In Victoria, despite the gaping holes the pandemic exposed in our public health system just five years ago, our investment has slipped back to near pre-COVID levels. The Australian Institute of Health and Welfare calculated that in 2023-24, Victoria spent just under $1 billion, or $185 per person, on public health. That places us, on a per capita basis, below every other mainland state and territory.
Since then, the government has further cut the funding it provides to the most significant COVID-era health reform: the establishment of local public health units across greater Melbourne and in regional centres. Thomas told parliament these units were duplicating some of VicHealth’s promotion and prevention work.
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VicHealth, a health promotions agency created by the Cain government in 1987 to help sports organisations kick their addiction to tobacco sponsorship, is not sacrosanct. Given its founding purpose has ceased to exist, it was reasonable for former top bureaucrat Helen Silver, in conducting her review of the Victorian public service, to closely examine VicHealth.
The criticism of Silver and her review team is they took only a cursory glance before recommending it be abolished as a standalone agency and folded into the department along with its ring-fenced, $45 million budget.
In making their recommendation, no one from the Silver review sat down with the VicHealth board or senior management to better understand what they do. When Ian Hamm, a VicHealth director, was last month appointed the organisation’s new chair, he was not aware of Silver’s recommendations or the government’s planned response.
This was a missed opportunity.
The early work of VicHealth in supporting the Sunsmart and Quit campaigns and replacing tobacco advertising contributed to profound changes in social behaviour. Smoking rates have roughly halved in Victoria since VicHealth’s inception.
In more recent years, VicHealth has moved into campaigns to combat violence against women, racism and gender inequality. The tagline of VicHealth’s 10-year strategy – “Healthier, Fairer Victoria” – speaks to a mission creep beyond health outcomes.
A well-considered review of VicHealth might have reimagined its purpose and sharpened its focus. The Silver review didn’t try to do either of these things.
Instead, at a time when the West Australian government has appointed Australia’s first minister for preventative health and South Australia has joined other jurisdictions in adopting the VicHealth model, Victoria is abolishing its best-known public health institution.
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If VicHealth is absorbed into the Department of Health without statutory protections for its purpose and budget, everyone in public health knows where it will end up. We only need to look at what is happening inside the department right now.
The jobs stripped from the community and public health division are part of a bigger restructure inside the department which, in effect, seeks to undo some of the damage inflicted by a previous restructure introduced less than two years ago.
The previous restructure diminished the role of Victoria’s Chief Health Officer by severing their direct control over communicable disease experts who provide frontline protection against outbreaks of measles, Mpox, RSV and whatever virus might fuel the next pandemic.
The latest changes are designed to restore this connection and give Chief Health Officer Caroline McElnay managerial responsibility for the state’s health protection. But if we return to the arithmetic, staff numbers don’t lie.
There are fewer people working for the Victorian government in public health than there were at the start of the year and two years before that. The same fate awaits VicHealth if the government goes ahead with its plans.
Chip Le Grand is state political editor.
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