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The Health Wrap: Election health check; flawed family policies; Indigenous justice; research update.

This fortnight’s Health Wrap is compiled by Frances Gilham, Digital Communications Manager at the Sax Institute. Enjoy the Wrap and tweet us via @saxinstitute if you have any ideas for future issues.

#HealthElection16 continues

With the federal election less than a month away, both major parties and the Greens have made announcements on health. Today saw the Labor Opposition announce two key policies: its plan for hospitals and on new models of primary care, and release this video featuring former Labor Prime Minister Bob Hawke warning voters about the future of Medicare under a Coalition Government. Meanwhile Health Minister Sussan Ley defended private health insurance as “a fundamental element of our health system” but promised to make it easier for people to shop around for a more-affordable deal.

Last fortnight’s Health Wrap reported on the debate around the Government’s decision to freeze any indexation-related increases in Medicare rebates for a further two years.

To make sense of some of the proposed changes to both the Medicare rebates and Pharmaceutical Benefits Scheme, three academics from the University of Sydney have done some modelling in this Conversation article around how patients will be affected under both Labor and Coalition proposals.

An article in The Land explored how the Medicare freeze may affect men in rural and remote Australia, particularly in some of the most disadvantaged areas in the country. Dr Ross Wilson, a doctor and sheep farmer from Bathurst, warned:

[quote]”There will be an increased risk of male youth suicide and a possible plague of suicidal tendencies within the community.”[/quote]

The newly elected president of the Australian Medical Association (AMA) Michael Gannon (see more below on the change in leadership) has vowed to fight the freeze, according to The Guardian.

[quote]“The freeze is unfair and it’s wrong. It reflects a continued underinvestment in general practice, the best value-for-money part of our health system in so many ways,” he said.[/quote]

The Australian reported on Labor’s announcement of a permanent health reform commission to advise the Commonwealth and States on ways to improve health outcomes and reduce disparities (paywalled).

Croakey said the body would take on the reform roles of several agencies abolished or downgraded by this Government, including the National Health Performance Authority, the Independent Hospital Pricing Authority, the National Health Funding Body, the former Health Workforce Australia, and the former Australian National Preventive Health Agency.

Indigenous organisations have come together, with the backing of many health groups and NGOs, to issue a landmark election challenge calling for transformative action to address structural inequalities, and to improve the lives of Aboriginal and Torres Strait Islander people, as reported by Croakey. The Redfern Statement demands definitive action on a number of fronts, including restoring $534 million cut from the Indigenous Affairs Portfolio in the 2014 Budget, Aboriginal Community Controlled Services (ACCHS) to be the preferred providers for health services for Aboriginal and Torres Strait Islander people and funding of an implementation plan for the National Aboriginal and Torres Strait Island Suicide Prevention Strategy.

Dr Jackie Huggins, co-chair of the National Congress of Australia’s First Peoples said it was the first time national Aboriginal and Torres Strait Islander leadership organisations had put this kind of united call to an incoming government.

[quote]“We have barely seen a mention of Aboriginal and Torres Strait Islander policy or issues this election campaign. That changes today. Aboriginal and Torres Strait Islander groups have come together to demand urgent action. It is time that Aboriginal and Torres Strait Islander voices are heard and respected. It is time for action,” she said.[/quote]

Meanwhile, Prime Minister Malcolm Turnbull announced $20 million for cancer research focusing on new genome technology to help treat childhood cancers, according to The Australian (paywalled).

Amid concerns that mental health policy was not receiving enough attention this election campaign, Professor Alan Rosen, a senior psychiatrist and academic, wrote a piece for Croakey calling for the Government to halt the closure of headspace services for young people with psychosis. Psychiatrist Professor Patrick McGorry raised similar concerns in his address to the National Press Club, saying mental health had gone backwards under the Turnbull/Abbott Government, prompting this response, as reported by Croakey, from Health Minister Sussan Ley.

And the Foundation for Alcohol Research and Education (FARE) released its election platform, calling on the major parties to address the “hidden harms” of alcohol on children and families, also reported on by Croakey.

See also this earlier useful piece at Croakey that summarising the state of play for health at the campaign halfway mark.

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Medicopolitics under the microscope

New AMA President Dr Michael Gannon has clearly differentiated himself from his predecessor Dr Brian Owler and is coming under criticism for his statements about the role of the private sector in the Australian health system, Croakey reports in this article on responses to the change in leadership.

Dr Gannon, an obstetrician from Perth, told The Australian (paywalled) that he has to be mindful of budget deficits and not ask for “more, more, more” funding for public hospitals, but confirmed the freeze on GP rebates was the number one issue for the AMA.  The Australian also dissected the legacy of the AMA’s immediate past president Dr Brian Owler arguing that under his leadership the AMA became an organisation ­divided. Croakey noted in this article that the AMA will likely be less active in advocating on issues such as asylum seeker policy under Gannon’s leadership, and urged readers to keep an eye out for the president of the Australian Medical Student Association, Elise Buisson, saying she gave an outstanding presentation to the AMA’s national conference, stressing the profession’s role in advocating on issues such as climate change and the social determinants of health.

Meanwhile, in a series on The Conversation on the strategies, political alignment and policy platforms of ten lobby groups that can influence this election, Stephen Duckett looked at how the AMA flexes its political muscle and asked whether the organisation was essentially a patient advocate or doctors’ union.

[quote]”The AMA is adept at dressing up its concerns in high-sounding rhetoric about the public interest. It is also skillful at concealing its weakness in terms of representing a united medical profession. For these reasons, it has been able to maintain its position as the foremost medical lobby group, and will probably continue to do so,” he wrote.[/quote]

[divide style=”dots” width=”medium”]

Flawed family policies

Policies and regulation around families and children were in the news this fortnight, with a pre-election report by a roundtable of experts recommending a series of actions to fix “flawed” policies that are “punishing” families in Australia, SMH reported.

Recommendations included providing a minimum of two days of care and education for all children regardless of whether or not their parents are working, as well as extending the current 18 weeks of paid parental leave to 52 weeks in the long-term, it said.

Fertility treatments were in the spotlight, with ABC News reporting on a Four Corners investigation which revealed that the corporatised fertility sector is misleading patients about their chances of treatment success.

But fertility experts denied there was a need for further regulation of the industry, with Dr David Molloy, Chair of the Heads of IVF Units of Australia, describing it as appropriate to be selling “limited hope” to prospective parents, saying it was difficult for doctors to refuse or discontinue fertility treatment. He said:

[quote]”I had a 43-year-old patient go through the program and you know, her prospect of delivering a baby is under 10 per cent. But every year you get several 43 year olds pregnant. It’s hard to let go of that hope yourself.”[/quote]

An article on The Conversation outlined the ‘No Vax, No Visit’ movement, which demands people visiting newborns are recently vaccinated against whooping cough. The piece argued that it could have unintended social consequences with little evidence for its benefit.

There were calls for stricter mandatory safety standards for the sale of button batteries after statistics showed about 20 children present at hospitals in Australia each week after swallowing the batteries, the Sydney Morning Herald reported.

And the Australian Medical Association and the Australian Institute of Sport released a joint recommendation on concussions in sport, highlighting the need for precautions to be taken particularly when it comes to children.

[divide style=”dots” width=”medium”]

Indigenous justice

A report released by the NSW Ombudsman’s office — “Fostering Economic Development for Aboriginal people in NSW” — said economic prosperity was key to improving social outcomes for Aboriginal people, according to an article on ABC News.

But the latest ABS report on Indigenous people in the workforce confirmed an ongoing trend of low participation.

Researchers from ANU wrote an article describing the barriers to Indigenous people obtaining and maintaining employment, with some suggestions for helping address this disparity, and Vicki Wade from the Heart Foundation wrote in Croakey about their Aboriginal and Torres Strait Islander Employment and Retention Strategy.

This theme touches on many issues — justice, education, healthcare, mental health, culture, identity and self-determination. Those involved in #IHMayDay16 would have seen these issues discussed at length. Croakey provided a huge wrap of the event here.

And the campaign #JustJustice continued the theme, with Croakey featuring articles on a paper in BMJ Global Health addressing Australia’s failure to address the high incarceration rates of Aboriginal and Torres Strait Islander people and this call from Aboriginal lawyer and researcher, Sharon Payne, for policies to reduce early childhood trauma and poverty.

[divide style=”dots” width=”medium”]

Tackling big public health problems

Another public health campaign featured in the media this past fortnight was World No Tobacco Day, marked every year on 31 May by the World Health Organisation and its partners to highlight the health risks associated with tobacco use and advocate for effective policies to reduce tobacco consumption.

VicHealth CEO, Jerril Rechter wrote a piece for Croakey reflecting on the progress Australia has made in reducing the harms associated with tobacco use, and the Sax Institute highlighted how cohort research is helping inform tobacco initiatives in Australia.

An interesting paper was published in PLOS Medicine which explored why low-agency population interventions are most likely to achieve public health aims of preventing disease and minimising inequalities — and why, although they should form the backbone of public health strategies, they are underused by governments.

This proposal from the NSW Government reported on by the SMH might be one such example of a “low-agency” intervention: in-ground traffic lights at pedestrian crossings — “to save mobile phone zombies from themselves”.

The Rio Olympic games and the risk of Zika virus continued to be in the news. ABC News reported that a group of 150 international doctors, scientists and researchers had written an open letter to the WHO calling for the 2016 Games to be moved or delayed due to the virus. BBC News reported on the WHO’s initial response, which played down concerns, and provided an update a few days later when the WHO said it would have an emergency committee meeting in June where it would discuss the Olympics.

The WHO also updated its suggested abstinence or safe sex period after travel to Zika zones, according to The Guardian.

In other infectious disease news, the BBC reported on the detection in the US of the first case of an infection to resist the antibiotic of last resort, colistin.

9News said the US would establish a a network of laboratories that could quickly respond to antibiotic-resistant “superbugs”, as infectious disease experts announced it was only a matter of time before an antibiotic-resistant bug reached Australia’s shores.

University of Newcastle academic Sergio Diez Alvarez gave some suggestions on antimicrobial stewardship in an article for The Conversation, and another interesting Conversation piece explained how computer modelling was allowing great advances in tracking the spread of infectious diseases.

Croakey also published this tribute to “tireless advocate for rural health and social justice” Gordon Gregory who recently retired from the helm of the National Rural Health Alliance.

[divide style=”dots” width=”medium”]

Research update

There was a flurry of submissions released commenting on the Australian Medical Research and Innovation Strategy and the future priorities for the Medical Research Future Fund (MRFF) before the closing date of 6 June.

The Sax Institute’s submission urged the MRFF to prioritise research that can shape the future of health services in Australia and improve the efficiency of the health system, with a strong focus on research into healthy ageing.

Professor Fran Baum and Dr Matt Fisher wrote a piece for Croakey in support of their submission, arguing for the Fund to prioritise research into the wider determinants of health and health inequalities, rather than taking a biomedical approach.

Research Australia also published a report, saying the MRFF needs to prioritise closing gaps between health research, health practice and the health economy.

[quote]“The Medical Research Future Fund is the opportunity of a generation to bridge the gaps, and bring what happens in the lab together with what happens in clinical practice, and vice versa,” Research Australia CEO Nadia Levin said.[/quote]

All publicly funded scientific papers published in Europe could be made free to access by 2020, under a “life-changing” reform ordered by the European Union’s science chief, Carlos Moedas, according to The Guardian.

In the US, Vice President Biden announced the launch of a first-of-its kind, open-access cancer database of both genomic and clinical data to allow researchers to better understand the disease and develop more effective treatments, the Washington Post reported.

And closer to home, a proposal to consolidate Australia’s existing cancer registries and link them with electronic health records has been met with a positive response, but Alison Verhoeven wrote for Croakey that there remain governance issues surrounding Telstra Health’s involvement in the project. The Grattan Institute’s Stephen Duckett also wrote on this topic for The Conversation, outlining the privacy issues involved.

[divide style=”dots” width=”medium”]

Other Croakey articles you might have missed this fortnight:

Frances Gilham is the Digital Communications Manager at the Sax Institute. Follow @SaxInstitute or @FrancesGilham on Twitter.

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