Chronic health Disorders

[12.48 p.m.]

Ms BURNET (Clark) - Deputy Speaker, I thank Professor Razay for bringing this motion and all aspects of this motion for discussion today. I also appreciate that the Minister For Health, minister Archer, is here in the Chamber listening intently to this very important debate.

I know that the minister talked about strong preventative health foundations, which is wonderful, but unfortunately, we have some of the worst statistics in Australia. As the government formulates the budget, this area of investment in prevention must be a reminder that prevention is always cheaper and better than cure. Studies suggest that public health expenditure is between three and four times more productive than health treatment expenditure. That prevention and public health expenditure is a much better way to go where we can, and its often a smaller, much smaller proportion, but an important proportion of the budget.

At a time when the exponential growth in the Health budget is one of the major contributors to our budget woes, surely the government recognises this, throwing more and more money into healthcare with diminishing returns is not a smart way to go, so I welcome the government's 20 year Preventive Health Strategy, but it must be adequately and sustainably resourced or it becomes pointless, an aspiration with no capacity to deliver.

I'll be looking very closely at this Budget for clear funding measures that are directed towards preventative health. We know the government is taking this preventative health whole‑of-government approach, but it needs a commitment by the whole of government and there needs to be transparency about the preventative health measures and their funding and for accountability around their delivery so that this isn't just a glossy strategy accompanied by a business-as-usual approach.

If the government is taking this seriously, it should be reported in the budget each year to ensure accountability and transparency. This transparency is something that TasCOSS have called for as well. The Tasmanian state budget papers do not report active transport as a distinct line item. As such, it's difficult to determine the amount and percentage of health funding allocated to preventative health in Tasmania, but if public health funding is any indication, the amount of money it is allocated as a portion of the total health budget has reduced by 50 per cent over the past decade, where it now receives less than 1 per cent of the total health budget.

Health literacy is important because we understand about our health and health care and when we do that, the healthier we become. Health literacy is a better predictor of health than education, socioeconomic status, employment, racial background or gender. Tasmanians have a variety of health literacy strengths and challenges. People with the greatest health literacy challenges have poorer health outcomes. The government previously took health literacy seriously. It has had a health literacy action plan since 2011, but the most recent action plan expired last year and hasn't been replaced.

If we think about chronic conditions, Ms Rosol and Ms Haddad have spoken about these issues around chronic health and chronic conditions and if we look at some of the worst chronic health outcomes there would be a link to health literacy in some of those areas. We can be strategic, we can target health spending and this would be a sensible way to go for the government.

On to broader considerations. It is important, Deputy Speaker, for the Preventive Health Strategy to be grounded in a commitment to addressing the social determinants of health and the daily conditions of life experienced by Tasmanians, extending well beyond any focus on individual health behaviours. This includes the determinants of housing and homelessness, electronic gaming machines and the harm they cause, equity and access to electricity.

To then truly embed this preventative health approach and achieve the deep-seated change required in Tasmania, the government needs to give greater consideration for long-term outcomes and impact in government policy and spending, a greater focus on strengthening the fundamental assets of people and communities and a rebalancing of resources towards people, services and infrastructure that are preventative.

The state government must look beyond the health sector with this strategy. Fair funding for infrastructure, leadership in regional land use planning, full implementation of the Tasmanian Housing Strategy and action on climate risks are all essential to achieving better health outcomes. We know that there will be more impacts from climate change on the health of the most vulnerable. We know where the heat islands are and we know that the most vulnerable and susceptible are those with chronic conditions, who cannot necessarily and may not be able to afford good air conditioning and keeping out of the heat and so forth. We need better planning and land use planning. I cannot stress this enough.

Ms Haddad and Ms Rosol touched on the concerns around funding for anti-smoking and anti-vaping and on Quit Tasmania. Unfortunately, short-termism will rule the day with the government. I'll give an example. Quit Tasmania is losing its state government funding for anti‑vaping campaigns and the Smoking Prevention Package for Young People from 1 July 2025. These are young people who are vulnerable to taking up smoking, who have some of the greatest vulnerability to the actions of tobacco companies and people who want to profit from their addiction. How can this be?

Smoking remains the leading preventable cause of death in Australia and the second leading preventable risk factor contributing to the total burden of disease. We've heard that Tasmania has one of the highest smoking rates in the country. We heard at a briefing this morning that 15 per cent of Tasmanians smoke, so that's gone up from your figures, Ms Haddad. That's 550 people dying each year in Tasmania from smoking and it's not only those people who are dying but also those who have chronic heart disease, and those with amputations. As a former podiatrist, I saw that often.

Minister, it's really important that the patient clinics that are doing the prevention rather than the acute management of those conditions are properly funded. There's a growing demand on these outpatient clinics and I  ear that a lot of the preventative health delivery is not happening in those outpatient clinics anymore.

I commend Professor Razay's call for collaboration between all three levels of government. This is really important and it's certainly something that the Local Government Association of Tasmania recognised in their submission. When they put in a submission for the 20‑Year Preventative Health Strategy, LGAT said:

Real lasting change happens when all levels of government work together with a shared vision, coordinated response and clear responsibilities.

Bike paths, cycleways and walking paths need to be funded. They're so important to connect communities, help with mental health and wellbeing, but also help with physical wellbeing.

Finally, we know that St Luke's Private Health has their bold mission to make Tasmania the healthiest island in the world. Let's not stop that bold vision; let's make it happen.