The Australian States were first established as British colonies beginning with New South Wales in 1788. They took their lead from existing British statutes in developing their own laws, and the first examples of public health law in Australia were concerned with vaccination against smallpox, quarantine, improving sanitation, the control of infectious disease, and other immediate health issues like a clean milk supply. Death rates from infectious diseases were high especially in the quickly growing cities. The development of employment, education, good housing, safe water supplies, proper sewage and garbage disposal, the availability of good food, and public health legislation were critical in the reduction of infectious diseases as the primary cause of death and the reduction in the overall death rate.

When the Australian Government was established in 1901, it had very limited involvement in public health issues, with the exception of quarantine. The health system had a large governmental sector with the States taking a major responsibility for health services ultimately provided through a strong network of public hospitals. Private medical practice dominated the health care sector. A 1946 amendment to the constitution gave the Australian Government a definite role in health services and the National Health Act provided more responsibilities in the areas of hospital and medical insurance benefits.  

Milestones
1848	English Public Health Act 1848
1854	Victorian Public Health Act 1854 The English Public Health Act 1875, together with the smallpox epidemics of the 1880s, produced a spate of colonial public health legislation: Victoria (1883 and 1889), Queensland (1884), Tasmania (1885), Western Australia (1886), South Australia (1884 and 1898) and New South Wales (1896)
1901	Formation of the Federation of the six Australian colonies or States as the Commonwealth (Australian Government ) of Australia
1908	Enactment of the Federal Quarantine Act
1921	Establishment of the Federal Department of Health
1925	Federal Royal Commission on Health recommends the establishment of the Federal Health Council to promote cooperation between the Federal and State Governments
1927	Federal Health Council established. Represents the first machinery for cooperative work between the government jurisdictions
1930	Establishment of the National School of Public Health and Tropical Medicine at the University of Sydney
1936	National Health and Medical Research Council (NHMRC) is established. Combined support for medical research with technical advice on health issues, absorbing the Federal Health Council
1973	Establishment of the Community Health Program. An example of the strong preventive aspect of public health policy
1974	Establishment of the Health Insurance Commission to operate Australia's first universal health insurance scheme, Medibank
1975	Establishment of Medibank, the tax-funded universal health insurance scheme
1984	Medicare (National Health Insurance) is established
1985	Better Health Commission established to report on the health status of the Australian population and to recommend how to address national health problems
1985	National Campaign Against Drug Abuse established
1986	Independent Review of Research and Educational Requirements for Public Health and Tropical Health in Australia (Kerr White Report) published
1987	Australian Institute of Health and Welfare (AIHW) is established
1988	Report of the Health Targets and Implementation (Health for All) Committee. This led to the National Better Health Program which oversaw the development of national strategy to improve health status and inequities
1989	Establishment of National Women's Health Program and National Aboriginal Health Strategy
1989	The first National HIV/AIDS Strategy is published
1991	BreastScreen Australia established. National Cervical Screening Program established
1996	Australian Health Ministers' Conference (AHMC) endorses the concept of the National Public Health PartnershipTransition in public health to a more general concern with a 'whole of system' approach

 

The major debate of the 1970s was about ensuring universal access to health care and the development of community based primary health care facilities. This resulted in 1975 in the introduction of the Federal Medibank, a tax-funded national health insurance scheme. It was subsequently replaced by Medicare, the current national health insurance program which provides access to doctor of choice for out of hospital care, free public hospital care and subsidised pharmaceuticals. Medicare also provides for specific health care needs for people, by ensuring appropriate use of technology, targeting preventive services for special at risk groups, and improving medical services.

In addition to government efforts, professional, community and charitable institutions have had an important role in the health sector, for example, the precursors to the Australian Public Health Association were formed in the late 1960s. Non-government organisations such as the National Heart Foundation and the anti-Cancer Councils have been significant in educating the public about the prevention of major health problems (e.g. cancer and heart disease). Historically, State governments have been the key providers of population based preventive services and they remain so. In the last decade or so, the Australian Government has become increasingly important as a source of policy initiatives as well as a source of substantial funding for public health. The Consumers' Health Forum of Australia was formed in the mid 1980s. The Forum is important in providing feedback to the government about the community viewpoint on health issues and government health initiatives.

In the 1980s, as part of Australia's response to the World Health Organisation's (WHO) Health for All by the Year 2000 agenda, greater attention was given to national public health strategies. The AIHW increased the influence of the Australian Government in the development of public health policy across Australia, and a statutory base was provided to existing national structures such as the NHMRC. National strategies were initiated in the 1980s and these included the National Drug Strategy, the National Better Health Program, the National Aboriginal Health Strategy, the National HIV/AIDS Strategy, the National Women's Health Program, BreastScreen Australia and the National Cervical Screening Program. In 1986, the publication of the Kerr White Report which made recommendations regarding public health education and research, led to expansion of public health training (through the Public Health Education and Research Program (PHERP)) and established the Public Health Research and Development Committee within the NHMRC.

The Better Health Commission of 1985 began the work of investigating and reporting on the current health status of the Australian population. This and subsequent programs gave rise to a process of collaboration between the Federal, State and Territory Governments which culminated in 1996 with the endorsement of the National Public Health Partnership by the Australian Health Ministers' Conference. The Partnership represents a shift away from the previous emphasis on programs directed at specific diseases or risk factors towards a "whole of system" approach to health.

Current public health practice in Australia reflects the WHO (Health for All) agenda and the WHO policy serves as an umbrella framework for national health development. Basic to the new approach to health in Australia is an understanding that many of the determinants of health lie outside the health care system itself. Moreover, the new approach is committed to meeting the health needs of the community through policy and programs which combine a "top down" philosophy with a process which encourages community consultation and input.

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