Introduction
Public health plays an essential role in promoting and protecting people’s and communities’ health by preventing and detecting health issues and responding appropriately to avoid the development of diseases. Healthcare systems should formulate and implement policies that promote health in societies (Sung et al., 2020). Therefore, this essay aims to describe the Public Health Act (WA) 2016 in terms of its background, key features, aims and objectives, what it intends to achieve, target groups, and the changes and reasons for its review. Moreover, the paper will describe the Act’s impact on individuals and the local governments and its roles and responsibilities in addressing and managing public health outbreaks such as Covid-19.
The Public Health Act (2016) repealed the outdated Health Act 1911 to provide modern legislation and regulation of public health among Western Australians. The new regulatory framework was to be implemented in five stages within 3-5 years. Stage one involved Royal Assent (25th July 2016), while stage two occurred the following day (26th July 2016). The first two stages involved various technical matters and the commencement of binding the Crown (Australian Government Department of Health, 2022).
Moreover, the third stage was proclaimed on 24th January 2017, involving the commencement of crucial administration matters. Stage four came into effect in September 2017. It involved enacting key provisions such as new infectious disease regulations, prescribed health conditions, serious public health incidents and emergency powers. However, stage five commencement was anticipated for the year 2022 but has been delayed. It involved the commencement of the remaining provisions and environmental health matters (Australian Government Department of Health, 2022).
What the Public Health Act 2016 Intends to Achieve
The Public Health Act intends to reform and improve Western Australia’s public health regulations. Additionally, the Act tries to achieve better public protection and prevention of illness and injury, promoting Western Australians’ health. Section 3 of the Act outlines objects and principles to consider to reduce preventable illness and protect, promote and improve public health. Therefore, decision-makers (authorised officers) should consider objects and principles during and before the decision-making processes under the Public Health Act (2016).
Objects outline the Act’s intended purpose. Therefore, the Act prevents disease, disability, injury, and death and improves the public’s well-being. Also, the Act tries to protect individuals and communities from public health risks and provide a healthy environment in Western Australia (Australian Government Department of Health, 2020a).
The Public Health Act tries to achieve equality among all communities in Western Australia. In addition, the Act intends to educate individuals and communities about public health risks, how to prevent diseases, and creating and maintaining a healthy environment. The Act tries to improve public health by supporting programs and campaigns to educate and increase awareness on various health matters and how to prevent illness (Sung et al., 2020).
However, each individual exercising powers or acting under this Act must do so by having regard for the principles. The Act has five principles; sustainability, precautionary, proportionality, inter-generational equity, and local governments. According to the Public Health Act (2016), the sustainability principle means that authorised officers ensure that their decisions benefit individuals today and do not have undesired impacts on future generations. Furthermore, the precautionary principle states that individuals working under this Act should exercise caution in protecting the public when there is limited scientific evidence of an outbreak.
The proportionality principle dictates that authorised officers make decisions and responses proportionate to the present health risk. Also, they should uphold the principle of inter-generational equity by ensuring public health is maintained to benefit future generations. The public should acknowledge and respect this Act’s enforcers (local governments). Therefore, this Act outlines its intentions of improving public health and well-being through objects and principles (Australian Government Department of Health, 2020b)
The Act’s Impact on Public Health
The Public Health Act (2016) has enabled individuals and communities to understand the role of local governments in creating conditions for healthy living. The Act integrates public health, healthcare, medicine, and law concepts to establish and maintain healthy environments for the public. Consequently, the Act has increased awareness among the public on how to prevent and manage various diseases, injuries, and disabilities. Also, the Act has resulted in increased equality through careful resource allocation to different members of the communities. Currently, most Western Australians participate in community health promotion and improvement programs (Watts et al., 2021). The Act has encouraged individuals and communities to plan for, establish and maintain optimum environments to improve their health and well-being.
Target Group
The Public Health Act’s enforcers are the local governments within their jurisdiction. They delegate powers to enforce to authorised officers investigating any public health-related issue. Therefore, this Act is designed to promote and protect the health of all citizens of Western Australia. The Act’s objects and principles focus on improving and protecting the health of individuals and communities regardless of gender, age, socioeconomic status, and cultural background. Also, the Act calls for collaboration and information sharing between individuals/communities and the enforcers. Thus, this Act places legal duty and responsibility on all people to behave and act in a manner that is not harmful to others. Western Australians have a legal responsibility to protect each other from harm. Authorities can fine individuals who violate this Act’s provisions up to $250,000 (Australian Government Department of Health, 2020a).
Changes and Reasons for the Review of the Act
The Public Health Act (WA) 2016 invalidated the old Health (Miscellaneous Provisions) Act 1911. The framers of the modern Act designed it better, enhancing and protecting Western Australians’ health. Also, the new regulatory framework is detailed, requiring the progressive introduction of the acts within 3-5 years. Thus, there are five stages of implementing the latest provisions in the Act.
The Health Act 1911 was reviewed due to limitations such as references to outdated public health risks and concerns. In recent years, Australia and other countries have encountered outbreaks, pandemics, and vaccine-preventable infectious diseases. Thus, the Western Australian health system reviewed the Health Act 1911 and designed it to fit modern disease prevention strategies. The review involved developing modern plans to address the ever-changing public health systems.
Also, the Health Act 1911 is limited in addressing other health concerns captured in other regulations. Thus, the modern framework is specific to issues affecting the general population and how to address them. Furthermore, the Health Act of 1911 does not address new and surfacing health concerns such as bioterrorism, industrialisation and epidemic illnesses. The old legislation was prescriptive and reactive. Therefore, the new Act is proactive and flexible based on public health risks. The proactive and flexible nature of the Public Health Act (2016) aids in addressing current health risks and outbreaks, promoting the health and well-being of individuals and communities.
Nevertheless, the Health Act of 1911 was revised and re-named the Health (Miscellaneous Provisions) Act 1911. The amended format contained public health issues such as child health and mortality committees and community health centres. The regulations that were maintained under the Health (Miscellaneous Provisions) Act 1911 are the Health (Rottnest Island) By-laws, Notifications of Stillbirth and Neonatal Death Regulations, and Health (Notifications by Midwives) Regulations 1994. Moreover, other retained provisions included the Health (Section 335(5) (d) Abortion Notice) Regulations 1998, and the Registration, Enforcement, and Discharge of Local Authority Charges on Land, Regulations.
However, the Blood and Tissue (Transmissible Diseases) Regulations 1985 transitioned under the Public Health Act (2016), implementation stage four.
Furthermore, some provisions were invalidated at the fourth implementation stage and replaced with the Public Health Regulations 2017. They include the Health (Notification of Intussusception) Regulations 2007, Health (Venereal Diseases) Regulations 1973, Health (Notification of Adverse Event after Immunisation) Regulations 1995, and the Health (Immunisation by Local Governments) Regulations 2000.
Opposition and Unintended Consequences of the Act
According to Oliver et al. (2019), public health legislation may face opposition and have unexpected consequences. Thus, understanding how policies and legislation affect outcomes is essential for legislators and policymakers to respond appropriately, reducing unintended consequences. However, authorised officers, individuals and communities may oppose legislation changes if they are not involved in the decision-making process. Also, changes to the Health Act 1911 were necessary to respond to the changing healthcare industry and the emergency of disease outbreaks and epidemic chronic diseases.
Nevertheless, unexpected consequences may be reported if there is poor regulation design or inappropriate evidence use. However, repealing the old acts and introducing modern and flexible acts results in desired consequences. Implementing the new framework has resulted in better ways to promote and protect public health (Oliver et al., 2019).
The Impact of the Act’s Changes on;
Local Governments
The Public Health Act (2016) states that local governments are responsible for the Act’s enforcement. The local government has always been the front line of operational activities in public health matters within their jurisdiction. Moreover, the state health department primarily plays the role of advisory and policymaking within the new framework. Therefore, section 16 of the Act outlines the local government’s roles. They include initiation, support, and management of health planning for the local government district per the Act and the Local government Act 1995. Also, they perform functions conferred on local governments by or under the Public Health Act and develop and implement policies and programs to achieve this Act’s objectives.
Furthermore, local governments are crucial in administering and enforcing the Public Health Act within their boundaries, following the Act’s object and principles.
Moreover, section 21 (1) of the Public Health Act (2016) permits the local government to delegate duties conferred on it to the CEO (Chief Executive Officer) or the local government-designated authorised officer. Therefore, the changes gave local governments delegation powers, provided they ensured appropriate delegations were in place to balance risk-based governance and the operational necessity of the administrative process.
Furthermore, section 22 of the Public Health Act (2016) requires local governments to provide a performance report and details of any ongoing disciplinary proceedings or the finalised ones under the Act to the Chief Health Officer (CHO). Hence, these administrative changes in the enforcement agencies improve service delivery, protecting and promoting public health.
Individuals
The Public Health Act (2016) outlines Western Australians’ legal obligation to conduct themselves in a manner that does not hurt others. The Act’s changes encourage individuals to protect others from harm. Violating these provisions attracts a fine of up to $250,000. The Act’s introduction of the health risk-based approach is statutory. The public health duty allows individuals to capture known, new, and unfolding public health risks. Also, the public health duty is a forward-thinking approach developed to suit the 21st century needs.
Also, the general public health duty applies to all activities that may negatively impact the public’s psychological and physical well-being, such as environmental concerns that expose the public to harm and adverse outcomes (injury or infestations). Therefore, individuals are significant players in protecting other peoples’ health by identifying health-related risks and responding appropriately to prevent harm (Watts et al., 2021).
Public Health Emergency Powers in the Public Health Act 2016
The Act defines health emergencies as circumstances or events that contribute to or cause serious adverse effects to the general public, requiring the exercise of extraordinary powers such as concerning vaccines or drugs. A minister formally declares the event as a public health emergency and authorises the application of powers. For instance, health emergencies may involve spreading epidemics of serious infectious diseases like the Ebolavirus and SARS. Such emergencies overwhelmingly require the relevant authorities to take action to protect the public. Also, the Emergency Management Act 2005 complements the emergency powers described in the Public Health Act (2016).
Also, Section 184 (1) also allows an emergency officer to direct a person to isolate, quarantine themselves for any period, undergo medical examination or treatment, and perform decontamination processes. Section 185 (1) allows an authorised emergency officer to enforce the requirement to undergo a medical observation or procedure.
These provisions outline health emergency planning and the roles of an authorised emergency officer in such emergencies. Their role is to respond to a public health emergency by exercising emergency powers conferred on them by the Chief Health Officer. For instance, the role of an emergency officer in Section 184 relates to quarantine, medical, or other procedures. Thus, the officer is authorised to instruct a person to remain in any specified location, quarantine, undergo medical observation, or decontaminate procedures for a specified period. Also, Section 185 (1) permits the emergency officer to enforce Section 184 by directing an individual to quarantine, apprehending and detaining a person to undergo a medical examination, apply restraint, or undergo treatment or vaccination (O’Sullivan et al., 2020).
During the Covid-19 pandemic, emergency officers applied Section 184 by directing Covid-19 patients to be isolated and quarantined for specific days and undergo medical examination and treatment. Also, the emergency officers applied Section 185 to enforce provision 184, involving mandatory vaccination against Covid-19 for high-risk employees. Therefore, public health emergency officers exercised their powers to apply sections of the Public Health Act (2016).
Conclusion
Public health officers are concerned with the health and well-being of the general society. Stakeholders such as health facilities, healthcare professionals, policymakers, and private and government institutions ensure good community health. Also, legislation is an essential concept in public health practice. Chief Health Officers apply various health-related acts to exercise powers in promoting and improving the health of individuals and communities. In Western Australia, the Department of Health regulates various public health acts, which guide health professionals in their practice.
The Public Health Act 2016 is modern legislation regulating Western Australians’ public health. This Act aims to promote communities’ health and well-being, inform people about health risks, and support programs to improve health and reduce health inequalities. Since the Royal Assent in 2016, implementation would occur in a staged manner over five stages. Nonetheless, stages one to four have been implemented, and the last stage is anticipated to be implemented in 2022.
The Public Health Act 2016 contains various provisions, roles and responsibilities of each stakeholder. However, in Western Australia, the Act is for all people. Western Australians have a legal duty to uphold the objects and principles of the Act by behaving and acting in ways that do not put risk to others. Citizens should actively participate in health promotion and disease prevention programs. Also, Western Australia’s Department of Health is working with local governments to enforce the Act.
References
Australian Government Department of Health. (2022). Timeline to Implement the Public Health Act 2016. Retrieved from https://ww2.health.wa.gov.au/Articles/S_T/Timeline-to-implement-the-Public-Health-Act-2016
Australian Government Department of Health. (2020a). Frequently asked questions- Public Health Act. Retrieved from https://ww2.health.wa.gov.au/Articles/F_I/Frequently-asked-questions-Public-Health-Act#:~:text=helping%20to%20prevent%20disease%2C%20injury,and%20maintain%20a%20healthy%20environment
Australian Government Department of Health. (2021). Australian COVID-19 Vaccination Policy. Canberra: Australian Government. Retrieved from https://www.health.gov.au/sites/default/files/documents/2020/12/covid-19-vaccination-australian-covid-19-vaccination-policy.pdf
Australian Government Department of Health. (2020b). Objects and principles- Public Health Act. Retrieved from https://ww2.health.wa.gov.au/Articles/N_R/Objects-and-principles-Public-Health-Act
Kevat, D. A. S., Panaccio, D. C. A., Pang, S. C., Dean, J. M., Farmer, C. C., & Mahar, P. D. (2021). Medico-legal considerations of mandatory COVID-19 vaccination for high-risk workers. Medical Journal of Australia, 215(1), 22-24.e1. https://doi.org/10.5694/mja2.51128
Oliver, K., Lorenc, T., Tinkler, J., & Bonell, C. (2019). Understanding the unintended consequences of public health policies: The views of policymakers and evaluators. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7389-6
O’Sullivan, D., Rahamathulla, M., & Pawar, M. (2020). The Impact and Implications of COVID-19: An Australian Perspective. International Journal of Community and Social Development, 2(2), 134–151. https://doi.org/10.1177/2516602620937922
Public Health Act (WA). (2016). Retrieved from https://www.legislation.wa.gov.au/legislation/statutes.nsf/main_mrtitle_13791_homep age.html.
Sung, B., Phau, I., Cheah, I., & Teah, K. (2020). Critical success factors of public health sponsorship in Australia. Health Promotion International, 35(1), 42–49. https://doi.org/10.1093/heapro/day107
Watts, R. D., Bowles, D. C., Fisher, C., & Li, I. W. (2021). The growth of Australian public health graduates and courses, 2001-2018: implications for education and employment opportunities. Australian and New Zealand Journal of Public Health, 45(2), 95–100. https://doi.org/10.1111/1753-6405.13076
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