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The Health Wrap: Ministerial rearrangements; World-wide worries; Research highs and lows

This Health Wrap is compiled by Frances Gilham, Digital Communications Manager at the Sax Institute. Enjoy the wrap and don’t forget to tweet us @SaxInstitute if you have any ideas you’d like to share.

Ministerial rearrangements

The year 2017 has kicked off amid plenty of political upheaval, with changes in State and Federal ministries likely to have implications for public health.

Following Sussan Ley‘s resignation as health minister, Greg Hunt was announced as Australia’s new health and sport minister, with Senator Arthur Sinodinos taking Hunt’s portfolio of industry, innovation and science, The Guardian reported.

Amid the reshuffle, Ken Wyatt was named Minister for Aged Care and Indigenous Health — the first Indigenous person to be appointed to the Commonwealth ministry. The Guardian, reporting on his appointment, quoted him as saying:

“Any Indigenous Australian has the capacity and capability of achieving their aspirations… There are a whole lot of barriers that impact on each of us individually, but you work to rise above those. And so the symbolism of being on the frontbench is a tremendous one.”

According to the ABC, his supporters welcomed his new ministry but suggested he would be well qualified to become the Federal Indigenous Affairs minister.

Croakey spoke to the new Minister about his agenda; read more about his plans, which include a commitment to improving Aboriginal and Torres Strait Islander peoples’ access to primary healthcare.

Meanwhile, health stakeholders have been busy lobbying Greg Hunt, ready with suggestions for priorities in his new role.

The Daily Telegraph reported that the Australian Medical Association (AMA) have already begun a discussion about ending the Medicare rebate freeze.

Associate Professor Joel Negin, head of the school of public health at Sydney University, wrote a great opinion piece for Fairfax outlining why prevention should be on the radar of both major political parties. He wrote:

“The value for money argument for prevention is strong but investing in prevention is not just about budget savings. It is really about building stronger families and communities. It improves people’s wellbeing, keeps them out of hospitals, and allows them to spend more time doing what they love.”

And Associate Professor Lesley Russell from the Menzies Centre for Health Policy at the University of Sydney set out a solid argument for Inside Story, also advising our new Minister to look beyond doctors and hospitals to improve Australians’ health.

Another must-read for the new Minister (and anyone else with a concern for rural health equity) is Margaret Faux’s critical analysis of suggestions to increase Medicare rebates for some services in rural areas. She says the suggestion “is not the solution to out of pocket expenses in the bush. Rather it demonstrates a poor understanding of the mechanisms driving medical service delivery in Australia, and the ways in which doctors are paid”.

And here you can read some diverse perspectives from Croakey contributors of Ley’s legacy in the portfolio, including Lesley Russell’s suggestion that she “will be remembered primarily as the Minister for Incomplete Actions”.

Meanwhile in NSW, the shock resignation of  Premier Mike Baird, followed by long-time Health Minister Jillian Skinner calling it a day, led to a local reshuffle.  After being announced as the new Premier of NSW, Gladys Berejiklian undertook at cabinet shake-up, appointing veteran parliamentarian Brad Hazzard as the new Health Minister.

We are yet to see what changes this holds for health.


World-wide worries

Internationally, the big news of course has been US President Donald Trump, and his early actions in his new role.

His initial executive orders will have implications for Obamacare, outlined by the Washington Post, but the publication later published news of Republican concerns about how to repeal the Affordable Care Act in a way that won’t damage the party or its chances of re-election.

President Trump also signed executive orders withdrawing the US from the Trans-Pacific Partnership trade deal, reinstating the ‘global gag rule’ barring US foreign aid from going to any non-government organisation that provides or discusses abortion services with its patients, and a 90-day ban on entry to the United States for people from seven predominantly Muslim countries.

Croakey has covered the health implications of Trump’s early policies, as well as publishing a range of responses from key health and medical professionals on social media, who have put forward suggestions on how they – and others – might respond to the changes, including: “the simple call for clear messages of condemnation, increased support for refugee and aid organisations, a boycott of US-based journals and academic meetings, a petition to halt state visits from the US, and calls for stronger, clearer leadership by our health professional bodies”.

An interesting article on Stat News shows how different types of visa-holders cover medical practitioners, students, trainees and scientists, with examples of the types of people who would be excluded from entering the US under the new orders.

In other international news, the World Economic Forum’s latest annual reports on global risks puts the spotlight on climate change and environmental degradation, as well as highlighting the threats to global security from growing income and wealth inequality, and suggesting the need to reform market capitalism to foster great solidarity. It also examines the risks associated with technological developments driving insecure work and other changes including, worryingly, an arms race in autonomous weapons systems. Read more in this Croakey report.

Another global report released in recent weeks highlights the growing market power of tobacco companies, according to Croakey.

Meanwhile, investigative reporting has revealed worrying practices in pharmacies in the US, with a story by the Chicago Tribune finding that 52% of Chicago pharmacies failed to warn patients that a pair of drugs, if taken together, could result in potential harm or death.

Health News Review covered the story, saying:

“The Tribune story should be only a beginning for the media. This is a local story everywhere.”

And a new report has found the health of children in Scotland to be the worst in Europe, with an “alarming” gap between rich and poor risking the health of the youngest generation, BBC reported.


Research highs and lows

In happier news back in Australia, the latest Australian of the Year award was announced, with medical researcher Emeritus Professor Alan Mackay-Sim a very worthy winner.

Read more about his work, which has led to groundbreaking advances in the treatment of spinal cord injuries using stem cells, according to the ABC, and how his winning has highlighted the important issue of medical research in Australia.

Over on The Conversation, researcher Professor Melissa Little wrote about the difficulty of balancing “hope” with “hype” when it comes to promoting stem cell research.

The issue of conflicts of interest in research has also been in the news this past fortnight, with JAMA Internal Medicine publishing a special collection of articles highlighting conflicts of interest between healthcare and industry, Health News Review reported.

And the BMJ published a paper highlighting the likely bias in research sponsored by drug companies. The analysis of 195 drug trials showed more than half had financial links to pharmaceutical companies, and those studies were more likely to report favourable results, according to 6minutes.com (registration required).

The Sydney Morning Herald also reported on this issue, highlighting a Deakin University study that reported on the types of tactics that the food industry in Australia used to try and influence health policies.

Still in research news, The MJA reported that younger children are twice as likely to be prescribed medication for attention deficit hyperactivity disorder (ADHD) than their older classmates, suggesting that immature children are being mistakenly diagnosed with the disorder.

An opinion piece by WHO expert Dr Abdul Ghaffar published on The Mandarin and the Sax Institute website has argued research should be embedded in health systems in order to make sure it has an impact in the real world.

Professors Tammy Hoffmann and Chris Del Mar from the Centre for Research in Evidence-Based Practice at Queensland’s Bond University also wrote for Croakey about their systematic review of studies that assessed how good clinicians are at quantifying the benefits and harms of the interventions and treatments they are considering. On related matters, veteran paediatrician and Emeritus Professor, Kim Oates, offered interns starting work in their new roles ten tips for quality care, including, first, put the patient first.

Reforming the way health data is accessed and shared would help us harness research to inform policy, according to the Sax Institute’s Deputy CEO Robert Wells in an article for The Australian (paywalled), in which he suggests the health system could act as a test system for data reform measures proposed by the Productivity Commission:

“There is a strong research and analytical capacity across the sector, particularly in the use of linked data and assessing value for money in health investments, so the sector has the expertise and knowledge required to function as an early adopter.”

Heeding health data was also the focus of an article on The Conversation by the Grattan Institute’s Stephen Duckett, who highlighted some of the concerning health statistics in the Productivity Commissions’ Report on Government Services 2017, saying it revealed serious problems in the areas of out-of-pocket health expenses, potentially avoidable early deaths, Indigenous health and state-by-state differences in health outcomes.

He suggested the new Health Minister Greg Hunt should table the report at the next health ministers’ meeting, focusing on where each state could make improvements. He added:

“It will be a tragedy if we allow these very comprehensive – and quite expensive – reports just to moulder on shelves rather than addressing the issues identified.”


Bugs and the environment

Scientists have confirmed 2016 was the hottest year ever recorded, saying human activities are to blameThe Guardian reported.

This article published on the BBC website explores the health risks associated with bursts of hot conditions, calling heat Australia’s deadliest natural hazard, while The Sydney Morning Herald reported that Sydney recorded its hottest ever month in January.

The recent ‘thunderstorm asthma’ event in Melbourne certainly demonstrated the deadly effect that extreme weather can have; a preliminary report has now been released by the government which said despite emergency services responding “remarkably” well to the crisis, limited communication and information sharing between and within agencies prevented them from fully understanding the situation.

Our environment shapes and affects our health in many ways.

A new study looking at antibiotic resistant bacteria in China’s estuaries has suggested antibiotics and resistance genes are likely to be contaminating the environment through sewage and waste water, or being released directly into rivers and lakes, on a world-wide scale, the Sydney Morning Herald reported.

Antibiotic stewardship was highlighted in the most recent issue of The MJA, which published an article by Professor Karin Thursky outlining the challenges of tackling antibiotic-resistant pathogens, as well as achievements so far; and one by anaesthetist Dr Simon Hendel discussing how the issue could affect the future of surgical procedures. He wrote:

“In the past fortnight, I’ve anaesthetised people having hip and knee replacements, major abdominal surgery for cancer and two young women needing emergency caesarian sections. All of these procedures are reliant on effective antibiotic prophylaxis to prevent surgical site infection.

If cases like these could no longer be done safely in Australia, the impact on our health system and on the lifestyles of Australians would be enormous.”

And in the UK, malaria drugs have failed to treat the disease for the first time, with scientists worried that this suggests early signs of a developing resistance, bbc.com reports.


Equality and funding updates

Research shows bugs don’t always strike all groups equally.

Aboriginal and Torres Strait Islander children are more than seven times more likely than their non-Indigenous peers to be admitted to intensive care suffering from life-threatening infections caused by a common bacteria, according to research reported on by The Guardian.

Other research, highlighted by NACCHO, has found cigarette pack warning labels are motivating Aboriginal and Torres Strait Islander smokers to quit smoking.

And a third study has found Aboriginal people on the New South Wales north coast are twice as likely to be hospitalised for mental health related issues as non-Indigenous people. The findings have prompted the Federal Government to allocate $300,000 to the North Coast Primary Health Network to start developing a special care model for Aboriginal mental health, ABC News says.

Another funding boost has come in the form of an Indigenous suicide prevention program, trialled in West Australia last year and set to be expanded into the Northern Territory and South Australia in 2017.

In contrast, an Indigenous sexual health program that has been running in Queensland for 21 years is set to close this year when federal funding stops, according to this article in the Daily Telegraph.

The issue of social exclusion – and its flipside inclusion  – are explored in this article on Croakey, in which Professor Fran Baum from Flinders University reports on a conference looking at what societal structures have caused people to become excluded in the first place, and how change those factors that are keeping vulnerable people on the outer.

Meanwhile, this “postcard from Sheffield” in the UK has plenty of suggestions for how to build a responsive, resilient health and care system, and inclusive communities.


Other Croakey reading you may have missed this fortnight:

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