Category: Health

Every Australian owes a great debt to John Deeble who died this week in Canberra, aged 87. Together with Dick Scotton he provided Gough Whitlam from 1967 onwards with the essential advice on how to establish a compulsory public insurance health program – Medicare. The result was Gough Whitlam’s triumph in government on 7 August 1974, in a joint sitting of the parliament, to establish Medicare. The scheme started on 1 July 1975 when Medicare cards were issued to all Australians.

We now have one of the best health schemes in the world, although it clearly needs renovation. Without John Deeble it is hard to visualise how Medicare would have been possible. (more…)

As responsible adults we need to do all we can to ensure that our young are provided with the best opportunities to live purposeful, fulfilling lives and are encouraged to partake of these opportunities. We need to strive to provide them with an optimum set of values and attitudes, and an environment in which they will make lifestyle choices that will enhance their physical, mental and social wellbeing. There is the question of alcohol and its place in our society.  (more…)

None of the “wicked’ problems in health – obesity, mental illness and suicide, chronic illness, ageing – will be solved with just hospitals, doctors, nurses and prescription pads. They all require resources beyond those provided by the health care system. That’s not news; there are very few health professionals who deny the impact of the social determinants of health on health outcomes and health care costs and the importance of linking into social services. The challenge is how to achieve this. In essence – how do we move the focus from general practice and primary care to primary health care? (There is a difference: see Primary care vs Primary health care: and who cares?)  (more…)

Medical oncologist Jonathan Page says being more in the moment helps him to be a better doctor.  His relationships with his patients were once characterised by “coldness…. and a lack of grieving”.  But a mental health crisis that led him to Buddhist meditation helped change that. 
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The Australian Institute of Health and Welfare (AIHW)  has released its Health expenditure Australia 2016–17 report. This report contains detailed data on expenditure throughout our health system and is a valuable resource for governments, policy makers and health stakeholders. (more…)

Public and private health expenditure amounted to 10.3% of gross domestic product in 2016-17, almost exactly the same percentage as in 2015-16, according to figures released today by the Australian Institute of Health and Welfare. (more…)

With the recent announcement of a Royal Commission into Aged Care, debate is raging in the aged care sector and beyond as to whether it is really needed.  (more…)

The Royal Commission announced this week will have a full agenda. If it can help us get aged care back on track we will all be the richer. (more…)

“Each Australian story I’ve heard is etched on my heart, permanently shifting my views and perspectives on leadership. I pray that you also have the humility to silence the chatter in your own minds and be inspired by the people you represent.” (more…)

Sheila holds 10 teaspoons in her hands and every time the cooker whistles, she puts one down.  After 10 whistles, she switches the cooker off. The rice is done. She takes down two pots and prepares one of the five vegetable dishes she remembers. When dinner arrives at the table, there are two places set for five people but she is resolute about particular people being assigned particular plates. There is to be no intermingling or sharing of plates; everyone must know their plate and place at this table.   (more…)

12 September)marks 40 years since the World Health Organization member countries gathered for the International Conference on Primary Health Care in Almaty, Kazakhstan, and signed off on the declaration of Alma-Ata. (more…)

Over 40 years ago, I was fortunate to do some of my paediatric training with Berry Brazelton. He wasn’t famous then, but there was something about him that set him apart from the purely organic focus of most of the senior staff at Boston Children’s Hospital. He was interested in babies as individuals with their own sets of skills. Here was a paediatrician prepared to question the status quo about the abilities of infants and young children who based his views, not on the prevailing dogma, but on careful observation. He was the first to recognise that a baby is a highly developed human, even when just newly born. (more…)

New medications are increasingly expensive. In Australia, where the Pharmaceutical Benefits Scheme (PBS) covers the vast majority of prescription medications, the spiraling cost of medicines has a significant impact on the sustainability of our health system.  In countries where patients are required to contribute substantially to the medicine cost, high prices can negatively influence their health outcomes.  (more…)

The 10^th September is recognised as World Suicide Prevention Day.

“The burden of suicide does not weigh solely on the health sector; it has multiple impacts on many sectors and on society as a whole. Thus, to start a successful journey towards the prevention of suicide, countries should employ a multisectoral approach that addresses suicide in a comprehensive manner, bringing together the different sectors and stakeholders most relevant to each context”. Director-General, WHO Preventing Suicide: A global imperative, 2014. (more…)

In 1974, the Whitlam Government decided to exclude dental care from Medicare for two reasons.  The first was cost. The second was political in that Gough Whitlam felt that combatting the doctors would be hard enough without having to combat dentists as well.

Forty-four years later, with Australia much richer and the proven success of Medicare, it is now time for dental care to be progressively included in Medicare. (more…)

Few challenges are a greater threat to the health of Australians than obesity. Weight gain has now become the norm—the biological and social path of least resistance. Within a decade and without significant government intervention, more Australians are expected to be obese than normal weight.  Opportunities to stem the tide of obesity do exist – we have the evidence and largely we know what to do. Here is an evidence-based five-point policy plan, a lifeSPANS approach, that focuses on our kids to move the health agenda forward. (more…)

Every day we hear stories about innovation in health care – new drugs, new machines and new tests that will help us live longer. We have got used to thinking that any improvements in health care will come at a price – often a big one, given the years of development and testing needed to bring the innovation to market. (more…)

The noisy public debate about patients’ out-of-pocket costs and their consequences reaches a crescendo when it comes to oral health and dental care. (more…)

Variation in rates of obstetric intervention, including caesarean section, were recently cited by the Grattan Institute’s Dr Stephen Duckett when suggesting that a new Code of Conduct for doctors should include a focus on over-intervention.

In the article below, Emeritus Professor Lesley Barclay AO, Professor Hannah Dahlen and Dr Nigel Lee argue that concerted efforts to reduce caesarean section rates in Australia would bring benefits for women, babies and those who fund health services. (more…)

Treating personal drug use as an administrative offence along the lines of a parking violation has worked well for Portugal. It has not only been a public health and public policy success but also a political one. (more…)

Australia’s drug policy regime is ruining people’s lives and causing more misery and cost than it saves.  A new approach is needed, one that is evidence based and recognises the personal, social and economic benefits of policies other than mere prohibition and law enforcement.  With good leadership and open-minded public debate, we can do better. (more…)

Current drug policy is based on the unrealistic belief that we can stamp out possession and use of illicit drugs, much like prohibition of alcohol in 1920s America.  It also fails to account for the harm caused by our strictly punitive policy approach. (more…)

This is mostly a personal story, about my son Damien, who died from heroin use in 1997, at the age of 23.  I feel sure that his death could have been avoided if we had at the time an approach to drug use that was based on harm prevention rather than punishment. (more…)

Every day people are imprisoned for drug-related crimes in line with ‘tough on drugs’ policies. It’s time to face the futility and unsustainability of this approach to drug use.   (more…)

Australian prisons are severely overcrowded. Much crime is drug related. Some 75% of prisoners have a substance abuse problem. The majority of prisoners are not rehabilitated by their prison experience as evidenced by high recidivism rates, particularly for First Nation people. A holistic, whole of community response is required founded in restorative justice and justice reinvestment. (more…)