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Why health reform?

George Larcos
Med J Aust 2009; 191 (10): . || doi: 10.5694/j.1326-5377.2009.tb03336.x
Published online: 16 November 2009

To the Editor: Finally! An article in the Journal about health reform that carries no spin and decries further futile experimentation in management. Lewis and Leeder are to be congratulated on their insightful review.1 As they point out, social and environmental determinants of health are far more important to a community’s well-being. This was recognised intuitively as long ago as 1986, with the promulgation of the Ottawa charter,2 and its recommendation that health services be reoriented primarily toward promoting heath rather than delivering acute care per se.


  • Westmead Hospital, Sydney, NSW.



  • 1. Lewis SJ, Leeder SR. Why health reform? Med J Aust 2009; 191: 270-272. <MJA full text>
  • 2. Canadian Public Health Association, Health and Welfare Canada, and the World Health Organization. Ottawa charter for health promotion. First International Conference on Health Promotion, Ottawa, 21 November 1986 — WHO/HPR/HEP/95.1. http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf (accessed Aug 2009).

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