Well the COAG announcements are out and we have more money for hospitals, Emergency Departments, and waiting lists . Great news?

I doubt it.

It looks like we have put more money into the ambulances and hospitals at the bottom of the cliff (and probably not enough to keep them running efficiently to meet the coming demand) while forgetting to build the fence at the top of the cliff to stop all these obese lemmings from falling over.

Until we try to build a health system (and not the current poorly interconnected illness-orientated industries) we will never get a healthy Australia community. It is hardly surprising that our current illness departments and services want more of the same. I just wish some brave politician would start allocating resources to keep us healthy (i.e. putting serious resources into health education and secondary prevention) rather than paying current providers more and more when we fall over the cliff.

John Wellness,

<I just wish some brave politician would start allocating resources to keep us healthy (i.e. putting serious resources into health education and secondary prevention) >

I wonder what you would call the immunization program?

what about the stop smoking program?

there was the Norm get fit program in the 1970's

There have been various screening programs for diseases.

Alot of oc-health and safety is about prevention,

We have had seat belts, and car safety.

There has been the safe sex messages,

Unfortunately for any education program to have any real effect, it would have to begin before kids even enter school and continue throughout their life.

Even better would be the banning of highly processed food,

Margarine was introduced in the 1960's in an attempt to reduce the incidince of heart disease.

So health promotion programs have been around a long time.

I totally accept that there have been numerous attempts to prevent illnesses and that many of these have been successful.

Yet our current health system has led us to the point where around 50% of the adult population are overweight or obese, still around a quarter of adults smoke, many do not do enough physical activity to maintain their health, less than half eat the recommended serves of vegetables and so on. These factors predispose our community to a number of chronic diseases such as diabetes, heart conditions and strokes.

The interventions you listed are mostly whole-of-population education programs. Huge numbers in the population know they shouldn't smoke, should eat healthily and so on but don't change their lifestyle.

As I see it we need different models of healthcare. We need multidisciplinary primary health care teams that focus on preventing chronic disease - more like GP Superclinics, Primary Health Care Centres, or Wellness Centres models. They need financial incentives to reward them for preventing chronic disease (as distinct to dealing with it). These centres can address at risk patients when they come for primary health care (and 85% of Australians go to a GP at least once in a year). As it is we generally address the problems 10 years too late - only after they have developed a chronic disease.

If we continue with our current illness models the ageing population and the rapidly impending tsunami of chronic disease will totally overrun our already stretched and ageing health workforce. We will also struggle to finance the extra costs of maintaining our current system. We are already hearing of children developing type 2 diabetes before they are teenagers. They will have to live with this condition for over 70 years (rather than the more traditional 20 years) with all the costs this involves - and depression and all the other medical and social problems that come with chronic disease.