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The Health Wrap: The Stolen Generations, health research funding shake up, action on tobacco control bears fruit

This fortnight’s Health Wrap is compiled by Helen Signy, Senior Communications Officer at The Australian Prevention Partnership Centre based at the Sax Institute. Enjoy the wrap and don’t forget to tweet us @TAPPCentre and @SaxInstitute if you have any ideas you’d like to share.


“Bad, sad day” on climate change

Richard Horton, Editor-in-Chief of The Lancet medical journal called on health and science communities to “unite in resistance” to US President Donald Trump’s decision to withdraw the US from the 2015 Paris Agreement on climate change. Horton tweeted:

“No scientist, no health professional can be either neutral or silent about President Trump’s turn to the medieval. This is a bad, sad day.”

US medical groups warned that Trump’s decision will endanger human health, according to this report which quoted, among others, the newly formed Medical Society Consortium on Climate & Health, composed of 12 US medical societies. Its statement warning that withdrawal from the Paris Agreement will have health consequences said:
The Paris Agreement is science-based and emphasizes clean energy and pollution reduction, which will improve health immediately and is a crucial tool with the potential to reduce the odds of more dramatic harms to health down the road.
The Los Angeles Times reported reactions from “furious” health experts, including Dr Georges Benjamin, executive director of the American Public Health Association, who described Trump’s decision as “reckless” and “further abdication of leadership at the federal level to protect public health.” He added:
The science is clear. Climate change is happening and it’s affecting our health. A changing climate affects our food supply, the spread of infectious disease, our water systems and air quality, and much more. All have significant impacts on human health.”
Former New York mayor Michael Bloomberg, the UN Secretary-General’s special envoy for Cities and Climate Change, said that US cities, states and businesses can still fulfil commitments made by the US under the Paris agreement, Reuters reported.
 
And Modern Healthcare reported several US healthcare executives as vowing also to continue efforts toward addressing climate change within their own facilities, including sustainability initiatives such as reducing landfill waste and water conservation to sourcing food from local producers.

A voice for First Nations

In 1967 we were counted, in 2017 we seek to be heard. We leave base camp and start our trek across this vast country. We invite you to walk with us in a movement of the Australian people for a better future.

Thus concludes the landmark Uluru Statement, which calls for a “First Nation’s Voice” to be enshrined in the constitution.
 
Adopted by 250 Aboriginal and Torres Strait Islander delegates at an historic convention held at Uluru, the Statement calls for a “Makarrata Commission” to supervise and monitor agreements between Aboriginal and Torres Strait Islander groups and governments as well as truth-telling about Aboriginal and Torres Strait Islander history, according to The Sydney Morning Herald.
 
Deputy Prime Minister Barnaby Joyce told RN Breakfast that the proposal for a constitutionally-enshrined Aboriginal and Torres Strait Islander chamber in Parliament would not fly with the Australian public, but Referendum Council member Professor Megan Davis said Joyce’s interpretation of the Statement’s call was wrong, The Saturday Paper reported online. ABC Indigenous Affairs Coverage Editor Stan Grant told the ABC’s Q&A program, as reported here by the Huffington Post:
…  I don’t think any serious thinking person in Australia could seriously dispute that we have such a long way to go in being able to deal with those questions of the disadvantage and get the voice that we need to be able to have influence on the policy that’s directed to us.

His concerns were echoed by a number of commentators who have highlighted continuing Aboriginal and Torres Strait Islander disadvantage 50 years since the Referendum. Chris Sarra, founder and chairman of the Stronger Smarter Institute, pointed out in the Guardian that 17,000 Aboriginal and Torres Strait Islander children are still sleeping away from their homes, making up 35 per cent of all Australian children in care (up from 20 per cent in 1997). Aboriginal and Torres Strait Islander people are not even counted in many health statistics, as this article in the Conversation explains.

And in this powerful articleDr Chelsea Bond, Senior Lecturer in the Aboriginal and Torres Strait Islander Studies Unit at the University of Queensland, explains that racism is still entrenched:

As a racialised subject, I have been subjected to lies dressed up as racialised truths that insist upon our inferiority. Every day, we are forced to contest these lies while having to live with them. In order to get by and get on in a social world that discounts us, we create for ourselves other lies.

The disadvantage experienced by Indigenous people has been prolonged by the failure to implement the 54 recommendations of the Bringing Them Home report 20 years ago, according to the Healing Foundation. Croakey covered of the launch of the Foundation’s new report, Bringing Them Home: 20 years on: an action plan for healing, which calls for a trauma-informed public policy environment, so that policy makers become better informed about the historical and living trauma suffered by Stolen Generations members and their descendants.

This article  by Healing Foundation CEO Richard Weston sets out four immediate priorities that he says are achievable, cost effective, and will likely be effective in changing the policy response to the Stolen Generations.


Health research funding shake up

Federal Health Minister Greg Hunt announced a radical overhaul of the National Health and Medical Research Council’s (NHMRC) grant program this fortnight. The aim of the restructure is to reduce increasing pressure on NHMRC funding schemes that had resulted in the number of grants declining and the success rate for applicants dipping to just 15 per cent.

The NHMRC will replace its 19 existing programs with four new grant schemes, to be fully implemented from 2018–19 for grants beginning from 2020:

  • Investigator grants: for high-performing researchers at all career stages to cover their salary, support teams and other research costs
  • Synergy grants: to bring together multidisciplinary groups to address a major challenge
  • Ideas grants: to encourage fresh thinking and innovation
  • Strategic and leveraging grants: including centres of research excellence, development grants, partnership projects, targeted calls for research and a new scheme for clinical trials and cohort studies.

NHMRC chief executive Anne Kelso wrote in The Australian (paywalled) that the reforms would promote creativity and innovation,  provide opportunities for talented researchers at all career stages, and minimise the burden on researchers of excessive application and peer review. She wrote:

Above all, it will provide a platform for research across the full range of Australia’s present and future needs — whether the focus is bench science or health systems, cardiovascular disease or mental health, rare diseases or those causing the heaviest burden, disease prevention or clinical care.

The NHMRC funding complements the Medical Research Future Fund (MRFF) and the Biomedical Translation Fund, both of which are starting to make funding allocations. These include $10 million of MRFF funding announced in the Federal Budget for The Australian Prevention Partnership Centre, and further funds for Advanced Health Research and Translation Centres, large-scale collaborative centres of excellence across healthcare, research and education.

Helena Teede, chairwoman of the National Alliance of Advanced Health Research Translation Centres, and Hans Meij, executive director of the Melbourne Academic Centre for Health, wrote in The Australian (paywalled) that this funding would reduce barriers, funding limitations and silos to enable translational collaborative research and healthcare that would lead to better outcomes.

Reduced duplication, better collaboration, less state or federal barriers: this is a platform for generating improvements that could benefit patients at an unprecedented pace and scale. It’s about getting the best and the brightest to do internationally competitive research wherever they are in Australia, and working together to come up with new ways to improve the health of Australians.

Meanwhile, last week saw the announcement of Australia’s largest ever philanthropic gift –$400 million from mining magnate Andrew ‘Twiggy’ Forrest and his wife Nicola to be used for causes including cancer research, the eradication of slavery, higher education, giving every child their best chance and building stronger communities. You can see a breakdown of where the money is targeted in this story from The Sydney Morning Herald and read Mr Forrest’s explanation of why he gave away the money in the Huffington Post.


Radical proposal for hospital funding

The question of the Federal Government’s commitment to private heath reared its head in recent days, with a report in Fairfax media that a government-funded taskforce was proposing overhauling hospital funding to remove the private health insurance rebate.

Under the taskforce plan, these funds would be pooled with existing expenditure on public hospitals and private sector doctors to create a Commonwealth Health Benefit that would pay a standard amount to hospital patients, regardless of whether they were in a private or public hospital.

Health Minister Greg Hunt quickly responded that the proposal, reportedly instigated when Sussan Ley was Health Minister, had been taken off the table in February:

It will not be government policy. It will never be government policy.

Media outlets reported that the private think tank Global Access Partners had developed the proposal for the taskforce, which involved Department of Health Secretary Martin Bowles and his deputy Mark Cormack, who is responsible for public hospital funding agreements, according to Fairfax.

Writing for The Conversation, Grattan Institute health program director Stephen Duckett outlined the need to simplify Australia’s highly complex hospital funding arrangements (which he described as resembling spaghetti in the National Health Funding Body’s flow diagram), and said there were many risks inherent with the taskforce plan.

Meanwhile, Croakey published this important in-depth analysis by Jennifer Doggett of concerns raised by the Australian Institute of Health and Welfare’s (AIHW) annual report on public hospital activity – Admitted patient care 2015-16: Australian hospital statistics.  This year’s report for the first time looked at waiting times for elective surgery by funding source, reportedly at the request of the Health Minister, and indicated that hospitals are providing faster access to elective surgery for private patients.

Its findings, she said, raise fundamental questions including “how to reconcile a commitment to equity and universality within our public health system with a system of private health insurance which promises preferential treatment for some”.


Action on tobacco control bears fruit

The UK’s recent introduction of tobacco plain packaging, based on the success of the Australian experience, has put the media spotlight on effective public health policy.

As reported in The Sydney Morning Herald, plain packaging in Australia has resulted in 100,000 fewer smokers in this country since 2012, even after controlling for other factors like excise tax increases. Similar measures could translate to 300,000 fewer smokers in the UK by 2018, according to a Cochrane Review.

In further good news, newly-released findings from the Australian Institute of Health and Welfare’s (AIHW) National Drug Strategy Household Survey showed a continued decline in Australians’ use of drugs, tobacco and alcohol, and a rise in the age of first use. The Age reported that middle-aged women are now drinking more riskily than their daughters, and this article in The Conversation provided a good breakdown of how use is trending.

Also this week, in findings that Curtin University’s Mike Daube described in The Age as “one of the most important papers on tobacco in recent years”, a US study published in the Journal of the National Cancer Institute found that cigarette filters have increased the risk of lung cancer from smoking.

The paper reported that the filters, which were introduced in the 1960s to dilute smoke with air and theoretically reduce the amount of tar inhaled, actually increase the harms of smoking because they cause the cigarette to burn more slowly, thus allowing more time for toxic components to be released. As a result, the incidence of lung adenocarcinoma in smokers has risen in the last 50 years relative to other lung cancer subtypes. The study is already leading to calls for governments to further regulate the design of cigarettes. The authors wrote:

The analysis strongly suggests that filter ventilation has contributed to the rise in lung adenocarcinomas among smokers. Thus, the FDA should consider regulating its use, up to and including a ban.

Meanwhile Jerril Rechter, CEO of VicHealth, reminds us of links between local, national and global tobacco control in this Croakey article, marking World No Tobacco Day.


Other Croakey reading you may have missed this fortnight:

What are the identified priorities for rural health? (And what’s missing?)

Stories from Primary Health Networks – small fish in poorly mapped, choppy seas

Shouldn’t rural doctors be on the call sheet in serious local accidents & emergencies?

Waves of health reform: not so impressive after all?

On the new work order: what it means for public health peeps, and others

Seven reasons to expose NSW’s gambling problem

Kids’ vitamin gummies: unhealthy, poorly regulated and exploitative

New knee osteoarthritis standards & why not everyone needs inpatient rehab after a knee replacement. But who decides?

A new Director General for the World Health Organisation

This week, “a much-needed conversation” – #LivingOurWay

Why the NDIS was a hot topic at #LivingOurWay – and stacks more conference news

Climate Council: climate, health and economics are against Carmichael mine

Wales is leading the world with its new public health law

Hypocrisy, abuse and the hollowness of mental health reform

Fitting the pieces together in mental health: beyondblue and the future of mental health promotion in Australia

Join us this Saturday for some walk, talk – and artistic reflections #CroakeyGO

About public interest journalism, an important request of Croakey readers and contributors

Too much medicine not enough quality media

LongRead: The sickness of social organisation: inequality will be the death of us

 

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