1. AUSTRALIA’S FUTURE HEALTH
Australian Medical Students Association (AMSA) Annual
National Leadership Development Seminar
CANBERRA – 30 August 2010
Professor Jim Bishop AO
Chief Medical Officer
Australian Government Department of Health and Ageing

2. OECD HEALTH DATA 2010
How Does AUSTRALIA Compare
Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
8,000
7538
7,000
6,000
5004
5,000 4627
4210
4079 4063
3970
4,000 3793 3737
3696 3677
3540 3470
3359 3353
3129 3060
3008
2902 2870
3,000 2729 2687 2683
2151
2,000 1801 1781 1737
1437
1213
999
852
1,000 767
0
1 Refers to insured po pulatio n rather than resident po pulatio n. 2. Current expenditure. 3. 2006. 4. 2007. So urce: OECD, OECD Health Data, June 201
. 0
Public expenditure on health Private expenditure on health

3. AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010

4. SELF- ASSESSED PHYSICAL
& MENTAL HEALTH, 2007
Source: AIHW Australia’s Health 2010

5. MAJOR DISEASE
BURDEN in
AUSTRALIA

6. BROAD CAUSE MORTALITY
TRENDS IN AUSTRALIA
Source: AIHW

7. AGED ADJUSTED DEATH RATES
From CVD, 1907 - 2006
Source: AIHW Australia’s Health 2010

8. Mortality-to-incidence ratio
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Ke
ny
a
Ni
Source: IARC 2010.
ge
ria
Eg
yp
Vi t
et
Na
m
Tu
rk
ey
In
di
a
Ch
in
a
Ru
So ss
ut ia
h
Af
ric
a
G
re
ec
e
Br
az
il
Cz Ja
ec pa
h n
Re
pu
bl
ic
Un
ite Ita
d ly
Ki
ng
do
m
Ca
na
da
G
er
m
an
Sw y
Ne ed
w en
Ze
al
an
d
US
Au A
st
ratios for selected countries - 2008
ra
lia
Males
Females
ALL CANCER – MORTALITY/INCIDENCE

9. CHANGES IN DEATH RATES IN MALES
using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW

10. CHANGES IN DEATH RATES IN FEMALES
Using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW

11. CANCERS WITH REDUCING DEATH
RATES 1997 to 2006 – ALL AGES
0
-5
-10
-15cancers, -13.8
All Breast, -13.8
-7.9
-20 Lung, -18.5 Bladder, -18.5
Colon, -19.6Rectum Prostate, -19.7
Bowel
-19.0 , -19.9
, -19.7
-25 -19.0 Leukaemia, -23.7Head and Neck, -23.7
, -18.9
Unknown, -24.8 , -15.2 , -24.3 Kidney
, -21.1 , -24.1
-30 Stomach, -29.4
-18.5
NHL, -25.1
-35 -31.9
-40 Cervix, -38.3
Testicular, -42.2
-45
Male Female
Source: Tracey et al, Cancer Institute NSW

12. PROJECTED BURDEN of
MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010

13. TRENDS IN LEADING CAUSES
OF DISEASE BURDEN 2003-2023
Source: AIHW Australia’s Health 2010

14. TOTAL CANCER CASES & DEATHS
per year (1972 to 2036)
Source: Cancer Institute NSW

15. HOW CAN HEALTH
BE
IMPROVED ?

16. THE KEYS TO PREVENTION
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol
Alcohol
Fruit/vegetables
Illicit drugs
Air pollution Total of 32%
Unsafe sex
0.0 2.0 4.0 6.0 8.0
% DALYs
Source: Table 4.1 AIHW Australia’s Health 2008

17. AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010

18. SMOKING IN AUSTRALIA
SMOKING
NSW VIC QLD WA SA TAS ACT NT AUS
STATUS
Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6
Weekly 1.2 1.5 1.4 1.2 1.5 0.6 0.9 1.2 1.3
Less than 1.4 1.7 1.3 1.4 1.8 1.6 1.6 1.3 1.5
Weekly
Ex-smoker 24.7 24.4 25.7 28.3 24.1 26.5 24.8 22.4 25.1
Never 56.3 55.9 54.5 54.3 56.2 48.6 57.9 49.8 55.4
smoked
National Drug Strategy Household Survey 2007Australian Government
Source: 2007 Household Survey,

19. AUSTRALIA’S INITIATIVES IN
TOBACCO CONTROL
 Advertising Bans
 Under the counter at retail sites
 Banning smoking in restaurants, pubs and cars
 Graphic warnings on cigarette packets
 Anti-tobacco campaigns
 Increase in tobacco excise
 Plain packaging

20. OBESTITY INCREASING
FOR ALL
Source: AIHW: Australia’s Health 2008

21. AUSTRALIAN HEALTH SURVEY
 Four components run by ABS 2011-13
- Health Survey
- ATSI Health Survey
- Nutrition and Physical Activity Survey
- Health measurement Survey
 Around 50,000 participants
 De-identified data available as summary statistics,
tables

22. MILESTONES IN
CANCER CONTROL
 Public health measures in smoking reduction,
screening breast, cervix, bowel, health literacy
 Adjuvant treatment of breast, lung and bowel
cancer
 New anti-cancer drugs and symptom control drugs
 Cancer research translated into practice
 Cancer registries, data linkage and analysis

23. NON-COMMERCIAL CANCER
RESEARCH EXPENDITURE, 2004
(A$ per CAPITAL)
Source: Eckhouse et al (2007), ABS

24. PRIORITY HEALTH AREAS
SOURCE: NHMRC Research funding 2010 facts book

25. CLINICAL GUIDELINES
SUPPORTS FOR CLINICAL
DECISION MAKING
 Evidence Base
 Highest Impact
 Range of best practice tools
 Successful implementation methods
 Monitor and report

26. MEASURES IN WORKFORCE
 $5.4 billion from 1 July 2010
Additional $632m - 5,500 places for GPs
- 5,400 pre-vocational GP
Places
- 680 Specialist places
 Health Workforce Australia established
Initial emphasis on Clinical training places

27. AUSTRALIA’S FUTURE
HEALTH SERVICES
CONCLUSIONS
 Orientated to known burden of disease
 Emphasis on prevention, early interventions
 Driven by evidence from medical research
 More opportunities for clinical training
 Evidence based standards and guidelines
implemented and monitored