PRIME MINISTER
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OMn 13 IVURM 1989
Ministerial colleague Neal Blewett
Distinguished Guests
Ladies and Gentlemen
I was delighted to accept Neal Blevett's invitation to
welcoe you to Australia and to Melbourne, and to open this
Ninth Cononwealth Health Ministers' Meeting.
I an particularly happy to meet you here so soon after
returning from the Commonwealth Heads of Government Meeting
in Kuala Lumpur. Much of the attention given by the media
to that meeting concentrated on the high profile issues of
Southern Africa and the environment.
It was right that this degree of attention should have been
paid to those issues as they are issues of very great
importance to the commoneelth and globally. I velcoae the
progress made by the Kuala Lumpur CHOGN on then.
But Heads of Government and, I hope, the public did not
underestimate the real value of functional cooperation as
another vital element in a sense, the muscle and fibre
of the Comonwealth's collective endeavours.
Coonwealth meetings in fields such as health, education
and youth affairs don't often hit the headlines. But they
are a very important part of the reason the Commonvealth
matters to us, because our size and diversity as a group
coverinq a quarter of the world's population our different
histories, our separate experiences, all mean that we have
much to learn from one another and to give to one another.
The Commonwealth Spans the Continents and is a bridge
between races and religions, between rich and poor. It
provides a unique foruz for us to discuss our problem
frankly, and a unique vehicle for us to work together for
solutions.
And perhaps nowhere is this more true than in the field of
health. Since the first meeting of Health Ministers took place in
Edinburgh in 1965, these meetings have become an important
part of the Comuonwealth's activities.
They have shown that informal discussion among Commonwealth
Ministers provides a very effective vay of addressing a
range of important health problem.
In April 1988, I had the pleasure of speaking to some of you
when I opened the second International Conference on Health
Promotion in Adelaide. That Conference concentrated on the
World Health Assembly goal of " Health For All" by the year
2000.
The theme for this meeting, " Community approaches to health
promotion and disease prevention", in an ideal vehicle for
continuing international progress towards that goal.
Over the last 40 or 50 years there have been some remarkable
improvements in the health of the world's9 peoples. Some of
the improvements have been dramatic such as the
eradication of small pox. Many others have resulted from
less spectacular but equally important developments such as
the improvement of water supply and sanitation. Many
efforts in the traditional public health arena have borne
fruit and are continuing, particularly in developing
countries such ans ass immunisation of children against
poliomyelitis and measles, and improvements in maternal and
child health.
However, none of us can afford to be complacent about our
achievements. Developing countries still face major though not
insurmountable -problem of malnutrition, disease and lack
of basic health services.
But developed countries, too, stand to benefit from
discussions at this conference.
National figures which show developed countries enjoy
increased longevity, for example, or low infant mortality,
frequently disguise large and unacceptable variations
between regions and groups within the population.
Certainly, Australians are aong the healthiest pOople in
the world. And we are justifiably proud that through our
national health care system Medicare, we have ensured that
access to health services is universally available and is
not limited by income.
Yet if we look beyond our well-off suburbs to focus on the
plight of the less well-off, not least of course the
Australian Aboriginal people, we find a real need for
further progress in improving maternal and infant health and
in providing clean water and safe waste disposal.
Australia is not alone among developed, healthy, countries
in having to ensure good health is a reality universally
throughout their communities.
At the same time developed countries face further problems
caused, perhaps paradoxically, by their affluence.
Pressures on the health care system resulting from motor
vehicle accidents, through to the less direct but very
significant health impacts of obesity and other diet related
problems, face most affluent countries.
And any developed country tempted to rest on its laurels
because it have achieved significant improvements in
inmunisation levels, for example, need only look to the
recent North American experiences for an effective warning
against complacency. Despite high immunisation rates,
children in their thousands have contracted measles in
outbreaks of what is too often regarded as a relatively
harmless disease and, tragically, a number have died.
so your theme, " Community approaches to health promotion and
disease prevention" addresses an issue facing all
Commonwealth countries.
There is a puzzling feature about the role of the community
in primary health care and health promotion: the importance
of community involvement in health services is widely
expounded, but much less practised.
But everyone hare would recognise that the involvement of
the community in health care is not a social nicety, but a
technical necessity. Health care program cannot achieve
coverage and effectiveness without the involvement of the
coomunity.
As we confront the problems of chronic, and in many cases
preventable, disease, we must ensure that communities play a
greater role in health promotion and disease prevention
st. rategies in both developing countries and in those
characterised as developed or industrialised.
This is particularly true in formulating a strategy to
combat that most threatening Of infectious diseases, AIDS.
Australia has developed an AIDS strategy that is widely
respected a respect that I believe is due to the
comprehensive way we went about finding national responses
to the challenges posed by this epidezic.
community participation and international cooperation are
among its key elements. The national Government is working
in concert with all State and Territory Governments of this
country in a cooperative effect which crosses party
political lines.
I pay tribute to the very effective contribution made here
in Victoria by the state Government in enlisting the
cooperation of th'e groups moat affected by AIDS and in
striking the balance between protecting public health and
civil liberties.
Comprehensive consultations enabled us to take account of
the views of individual Australians, cozmunity groups, the
research community, the private sector and state and Federal
Government authorities. The strategy relies heavily on
cooperation among these sectors of the community for its
Success. In the same way we are relying on community effort in our
campaign against drug abuse, a problem which received
significant attention at the recent Commonwealth Heads of
Government Meeting in Kuala Lumpur.
The campaign does not try to divide the problem. s of drug
abuse and focus solely on illegal drugs or alcohol or
tobacco. Rather it recognises the interlocking nature of
these problems.
With the support of every Government in Australia, our
campaign seeks to provide:
an effective prevention strategy with particular
emphasis on messages encouraging young Australians to
avoid drug misuse;
* expaded and improved treatment and rehabilitation
services for persons with drug-related problems and
law enforcement and control measures to limit the supply
of drugs.
Last year$ my colleague Neal Ulewett released a report which
sets a dramatic new course for Australian health policy.
The report, " Health for all Australians", in Australia's,
blueprint for action to achieve the world Health
Organisation's goal of " Health for All by the Year 2000".
The report, and our follow-up actions, show that Australia,
1like other nations represented here today, has accepted the
challenge posed by this world Health Organisation goal.
Over the past year a great deal of detailed planning has
been done on our Health for All report and so I an delighted
to have the opportunity in this forum today to launch the
product of this work the National Better Health Program.
Australian Governments led by the Federal Government have
COMitted $ 41 million to this three-year program, dedicated
to promoting the health of all our citizens, and
particularly those who are disadvantaged.
What we're trying to do is to prevent sickness before it
occurs from the personal and national view, that's a much
better approach than treating people after they have
succumbed to an illness.
Unlike earlier programs that have concentrated on single
issues, the Better Health Program will be far more
comprehensive in the issues it cover., and in the way it
covers them.
This program will encourage better health through community
action and education in five major health areas:
controlling high blood pressure; encouraging better
nutritioni detecting, treating and preventing cancers of the
lung, skin, breast and cervix; improving the health of older
people; and preventinq comon injuries that occur for
example in sports, swimming pools, playgrounds and the home.
Our commitment to the World Health Organisation goal of
Health For All leads us to pose fundamental questions about
health and health service delivery in Australia.
The fact is, unless we are willing to identify those with
poorest health we cannot hope to mount effective strategies
for health promotion and disease prevention.
The solution to the problems of growing chronic, preventable
disease is not simply more high tech facilities and wonder
drugs though these must continue to have a role to play
but the involvement of the community in changing the
attitudes that cause ill-health.
The agenda item for your discuss ion acknowledge that health
promotion and disease prevention have always presented a
tremendous challenge for communities across the world: that
the fundamentals of health promotion are the fundamentals of
life.
The creativity, resourcefulness and caring of communities
are all important ingredients of health prevention. But
community participation is essential. And it is up to
governments to encourage their communities to become
involved in understanding, protecting and promoting their
own health. If we ac-hieve this, we must listen and we must
be honest.
We must askc, at the community level, what is important, what
diseases are needlessly occurring, and what is obstructing
attempts to promote health.
We must break don the residual taboos about discussing
certain issues which are integral to personal and communal
health, issues such as sexually transmitted diseases, mental
illnesses and drug use. These problem must be tackled with
tact and openness, or they will remain a source of unspoken
misery for their unfortunate sufferers.* Problem cannot be
solved until they have been admitted.
Ladies and gentlemen,
In speaking about our planning and our aspirations for the
future, I know I an only touching on issues which you will
explore in greater detail.
I wish you well in your deliberations.
As political leaders, we are all acutely aware that world
opinion is increasingly focused on the very significant
effects on humn health of actions which damage our
envirortment. Nations must strike a balance between
development and the need to bequeath the heritage of a
healthy environment, one that will sustain human health, for
f uture generations.
This quest for sustainable development is an international
one. The responsibility in one we all share.
And it is an issue closely related to your these, as it is
an issue requiring real commnity involvement.
Environment was a major theme of the Kuala Lumpur CROGN last
month. Perhaps you will decide, here in Melbourne, that the
theme of environment and health could provide a focal point
for discussion at the Tenth Comnealth Health Ministers
Meeting in 1992.
7.
With that I thank you for the invitation to open Your
Conference. Again I extend to you a warm welcome on behalf
of the Govorrament and people of Australia and offer you our
best wishes for a successful meeting.
It is my pleasure to declare this meeting open.