Indigenous health, medical and public health experts have raised wide-ranging concerns about the Federal Government’s changes to university funding that will increase the costs for students taking humanities courses.
Their criticisms follow calls by health professionals earlier this week urging the Federal Government to abandon plans to increase charges for humanities courses, arguing that these studies make a vital contribution to health and to the work of the health sector.
Julie Leask, Professor in the Susan Wakil School of Nursing and Midwifery at the University of Sydney, said she was “deeply disappointed” to see the Government devalue the humanities, and described the importance of humanities disciplines in addressing a range of health issues.
“Science might help us develop life-saving technologies and medicines. But it cannot tell us how best to distribute and use them; how to address the complex ethical challenges they bring us, and how to look to the past to help us to wisely plan for the future,” she said.
Dr Arnagretta Hunter, a cardiologist and consultant physician and a Human Futures Fellow at ANU, said the skills from the humanities are central to developing good health policy, good hospital policy, and good patient care.
Dr Nick O’Connor, a psychiatrist in NSW, said the pandemic had brought home to him the importance of the humanities and arts to a holistic understanding of and response to this epoch-changing event.
Professor Bronwyn Carlson, head of the Department of Indigenous Studies at Macquarie University, said she was shocked by the increased charges for humanities subjects.
“In the world we have seen a rise in white supremacy thinking and we have seen that here too,” she said. “Humanities provides students with critical thinking skills which is dangerous when you want everyone to tow a particular line. That is why Indigenous Studies is so very important. It has always provided the counter narrative and assisted students with the ability to understand how society functions and how power operates.”
Indigenous Allied Health Australia (IAHA) has raised concerns about the impact of the funding changes on social work, Indigenous studies, and other important areas of study in the humanities.
The move “contradicts the overwhelming need to build the mental health workforce and provide support for other professional pathways important to Aboriginal and Torres Strait Islander Peoples, such as rangers and cultural advisors”, IAHA said in a statement.
Jon Wardle, Professor of Public Health at Southern Cross University at Lismore, said the damage extended beyond the impact on the humanities:
While humanities have the headlines, this is a disastrous reform even for those areas that the Government has deemed worthy of student incentivisation through reduced student contributions. Someone is paying for the new places, and it is not the Government.
In fact the Government is paying less, and universities are expected to train more students with less money…
Nearly every other country in the world has viewed its university sector as something that should be supported as part of the COVID response, particularly because the university sector is essential for finding the solution to recovering from COVID.
The Australian Government has not only chosen not to support the sector, it has chosen to use the COVID crisis to actively attack it.”
This is the second in a series of compilation posts of health sector responses (see the first one here).
Below are responses from Dr Michelle Johnston, Kristy Schirmer, Professor Bronwyn Carlson, Professor Julie Leask, Terry Slevin, Dr Gemma Crawford, Dr Nick O’Connor, Dr Cathy Fraser, Dr Arnagretta Hunter, Dr Tristan Kennedy, Professor Jon Wardle, Dr Claire Hooker, Associate Professor Lesley Russell, and Dr Jill Gordon.
Great cultures are built on great humanities
Dr Michelle Johnston
Dr Michelle Johnston is an Emergency Physician at Royal Perth Hospital, situated on the magnificent land of the Noongar people of the Whadjuk nation. She is also a novelist, having published her first, Dustfall, in 2018, about medical error and the legacy of Wittenoom. On a good day it is difficult to tell the difference. She is passionate about equity and education in medicine, but mostly just specialises in trauma and mess.
Q: What is your view on the increased charges for humanities subjects?
I view the recent decision as a grave turn. In times of turmoil, such as those we are currently facing, there is a temptation for knee-jerk decisions; a kind of scramble to stoke the economic fires and appease those clamouring for tangible, measurable solutions, but this is exactly when long term thinking, and planning, is necessary. To hike fees for university subjects and courses not deemed ‘job immediate’ is the type of instinctual reaction which may flare with some sort of common-sense at the time, but is, in fact, deeply damaging in the long run.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
Medicine is unutterably complex. The scientific knowledge that underpins it is so vast, and so rapidly evolving, that no single brain can get their heads round its totality. This is why we specialise. But this also means that medical school has its work cut out for it just trying to keep up with the behemoth of scientific understanding. The room is small for humanities. So, in the first place, the doors need to be open outside the medical curriculum for other subjects, courses, hell – whole other degrees, that permit those in purely scientific endeavours to come to grips with the elements that are complementary, and necessary, to the practice of medicine. Social and public health. Research and communication. Art and literature and empathy. But this is not just about those studying in medical fields, it is for all those who intersect with health. Broad education means high level literacy across multiple areas. The list of who benefits is long, and, in the end, may be all of us.
Q: What will be the implications for Indigenous Studies and related courses at your institution or more generally?
Australia is at a crossroad. Time is up for the way we have always done things, wallowing in a colonial past, sweeping over racial injustice and barrelling forwards with the policy of most good things being only accessible to white, wealthy, new Australians. Losing an inch of Indigenous education is unconscionable. We have an opportunity to build on our slowly opening eyes, and make Indigenous and cultural studies even more fundamental to what we do and who we are as Australians. This is particularly so in health.
On that topic, of course, the government will argue that they are not removing humanities degrees. No, they are not. They are simply making them unaffordable to huge swathes of the generations who are going to take on all the mantles of society, once again, leaving these subjects for the rich only. Not equitable, not fair, not right.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
I am of a certain, slightly creaking, age, and can remember when we only had medical students come through our hospital who were admitted to medicine on academic marks alone. Indeed, I was one of those. I tutted, and made disapproving noises when the entry criteria to medicine changed, first to interview (looking for those elusive human skills), and then, quelle horreur, medicine becoming a post-graduate degree, with medical students steeped in higher learning about broad human topics before they dissected a formaldehyde soaked one. I can say, with a certainty beyond measure, that the medical students who have studied humanities, worked in humanities, lived a life of humanity before entering medicine are equipped incalculably better to deal with the complexity of medicine; they are better thinkers, better doctors, better humans.
Q: What is your advice to the Government on the recent announcements?
Leadership is difficult; leading for a future, when so much is uncertain, is even more so. But investing in the humanity of the next generations, is the only way to leave a legacy. And investing in the study of humanities, our human-ness, is the straightest path to get there.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
It is easy, in a way, to argue for the value of studying the humanities – the subjects which integrate the human into every other aspect of the world – make them comprehensible, give them any sort of context. What is more opaque, but arguably more important, is the leadership that’s required to be able to see the broader picture. To see what we do now is only planting seeds for future generations. To have the ability as leaders and politicians to say, I believe in something greater than now, my term, the next economic cycle. Great leaders beget great cultures, and great cultures are built on humanities. The open, supported study of humanities may be the only thing to get us through.
Social engineering
Kristy Schirmer, Principal Consultant, Zockmelon Health Promotion and Social Media Consulting (www.zockmelon.com.au), Co-Founder Australian Public Health Consultants Network.
Q: What is your view on the increased charges for humanities subjects?
I am appalled by this social engineering. A conservative government who increases the cost of humanities education by 113% – those subjects that teach sociology, political science, journalism, literature, and Indigenous-focused topics (and so much more). It’s almost like they don’t want young people exposed to ideas that encouraging questioning of governments.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
A health promotion adage is that it is both a science and an art. A real concern is that students will be coerced through this economic disincentives to focus on the science side of health promotion and neglect the education offed in arts and humanities.
The IUHPE Core Competencies and Professional Standards for Health Promotion place emphasis on skills including collaboration across a range of stakeholder groups, communication and advocacy strategies, and culturally safe and empowering practices. These are not skills that can be acquired through engineering electives.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
Above all else, we need health promotion and public health practitioners who understand that health is political. I would expect that most Health Science courses will have core topics which examine the social and political determinants of health. I remain hopeful that Health Science graduates won’t be entering the workforce with an absolute positivist approach to public health. However, other essential competencies to improve health such as communication, political advocacy and marketing are going to cost a greater chunk of change.
Q: What is your advice to the Government on the recent announcements?
Read the room. Humanities and arts are critical to a vibrant and healthy society.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
In my undergraduate degree in Health Sciences, we were able to choose electives from a range of disciplines. One of the most impactful topics I took was from ‘up the hill’ (Flinders University Sturt Campus students will understand this reference) and enabled me to actually learn some Indigenous history and politics that I hadn’t learned during my schooling.
Problematic on so many grounds
Professor Bronwyn Carlson, Head of the Department of Indigenous Studies, Macquarie University
Q: What is your view on the increased charges for humanities subjects?
I was pretty shocked to see this announcement. It is pretty evident that humanities provide a lot and given the PM’s lack of knowledge about history here in Australia I would say even more so now. While shocked, sadly not surprised. In the world we have seen a rise in white supremacy thinking and we have seen that here too. Humanities provides students with critical thinking skills which is dangerous when you want everyone to tow a particular line. That is why Indigenous Studies is so very important. It has always provided the counter narrative and assisted students with the ability to understand how society functions and how power operates.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
Health is of course so very broad when we are thinking about Aboriginal ways of understanding it. Humanities provides the knowledge and tools to understand how society operates. How race and racism function and how power is used to maintain the status quo. This is important for health related research and policy. We know fabulous work is being done on the ground in communities who understand what is needed and how to work with local people. I worked for a number of years in my local Aboriginal Medical Service. Policy mostly misses this and operates through a lens that doesn’t always benefit Aboriginal people at all. What Indigenous Studies offers is a better understanding of Aboriginal and Torres Strait Islander ways of knowing, being and doing.
Q: What will be the implications for Indigenous Studies and related courses at your institution or more generally?
Personally I believe people will still enrol in Indigenous Studies and other Humanities disciplines. It is well known and evidenced that employers value the skills we provide. From the feedback we receive from students we know Indigenous Studies transforms lives. The implications will be the cost that students will have to take on to receive an education that many of our politicians got for free. It will mean students will be in debt for longer and take many years to pay off student loans and HECS. For Indigenous students this will be difficult and costly and cause much hardship. Generational wealth is not something that is significant in our families and this decision will ensure that our economic disadvantage continues. It flies in the face of the government’s own Close the Gap targets. It shows just how unstable their decision making is in relation to their commitment to Indigenous peoples.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
It is well documented that health and medical professions have not always considered Indigenous people’s understandings of health and wellbeing or the impact of colonialism, structural racism, poverty and trauma. Humanities and particularly Indigenous Studies does this hard work. I have known a lot of health professionals who have had the opportunity of working in Aboriginal Medical Services and all of them say it is the best thing that ever happened to them. They speak of what they have learned and often comment that this is how health should be provided. Non-Indigenous people can learn a lot from us and how we care for each other and our communities. Understanding health from our perspective totally shifts the focus.
Q: What is your advice to the Government on the recent announcements?
To seriously rethink this move. I fear it is strategic however. Whenever too many people take up Arts, Humanities, Indigenous Studies they begin to question the world – which is the best thing we can ever do. This is counterproductive to maintaining power however and protecting those with privilege. The Black Lives Matter global movement has brought attention to the appalling conditions here in Australia also. It has shone a light on police brutality and also on our health systems. The recent case at St Vincent’s where a young Indigenous woman was left out on the streets although barely conscious and very ill. Staff commenting that care was not provided or warranted because it was behavioural. This highlights the levels of racism and structural violence Indigenous people have to deal with. Governments should be listening to the issues, not denigrating those who took to the streets to protest and framing them as un-Australian and a risk due to the coronavirus.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
Students will still enrol in Humanities. If you are interested in Arts, Humanities, Indigenous Studies you are not going to change your mind and become a nurse for example. Our government has lowered the cost of studying nursing while at the same time attempting to freeze their pay. There is too much hypocrisy. I saw a Tweet the other day by Tanya Plibersek and then Bill Shorten talking about if someone gets the “right marks” they should be able to go to university. Arts, Humanities and Indigenous Studies often provide a bridge for people to get to their dream of studying other disciplines too. The “right marks” doesn’t equate to successfully completing a degree. It is another way of saying some people don’t deserve to have access to education. This is appalling given how many politicians have Humanities degrees that they were afforded the opportunity to get for no cost. Investing in education is investing in futures.
Deeply disappointed
Julie Leask, Professor in the Susan Wakil School of Nursing and Midwifery at the University of Sydney
Q: What is your view on the increased charges for humanities subjects?
I am deeply disappointed to see the government devalue the humanities in this way. Females are more likely than males to enrol in humanities degrees. This decision adds to a range of recent policies that de-value women. It also says that government idealises a technocratic society without recognising that people should also flourish in that society. Science might help us develop life-saving technologies and medicines. But it cannot tell us how best to distribute and use them; how to address the complex ethical challenges they bring us, and how to look to the past to help us to wisely plan for the future.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
In our work on pandemics and immunisation, we routinely use scholarship from the humanities. If we look at how to balance individual liberties with social goods like disease control, we turn to moral philosophy. If we look at how societies have previously managed then recovered from pandemics, we can delve into rich historical work already done to find rapid answers.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
We look to solve complex problems in public health: anti-microbial resistance, pandemics, low immunisation rates, inequity in access to health care and so forth. Multidisciplinary teams are the best for solving these problems because they bring a range of lenses. In my teaching at the Sydney Nursing School, I routinely turn to the humanities to help teach things like ethics in research, learning how the past affects First Nations people, and the epistemological traditions that underpin qualitative enquiry. Without them, my teaching in these fields would be superficial and inadequate.
I have supervised students with backgrounds in documentary making, history and philosophy. They always bring a fresh angle and scholarship to their public health study. They make important contributions to scientific fields.
Q: What is your advice to the Government on the recent announcements?
I urge senators to think carefully about what passing this legislation would say about their sense of what makes a balanced society.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
My daughter faces having to pay more than twice for her degree than my son. This communicates to people like her that their interests and skills are less valued by this government.
Poor policy
Terry Slevin, CEO of the Public Health Association of Australia
The recent changes announced by the Federal Government have unfortunately some winners and some losers. It is important to acknowledge there are benefits in cheaper tertiary education for people study in areas like the environment and science. However, an increase in cost and therefore a disincentive for students to study in some areas, including the humanities.
As a principle PHAA supports greater access to tertiary education for all Australia’s and opposes efforts to create disincentives to study any particular discipline.
Public Health is a very multidisciplinary workforce which draws strength from that diversity. Understanding, characterising and addressing the important social influences on the health of individuals and the community is often led by those with humanities training.
Similarly those with humanities training make vital contributions to areas as diverse as fundamental critical thinking, health policy development and analysis, qualitative research, the ethics of health care, effective patient communication, the understanding of power and influence in health investment and decision making, the influence of culture on health decision making and outcomes and much much more.
Excellence and diversity in tertiary education in Australia is a fundamentally important building block to an effective health system and vital to the advancement of public health.
Price signals picking “winners and losers” is a poor policy option that should be reconsidered.
A retrograde move
Dr Gemma Crawford, president, Australian Health Promotion Association
Q: What is your view on the increased charges for humanities subjects?
I think that it is a retrograde move. Universities are not, nor should be, job factories. Regardless of intention, this signals that studying humanities is not helpful for careers which I believe is erroneous. It is my personal and professional experience that this background is enriching for any future career and that it often provides transferable skills prized in many graduate programs from public health to finance and policy. It also seems to me that studying the humanities has been a pathway to many of the senior roles in politics and in government, so curious then-are we seeking fewer politicians and bureaucrats?
I absolutely believe that we should be clearing a path towards greater student participation in STEM courses and careers – but not at the expense of humanities. Surely there is a strategy where in raising up some career pathways we don’t have to obliterate others.
This will impact some universities harder than others, some students harder than others, but it will impact on all of us equally if humanities are not protected and raised up as critical to our collective future. It may also have a more material effect on choice of university which may impact on a number of universities already struggling post COVID-19.
Are we actually saying that only those that can afford it can study humanities? Does this create further inequities-those who cannot afford the increased fees are funnelled into only choosing direct career oriented degrees and have no ability to be exposed to other disciplines? Even with any subsidies and different models of funding, will it perhaps be the case that if science degrees cost less (or there is less student contribution), will there also be less teaching related income to support institutional research?
Are we suggesting that the humanities becomes the whipping boy for post COVID-19 recovery? I think this is unjustified. Will humanities ostensibly act to cross-subsiding sciences and health? Are we also saying that a student who is gifted towards an arts subject should be punished by either paying more or –being pushed towards courses where they may not have aptitude and where there is the subsequent risk of attrition from courses and higher education entirely. What a loss to us all if this is the case.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
Winslow defined public health as “the science and art of preventing disease, prolonging life and promoting human health through organized efforts and informed choices of society, organizations, public and private, communities and individuals.” These organised efforts and this art is not achieved without engagement in the humanities. It would seem then, that unless we engage in, and invest in the art we cannot achieve public health’s raison d’etre. It also speaks to the important, delicate and symbiotic relationship between the science and the art. It is my belief that it is the relationship between the humanities and the sciences that produces the answers to many of our messy, complex and live questions.
Certainly my experience working in HIV and my understanding of the history of this area is that without the humanities which often stemmed from backgrounds in humanities we may not understand the contexts in which HIV acquisition occurred or in which knowledge and attitudes were conceived. I do not believe we would sufficiently understand perspectives of policy, the benefits of bi-partisanship and the real, positive impact of partnerships between government, clinicians, researchers, advocates, community and affected groups or about the powerful role of advocacy and social mobilisation. Without human geography we may not understand the impacts of population mobility on HIV acquisition. Without law we may not understand the frameworks that protect or discriminate against vulnerable populations. Without politics we may not have understood the levers to affect political change in relation to HIV policy.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
As someone who coordinates postgraduate health promotion and public health course I welcome students from degrees as diverse as marketing, foreign affairs, political science, medicine, education, dentistry, economics, theatre, creative writing. This makes for a richer learning experience, for well-rounded graduates who are able to tackle wicked problems. I believe it can lead to greater preparation for postgraduate studies in public health as students are not tied a biomedical paradigm or a particular health discipline. Of course this is not to suggest that those from health sciences or sciences do not thrive in public health. But I think given the nature of the work in public health and the complexity of the issues that we are seeking to address that the wider the range of perspectives brought to the table the better for our critical thinking, debate and problem solving. As the argument for prevention and for action on the determinants of health becomes overwhelming it is clear that issues will not be solved in one sector or on discipline alone. Ability to act as boundary spanners, across sectors and disciplines will become increasingly important.
Q: What is your advice to the Government on the recent announcements?
Studying a degree takes at least 3 years. The government is craving skilled workers now. Young people need jobs now. There has to be another solution that addresses these broader policy failures, COVID-19 notwithstanding. An attack on humanities is not it.
There are no guarantees that there will in fact be the jobs available for the graduates from the courses being promoted. Investment in career structures and pathways, graduate programs, incentives to support scientists to win grants in their home states, making more funding available for research etc will be critical if we suddenly see increases in the number of students choosing to enrol in those courses. A university and the education that it provides is key to developing good world citizens –and to contribute to the pursuit of knowledge that contributes to global peace and prosperity.
It is time to reflect on the modern Australian university and its critical contribution to these issues. As the first president of Johns Hopkins University, Daniel Coit Gilman spoke about his vision for higher education “It is a reaching out for a better state of society than now exists…it means a wish for less misery among the poor, less ignorance in schools, less bigotry in the temple, less suffering in the hospital, less fraud in business, less folly in politics; it means…more lessons from history…more health in cities…more wisdom in legislation…more happiness.”. I believe that this continues to hold as the true purpose of modern universities and modern society. To achieve this, study of the humanities is paramount.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
I remember once someone asked me what I would do with my BA. “After all” they asked, “isn’t it a BA for Bugger All?” I pondered this for a while. My parents were very clear on the role of education-it is uplifting regardless of the career you pursue and a grounding in a liberal arts degree can provide a foundation for the future. Surely the ability to study amongst other things English, Philosophy, Ancient History and Anthropology only contributes to an understanding of the human condition. Surely in order to understand where we are going in the future we need to understand our past. Surely many of the big ethical questions related to resource allocation, health and medical research, policy implementation would be supported by an understanding of philosophy. Surely the study of English and other languages supports communication that is critical in the modern world. As the events of the past 6 months have shown, now more than ever we need to understand the human condition, the lived experience and the social forces which shape the conditions that influence health.
Humanities critical for science
Dr Nick O’Connor, psychiatrist, NSW
I think the Government’s proposed changes to studying the humanities is very likely going to be counterproductive as it will incentivise the universities to enrol more students into the high paying Humanities courses. However, I am concerned by the Government’s intention to reduce graduates of the Humanities and Arts because I believe that these subjects are foundational to a liberal democrat polity and for that matter to the production, sense-making and application of good science.
Observing the pandemic has brought home to me how important the Humanities and Arts are to a holistic understanding of and response to this epoch-changing event. See this extract from a recent paper I’ve contributed to:
“By the third week of March 2020 COVID-19 cases had reached a peak in NSW and certain things have seemed obvious from that point. The world has changed to one of ubiquitous uncertainties. Everyone is now a stakeholder and an agent in the future. The pandemic presents a series of problems that are interconnected like pieces in a massive jigsaw. Due to the exponential nature of pandemics, crucial public health, economic and other decisions are analogous to a game of snakes and ladders: make the best decision and you reap a large benefit; make a poor decision and you may accrue a large setback. The pandemic has plunged medicine and public health, financial services and economics, governance, communication and leadership into epistemological crisis. How do we know the best course of action?
By the third week of March, the number of publications on COVID was rising (though not yet exponentially). Peer-reviewed journals are rushing out pre-press copy, and social, digital and traditional media are connecting and focusing knowledge sources from around the world. A global sentient web has been activated, focusing our collective consciousness, intelligence and memory. Clues to the pandemic puzzle are crystallising from the usual sources; medical science, epidemiology, mathematics, economics. We look forwards to these sources to provide us with the ‘knowable unknowns’. History and ethics tells when there are ‘unknown unknowns” and the ‘known unknowables’ a precautionary approach to planning and decision making is wise.
Other important lessons and clues are coming from the reaches of civilization and culture: history, literature, philosophy, sociology. Indeed, there is some intelligence and wisdom even in the noise and madness of social and digital media. For the ‘forgotten and unknown knowns’ we need to look back to the past and outwards to our current collective intelligence. While many commentators refer to the situation as “unprecedented”, actually, mankind has been here before.
So much of what we know about everything could be potentially connected in meaningful ways to particular problems that make up the jigsaw of the best pandemic responses.”
Vital for health and wellbeing
Dr Cathy Fraser, President, NSW Doctors Orchestra and retired GP
Q: What is your view on the increased charges for humanities subjects?
I am horrified that students are being discouraged rather than encouraged to study subjects in the humanities. Choice of study should not be influenced or controlled by government policy, based purely on current economics and political agendas, without a clear vision of the possible future impact. People should be free to choose their life’s direction in postgraduate education, free to further develop their areas of strength without being manipulated by government led incentives. Any meddling with direction of study now is bound to have a ripple effect for decades to come. We already have a dearth of support for the arts in Australia. Now the future looks even more bleak.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
The arts are vital in promoting health and wellbeing. Attending to health of humans incorporates knowledge in both health science and humanities. Medicine is not science or art. Medicine is both science and art. The same applies to other professional fields. Optimal healthcare relies on awareness, education, skill and experience in the humanities.
Education ideally prepares our youth for a life of personal fulfilment and useful contribution to society. Despite the government’s lack of support for the arts, we are a cultured nation. Pursuit of knowledge to advance our society needs to be broad and inclusive.
There is a battle to foster arts education even in schools. Universities are about further education. Academic subjects can’t be cleanly cut into either arts or science, split into humanities and non-humanities. (It’s inhumane to meddle with the nurturing of the humanities!)
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
Working in health care and health science requires maturity and life experience. That requires a broadminded approach, and a balanced lifestyle.
Q: What is your advice to the Government on the recent announcements?
Rethink! Plan for the future health of our communities. Decisions need to be based on optimal future outcomes rather than current economics. This is a backward step.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
In my 27 years of experience in doctors orchestras, regionally, nationally and internationally, I have witnessed the multitude of benefits that music study, practice and performance bring to medical students and doctors throughout their careers. Involvement in music offers significant help in doctors’ health care, an issue very much in the news with alarming rates of suicide in young health care workers. Since 1993, the Australian Doctors Orchestra has offered opportunities in a music community to a medics at all stages of their careers, from teenage students to retired doctors in their eighties. I founded the NSW Doctors Orchestra (‘Musicus Medicus’) in 2004, to further supplement such opportunities. Our mission statement is: Musicus Medicus aims to improve the health and well being of Australians by using the universal language of music to raise money for charities in medicine and the arts.
The University of Sydney established the joint music and medicine degree in 2006, in its 150th year. Our NSW Doctors Orchestra played at the university’s 150 year anniversary which launched this joint degree. This was a forward step. Recent announcements are a backward step.
There is a worldwide doctors orchestra movement, and many Australian doctors play in the World Doctors Orchestra regularly. I had the privilege of sharing in the experience in Washington and in Japan.
In addition, involvement with the Creative Doctors network over many years has demonstrated similar effects in a wide spectrum of the arts, including performance, all visual arts, literature, film making and philosophy.
I therefore believe that healthy doctors balancing their lives with actives in humanities are setting a noteworthy example. We need the Government to take note.
Invest broadly and deeply in education
Dr Arnagretta Hunter, physician and cardiologist, Canberrra
Q: What is your view on the increased charges for humanities subjects?
We know that education is the most significant social determinant of health; barriers to education are counter-productive for our society and our health. During a time of extraordinary economic uncertainty these changes to cost of education are likely to be significant barriers to participation, particularly in the humanities.
The study of humanities helps mould critical thinkers who can approach complex problems from a range of perspectives. It’s crazy and counterproductive to try and value different skills in the manner proposed by this federal government policy change. Who can value history in comparison to maths? Can our society choose one over the other? They are both essential skills for a balanced, creative and equitable society.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
Skills from the humanities are central to developing good health policy, good hospital policy, and good patient care. History, language, psychology and politics are all central to human wellbeing. The language of communication is taught by experience in the humanities.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
As a teacher I observe medical students and junior doctors from non-biological sciences tend to have good quality communication skills, good organisational skills and a passion for their work. Sometimes perceived as a disadvantage, I have only observed advantages for students from diverse backgrounds entering medicine.
Q: What is your advice to the Government on the recent announcements?
Reconsider the strategy in light of broader consultation and advice. Now is a time to invest broadly in education and training. In 2020 the world faces more and complex threats and challenges than at any time in recent history. To survive and thrive in this complex time Australia should invest broadly and deeply in education. Barriers to education will be counter-productive for our students today and will resonate into the future.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
At the end of school I did a BA(Hons) in political science at University of Melbourne. Decades later I know it set me up for a rich, diverse and sometimes successful career as a doctor. Analytics, reasoning skills, communications and debate, a broader understanding of society and political dynamics, all these skills I still use today in patient care, in health system analysis, medical research and in advocacy.
I was part of the first year of the Graduate Medicine Program at University of Sydney in 1997. In our year of just over 100 students, there were a handful of us with BA degrees. We have all gone on to specialist careers either as physicians, psychiatrists or a combination of the two. Several of us have received international fellowships. My experience practising medicine is that good hospitals attract doctors from diverse backgrounds and with diverse skills. Those practising medicine with previous study in humanities and non-biological sciences tend to offer excellent communication skills – a central skill for good patient care.
I worry about a healthcare landscape that values biological science dominantly over other skills. It is a poorer environment and one in which the patient voice and experience is often much less.
Indigenous students will miss out
Dr Tristan Kennedy, Lecturer, Department of Indigenous Studies, Macquarie University
Q: What is your view on the increased charges for humanities subjects?
The Ggovernment hasn’t thought this one through. It shows they don’t understand the importance of humanities subjects to the overall prosperity of the country. Moreover, it seems an economic own goal. By discouraging students studying humanities it removes a huge portion of income for universities, income that is used to support the much more costly STEM subjects.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
Humanities examines all aspects of society. Key to studies in the humanities is the identification of current issues faced by various populations – including health outcomes. Identifying social aspects of population health is key to informing health policy and identifying the most efficient ways to spend taxpayer dollars.
Q: What will be the implications for Indigenous Studies and related courses at your institution or more generally?
Indigenous studies will, of course, become more expensive. There are a couple of problems here:
1) Indigenous studies sees a larger proportion of Indigenous students who are statistically less financially well-off. In short, Indigenous students will miss out.
2) The is a real risk that Indigenous Studies will miss out on much needed research funding, in part derived from student fees, to address on-going issues surrounding Indigenous citizenship – in the current climate of Black Lives Matter it would be disastrous to miss an opportunity to fully understand what is proving to be a turning point in colonial and world history.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
Of course it does. For years employers in STEM fields have been asking for graduates who have high level communication and critical thinking skills. Humanities is the only place where students are encouraged to develop these skills. Humanities produces thoughtful, politically engaged, intellectuals in all industries.
Q: What is your advice to the Government on the recent announcements?
Think harder. Clearly they need to respond quickly to economic issues arising from COVID-19. But this proposal, ostensibly based on a guesstimate regarding future employment markets, is near-sighted at best. It is true we need to support the health industry and STEM research but the disproportionate increase in humanities fees is an affront to the very foundations of academia and may in fact have the opposite effect.
Disastrous reform
Jon Wardle, Professor of Public Health, Southern Cross University, Lismore
Q: What is your view on the increased charges for humanities subjects?
Short sighted and sad. The symptom of an approach that knows the price of everything and the value of nothing. This change – more than nearly any other announced in the government’s education reforms – signals that the role of the university to allow societies and individuals to achieve their full potential and capability is dead in Australia. Tehan has signalled that university is now about narrowly training for a job, not for laying the foundations for societies and individuals to meet the challenges and embrace the opportunities of the future. Silos are back, and the government has indicated well-rounded education is now seen as a luxury rather than a necessity to address the challenges of the future. But narrow minds are born from narrow focus, and narrow minds are not what we need to face the future.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
The humanities play an essential role in health. Humanities make practitioners better practitioners, they help us design better policy, they help us to understand what health is and how to improve it. We know that social determinants have an enormously significant impact on health, and we know this because of the impact of the humanities on health practice, health research and health policy. We have spent decades trying to break free of silos and encourage multi-disciplinary perspectives in health. There is not one aspect of health that has not been improved by bringing fresh perspectives to solving problems.
Q: What will be the implications for Indigenous Studies and related courses at your institution or more generally?
The Government has made a big deal about how this package increases Indigenous student access to university, and it does to an extent. All university students and universities themselves are going to benefit from an increased Indigenous presence. Unfortunately this is where any improvements end, as the Government has made it harder for students to study Indigenous studies, which sit in the Humanities funding cluster and are the subjects with the highest increase in student contributions. The Government removed English from the Humanities cluster and spared it student contribution increases because it viewed it as a discipline it wanted to encourage students to take it up, but it has taken the opposite view of Indigenous studies.
There won’t be an Indigenous studies unit in Australia that isn’t adversely impacted by these changes. More worrying is the Government’s admission that increases in the student contribution for Humanities subjects are meant to serve as a disincentive, as they view these subjects as less relevant to Australia’s future than other subjects. If this is how the Government views Indigenous studies more broadly, Indigenous studies in Australia have far more problems coming their way than these funding changes.
Q: What is your advice to the Government on the recent announcements?
Now is not the time to skimp on education, and Australian society and the Australian economy benefit more from every dollar they put into universities. The government is justifying increasing the student contributions by highlighting the fact education is an investment, not a cost. Perhaps they should listen to their own advice?
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
While humanities have the headlines, this is a disastrous reform even for those areas that the government has deemed worthy of student incentivisation through reduced student contributions. Someone is paying for the new places, and it is not the government. In fact the government is paying less, and universities are expected to train more students with less money. On current enrolments these changes rip around $80 million dollars out of nursing education, around $100 million dollars out teaching education and around $300 million dollars out of science education. Australian universities are now in the situation where the full costs of teaching are no longer covered by student and government contributions, the full costs of research are not covered by grants, and they are told to stop looking for other funding sources.
Nearly every other country in the world has viewed its university sector as something that should be supported as part of the COVID response, particularly because the university sector is essential for finding the solution to recovering from COVID. The Australian government has not only chosen not to support the sector, it has chosen to use the COVID crisis to actively attack it. It is hard to see how the message the Australian Government is trying to convey to the university sector as being anything other than “drop dead”.
Lagging the world
Dr Claire Hooker, Senior Lecturer in Health and Medical Humanities at Sydney Health Ethics, University of Sydney, and Chair of the Arts Health Network NSW/ACT.
Q: What is your view on the increased charges for humanities subjects?
This is a short sighted, ideological exemplar of bad policy. Businesses have been recently emphasising the value of humanities degrees and the increasing importance of the skills they provide. These are the very skills critical for managing an increasingly uncertain future.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
The health humanities, along with creative arts in health, are a rapidly expanding field of research and practice globally – so this policy takes us back to the twentieth century, leaving Australia behind the rest of the world. As indicated by a recent review of evidence from the WHO, by the All-Party Parliamentary Group on Arts, Health and Wellbeing in the UK, and by the philanthropically backed Australian organisation, A New Approach, arts and humanities are crucial to our health and wellbeing.
That’s partly because the chief determinants of our health are not what we eat nor how big our waistlines are, but are instead our connection to culture, the degree to which we are socially included, the quality and extent of our relationships, our self-efficacy and our agency and self determination. Numerous studies have demonstrated this, most notably those by Sir Michael Marmot and colleagues.
The arts and humanities are the means by which we achieve these conditions necessary for health. Beyond this, the humanities have been critical in tackling the many issues in healthcare and health research that biomedical models cannot approach: they have provided insight into the social organisation that determines capacity to deliver and optimise health care, identify and prevent errors, and generate effective therapeutic relationships and communication.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
A humanities background can predict a stronger, not a weaker, performance in health services careers. This background provides the expanded skill set without which technical knowledge cannot be efficiently or adequately operationalised. Just look at the pandemic. You can have the best control strategies and they will not work if you cannot communicate about them well.
Q: What is your advice to the Government on the recent announcements?
I advise the Government to listen to the experts and be guided by the evidence in a non-partisan manner. This is what all Goverrnments should do and it is the only foundation on which good policy can be constructed.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
The humanities holds the things we hold dear, intangible things that cannot be valued by money. I cannot count how many students I have seen transformed by their studies within them. Humanities degrees ought to be freely available to all, and encouraged as a social good.
Makes no sense
Associate Professor Lesley Russell, Adjunct Associate Professor at the Menzies Centre for Health Policy, contributing editor at Croakey Health Media
Q: What is your view on the increased charges for humanities subjects?
It makes no sense if Australia is to provide the opportunities for a well rounded education (at all levels) and graduate thinking people who are well prepared for the workplace, for contributing to society, for assessing and developing societal norms, values and ethics.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
They teach to how to think, how to communicate meaningfully, how to develop an ethical stance, how to appreciate and understand others cultures and values, how to see that there is more to health and care and quality of life than than technology, medicines and surgical skill.
Q: What will be the implications for Indigenous Studies and related courses at your institution or more generally?
I worry about what it means for knowledge of/ability to analyse: history, literature, art, languages, other cultures & religions. And scholarship for its own sake. Who will work on bringing back Indigenous languages?
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
I’m not sure but likely able to take a broader approach to the issues, think outside the box. Would like to think that humanities students have an appreciation of the value of words and phrases, good writing.
Q: What is your advice to the Government on the recent announcements?
Re think it. Abandon the disdain for subjects like philosophy, anthropology, the arts in general. Think about universities as places of great thinking, analysis and innovation not factories for delivering jobs.
And recalculate the costs and savings – they are clearly wrong.
Q: Any other personal reflections to share on the role or the humanities in health education, or other comments you’d like to make?
I have a BSc (Hons) in organic chemistry and a PhD in Molecular biology (lab bench science) and a BA in philosophy and Italian. (PS great benefits from free tertiary education which my family could not have otherwise afforded).
It’s difficult to articulate exactly how these have contributed to my employment opportunities, earning capacity, thinking abilities – I’m sure they have – but each degree, each discipline has contributed to my ability to enjoy life and study and research and writing and hopefully to be a useful, valuable citizen.
Humanities matter
Dr Jill Gordon, who has written and taught widely on the medical humanities
Q: What is your view on the increased charges for humanities subjects?
The devil is in the detail…I need to understand exactly how it will work in practice.
Q: What role do the humanities play re the community’s health, healthcare, health research, practice, and policy?
They underpin EVERYTHING.
Q: Does a humanities background make any difference to students’ aptitude or performance in the health sciences?
Absolutely – healthcare needs and niches are so diverse that they require students and practitioners from a wide range of (preferably eclectic) backgrounds.
Practitioners from overly narrow backgrounds can do all kinds of unseen and unintended harms.
Q: What is your advice to the Government on the recent announcements?
Get out of the way of the academics (just as you got out of the way of the public health experts on COVID-19), so that they can make academic/teaching/research decisions unpolluted by financial and political considerations.