Conference in Australia is, in
part, a recognition of Australia's achievements in the
health arena in treatment and in prevention of disease.
The principal feature of my Government's involvelfent in
health care in Australia has been to ensure thatall
Australians have access to quality medical care in
accordance with their medical needs and irrespective of
their financial circumstances.
Since February 1984, Australians have benefited from
universal insurance against the cost of medical services,
together with access to free hospital care in public
hospitals. Medicare, funded in part through a levy on taxable income,
has been an integral element in ensuring quality health care
is available, on fair terms, to all Australians.
Almost two million people who previously had no health
insurance are now covered by Medicare.
Medicare has delivered real advantages to those on lower
incomes, especially families. An average family is $ 21 a
week better off than it would be under a return to private
insurance cover.
Health care thus forms an integral part of the Government's
approach to the management of the overall economy. In an
era when real restraint has been required in wages, we have
ensured that compensatory improvements in the social wage
have protected living standards as much as possible.
Medicare, along with a new family assistance package,
education reform, real increases in age pensions, increased
resources for public housing and related measures have all
played their part in making Australia a fairer society.
Professionals such as yourselves involved in health policy
making should not, I believe, overlook the fact that
Medicare's universal health insurance helps make Australia a
healthier society as well. 005529
As Dr Blewett will argue later this week, the Government's
structural reforms aimed at lifting the social wage also
have important benefits for the overall level of health of
Australians. Ladies and gentlemen,
Australia has also distinguished itself in the field of
preventive health care through its campaigns against drug
abuse and the spread of AIDS.
The National Campaign Against Drug Abuse has involved a
major political commitment by all Governments in Australia
to increase greatly the resources devoted to tackling the
problems of drug abuse.
It is not just a health campaign or a law enforcement
campaign. It is truly an example of healthy-public policy
in action.
The campaign has taken an integrated approach, involving
enhanced and expanded treatment and rehabilitation
services in the health arena;
major efforts in preventive education, through
media information and research,-and
law enforcement reform and enhancement of
capacities.
The Campaign did not try to divide up the problems of drug
abuse and focus solely on illegal drugs or alcohol or
tobacco. Rather we have taken an overall approach which
recognises the interlocking nature of many of these
problems. The Campaign has been in progress for three years and the
Government late last year announced a commitment to continue
it for a further three years.
To meet the challenge posed by the spread of AIDS,
Australians recognised a special and innovative relationship
was necessary between Governments and the community. The
Commonwealth Government's three-pronged attack on AIDS
accordingly involves:
Government cost-shared prevention programs
including education;
scientific advice and research; and
community involvement and funding of community
projects. 0 05
6.
The Government has recently streamlined its advisory
structure by establishing a single National Council on AIDS
to advise on all matters related to AIDS.
The AIDS crisis demanded a radical response. We in
Australia made that response, and the evidence suggests it
is working. Surveys of public knowledge about the
transmission of AIDS indicate growing levels of awareness
among all groups, and significant increases in the numbers
of people who understand what does, and does not, constitute
risk behaviour.
Ladies and gentlemen,
In sketching the broad parameters of these two campaigns I
know I am only touching on issues which will be debated in
much more detail by participants in this conference. J.
I wish you well in those deliberations.
You will tackle issues of the utmost importance to all
countries striving towards better health. The conclusions
you come to will bring us another step closer to enabling
all people to lead economically productive and socially
rewarding lives.
It is my pleasure now to declare this conference open. 005531