Andrew should have made reference to how health promotion could be delivered to various religious or ethnic groups and his contribution would be awash with posts from all and sundry.

Had he written on the need to deliver a culturally sensitive health message to young muslim men and women on contraception or a similar message to 13 year old teenagers on safe sex Andrew may have scored as many hits as John Stones piece!

As it is, some time well into the day, no really gives a rats arse about health promotion. There is no money in it.
There's no money in it for the doctors, no money in it for the Maynes or the othe private conglomerates or the pathology companies. And there's no money in it for the thousands of health bureacrats who filter the money down to the bed side after months of work shops, policy treatments, target group setting and training days.

The only group to get a return on the investment would be the community. Far too radical a thought.

Sadly we live in a economy these days and not a community. In spite of the economc wins to be made the current settings will not permit much of a shift in the balance of expenditure that will put a welness clinic at the top of the cliff rather than an ambulance at the bottom of said precipice

Please, please, please do not follow what's happening in England in relation to health promotion...education or universities. As a discipline/subject/area/profession health promotion doesn't really exist. This government is set on governance, control and surveillance (some would say with good reason). Individual responsility for prevention...or for anything come to that, doesn't really exist in this country. Communities are in real decline and there are no mechanisms to support them.
In my expereince, health promotion sounds great when taught at universities but in the world of imploding communities it is far from the answer. Community development...now that might be something else...

Nearly 24 more hours on - 2 comments; just barely on the radar of popular interest.

Clearly many contributors would rather argue the toss about whose up whom or what the local muslims wear or what the swarthy among us are plotting next than examine an issue that will effect all of us and our children far greater than any flash in the pan pre occupation with terrorists.

Our health services are groaning under the weight of excess demand - some of it descretionary and garbage - sucking up time, skill and resources like cosmetic surgery, over servicing and over sue of high tech investigations and over prescribing and the like - but a big chunk of it is genuine.

Workforce analysis shows us an ageing workforce within the ranks of health professionals. Those left demonstrate a desire to work less heroic hours - while that issue needs to be addressed so does the issue of health promotion and illness prevention - but lets not worry about that; those pesky muslims still insist on wearing hankies on their heads! What an afront.

Donald Horne died today - he was right: we are a lucky country led by second raters who have cashed in on the luck: it is the second part of his assertion that carries the true meaning; most of us just run around thanking god we're so lucky.

I am and will be until I decide to be otherwise - Sneekeepete.

It is ironic Pete, almost everyone one of us will at some time have our lives depend on the health system and in all liklihood it will increasingly fail us, yet it doesn't seem to rate in these forums as very important topic. Instead it seems most people would prefer to debate remote issues which hardly effect them or of which they have no experience. Hopefully its because the articles on health contain so much good sense and everyone agrees with them. I thought this article was good, although like Shearer I was surprised by the positive references to the UK system.

As someone said in another forum, we should not forget that the health system is about people's lives and their quality, but I also think it needs to be about efficiency because funds are limited. Prevention is a highly efficient way of handling many health problems, although not all health problems are preventable and eventually we all succumb to something. No government (and it seems few writers or forum participants) seems to want to reform the entire system, but I think this is the only way to really address its shortcomings.

[Quote] Be it Australia or in countries like Vietnam, there are many who have “powerful interests that will fiercely resist changes... because they could lose profits and influence.”

I was shocked in Vietnam, at the conceited boost and imposition of the Western medicine propaganda machine. In a country of over 70 million, where at least 95 % are genuinely just very poor, we see the sterility of what is now a backlog of “non-sensible dilemmas” surrounding the pronounced superiority of Western Medicine.

Instead of building on the wealth of historical knowledge found in Vietnamese Health idealologies, which has supported the Vietnamese people for more than 1000 years (see Vietnamese Health Prevention, and references to Ho Chi Minh), including through the last Vietnam War, we see the West, intimidate this knowledge base, down play it’s proven value, under a “guise” of Western modernisation.

At village level Vietnam has an intricate Health network, based on primary health education and preventive health. At village levels, Health Staff work informally and formally with individuals and groups, integrating health care and health knowledge, at ground level. The guidelines of this system run complimentary to the UN World Health System policies and guidelines, and are based on the engagement of micro-economic principals in Primary Health Care delivery.

In the main hospitals, in the major cities however, there is much chaos. Hundreds of people wait daily (some for days) in “grimy” looking waiting rooms, to see a doctor. There is no Medicare, and the cost to whole family’s, who often have to travel with the sick, from the village, to the provincial facility, to be referred to the city, find it hard to find proper accommodation and food.

In many of the larger hospitals however, up stairs from the crowded waiting rooms, is a growing medical elite. With large “fancy” machines, the latest technology, you find an expensive and decorative pastel scheme of service, marketed proudly, with the kind of up-beat demonstrations in medical science, that have nothing in common with the practical demand for health care that plagues those suffering, among the people, waiting down stairs.

My point is that we do need to think and act diligently, against a brain-wash of new ideologies systematically creeping in to the world health system, at present. For example, to support and quote Shearer’s discussion where he says;

“Please, please, please do not follow what's happening in England in relation to health promotion...education or universities. This government “is set on governance, control and surveillance…”.

I add, it is ever critical to demand balance. Given my research in Health and Crime Prevention, I ask you to view the “Preserving Life and Dignity” a Public Advocate Qld Report put out June. - http://www.justice.qld.gov.au/guardian/pa/discussion.htm - it is one area where the “power” of new definitions on the concept of “surveillance” must be severely scrutinised, especially when we consider the vigorous promotion of having a integrated “IT information system” connected nationally to all “essential service delivery”.

I see data entry IT systems at present merely as classification systems, to assist and ID the profile of clients, I do not see this information gathering, targeting, or processing the knowledge necessary, to enhance the promotion of “wellbeing” at a human level.

Before we know it, I sense, we will all be registered and labelled as “clients”, in one form or another.

One matter to claify for "Shearer": health promotion is a broad field that encompasses community development. In other words, health can be promoted (the goal) by some community development program (the strategy).