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The Health Wrap: Conflict on the menu, closing the gap, the price of disadvantage, policy conundrums

 

By Kellie Bisset


Conflict on the menu

Conflict of interest has featured heavily on the health agenda this past fortnight and the story of the hour is the controversy over Assistant Health Minister Fiona Nash’s office pulling down a government-approved healthy food rating website just hours after it went live.

Central to the debate is Nash’s chief of staff Alastair Furnival, who resigned after it was revealed he had links to the food industry through his involvement in the companies Australian Public Affairs and Strategic Issues Management. Gary Sacks covers the issue of Big Food and government influence in this piece posted on both Croakey and The Conversation. And this article by SMH health reporter Amy Corderoy claims the companies also have links with the alcohol industry. The story questions what role Furnival had in the recent decision to defund the Alcohol and other Drugs Council of Australia (ADCA) after 46 years of operation. The Guardian also looks at the issue of Furnival’s association with both companies and a further SMH piece explores his links with Cadbury and a government funding deal to upgrade one of its factories.

Public Health Association of Australia CEO Michael Moore told AM and the SMH that ADCA should be reinstated and the healthy food  website should be returned to give consumers a fighting chance to make sound judgements about what’s in their food. And writing in the SMH, Professor of Health Policy at Curtin University Mike Daube argues that the spotlight will now be on Fiona Nash and her performance in helping to reduce the huge toll from tobacco, alcohol and obesity. The Greens and Labor will be keen to keep the issue running – the SMH reports they plan to pursue Senator Nash in Senate Estimates hearings next week.

The Conversation looks at public-private partnerships more broadly with this perspective on relationships between government and the food industry.

And you can read a statement from Australian Public Affairs here. It says Furnival had resigned as chairman when he took up the position with Fiona Nash and was in the process of divesting his shares. Furnival has denied any suggestion he acted improperly.

The story follows on the heels of publicity over a $15 m partnership deal between La Trobe University and the Swisse vitamin company to help establish  complementary medicine research centre. The deal saw La Trobe academic Dr Ken Harvey resign in protest. See a summary in the last Health Wrap here. Since then, The Conversation ran this article about the need for alternative medicine research to be publicly funded.

***

Sugary drinks and the question of cost  

More interesting food news comes from California, where a bill has been proposed to put label warnings on sugary drinks. This article on townhall.com gives an overview, though it describes the proposed legislation as a nanny state bill. 

In New Zealand, health researchers are calling for a 20% tax on sugary beverages, which is interesting in light of new research from the American Journal of Public Health showing higher prices for healthy food are associated with higher blood glucose levels in people with diabetes.

Controversy over a research paper on the ‘Australian sugar paradox’ has also emerged. Australian Food News reports the University of Sydney has launched an inquiry into the paper, which contended that sugar intake declined in Australia at the same time as obesity levels had risen. Data used in the paper has been questioned and was the subject of a recent ABC Background Briefing report.

The latest issue of Harvard Magazine meanwhile, reports on a meta-analysis from its researchers published late last year in BMJ Open, which shows that a healthy diet, while out of reach for a proportion of people, is not as expensive as some might think.

***

Closing the Gap report released 

Repeatedly stating our commitment to progress – and measuring our lack of it – does not actually make that progress happen, writes Elizabeth Strakosch for The Conversation. Her comments come in the wake of the latest Closing the Gap report, and she asks whether Prime Minister Tony Abbott will be able to “walk the walk” in addressing the issue of Indigenous health disadvantage. Michelle Grattan asks some similar questions.

New Matilda meanwhile, looks at the PM’s speech on the report, arguing that his focus on school attendance rates is a much easier issue to highlight than the national shame of Indigenous incarceration rates.

The NACCHO website carried a piece from Angela Webb, from the Secretariat of National Aboriginal and Islander Child Care, which said that to make real progress in closing the gap requires action to be taken when the gap first appears.

And Croakey collected a series of resource links – available here – including a Guardian opinion piece from Closing the Gap Co-chairs Mick Gooda and Kirstie Parker, which called for sustained political commitment.

Just days later, Padriac Gibson, also writing in The Guardian, chronicled recent federal government cuts to Indigenous specialist services – a move he said would directly impact on the health of Aboriginal children.

Criticism was also directed at a new federal parliamentary inquiry inquiry into harmful alcohol use in Aboriginal communities. Inquiry chair Sharman Stone told the ABC that Indigenous people were not being singled out as the only group to be affected by harmful alcohol behaviours, despite initial plans for the inquiry to be far ranging and related to all sections of the community. However, there is hope in some quarters that the inquiry will yield some positive results. NACCHO Chair  Justin Mohammed told SBS that the  inquiry was a good opportunity to examine what policy approaches have and haven’t worked at combating alcohol abuse in Indigenous communities.

Meanwhile, ANU has launched National Centre for Indigenous Genomics, which aims to help improve health outcomes by analysing the role of genetics. Aboriginal and Torres Strait Islander social justice commissioner Mick Gooda will chair the governance board of the centre, which will work collaboratively with Indigenous communities, the ABC reports.

***

The price of disadvantage 

The seemingly small amount of $5 would represent an insurmountable barrier to healthcare services for some patients, the Senate Inquiry into the Commission of Audit has heard. This article on Croakey from Jennifer Doggett discusses a Consumers Health Forum survey on co-payments in the health system that was presented to the inquiry.

Croakey also highlighted a new report by Sharon Friel and Richard Denniss Unfair economic arrangements make us sick, which looks at the link between financial inequities in Australia and health outcomes.

Internationally, the Independent reports that UK GPs are referring an increasing number of people to foodbanks — and research funded by the Wellcome Trust shows men who are unemployed for more than two years show signs of faster ageing in their DNA.  Harvard Professor of Public Health David R. Williams is giving a series of talks to physicians in Canada about the impact of discrimination on health. Evidence shows discrimination has emerged as a major risk factor for disease, he told Canada’s The Chronicle Herald.

And an interesting story on Medical News Today discusses a joint commission from The Lancet and Norway’s University of Oslo, which finds that global power imbalances are failing to protect public health and must be reformed.

***

Policy conundrums

Health Minister Peter Dutton has signalled major changes are on the way to curb healthcare spending costs, floating the idea of patient co-payments as one potential option to meet future financial challenges. Jennifer Doggett outlines some of Croakey’s take-home messages from the Minister’s speech to the Committee for the Economic Development of Australia conference.

The Grattan Institute’s Stephen Duckett argues that asking the rich to pay more for their healthcare is not necessarily the best answer. In another piece for The Conversation, he says the government’s shaky start on health does not bode well for reform.

Whether any of the predicted government savings will come from Medicare Locals still has the health community talking. Croakey features this piece looking at the public relations battle ahead for Medicare Locals in the face of opponents determined to paint them as a bureaucratic waste of taxpayer dollars.

Stories of on-the-ground success – such as this example of regionally driven health reform from the Hunter – continue to emerge. How much traction they get and with whom will be central to driving the discussion forward. 

On the subject of regional solutions, Dr Jennifer Bowers, from the Australasian Centre for Rural and Remote Mental Health, has spoken out about the importance of the National Mental Health Commission review focusing on the specific challenges faced by rural communities. Access to medical care would be a good start. From the primary care perspective, both the AMA and the Rural Doctors’ Association of Australia have called for an urgent review of the geographically based classification system that dictates doctor:patient ratios in rural areas.

Discussion over the stance the government will take on funding prevention continues, and this article in The Conversation by Professor Jane Hall, explores just how the government’s Commission of Audit might view spending efforts on prevention to date and suggests it should consider not just the costs but the value that organisations like the Australian National Preventive Health Agency Bring to the table.

Looking at the evidence for what works is a subject that is increasingly occupying the minds of those charged with devising policy solutions. But the trajectory of evidence as it winds its way down various policy paths is not always predictable or guaranteed. And barriers in the research world as well as the policy making sphere come into play. These issues are highlighted by a new book, Beyond Evidence-Based Policy in Public Health: The Interplay of Ideas, reviewed here on the London School of Economics website by social policy lecturer Lee Gregory.

***

Muddling on through with e-health

Medibank has upped stumps on its e-health record project ‘healthbook’, which aimed to test whether consumer-entered health data for patients with chronic disease could integrate with the national personally controlled electronic health record (PCEHR), Pulse + IT reports. The project, which received $7.5 m in federal government funding, stalled due to lack of consumer interest, the site says.

More bad news  for the PCEHR comes from Medical Observer, which reports former NEHTA clinical lead and practising GP Dr Mukesh Haikerwal as saying the records are garbling uploaded patient information, leading to the potential for confusing or misleading information to be recorded.

E-health solutions will no doubt be canvassed at the Australian Telehealth Conference to be held in Melbourne next month. Pulse + IT says one of the speakers, clinical director of Adelaide UniCare E-Health Victoria Wade, has been attributed with the description of Australian telehealth as having “more pilots than Qantas”.

***

A smoking news bonanza

Smoking shows no signs of disappearing off the media radar, despite the fact we all know it’s a killer. The big smoking story of the past two weeks is, of course, the decision by major US pharmacy chain CVS to ban tobacco sales. While considered a drug store chain, CVS sells many grocery items, and there are enough parallels with Coles and Woolworths to put the major supermarkets into a PR spin, according to this piece from The University of Newcastle’s Craig Dalton, published on Croakey and The Conversation.

The move was followed by suggestions from US public health experts that CVS should also reconsider its approach to junk food, this story from Forbes says.

Opinion has oscillated between whether the move to ban tobacco was a victory for public health or a clever publicity stunt. Customer strategy website 1to1 says the company had much to gain and little to lose from the move, but removing junk food from the shelves would be an altogether different financial proposition.

Cardiologist Wes Fisher, writing for the KevinMDblog, says the announcment made his bulls..t meter go off. “… tobacco smoking is seeing a huge resurgence in both the young and old in America,” he says. “But politicians and public health experts, reeling from this reality, are desperately in need of some good news to spin.” There are so many variables in a person’s decision to smoke that the CVS decision is but a drop in the ocean, he says.

On the e-cigarettes front, more and more jurisdictions are beginning to view the products in a negative light, with vaping bans enforced or about to be enforced in Long Beach California, Nova Scotia, and in all public health facilities in Guam. The Tenessee Health Department has also issued an advisory urging consumer caution over e-cigarettes, given the health risks are still unclear.

Meanwhile, this Associated Press article has public health experts contemplating the tobacco endgame: smoking rates of 0%. If this is to happen, policy makers might need to take the advice of a new research paper published in PLOS ONE, which says we need to ‘wise up’ to the diverse range of tactics used by Big Tobacco. One such tactic might be quoting low quality or off topic research in support of the industry position, according to another research paper published in BMJ Open.

If you have a story for The Health Wrap, find me on Twitter @medicalmedia or contact my colleague @MelissaLDavey

  • Kellie Bisset is The Sax Institute’s Communications Director. She has worked in mainstream and medical journalism and communications for more than 20 years. During that time she edited both of Australia’s weekly medical publications for doctors, Australian Doctor and Medical Observer and developed a strong interest in health policy and evidence. The Sax Institute is a not-for-profit organisation that drives the use of research evidence in health policy and planning.  

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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
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Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
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2014 conferences
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National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
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Population Health Congress 2015
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