more_vert“Wherever we look, we find signs that whatever dominance the journal may have possessed is fast unravelling.” Alex Csiszar arrives at this unnerving conclusion (at least unnerving to me) in his compelling new book, The Scientific Journal: Authorship and the Politics of Knowledge in the Nineteenth Century (2018). By traversing the histories of scientific knowledge in England and France from 1665 (the birth year of the Journal des Sçavans in Paris and Philosophical Transactions in London), he uncovers clues to understanding the upheavals presently facing traditional scientific journals and publishers.
Preference: Government and politics
My Health Record opt-out extended
The My Health Record opt-out period has been extended until January 31, 2019.
The Government had to back down and delay the cut-off date for people wanting to delete their digital health records in the new system.
The Senate forced the Government into its embarrassing position by voting in mid-November – just before the opt-out was supposed to end – to extend the period.
Despite this, Health Minister Greg Hunt described the vote as win for the Government because Labor had tried to extend the opt-out period by 12 months.
“Labor’s plan to delay and derail the rollout of the My Health Record was blocked today,” Mr Hunt said after the Senate vote.
“We thank the crossbench for not delaying this important policy change as Labor tried so desperately to do.”
But Shadow Health Minister Catherine King said the Government was “dragged kicking and screaming” into accepting the extension.
“For months, Labor has been calling for an extension in order to get this important reform right. For months, the Liberals have been insisting there was no need for an extension,” Ms King said.
“But in the Senate on Wednesday the Government quietly capitulated and accepted a two-and-a-half month extension.
“It’s extraordinary that Labor had to force the Government’s hand by introducing legislation to make this happen.
“Minister Hunt could have implemented an extension with the stroke of a pen weeks ago.”
More than one million Australians have already chosen to opt out of My Health Record system. The extension gives another 17 million Australians the opportunity to do the same.
AMA President Dr Tony Bartone said the time had come now to get on with the process of implementing the online system, which he described as an important and valuable tool in the delivery and communication of health records.
“At the end of the day, it’s called My Health Record because patients will be able to control and ensure who can or can’t see,” Dr Bartone said.
“Now, if a patient doesn’t feel comfortable with the security or privacy provisions that have been enhanced significantly… they can opt-out.
“Now there’ll be a degree of people that will fall into that category, but what we’ve been missing now… we don’t have the critical mass of records created with the critical information and data.
“We still don’t have most hospital data on that My Health Record for the ones that have been created. We’re only now getting the ability to have the pathology and diagnostic imaging results communicated. And the list goes on.”
CHRIS JOHNSON
Government expands football partnership aimed at young Indigenous health
The health, wellbeing and future prospects for children in remote communities will be winners, through a major extension of the successful John Moriarty Football program to 12 centres across New South Wales and Queensland.
The Federal Government is committing up to $4.5 million for the expansion, to be driven through a partnership between the Football Federation of Australia (FFA) and John Moriarty Football (JMF).
JMF and FFA will work together to provide senior coaching staff, mentoring, training and education for children involved in the program. FFA will also identify and support pathways to national football programs.
“This is a game-changing move for Aboriginal and Torres Strait Islander communities, designed to help children between two and 16 to reach their full potential in football, in education and in life,” Indigenous Health Minister Ken Wyatt said.
“We have seen the success in the remote Northern Territory centres of Borroloola and Robinson River, which have been involved in the program since it was established in 2012, with more than 90 per cent of children in Borroloola now participating.
“Two hundred children have enrolled each year, including Shay Evans who is now playing with the Westfield Young Matildas.
“I congratulate Shay and her fellow JMF scholarship winners, but scores of other participants are also continuing to kick personal and life goals, both on and off the field.”
The JMF program is community driven, with children supported to attend school and make healthier lifestyle choices.
The expanded program will focus on primary health through:
- Nutrition programs, with meal plans developed by a sports dietitian;
- Mental wellbeing, through emotional self-regulation training, with coaches focussing on building resilience;
- Community cohesion, through gatherings to support tournaments and holiday clinics encouraging community interest and participation; and
- Parental involvement to enable families to improve health through physical activity.
JMF Managing Director Ros Moriarty said the Foundation was “extremely grateful” for this “very significant” funding commitment.
“We look forward to replicating our model of football as a powerful tool for wellbeing, supporting resilient, healthier outcomes for young players, their families and communities,” Ms Moriarty said.
NSW and Queensland communities to participate will be selected on the basis of evidence of strong local interest and intention to embrace the program.
“Our game has a deep history of Indigenous participation, and this step will allow us to do so much more to improve health outcomes for Indigenous children,” said Moriarty Foundation Board Member and FFA Board nominee Craig Foster.
“Football has the power to unite the whole community to support opportunity for all young Australians.”
FFA Chief Executive David Gallop said FFA had been a keen supporter of John Moriarty Football for several years.
“Matildas Head Coach Alen Stajcic has visited Borroloola on a number of occasions and scouted Shay Evans back in 2014,” he said.
“This announcement will help achieve our vision of involving more Indigenous Australians in football, as players, coaches, referees and administrators.
“We look forward to working closely with John Moriarty Football to generate significant health and community benefits while offering a pathway for Indigenous footballers to emulate the success of Young Matilda Shay.”
Mr Wyatt said regular sport and physical activity, particularly for young children, has documented and far reaching health benefits.
“It reduces the risk of obesity, increases cardiovascular fitness, promotes healthy growth of bones and muscles, improves coordination and balance, and gives children a greater self-confidence and belief in their abilities, on and off the sporting field,” the Minister said.
“The JMF program has the potential to contribute to Closing the Gap in health equality, education and employment, and positively impact on the high chronic disease prevalence rates among First Nations people.”
The three-year funding will be provided through the Indigenous Australians’ Health Program over 2018–19 and 2020.
Government releases new national plan for FASD
The Government has unveiled a new national plan to ramp up the fight against fetal alcohol spectrum disorder (FASD), and has allocated more than $7 million to the initiative.
FASD is often an outcome of parents either not being aware of the dangers of alcohol use when pregnant or planning a pregnancy, or not being supported to stay healthy and strong during pregnancy.
The disorder can inflict lifelong physical and neurodevelopmental impairments that can result from fetal alcohol exposure.
Health Minister Greg Hunt said the aim of the new national plan was to significantly help reduce the impact of FASD on individuals, families and communities.
“This plan will show us the way forward to tackle the tragic problem of FASD – guiding future actions for governments, service providers and communities in the priority areas of prevention, screening and diagnosis, support and management, and tailoring needs to communities,” he said.
“Alongside the plan’s release, I am pleased to announce a new investment of $7.2 million to support activities that align with these priority areas.
“This funding will enable work to start immediately and help protect future generations and give children the best start possible.”
Funding includes $1.47 million for prevention; $1.2 million for screening and diagnosis; $1.2 million to inform schools and workplaces and support the justice system; $1.2 million to tailor solutions to local communities; and $1.55 million to continue developing a one-stop digital hub for information and support.
Indigenous Health Minister Ken Wyatt said the Government’s approach to FASD was to invest in activities which have been shown to be effective.
“Success is underpinned by a team effort, with collaboration between families, communities, service providers and governments,” Mr Wyatt said.
“FASD requires a national approach, linking in closely with local solutions. We are acknowledging the scale of the issue in Australia and intensifying efforts to address it.”
A win for consultation – reports being made public
The AMA would also like to take the time to thank all those who have responded to the call for input on the MBS Review, and to take the time to review the AMA’s MBS Review website.
Please continue to feel free to provide feedback – especially now that the AMA’s calls for the Government to make the MBS Review reports that are currently out for consultation publicly available – meaning AMA members can now see the reports on the Department of Health’s website.
IT IS MEMBERSHIP RENEWAL TIME
Thank you for being an AMA member. Your membership keeps us strong.
There will be a Federal Election in 2019. Health policy will help determine the next Government.
Your AMA will be advocating for:
- Significant new investment in general practice
- MBS review outcomes that improve the delivery of health care
- Increased public hospital funding
- National Mandatory Reporting laws that help doctors and patients
- Better value and more transparent private health insurance
- A My Health Record that protects patient privacy and confidentiality
- Better health care for asylum seekers and refugees
- A greater focus on mental health
- Urgent action on aged care reform
- Strategic funding and programs to improve Indigenous health
- A reinvigorated approach to public health and prevention
- Cohesive medical workforce and training policies across all governments
The AMA is the only organisation that can cover the depth and breadth of health policy across the Federal, State/Territory, and local levels. The AMA is your partner to influence and improve health policy, and to provide advice and resources to support you in your practice and career.
The AMA is the voice of the medical profession and the voice of the patients in our care. The AMA is your voice.
Simply renew your tax-deductible membership online or contact your local AMA office.
Self-testing kit approved for HIV
The first HIV self-testing kit has been approved by the Therapeutic Goods Administration and a new HIV medicine has been listed on the Pharmaceutical Benefits Scheme.
The Federal Government has also announced funding for a new strategy that it says aims to virtually eliminate the transmission of HIV.
The first HIV self-testing kit, the Atomo Self Test was approved for use by the TGA on November 28. The test is a single-use rapid finger stick test for the detection of antibodies to HIV and will enable people to test for HIV in their own home.
It will make testing accessible and convenient, especially for people that need to test frequently or do not test at all.
The medicine Juluca® (dolutegravir and rilpivirine), which works to stop the replication of the HIV virus, is listed on the PBS from December 1, which is World AIDS Day.
This listing means about 860 people a year will be able to access this medicine that would otherwise cost patients up to $10,800 a year without the PBS subsidy.
Patients will now pay a maximum of $39.50 per script, with concessional patients, including pensioners, paying just $6.40 a script.
“Getting people with HIV on sustained, effective treatment is important not only for the individual’s health but also because people with HIV who take treatment daily, and achieve and maintain an undetectable viral load, have effectively no risk of sexually transmitting the virus,” said Health Minister Greg Hunt.
“I am also pleased to announce that the Government will commit $5 million to support the implementation of Australia’s next National Blood Borne Virus and Sexually Transmissible Infections Strategies”
These include:
- The Eighth National HIV Strategy 2018–2022;
- The Fifth National Aboriginal and Torres Strait Islander BBV and STI Strategy;
- The Fifth National Hepatitis C Strategy;
- The Fourth National STI Strategy; and
- The Third National Hepatitis B Strategy.
“The Eighth National HIV Strategy will be the roadmap to help further reduce new infections and improve health outcomes,” Mr Hunt said.
“Its goals include virtually eliminating HIV transmission in Australia by 2022, reducing mortality and morbidity related to HIV and supporting those living with HIV by reducing stigma and discrimination.
“A few short years ago defeating HIV was seen as impossible but today we are on the cusp of eliminating the transmission of HIV.”
In 2017, more than 27,000 people were living with HIV in Australia.
Last year, Australia recorded 963 HIV notifications—the lowest annual number of notifications since 2010.
There has been a reduction of 15 per cent in diagnoses among gay and bisexual men in the past year alone.
“I am proud to say that our Government is taking decisive action with a range of measures to address HIV in our community,” the Minister said.
“These important announcements today come on top of our Government’s decision this year to list the daily preventative medication known as PrEP on the PBS on 1 April 2018.
“The $180 million listing of PrEP, on the PBS, benefits up to 32,000 patients who would otherwise pay $2,496 a year without the subsidy. By listing PrEP we put Australia in reach of being one of the first countries in the world to end transmission of HIV.
“Since the first HIV diagnosis in Australia more than 30 years ago, our understanding around prevention, transmission and treatment of HIV has improved significantly.”
Australia’s theme for World AIDS Day 2018 is ‘Everybody Counts’. World Aids Day is about ensuring people with HIV can participate fully in the life of the community, free from stigma and discrimination.
The strategies are available on the Department of Health website www.health.gov.au/sexual-health
AMA tells Canberra that obstetricians must lead maternity services
The AMA insists that national maternity services must use a collaborative care model that is led by obstetricians or general practice obstetricians.
It has said exactly that in its submission to the Commonwealth Department of Health and Ageing on the proposed new National Maternity Services Strategy.
AMA President Dr Tony Bartone said best-practice maternity care in the 21st century is provided by a multi-disciplinary team of health professionals.
“Obstetricians are the leaders and, along with midwives, are the key carers, but the team also includes general practitioners, anaesthetists, psychiatrists, obstetric physicians, pathologists, haematologists, paediatricians, and nurses,” Dr Bartone said.
“Current evidence supports that this model of care – led by an obstetrician or GP obstetrician – is the safest for mothers and babies, and optimises a range of other health outcomes.
“Obstetrician-led or GP obstetrician-led care means that, at a minimum, there will be initial assessment by either an obstetrician or GP obstetrician, and assessment and regular review during labour.
“Models of care should not result in situations where obstetricians only become aware of a labour problem once it has become acute or serious.
“Women should be encouraged and supported to make their own choices about their maternity care.
“But they should be fully informed about the risks and benefits of each model as it relates to their own specific health situation, pregnancy, and circumstances, after assessment by an obstetrician or GP obstetrician.
“In many instances, GPs are the health professionals who start the conversation with women about having children.
“GPs are best placed to provide continuity of care for women before, during, and after their pregnancies.
“And GPs are especially important in providing whole of maternity care for women in rural and remote communities.”
Dr Bartone said significant additional Federal Government funding will be needed to ensure safe, high-quality, and easily accessible maternity services across Australia.
The AMA used the following principles to assess the draft strategy:
- The primary objective of all maternity services should be healthy mothers and babies.
- Ideology and practitioner-specific agendas should not determine maternity policies and services.
- Policies and services should be evidence-based.
- Policies and services should consider the woman, her baby, and family.
- Funding should follow models of care which improve the health and survival of mothers and babies, are cost effective, and improve women’s experiences.
[Correspondence] Khan faces tough test as Pakistan’s Prime Minister
Prime Minister Imran Khan’s inaugural speech was well received by supporters and political opponents alike. A focus on austerity measures to reduce the effect of debt servicing through International Monetary Fund loans, and an emphasis on human development, became a cause for optimism.1 However, health-care financing and strengthening remains a pertinent issue. As young doctors who are vested in Pakistan’s future, we ask the Government the following questions with regards to health care.
[Correspondence] Australian health professionals’ statement on climate change and health
The Australian Government’s contemptuous dismissal of the latest report of the Intergovernmental Panel on Climate Change (IPCC), including the panel’s recommendation to dramatically reduce coal power by 2050, is unacceptable. As Australian health professionals and scientists, we are dismayed by the implications of our government’s ongoing stance to disregard the consensus of the world’s leading climate scientists, the precautionary principle, and any idea of duty of care regarding the future wellbeing of Australians and our immediate neighbours.