We want all people to experience the wonders that the future will hold. To make sure this happens, we need to keep our minds and bodies healthy. An efficient, well-resourced and intelligent public health system is an essential part of achieving this for every person.
The early death of any individual is a tragic waste. The longer a person is alive and healthy, the more they can enjoy life, pursue passions and pastimes, and share time with loved ones.
Improving the quality and length of our lives will pay for itself economically, as those who live longer will have more productive working lives. A healthier population means greater progress for society, allowing individuals to enjoy longer lives while contributing to society for longer.
The following policies should be a focus of reforms made to the health system by the federal government.
1. Universal health care
1.1: The Science Party supports further investment in Medicare as a universal health care scheme for all Australians.
One of the Science Party's principles is that high-quality health care should be afforded to all people, regardless of whether they have the ability to pay up-front. The Australian system is currently a hybrid system of private and public health care; one of several models in use around the world. Our system delivers good outcomes to patients at a cost (as a percentage of GDP) comparable to most developed nations. Any changes to this system should be the result of a review that aims to improve the system; not an attempt to shave short-term costs from primary points of care without regard to the long-term consequences.
1.2: The Science Party supports the addition of non-aesthetic, basic dental care to the Medicare scheme.
Dental care is an important component of health care. Ongoing dental problems affect lifestyle choices and quality of life, and like many conditions become more costly to treat with time. Despite the importance of dental care, it is covered by the public health system only for some children and some concession card-holders. The Science Party supports a review of the various dental cover schemes in place to determine the most efficient way that basic dental care can be incorporated into the national public scheme.
2. Aging to be treated as a disease
Aging, although a natural process, does not have to be inevitable.
See our blog post on this policy here.
Infectious and degenerative diseases are natural processes too, and we have successfully eliminated or reduced the burden of many of them. Maternal and infant mortality have decreased dramatically, and once-common causes of death like many infectious diseases are now far less common and rarely fatal, thanks to our determination to use medical science to reduce unnecessary suffering and death. We are committed to preserving the lives of all people in a way that maximises happy, healthy living (or healthspan). Diseases that have a high mortality rate and/or a high impact on quality of life should be prioritised.
Potential scientific approaches include the detailed understanding of individual genetic variation combined with stem-cell therapies. A greater understanding of aging has the potential to both extend life and make those extra years of life healthier and more productive. The outcome will be a net economic gain, as money will be saved by preventing disease rather than treating it, and by allowing people to be employed to an older age if they choose to be.
3. Preventative health care
3.1: Preventative health care should be a core focus of the health care system, and that all laws, policy and funding should be considered in the light of preventative health care.
Preventative health care has a long history of reducing illness in the community. Vaccines have eliminated or almost eliminate great numbers of diseases that used to be quite common. Reductions in consumption of mortality inducing substances such as cigarettes and alcohol has resulted in massive decreases in deaths due to the use of these substances. By aiding people to maintain healthy lifestyles and providing care that prevents easily treatable conditions from turning into hard to treat conditions, we both improve the quality of life of the individual and reduce overall expense to the taxpayer.
4. Australian Centre for Disease Control (ACDC)
Aim: Improve coordination of Australia's response to health crises, to better preserve health and life.
Policy: Establish an Australian Centre for Disease Control (ACDC) to coordinate Australia's response to communicable and non-communicable diseases. The model should be established after a comprehensive and independent review. Core responsibilities of an ACDC should include:
- emergency response to outbreaks;
- public health surveillance and reporting; and
- communication of public health information.
Discussion: A parliamentary committee in 2013 released a number of recommendations, including for the Australian government to assess the case for establishing a CDC. Parliament rejected this recommendation.
Australia's reliance on the Australian Health Protection Principal Committee for guidance during the COVID-19 pandemic highlights the importance of a national response. However, non-government organisations carried out important functions like infection modelling, suggesting a role for better resourcing of a national disease control organisation.
Australia is the only OECD (Organisation for Economic Co-operation and Development) country without a CDC, and the Australian Medical Association and the Public Health Association of Australia recommend establishing a CDC. Doing so would benefit Australia and be an act of good global and regional citizenship.
Read our blog post introducing this policy here.
5. Electronic health records
5.1: The Science Party supports the creation and use of a secure, beneficial and straightforward electronic health record (EHR) system.
- Amend EHR legislation to improve its privacy and security:
- Restrict access to identifiable health data to a patient's current (and referred) practitioner, practice or hospital only, with a time limit on access;
- Allow EHR holders to access their own record at any time and view a log of every time their data was accessed, and by whom;
- The system should be opt-in;
- Patients must be informed and provide consent before data is made available to researchers. Aggregate data (e.g. "20 cancer patients currently being treated at this practice") can be collected at a practice level without patient consent; and
- Law enforcement may access identifiable data only with a warrant.
- The project should include funding for strong security.
- Encourage measures to maximise the usability and benefit of the system. Practitioners must have access to training in effectively using the system.
- Set metrics for the success of the EHR system so it can be properly evaluated.
A good EHR system, designed with reference to successes from similar systems internationally, should be promoted more strongly to the Australian public. All doctors receiving Medicare payments must ask each patient who has not yet been asked if they would like to join the EHR system, explain the relevant points of the system, and record the patient's response.
We strongly support the development of a good EHR system, for its potential to improve health care. However, a bad EHR system without proper privacy and security controls exposes Australians to unacceptable risks. The current EHR system (My Health Record) was unpopular in trials, and yet it was made compulsory, with a short opt-out period.
For individuals, EHRs allow for better patient care by collating a patient's medical records as the individual moves between health providers. They are easier to search for relevant information compared to paper records, helping to reduce oversight of pre-existing conditions.
EHRs also allow for deep data analysis: for example, computer algorithms can inform practitioners if the combination of a patient's existing conditions indicate an underlying condition. A widely-used EHR system can identify differences in health outcomes by demographic in a population, allowing public health resources to be effectively allocated.
Regarding identifiable data: anonymised data should be made available to third-party researchers. Importantly, "anonymisation" is more than simply removing the name and contact details from a health record, as some individuals—often the most vulnerable—can be identified from the combination of their demographic and health data. Data must be aggregated to an extent which makes re-identification extremely unlikely, for example following the rules used by the Australian Bureau of Statistics to minimise the risk of such disclosures.
6. A New Health Monitoring System
6.1: Develop an opt-in health monitoring system that asks people to log their health outcomes (weight, exercise regimen, etc.) and aims, and if those aims are met. This system can also be used to capture information about user behaviour that impacts health. This health monitoring system can be integrated with the electronic health care system, such that the doctor can access these records if the individual consents. The health monitoring system can be used by practitioners to try different regimens with a patient, and will be convenient to access either by computer, or by smartphone application.
7. Healthy eating initiatives
7.1: Establish healthy eating initiatives. Publications will be produced that will focus on cheap, easy to prepare and healthy meals from a variety of cultures in Australia. Guidelines and resources will be provided for healthcare professionals to improve the quality of such programs by personalising to individual needs.
8. Food labelling laws
8.1: Adjust alcoholic beverage labelling to include nutritional information.
Making healthy eating decisions is impossible without information about what you are eating. Alcoholic beverages are currently exempted from having to include nutritional information on its packaging, despite having highly controlled ingredient compositions. Alcohol represents a significant proportion of energy consumed, and this information should be clear for consumers.
8.2: If a nutritional claim is made on food packaging, it must be accompanied by the energy content of the food in text that is the same size as the claim. For example, if a food packaging has a claim "Contains only 3g of fat", it must also include a standardised label of the equal size noting how much energy is contained in the food and the percentage equivalent of the standardised recommended dietary intake (RDI).
As the number of health claims made on food increases, so too do obesity rates. Health claims on food are often deceptive—for example, many foods that claim to be low in fat are high in sugar. People should enjoy a variety of foods, including those that are considered to be less healthful. Consumers should be allowed to make informed choice about the foods that they eat; this requires changes to food labelling, which is currently confusing or lacking in information.
9. Alcohol and Other Drugs
Alcohol and other drug use (AOD) is a complex topic that touches on many aspects of Australian life. Harms from AOD misuse impact users, their families and the community. The Science Party acknowledges that any policy change will require community engagement, education and collaboration to ensure the best possible outcomes. With that in mind, the Science Party supports the aim of Australia's National Drug Strategy which is:
"To contribute to ensuring safe, healthy and resilient Australian communities through minimising alcohol, tobacco and other drug-related health, social and economic harms among individuals, families and communities."
In particular, it agrees with the key principle that:
"Funding, resource allocation and implementation of strategies should be informed by evidence where possible [...] Where evidence is not available or limited, effective policy should still be implemented, especially when this will expand the knowledge base."
There is a significant disconnect between this intent and the current implementation however, which is where the Science Party focuses policy. The use of certain drugs in Australia is currently treated as an issue for the criminal justice system. Drug use in all forms should be considered as a health issue first and foremost, and policy should reflect this view.
9.1: The Science Party supports the following changes, following the Portugal model:
- Decriminalisation (but continued illegality) of the possession of all illicit drugs. Drug possession would be considered a minor infringement; and
- The implementation of dissuasion and harm minimisation panels for those found infringing drug possession laws. Panels would consist of medical, social and legal staff whose role would be to determine opportunities to minimise the harm to the user through treatment, social services or other means.
Australian states spend considerable police resources and court time on enforcing drug possession. However, significant evidence from Australia and overseas shows that criminalisation of drug users neither serves the public good nor addresses drug harms, and that decriminalisation and dissuasion is more effective in reducing drug harms. Recent Australian research also shows that this approach is more cost effective and fosters better community perceptions of law enforcement. The World Health Organisation and United Nations jointly recommend decriminalisation of drug use.
It is important to differentiate between decriminalisation and legalisation. Decriminalised drug offences would remain unlawful and subject to non-criminal penalties.
Legalisation, on the other hand, implies regulation and legal trade. This approach presents issues including but not limited to contravention of the Single Convention on Narcotic Drugs (an international treaty to which Australia is a signatory). This does not mean that legalisation is not an option for the future, but it requires more consideration and evidence before pursuing.
9.2: Increased funding for alcohol and other drug (AOD) treatment and support services.
Regardless of the success of decriminalisation, increased funding is required to meet the public health responsibility that the government has regarding what is a public health issue, but also in reducing the substantial social costs of harmful AOD consumption.
It is estimated that fewer than half of those seeking AOD treatment are able to access appropriate treatment. Funding for these services could be expanded through savings made by reducing incarceration for drug possession. For example, in Queensland in 2017 more than 200 people were incarcerated for drug possession at a cost to the taxpayer of over $20 million per year.
Research including drug-driving and medical cannabis
9.3: Increased funding for research into illicit and prescription drug use and abuse, specifically including but not limited to drug-driving and impairment, and increased scope for medical marijuana.
Australian federal and state governments spent approximately $1.7 billion on illicit drug related activities in 2009/2010. In contrast, only $20 million was spent on drug research (including efficacy and cost-effectiveness studies). There are significant opportunities for improved technology and policy through better understanding of drug use and abuse.
Regarding medical marijuana, areas of interest include managing chronic pain.
Regarding drug-driving, Australia has a world-class Accident Research Centre at Monash University but it has been rarely used to research the impact of illicit drugs on driving impairment.
9.4: The establishment of the Drug Administration Authority (DAA), an independent body of social science and medical experts. The DAA would subsume the work of existing federal bodies concerned with drug policy such as the Australian National Advisory Council on Alcohol and Drugs (ANACAD). The DAA will:
- Oversee drug policy trials (see above) and subsequent implementation of full decriminalisation pending its outcome; and
- Periodically review the status of all legally restricted substances and advise governments of instances where relaxations of those restrictions may be warranted.
The National Drug Strategy (2016-2025) provides a framework for various Commonwealth, State and Territory governments but neither it, the Intergovernmental Committee on Drugs that oversees it or ANACAD possess any operational capabilities. The proposed authority would be the proactive arm of the Intergovernmental Committee on Drugs.
9.5: Reassessment of roadside drug testing, in particular related to:
- The drugs tested for; and
- The lack of impairment-related testing.
In most jurisdictions police use the Drugwipe 6S, a device which can detect the presence of 6 different categories of drugs (Benzodiazepines, Cannabis, Amphetamines, Methampetamines, Cocaine and Opiates). However current usage of these tools only covers Cannabis, Amphetamines and Methamphetamines. If the evidence for roadside drug testing is sufficient for those drugs, the same body of evidence exists to cover prescription medications (Benzodiazepines and most Opiates) as well as Cocaine.
Regarding impairment, the detection of a substance in saliva is poorly indicative of driving impairment. It is also worth noting that fatigue accounts for more fatal road accidents than drink driving or drug driving, yet there are no tools currently used by police to detect even severe fatigue.
Drug testing services
9.6 Policy: Replacement of drug detection dogs with drug checking (AKA pill testing) facilities.
The rationale behind drug detection operations at events such as music festivals is that the loss of a single life due to illicit drugs is worth the cost of operating dog units. Mounting evidence (including Australian research) indicates that enhanced police presence at events does little to reduce drug taking and even encourages riskier behaviour (such as taking more drugs at once than desired, in order to not be found carrying them).
Drug testing allows users to know the composition and concentration of the drugs in their possession. It also allows public health researchers to observe trends in illicit drug makeup.
Safe drug-using facilities
9.7: Support for medically supervised drug-using rooms, following the Kings Cross model, where there is community support.
The medically supervised injecting centre in Kings Cross allows the possession and personal use of a defined small quantity of otherwise illegal drugs. Supply of illicit drugs to another person remains illegal. Demonstrated benefits of the centre include:
- zero deaths from overdose to date;
- increased likelihood (see KPMG review) of accepting referrals to drug treatment services;
- 50% reduction in discarded needles in the surrounding area; and
- financial savings (see SAHA review 2008) through outcomes such as reduced ambulance callouts.
If safety is the number one priority then conceding that drug use is unavoidable allows the issue to be treated as a health matter.
10. Mental Health
10.1: Continued funding for early intervention in psychosis.
The Science Party welcomes and supports recent moves by the Federal government to fund early intervention services for people suffering psychosis and related disorders. This model accords with both the latest evidence from clinical research and with The Science Party’s general preference for greater preventative rather than reactive healthcare, as the most effective and affordable way to achieve better health outcomes.
10.2: Provision of intermediate-level mental health services across Australia.
Most resources in Mental Health in Australia are invested in high level acute care (primarily emergencies requiring treatment in psychiatric hospitals); and in low level care (treatment of low to moderately severe cases of anxiety and depression in the general population, by general practitioners and psychologists). There are few publicly funded treatment services available that fall between these levels of care, e.g. for people suffering serious chronic mental health conditions who are not experiencing an acute episode. Given the large costs to individuals and society of responding to psychiatric emergencies, we supports the provision of more medium level services to reduce the incidence of acute ill health.
Early Intervention in Psychosis model is a good step in this direction. The Science Party would also fund at a federal level a nationwide rollout of supported accommodation services, along the lines of the model established in Victoria.
10.3: Train front line public health and other government employees in mental health first aid.
Front line public sector employees—including emergency service workers but also, for instance, bus drivers, teachers and Centrelink staff—frequently have to work with members of the public suffering from mental health problems. This may include encountering psychiatric emergencies in their workplaces, such as a suicide attempt or a psychotic episode.
At least 10% of all front line public employees should receive basic training in identifying and responding to mental health problems, in the form of the Australian-developed and award-winning Mental Health First Aid certificate. This course is inexpensive and requires only a day of training.
11. Communicable Diseases
11.1: Treatment of communicable diseases should follow an evidence based, harm minimisation approach.
Communicable diseases are at the nexus of societal interaction and health. Communicable diseases are a result of interactions with other human beings, whether it be through sex, drug use, or close interactions that result in the transfer of infections such as influenza. Hence effective strategies in communicable diseases must take into account the social situations that result in the transfer of these diseases.
Policy regarding communicable diseases should follow an evidence based, harm minimisation approach. Fear of criminal repercussion and shame prevents some people from seeking treatment. For example, decriminalising drug use will reduce fear associated with disclosing drug use to doctors, and hence promote treatment and prevention of diseases such as Hepatitis C. Our drug policy reflects this approach to health care.
The Science Party views abortion as a medical rather than legal matter and supports access to safe and affordable abortion services.
- Abortion should only be carried out by an appropriately trained medical practitioner, who must inform the pregnant person of the medical implications of the abortion. There should be no other legal restrictions on accessing abortion up to and including the 24th week of pregnancy.
- After the 24th week of pregnancy, two appropriately trained medical practitioners should agree that an abortion would represent less of a risk to the pregnant person's physical or mental health than would continuing the pregnancy (as per current Victorian practice).
- Medical abortion (such as the "abortion pill" RU486, mifepristone) should be offered when the attending medical practitioner believes it is a safe option.
Later-term abortion carries greater risks than early-term abortion, and so while it must still be available as an option, the pregnant person must be made aware of these risks so that abortion is carried out with fully informed consent in all cases. Data from South Australia, the USA and Canada suggest that later-term elective abortion represents approximately 1–2% of all abortions when abortion laws are permissive.
12.2: Improve access to abortion through Medicare funding for abortion at all stages of pregnancy. Standardise abortion legislation nationwide, including, as per current Tasmanian legislation:
- No individual should required to participate in any non-emergency termination if the individual has a conscientious objection to terminations.
- A medical practitioner has a duty to perform a termination in an emergency if a termination is necessary to save the life of, or to prevent serious physical injury to, a pregnant person.
- If a practitioner has a conscientious objection to terminations, the practitioner must, on becoming aware that a patient is seeking a termination or advice regarding pregnancy options, provide a referral to a clinic or practitioner who does not have such objections.
The Science Party believes that the laws surrounding abortion should be consistent around Australia to ensure that people from all states and territories can access abortions that are safe and affordable. Consistent legality also avoids health professionals having to consider the legal implication of procedures when crossing state lines for work. All people should have the ability to choose whether to continue a pregnancy, regardless of geography or income level.
13. Electronic cigarettes
13.1: The Science Party will act to prevent the deaths of thousands of Australians every year. Electronic cigarettes (e-cigarettes; vaping) will be legalised in Australia. In particular the Science Party proposes to:
- Allow the sale of e-cigarettes and nicotine liquid, without restriction for adults. People under 18 will be allowed to purchase e-cigarettes from pharmacies only, after a consultation with the on-duty pharmacist and receiving a prescription.
- Allow the importation of e-cigarette vapourising devices and nicotine liquid without restriction.
- Not charge additional taxes on vaping except for GST, to ensure that it is affordable for smokers to give up cigarettes and use vaping instead.
- Allow the advertisement of vaping as a method for smoking cessation.
Smoking kills around 15,000 people per year in Australia.
Vaping is a safe and effective way to reduce smoking, especially for those people who find it difficult to quit by going cold-turkey or using traditional smoking cessation methods like nicotine patches.
The National Health Service in England recommends the use of e-cigarettes to reduce smoking on the back of a review of available literature carried out by Public Health England. The NHS also recommends that vaping should not be banned in hospitals or prisons.
14. Conversion therapy
14.1: Treat claims surrounding "conversion therapy" (for sexual orientation or gender identity) as health claims, allowing members of the public to make complaints about their operation to the relevant office in their state or territory (e.g. Health Complaints Commissioner or Health Ombudsman).
Providers of "conversion therapy" claim to be able to change a person's sexual orientation through counselling and treatments including electroshock therapy. The practice is opposed by organisations including the World Psychiatric Association, the Australian Psychological Society, and the Royal Australian and New Zealand College of Psychiatrists (RANZCP; see "Ethics" section) as evidence shows that it is not only poorly effective, but also detrimental to the health of those undergoing the treatment.
Every state and territory has a Commissioner or Ombudsman to hear and collate complaints from the public regarding health providers, and to provide an avenue for investigating these complaints. While there might be loopholes for providers of "conversion therapy" to argue that they are not making medical claims with regards to the service they provide, we encourage the reporting of such providers to health complaints offices to make these providers known.
15. Non-interference of religion in health care
- Ban surgical procedures determined by the medical profession to be non-therapeutic, including religious-based male circumcision or female genital mutilation, for children too young to consent to the procedure.
- Introduce legislation to prevent healthcare providers from refusing clinical procedures on religious grounds.
Health care must be based as far as possible on evidence, patient consent, and the principle of benefit-to-harm. The personal and religious preferences of a provider or a legal guardian should not dictate or restrict the procedures that a patient must or may undergo.
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