Health on the hustings
Health issues have been firmly in the spotlight on the federal election trail this fortnight, with much of the debate focusing on the Government’s decision to freeze any indexation-related increases in Medicare rebates for a further two years.
Croakey reported that the Consumers Health Forum of Australia (CHF) had become the latest organisation call for an end to the rebate freeze, and in this article, lawyer and researcher Margaret Faux warned that if doctors did stop bulk-billing in the face of the freeze, patients would have to pay the entire fee upfront, before claiming their rebate back from the Government, which would hit them harder than they realised.
The Australian reported (paywall) that bulk-billing rates had continued to rise under the Coalition, undermining claims by Labor and health groups that the MBS freeze would force more patients to pay to see a doctor.
One of Labor’s first major election announcements was that it would end the rebate freeze — a pledge that The Guardian reported would cost $2.4bn over the next four years, and $12.2bn over the decade, but that quickly won the approval of doctors, according to news.com.au.
Health Minister Sussan Ley found herself in the spotlight over her comments that she too wanted to lift the freeze but the Finance and Treasury departments were not “allowing” her to make the change. She told the ABC:
“I’ve said to doctors I want that freeze lifted as soon as possible but I appreciate that Finance and Treasury aren’t allowing me to do it just yet.”
Prime Minister Malcolm Turnbull defended his health minister’s comments:
“The reality is the freeze will end at some point, clearly. The question is it will end when we judge it is affordable within the context of the health budget, that’s all that Sussan is saying — it’s common sense,” he said.
In other major health announcements, the Coalition struck a “peace deal” with pathologists, who have been fighting the plan to cut pathology bulk-billing incentives. While the cuts will go ahead, the Coalition agreed to change the law to reduce the rents that pathologists pay to doctors for co-locating their collection centres in surgeries. The Guardian reported the move would see some of Australia’s biggest pathology companies “millions of dollars better off”.
Meanwhile, Telstra Health – a division of Telstra – was awarded a Federal Government contract thought to be valued at up to $180 million over three years to manage a new national cancer screening register from next year, signalling an end to a series of smaller registries managed on a not-for-profit basis, The Sydney Morning Herald reported. A Department of Health media release noted that the Department of Human Services was eligible to participate in the tender, but did not apply.
A Coalition pledge to provide Indigenous school attendance officers and jobseekers in remote communities with specialised training in Indigenous mental health first aid was welcomed by NACCHO, although chairperson Matthew Cooke called for the initiative to be extended nationally to others on the frontline of suicide prevention and mental health.
Meanwhile Oppostion Leader Bill Shorten announced that his party would axe the Coalition’s planned changes to the Pharmaceutical Benefits Scheme (PBS) that would increase the cost of some medicines. The Coalition plan, under which Australians would pay an extra $5 towards the cost of each PBS prescription (80 cents for concession card holders), was introduced in the 2014 Budget but was blocked by the Senate.
The Greens were also focusing on health, with leader Richard Di Natale promising to increase hospital funding by $4 billion over three years, and to end the freeze on increases in Medicare rebates at a cost of $2.4 billion. He also unveiled a $5 billion plan to revitalise Australian research (paywall), including extra funds for the Australian Research Council and the National Health and Medical Research Council, as detailed by The Australian.
Meanwhile, the University of Sydney’s Emeritus Professor Lesley Barclay highlighted some of the rural health gaps in need of some #HealthElection16 action in this Croakey article, which also details the four key proposals in the Australian Women’s Health Network’s charter for women’s health.
Taking a step back from the election race and looking at the big picture, this piece by the Sax Institute’s Professor Don Nutbeam on The Mandarin explored how improving the dialogue between policy makers and researchers could have long term benefits, in terms of more evidence-informed policy making.
Pleas to pollies on welfare, aged care and suicide
Suicide prevention organisations have released electorate-by-electorate figures for suicide for the first time and called on political parties to pledge to address the problem. The Guardian revealed that the electorates with the highest rates of suicide were Casey and Corangamite in Victoria, which had 184 and 111 suicides in the period 2009 to 2012, and Longman and Brisbane in Queensland, which had 162 and 105 suicides respectively.
Prime Minister Malcolm Turnbull was caught off guard by a blunt question about his plans to tackle suicide rates while visiting Corangamite, The Sydney Morning Herald reported. Would he sign a promise to reduce the number of people who take their own lives?
Mr Turnbull said mental health was a “national priority”.
“We will leave no stone unturned in our effort to improve, protect and advance the mental health of Australia, the mental wealth of Australia,” he said.
Meanwhile, Marie McInerney’s coverage of the recent VICSERV #TowardsRecovery conference highlighted many mental health policy concerns, including the importance of fairer, more inclusive societies that enable and value participation by people with mental illness (including as peer workers). Conference participants also heard of a “perfect storm” facing the sector due to so much change, including from reforms related to the NDIS and Primary Health Networks.
The SMH also reported that six of Australia’s largest welfare groups have written to the country’s major political parties, drawing attention to the growing number of people who fall into homelessness through sheer bad luck and lack of affordable housing.
An alliance of 48 aged care consumers, providers and staff groups has also urged both major parties to address the shortfall in residential places and home care services, according to ABC News Online.
“Too often in elections older Australians don’t get the priority that they should. We have had elections in the near past when neither party actually issued an aged care policy, so we are asking the parties to be much more explicit with the Australian people about what we’re doing for the care of older Australians, much earlier in the campaign,” Council on the Ageing (COTA) chief executive Ian Yates said:
Aged and Community Services Australia (ACSA) has also launched a campaign entitled Old, frail and invisible that will use the election run-up period to highlight the significant issues impacting on older people who require residential or community care, as detailed on Croakey.
Meanwhile, ABC reports that its Vote Compass shows that Australians are overwhelmingly in favour of allowing voluntary euthanasia for the terminally ill, despite the fact the major parties are not touching the issue.
As the World Health Assembly in Geneva put the global spotlight on the public health threats of climate change, Australian doctors urged health professionals to divest from banks supporting the fossil fuel industries, while an article from The Conversation, republished at Croakey, asks: Why has climate change disappeared from the Australian election radar?
Tackling chronic problems
In what medical website Medical Observer described as the “biggest change to type 2 diabetes treatment in a century”, new guidelines agreed on by 45 international diabetes bodies recommended that bariatic surgery should be considered a standard treatment option for many obese patients with type 2 diabetes (T2DM).
“The evidence behind bariatric/metabolic surgery in its treatment for diabetes in the right patient at the right time is so overwhelming that it would be negligent not to offer people treatment,” says Professor John Dixon, head of the Baker IDI clinical obesity laboratory, who was a member of the guidelines oversight expert committee.
We also learned this fortnight that almost 20 per cent of NSW adults live with signs of chronic kidney disease, as reported by ABC News Online. Kidney Health Australia’s annual State of the Nation report also showed that the gap in Indigenous kidney health remained critical, with Indigenous Australians more than twice as likely to have signs of kidney failure than non-Indigenous people.
“We need a national taskforce to tackle the devastating rate of kidney disease in Aboriginal and Torres Strait Islander communities,” Kidney Health Australia CEO Anne Wilson said.
Kidney Health Australia welcomed an announcement by the Labor Party that if elected, it would convene such a taskforce.
The Sydney Morning Herald reported that older smokers are resisting quitting, as the younger generations drive a dramatic drop in smoking rates, according to NSW Health data. It also revealed that Australia’s love affair with booze is waning, with results of the annual Foundation for Alcohol Research and Education survey of 1800 Australians are now in favour of alcohol tax rises and bans on advertising during sport.
Croakey published a snapshot of a broad range of election priorities from some #IHMayDay participants, including calls for the NT intervention to be repealed, more funding and support for people with Alzheimer’s disease and their carers, Aboriginal and Torres Strait Islander led policies across all areas, and better mental health crisis services for Indigenous communities.
Meanwhile, Indigenous leader Jackie Huggins told a major UN forum in New York that the Coalition’s Indigenous policies were not meeting international human rights standards. Ms Huggins, co-chair of peak Indigenous body the National Congress of Australia’s First Peoples, told the UN Permanent Forum on Indigenous Issues there were significant failings around constitutional reform, closing the gap on Indigenous disadvantage, social policy in the Northern Territory and with Indigenous outcomes in the justice system, The Australian reported (paywall).
In WA, residents of remote communities have urged the State Government to fix their drinking water supplies, some of which have been contaminated with deadly bacteria and chemicals for decades. Dozens of communities are becoming increasingly reliant on bottled water, among them Pandanus Park, 120 kilometres east of Broome, ABC News Online reported.
A review of service delivery in remote communities found that of WA’s 271 Aboriginal communities, more than a dozen had enough nitrate in their water supply to cause the potentially fatal condition blue baby syndrome. The issue of ensuring a safe water supply for Indigenous communities was also explored in a recent perspective paper in the journal Public Health Research & Practice.
A healthy diet is cheaper than junk food, but is still too expensive for the most vulnerable Australians, according to new research that was explained in this piece on The Conversation by Professor Amanda Lee, a chief investigator with The Australian Prevention Partnership Centre.
In the UK, nutritionists and public health experts are in meltdown over a report claiming that fat is good for us. Against conventional thinking, the National Obesity Forum and a new group calling itself the Public Health Collaboration, say eating fat, including butter, cheese and meat, will help people lose weight and combat type 2 diabetes, and that the official advice is plain wrong, The Guardian reports. The report has been dismissed by experts as laden with opinion rather than evidence.
And Australian experts questioned a US study that found eating potatoes can increase blood pressure, the ABC reports, while news.com.au went behind the headlines in its article about what food studies really say.
Battling superbugs and super mossies
A fatal Legionnaires’ disease outbreak in Sydney’s inner west continued to make news, with a fifth person diagnosed, The Guardian reported. Our use of antibiotics to treat diseases like Legionnaires could become more difficult, with ABC’s PM program reporting that superbugs could kill someone every three seconds by 2050. A report commissioned by the UK Government calls for patients to stop demanding antibiotics when they’re not needed, and urges a big drop in the use of antibiotics in animal feed lots.
At the 69th World Health Assembly in Geneva this week, the WHO’s Director-General, Dr Margaret Chan highlighted the challenges to global public health of infectious diseases in an interconnected world.
“Above all, the spread of Zika, the resurgence of dengue, and the emerging threat from chikungunya are the price being paid for a massive policy failure that dropped the ball on mosquito control in the 1970s,” she said.
Croakey reported on the work of three scientists who are investigating how scientists are responding to the threat of mosquito-borne viruses in Queensland, one of the most susceptible places in Australia.
Meanwhile, in some good infectious disease news, more than 1100 NSW men have signed up to Australia’s largest clinical trial of the pre-exposure prophylaxis (PrEP) Truvada to protect themselves against HIV and eradicate new HIV infections across the state. The Sydney Morning Herald reported that Health Minister Jillian Skinner’s championing of the trial has gained her “gay icon” status.
A British aid charity is warning that by 2060 more than a billion people worldwide will live in cities at risk of catastrophic flooding as a result of climate change. The eight most vulnerable cities on the list are all in Asia, followed by Miami in the US, BBC News reports. The report was released as new figures showed April was the seventh month in a row that broke global temperature records.
Where you live affects how much sleep you have, a study has revealed. Cultural factors affected when people went to bed and for how long they slept, with Spaniards the latest to bed, the Dutch getting the most sleep, and people in Singapore and Japan the most sleep-deprived.
In Japan, where birth rates are at record lows and the ageing population at record highs, men are being urged to use a phone app to check their sperm count in the privacy of their home.
And finally, we learned that life expectancy across the globe has increased by five years since 2000, the fastest rise in lifespans since the 1960s, according to the World Health Organisation (WHO).
The Guardian reports that babies born in 2015 can expect to live to 71.4 years (73.8 years for females; 69.1 years for males). The longest lifespans are in Japan, where last year’s newborns are expected to live to almost 84, followed by Switzerland, Singapore, Australia and Spain.
More Croakey reading you may have missed this fortnight:
Megan Howe is Publications Manager at the Sax Institute. Follow @SaxInstitute or Megan via @meghowe68 on Twitter.