Output 1.3 - Public Health Services

The aim of Output 1.3 is to improve the health status of the ACT population through interventions which:
  • promote behaviour changes to reduce susceptibility to illness

  • alter the ACT environment to promote the health of the population

  • promote interventions that remove or mitigate population health hazards.

This includes programs that:

  • evaluate and report on the health status of the ACT population

  • assist in identifying particular health hazards and measures to reduce the risk to the health of the public from communicable diseases, environmental hazards and the supply of medicines and poisons.


The Population Health Division (PHD) has primary responsibility for managing population health issues within ACT Health. The division undertakes the core functions of:

  • prevention

  • assessment

  • policy development and assurance.

It also contributes to:

  • local and national policy

  • program delivery

  • protocols on population health issues.

In 2014, PHD commissioned an independent external review of the effectiveness of ACT Health's organisational approach to emergency management. The objective of the review was to:

  • provide ACT Health with an independent, external analysis and opinion on the effectiveness of the directorate's approach to emergency management

  • make recommendations for improvement.

The review was conducted between May and June 2014. It included:

  • analysis of legislation, plans and policy

  • interviews with executives and managers who execute emergency management arrangements.

The ACT Health Executive Council considered the external review report in late 2014 and again in April 2015. Of the eight recommendations made in the report, the council:

  • fully agreed to three

  • partially agreed to two

  • disagreed with the remaining recommendations.

The agreed recommendations relate to:

  • reviewing and simplifying ACT Health’s current suite of emergency plans, including the Health Emergency Plan

  • clarifying identified triggers for internal escalation of emergency response

  • providing a dedicated emergency exercise program and budget for the directorate

  • renaming and clarifying the roles of the unit that provides core emergency management support to the Chief Health Officer and the broader directorate.

The PHD is now developing an implementation plan in line with the Executive Council’s determinations and will report regularly to the council on implementation progress.

Performance against accountability indicators

On 27 November 2014, the Food Amendment Bill was passed by the Legislative Assembly. The bill introduced provisions to reduce red tape for food businesses and non-profit community organisations that sell food for fundraising purposes.

More information: Detailed information about the amendment is provided in the C.6 Statement of performance, Output 1.3: Public Health Services section.

From 1 January 2015, food businesses have had the option of registering under the Food Act 2001 for up to three years, rather than annually. Food businesses that were required to notify their details to PHD are no longer required to do so, and the $57 fee previously charged to businesses for changing or updating their details has been abolished.

From 20 April 2015, eligible non-profit community organisations have been removed from the operation of the Food Act 2001, meaning there are no restrictions on the types of food they can sell as part of their fundraising activities. The changes have:

  • reduced the regulatory burden on these organisations

  • provided an incentive to sell more nutritious foods, such as salads, sandwiches and fruit, at community fundraising stalls.

In line with ACT Government regulatory reforms and reducing red tape, PHD began implementing multi-year licenses and registrations for businesses and individuals. The aim was for 20 per cent of all licenses and registrations to be multi-year by the end of the financial year. The Health Protection Service was able to progress this program earlier than anticipated and achieved 100 per cent compliance in this area.

More information: For additional information, see C.6 Statement of performance, Output 1.3: Public Health Services.

As part of a continuous review process, updated tobacco compliance testing procedures were introduced on 9 December 2014. The updated procedures clarify recruitment and training requirements, and streamline administrative processes. Compliance testing is an essential regulatory tool used across Australia to help reduce tobacco sales to young people.

Altering the ACT environment

On 8 December 2014, the ACT Health Air Quality Monitoring website was launched at the Health Protection Service. The website includes an Air Quality Index (AQI) value to indicate the cleanliness of ACT air; the lower the index, the better the quality of the air.

The AQI provides a number that allows easy comparison of different pollutants, locations and time periods. The website provides real-time air quality data from the three air quality monitoring stations operated by ACT Health, which are located at:

  • Monash

  • Civic

  • Florey.

The stations at Monash and Florey monitor the following five pollutants:

  • carbon monoxide

  • nitrogen dioxide

  • ozone

  • particulate matter less than 10 microns (PM10)

  • particulate matter less than 2.5 microns (PM2.5).

The air quality station at Civic monitors ozone, PM10 and PM2.5.

Interventions and mitigations

To provide a collaborative and transparent approach to food regulation issues, PHD has established a Food Regulation Reference Group (FRRG), which meets quarterly. The FRRG first met in September 2014. Members include representatives from:

  • industry

  • public health and consumer groups

  • ACT Government stakeholders.

The PHD also drafted and coordinated input into the ACT Government Submission to the Standing Committee on Health, Ageing, Community and Social Services inquiry into the exposure draft of the Drugs of Dependence (Cannabis Use for Medical Purposes) Amendment Bill 2014 and related discussion paper.

The PHD also developed the ACT Government submission to the Senate Legal and Constitutional Affairs Legislation Committee inquiry into the Regulator of Medicinal Cannabis Bill 2014.

In February 2015, a team of 11 public health officers conducted food inspections during the three-day National Multicultural Festival as part of a strategy to minimise public health risk from serious breaches of the Food Act 2001. During inspections of food stalls, public health officers routinely look for issues (breaches) that would give rise to unacceptable food safety risks including:

  • inadequate temperature control

  • poor hand washing facilities

  • inappropriate food storage.

Over 290 inspections were conducted during the event. A number of food safety breaches were identified, resulting in five incidents of voluntary disposal of food. No food was seized.

In May 2015, an extensive property clean-up was conducted under the Public Health Act 1997 due to an insanitary condition. The property had an accumulation of food and other material in and around the house. The food was decaying, odorous, providing harbourage for vermin and impacting on neighbours. Due to the tendency for this occupant to relapse and difficulties in managing hoarding cases, PHD has begun developing a multi-agency model for handling hoarding cases.

On 7 May 2015, PHD hosted a forum for the staff of aged care facilities. The aim of the forum was to provide aged care facilities with information and advice for preventing and managing influenza and gastroenteritis outbreaks. It covered topics such as:

  • the epidemiology of influenza and gastroenteritis in the ACT

  • influenza vaccination

  • outbreak management

  • infection control.

Presenters at the forum included staff from PHD and Canberra Hospital. More than 20 representatives from facilities in the ACT attended the forum.

The Drugs and Poisons Information System (DAPIS) was successfully deployed in PHD in September 2014. DAPIS collects and records information about prescribing and supplying controlled medicine in the ACT. DAPIS enables pharmacies to submit electronic reports of controlled medicine supplies to PHD, which is used for monitoring purposes. All ACT pharmacies are now submitting their reports electronically to PHD every month (Phase 1). Phase 2 of the rollout will result in pharmacies reporting dispensing information in real-time. This is dependent on pharmacy software vendors making necessary updates to software. PHD is assisting software vendors in this regard.

The ACT Chief Health Officer served a Disciplinary Notice on an ACT practicing pharmacist for failing to record controlled medicines dealings as prescribed by regulation and demonstrating a lack of accountability for controlled medicines. The proposed disciplinary actions included:

  • a formal reprimand

  • cancellation of the pharmacist’s authority to deal with controlled medicines

  • cancellation of the pharmacist’s Opioid Dependency Treatment Licence

  • a copy of the final disciplinary Decision Notice being forwarded to the Pharmacy Board of Australia.

The final disciplinary action was reduced to a formal reprimand for the contraventions of the Medicines, Poisons and Therapeutic Goods Act 2008.

Health status evaluations and reports

The PHD undertook or published the following population health surveys and data collections in 2014–15:

  • The ACT General Health Survey (GHS), which is a telephone computer-assisted technology household survey that collects information on a range of factors influencing health status.

  • The ACT Secondary Students Alcohol and Drug Survey, ASSAD ,which is a classroom-based questionnaire collecting information on risk behaviours of ACT secondary school students, including alcohol, tobacco and illicit drug use.

  • Finalised the collection of birth and death data from The ACT Registrar of Birth, Death and Marriage.

The division also:

  • improved the completeness and timeliness of maternal and perinatal data and continued to report nationally against key indicators

  • increased availability of public hospital data for data-linkage purposes

  • through the NSW Cancer Institute, improved the quality and efficiency of ACT cancer registry data collection.

To inform the future strategy of the ACT Cancer Registry an independent review was undertaken by experts in the field. Key recommendations are being implemented to improve the relevance, timeliness and flexibility of the information collected and able to be reported for public health benefit.

The PHD continued to monitor, analyse and report on the health outcomes across the population through a variety of methods and formats including:

  • Completing a proof of concept internet-based project to provide more timely access to population health data.

  • Continuing capacity building to link different data sets through data-linkage with the Centre for Health Record Linkage in New South Wales. This provides an invaluable tool to better understand health challenges and outcomes across the ACT community. For example, ACT Health is collaborating on a project, using data-linkage to better understand the outcomes of cardiac care, with the aim of improving services.

  • Continuing a partnership with the National Health and Medical Research Council's (NHMRC’s) Australian Prevention Partnership Centre. The centre focuses on the primary prevention of chronic health conditions.

  • Partnering with the ANU, after winning an Australian Research Council grant in 2012. This includes providing support for a PhD student research internship focused on dementia.

Health hazards and countermeasures

Exercise Melilla

On 26 March 2015, PHD conducted a functional one-day exercise, named Exercise Melilla. The exercise took eight weeks to plan and develop and aimed to validate the preparedness of the ACT Health sector to identify, transport and treat a suspected case of Ebola Virus Disease (EVD).

The scenario for Exercise Melilla involved:

  • a role-player patient presenting at Calvary Hospital

  • activating public health protocols by the Health Protection Service, Communicable Disease Control

  • transporting the patient to Canberra Hospital via ACT Ambulance Service for reception and testing.

The exercise included approximately 60 participants across four sites, and was a timely and valuable opportunity to practice infectious disease response coordination.


As part of the ACT Government’s ongoing commitment to reducing red tape, PHD assessed public health regulation to identify areas that may be deregulated without compromising public health. The division’s historical data showed that the ACT’s licensed boarding houses and hairdressing businesses had high rates of compliance with public health requirements. The risk to public health from licensed boarding houses and hairdressers was therefore considered minimal.

Based on this assessment the Minister for Health concluded that it should no longer be necessary for:

  • boarding houses and hairdressing businesses to be declared public health risk activities or

  • the occupation of hairdressing to be a declared public health risk procedure.

Accordingly, the Minister for Health determined that from 1 January 2015 licenses under the ACT Public Health Act 1997 would no longer be required to operate a boarding house or a hairdressing business. The Health Protection Service has retained regulatory powers under the Public Health Act 1997 to address any condition that is, or may become, a public health risk or be offensive to community health standards. PHD will continue to investigate any public health complaints received from the community concerning practices at boarding houses and hairdressing businesses. 


In 2014–15, eight cases of measles were notified in the ACT. All eight cases were in children that that had not been immunised. Four cases acquired their infections overseas. The remaining four cases were a family cluster with an unknown source of infection although likely acquired interstate.

An increase in overseas-acquired measles cases has been observed nationally in recent years, highlighting the importance of measles vaccination, especially prior to overseas travel.

In March 2014, Australia achieved measles-free status, as declared by the World Health Organisation (WHO). This means that Australia has:

  • no local strain of measles circulating in the community

  • well-performing surveillance systems to rapidly detect and respond to measles cases.

Achieving measles-free status does not mean the complete absence of the disease in Australia, but recognises that cases will continue to be imported by travellers from countries where the disease is prevalent. PHD investigates and implements disease control measures for each confirmed case of measles under national guidelines. Since the beginning of 2010, 32 cases of measles have been notified in the ACT.

Medicines Advisory Committee

The Medicines, Poisons and Therapeutic Goods Regulation 2008 was amended on 23 October 2014 to increase the membership of the Medicines Advisory Committee from three to seven members. The Medicines Advisory Committee is an independent statutory committee that provides advice to the Chief Health Officer on complex matters relating to prescribing controlled medicine. The committee was expanded to allow a broader range of expertise and includes new pharmacist, pain or addiction specialist, GP and consumer positions. 

Ebola Virus Disease

In April 2015, a multi-agency health response was required to investigate and manage a returned Health Care Worker (HCW) from Liberia who reported symptoms consistent with early Ebola Virus Disease (EVD). The HCW reported no known contact with Ebola cases and was considered as low risk for having acquired Ebola.

A multi-agency response was enacted by the:

  • Population Health Division (PHD)

  • Canberra Hospital and Health Services (CHHS)

  • ACT Ambulance Service (ACTAS).

The HCW was transported to Canberra Hospital for treatment and testing. The HCW was subsequently confirmed negative for EVD and discharged to home quarantine.

Following the response the division implemented a detailed After Action Review plan to capture relevant response diagnostics from participating agencies. A multi-agency debrief with PHD, CHHS, ACTAS and CSD was conducted on 23 April 2015. Findings from the multi-agency debrief concluded that overall the multi-agency response had worked well. Diagnostics identified a number of strategic-level improvements that could be realised. The recommendations arising from the review to streamline and strengthen future EVD responses will be managed through the Health Emergency Management Sub Committee, which is chaired by the Chief Health Officer.

Future directions

Behavioural changes

As part of Future directions for tobacco reduction in the ACT 2013-2016, PHD will investigate options to further restrict places of tobacco use. This will include a community consultation on creating new smoke-free areas in the ACT, with the aim of reducing the exposure of the community to environmental tobacco smoke.

The PHD will also continue to work on improving the policy and legal framework that supports organ and tissue donation in the ACT. Amendments to arrangements related to organ and tissue donation aim to enhance efficiency and maximise clinical outcomes for organ recipients.

Interventions and mitigations

The division will continue to progress work to address the potential public health issues associated with the sale and use of electronic cigarettes.

Health status evaluations and reports

The PHD will continue to work towards enhancing knowledge of and raising awareness regarding the health risks associated with exposure to loose-fill asbestos.

Health hazards and countermeasures

PHD will continue to progress work on improvements to food regulation in the ACT, including its transparency. This work includes:

  • improving stakeholder engagement

  • further developing tools used by public health officers, for example guidelines, manuals and procedures

  • improving information for food businesses and the public

  • implementing a staff development program

  • developing IT solutions to improve both data integrity and the efficiency and transparency of the food regulation system

  • improving the effectiveness of food safety services.

PHD continues to progress work on improving controlled medicines regulation in the ACT. Consultation was undertaken in 2013 on a proposed model to remove the current Chief Health Officer approval requirement for prescribing controlled medicines. This was to be coupled with improved prescription monitoring by PHD using pharmacy data.

While the majority of stakeholders supported the proposal, some stakeholders have raised concerns that removing the current safeguards will put patients at risk. PHD is currently considering an alternative model to retain the approvals system for consideration by the Minister in 2015–16.

As various inquiries into matters related to the medicinal use of cannabis are finalised, additional issues will need to be considered and significant analytical policy work will continue.