On the importance of regular reporting from governmental public health bodies

Mr Jackson Blythe


Mr Jackson Blythe
Fourth Year Medicine/Medical Science
University of New South Wales

Jackson is a medical science/medicine student currently undertaking an Honours project investigating glucose metabolism at the Garvan Institute of Medical Research. He is also interested in mental health and health promotion, and intends to forge a career in rural general practice.


Despite the increasing importance of transparency and accountability in government, and the demonstrated efficacy of consultation, communication, and response to criticism in policy development, the last decade has seen a backwards step in the effective output of Australia’s governmental public health bodies.

The National Public Health Partnership (NPHP), a federal government organisation formed in 1996, was, and continues to be, widely celebrated by public health practitioners for its enduring contributions to Australian public health. The NPHP published quarterly newsletters and produced close to 100 publicly accessible reports in their relatively short tenure [1,2] covering a very broad set of issues. In 2006, the NPHP was dissolved and replaced by two advisory committees: the Australian Health Protection Principal Committee and the Australian Public Health Development Principal Committee (APHDPC). The former group exists in order to formulate strategies for response to public health emergencies and other large-scale heath threats, while the APHDPC was intended to “coordinate a national effort towards an integrated health development strategy” [3]. To rename, rebrand, divide, and unite government entities is a common process undertaken for a variety of reasons. Indeed, the APHDPC appears to have since been divided into five separate principal committees, all advising the Australian Health Ministers’ Advisory Council (AHMAC) [4]. However, these newer committees do not publicly report on their work, which is problematic in a number of dimensions.

Most governmental organisations communicate their work as a matter of principle (even ASIO releases yearly reports [5], and secrecy is their business). Accountability of governmental institutions is becoming an ever-more important factor in modern societies [6], and it is imperative that the public have some sense of the function of government departments. This is important for ensuring that public expenditure is well-targeted and produces meaningful results. In an ideal system, underperforming government entities will be subject to public pressure calling for internal change to either increase the efficacy of the entity in question, or remove it entirely. This is one of the key arguments for the importance of governmental transparency [6].

More importantly, the infrequency and inconsistency of publicly available reports emerging from the new principal committees are counterproductive to their stated aims. It is clear that consultation with the public is crucial to maximising the efficacy of emerging public health practices and policies [7]. As the peak groups responsible for advising governments on health policy, their work should be open to criticism, and therefore improvement, through as many avenues as possible.

Stifling the process of wider input into policy development restricts scrutiny to after-the-fact analysis. Australia has clear mechanisms to evaluate the progress of certain health outcomes and effectiveness of new policies – the Australian Institute of Health and Welfare and the Bureau of Statistics are responsible for this – so why is it that the evaluation of developing policies is not as open? Delaying consultation with academics and calls for public submissions on proposed policies until the implementation stage is not ideal; as with public health issues themselves, suboptimal policy decisions are best addressed upstream. It is critical for academics, non-government organisations, and the general public to have access to plans for developing public health programs, reports on current strengths and weaknesses, and other procedural documents. Helpful scrutiny can arise from such publicity and accelerate Australia’s advances towards a healthier society.

After the immensely public legacy of the NPHP, the sudden absence of regular reporting in the sphere of public health policy development is somewhat disarming, but the reasons underlying this sudden disappearance are unclear. The central issue here appears to be primarily one of communication. A small suite of reports is available for download on the Council of Australian Governments (COAG) Health Council website, which represents the recent work of the principal committees which comprise the AHMAC [8]. These are, however, poorly advertised, difficult to find, and infrequently accessed. In short, a number of issues conspire to ensure that the work that does emerge from the COAG Health Council goes relatively unnoticed.

Consultation is a cornerstone of policy development in any sector, and all government bodies should seek to interact with the public in order to promote their work and receive feedback. Australians have a right to know what ideas our governmental public health groups are proposing and developing, and the optimisation and implementation of these ideas depends on communication with clinicians, public health practitioners, and the wider community. If the COAG Health Council and its subsidiaries more regularly presented work for public criticism, our formulation and implementation of federal public health initiatives would inarguably be more successful. A strong collective public health partnership is vital for the effective dissemination of information, as well as discussion and improvement of developing public policy. The current widespread radio silence from our peak intergovernmental public health bodies is damaging to the future of Australian health, and these organisations should be expected to more frequently demonstrate interest in communicating with the community through both consultation and the release of public reports.

Acknowledgements
None.

Conflicts of Interest
None declared.

References

[1] Victoria Health. NPHP News Archive [Internet]. Melbourne, Victoria: Victoria health; 2003 [updated 2005 July 1; cited 2016 March 4]. Available from: http://www.health.vic.gov.au/archive/archive2014/nphp/nphp_news/archive.htm.

[2] Victoria Health. NPHP Publications [Internet]. Melbourne, Victoria: Victoria health; 2003 [updated 2006 July 24; cited 2016 March 4]. Available from: http://www.health.vic.gov.au/archive/archive2014/nphp/publications/wa_index.htm.

[3] Victoria Health. The National Public Health Partnership (NPHP) [Internet]. Melbourne, Victoria: Victoria Health; 2006 [updated 2010 February 22; cited 2016 March 4]. Available from: http://www.health.vic.gov.au/archive/archive2014/nphp/.

[4] COAG Health Council. Principal Committees [Internet]. Adelaide, South Australia: COAG Health Council; 2014 [cited 2016 April 13]. Available from: http://www.coaghealthcouncil.gov.au/AHMAC/Principal-Committees.

[5] Australian Security Intelligence Organisation. ASIO Report to Parliament 2014-15 [Internet]. Canberra ACT: Australian Security Intelligence Organisation; 2015 [cited 2016 March 4]. Available from: http://www.asio.gov.au/Publications/Report-to-Parliament/Report-to-Parliament.html.

[6] Bertot JC, Jaeger PT, Grimes JM. Promoting transparency and accountability through ICTs, social media, and collaborative e-government. Transforming Government: People, Process and Policy. 2012 Mar 16;6(1):78-91.

[7] Organisation for Economic Co-operation and Development (OECD). Citizens as Partners: OECD Handbook on Information, Consultation and Public Participation in Policy-Making. Paris: OECD; 2001.

[8] COAG Health Council. Reports [Internet]. Adelaide, South Australia: COAG Health Council; 2014 [cited 2016 April 13]. Available from: http://www.coaghealthcouncil.gov.au/Publications/Reports/PgrID/514.