Disease control agency will be ‘white elephant’ without support of states: Coatsworth

Establishing a centre for disease control could bring Australia’s pandemic data collection up to international standards and make public health decisions transparent, but experts say it would need states and territories to ditch the secrecy of national cabinet.

Australia is the only OECD country without a “centre for disease control” – a national public health agency that monitors outbreaks and provides public health advice. Labor has promised to establish an Australian “CDC” if the party wins the May 21 federal election.

Former deputy chief medical officer Nick Coatsworth was sceptical about the impact a CDC would have.Credit: Jamila Todera

But former deputy chief medical officer Nick Coatsworth warned the agency will be a “white elephant” without the backing of states and territories, which operate hospital systems and do not collect or report data in a timely, uniform way.

“If Labor gets in and commits to a CDC they should absolutely – and with a laser-like focus – make that about harmonising health data collection between states territories and the federal government to make sure that we have access that policymakers have access to the real-time data,” he said.

“There is going to be a white elephant unless we reform our data collection system, so the first task of any CDC has to be data collection reform.”

Coatsworth said up-to-date data was a significant gap in Australia’s pandemic response.

On Wednesday, The Sydney Morning Herald and The Age revealed no state or territory had publicly reported information about the number of COVID-19 cases caught within its hospitals during the Omicron wave, despite data abroad showing high rates of hospital-acquired infections associated with the variant.

University of Newcastle infection control expert Professor Brett Mitchell said Australia needed a national body to coordinate surveillance of infections in hospitals and “use that data to inform recommendations”.

The Grattan Institute’s new health program director Peter Breadon said a CDC would help “keep politicians accountable, by making the public health advice transparent” and learn from mistakes made during the pandemic.

“National cabinet decision-making was often quite in-transparent, the expert advice was quite in-transparent,” Breadon said.

National cabinet, made up of state and territory leaders along with the prime minister, makes joint decisions on pandemic response measures. It has been criticised for opaque decision-making and refusing to release minutes of meetings, which are labelled “cabinet-in-confidence”.

The Australian Health Protection Principal Committee, made up of state and territory chief health officers, advises national cabinet, but its expert advice is secret.

Breadon, a former deputy secretary of Victoria’s health department, said the most difficult pandemic decisions were “about trade-offs across different objectives – economic, social, liberty and health impacts” and accountability was needed because “they’re very consequential”.

Public Health Association of Australia chief executive Terry Slevin said a CDC could help ensure the public can access nationally consistent data “in a timely manner”, saying transparency would be “vital currency when it comes to putting trust in the CDC”.

“If people are going to take guidance from an expert entity, they have to have trust that they know what they’re talking about,” he said, adding its independence and sole motivation of improving public health would be a “key ingredient”.

“Trust has to be earned, and that has to be built on most sound possible expertise and data, and being open about where the data and advice come from,” he said.

Slevin said the design of a CDC was complicated by the federal division of health powers, with states and territories making public health orders while the Commonwealth decides on border closures.

A spokesman for Health Minister Greg Hunt rejected the CDC proposal, saying establishing one “would not add to Australia’s proven expertise and capacity to effectively respond to national communicable disease outbreaks [and] could risk overlap and duplication with existing communicable disease control functions”.

The spokesman said the government’s response to COVID-19 through the national cabinet “meant one of the earliest, fastest and most successful models in the world produced one of the best outcomes in the world”.

ANU infectious diseases expert Peter Collignon said there was a need for “better centralised data disseminated in a timely way”, but that CDCs “haven’t stopped the pandemics in the US and Europe being much worse than in Australia”.

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