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The Health Wrap: Keeping patients safe; weapons and war; listening to Indigenous voices, inequality and more

This fortnight’s Health Wrap,  is compiled by Megan Howe, Publications Manager at the Sax Institute. Enjoy the Wrap and tweet us via @SaxInstitute if you have any ideas for future issues.

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 Healthwrote 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

Public health experts are among 39 gun control advocates who have penned an open letter to Federal Justice Minister Michael Keenan seeking the opportunity to put forward their case to the current review of the National Firearms Agreement in the same direct way as the firearms lobby.
The Guardian published the letter this week, as debate continued over whether restrictions on importing the Adler shotgun into Australia should be lifted. The letter states:
“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.”
The debate comes as The Sydney Morning Herald reported on increasing gun violence in the United States, with six people killed and 31 others wounded in shootings in Chicago over a single weekend. The American Medical Association has called gun violence a “public health crisis” and urged Congress to fund research into the problem, the paper reports.
Meanwhile, The Guardian revealed that Australia will not support a resolution before the United Nations general assembly to begin negotiations to outlaw nuclear weapons, and Phoebe Wynn-Pope, Director of International Humanitarian Law at Australian Red Cross questioned what behaviour we are prepared to accept in war in this opinion piece on the ABC, following calls by figures, including Senator Jacqui Lambie, for the laws of war to be disregarded for some combatants.

Listening to Indigenous voices

Former Social Justice Commissioner Professor Tom Calma highlighted the value of longitudinal data to explore how changes have affected the lives of Indigenous children, in this article on The Conversation. The Footprints in Time – or  Longitudinal Study of Indigenous Children (LSIC), which is approaching its 10th year of collecting data from around 1700 Indigenous children, their families and teachers, shows how powerful data sets can be used to look at how Indigenous children have grown up against a backdrop of efforts to resolve and improve long-term indicators of disadvantage. He writes:

“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 CroakeyShe 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.

And Summer May Finlay, also writing on Croakey, asked whether the Federal Government was truly listening to the Aboriginal and Torres Strait Islander sector on the issue of justice and over-incarceration. The recent funding cuts, unmet need, prevention, justice targets, support for people with Foetal Alcohol Spectrum Disorder and Aboriginal and Torres Strait Islander-led solutions were the focus of recommendations in a recent Senate inquiry into Aboriginal and Torres Strait Islander experience of law and enforcement and justice services – all issues that have been raised previously but not acted on, she wrote.
The issue of incarceration was also raised by Allan Clarke on Buzzfeed, in an article in which Aboriginal prisoners revealed what life is really like behind bars, and warned about the alarming rise of young methamphetamine-addicted people in our gaols.

Inequality exposed

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 reportswith people living in the South, especially men, disproportionately affected.

The news came as the US Department of Health and Human Services released a White Paper entitled “Public Health 3.0” which details a national strategic plan to make America healthier.

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.”

Family violence was highlighted a serious public health issue in Canada, with the country’s Chief Public Health Officer Gregory Taylor tabling a report in Parliament showing that every four days in Canada, a woman is killed by a family member, as reported by The Globe and Mail.
And in Scotland, every newborn baby is set to be given a box of essential items such as baby clothes and nappies from next year in a new policy borrowed from Finland, which has contributed to that country having among the lowest rates of child mortality in the world, The Independent reported.
In a thought-provoking article on Croakey,  Jason Cone, Executive Director for Doctors Without Borders/Médecins Sans Frontières in the United States, explained why the organisation had turned down a donation of free pneumonia vaccines from pharmaceutical giant Pfizer.
Dr David Berger, a member of Doctors for Refugees and author of a recent editorial in the BMJ, has called on Australia’s doctors to show moral and ethical leadership and to take to the streets with him to protest at the appalling ill-treatment of asylum seekers.

“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:

Megan Howe is the Publications Manager at the Sax Institute. Follow @SaxInstitute or @meghowe68 on Twitter

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