We know general practice is the setting where much of this work can happen early, safely and effectively. The question is whether we are prepared to fund prevention as seriously as we fund rescue.
I came away from the Wild Health Preventative Care Conference in Canberra recently thinking about a question we do not ask often enough.
Why do we still talk about prevention as a health cost, rather than an investment in economic productivity?
In Canberra, the conversation was rightly focused on preventive care, chronic disease, early detection, digital health, equity, implementation and the future of our health system. However, sitting in that room, I kept thinking that the prevention conversation needs to move beyond health.
It equally belongs in Treasury. It belongs in productivity reform. It belongs in every serious conversation about workforce participation, business sustainability, hospital pressure and nation building.
Australia is having a serious productivity problem. The Productivity Commission’s latest figures show labour productivity fell by 0.6% in the March 2026 quarter and grew by only 0.3% over the year. Across the year, hours worked grew faster than output.
So here is a thought. A healthier population is a more productive population.
Maybe prevention should be treated with the same seriousness as infrastructure. We will spend billions on roads, rail, tunnels, and energy projects because we understand they support long-term economic growth. But what is the point of building the infrastructure of a modern economy if we neglect the human infrastructure that actually powers it?
When people avoid preventable illness, they are more likely to stay in work, contribute to their communities, care for their families and live independently. Businesses lose fewer days to sickness. Hospitals face less avoidable pressure.
Governments spend less reacting to illness that could have been prevented, detected earlier or better managed in the community. Families are spared the emotional, financial and practical disruption that illness brings. The numbers are significant.
Australia spent $270.5 billion on health in 2023-24. Yet only $14.6 billion, around 5.4% of total health spending, went to unreferred medical services, mainly general practice. Formal government public health activity was even smaller, at $5.4 billion, or about 2.0% of total health spending.
That is the prevention gap.
We are prepared to spend heavily once people become sick, but we remain far more hesitant to invest properly in the systems that keep people well. The Australian Institute of Health and Welfare estimates that in 2023–24, $38 billion in health system spending was attributable to potentially avoidable risk factors. Overweight and obesity alone accounted for $7 billion.
In the same year, Australia recorded 788,000 potentially preventable hospitalisations, costing an estimated $7.7 billion. That is 8.5% of all admitted patient spending. Chronic conditions accounted for the largest share of that cost, led by diabetes complications, congestive cardiac failure and COPD.
These are not abstract accounting lines. They are hospital beds, emergency department presentations and ambulance transfers.
They are people missing work, businesses carrying disruption, carers stepping in, families reorganising their lives and patients losing independence.
The Australian Burden of Disease Study 2024 found that 36% of Australia’s disease burden could be avoided or reduced by addressing modifiable risk factors. The leading contributors include overweight and obesity, tobacco use, poor diet, high blood pressure and high blood plasma glucose.
In other words, more than one-third of the burden we carry as a nation is potentially preventable.
Behind every one of those numbers is a person, a family, a workplace and a community – a parent whose diabetes could have been detected earlier, a worker whose heart disease risk could have been addressed before the heart attack, an older person whose fall, infection or deterioration may have been prevented with timely community care, a child whose vaccine-preventable illness could have been avoided, a hospital bed that could have been used for someone who truly needed acute care.
In my own family, I have seen what happens in a country where preventive healthcare is not built into the system. Illness is often found late. High blood pressure, diabetes and cancer may go unnoticed until they become serious. Sometimes the first real contact with care is the emergency department, if you get there in time. That experience changes how you see prevention.
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It is the difference between early detection and late diagnosis – between planned care and crisis care, between remaining independent and losing independence, between staying in work and being forced out of it, between a family coping and a family being overwhelmed.
Australia has many strengths. We have Medicare. We have high-quality general practice. We have immunisation programs, cancer screening programs, antenatal care, chronic disease management, cardiovascular risk assessment and a strong public health tradition.
However, we still underinvest in prevention.
The recent paper Prevention pays: Investing in Australia’s health and economic future makes the case clearly. Preventive health is not just good health policy. It is economic policy. It improves human capital, supports labour market participation and reduces the productivity losses that come from absenteeism, presenteeism, early workforce exit and premature mortality.
The paper also reminds us that we know many preventive interventions work.
The ACE-Prevention study assessed 123 interventions across alcohol, tobacco, physical activity, diet, body mass index, blood pressure and cholesterol. It found 23 interventions were both cost-saving and health-promoting, while another 51 were cost-effective. The ACE-Obesity Policy study found all 16 obesity prevention interventions it assessed were cost-effective, with 11 being cost-saving.
So, the problem is not that we lack evidence. The problem is that prevention keeps losing to short-term budget cycles.
Governments often fund what is immediate, visible and politically urgent. Hospitals are visible. Ambulance ramping is visible. Waiting lists are visible. Crisis is visible.
Prevention is quieter. It is the heart attack that does not happen. The stroke that is delayed. The diabetes complication that is avoided. The hospital admission that never occurs.
That is harder to photograph at a press conference, but it is exactly where productivity lives.
If we are serious about prevention, we need to move from rhetoric to architecture.
First, Australia needs a National Prevention Investment Framework with real authority.
This should not be another strategy that sits on a shelf. It needs an independent, cross-sector advisory body that can evaluate preventive health investments, model their economic and health returns, and recommend where governments should invest.
Second, prevention funding should be pooled across Commonwealth, state and territory governments.
At the moment, one part of government may pay for prevention while another receives the benefit. A GP clinic, community health program or public health intervention may prevent a hospital admission, but the savings often appear in a different budget. That is why siloed budgets work against prevention.
Third, prevention needs long-term funding that survives political cycles.
Australia has been here before. The National Partnership Agreement on Preventive Health invested $872 million and established the Australian National Preventive Health Agency. But the agency was abolished in 2014.
That history matters. Prevention needs durable, bipartisan structures, not short-term enthusiasm followed by quiet dismantling.
Fourth, we need to fund prevention where it actually happens: in general practice and primary care. General practice is where prevention becomes practical.
It is where risk factors are identified, screening is discussed, vaccines are given, blood pressure is checked, diabetes is detected, medications are reviewed, smoking is addressed, mental health is supported, and the patient’s life context is understood.
Prevention is rarely a single intervention. It is a series of conversations over time. It is the GP who notices the blood pressure creeping up. The practice team that follows up the abnormal result. The trusted relationship that allows a patient to finally talk about alcohol, weight, stress, family violence, depression or financial hardship.
That is prevention. And it is productivity policy in its most human form.
Fifth, prevention must be equitable.
A productivity lens is useful, but it must not become a narrow workforce-only lens. Prevention must prioritise Aboriginal and Torres Strait Islander peoples, rural and remote communities, people living in poverty, people with disability and communities carrying a higher burden of preventable disease.
Otherwise, we risk improving productivity while widening inequality.
If we are serious about productivity, we need to stop treating health as only a cost centre. Health is not just expenditure. It is economic infrastructure.
The Productivity Commission has challenged Australia to think differently about productivity. Preventive health should be part of that conversation.
At Wild Health, there was energy, innovation and ambition. But the challenge now is implementation. We know enough to act. We know general practice is the setting where much of this work can happen early, safely and effectively.
The question is whether we are prepared to fund prevention as seriously as we fund rescue.
Dr Ramya Raman is a specialist GP and practice owner. She is a candidate for the presidency of the Royal Australian College of General Practitioners.
