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Government on the slow coal train as world faces collapse

David Shearman

The Government’s draft Strategy on Health and Climate Change is vital to cope with the expected increase in deaths and illness from accelerating climate change. It fails in many respects and should be rewritten to reflect the views of medical experts.

Surely it is now obvious that climate change is the fast train to world collapse whereas our government travels on the slow coal train with little hope of catching up.

A leading medical journal, The Lancet has said that climate change is the greatest global health threat facing the world in the 21st century. Our doctors have waited a decade for concerted government action on this vital health issue. Last week public submissions to the National Health and Climate Strategy closed and many doctors and their organisations have made a range of excellent suggestions.

Despite having worked on the issue for thirty years, I declined to submit for the following reasons:

When I read the Consultation Paper two months ago, it seemed to be no more than a perfunctory review of the available literature and I was left wondering which set of medical experts had written it, if any. There was little insight into the problems of the health service, and particularly public health departments, in addressing the issue.

Then when a month ago the Parliamentary Joint Committee on Corporations and Financial Services explored the PwC tax scandal, which revealed the depth of their involvement in crucial government business, the question in my mind was whether the Climate and Health Strategy was written by PwC.

It then became apparent from a study by public health experts that KPMG wrote the Strategy and had a significant conflict of interest because of their involvement with the coal industry.

KPMG global head of energy had said recently “The world cannot afford to follow the International Energy Agency’s call for no new oil, gas or coal projects at a time when greater importance is being placed on energy security”. Incredibly the words “fossil fuels” were not mentioned in the Strategy! It was a John Cleese “don’t mention the war” omission.

This raises the questions; was KPMG chosen by government, and were instructions given to avoid the issue of fossil fuels and climate change at a time of government expansion of the fossil gas industry? And does KPMG now have the standing and ability to revise the document or should it be rewritten by experts? My answer is yes, it must be rewritten.

The Strategy has four Objectives; measuring health system greenhouse gas emissions; mitigation of these emissions; adaptation of the health system to climate; and Health in All Policies.

Unfortunately the Strategy does not recognise that human health and survival is ultimately based on the integrity of our life support systems, a stable climate, water and ecological systems. Climate change is increasingly affecting water availability and ecological systems and these have health impacts.

The Strategy states that “Health in All Policies” was proposed because “Most decisions affecting the wider determinants of health – i.e. policies on food and agriculture, housing, employment, infrastructure, land use and transport – are made outside the traditional confines of ‘health policy”. This is true, but KPMG is compromised in addressing these health issues.

In 2007, South Australia introduced a Health in All Policies approach to stimulate cross-department interaction to improve population wellbeing and reduce health inequities. By 2017 economic pressures had resulted in the government narrowing its priorities to economic goals and the policy declined into obscurity. This will always be so under the yoke of an economic system which fails to prioritise our life support systems. KPMG and the other three big Consultancies are fundamental to this economic system.

Mark Diesendorf explains that conventional economics assumes that endless economic growth on a finite planet is feasible and desirable, that human wellbeing and welfare can be measured by GDP and that the natural environment is an infinite resource and infinite waste dump. It teaches that wealth trickles down from the rich to the poor and that government intervention in the market must be avoided. All are untrue.

“Unlike neoclassical economics, ecological economics gives priority to ecological sustainability and social justice over economic efficiency. It works towards a transition to a steady-state economy. That is, one with no global increase in the use of energy, materials and land, and no increase in population”.

Current economic ideology embraces the big four banks and consultancies, most of the media, big business, their lobbyists and the revolving door. It is a ‘state capture’. It has become even more secure after the RBA review recommended removal of the RBA’s third mandate “economic prosperity and welfare of the people of Australia”, enshrined in the 1959 RBA Act. The economic citadel is now unassailable to alternative economic theories. Health may now be at the mercy of inflation and unemployment debate.

Current economic ideology, operating mainly though the market, is party to one of the lowest rates of preventive (public) health spending of any OECD country. It has been less than 2% of total health expenditure for the past ten years whereas in Canada, New Zealand and the United Kingdom – nations with comparable health systems – it is around 5%.

It urgently needs more money, staff and a new strategy to be effective for recent climate change extreme events will bring more health disasters. Nature is about to effect vengeance on populations which have not prepared. Under current economic thinking the thin red line of preventable health will remain impoverished.

The Strategy fails to address urgent issues which must be delivered now to save lives, one example is the current death rate of 2% p.a. from heat waves which is now likely to increase with accelerating climate change. Many cities and larger towns have identified public buildings which can be refuges during heat waves but smaller towns and remote communities particularly Aboriginal ones may need refuges to be built. The US and some other western countries are well ahead of us. Where is our national strategy?

The strategy also fails to recognise that a Health Impact Assessment (HIA) must be used as part of the Environmental Impact Assessment for development projects. HIA is an integral part of protecting community health. The States fail to use it because it is seen as an impediment to their necessary resource development. In addition, WHO advocates the social component of HIA which can provides a more appropriate interaction with disadvantaged groups and particularly First Nation land holders and their communities than the use of “consultation” processes.

The Strategy is to be commended in having a section on “First Nations health and climate change” which explains their vulnerability to climate change.

This week the express train has increased its speed. The government’s slow coal train with its sleepers (human and wagons) and buffet cars has been delayed by a nosh up with gas-company executives invited to celebrate clean natural gas. Under the circumstances the health fraternity was not invited.


Dr David Shearman AM is Emeritus Professor of Medicine at Adelaide University, co-founder of Doctors for the Environment Australia, and also an ERA patron.

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