- I think any close examination
of the sustainable development goals
will leave you quickly understanding
just how interrelated they all are
and how important it will be
for governments at all levels,
nationally and locally,
to work across government
to try and tackle some of these
sustainable development goals.
The health sustainable development goal
is fundamentally dependent
upon the actions in other sectors
and unless and until we can achieve much greater level
of integration and coordination
across the different paths of government,
we have no chance of achieving that health goal.
It's also the case, though,
that many of the other sustainable development goals
are dependent upon there being
a healthy, engaged population
and so these co-dependencies and co-benefits
are observable right across
the sustainable development goals.
So, my sense is that Health in All Policies
will become a really important strategy
and an important way of working
that we need to keep promoting
over the course of the coming years.
- With the SDGs, we talk about the five Ps.
People, planet, peace, prosperity, and partnerships.
That's the focus.
Partnership is the means to do it.
We talk about the SDGs
as being interconnected and indivisible
and that means we have to take an integrated approach.
Health in All Policies is such an approach.
It fosters synergy across the different sectors,
it ensures policy coherence,
and it involves citizen engagement.
And by applying this, at local national levels,
we have a much better opportunity
to actually achieve the SDGs.
- There's also a strategic element
to co-benefits in my mind,
and the big environmental problems
that we're wrestling with now, like climate change,
have got enormous momentum.
So that means that if we take action now,
visible changes are not going to be apparent
for years, decades even.
So there's some strategic venue
in choosing interventions that bring along with them
other gains that are visible early.
I think that's worth keeping in mind.
- There are several success factors
to the Health in All Policies approach in South Australia.
From my perspective,
it is very much the cooperation
between the Department of Premier and Cabinet
and the health department.
It has been that commitment to overall policies
combined with a commitment to driving
a determinant spaced health policy forward
and this cooperation has also led to the continuity
of the Health in All Policies approach
because despite major reorganisations
and the health service itself,
the mechanism of Health in All Policies
was considered important enough to keep going
because it had such excellent rapport also
with other sectors of government.
As people in other departments
moved from these departments elsewhere
or moved up in the hierarchy,
they took this Health in All Policies thinking with them
and therefore, I think Health in All Policies culture
has been created through the South Australian government,
which is also reflected in the major document
on working together in public service
and public administration.
- I think some of the critical success factors
in the South Australian Health in All Policies approach
have really been around learning by doing,
being flexible with our approach,
and being adaptive to the ever changing
political strategies, focus areas,
and objectives of the partner organisations and sectors.
And it's actually been health learning
as it has gone through this process.
We can never underestimate the value
of good working relationships, partnerships,
networking, developing communities of practise
to support one another
in facing those challenges and problems
that are often unique to the context where we work.
- Health in All Policies
is a different way to relate to other organisations.
It brings a level of humbleness
to the way that you think
and the way that you practise.
The idea behind being humble
is that you go and you talk to the agency
and you listen.
You don't talk, you listen.
You ask them what their priorities are
and you ask them what their goals are.
And then you try and work out
the best way to try and achieve those goals
because their goals
are the essential determinants of health.
So if we can achieve their goals, we achieve our goals,
and that is the real benefit of Health in All Policies.
- We've been evaluating
Health in All Policies in South Australia
for the past five years
and we've really focused on
a sort of burden of proof approach
which is very akin to that used in a court of law
where we're sort of collecting
a lot of interviews from people,
we've been building programme logics to show the link
between the activities in HiAP
in eventual health and equity outcomes,
and, of course, analysing that material
and feeding it back into the process
'cause it's very much been an action research process.
Our sort of headline messages
are that HiAP has been really effective
in getting other sectors to take account of health
in the work that they're doing
and we've also found
that that, of course, has led to a whole cadre
of public servants in South Australia
who really understand the social determinants of health
and understand that the work in their sectors
is actually having a strong impact on health.
An example would be in urban planning or environment
and there, of course, of being
a number of initiatives
such as the Healthy Parks Healthy People's initiative
which will have benefits for the whole population
and we know that if we can have interventions
that affect the whole population,
then they're likely to be particularly effective
in improving population health.