Policy Futures: A Reform Agenda
We are delighted to again offer another selection of contemporary perspectives from Churchill Fellows that have the potential to shape best practice and policy reform on some challenging and pressing issues facing Australia today.
The words of Winston Churchill, “Healthy citizens are the greatest asset any country can have”, may be reflected upon to provide inspiration from which to inform contemporary policy thinking at all levels of government.
It is encouraging that our Commonwealth Government is adopting a “wellbeing budget” which has the potential to focus policy makers on the health of our citizens by measuring the impact on things like social equity, environmental health and mental wellbeing.
The importance of supporting healthy citizens and healthy communities has emerged as a strong theme from the articles in this edition of Policy Futures: A Reform Agenda.
Healthy school lunch programs to improve our children’s health and education and better ways of caring for our dying and deceased are just some of the policy ideas to stimulate fresh thinking – or to consider different ways of approaching issues from a “health of the citizen” viewpoint that have been effective in other countries.
Feeding children well: The importance of school lunches to education, health and social outcomes, and the impact on local food economies.
By Julie Dunbabin
Australian governments have recognised the importance of good childhood nutrition through a number of national policies. The recently released National Obesity Strategy identified that healthy policies and practices in schools and promotion of healthy behaviours in the Australian curriculum would help to prevent obesity.
The federal government’s The Good Practice Guide: Supporting healthy eating and drinking at school guide noted in 2019:
‘Australian children are growing up in an environment where food and drink high in added sugars, saturated fats, and added salt are readily available, heavily promoted, and perceived as low cost. This trend results in the low intake of essential nutrients, poor oral health, sub optimal educational performance, and a higher risk of children being overweight or obese.’
Strong government policy on school food implementation at the national, state, and territory level is needed to withstand food industry activity that encourages the consumption of highly processed foods.
Australian children consume at least one third of their daily food intake at school. But the Australian school meals system is ready for an overhaul. Where children have broad choice, they choose what they know and what is on offer, and unfortunately this is too often pies, sausage rolls, and chicken nuggets. Or they are going hungry through being unable to access food.
There needs to be a shift in Australia to provide school lunches that are nutritionally balanced, flavoursome, and cooked from locally sourced foods with minimal processing. International school food history shows that children fed well while at school reach their best educational, health and social potential.
Schools cannot fulfil their educational mandate if students have inadequate access to healthy food during their school day.
Case study: A school lunch trial in Tasmania
Findings from Julie’s Churchill Fellowship informed a 2020 school lunch trial in three schools in Tasmania to explore the feasibility of providing cooked lunches. The meals were prepared from scratch using seasonal produce where possible.
Among the findings:
• A sit-down cooked meal is possible with the right mix of staff and resources.
• Children enjoyed sitting with their friends to eat and enjoyed eating vegetables.
• Children were able to concentrate better in class before and after lunch.
• Student attendance improved during the trial and 90% of parents would like a cooked lunch available every day.
• Use of local and seasonal produce connected with growers and school garden programs.
This trial has expanded to a pilot in 30 schools in 2022/23 and will be evaluated.
Policy recommendations
The National Cabinet should establish and facilitate a key stakeholder roundtable to:
• identify the benefits and challenges of a universal school lunch program through a whole-of-government policy approach, particularly education, health, community and agriculture
• explore extending the Tasmanian School Lunch Project (2020–23) from a state project to a national program, serving nutritionally balanced, safely prepared meals on every school day to all students.
Reimagining deathcare for our ageing population
By Rebecca Lyons
As many as 70% of Australians want to die at home, and yet comparatively few achieve that. Overwhelmingly, people are not achieving the end of life they desire.
By 2066, it is estimated there will be more than 430,000 deaths per year, compared to about 163,300 deaths registered in 2020. If current procedures are continued, Australia will need to significantly increase numbers of doctors, nurses, palliative care wards, places in nursing homes, aged care workers, hospice programs, hospital beds, nonmedical supports, providers, and workers, equipment-hire schemes, and potentially funeral homes, to support the numbers of people projected to die.
The modern funeral industry is only about 120 years old and in that time we have shelved over 5,000 years of knowledge about caring for the dead. Normalising home funeral and after death care has been largely grass roots led, but is gaining traction as people’s awareness of end of life options increase.
The integration of formal and informal services at end of life (and in death) is an important step toward meeting the growing demand on existing services in the future.
The funding of hospice/palliative care at home programs should enable people to access formal and informal services to support them to die at home. The subsidising of access to private carers, hospice services, community care, social support, spiritual comfort, and medical outreaches would ease the burden on hospitals, nursing home facilities, and aged care services and their workers.
Further, the integration of informal services such as end of life doulas (EOLDs, a non-medical role that provides support, options and education assisting the dying) into formal end of life care models would add a valuable layer of support to a person’s ability to experience the end of life they want.
As a direct result of the findings of my Churchill Fellowship report, the Australian Home Funeral Alliance (AHFA) has been established to address this gap. AHFA exists as a peak body with a view to educating and empowering people to seek out alternative approaches to conventional funerals, and skilling them to achieve it.
One of the ways AHFA promotes addressing the wave of death to come and the often unrealistic cost of funerals, is to move all or part of the after death process back into the hands of family and community using a family led home funeral approach. This informal service of home funeral is designed to empower and skill a family to care for their person in death as they often have in life, and it has emotional, social, and financial benefits.
Policy recommendations
It is recommended that the Commonwealth Department of Health and Ageing engage the Primary Health Network to establish and facilitate a national interdisciplinary roundtable to develop strategies for the integration of formal and informal supports and services at end of life and death care.
The full policy articles for these Churchill Fellows along with others will feature in Policy Futures: A Reform Agenda Issue 2, launching in the Churchill Policy Room at Australian Parliament House, November 30. Learn more, receive a copy or request a policy presentation by our Fellows.
Summary of Introduction by Adam Davey, CEO The Winston Churchill Memorial Trust; and Professor Greg Marston, Director, Centre for Policy Futures, the University of Queensland.
