The Australian Medical Association Limited and state AMA entities comply with the Privacy Act 1988. Please refer to the AMA Privacy Policy to understand our commitment to you and information on how we store and protect your data.

×

Search

×

Keeping the faith in politics

The Queensland election result amplifies the message that was so clearly sent to the Labor Government in last year’s NSW poll - responding to community concerns and keeping faith with commitments is gold in politics. Governments lose community support when they fail to convince the electorate that they have their interests at heart.  Promulgating ‘tough decisions’ and ‘hard choices’ is one thing, but failing to demonstrate – or explain clearly – how these ‘difficult’ policies will actually improve the lot of ordinary citizens is terminal.

02 Apr 2012

The Queensland election result amplifies the message that was so clearly sent to the Labor Government in last year’s NSW poll - responding to community concerns and keeping faith with commitments is gold in politics.

Governments lose community support when they fail to convince the electorate that they have their interests at heart.  Promulgating ‘tough decisions’ and ‘hard choices’ is one thing, but failing to demonstrate – or explain clearly – how these ‘difficult’ policies will actually improve the lot of ordinary citizens is terminal.

That said, there is no doubt that governing these days is very difficult.

What flies below the surface in public opinion polling are the everyday concerns of people and communities.  The newspapers are keen to highlight topical issues and dramatic events - carbon and mining taxes, the beauty contest between leaders, or the value of a one per cent drop in the company tax.  They even suggest that these factors shape the bi-weekly snapshot of the community’s political preferences.

Maybe they do, but it is also common sense to note that the issues that make up the regular negotiation of life are those that matter most.  It is usually the immediate concerns, the ‘top of mind’ worries, that consume the waking hours of people, rather than issues that are too far removed from their daily lives.

Consequently, when pollsters publish the ranking of community concerns as opposed to political preferences, health, education, housing, employment and interest rates always remain at the forefront.

Of course, this is the dilemma for political parties – remaining relevant between elections.

As is so often commented, the pervasive degree of disengagement in the community with the ‘business of politics’ is only matched by the enthusiasm with which television shows like My Kitchen Rules dominate household life over the course of the year.

Partisan politics aside, people expect their governments to soberly keep things in order and to give everyone a fair go.  They expect sensible decisions that don’t waste money and which favour the majority.  They shy away from extremists and put their lot with those of practical experience and demonstrated prudence.  Change is only embraced when it seems inevitable, and hubris and flamboyance always send warning signals. There is nothing so successful as an ordinary politician known for hard work, caution, and pragmatic decisions.

This rather colourless scenario suits an ageing demographic.  One that has seen it all and outlived the lot!  But not only the elderly.  People on average incomes and families with little to no savings are looking to governments for economic and social security.

They can ill afford uncertain swings in their prosperity, even their prospects.  Proper safety nets and affordable essential services are the bedrock for most Australians and the trust a government engenders is proportional to the degree to which they deliver these across the community.

Labor’s time in office federally has been marked by its push for health reform.  The AMA was initially enthusiastic about the prospects for reform - less bureaucracy, either in structures or red tape; more resources at the hospital bedside, surgery or clinic. 

Sadly and disappointingly, not all this has transpired.  Even though more funding has been injected into public hospitals, results on the ground are contestable.  Despite favourable noises that GPs would be freed of red tape, precious real change has occurred.

Even in the face of massive infrastructure depletion in the general practice sector, the Government has persisted with building Super Clinics and mounting a relatively limited capital support programs for existing practices.

In many instances, the Government seemed to want to innovate in the face of more pragmatic alternatives.

On a positive note, medical training requirements have remained centre stage, but the cost implications and quality of the training continue to be points of tension between the Commonwealth and the other governments.  That said, the system still relies heavily on the goodwill of the profession and the availability of senior doctors to spare the time to become the teachers so sorely needed.

Nobody has ever said that meeting the demands of a sophisticated health system is an easy task.  However, it can be said that the political debate that surrounds health care is too often characterised by political parties promising big and delivering far less.  As commentators have remarked about politics in general these days, spin prevails over substance.  Health is one of the areas where frustration in the community does translate into political perceptions.

The next federal election is already being framed within the context of trust and reliability.  Being transparent with the community about what is achievable and affordable will be vital to winning that trust.

Our entitlement systems are straining and the use of market forces is not always to the benefit of all.  Our workforce is ageing and access to services is suffering.  With prosperity and technology come increased demand pressures and our health system still functions as if we were in the 1980s.  New drugs and procedures may make for better life prospects, but they also raise the bar on affordability.  Urgent needs like dental care, proper disability support, and mental health services remain sadly underdone.

Change is essential, but so too is the explanatory story.  Juggling the financial challenges of a health system so forcefully driven from both demand and supply side influences is proving to be politically unmanageable.  We do need to reconfigure our system and better serve the battler as well as the entrepreneur.  We do need to keep pace with improved ways to deliver services, promote wellbeing and distribute the financial burden more equitably.  We do have to recognise that rationing of scarce resources is a community responsibility and not a myth.

So what is the upshot?  On one side, you have well-intentioned and intelligent public servants charged with prudent use of public funds to finance health services.  On the other, you have highly committed and intelligent doctors, health professionals, carers, and consumers negotiating the daily task of meeting the needs of the sick, frail, and suffering within limited resources.

It may have always been thus but unless this dynamic can be conducted within a community consensus of what is possible and what is not, the grounds for partisan political posturing and myth making will be fertile indeed.


Published: 02 Apr 2012