Issue: Australia has one of the best health systems in the world, and one of the highest life expectancies. Despite this, many Australians suffer from chronic illness, which is a growing problem facing the health system as the population ages. Chronic diseases – such as diabetes, heart disease, cancer and arthritis – are estimated to be responsible for nearly 80 per cent of the total burden of disease and injury in Australia, and more than two thirds of all health expenditure. Diabetes and heart disease alone cost the health system more than $6 billion per annum. These chronic diseases also have a disproportionate impact on some population groups, particularly Indigenous Australians.

Evidence has shown that lifestyle interventions can prevent or delay the onset of chronic diseases such as diabetes. Many of these diseases can be effectively prevented or their impact delayed, through action on lifestyle factors such as poor diet or insufficient exercise, or through better management of conditions such as high blood pressure or obesity.

In response to these trends, the Australian Government, in partnership with the states and territories, is strengthening the focus of the health system on prevention and health promotion, and management of chronic disease. From 1 July 2006, the Australian Government and the state and territory governments will begin implementing a five-year, $500 million national package called the Australian Better Health Initiative to reduce the impacts of chronic disease. The package will have an appropriate focus on the needs of Indigenous Australians. It will include the following priority areas:

• Promoting healthy lifestyles

     This program will encourage people to make informed lifestyle choices and reduce the risk of developing chronic disease. A particular focus will be on agreement of simple, consistent messages between all jurisdictions so that all Australians can benefit from healthy lifestyle advice.

     The details of these activities, including a national social marketing campaign to promote health and well-being, will be developed by the Australian Government and state and territory governments. States and territories will consider the implementation of consistent school canteen guidelines across Australia.

• Supporting early detection of risk factors and chronic disease

     From November 2006, the Australian government will introduce a new Medicare Benefits Schedule (MBS) item to support general practitioners, assisted by practice nurses, to provide a focused health check for patients aged around 45 years with identifiable risk factors such as weight, smoking or family history. This health check will identify patients at risk of developing chronic conditions and provide an opportunity to promote lifestyle changes, for example through Lifestyle Prescriptions (Lifescripts), or referrals to programs such as Quitline.

    This new item will also help general practitioners and their staff in the early detection of chronic disease so that any required treatment can be commenced early and the risk of the disease progression reduced.

• Supporting lifestyle and risk modification

    The initiative will provide support for people at high risk of developing a chronic condition to make lifestyle changes and reduce their risk. Individual and group lifestyle counselling and education services, including progress monitoring and follow up, will be made available to patients identified as having significant modifiable risk factors.

    The services will be given by approved providers such as registered nurses, Aboriginal health workers, and allied health professionals. State and territory governments will also expand services to help people to reduce their risks of chronic disease by quitting smoking or losing weight.

• Encouraging active patient self management of chronic conditions

    This measure will encourage active patient self-management of chronic conditions through targeted training for health professionals to assist people with chronic conditions to better manage their health. State and territory governments will provide leadership and support for a range of local and regional level self-management activities for patients such as face to face group courses, telephone counselling and motivational counselling.

    The Australian government will work closely with health care professionals and state and territory health authorities to support the education and training of GPs and other health providers in self-management practice; assist the university and TAFE sectors in the provision of self-management education for new general practitioners, nurses, allied health professionals and Aboriginal health workers; and ensure quality control and accreditation processes relating to a range of self-management interventions and innovative research on enhancing self-management practice.

• Improving the communication and coordination between care services

     This measure will improve the coordination and continuity of care for people with chronic diseases, especially cancer.

     Governments will provide incentive funds to appropriate organisations to improve the connections at a local level between service providers including private medical services, community health services and allied health services, so that patient’s needs are better met.

     From November 2006, a new MBS item for case conferencing will provide increased support for cancer specialists to bring together all experts working with an individual patient.

     State and territory health services will improve coordination of treatment and support for cancer patients, including the use of “care coordinators.”

These five priority areas are consistent with the directions of the National Chronic Disease Strategy, endorsed by Health Ministers in November 2005.

The Australian Better Health Initiative demonstrates the commitment of the Australian government to work collaboratively with the state and territory governments to address key health issues. Some components of the initiative, such as the MBS health check for patients aged around 45 years, will be managed and funded directly by the Australian government, while others will be conducted by the states and territories, consistent with specific needs in each jurisdiction. The Promoting Healthy Lifestyles component will be jointly developed and funded by all governments.

Health professionals, including the Australian Divisions of General Practice, consumer groups, non government organisations and the private sector will be consulted on development of specific activities under the initiative.