At some stage during the life of the Rudd government, a study will declare that the negative health effects on Australians from physical inactivity and obesity have surpassed those of smoking. This is a tribute to the efforts of governments past in tackling the scourge of smoking, but equally represents a damning failure to have done anything significant to encourage physical activity.

Despite the good example set by John Howard on his morning walks, Australians generally became significantly fatter and significantly reduced their physical activity under his watch. There will be a subsequent major cost to the health system in terms of increased diabetes, heart disease, cancer and other diseases as a result of this trend.

Although most of the failure of the outgoing government was neglecting the issue, some of their policies actively decreased physical activity. While he was Minister for Education, Brendan Nelson oversaw a decision to castrate the university sports associations with the VSU legislation. University sports associations had their major income stream substantially reduced and have had no choice but to cut services, resulting in a 17% drop in university sports participation since the VSU introduction.

Further, the Howard government deliberately resisted necessary reform of the health system, such as the recognition of sports physicians as medical specialists. Despite the Prime Minister’s alleged love of sport, it was trumped by the pandering of his successive Health Ministers to the closed-shop mentality of the traditional specialist colleges and AMA.

The Australasian College of Sports Physicians (ACSP) has been administering, unfunded by government, a medical specialist-standard 4-year full-time training program and examinations since 1992. Despite an application for recognition being on the table since 1994, the previous government failed to make a decision to recognise sports and exercise medicine practitioners as legitimate medical specialists in Australia. This was out of step with all other major Western nations, including recognition of the ACSP program itself by New Zealand in 1997.

Unfortunately, no doctors have joined the ACSP training program in the last two years in NSW, which is not surprising when prospective trainees consider the restricted rights they will have under Medicare as a sports physician, such as inability to order MRI scans. Given that injury is a limiting factor for 20% of those who don’t exercise enough, Medicare should encourage rather than discourage practitioners whose goal is to make injured patients more active.

There are other telling indictments of how systems in Australia neglect to reward and thereby encourage exercise. A drunk-driver who becomes a quadriplegic crashing into a pole can expect to receive upwards of $5 million in compensation, whereas the maximum compensation for an individual who suffers the same injury from playing sport in Australia is $300,000. Catastrophic sports injuries in New Zealand result in far more realistic compensation and their government body which provides this compensation has, with preventive programs, managed to substantially lower the rate of catastrophic injuries in rugby union. It is now more than twice as safe, with respect to the risk of quadriplegia, to play rugby union in New Zealand than it is Australia.

It is also compulsory to wear a mouthguard in rugby in New Zealand, again making the risk of dental injury in rugby less than half the Australian rate. Yet calls to replicate a similar Federal government body to monitor and prevent sports injuries in Australia have been unheeded to date. It is not coincidental that the rate of increase in obesity over recent years has been far slower in New Zealand than it has been in Australia. It is also analogous that state governments in Australia have devoted far greater resources to the rights of those driving motor vehicles than the rights of those who wish to take to healthier options of travelling by bicycle or on foot.

While in opposition, the ALP instituted Kate Lundy as a Shadow Minister for Health Promotion (as distinct from “Health” held by Nicola Roxon), a sign perhaps that they were more prepared than the Coalition to take these issues seriously. Sadly, to date this new ministry appears not to have been replicated in the Rudd government. It is long overdue.

We need a new government that is bold enough to declare that the level of only 50% of Australians who are adequately physically active is a national disgrace, particularly when we have a climate that should allow the population to have high rates of activity. A Minister for Health Promotion, who set a goal of trying to increase this figure to 75% or more of the population, along with continuing the success of reducing the rate of smokers, possibly would have an even more important impact on the future health of our country than the Minister for Health herself.

John Orchard is currently team doctor for the Sydney Roosters (NRL), a position he has held since 1998. He has also worked for the Australian Cricket team (2007), Sydney Swans (1994-1997) and the NSW State of Origin team (2000-2006) and as a Sports Medicine Fellow at the Australian Institute of Sport (1993). He is also a board member of Sports Medicine Australia, sits on the NSW Sporting Injuries Committee and is a director of the injuryupdate.com.au website.