At a panel billed "Predict. Prevent. Personalise," Australian leaders in general practice, pathology, genetics and consumer advocacy, joined by a visiting health economist, agreed prevention already works. What's missing, they found, is a funding model and a delivery system built for a country this large and this uneven.

The session opened with an audience poll, and the result left little doubt about where the room stood. Asked whether Australia needs to move from reactive to proactive healthcare, the vote skewed heavily toward urgent change, with only a handful favouring a slower transition. Chairing the panel, titled "Universal vs Uniform Healthcare," was Matthew Britland, co-founder of Edge Medical Solutions, whose background spans medical affairs roles across the pharmaceutical industry in oncology and haematology. His question to the panel was straightforward: if the appetite for change is this strong, why hasn't it happened?

A System Good Enough to Feel Safe

Dr Michael Wright, President of the Royal Australian College of General Practitioners and a health economist by training, argued that Australia's relative success is itself part of the problem. Good general practice, he said, is largely invisible: when prevention works, "you don't see heart attacks, you don't see kidney failure," so it gets treated as a cost rather than a system-wide benefit. He linked this directly to burnout, arguing the deeper issue in general practice is autonomy as much as money: clinicians who can't change how they work lose the agency that makes the work sustainable. "We know what we have to do," he said. "It's actually how we're going to do it" that remains unresolved.

Dr Elizabeth Deveny, CEO of the Consumer Health Forum, located the same problem in public understanding rather than clinical practice. The biggest barrier she sees on the ground isn't funding or evidence, but a lack of awareness and education, among patients and policymakers alike. "Everyone in this room is so across this," she said, "but … unfortunately the awareness and the education isn't getting through" to the people who need to hear it.

Why We Fund Treatment, Not Prevention

When the audience poll turned to barriers, one answer dominated: funding. Dr Wright, drawing on his own research into primary care funding, argued that Australia's fee-for-service base supports neither the care being delivered nor the transformation required to deliver it differently: practices are rarely paid for the time spent improving how they work. "If you pay for what you measure," he said, "you're also choosing what you don't improve."

The panel's visiting guest, a Scandinavian health economist introduced during the session as Hans, located the same problem inside the design of funding models more broadly: schemes need to support both today's care and tomorrow's transformation, and very few manage both. He pointed to a Swedish university preventive health programme, Leap For Life, where prevention research struggles to attract investment compared with direct treatment funding. "It's crazy in a way," he said. "These are not costs, they will come back … in the future."

What the Labs Can Already Tell Us

Dr Michael Page, CEO of Clinipath Pathology and a chemical pathologist with a particular interest in familial hypercholesterolaemia, argued that better prevention often needs smarter use of what pathology already holds, more than new technology. Lipoprotein(a), a biomarker linked to substantially higher cardiovascular risk in roughly one in five people, sits outside the Medicare Benefits Schedule, so testing costs pass directly to the patient; familial hypercholesterolaemia testing is funded only under narrow criteria. He also pointed to a cultural quirk in how pathology requests are treated: write "screening" on a form and some providers hesitate, but list symptoms instead and "all of a sudden it's fine" — reactive care moves easily through the system in a way preventive care doesn't. With years of stored results, he said, a lab can already model an individual's long-term risk the way a major outcomes trial would, in minutes rather than years. For Page, the deeper shift is about ownership: people need to see their own health data the way they already do their banking, he argued, rather than leaving it scattered across servers they can't access — "we kind of just accept the fact that … where's my health data? I'll tell you where, it's in some server."

Zoë Milgrom, co-founder and Chief Clinical Officer of genetic testing and counselling service Eugene, made a related case for genomics specifically. Drawing on earlier work in genetic counselling within the public health system, she pointed to predisposition testing in childhood cancer as an example of genomics already reshaping what "treatment" means: a meaningful share of children diagnosed with cancer carry an inherited predisposition, turning what looks like a treatment question into a prevention one.

Equity Across a Continent

Bob Partridge, who manages 22 regional pathology laboratories for Pathology Queensland across a landmass roughly eight times the size of Victoria, brought the discussion back to logistics. Genuine national equity, he argued, isn't just about funding a new test, it's about whether it can be delivered consistently once it leaves a capital-city pilot: building capability at regional sites rather than concentrating it in a single specialist hub, and working out how data flows once a programme moves from a trial to a statewide service. Without that groundwork, he suggested, well-funded screening programmes simply don't reach the people furthest from a major hospital.

Milgrom raised a related but distinct equity question: genomic carrier screening already accounts for a significant share of Medicare-funded genetic testing, with roughly 150,000 tests ordered annually, yet an expanded panel can still cost a patient $1,000 to $2,000 out of pocket. The risk several panellists pointed to is a two-tier system, where the wealthy and well-connected access prevention privately while everyone else waits for a fully funded, universal rollout that may take years to arrive.

Trust Is the Missing Infrastructure

Asked for the one change that would accelerate Australia's shift to proactive care, the panel converged on relationships rather than mechanics. Deveny wants a louder, better-informed public pushing local MPs as advocates for change. Milgrom argued for going directly to consumers rather than waiting on institutional processes, partly as a hedge against health misinformation in an "attention economy" where trust, not knowledge, is the scarce resource. Wright pointed to the same dynamic inside the clinic: trusted relationships, sustained over years, let a GP have a different kind of conversation with a patient than a single test result ever could.

If the visiting Danish perspective offered anything to take home, it was this: in Denmark, a cancer patient organisation's chief executive sits on the committee that decides what gets prioritised nationally. For an Australian panel that spent 75 minutes circling one conclusion — that the evidence for prevention is no longer in question, only the willingness to fund, deliver and trust it — giving the people most affected a seat at that table might be the simplest place to start.