One of the consequences of the COVID-19 pandemic is that government health advisers have been thrust into the limelight. The prime international example has been Dr Anthony Fauci in the United States, who clashed with President Donald Trump and emerged triumphant though bloodied.
Some Australian health advisers have become celebrated. At the Commonwealth level, Professor Brendan Murphy, now secretary of the Department of Health, has received various accolades, including Father of the Year and ACT Australian of the Year. Many of the state and territory chief health officers, including Dr Kerry Chant of NSW and Dr Kerryn Coleman of the ACT, have achieved high profiles beyond anyone's expectations, because of their regular appearances on television. Often, they have appeared daily during lockdowns besides their premier or chief minister.
The public role of a chief health officer is twofold. One, which is unproblematic, is to provide detailed reports and to answer specific medical questions that only an expert, rather than a political leader, can be expected to answer. That also frees the political leader from being caught up in too much of the nitty gritty. The same applies to others with specific operational roles, like police commissioners.
The second role, which can be more problematic, is to back up the political leader. Here the role is like that performed by the Chief of the Defence Force standing beside the Minister for Immigration or the Minister for Defence while boats full of asylum seekers are being turned back; or the fire commissioner standing by the Premier during the bushfire emergencies.
This is more than back-up. This role is to provide cover for the political leader and reassurance for the public that what is being said by the political leader is not just political spin.
The constant refrain of political leaders during the pandemic has been that the actions of their government have been taken "on health advice". It has become both a mantra and a defence against criticism. This has applied to uncontroversial operational matters, like personal hygiene and social distancing, but also to the many controversial matters, like lockdowns, quarantine, mask-wearing, and others.
The reason this latter role can be problematic is that, in pushing the chief health officer into the limelight, the situation forces them to go beyond the traditional minister-public servant relationship. The traditional career public servant gives advice to the minister, but does not take responsibility for the government actions which follow that advice. The public servant retains a certain anonymity. The minister takes the heat.
Generally, the chief health officers in Australia have avoided undue controversy. There has not been an equivalent of Fauci, the American, in Australia. One exception came when the Queensland chief health officer, Dr Jeannette Young, was quite outspoken and effectively criticised the plans of the federal and NSW governments to open up their communities.
Public arguments, even disagreements, between politicians and chief health officers are not part of our system of government. When there is a disagreement between a minister and a public official, the public official is either sacked or resigns. There have been plenty such examples. For instance, there have been revelations that Scott Morrison, when he was head of Tourism Australia, fell out with the tourism minister, Fran Bailey, and lost his position.
Political leaders need the public endorsement of their chief health officers. It would be damaging for them if it was not forthcoming when a difficult announcement, like the end or extension of a lockdown, was made. There will be many such announcements during the rest of this year.
It is quite possible in either eventuality for there to be a disagreement between a premier or chief minister and their chief health officer. Either the premier or chief minister could "open up" before the chief health officer was ready to do so, or, probably less likely, the premier or chief minister could be more cautious than the chief health officer.
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Such an outcome would be well within the norms of the Westminster system of government. The chief health officer is the source of medical advice, but within government there are many other sources of advice. Government COVID-19 decisions are also made on economic and financial advice, social advice and political advice. Decisions by government are made on balance, even when they are announced as being "on medical advice". Among the commentators, it is Waleed Aly who has made this point very well.
However, the pressure is still on the chief health officers and their deputies because of their place in the limelight. Media conferences have the potential to put them under great pressure. Journalists are often not content to take "on medical advice" at face value. Nor should they. Government advice is rarely transparent. This lack of transparency about key elements in decision-making - like modelling, vaccine availability and internal government reports - has been one of the weaknesses of the period in which we have been dealing with COVID-19.
Their regular presence on the podium alongside the political leader makes it hard for chief medical officers to avoid political hot potatoes when they are tossed around. They can be put in the position of publicly supporting a course of action when they would rather not. As Gladys Berejiklian, the NSW Premier, has come under pressure from the media, Dr Chant, her chief health officer has been dragged into the politics.
Chief ministers, premiers and the Prime Minister are under enormous pressure, but so too are their medical advisers. Their position is an unenviable one.
- John Warhurst is an emeritus professor of political science at the Australian National University.