John Dwyer

Providing communities with accurate, timely and logical information about the control measures required to minimise harms associated with infectious diseases is essential to avoid both complacency and panic. (more…)

Providing communities with accurate, timely and logical information about the control measures required to minimise the harm associated with infectious diseases is essential to avoid both complacency and panic. (more…)

John Menadue’s insightful essay on urgently needed reforms to health care in Australia ( P&I Feb 7) correctly emphasised that a “priority area for implementation and funding should be primary care with the rollout of multi-disciplinary primary health care clinics across Australia. (more…)

Opioid addiction is pervasive  and growing rapidly. Medicine and Science are threatened by the phenomenon. (more…)

At least 50% of the money private health insurers pay out annually to those insured is absorbed by just 5% off their customers.  Most of these patients have chronic medical problems and have multiple admissions per year .While private hospitals need bottoms on beds to be profitable, public hospitals and private insurers are desperately in need of a  reduction in hospital admissions. Numerous strategies for achieving this are being floated but sensible reforms are difficult as those with vested interests in the status quo have undue control of government initiatives.  (more…)

It was a right hook in the third round that sent the 26 year old boxer to the canvass. The crowd cheered with excitement; after all, this is what they had hoped to see. On the referee’s count of “five” the man struggled to his feet and was directed to the ring side doctor. That professional shook his arms looked at his pupils and asked if the man wanted to continue. “Yes”, he said, upon which he was allowed to return to the slaughter. Twenty-seconds later he was back on the canvass, 24 hours later he was dead. Numerous small blood vessels, torn asunder as his brain bounced back and forward inside its bony cage, bled and bled. All the intensive care staff could do was watch him die. (more…)

The Opioid epidemic that has so devastated America is now well established in Australia. (more…)

When I was much younger I often dipped into Ripley’s “Believe it or not” for a laugh, amazement and even enlightenment. I had a look at their website recently as I prepared to tell you a story that would fit well into their library and found that  “Ripley’s” is alive and well, daily producing their remarkable vignettes; Frederic Baur, creator of Pringle’s chips had his ashes buried inside one of his cans, the common Swift can stay in the air for 10 months without landing, men only blink half as often as women, cats can be allergic to humans!  Well, here is a serious story that is certainly hard to believe but, regrettably, is true. (more…)

“Australia’s private health insurance (PHI) industry fears it is in a death spiral, and politicians need to rethink whether or to what extent taxpayers should continue to subsidise the industry” the Grattan Institute tells us as they call for a review of the purpose of PHI in Australia. The Grattan report emphasises what is already widely appreciated that, “Australians are increasingly dissatisfied with private health insurance, and policy reform is urgent.”
“Premiums are rising much faster than wages or inflation. People are dropping their cover, especially the young and the healthy. Those who are left are more likely to get sick and go to hospital, driving insurance costs up further”.However any review of PHI should start with an analysis of the failure in our efforts to have a public health system providing timely quality health care to all on the basis of need rather than financial wellbeing. PHI arrangements are symptoms of this failure. (more…)

Shadow health minister, Catherine King, in an address to the National Press Club, has detailed the major health initiatives Labor would embrace if elected in May. Her plans indicate that she has heard and accepted many of the priorities for reform proposed by would be health reformists. The status quo is unacceptable. Most encouraging was her recognition that patient-centred reforms, which must include truly integrated care, was impossible if the current jurisdictional division of responsibility for health care continued. The portfolio of reforms she presented are welcomed and would be readily understood by electors if they could hear these plans. Fears were expressed at her presentation that totally unjustified scare tactics about boarder security might so dominate election debates that these important promises might get little attention. Certainly there has so far been very little media reporting on the health initiatives announced with some of the few comments made by journalists suggesting they did not understand the proposals.

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Our health care system provides, at least for metropolitan based Australians, world class management of medical emergencies. A stent in a coronary artery in the middle of the night can save a heart in danger and our dedicated stroke units routinely dissolve blood vessel blockages that could have proved fatal or caused major permanent disabilities. While we can be grateful for these interventions the reality is that the management of the majority of health issues that trouble us do not meet this standard of excellence. (more…)

The artemisia annua plant has been used for centuries in China to fight malaria. In 2011 a Chinese scientist, Tu Youyou, discovered how to extract the ingredient responsible for the anti-malarial effect (now called Artemisinin) and her reward was a Nobel Prize. Where there is good anecdotal evidence that something in a herb or plant can help with certain diseases, it’s more than appropriate for modern scientific techniques to be used to try and identify, purify and standardise the responsible chemical. This has nothing to do with the concepts associated with Traditional Chinese Medicine (TCM).  Many of the drugs we use today are derived from plants thought to have medicinal properties in numerous cultures. (more…)

Remarkably and unfortunately politics, not clinical effectiveness, is powering the global penetration of Traditional Chinese Medicine into health care systems. The term “Traditional Chinese Medicine” (TCM) was dreamt up by Chairman Mao Zedong in a cynical response to the Communist Party’s inability to provide evidence-based health care for the then 500 million Chinese. Mao knew that TCM was largely useless and was derogatory about TCM practitioners but he none-the-less set about its expansion. This saw a reversal of a progressive acceptance of scientific medicine in China which started in the 19th century.  (more…)

The child was six years old. His parents were struggling to manage his Diabetes. He had Type 1 diabetes, the most serious form of the disease caused by his own immune system destroying his pancreas. As a result he could no longer produce required amounts of Insulin to control his blood sugar levels. Regular injections of Insulin were keeping him alive. The heartbreaking tragedy that descended on this vulnerable child and caused his death involved the practice of “paidalajin”, an alternative Chinese medicine technique that involves slapping, pulling and stretching the skin until it bruises.

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Without acceptance of a ten year plan and the creation of an instrument to implement that plan we will not be able to engineer the evidence based structural reforms to our health care system that will improve quality, equity and cost effectiveness. (more…)

Without acceptance of a ten year plan and the creation of an instrument to implement that plan, we will not be able to engineer the evidence-based structural reforms to our health care system that will improve quality, equity and cost effectiveness.  (more…)

Touted by Minister Hunt as the biggest health care reform initiative since the introduction of Medicare, the “Health Care Home” model for the better management of patients with two or more chronic diseases is floundering, beset with predictable organisational and resource inadequacies. As is so often (too often) the case with health policy initiatives, a laudable concept collapses at the implementation phase (e.g. Primary Health Networks). The boldness of the plan is not matched by the necessary resource boldness.   (more…)

On May 3, Health Minister Greg Hunt spoke at a conference organised by the Pharmacy Guild of Australia. This is the pharmacy owners association (all pharmacists) which in 2011, notoriously, entered into a deal with the vitamin and supplement provider, Blackmores, to have 5000 pharmacies try and sell a Blackmores’ product to clients picking up prescription medicines. Once revealed the subsequent opprobrium, of course, resulted in the deal being cancelled. (more…)

Australia’s health “system”, such as it is has two “Achilles’ Heels”. The left one is our lack of emphasis on the prevention of disease while the right one concerns our incompetence in integrating health services in a patient-focused way. Both were on vivid display recently with the release of a new report by the  “Australia’s Oral Health Tracker”. (more…)