An ounce of prevention is worth a pound of cure

A new study shows that less than 2% of total Government health spending in Australia goes towards public health efforts like infectious and chronic disease protection, prevention and health promotion.  The research also uncovered a lack of transparency in exactly how much and where public health money is spent.

Leading public health experts says the research demonstrates the need for a new Government model to ensure that public health spending has maximum impact and is visible.

Published in the Australian and New Zealand Journal of Public Health, the study is the first to analyse and map public health funding from both Federal and State/Territory Governments. It was funded by The Australian Prevention Partnership Centre, a research, policy and practice collaboration and Centre of the Sax Institute.

The study reports that in 2019-20, 1.8% of overall health spending (or $140 per person) was allocated to public health initiatives, though the amount varies among states and territories. For example, the Northern Territory spent $527 per person on public health, while Victoria spent $110.

Lead author, Emeritus Professor Alan Shiell from La Trobe University says that “the effectiveness of public health funding isn’t just determined by how much funding is given, but also how it is allocated.

“Our research uncovered a complex and piece-meal funding system. While delegating funding decisions to the states and territories who understand local need is a strength of our current model, it leaves the public in the dark about exactly where the money is going and exactly how much is being spent on public health.

“It also makes it very hard for us to assess what difference public health spending is making.”

Adjunct Professor Terry Slevin, CEO, Public Health Association of Australia says that as well as greater transparency, the study demonstrates the need for a new Government funding model for prevention to ensure that the health budget is effectively spent.

“After a clear “spike” in public health spending due to the pandemic, investment in this area looks to have returned to pre COVID levels.

“We have a sophisticated system to determine the best investment in medicines – the Pharmaceutical Benefits Scheme (PBS). We need a similar system to ensure that proven, cost-effective public health programs receive consistent funding.

“This would help ensure more consistent and effective health spending to help everyone in Australia live healthier lives.

“The Australian Centre for Disease Control could play an active role in developing this proposed funding model. Prime Minister Albanese is on the record as saying prevention will be one a focus of the Centre,” Prof Slevin added.

Over the last 10 years, the Prevention Centre have strengthened the evidence base for where to target investment in prevention action. Further investment in proven strategies will improve chronic disease outcomes nationally.

Head of The Australian Prevention Partnership Centre Nadia Mastersson says, “this research should encourage discussion on how public health funding mechanisms in Australia can be improved to ultimately keep more Australians healthy and well.”