Keeping patients safe
The media focus has turned to patient safety this fortnight, with the announcement of sweeping changes to how Victoria manages medical errors and patient safety following a review into a cluster of avoidable newborn and stillborn baby deaths at a Bacchus Marsh Hospital.
The Age reported that Stephen Duckett’s damning review report, entitled “Targeting Zero”, showed that the state health department had left patient safety in the hands of individual boards, creating holes in monitoring and a culture of cover-up and missed opportunity. The”biggest health shake-up in decades” will see a new hospital safety watchdog called Safer Care Victoria established to take charge of monitoring patient safety, including the state’s chief medical, nursing, paramedic and allied health officers.
In an article on The Conversation, Professor Andrew Street from the University of York, UK, said the report fell short, because it failed to recommend that data about the clinical performance of individual clinicians be made available to patients, parents and the general public − a move he argues is vital to improving patient safety. He writes:
“It’s taken a long time, and far too many cases of unavoidable deaths or harm to patients, but the medical profession in England is now fully committed to the publication of data about their own performance.”
Professor David Watters OBE, Alfred Deakin Professor of surgery at Deakin University and Barwon Health, wrote on Croakey that the reforms would see a more collegiate response to sharing of knowledge and greater support for smaller health services and hospitals in Victoria, while The Mandarin reported Victorian Department of Heath and Human Services Secretary Kym Peake’s comments that the state’s health system must get better at sharing success stories to avoid preventable harm to patients.
Susan Biggar, senior manager at Melbourne’s Health Issues Centre, also in a piece on Croakey, argued that that the reforms should not overlook the importance of involving patients and their families in making health care safer.
“A person centred approach to health care, which calls for patients and their families to be involved at the level they choose, is increasingly seen by experts as integral to high quality, safe care,” she wrote.
Meanwhile, patient safety in NSW hospitals was also making news, with The Australian reporting (paywall) that lawyers for an oncologist who allegedly under-dosed chemotherapy for a number of cancer patients at the state’s hospitals had written a letter to the upcoming inquiry into the issue, the public had been misled by the State Government over the issue and that employees were being censored.
Also in NSW, a coronial inquest into the sudden, unexplained death of a 10-year-old boy heard that crucial information had been lost after his test results were inadvertently deleted, along with those of 151 other children, at Nepean Hospital in Sydney, according to ABC News Online.
And in South Australia, ABC reported on the coronial inquest into the death of former Socceroo Stephen Herczeg at Adelaide’s Queen Elizabeth Hospital. The inquest heard the 72-year-old died after his oxygen supply was connected to his catheter, causing his bladder to burst and lungs to collapse.
Weapons and war
“Gun violence can affect people in their relationships, their workplaces, their homes or the public domain. So it is essential you officially engage with representatives from the public health sector, criminologists, gun control advocates, unions, domestic violence workers and victim support groups.”
Listening to Indigenous voices
“The LSIC study, and a Beyondblue report, show discrimination is significant whether you ask the non-Indigenous or the Indigenous population. Discrimination causes harm to the mental and physical health of Indigenous people, and like cumulative stress, impacts strongly on the children of affected families from one generation to the next.”
His comments came as a new study revealed how another longitudinal study of the health of urban Aboriginal children has led to a innovative partnership program to tackle speech and hearing difficulties, in a model that researchers suggest could be part of a broader solution for long-term health.
As reported by the Sax Institute, the HEALS (Hearing EAr health and Language Services) program is an outcome of the largest ongoing study of urban Aboriginal children ever conducted, the Study of Environment on Aboriginal Resilience and Child health (SEARCH), involving 1600 urban Aboriginal children and their families. The HEALS program, a partnership between Aboriginal Community Controlled Health Services, researchers and hospitals in NSW, has now delivered more than 7000 life-changing speech and language services and ear operations to almost 800 urban Aboriginal children.
The woman behind another Indigenous-led, health success story has been honoured, 10 years after her campaign to reduce the problem of petrol sniffing saw the roll out of non-sniffable Opal fuel in Central Australia and the APY Lands, as reported by the ABC and NACCHO. Janet Inyika fought tirelessly to convince the Government to introduce the low aromatic fuel, which CAYLUS (Central Australian Youth Link Up Service) estimates has led to a 94% reduction in the number of sniffers in the region.
And Croakey reported on the Dead or Deadly program – an example of a health program that emerged from community-identified need, and a willingness to listen and respond in practical ways to the problem of Aboriginal women in the Shoalhaven area being disproportionately affected by chronic diseases.
This week Attorney General George Brandis, in a speech to the Australian Bar Association, announced a new inquiry into high rates of Indigenous incarceration, saying the over-representation of Indigenous people in the justice system was a “national tragedy” and a poor reflection on Australian society.
The Guardian reported that Indigenous leaders had cautiously welcomed Mr Brandis’ pledge to ask the Law Reform Commission to investigate the the problem – providing it delivers tangible changes in government policy.
But Warren Mundine, head of the Prime Minister’s Indigenous Advisory Council, was scathing, saying the work to highlight the over-representation of Indigenous prisoners in gaol had already been done and holding an inquiry, rather than acting on existing reports, was a “joke”. As reported by ABC, he told Sky News:
“I don’t know who the dickhead is who actually thought up this incredibly brilliant idea. It’s just a total waste of taxation money. It’s going to have no end. I actually could tell them what they need to do.”
Mr Brandis’ announcement came after Megan Williams raised questions about why Australian leaders would not embrace Aboriginal and Torres Strait Islander solutions to the criminal justice crisis, in an article on Croakey. She outlined a range of Indigenous peoples’ actions to address the disproportionately high rates of criminal justice system contact and incarceration that were highlighted at the recent Closing the Prison Gap: Cultural Resilience Conference in northern NSW.
The Guardian reports that 13.3% of the Australian population are living below the poverty line, according to a new report by the Australian Council of Social Service (ACOSS) which shows the level of overall poverty in the community hasn’t been reduced since 2003-04.
ACOSS chief executive Cassandra Goldie described the poverty rate as a “national shame”. She added:
“We need to shift the mindset that poverty is a reflection of the individual and instead view eradicating poverty as a shared responsibility.”
In an article on The Conversation headlined “Housing: the hidden health intervention“, researchers address another area of inequality. They argue that affordable housing is an effective health intervention and say that while Australia debates solutions to the increasing cost of housing, government assistance to meet housing costs can protect people from poor mental health, and possibly depression.
There is also a major social divide in Australia when it comes to infectious disease, reports Medical Xpress, with a 21-year study of more than 2.4 million cases of infectious disease showing that being poorer, living remotely or being an Indigenous Australian means having an increased risk of sexually transmissible infections. The study, published in Lancet Infectious Diseases, revealed that people living in remote areas of Australia were three times more likely to have a notifiable disease and that the incidence of STIs was six times higher in such regions.
Meanwhile, a new report released by the Garvan Institute looks at cancer incidence and mortality rates in rural Australia, showing that improvements that are being experienced in major cities are not being seen in rural areas and confirming that the further a cancer patient lives from a major city, the more likely they are to die within five years of diagnosis.
Don’t miss this compelling read by Dr Ruth Stewart, the new president of the Australian College of Rural and Remote Medicine, reflecting upon her career in rural and remote medicine, and also her insights as a patient, having telehealth chemotherapy for lymphoma on Thursday Island in the Torres Strait where she lives and works. “I hope to see the model of care from which I am benefitting available to rural and remote Australians right across the country,” she wrote at Croakey.
A spoonful of sugar
The Sydney Morning Herald this week reported on a secret plan by Coca-Cola to monitor research at Sydney University that is examining how private companies influence public health outcomes in areas such as obesity. A leaked internal email revealed how a paid consultant to Coca-Cola South Pacific had detailed plans to monitor research linked to researcher Professor Lisa Bero, through the Charles Perkins Centre.
Head of the Charles Perkins Centre, Professor Stephen Simpson, commented:
“On the one hand, it’s not surprising that Coca-Cola [is] tracking academic activity that may impact upon their business. It’s testament to the quality and impact of our work that they should wish to follow Professor Bero’s research. But on the other hand, it is kind of creepy.”
Meanwhile, The Guardian reported on a Swedish study that showed drinking more than two sugary or artificially sweetened soft drinks a day greatly increases the risk of diabetes, while drinking at least five soft drinks daily increased the likelihood of having the disease more than 10-fold.
The sweet-toothed nation of Egypt – where 20% of the population has diabetes – is facing a sugar shortage crisis, The Sydney Morning Herald reports, causing panic and desperation as residents seek supplies of the food staple.
And obesity and diabetes were the focus of a keynote address by Dr Margaret Chan, Director-General of the World Health Organization, at the recent 47th meeting of the National Academy of Medicine, as detailed by Croakey. Dr Chan said governments must recognise that the widespread occurrence of obesity and diabetes was a due to failure of political will to take on powerful economic operators, like the food and soft drink industries, rather than a failure of individual willpower to resist fats and sweets or to exercise more:
“If governments understand this duty, the fight against obesity and diabetes can be won. The interests of the public must be prioritised over those of corporations,” she said.
Global public health crises
New research shows that 30 per cent of all US cancer deaths – more than 167,000 cancer deaths in the 2014 – are linked to tobacco smoking, CBC News reports, with people living in the South, especially men, disproportionately affected.
In the UK, addiction to prescribed medicines may be as great a problem as addiction to illegal drugs, according to a group of UK doctors and politicians who are calling for urgent action to help people addicted to painkillers, antidepressants and anti-anxiety medications. New Scientist reports that Harry Shapiro, head of addiction charity DrugWise, told a Parliamentary meeting:
“We are in the midst of a great public health disaster, which is killing hundreds of people a year and ruining the lives of millions.”
“I hope, therefore, that all doctors, healthcare professionals and other caring people will join me on ‘The Doctors’ March’ in Sydney on Saturday November 5th at 1pm at Archibald fountain in Hyde Park to march to Circular Quay, he wrote at Croakey.
Other Croakey reading you may have missed this fortnight:
- Some questions and answers on the Health Workforce Scholarship Program
- Delays in scholarship program put rural allied health workforce at risk *UPDATED*
- Choosing Wisely update: keep questioning the need for tests and treatments
- Fears that ABS set to cut back Patient Experience Survey
- Out in the heat: why poorer suburbs are more at risk in warming cities
- AntiPovertyWeek: For good rural health we need good rural jobs
- Call for public hospital reps on Minister’s Private Health Advisory group if it starts to look at “cost-shifting”
- The right to health is at the heart of eliminating disability discrimination: Disability Discrimination Commissioner Alastair McEwin’s recent Southgate Institute for Health, Society and Equity Oration
- Magical realism and the draft Fifth National Mental Health Plan.
Megan Howe is the Publications Manager at the Sax Institute. Follow @SaxInstitute or @meghowe68 on Twitter