Ruth Armstrong: You’ve been warned!

WAS anyone else surprised by the flamboyance that accompanied the delivery of last Tuesday’s federal Budget?

I was pretty unpopular at home for forsaking our current family ritual of predicting whose chairs will turn on The Voice in favour of the Budget. Between the Treasurer and a few trolls on Twitter, I think I got better entertainment.

Then for an encore on Thursday (with no significant programming clashes) came the Opposition leader’s reply: a “spirited” and equally theatrical, colour-coordinated warning to the government that they would seek to block the projected reforms to health, welfare and education when they come before Parliament.

Of course, politics being politics, warnings often go unheeded. Our first InSight news story visits the Budget one more time, in relation to an initiative that attracted a lot of discussion and warnings long before it was revealed on Budget night — the Medicare copayment. It seems evidence provided over the past few months about the detrimental health impact and economic folly of copayments changed nothing in the Budget regarding Medicare, leaving health leaders, economists and policy experts a little disillusioned, but energised for a fight.

Writing early this year in the MJA, academics from the Nossal Institute for Global Health warned that there were uncertainties about the health effects of unconventional gas production and that Australia should proceed with caution.

A follow-up letter to the Journal, outlining an instance of groundwater contamination with heavy metals and uranium from a coal seam gas operation in north-western NSW, is the subject of our second news story.

With the recent suspension of gas exploration at the highly controversial Bentley site in northern NSW, and the mining company’s referral to the NSW Independent Commission Against Corruption for inadequate community consultation, emerges another salient warning — the need for informed public discussion about health harms and benefits before embarking on such projects.

Our third news story puts telehealth on notice, with a perspective article in the MJA pointing out that a lack of clinical and economic evidence is leading to slow and patchy implementation. Mobile technologies — cheap, efficient and almost universally available — may save the day but these too should be subject to careful evaluation.

A sobering warning for those of us who are part of the vaccinated generations emanates from a comment article this week. In a long career as an infectious disease physician, Emeritus Professor Clem Boughton saw severe cases of diptheria, polio, pertussis, congenital rubella, measles and other vaccine preventable diseases. He is now on a mission to ensure that we never forget why we immunise our children and to make sure future health professionals recognise a case when they see one, by preserving an archive of clinical photographs and recordings.

Not everyone gets the benefit of a warning. In her column, Jane McCredie reveals the growing phenomenon of surrogacy in India, wondering how the young women who agree to be involved can be fully informed of the many risks involved.

While the “entertainment” value of the Budget debate is likely to be turning chairs for some time to come, and as politicians churn out the classic ballads of class warfare and election speculation, it needs to be remembered that what happens next will impact on Australians’ future health.

During last Tuesday night’s fracas, a good friend who is a GP sent me a text which I added to the Twittersphere: “This co-payment won’t make GPs any less likely to do other than what’s best for patient care” — a grassroots perspective reflected in the comments of Professor Geoffrey Dobb, AMA vice-president, to InSight. Dobb reinforced the AMA’s position that its job was to help minimise the adverse impacts and unintended consequences of the federal Budget’s health measures, “particularly in terms of the impact on services for poorer people and children”.

With a few notable exceptions, doctors are not given to strutting their stuff on stage, but our medical leaders have made it abundantly clear that they will continue to strive for what is best for patients.

Politicians and policymakers, consider yourselves warned!
 

Dr Ruth Armstrong is the medical editor of MJA InSight. On Twitter @DrRuthInSight