Introduction by Croakey: Federal Labor MP Dr Mike Freelander, a paediatrician who has been outspoken on many health and justice issues, today called for dental care to be part of Medicare – albeit in a measured, gradual way – and for a complete ban on gambling advertising.
Freelander also talked this week about his journey into politics, in a podcast interview with Australian Medical Association President Professor Steve Robson.
Robson has interviewed other MP/medicos on the regular podcast, including Dr Sophie Scamps, and Dr Monique Ryan, as well as Health Minister Mark Butler, former Health Minister Greg Hunt, Indigenous ear, nose and throat surgeon Professor Kelvin Kong, health journalists and others in the field.
Marie McInerney writes:
Federal Labor MP and paediatrician Dr Mike Freelander has encouraged other medical professionals to consider going into politics, so they can seek to better the lives of their patients and communities by working to address the wider determinants of health.
A former Head of Paediatrics at Campbelltown Hospital in Sydney’s south-west, Freelander talked this week on the Doctorama podcast hosted by Australian Medical Association President Dr Steve Robson about his decision to go into politics.
Paediatricians have the luxury of seeing people “from day one of their entry into the world”, and he had always felt a bond with the children he saw, Freelander said.
But increasingly, he was finding that issues “beyond their control and their family’s control and my control were directing their success in the wider world and their success in life”.
“I’d always had an interest in politics and I wanted to enter the political fray to see if I could change things for the better, for those kids that I saw.”
Family history
Elected in 2016 as the Member for the Sydney seat of Macarthur, in his maiden speech Freelander talked about his background, including being born into one of the oldest Jewish families in Australia. He cited Sir Michael Marmot and Martin Luther King, and focused on inequalities in healthcare.
Freelander’s great-great-grandfather Abraham Rheuben came to Australia as a convict at age 16 and helped build the country’s first permanent synagogue in Hobart, and had a reputation for fairness. “It was said of him that he always reached out into the darkness to help those less fortunate than himself.”
His great-grandmother Jenny Scott Griffiths was, he said, a mother of 10, a prominent Labor Party leader at the turn of the century, a prominent feminist, pacifist and also the editor of the Australian Women’s Weekly during the First World War who was sacked from her role as editor for her anti-conscription views.
Talking about the social determinants of health, Freelander told Parliament about a family he had known for years, with one child born with multiple congenital abnormalities. He had been working with them to get school support for their daughter, including modification of the local school itself, when the family was told the house they rented was to be sold and they had to move.
“They would have to move to another area and we would have to start all over again the whole process of organising school support, as well as medical supports,” he said.
This was going to make life very difficult for the family, and he pointed “to non-medical difficulties such as housing affordability and having access to stable housing, which makes ongoing care very difficult”.
The need for change
Speaking on the podcast, Freelander said his move into politics was supported by family, as well as his former patients.
“They could see the need for change in society, change in terms of education system, in terms of access to jobs, in terms of infrastructure, like transport infrastructure,” he said, talking about the real difficulties now for people struggling with the cost of living, housing issues, amid the increasing gap between rich and poor.
“My job is to try and change that,” he said. “And whilst I can sometimes see it being quite frustrating, I think what I can do is have their voices heard in the Australian Parliament.”
Freelander stepped up on some of those issues again today, backing calls in a new report from the Grattan Institute for a gambling advertising ban. The report will add to the pressure on the Federal Government after it backed away recently from plans for a full ban for the sake of free-to-air television revenues.
Gambling is a “major public health issue”, Freelander told RN Breakfast host Patricia Karvelas. “Nothing good comes from the gambling industry, nothing, and we should not be promoting it,” he said.
Pressed, he said he would support whatever the Government decides to do in the long run, “but I think I’ve made my views pretty clear”. Asked if hoped Cabinet would change its mind, he replied: “I live in hope, Patricia.”
The Greens have stepped up their campaign to include dental care in Medicare under their self-dubbed ‘Robin Hood Reforms’ – key policies to help people’s economic pain, paid for “by taxing big corporations that are profiting off price gouging during a cost of living crisis”.
Freelander, the son of a dentist who lobbied the Australian Dentist Association during the Whitlam years for dental care to be included in the then Medibank scheme, also told RN Breakfast it was time to look at the introduction of comprehensive dental care into Medicare.
But he said it should be done in a gradual, measured way “that the country can afford”, initially providing access for at risk groups like children and older people, noting that “poor dental care in life leads to ongoing chronic health problems”.
Diabetes inquiry
In the podcast with Robson, Freelander highlighted his work as Chair of the House Standing Committee on Health, Aged Care and Sport, which just completed a year-long inquiry into the state of diabetes mellitus in Australia (see Croakey’s report here), and is now investigating the health impacts of alcohol and other drugs.
He welcomed generous input to such inquiries from the community and health professions, saying the diabetes inquiry heard not just from research organisations and medical professions, but from many affected individuals.
“To be able to hear their very personal accounts of dealing with diabetes…with a child who has had diabetes and passed away, or some of those very harrowing stories of personal loss and personal difficulties, was a great privilege, but also a great responsibility.”
The inquiry had raised big structural issues in diabetes for Aboriginal and Torres Strait Islander people, including lack of suitable housing and access to potable water — with the National Aboriginal Community Controlled Health Organisation (NACCHO) having warned that about 25,000 Aboriginal and Torres Strait Islander people live in remote communities without access to safe tap water for drinking.
Speaking to the long-term health risks, NACCHO said: “In some of these communities SSBs [sugar sweetened beverages] can be viewed as the safer option to the community’s water supply, and consumption can be high among young children and babies.”
With such drivers of ill health, Freelander said he worried that the Closing the Gap targets were too short-term. “Certainly from a paediatric point of view, any changes occur over generations,” he said.
“We saw in the diabetes inquiry communities that have no power, no cooking facilities, no access to clean potable water. That can be fixed. It requires investment, but it can certainly be fixed. We need to draw a line in the sand on this stuff.”
Other major urgent issues that he highlighted in the interview included the cost of healthcare, aged care and end of life issues, health literacy, child health and the danger of developing a two tiered health system, not just through income but also geography.
Freelander said these are highly complex issues that Health Minister Mark Butler is trying to address.
“I’d like things to happen a bit more quickly, and particularly in the equity of access area, and I think there’s a lot of reform needs to happen in how our hospital system works.
“But probably the biggest issue to me is I am still a real believer in the general practitioner being at the cornerstone of good healthcare and being the navigator of healthcare for each patient,” he said.
He would like more done to encourage people to go into general practice, not just by increasing payments, “but by looking at how we can join our systems together, particularly our hospital system and our general practices”.
Political life
Freelander told Robson that life in politics can be frustrating but also very fulfilling.
However, he warned fellow doctors, used to exercising authority, that they might struggle more in the political arena to get people to take their advice, and that they might end up writing prescription repeats for colleagues who didn’t pack well for their week in Canberra.
Politicians are also required to have a thick skin, something Freelander conceded he had yet to do.
Many people “don’t hold back” in letting politicians know their deficiencies, he said, acknowledging that he’s “not very good at dealing with criticism or insults”.
“I don’t like to let things go, I like to always have a comeback, but I’ve had to learn to curb that,” he said, reflecting on how that criticism can stem from the toll that life can have on people.
Door knocking through the suburbs, being invited into people’s homes and seeing how they and their families live “is a real eye-opener”, hearing about the struggles many have had.
“I’ve felt very privileged to be able to do it,” Freelander said. “You can do a lot. You can also learn a lot, I’ve seen it as a huge learning experience.”
See Croakey’s archive of articles on health inequalities
