Social movements and the Whitlam-initiated community health movement in Australia

Abstract

Background: This paper examines the social movements that influenced the development and implementation of the original Whitlam Government Community Health Program, the community health movement that emerged, and the opportunities it created for people to develop and deliver health programs in new ways.

Methods: Oral history interviews with 93 people involved in community health in South Australia, Victoria and New South Wales, and 212 community health policy and archival documents were collected as a part of an Australian Research Council study documenting the history of community health services in Australia since the 1970s.

Results: Ideas about community health in Australia were influenced by several social movements that had overlapping, but distinctive, contributions: (1) left-wing movements: political parties, workers' health; trade unions, anti-war and anti-establishment; (2) international social medicine and community-oriented primary care; (3) Indigenous rights/Black Power; (4) feminist; and (5) community development/community power. These movements influenced Australian community health to embrace community management, advocacy and community development strategies in addition to multi-disciplinary care. However, these progressive elements were undermined by neo-liberal management reforms and medical opposition to elements of the Community Health Program.

Conclusions: The early passion for community health in the 1970s and 1980s was fuelled by social movements, but the inconsistent support from the federal and most state governments limited progressive and innovative community health practice. The window of opportunity for the Community Health Program was supported by progressive social movements, but restricted from the 1990s onwards.

Keywords: Whitlam; community health; health equity; health policy; health promotion; medical power; social determinants of health; social movements.