My diagnosis is serious. As I watch the nurse search for a good vein, I can’t help but do the maths

I was about to pull on my suit for parliament one morning in October when I noticed my left leg looked puffy and swollen. I swapped the suit for jeans and headed for an ultrasound to rule out a blood clot. The sonographer was very kind. “There’s no clot. Your lymph nodes are enlarged. You need a CT scan.”

It was then that I started to think about the small melanoma removed from that leg six years earlier. I thought I had dealt with it. But more scans and a biopsy soon revealed widespread melanoma with what doctors called a “high burden of disease”. I was advised to begin immunotherapy immediately.
So, you can imagine how I felt sitting in a hospital chair a few weeks later – a former GP and medical researcher, current Greens MP and member of the VicHealth board – having $25,000 worth of medicine pumped into my veins to treat an aggressive and largely preventable disease, while the Allan Labor government announced they will close VicHealth, our only health promotion agency.

Every three weeks, I front up to a public hospital for a dose of immunotherapy and three months into treatment, my PET scan shows more than half the disease has vanished. I am one of thousands of Australians benefiting from this revolutionary approach to cancer. I’m deeply grateful, but as I sit there watching the nurse search for a good vein, I cannot help but do the maths.

Skin cancer is the most commonly diagnosed cancer in Australia. Treating it costs our health system more than $1.7 billion every year. Much of it is preventable. For decades, VicHealth has funded prevention work through the Cancer Council, including the SunSmart campaign that changed how Australians think about sun exposure. “Slip, slop, slap” wasn’t just a slogan. It helped shift behaviour, reduce melanoma rates in younger Australians, and save lives.

Yet while the federal government spends hundreds of millions of dollars each year on drugs like the one I’m receiving every other week, and state governments spend billions running hospital systems strained by chronic disease, only a tiny fraction of health spending goes towards preventing illness in the first place.

In Victoria, health now consumes around 30 per cent of the state budget. VicHealth accounts for just 0.15 per cent. That’s only 15¢ in every $100 the state spends on health. Closing it will not repair the state’s finances, and it may well cost us far more in the long run.

When I was a medical student in the 1980s, cigarette advertising was everywhere – on billboards, at the tennis, even opposite the Children’s Hospital. I joined a small group who spray-painted health warnings on billboards and was even briefly arrested for my role in the group BUGA UP.

By today’s standards it may seem optimistic to imagine a Labor government standing up to the marketers of unhealthy products. But in 1987, it was the Cain government who banned tobacco advertising and imposed a tobacco levy to fund the world’s first health promotion foundation, VicHealth.

Crucially, VicHealth’s funding was embedded in legislation to shield it from future treasurers inevitably hunting for savings. It is a striking irony that a safeguard created by a Labor government is now being dismantled by one.

The foresight of the parliament 40 years ago paid off. VicHealth helped fund Quit and smoking rates plummeted. More recently they have tackled junk food, alcohol and vaping and their current strategy calls for more attention to diseases driven by three things: commercial interests, our food supply and our built environment.

The Allan Labor government talks about VicHealth being “absorbed” into the Department of Health but it is important to remember VicHealth’s independence was not an accident. VicHealth takes on powerful industries like big tobacco, junk food and now vaping corporations, and they do so in ways that are not always politically convenient.

Today, even the Liberal opposition has indicated it will not support closing VicHealth. VicHealth was born of bipartisan support, with members of both major parties recognising that prevention should sit above short-term politics. A principle, I think, is worth the Allan Labor government rediscovering now.

The argument for public health has long been that it is better to build a fence at the top of the cliff rather than ambulances at the bottom. Closing VicHealth may look like an easy saving ahead of an election year but it is a false economy.

As the nurse threads the needle along the vein in my forearm, I think about how I might have avoided all this if I had worn long pants a bit more. Prevention might feel optional in the moment – until it isn’t.

My diagnosis is serious, and I don’t know exactly what the future holds. The cost of delay is always greater than the cost of acting early. This lesson is one that weighs heavily on me and I can’t help but draw the parallel to climate change, which has been my biggest fight during my time in parliament. Now, in the time I have left as a member of parliament, I’m fighting to save VicHealth under that same principle, and will be throwing everything at it before I walk out the door.

Dr Tim Read is the Greens MP for Brunswick.

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