Public Health and Community Wellbeing Plan

Wider policy and funding challenges

There are a range of factors causing major policy and

program shifts in the way that public and community health

is approached, and which will have an impact on public health

planning and implementation into the future. The key agents

for change include:-

• The reduction in revenue at all levels of government due

to a range of policy decisions and global economic events

• A reduction in investment of resources in preventive

health and other key programs

• The trend to centralise public and community health

services, resulting in a loss of local needs-focused

community centres and services

• Evolution of the roles and responsibilities of Local

Government relative to the State Government

(potential for ‘cost-shifting’)

• Changing health services funding models and policies at

Commonwealth level which affects resourcing for primary

health and local community services

• The increasing outsourcing of some services and

activities, risking loss of policy direction and ‘economies

of scope’ benefits

• Third-parties undertaking compliance activities in

increasing areas of environmental health surveillance, with

resulting impacts on the environmental health profession

• A raft of new legislation and State strategies related

to wellbeing and health , specifying additional Local

Government roles and responsibilities

• Greater requirement for evaluation and measurement

systems to support funding allocation in an increasingly

competitive funding environment

• Climate change adaptation frameworks in place at State

and national level, including the preparation of Council-

based regional adaptation plans to address health

implications.

• Aged care and funding reforms at national level have

significantly affected models and levels of service

delivery to key community groups – particularly via the

introduction of the National Disability Insurance Scheme

(NDIS). Council plays a collaborative and co-resourcing

role in the new scheme, where it relates to Supported

Residential Facilities and related aged care programs.

The State and Commonwealth funding context

The State Public Health Plan 2013 has been released at a time

of financial constraint at all levels of government - and within

the not-for-profit services sector, which is seeing a reduced

donation and general revenue base at the same time that

government funding is being reduced or withdrawn in many

cases. In that context, the State Public Health Plan aims to

improve co-ordination and efficiencies across the three

levels of government in general, particularly in relation to

delivering primary and preventive health and wellbeing

services to the community.

While the risk of cost shifting is ever-present

, the City of Port

Adelaide Enfield sees the preparation of its Public Health and

CommunityWellbeing Plan 2015-2020 as a timely and valuable

opportunity to strategically investigate the needs of the

community (as also required in Council’s Corporate Plan), and

identify the best use and prioritisation of Council’s community

and health resources over the next planning period.

The emphasis in the State Plan is to ensure that resources

are being targeted appropriately to the most at-risk areas

and communities, and activities are being undertaken in an

integrated and co-ordinated manner – recognising the inter-

links between the influence that urban planning, recreational

and open space planning, regulatory enforcement, emergency

preparedness, local economic development, cultural activities,

and community development programs can all have on

health and wellbeing outcomes. Council’s Public Health and

CommunityWellbeing Plan 2015-2020 therefore aims to

achieve that integration effectively, and ensure a needs-based

strategic approach to targeting, resourcing and implementing

community wellbeing and health–focused programs.

The previous Commonwealth Government re-structured

its health sector funding model to establish Medicare Locals

(MLs) in South Australia to co-ordinate the Commonwealth’s

funding streams – the delivery of funds to be determined via

a needs-based approach. Port Adelaide Enfield Council sits

across two Medicare Local regions (Northern, and Central

Adelaide Hills). In 2014, the new Commonwealth Government

has proposed to restructure again, replacing Medicare Locals

with two Primary Health Networks - at this point a final

funding framework is unclear. Council’s Public Health and

CommunityWellbeing Plan will include a range of actions

and programs that could best be undertaken in liaison with

the Commonwealth’s regional organisations - via potential

‘Partnership Authority’ arrangements under the Public

Health Act which provide an opportunity to work with

the funding bodies directly, where assessed to be in the

community’s interest.

Including Childhood Development andWellbeing Bill 2013; SA Public Health Act 2011; Safe DrinkingWater Act 2011 ; new Policies under the Environment Protection

Act 1993 inc.waste management; SA Suicide Prevention Strategy 2012-2016; new Development Regulations 2008 re swimming pool safety effective from Jan 2014;

Radiation Protection and Control Bill 2013; Environmental Nuisance Bill (pending 2015)

Ref. the McCann Review of non-hospital based services 2012