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EDITORIAL: THE KERR WHITE REPORT

EDITORIAL: THE KERR WHITE REPORT COMMUNITY HEALTH STUDIES VOLUME X. NUMBER 1. 1986 Which recommendations of the White report 1984 and 1985 have been significant years for are consistent with the continuing development of public health in Australia. The establishment of public health in Australia? the Australian Institute of Health (AIH) and the Better Health Commission and the reorganization The most significant recommendations relate of the Department of Health were three very public to the institutional changes proposed for public health education. White has recommended that the statements that a government of Australia was taking seriously, perhaps for the first time since SPHTM be closed and its resources and funds be major efforts were made to control tuberculosis, redeployed to other centres. He specifically the issue of public health. identifies a new National Research Centre for The review of research and educational Epidemiology and Population Health at ANU and requirements for public health and tropical health, three regional centres - Newcastle, Westmead and Adelaide. Tropical health research would go undertaken by Kerr White at the request of the Health Minister is a fourth such public statement. to Brisbane and Townsville. The principle of this distribution is a sound one - re-establishing a Public health involves inappropriate connotations for many in the face of 20th century central institution with a primary mandate for Western disease patterns - rats, drains, pure training to doctoral level while strengthening the water and unadulterated food. These, the concerns periphery; the details will probably be a matter of of health reformers particularly in 19th Century dispute. Europe (and still the concern of Third World A major concern for public and community health services) have been largely controlled by health workers at this point must clearly be that the technologic and economic means. Rather, our closure of the SPHTM may not be followed by the concerns have become chronic disease and re-establishment of a centre for public health disability and the way in which our environment training and research. Such a re-establishment can and lifestyle impinge on risk. Thus the major take advantage of the excellence of individual model now for public health in Australia involves workers and groups at SPHTM, can add elements other than the bacterial preoccupation of additionatexpertise in areas currently lacking and our predecessors. can institute appropriate links between Our information base for public health population-based public health science and social emerges from population-based studies and the analysis intrinsic to the prevention of diseases for appropriate model of health and disease is which hospital-based management is so costly in intrinsically a social one. Factors and policies both economic and human terms. The current which influence housing, education, employment facilities for public health must be replaced and and income distribution influence the health of the extended. community. In order, therefore, to influence the White’s major recommendations for the health status of Australians both appropriate support and development of public health research support for population studies and a include a restructuring of the National Health and social/ biologic model of disease is essential. Medical Research Council (NH & MRC) so that The White review was viewed with suspicion the Medical Research Committee (to be renamed by those who saw it, from the outset, as an excuse the Health Research Committee) and the Regional to dismantle the Sydney School of Public Health Grants Interviewing Committees include members and Tropical Medicine (SPHTM). Those who competent in population sciences. This would imagine public health to be “rats and drains” and represent a significant improvement in NH & therefore largely irrelevant to the needs of MRC‘s capacity to assess adequately and Australia in the 1980s were equally suspicious. The therefore to fund public health projects, an area resultingreport, released on 29 January 1986 by Dr which has not been one of its strong points in the Blewett,* may have confirmed the fears of the first past. It is to be hoped that not only will this group but should have broadened the horizons of the second. Tropical Health in Australia”. Report to the Minister for The report is entitled “Australia’s Bicentennial Health Health, Canberra, 1986. A summary of its Initiative - Independent Review of Research and recommendatidns will appear in a special edition of “In Educational Requirements for Public Health and Touch”. VOLUME X, NUMBER 1 I1 COMMUNITY HEALTH STUDIES restructuring improve funding for aetiologic changes within NH & MRC. The major research but that projects in health services recommendations in which Community Health epidemiology and the sociology of health will also Studies readers will be most involved, however, receive support. NH & MRC has loudly asserted appear to be the institutional changes related to that excellence of research design and capability training and research and the structural changes are the only relevant criteria for funding. If, in the within the National Health and Medical Research future, they are equipped to recognize these Council (more NH and less MR) and the AIH. qualities in population research, the assertion will One area that White does not address more be more compelling. An additional criterion, in a than fleetingly, is why we wish to collect public time of limited resources, is that of social health data and undertake public health research relevance. - tasks which his recommendations will indeed facilitate. The purposes, however, of such activity Amongst the most interesting developments should not only be made explicit but ways and are three recommendations regarding the means of achieving those purposes considered. Australian Institute of Health. White points out How do we pass on the relevant data and the that the AIH has a fuzzy mandate and an elegant analysis into the sphere of public health ambiguous relation to governments, education activity where conclusions drawn and mechanisms and research. He recommends that the AIH be understood become prevention programs given a clearly defined role - that of policy established, community integrity strengthened, analysis and intelligence - and that two other and human health enhanced? functions - descriptive statistics and technology assessment - be constituted as separate This report represents opportunity for the legislatively mandated entities. Of these areas, development of public health but, as it stands, it both policy analysis and statistics have been would be uneven development. There is an particularly.neg1ected in Australia; thus additional understanding here of the necessity to provide recommendations regarding the latter and almost support for population-based research. However, the first formal pronouncement on the need for the the research that will enable those findings to be former are greatly to be welcomed if only because put into practice in the Australian community of their capacity to elevate their subject matter into research on the relationship between the public, political, and bureaucratic consciousness. determinants of health and the structure of society However, the form of the policy analysis unit and research on the barriers between the is an issue that needs considerable debate. Simply perception of risk and avoidance of risk as a asserting that it should be a Ministerial group community and as individuals - these are not so without seriously canvassing other approaches obviously included in the White view of the future raises unresolved questions regarding sources of of Australian public health. independent advice on this long-neglected area in Australia where health policy has usually meant hospital policy and hospital policy has revolved There are three tasks facing public health around “how many beds?” and “how much does workers in Australia. The first is to ensure that the each cost?” The idea of a policy research unit report does not become an excuse for the external to a Health Department is one that has dismantling of the SPHTM without the relevant been around for more than a decade (for instance expanded facilities. The second is to enable the see the Bright Commission Report into Health political and bureaucratic understanding of public Services in South Australia, 1973) and should be health to continue to evolve from a nineteenth to a considered as a serious option. twentiet,h century view. The third is to ensure that The report makes other recommendations on the two elements of such a view - population the establishment of an Australian Academy of based research and a social/ biologic (not Health, on additional modest support for public biologic/ mechanistic) model of health and disease health training and management training in -are both perceived as intrinsic parts of the public institutions other than those mentioned above, on health. scholarships for public health training (greatly to be welcomed) and on funding (as well as structural) John D. Potter VOLUME X, NUMBER 1 78 COMMUNITY HEALTH STUDIES http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

EDITORIAL: THE KERR WHITE REPORT

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Publisher
Wiley
Copyright
"Copyright © 1986 Wiley Subscription Services, Inc., A Wiley Company"
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/j.1753-6405.1986.tb00082.x
Publisher site
See Article on Publisher Site

Abstract

COMMUNITY HEALTH STUDIES VOLUME X. NUMBER 1. 1986 Which recommendations of the White report 1984 and 1985 have been significant years for are consistent with the continuing development of public health in Australia. The establishment of public health in Australia? the Australian Institute of Health (AIH) and the Better Health Commission and the reorganization The most significant recommendations relate of the Department of Health were three very public to the institutional changes proposed for public health education. White has recommended that the statements that a government of Australia was taking seriously, perhaps for the first time since SPHTM be closed and its resources and funds be major efforts were made to control tuberculosis, redeployed to other centres. He specifically the issue of public health. identifies a new National Research Centre for The review of research and educational Epidemiology and Population Health at ANU and requirements for public health and tropical health, three regional centres - Newcastle, Westmead and Adelaide. Tropical health research would go undertaken by Kerr White at the request of the Health Minister is a fourth such public statement. to Brisbane and Townsville. The principle of this distribution is a sound one - re-establishing a Public health involves inappropriate connotations for many in the face of 20th century central institution with a primary mandate for Western disease patterns - rats, drains, pure training to doctoral level while strengthening the water and unadulterated food. These, the concerns periphery; the details will probably be a matter of of health reformers particularly in 19th Century dispute. Europe (and still the concern of Third World A major concern for public and community health services) have been largely controlled by health workers at this point must clearly be that the technologic and economic means. Rather, our closure of the SPHTM may not be followed by the concerns have become chronic disease and re-establishment of a centre for public health disability and the way in which our environment training and research. Such a re-establishment can and lifestyle impinge on risk. Thus the major take advantage of the excellence of individual model now for public health in Australia involves workers and groups at SPHTM, can add elements other than the bacterial preoccupation of additionatexpertise in areas currently lacking and our predecessors. can institute appropriate links between Our information base for public health population-based public health science and social emerges from population-based studies and the analysis intrinsic to the prevention of diseases for appropriate model of health and disease is which hospital-based management is so costly in intrinsically a social one. Factors and policies both economic and human terms. The current which influence housing, education, employment facilities for public health must be replaced and and income distribution influence the health of the extended. community. In order, therefore, to influence the White’s major recommendations for the health status of Australians both appropriate support and development of public health research support for population studies and a include a restructuring of the National Health and social/ biologic model of disease is essential. Medical Research Council (NH & MRC) so that The White review was viewed with suspicion the Medical Research Committee (to be renamed by those who saw it, from the outset, as an excuse the Health Research Committee) and the Regional to dismantle the Sydney School of Public Health Grants Interviewing Committees include members and Tropical Medicine (SPHTM). Those who competent in population sciences. This would imagine public health to be “rats and drains” and represent a significant improvement in NH & therefore largely irrelevant to the needs of MRC‘s capacity to assess adequately and Australia in the 1980s were equally suspicious. The therefore to fund public health projects, an area resultingreport, released on 29 January 1986 by Dr which has not been one of its strong points in the Blewett,* may have confirmed the fears of the first past. It is to be hoped that not only will this group but should have broadened the horizons of the second. Tropical Health in Australia”. Report to the Minister for The report is entitled “Australia’s Bicentennial Health Health, Canberra, 1986. A summary of its Initiative - Independent Review of Research and recommendatidns will appear in a special edition of “In Educational Requirements for Public Health and Touch”. VOLUME X, NUMBER 1 I1 COMMUNITY HEALTH STUDIES restructuring improve funding for aetiologic changes within NH & MRC. The major research but that projects in health services recommendations in which Community Health epidemiology and the sociology of health will also Studies readers will be most involved, however, receive support. NH & MRC has loudly asserted appear to be the institutional changes related to that excellence of research design and capability training and research and the structural changes are the only relevant criteria for funding. If, in the within the National Health and Medical Research future, they are equipped to recognize these Council (more NH and less MR) and the AIH. qualities in population research, the assertion will One area that White does not address more be more compelling. An additional criterion, in a than fleetingly, is why we wish to collect public time of limited resources, is that of social health data and undertake public health research relevance. - tasks which his recommendations will indeed facilitate. The purposes, however, of such activity Amongst the most interesting developments should not only be made explicit but ways and are three recommendations regarding the means of achieving those purposes considered. Australian Institute of Health. White points out How do we pass on the relevant data and the that the AIH has a fuzzy mandate and an elegant analysis into the sphere of public health ambiguous relation to governments, education activity where conclusions drawn and mechanisms and research. He recommends that the AIH be understood become prevention programs given a clearly defined role - that of policy established, community integrity strengthened, analysis and intelligence - and that two other and human health enhanced? functions - descriptive statistics and technology assessment - be constituted as separate This report represents opportunity for the legislatively mandated entities. Of these areas, development of public health but, as it stands, it both policy analysis and statistics have been would be uneven development. There is an particularly.neg1ected in Australia; thus additional understanding here of the necessity to provide recommendations regarding the latter and almost support for population-based research. However, the first formal pronouncement on the need for the the research that will enable those findings to be former are greatly to be welcomed if only because put into practice in the Australian community of their capacity to elevate their subject matter into research on the relationship between the public, political, and bureaucratic consciousness. determinants of health and the structure of society However, the form of the policy analysis unit and research on the barriers between the is an issue that needs considerable debate. Simply perception of risk and avoidance of risk as a asserting that it should be a Ministerial group community and as individuals - these are not so without seriously canvassing other approaches obviously included in the White view of the future raises unresolved questions regarding sources of of Australian public health. independent advice on this long-neglected area in Australia where health policy has usually meant hospital policy and hospital policy has revolved There are three tasks facing public health around “how many beds?” and “how much does workers in Australia. The first is to ensure that the each cost?” The idea of a policy research unit report does not become an excuse for the external to a Health Department is one that has dismantling of the SPHTM without the relevant been around for more than a decade (for instance expanded facilities. The second is to enable the see the Bright Commission Report into Health political and bureaucratic understanding of public Services in South Australia, 1973) and should be health to continue to evolve from a nineteenth to a considered as a serious option. twentiet,h century view. The third is to ensure that The report makes other recommendations on the two elements of such a view - population the establishment of an Australian Academy of based research and a social/ biologic (not Health, on additional modest support for public biologic/ mechanistic) model of health and disease health training and management training in -are both perceived as intrinsic parts of the public institutions other than those mentioned above, on health. scholarships for public health training (greatly to be welcomed) and on funding (as well as structural) John D. Potter VOLUME X, NUMBER 1 78 COMMUNITY HEALTH STUDIES

Journal

Australian and New Zealand Journal of Public HealthWiley

Published: Mar 1, 1986

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