Why Australia needs strong, independent preventive health agencies

Author: Dr Alexandra Jones, Co-Founder and Board Chair
This article was originally published in Croakey Health Media on 11 December 2025

When you work on the frontline of healthcare, you see very quickly where health systems are failing people. You see what happens when we wait until crisis hits. You see what happens when prevention is treated as optional rather than essential.

That’s why the Victorian Government’s decision to absorb VicHealth into the Department of Health is so alarming. It’s a decision that weakens prevention at precisely the moment we need to strengthen it.

As someone who works across clinical care, research and public health, I can tell you that independence in prevention is not a philosophical preference. It’s a practical necessity.

Independent health promotion agencies can identify emerging issues early, respond rapidly to community needs, and speak plainly about the commercial and social forces harming people’s health.

Government Departments simply can’t do that in the same way. They are limited by wide-ranging priorities, internal processes, and unavoidable caution.

VicHealth’s independence has allowed it to support initiatives that have saved lives. Its model has shaped international best practice. Its partnerships reach deeply into communities in a way that bureaucracy cannot replicate.

That matters because prevention only works when it’s community-driven, trusted, local, and responsive.

There’s a misconception that bringing functions “in-house” automatically creates efficiency.

You gain efficiency when you have teams with deep expertise who are laser-focused on prevention, not spread thinly across dozens of competing priorities.

You gain efficiency when you have people embedded in communities, building trust over years, not consultants rotating through short-term projects.

And you absolutely gain efficiency when you give skilled, independent organisations the ability to respond quickly to emerging local challenges.

These are exactly the kinds of interventions VicHealth can lead with agility. That capacity risks being lost if it is absorbed into the Department.

We already spend far too little on prevention in Australia. Less than five per cent of our national health budget goes towards it, despite overwhelming evidence that prevention is the most cost-effective investment we can make.

When we look at oral health, every year more than 80,000 Australians are hospitalised for preventable dental conditions. Children are one of the most affected groups. These hospitalisations cost hundreds of millions of dollars, and that’s before you count lost productivity, GP visits, pain, missed school and long-term complications.

As a clinician, I have treated countless people whose conditions could have been avoided entirely if they’d received preventive support earlier.

Commercial interests aside, when the main shareholder is the Australian people, the business case for prevention is in.

But prevention work isn’t scalable without independent leadership, long-term investment and community partnerships, all of which VicHealth has built over decades.

Undermining that infrastructure now will widen inequities and increase demand on already stretched health and hospital systems.

Communities today are facing rising chronic disease, widening inequities, long COVID impacts, the health effects of climate change, mental health pressures, and commercial environments saturated with products that harm our health.

We need stronger prevention, not weaker.

We need more independent agencies, not fewer.

We need a system where local knowledge, lived experience and cultural expertise guide investment.

VicHealth has helped shape one of the most successful public health eras in Australia’s history. Its independence is not incidental to that success, it is foundational.

For the sake of communities across Victoria, and for the integrity of Australia’s prevention agenda, I urge the Victorian Government to reconsider this decision.

Dismantling VicHealth won’t make people healthier. Strengthening it will.

And as someone who has seen firsthand the human cost of systems that wait until people are in crisis, I cannot overstate how much this matters.