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Signing out with a song, and some thoughts on the highs and lows for public health of 2015

Below, some of Croakey’s talented and generous contributors reflect upon the past year and its highs and lows for public health.

But first, take a few minutes to listen to the Yugambeh Museum Youth Choir singing Christmas carols in Yugambeh language (thanks Radio National!) – it’s a Christmas gift not to be missed.

https://soundcloud.com/user-923113327/yugambeh-2

***

JulieLAssociate Professor Julie Leask

Follow on Twitter: @JulieLeask
Sydney School of Public Health
University of Sydney

Q: What was the defining moment/issue for you in 2015 – professionally?
I received two awards for public health research and impact. It was a huge honour but it made me even more mindful of the very quiet achievers in public health research who don’t get much recognition. For that reason, I was delighted to see Amy Corderoy’s report on how in NSW, Aboriginal Health Workers are quietly helping to close the gap on immunisation rates.  She interviewed one of my former research students, Telphia Joseph, who had looked closely at how Aboriginal Medical Services in NSW were supporting immunisation programs in many different ways.

Q: What was the defining moment/issue for you in 2015 – personally?
My second child finished primary school, marking the end of an era.

Q: What was the most encouraging development for health this past year?
In April, the Health Minister Sussan Ley acknowledged the 166,000 children who were behind on immunisations but not part of the 39,000 group whose parents were vaccine objectors. The objector parents had generated so much public outrage but the other group were larger mostly faced logistical or health services barriers. Our health minister was recognising them  and announced a package of measures to support them.

Then in May the budget quietly added the most important reform in years – expanding the Australia Childhood Immunisation Register through to adulthood. Those of us in the immunisation field cheered, having called for this reform for 15 years.

Q: What was the most disheartening development for health this past year?
The escalation of the vaccination wars – we need more constructive solutions to the problem of vaccine refusal and to build trust, not erode it further. For that there needs to be better understanding and evidence.

Q: What was the most useful article you read this year?
The best blog I read this year was “I thought all anti-vaxxers were idiots. Then I married one.”  The writer was supportive of vaccination but better understood the issues.

Q: What is the best book you read this year?
Hack Attack, by Nick Davies – the disturbing story of how Murdoch’s UK newspaper, News of the World bullied, spied on people, and covered it up.

Q: The best film you saw this year?
Inside Out. A funny, entertaining, and fairly accurate explanation of the development of complex emotions in children.

***

JaeleaSkheanJaelea Skehan

Follow on Twitter: @jaeleaskehan
Director, Hunter Institute of Mental Health

Q: What was the defining moment/issue for you in 2015 – professionally?
This year the Hunter Institute of Mental Health has partnered with Orygen the National Centre for Excellence in Youth Mental Health to develop the suicide prevention strategy and youth suicide prevention plan for Tasmania.  While the Commonwealth Government has taken all year to finally respond to the National Mental Health Commission’s recommendations for mental health reform, many of the states and territories have been getting on with business in 2015 – thinking about reform in both mental health and suicide prevention. What I hope we will see from 2016 and beyond is a coordinated approach between the Commonwealth and the States to ensure suicide prevention activity gets the best of our collective knowledge and resources so it can make a real difference to the lives of all Australians, no matter where they live.

Q: What was the defining moment/issue for you in 2015 – personally?
This year I turned 40. In the lead up, I really struggled and approached the date with some dread. It wasn’t the number per se, but the fact that a decade had gone past in the blink of an eye and I really questioned how ‘mindful’ I had been about my life and the decisions I made in that decade.

But, like all transitions or periods of change, what I found was that I gained more than I lost.  Yes, I lost my 30s and many of the things I thought I might have done in my 30s, but it was a great opportunity to celebrate the people I am fortunate to have in my life and an opportunity to reflect on how I wanted to spend the next decade of my life. I am already seeing that period of reflection paying off.  Whether it is obvious from the outside or not, I am a different person than the one I was a few months ago.

Q: What was the most encouraging development for health this past year?
The biggest news in mental health this year was the Commonwealth Government’s response (finally) to the National Mental Health Commission’s review of mental health and suicide prevention.  Of course, we are still waiting on further details, but after two years of review and further consultation, the mental health and suicide prevention sectors at least feel like they can finally get on with the business of important reform.

The announcement, made on 26 November, reflects what individuals, their families, the sector and the National Mental Health Commission has recommended; the need for a focus on national leadership and regional planning and implementation. It supports a move towards prevention, as well a more person-centred approach to care that integrates new innovation – including digital innovation.

While this is all encouraging, 2016 will be a critical year for implementation and the proof will be in the (Christmas) pudding.

Q: What is the best book you read this year? 
I have read quite a few books I’ve enjoyed this year, but am currently reading Kurt Fearnley’s biography “Pushing the Limits”.  It is a great read, with plenty of good humour throughout. It had me at the first line that goes something like… “Who knew how hellishly slippery vomit could be”. The book has many of the things I am passionate about in it – lots of sport, my home town of Newcastle and an insight into the power of positive thinking and never believing you can’t do something.  It’s a great Xmas present for anyone who has left their shopping to the last minute.

Q: What is the best film you saw this year? 
I will give you a hint….At the age of 40 I still own a Millennium Falcon, my prized childhood possession. Like probably billions of others I am a massive Star Wars fan, so I was beyond excited to see the new instalment. For me, it didn’t disappoint.  Apart from a welcomed return to the style of the original series, it was fabulous to see a female in the kick-ass lead role. Girl power + Star Wars = Very Happy.

***
TarunWProfessor Tarun Weeramanthri

Follow on Twitter: @tarunw
Chief Health Officer
Assistant Director General, Public Health
Department of Health, WA

Q: What was the defining moment/issue for you in 2015 – professionally?
The passage of the new Public Health Bill through the lower house of the WA Parliament (hoping for progress through Upper House in first half of 2016).

Q: What was the defining moment/issue for you in 2015 – personally?
The Paris Agreement on climate change, and hearing Kiribati President Anote Tong speak on radio. Now for national action – no excuses.

Q: What was the most encouraging development for health this past year?
Focus on rebuilding basic health systems (primary care and public health) in all countries, triggered by lessons from Ebola response.

Q: What was the most disheartening development for health this past year?
Booing of Adam Goodes and the belated response from sports officials and commentators. Australia still has a problem saying the R word – Racism.

Q: What was the most useful article you read this year?
‘Talking about the Smokes’ Medical Journal of Australia supplement on the evidence guiding Aboriginal and Torres Strait Islander tobacco control, available at https://www.mja.com.au/journal/2015/202/10/supplement?0=ip_login_no_cache%3Ddcb4e4daeba279928ad25a085cc10e30

Q: What is the best book you read this year? 
To Save a People by Alex Kershaw. One way to feel the painful ironies of the current refugee crisis in Europe is to go back 70 years to the story of the Hungarian Jews at the end of World War II, and walk the streets of Budapest now.

***

Margaret Faux

MargaretFFollow on Twitter: @MargaretFaux
Lawyer, the founder and managing director of one of the largest medical billing companies in Australia and a registered nurse. A a research scholar at the University of Technology Sydney

Q: What was the defining moment/issue for you in 2015 – professionally?
I experienced a brutal business betrayal in 2015, from which I have learnt a great deal – not all of it positive – I’m reassessing how I hand out trust.

Q: What was the defining moment/issue for you in 2015 – personally?
I published my first journal article for my PhD on the topic of Medicare claiming and compliance, and realised that I never thought I would ever be considered an expert on anything.

Q: What was the most encouraging development for health this past year?
On the basis that every minister is a health minister and that fish rots from the head, I’d have to nominate Tony Abbott’s removal from the top job as being the number one most encouraging development for health in 2015. But as a woman I’m of course going to miss those handy little carbon credits around the house.

Q: What was the most disheartening development for health this past year?
The complete breakdown in trust between all stakeholders in health. In my day job I sit between doctors, patients and hospitals on the one hand, and the payers on the other. No-one trusts anyone out there anymore and it’s beginning to feel like the wild west with everyone thinking everyone else is trying to rip off the system and therefore they’re all taking the law into their own hands. Problem is, no-one really understands this area of law and as a result some of the conduct I see (and I’m not talking about doctors here) is nothing short of scandalous.

Doctors are still being accused of rorting Medicare, with monotonous regularity, even though there is no evidence to support such claims. I see more under-claiming and genuine confusion than anything else and my experience is that doctors are actually quite a boringly compliant lot who would like to be doing the right thing by Medicare if only they knew what that was.

Q: What was the most useful article you read this year? 
I’ve been really interested in following the journey of the newly introduced universal healthcare system in Indonesia and travelled with an Australian trade mission to Jakarta this year to check it out in more detail. This Ernst and Young report was one that I found to be the most comprehensive in understanding the operation of the scheme.

Q: What is the best book you read this year? 
It’s probably not the ‘best’ book I read in 2015, however ‘A history of the world in 10 ½ chapters’ by Julian Barnes, is one that has stuck in my mind. The central theme of the nature and essence of history appealed to me, and the opening chapter ‘Stowaway’ is quite possibly the most side splittingly funny account of Noah’s Ark I have ever read.

Q: What is the best film you saw this year? 
A short documentary called ‘Is Poverty Genetic?’. I liked this little gem so much I’ve watched it twice. It’s available on Virgin Australia on your inflight system and is about 45 minutes long so you can even fit it in on a quick commute between Sydney and Melbourne. Narrated by Morgan Freeman and packed with fascinating research, it explores the factors influencing the distribution of the world’s wealth.

***
YottiDr Jonathan Kingsley

Follow on Twitter: @YottiKingsley
Research Fellow, Indigenous Health Equity Unit
Centre for Health Equity, Melbourne School of Population and Global Health
The University of Melbourne

Q: What was the defining moment/issue for you in 2015 – professionally?
Participating in the Future Leaders Academy at the 1st World Forum on Ecosystem Governance where I contributed to the development of the Beijing Declaration.

Q: What was the defining moment/issue for you in 2015 – personally?
Welcoming my first child Mietta into this world and watching her develop with my wife Marissa.

Q: What was the most encouraging development for health this past year?
The formation of the 2015 Lancet Commission on Health and Climate Change.

Q: What was the most disheartening development for health this past year?
The discussions and actions taken earlier this year around the closure of Aboriginal communities in Western Australia and Northern Territory.

Q: What was the most useful article you read this year?
Alessa L, Kliskey A, Gamble J, Fidel M, Beaujean G, Gosz J (2015) The role of Indigenous science and local knowledge in integrated observing systems: moving towards adaptive capacity indices and early warning systems. Sustainability Science; DOI: 10.1007/s11625-015-0295-7 [Online April 4, 2015]

***

Professor Glenn Salkeld

Follow on Twitter: @gsalkeld
Executive Dean, Faculty of Social Sciences
University of Wollongong
(Formerly of Sydney School of Public Health)

Q: What was the defining moment/issue for you in 2015 – professionally?
Deciding it was time to find my next professional challenge. That came in the form of a new job – Exec Dean of Social Sciences at the University of Wollongong

Q: What was the defining moment/issue for you in 2015 – personally?
My father passing away in April

Q: What was the most encouraging development for health this past year?
The Inaugural Sax Institute Research Actions Awards. The Institute established the annual awards to recognise research that supports policy decisions that make a real-world difference to people’s health and wellbeing.  I’m a little biassed here – two of our best and brightest academics (from Sydney School of Public Health) – Julie Leask and Ann Cust – were among the winners of the award.

Q: What was the most disheartening development for health this past year?
I am disheartened by the very slow uptake of person/citizen/patient empowerment in our health care system. The technology has caught up with the idea, so why is there so much resistance to integrating individual’s wishes and desires into health care practice?

Q: What was the most useful article you read this year?
Steve Leeder’s piece in The Australian on academic publishing.

Q: What is the best book you read this year?
The Country of First Boys by Amartya Sen. Stimulation from the great intellectual democrat on a wide range – though connecting – issues that matter.

Q: What is the best film you saw this year? Why?
I need to get out more – movies screened on a plane never seem to make the grade!

***

RebeccaProfessor Rebecca Ivers

Follow on Twitter: @rebeccaivers
Director, Injury Division
Professor of Public Health, The University of Sydney
The George Institute for Global Health

Q: What was the defining moment/issue for you in 2015 – professionally?
Seeing the NSW Government fund driver licensing support programs across the state following the successful trial (still in progress) of our Aboriginal driver licensing support program, Driving Change.

Q: What was the defining moment/issue for you in 2015 – personally?
Visiting burn and trauma centres across India and seeing the passion of dedicated staff working in very resource poor settings with patients with very challenging conditions. But also being with my brother and sister in law celebrating the latest addition to our family, the gorgeous baby Vivienne!

Q: What was the most encouraging development for health this past year?
Having targets for road injury, and access to safe, affordable, accessible and sustainable transport systems, included in the sustainable development goals.

Q: What was the most disheartening development for health this past year?
Sad to see the College Street Cycle way in Sydney torn up, and while terrific to see the one metre rule brought in for car drivers (around cyclists), the NSW Government has also brought in some disproportionately heavy fines for cyclists, likely to discourage cycling.

***

AHHA

Follow on Twitter: @AusHealthcare

Q: What was the defining moment/issue for you in 2015 – professionally?
The multiple review processes underway throughout the health sector and the essential need for the Government Responses to these reviews be coordinated in a whole-of-system approach to make the entire sector as effective and efficient as possible.

Q: What was the most encouraging development for health this past year?
COAG leaders agreeing on 11 December that health reforms be based on the principles of Medicare; that a fair and efficient hospital funding scheme be agreed to; and that community and primary health care be integrated with a focus on chronic care models for at risk health consumers and those with complex needs. The Commonwealth’s regional focus of Primary Health Networks will assist in moving this work forward.

Q: What was the most disheartening development for health this past year?
The health sector continues to wait for the Commonwealth Government to explain how the sector will be placed on a sustainable footing following the significant cuts to hospital funding in the 2014–15 Budget that were announced without any consultation.

Q: What was the most useful article you read this year?
From early 2015, the Australian Health Review’s ‘Co-payments for health care: what is their real cost?’ provided an analysis of the tension between economic and health policy. In late 2015, the Australian Health Review’s ‘Relinquishing or taking control? Community perspectives on barriers and opportunities in advance care planning’ brings to light the increasingly important issue of advance care planning and end-of-life decisions, which will only grow in importance as the population ages and will be a focus of AHHA activities in 2016.

***
Carol Bennett

Alzheimers Australia

Q: What was the defining moment/issue for you in 2015 – professionally?
The launch of the new National Institute for Dementia Research. It is fantastic to see dementia research collaboration supported in Australia.

Q: What was the defining moment/issue for you in 2015 – personally? 
The apparent shift in understanding the impact climate change will have on health in this country. The realisation that climate change will have an impact on every single health condition. The commitment Australia is making to reduce our environmental impact.

Q: What was the most encouraging development for health this past year?
The most encouraging development for health in 2015 was the shift of aged care into the Health Department. Dementia is now the second leading cause of death in Australia, and a condition that affects more than 25 000 people under 65. Dementia is not only an aged care issue, it is a priority health issue.

Having aged care and health in the one department better ensures the needs of people with dementia are at the forefront of health and well-being policy debates. The experience of dementia is largely informed by the response of the health system and the broader community. Dementia should not be relegated to just being an issue of ageing or aged care. The vast majority of people living with dementia are in the community and many will not access aged care services.

Q: What was the most disheartening development for health this past year?
The most disheartening development for health in 2015 was the negative messaging around the 2015 Intergenerational Report government released that suggested ageing and older Australians are a burden on the budget rather than contributors to our country’s prosperity. It failed to recognise the significant value and contribution older Australians make to our communities.

Q: What was the most useful article you read this year?
Stephen Duckett’s articles which set out to “bust” the myths around health expenditure in Australia.

Q: What is the best book you read this year?
Advanced Australia by Mark Butler. The former Minister for Ageing in the Gillard government’s new book has a refreshingly positive approach to ageing and argues for the continuing contribution older Australians make to our community.

The average Australian’s life expectancy has increased by twenty-five years over the past century—from mid-fifties to early eighties. For decades to come ageing will touch almost every area of policy—retirement incomes, housing, employment, urban design and of course health. It was a very interesting read focusing on this unprecedented area of change

Q: What is the best film you saw this year?
Still Alice – it was very encouraging to see Alzheimer’s disease being brought into the mainstream public domain in such a realistic way. Dementia is now the second leading cause of death in Australia, yet the awareness and understanding of the condition is extremely low. This film goes a long way towards creating more awareness of the condition.

***

Professor Ric Day

Professor of Clinical Pharmacology
UNSW

Q: What was the defining moment/issue for you in 2015 – professionally?
Partnership grant from NH&MRC to improve outcomes from gout

Q: What was the defining moment/issue for you in 2015 – personally?
Abbott being replaced by Turnbull– relief!

Q: What was the most encouraging development for health this past year?
Health workers demonstrating against asylum seekers being sent offshore

Q: What was the most disheartening development for health this past year?
Mental health of asylum seekers especially children sent to Manus Is

Q: What was the most useful article you read this year?
A NEJM piece about malignancy and how it develops (focus on research The Path to Cancer — Three Strikes and You’re Out Bert Vogelstein, M.D., and Kenneth W. Kinzler, Ph.D.)

Q: What is the best book you read this year?
A Place of Greater Safety by Hilary Mantel (about the French Revolution– v interesting

Q: What is the best film you saw this year?
Underwhelmed by Walk in the Woods

***

Dr Mukesh Haikerwal

Follow on Twitter: @DrMukeshH
A General Medical Practitioner in Melbourne (who also recently tweeted for @WePublicHealth)

Q: What was the defining moment/issue for you in 2015 – professionally?
I had twin towers that stood out: one burnt leaving the Chair of the WMA liberating me; the second was being allowed another lease of life for Australia’s Institute of Health and Welfare and re-invigorating it in the new year.

Q: What was the defining moment/issue for you in 2015 – personally? 
My 3 boys completing year 1 PG Med, BSc and year 1 PPE at ANU.  It was the end of parenthood of children and redefining adult relationship with them at a time that my 30+ years advocacy ran aground with medical suicides and blatant bullying harrassment and overbearing unbridled bureaucracy.

Q: What was the most encouraging development for health this past year?
The defining moment in health for me was the re-affirmation of the central role of General Practice and Primary care in health care delivery ramped up in the public eye by the RACGP ad series.

Q: What was the most disheartening development for health this past year?
The potential unravelling of Australia’s egalitarian balanced accessible health system by stealth removing the ability of practitioners to use their full scientific and Clinical knowledge in patients’ best interest.

Q: What was the most useful article you read this year?
Shirt fronted serialised in the Fairfax media: reflections of the human condition.

Q: What is the best film you saw this year?
I loved Spectre because I’m a lifelong Bobd fan – especially the DB5

While guesting at @WePublicHealth, he looked back at some of the big health stories of 2015

Mukesh3Mukesh2

Mukesh

***

Finally, Croakey would like to acknowledge the passing this year of a highly esteemed public health advocate, Professor Elizabeth Waters, who is remembered in this obituary by her husband Paul Joyce as a “force of nature”.

And warm thanks to all those who engage with Croakey; our readers, contributors, funders, critics and collaborators. We will be back early in the New Year.

Stay tuned for some public health travel writing (is this a new genre?) from Dr Lesley Russell about her recent walk on the camino pilgrim’s trail in France. It will be perfectly timed for those making New Year’s resolutions about experiencing the world in new and health-promoting ways…

 

 

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