Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action

iv - Influence markets and develop connected and coherent policies

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Table of contents

The conceptual framework for the Strategy (described earlier in this chapter) shows that where imperfect markets are found, which the Taskforce has agreed is the case in Australia, consumption patterns can lead to poor health outcomes.

In this Strategy, action is specifically applied to improving markets, policies and cost-effective investments directed towards obesity, tobacco control and reduction of harmful consumption of alcohol. Similar actions are also relevant for other areas of preventative health – for example, for mental health, immunisation and injury prevention – and they are central to future preventative health strategies.

While the policies required to action change will be government-led, improvements in market efficiency will require substantial cooperation from industry and business, the non-government sector, the research community, health insurers, unions – and, most importantly, from individuals, families and the communities in which they live.

The conceptual framework links directly to four elements of policy development. These are described below:

  • Ensuring a well-informed public
  • Keeping people and families at the centre of action
  • Responsive regulation
  • Supporting vulnerable groups

A well-informed public

For prevention programs to work, individuals, families and communities need to have access to information, and be able to make informed choices about their health. Government action is critical to ensuring that people are well informed and can make the best decisions for their health and wellbeing, including choices about optimal health-promoting behaviours. A comprehensive approach offers the best way forward. The key components of such an approach include:
  • Social marketing that is sustained, appropriately funded and well implemented, including approaches that reflect the specific needs of individual groups and communities
  • Curbs on marketing of harmful or potentially harmful products and activities
  • Accessible and simple product information
  • Locally generated community initiatives
  • Assistance for people to assess the appropriateness and quality of services available
  • Health literacy education (as proposed by the NHHRC)

Keeping people and families at the centre of action

As well as good information, a sound prevention system will need to empower individuals and families to manage their health and wellbeing. To achieve this, people need:
  • Access to professionals who are trained to empower their patients
  • Health practices that are accountable for, and reward, patient-centred approaches
  • Involvement in decision making at the community level
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Responsive regulation

This Strategy places substantial emphasis on the use of responsive regulation.

Consumers and providers face a number of confusing signals about the products on offer in the community. Adjustments may be needed to pricing so that people in the community receive clear signals about the full cost of harmful behaviours and purchases.

Adjustments can be achieved through revisions to taxation, so that the price of a product that can harm consumers and others (for example, alcohol and tobacco) reflects the full cost of that product, and through regulatory approaches that reduce the promotion of, or access to products with high potential for harm.

'Responsive regulation' has been extensively researched and is widely accepted in a range of non-health contexts; for example, in tax systems, in competition policy and in environmental regulation. It proposes a staged and potentially escalating approach to change, allowing for 'soft' mechanisms to be trialled, such as voluntary change, self-regulation, co-design, public reporting or positive incentives. Where appropriate, rather than opting immediately for harder mechanisms of regulation, enforcement or fiscal sanctions, the results are measured and assessed, with action to follow if necessary.

    Figure 1.8:
    Regulatory pyramid and regulatory mechanisms (children’s television advertising example)
Figure 1.8: Regulatory pyramid and regulatory mechanisms (children’s television advertising example)

    Source: Adapted from Healy J, Braithwaite J. Designing safer health care through responsive regulation. MJA 184 (10): S56-S59.

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This approach respects the fact that, when confronted with good evidence of the negative externalities arising from particular practices, many players in the marketplace want to do the right thing. Responsive regulation allows for voluntary adjustments and the development of creative solutions through government, industry and consumer partnerships, but actions are clearly seen to occur within a framework of regular review and the introduction of sanctions should inappropriate behaviours persist.

Currently in Australia a voluntary, self-regulatory system operates in the regulation of some forms of alcohol advertising (but not sponsorship), with much stronger regulation and enforcement of drink-driving measures and licensing for the sale of alcohol.

In 2009 a new voluntary, self-regulatory system has commenced in certain forms of food and beverage advertising. This approach contrasts to that in tobacco, which over the last 30 years has moved from soft codes of conduct for advertising to regulation and legislation, with recognition of taxation as a very effective mechanism to increase pricing and reduce consumption.

The effectiveness of the voluntary codes that are in place can now be monitored and shifted to ‘harder’ mechanisms if they are found to be ineffective.

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