This week’s Health Wrap is compiled by Megan Howe, the Sax Institute’s Publications Manager. Enjoy the Wrap and tweet us via @medicalmedia or @meghowe68 if you have any ideas for future issues.
Is the Trans-Pacific Partnership good medicine?
The impact that the “landmark” Trans-Pacific Partnership deal will have on health, both in Australia and globally, continues to make headlines. While Prime Minister Malcolm Turnbull said medicines would not be more expensive as a result of the deal, the Sydney Morning Herald reported that health groups believed the TPP would cost lives, with Medecins Sans Frontieres warning the agreement would force developing countries to adhere to tough intellectual property rules that would prevent them providing cheaper versions of drugs for their citizens. An article on The Conversation agreed the deal posed a threat to global access to medicine.
One of the key sticking points in getting the agreement signed by all 12 nations including Australia, the US and Japan was around how long drug companies should have monopolies on expensive biologic drugs including cancer therapies. The Guardian explained that while the US provides 12 years of exclusivity for drugs like cancer therapy Avastin, Australia insisted on five years of protection to control health care costs.
While the Public Health Association of Australia welcomed Australia’s refusal to give in to US demands to extend the drug monopolies, CEO Michael Moore told Croakey that public health experts still needed to see the detail of the agreement to evaluate whether it would adequately protect the Australian health system.
Doctors’ detention stance
Doctors at Melbourne’s Royal Children’s Hospital (RCH) have refused to discharge an asylum seeker and her child because the immigration department would have sent them back to detention at the expense of their health, it was reported this week. The woman was suffering post-traumatic stress disorder and post-natal depression, which also affected her infant child’s development.
The news came after doctors from the hospital penned an editorial in the Herald Sun (paywall) about the harm detention causes to children, calling for “moral leadership on this issue to find a solution, quickly, to use alternatives to detention and to stop the harm”. As detailed on Croakey, their stance won the support of Victoria’s Health Minister Jill Hennessy, as well as the Australian Medical Association
With the Sunday Herald Sun running a front page headline “Free the kids,” with a photograph of hundreds of protesting RCH staff, The Monthly suggested the Australian public was also now starting to question the detention of children. Nick Feik wrote:
It’s arguable whether the broad Australian public has ever stood up and said it’s “not on” regarding the treatment of asylum seekers, but there are tantalising signs that keeping children in indefinite detention has now become broadly unacceptable.
Meanwhile, The Guardian reported that the Australian National Audit Office was conducting a sweeping audit of asylum seeker healthcare and the relationship between the immigration department and the multinational company that provides medical services.
Welfare card on the way
The Senate has cleared the way for the government to proceed with the trial of its cashless welfare card designed to restrict access to alcohol and gambling, The Guardian reported. The Bill passed the upper house without amendments, meaning up to 80 per cent of a person’s welfare payment can be placed on a bank card that cannot be spent on alcohol or gaming. The first trial of the card will start next year in the South Australian town of Ceduna.
The Senate vote came after much debate. While the Greens accused the Government of rushing through the laws while many questions remained unanswered about how the card would operate, The Australian had reported (paywall) earlier in the week that Indigenous groups were urging Senators to pass the Bill, saying it would save lives and prevent families being destroyed by alcoholism.
Ceduna Aboriginal Corporation chief executive Michael Haynes told The Australian:
There have been programs in the past that have been tried, tested and failed. We cannot continue to go down this path,” “We do not want our people to continue down a well-worn path of ruin and heartbreak. We are doing this to save lives, improve the overall health and well-being of our people (and) provide safer communities.
However, Mick Gooda, the Aboriginal and Torres Strait Islander Social Justice Commissioner, raised grave concerns about the move. Writing at The Drum, he said:
The current trend back towards management of Aboriginal people’s and Torres Strait Islanders’ incomes is worrying on two fronts. Firstly, while there’s no doubt that many disadvantaged Aboriginal people would like support, the evidence in relation to income management is mixed to say the least.
Any possible benefits must be weighed against the sense of disempowerment people report, the stigma they feel and punitive perceptions.
A spoonful of sugar…
A tax on sugar in Australia is inevitable, with the unfolding story of foods that contribute to obesity identical to that of tobacco, according Boyd Swinburn, director of the World Health Organisation Collaborating Centre for Obesity Prevention.
The Canberra Times reported that Professor Swinburn, addressing a health forum in Canberra, called for leadership from “brave” governments who would act to prevent obesity through key measures such as restrictions on junk food marketing to children, fiscal policies such as a tax on sugar, health labeling systems and healthy food policies in any place where the government had jurisdiction, such as public schools and hospitals.
The issue of a tax on sugar is also making news in the UK, where the head of Public Health England is set to be hauled before MPs amid accusations vital evidence is being withheld about the merits of a sugar tax.
Meanwhile, the health-star rating scheme is achieving the desired effect of pushing companies into making more nutritious foods, according to a Sydney Morning Herald report which revealed Nestle had drastically cut salt, fat and sugar in its popular muesli bars in order to double the average health-star rating to four.
And the Huffington Post reported on a graphic ad campaign launched by the Cancer Council, Heart Foundation and Victorian Health Department that depicts the way sugar affects the body’s vital organs in a bid to highlight the danger of consuming sugary drinks.
The daily coffee run is also in the firing line, with ABC News reporting that a Cancer Council NSW study showed that it may result in many Australians unknowingly consuming their entire daily sugar and saturated fat limits, as well as half of the suggested kilojoule intake. The study assessed the nutritional content of drinks and sweet treats sold at five popular coffee chains and found 54 per cent of cold beverages, such as iced coffee, contained more than half an adult’s daily recommended sugar allowance in a single serving.
Anti-poverty week saw the media drawing attention to the plight of the poor, with the Huffington Post reporting Australia’s peak welfare body, the Australian Council of Social Services (ACOSS) calling for the federal government to adopt a national plan to help lift more than 2.5 million Aussies out of poverty.
Meanwhile, a long-term study of Anglicare’s emergency relief centres in NSW revealed that more than half the people seeking emergency food parcels, cash or clothing have used crisis services on multiple occasions with a high proportion of them living on or below the poverty line, according to The Sydney Morning Herald.
And The Guardian said that another Anglicare report showed that older single women were the new face of homelessness in Australia. The report said:
Older single women represent the changing face of homelessness; experiencing homelessness for the first time later in life,” the report said. “Most have limited financial resources and assets meaning they are unable to hold their place in a housing market which is becoming increasingly unaffordable.
Croakey reported on concerns about the impact on disadvantaged communities in south-west Sydney of NSW Health plans to outsource The HUB Community Health Centre, in Miller.
And public health leader Siobhan Harpur wrote powerfully about the need for commitment, conviction and innovation to transform the population’s health in Tasmania – which currently has some of the highest levels of intergenerational poverty and food and income insecurity.
State governments are being encouraged to open up the delivery of health and education services to the private sector under recommendations of the Harper Review, which will be put before state and territory treasurers at their next meeting, Sky News reported.
But responding to the idea on Croakey, four health experts warned that the government should hasten slowly, or not at all, in boosting competition in healthcare. Jennifer Doggett, a Croakey moderator and Fellow at the Centre for Policy Development, wrote:
There are some areas of health care in which attempts to increase competition would clearly be misguided. In many areas of Australia, primarily rural and remote communities, there is effectively no competition for the provision of many forms of health care. When communities struggle to get one GP, psychologist or physiotherapist to work in their local area, arguments about the need for more competition from politicians in Canberra are unlikely to be well received.
Mental health overhaul
The media turned its focus to mental health this past fortnight, with the ABC running a host of programs on the issue as part of its “Mental As” week and Federal Health Minister Sussan Ley announcing that the Government would release long-awaited plans to overhaul mental health by the end of the year.
Writing on Croakey, Professor Tim Carey, Director of the Centre for Remote Health, welcomed the news, but said it was conceptual reform rather than structural reform that was needed, and a shift from ‘patient-centred’ care – which too often still sees the clinician making decisions about and for the patient – to a system focused on the perspective of the patient.
Labor leader Bill Shorten also announced a new mental health plan to reduce suicide rates by 50 per cent over the next decade, with a focus on broadening responsibility for suicide prevention by better engaging the community, including businesses and unions.
Meanwhile, two senior advisers to the Australian government on mental health, speaking on Q & A, said addressing skyrocketing rates of suicide among Indigenous Australians would require governments to trust Aboriginal and Torres Strait Islander people to take control of mental health support and suicide prevention. Professor Pat Dudgeon, chair of the National Aboriginal and Torres Strait Islander Leadership in Mental Health group and Professor Ian Hickie, co-director of the University of Sydney’s Brain and Mind Centre, suggested attempts to improve mental health rates in Indigenous communities had failed for not being Indigenous-led.
Their comments came as research by Mental Health Australia revealed that only 18 per cent of Australians regularly seek support when stressed or feeling down, and a US study showed that little face-to-face social contact almost doubled the risk of someone having depression two years later.
In a move that flies in the face of the push for prevention of ill health rather than cure, medical newspaper Australian Doctor reported (registration required) that a new “hangover clinic” would be launched in Australia next month to send doctors to people’s homes to administer IV fluids and medications to treat hangovers, at a cost of about $120 per visit.
A similar service, IV Doc, dubbed “the Uber of hangover cures”, was already operating in New York, aimed at 24 to 44-year-old professionals who want to “get on with their day” and sober up before work, The Australian reported.
A script for cannabis
Medicinal cannabis could be legally grown and prescribed to patients as early as next year under a cross party bill that has attracted initial support from Prime Minister Malcolm Turnbull, the Fairfax press reported. Greens leader, senator Richard Di Natale, announced that the bill to create a regulator for medicinal cannabis for certain conditions had been drafted and would be put before the Senate for a vote in the next month.
The Australian reported that Victoria was set to become the first state to create a medicinal marijuana industry, with legal changes expected to pass parliament to license the growing, dispensing and consumption of approved cannabis. Children with epilepsy would be the first to get access to medicinal marijuana in 2017, it said.
While cannabis may soon be available on script, it could become more difficult to access codeine-containing medicines such as Nurofen-Plus or Panadeine, The Sydney Morning Herald reported. From June next year, about 150 codeine products may no longer be available over the counter at pharmacies, with the TGA considering moving them to prescription-only. The move comes as a study revealed that codeine-related deaths more than doubled between 2000 and 2009, according to ABC News.
The US bombing of a Medicins Sans Frontiers hospital in Afghanistan that killed at least 22 people including medical staff provoked international outrage, with a group of the world’s leading aid agencies backing MSF in calling for an unprecedented international investigation into the “horrific” attack.
US President Barack Obama apologised to the MSF president Joanne Liu for the bombing, as well as to the president of Afghanistan, BBC News reported.
But writing in The Sydney Morning Herald, Dr Phoebe Wynn-Pope from the Australian Red Cross suggested that the bombing was not an aberration, but part of a growing trend for breaches of international laws that protect medical services in war zones ‒ a trend she said threatened the future of humanitarian action in war. She said:
The consequences of each attack on healthcare go beyond the carnage they cause. If medical missions are not adequately protected, the risks may be too great to continue. Organisations may withdraw their staff from conflict zones if they cannot trust in the laws of war to protect them. Healthcare professionals may be less likely to take on humanitarian work – and their families left more anxious every time they go on mission.
Ageing is all in the mind ‒ and we are failing to adapt to the prospect of lifespans that could exceed 135 years, according to a story (paywall) in The Australian about a new book by geriatric medicine expert Rudi Westendorp. He points out that we are gaining six hours in life expectancy every day — and he expects this to continue. “The first person to reach the age of 135 has already been born.”
But when we do reach the end, Australia’s not a bad place to die, new research suggests. The Guardian reported that a study comparing end-of-life care in 80 countries ranked the UK at number one, and Australia second.
CRANAplus conference coverage
The Croakey Conference News Service provided reports from the CRANAplus conference in Alice Springs, including:
More Croakey reading you may have missed:
- Acting globally and locally: doctors for climate action
- JustJustice: Young offenders must be screened for fetal alcohol spectrum disorders before sentencing
- Publish or perish – or publish excessively & become addicted?
- Mobile and healthy cities: can Australian policy catch up with the evidence?
- Where is the outrage about this threat to primary health care research?
- Prison is not the answer. Instead, address the needs of traumatised Aboriginal women