Friday, June 05, 2015

It Seems I Am Not The Only One Who Thinks The Health Department Could Do A Much Better Job.

This appeared last week.

How the rise of the lobbyist is corrupting Australia's democracy

Date May 18, 2015 - 12:15AM

John Menadue

Australia's capacity to tackle important public issues – such as climate change, growing inequality, tax avoidance, budget repair, an ageing population, lifting our productivity and our treatment of asylum seekers – is diminishing because of the power of vested interests, with their lobbying power to influence governments in a quite disproportionate way.
Lobbying has grown dramatically in recent years, particularly in Canberra. It now represents a serious corruption of good governance and the development of sound public policy.
In referring to the so-called public debate on climate change, Professor Ross Garnaut highlighted the "diabolical problem" that vested interests brought to bear.  Ken Henry, a former secretary of Treasury, says he "can't remember a time in the last 25 years when the quality of public policy debate has been as bad as it is right now". He was followed as secretary of Treasury by Martin Parkinson, who has warned about "vested interests" who seek concessions from government at the expense of ordinary citizens. The former ACCC chairman, Graeme Samuel, has cautioned that "A new conga line of rent-seekers is lining up to take the place of those that have fallen out of favour". And in referring to opposition to company tax and carbon pollution reform policies, Fairfax columnist Ross Gittins says:  "Industry lobby groups have become less inhibited in pressing private interests at the expense of the wider public interest. They are ferociously resistant to reform proposals."
These problems are widespread and growing.
There are 266 lobbying entities registered in Canberra with the Department of Prime Minister and Cabinet. On top of these "third party" lobbyists, there are the special interests who conduct their own lobbying. These lobbyists encompass a range of interests including mining, clubs, hospitals, private health funds, business and hotels, that have all successfully challenged government policy and the public interest. Just think what the Minerals Council of Australia did to subvert public discussion on the Mining Super Profits Tax, or the activities of Clubs Australia to thwart gambling reform, or the polluters over an Emissions Trading Scheme and the Carbon Tax.
I estimate there are more than 1000 lobbyists, part time and full time and of all shapes and sizes, operating in Canberra. Secret lobbying is pervasive and insidious.
With journalism under-resourced, the media depends increasingly on the propaganda and promotion put into the public arena by these vested interests. The Australian Centre for Independent Journalism found in a survey of major metropolitan newspapers published in Australia in 2010 that 55 per cent of content was driven by public relations handouts from lobbyists and their associated public relations arms, and 24 per cent of the content of those metropolitan newspapers had no significant journalistic input whatsoever, relying heavily on public relations handouts.
Many of the so-called economic experts we read, hear and see on our media are in the employment of the banks and accounting firms, with their own self-interested agendas.   
The health "debate" in Australia is really between the minister and the Australian Medical Association, the Australian Pharmacy Guild, Medicines Australia and the Private Health Insurance companies. The debate is not with the public about health policy and strategy; it is about how the minister and the department manage the vested interests.
Departments such as Health which are so influenced by special interests should have different governance arrangements. The traditional minister/department model in Health is a happy hunting ground for vested interests. The Reserve Bank, composed of independent professionals, has shown the benefit of such governance arrangements in keeping vested interests at bay and promoting an informed public debate. We need such an arrangement in the health field particularly.
No minister or senior government official should work with a vested interest group that they have been associated with for at least five years after retirement or resignation.
This is an edited version of an article on the blog Pearls and Irritations (
The full article is found here:
If ever you want to see the effect of the ‘conga line of rent seekers’ you only have to have watched what happened to the PCEHR in recent times with the obvious decision to scrap the PCEHR not being taken after what you can be sure has been many months of pressure from all sorts of interests who seem to think there is still money to be made by having the program stuttering on.
Of course there is no evidence the PCEHR is actually making a clinical difference but it might be that it is making a financial difference for those involved - or am I being a trifle cynical?
I will pop back in my box now and hope when I come out again we might actually see the Department of Health using evidence for policy making - rather than any other approach! I may have to hide for a long time.


Trevor3130 said...

Rob Moodie writes
Chronic disease is caused largely by lifestyle factors such as physical activity, diet, tobacco and alcohol consumption, and by the tobacco, alcohol and junk food and drink industries.

There's a strong argument for "big data" to provide information, on individuals' consumption of discretionary products, back into a digital health record. Any takers?

Bernard Robertson-Dunn said...

Are you suggesting that the PCEHR could be used for more than just a dumb document repository? Now there's an original thought.

Of course, if a government application were to trawl through everyone's health record looking for bad lifestyle factors and then sending out emails telling them to get their act together, that would really freak out the average punter.

It would also probably be illegal.

But the government could change the law and it could write such an application. Once it has everyone's health record in their database the government could do lots of things. We do trust them not to. Don't we?