Health outcomes are about more than access to healthcare services: they are highly dependent on the social and economic determinants of health. Despite lip service to the importance of these factors and preventive health actions, the Australian healthcare system is relentlessly focused on treating sick people, with subsequent economic and social costs incurred by governments, society and individuals. (more…)
Category: Health
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Neoliberal learning: Horses for courses and donkeys in the paddock
This series is built on the firm belief in “a paradigm of care” being the answer to the cancer of neoliberal economic rationalism, and its bedfellows bullying managerialism, monetarism and compliance surveillance. But following the maxim that “no one likes a whinger”, I am also advocating the timeless message from Swiss American psychiatrist and expert “On death and dying”, Elizabeth Kubler-Ross: “If what you have been doing hasn’t been working, do something different!” (more…)
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X-raying the architecture of empire and removing some tumours
Anyone having to deal with the health and human services industries knows how rigidly they are controlled by the Medical Model and its sister act, Compliance Surveillance. What goes unnoticed in this mechanically e-captive state of affairs is that the dominant model of assessing and accrediting the quality of care is only one approach to monitoring “patient outcomes”. There are other ways of checking and reporting on how things are going beyond the objectifying, scientistic, reductionist world of “stats”. (more…)
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Trump’s decision to withdraw American support for WHO is a huge mistake
It only took a week for Donald Trump to have America looking like Belarus as a dictator, helped by totally subservient politicians, put governing in the hands of unqualified, unintelligent loyalists. As one commentator asked this week “When did brains go out of fashion!” (more…)
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Working for Whitlam
Future MP Race Mathews had an insider’s view of policy development — not least health policy — in the office of the leader of the opposition. (more…)
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Should we believe a Mediscare campaign?
For the last two and a half years the opposition under Peter Dutton’s leadership has avoided virtually any concrete policy commitments in the health area. What happened last time the Coalition won government, when Dutton became health minister? (more…)
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The great mental health experiment … and why it went so wrong
Half a century ago, governments around the world ditched their old psychiatric hospitals for something they said would work better. It didn’t. (more…)
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Is there much life after age 80?
More people live longer as life expectancies grow over the decades. For example, in 1900, the worldwide average life expectancy (defined as the average number of years remaining) was 32 years. By 2024, it is now 73.3 years. A commonly-asked question is how much life is left for those of us aged 80 and above? (more…)
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Another wrongful conviction? UK nurse Lucy Letby may be a scapegoat for an under-funded NHS
In August 2023, nurse Lucy Letby was convicted of the murder of seven babies and attempted murder of six babies in the neonatal unit of a UK National Health Service (NHS) hospital. The Australian media has reported on the current instalment of the saga (viz. a judicial inquiry into conditions at the hospital where Letby worked). (more…)
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Addressing misdiagnoses and gaps in Australia’s COVID-19 inquiry
The national report on Australia’s COVID response is long, at 877 pages (depending upon the format), with 4,647 footnotes. But long is not synonymous with comprehensive, and there are significant gaps in the report’s analysis and conclusions. (more…)
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They destroyed what was inside us: The children of Gaza
From the day the war began, 15-year old Ghazal’s life was irreversibly changed. “They destroyed what was inside us,” she said. Her story is a window into the larger tragedy of how war has devastated children, especially those with disabilities.
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‘No appeal from the grave’ Phillip Hughes, workplace deaths and getting the balance right
The death of cricketer Phillip Hughes ten years ago to-day (November 27) was one of several hundred workplace fatalities in 2014. (more…)
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COVID 19 Response Inquiry Report: A comprehensive review despite its limited terms of reference
My recent review of the book, Australia’s Pandemic Exceptionalism, by Steven Hamilton and Richard Holden (H&H) highlighted its ‘convincing, frank and honest account’ in just over 200 pages, and encouraged the Health Department in particular to listen to its lessons. The official COVID-19 Response Inquiry Report by Robyn Kruk, Catherine Bennett and Angela Jackson ( KB&J) may lack H&H’s punchiness but is an equally impressive document that deserves careful reading not only by Health but across the Commonwealth and the States. (more…)
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Health Department: Listen to these lessons from our COVID 19 experience
A review of Steven Hamilton and Richard Holden, Australia’s Pandemic Exceptionalism: How we crushed the curve but lost the race, UNSW Press (more…)
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Health and Human Security: a sense of control over one’s life
It is time to think more broadly about security than the narrow military concept about which there is endless debate. (more…)
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Putting the mouth back into Medicare
How would it be to walk into a general practice with a toothache and be triaged to see the oral health therapist, who assesses and then develops an oral health care plan? They are then qualified to provide dental treatment but may also involve a GP or dentist across the corridor for further assessment. It is time to dream this could become a reality if Labor is prepared to embrace the mouth, gently. (more…)
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Trump victory increases hazards for climate and global health
The well documented and steadily increasing health problems globally, directly associated with climate change, have been discussed with appropriate alarm by many expert contributors to P & I. (more…)
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Reform starts here: APA welcomes the final report of the scope of practice review and its potential to transform primary care
The Australian Physiotherapy Association (APA) welcomes the final report of the Scope of Practice Review, Unleashing the Potential of our Health Workforce, which outlines robust solutions to overcoming barriers limiting high-value care across settings. (more…)
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Conflicts of interest and the subconscious mind
In recent days, our media have covered two “scandals” involving allegations against public figures of failing to adequately address identifiable conflicts of interest. (more…)
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Facing an aging population and financial challenges, hospitals in China are converting to senior care facilities
I have always had an interest in reading local official research documents. First, compared with the central level document, it provides a more “grassroots angle” of viewing problems and the way they get things done. Second, it is enriched with cases rather than theories. It’s just more practical. Third, it has a specific format and is easy to read after you get familiar with it. For today’s episode, I bring the study made by the Luoyang government in Henan province (in the very middle of China). It studies the transformation of “Secondary hospitals“ in the region and gives some policy suggestions to the Luoyang government.
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Rescuing hospitals
The nation’s public hospital system is sicker than it looks. There are practical, affordable ways to make it better — but not if governments go on doing the same things. (more…)
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The question of voluntary assisted dying in dementia is not simple
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Restoring universal health care in Australia
Listen to Australian Community Futures Planning (ACFP) Founder, Bronwyn Kelly, interview Ian McAuley about the prospects for restoration of universality in Australia’s health care system. (more…)
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How well is Australia doing on wellbeing?
The Australian Government has established ‘Measuring What Matters’, Australia’s first national wellbeing framework. It follows similar frameworks in SA, Victoria and the ACT, and one under development in NSW. Will these frameworks help to improve psychological wellbeing in Australia? (more…)
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A campaign to raise awareness of aged care star ratings is wasting public money
Last week the government launched a media campaign to “build awareness, trust, and use” of the system of aged care star ratings. (more…)
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Singing from the same hymn sheet – solutions for mental health care in Australia
At a time when there is a surge in mental health disorders in young Australians of 47 per cent over 15 years and the health system is struggling to cope with the growing complexity and demand, multidisciplinary solutions are being proposed between the Royal Australian and New Zealand College of Psychiatrists, the Australian College of Mental Health Nurses and other consumer and health professional groups. (more…)
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The conveyor belt for terminally ill older people
The default for people who are older and near the end of life when they suffer an acute deterioration is often hospitalisation. They are placed on a conveyor belt – ambulance, Emergency Department (ED), hospital, often ending up on life support in the intensive care unit. (more…)
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Behind the headlines on Australia’s ‘top performing health system’
It is quite challenging to reconcile headlines like ‘Record number of Australians raid super to fund medical treatments’ with a health minister’s statement claiming, ‘Medicare top performing health system in the world’. (more…)
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Aged care reforms unfair, unreasonable, unsustainable
Bipartisan agreement between the government and opposition have resulted in compromised, ageist inflected amendments to aged care legislation that do not respond adequately to the damning findings and reasoned recommendations of the royal commission. (more…)
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Nurse-led clinics: getting a return on your taxpayer dollar
It is disappointing, although hardly surprising, to see the medical organisations in July of this year trotting out their opposition to anything other than GP-led primary health care in both Queensland and the ACT; and then (again in a September media release) to see that remarkably (or maybe predictably) the RACGP is restoking its outrage about the ACT clinics. (more…)