The Australian Medical Association is urging the Morrison government to set up an Australian national centre for disease control to provide independent advice to governments about the management of pandemics, and ensure a national stockpile of essential equipment is in place for the next crisis.
The AMA’s president, Tony Bartone, made the pitch, backed by the Australian Nursing and Midwifery Federation (ANMF), during an appearance at the Senate inquiry into the government’s management of the Covid-19 crisis.
Bartone said he was aware of some resistance within government to creating a new health bureaucracy, but he said the benefits of a CDC-like body was having an organisation speaking “independently of governments, and … permanently resourced at a sufficient level during non-pandemic periods in order to be ready for the next pandemic to occur”.
Bartone said the nine governments in the Australian federation had rallied “after a slow start” to managing the Covid threat well, but he said there were obvious weaknesses in the Australian response at the beginning.
“There has at times been a lack of consistent public health Covid-19 advice from governments, particularly in the early stages of the pandemic,” the AMA president said. “This caused communication challenges”.
Bartone said the medical profession in Australia recognised and applauded the work of chief medical officers in improving the coordination of public health advice, and noted that Australia’s Australian Health Protection Principal Committee structure comprised many elements of a national infectious diseases body.
But he said the AHPCC did not speak independently of governments. It was imperative, he said, that a CDC work “frankly, fearlessly and independently of governments of the day” and be in a position to collaborate with all the public health expertise in the community.
Annie Butler, the federal secretary of the ANMF, said the two biggest concerns at the start of the crisis was a lack of personal protective equipment for frontline medical workers, and different guidelines in different states about how any equipment should be used. “There was a lot of confusion at the beginning,” she said.
She said a CDC-like body would be in a position to ensure those sorts of deficiencies didn’t occur. Butler said the crisis had also demonstrated the importance of Australia being about to manufacture its own essential medical equipment rather than rely on global supply chains, which were disrupted in the opening months of the pandemic.
Thursday’s hearing also heard evidence from a number of other medical experts. Peter Collignon, professor of microbiology at the Australian National University, and an expert in infectious diseases, told the committee he thought a CDC like the American model was “too centralised”.
Collignon said the European Centre for Disease Prevention and Control was a better model to consider than the American example. He said the status quo in Australia was adequate when medical officers and governments were cooperating, but the current arrangements could be improved.
Another expert Kirby Institute professor Raina MacIntyre, said her view was Australia was disadvantaged by not having a CDC. While the systems in Australia worked well during the Covid-19 crisis, she said Australia lacked a cross-jurisdictional response capacity.
Consultant Bill Bowtell, who was chief of staff to the former federal health minister Neal Blewett during the Hiv/Aids crisis in the 1980s, told the committee the critical thing was epidemiological advice needed to be fully independent from government.
He said politicians were uncomfortable with entirely independent advisory bodies giving the public unfiltered advice, but he said there needed to be a demarcation between the scientific advice and the political judgments necessary in any representative democracy.
But medical doctor and ABC science broadcaster Norman Swan was sceptical when asked for his view about whether Australia should have a CDC. Swan said the organisational structure wasn’t a problem, the main problem exposed during the Covid-19 crisis was there wasn’t good data sharing between the jurisdictions.
“Having a CDC didn’t help America,” Swan said.
