Ideas@TheCentre
No evidence-base State is effective health nanny
A golden thread runs through modern civilisation—a hypothesis remains a hypothesis unless the evidence proves it is science.
Politicians are always keen to cloak their activities in the shroud of evidence, as if governing were a science. Hence the term ‘evidence-based policy’ has entered the lexicon. It’s really nothing new—governments have long been in the habit of establishing inquiries to produce evidence that will justify what they intend to do.
The notion behind evidence-based policy is that if policy lever A is pulled, this will produce outcome B and solve problem C. Evidence-based policy is the mantra of the Rudd Government.
For example, the government maintains that providing billions of dollars for capital infrastructure and recurrent funding to create a national network of GP Super Clinics will solve the hospital crisis. By providing better preventive care—i.e. Medicare paying health professionals to advise unhealthy people to diet and exercise more—Super Clinics will curb the lifestyle disease ‘epidemic’ and keep more people ‘well and out of hospital’.
This is the Nanny State in excelsior. Last year I wrote a paper which found that rather than evidence-based policy, the Super Clinics plan was a policy looking for an evidence base. A range of studies have shown that preventive care is ineffective because lifestyle modification is a personal responsibility and is difficult to achieve unless individuals have the will and self-discipline to sustain behavioural changes.
Super Clinics are therefore a questionable measure because of the danger governments will be left funding a lot of so-called ‘preventive’ care.
The Rudd Government’s National Health and Hospital Reform Commission was concerned enough to commission some papers examining the evidence. One found there was ‘little empirical evidence upon which to base reforms aimed at improving the delivery of preventive health care.’ A second went further and concluded that though it has been postulated that preventive care would keep people out of hospital, ‘the evidence here is equivocal’, because the expected reductions in hospital admissions ‘did not occur’.
But this didn’t stop the NHHRC from endorsing the government’s policy. Its February report on health reform still claimed that the evidence shows Super Clinics will take pressure off hospitals by keeping more people healthy. So much for evidence-based policy.
Dr Jeremy Sammut is a research fellow in the CIS’ Health and Ageing Programme
