Senate notes World Tuberculosis Day

A cross-party motion in the Senate has recognised World Tuberculosis Day and noted the enormous contribution of 19^th century German physician Dr Robert Koch in combating the disease.

It has also highlighted the prevalence of TB in this region, particularly in Papua New Guinea, and Australia’s leadership in testing for and treating it throughout the Pacific.

Prior to March 24, which was World Tuberculosis Day, Liberal Senator Concetta Fierravanti-Wells, who is also Minister for International Development and the Pacific; Labor Senators Claire Moore (Shadow Minister for Women) and Lisa Singh; and Greens Leader Richard Di Natale combined to draw attention to TB and Dr Koch’s legacy.

Their motion insisted on the Senate noting that:

24 March is World Tuberculosis Day, and marks the anniversary of German Nobel laureate Dr Robert Koch’s 1882 discovery of the bacterium that causes tuberculosis;
tuberculosis is contagious and airborne, ranking as the world’s leading cause of death from a single infectious agent;
in 2016, 1.7 million people died from tuberculosis worldwide and 10.4 million people became sick with the disease, with over 60 per cent of cases occurring in countries in our region;
large gaps in tuberculosis detection and treatment remain, with 4.1 million cases of active tuberculosis that were not diagnosed and treated in 2016, including 600,000 children;
in 2016, Papua New Guinea had one of the highest rates of tuberculosis infection in the Pacific, with an estimated 35,000 total cases, including 2,000 drug-resistant cases, not taking into consideration the large number of cases that go unreported in many regions; and
tuberculosis is… the leading cause of death among HIV positive people globally.

Their motion went on to detail how HIV weakens the immune system and is lethal in combination with tuberculosis, each contributing to the other’s progress.

“It is now linked to non-communicable diseases like diabetes, and considered a preventable and treatable disease, however many current treatment tools – drugs, diagnostics and vaccines – are outdated and ineffective,” they said.

The Senate also recognised that the funding Australia is providing to support the testing and treatment of tuberculosis in PNG, including the joint program with the World Bank, is already leading to an initiative to achieve universal testing for tuberculosis in the township of Daru.

It also noted he commitment of up to $75 million over five years for Product Development Partnerships in the Indo-Pacific Health Security Initiative to accelerate access to new therapeutics and diagnostics for drug resistant tuberculosis, and malaria and mosquito vector control – an increase in funding to build on the successes of Australia’s previous investments.

Australia has a three-year $220 million pledge to the Global Fund to Fight AIDS, Tuberculosis and Malaria (2017-2019) – a fund that has supported tuberculosis testing and treatment to 17.4 million people since 2002, including over 8.2 million people in the Indo-Pacific region.

Through Australia’s endorsement of the Sustainable Development Goals in September 2015, it made what the Senators described as a bold commitment to end the tuberculosis epidemic by 2030.

“The scheduling of the first United Nations High-Level Meeting on Tuberculosis in September 2018… will set out commitments to accelerate action towards ending tuberculosis as an epidemic and provide Australia with an opportunity to showcase the success of our investment in tuberculosis in our region,” they said.

Their motion also called on the Australian Government to attend the UN High-Level Meeting this year, and commit to increased Australian action and leadership on research and development, prevention, testing and treatment as part of the global effort to eradicate tuberculosis.

CHRIS JOHNSON

Immunisation data pinpoints communities at risk

The latest release of Australia’s childhood immunisation and HPV immunisation rates show a wide variation of uptake across communities.

While new data from the Australian Institute of Health and Welfare (AIHW) confirms childhood immunisation is increasing, Australians continue to fall short of the 95 per cent national goal.

Nationally, 93.5 per cent of all children aged five were fully immunised in 2016–17. Aboriginal and Torres Strait Islander children aged five had a higher national immunisation rate, of 95.7 per cent.

“The greatest improvement was seen in the Central Queensland, Wide Bay and Sunshine Coast Primary Health Networks (PHN) area, which rose from 91.6 per cent in 2015–16 to 93.3 per cent in 2016–17,” said AIHW spokeswoman Tracy Dixon.

“Despite the majority of Australian children being immunised, it’s important that we don’t become complacent. We need to maintain high immunisation rates to protect the vulnerable groups in our community.”

Vaccines have played a big part in helping halve the number of child deaths since 1990. The World Health Organisation (WHO) estimate vaccines save 2-3 million lives each year.

Importantly, the new AIHW data helps to identify where Australian communities of low immunisation are. Categorised across Australia’s 31 PHN, the data shows variation in immunisation rates that range, from 98 per cent in the Nepean Blue Mountains, NSW to 89.8 per cent in Western Victoria, for example.

Health Minister Greg Hunt said the Government would strategically use the new data to target geographical areas with low immunisation rates and identify the 10 per cent of Australians there who have some doubts or uncertainties about it.

“They’re the areas we’re focusing on and, in particular, now we’re able to micro-target through Facebook, through Google, through GP practices,” he said

The Government currently targets areas of low immunisation through the Get the Facts campaign, which seeks to provide parents, through a range of platforms, with evidence based information on the benefits of immunisation.

“The messaging here is very, very clear, that immunisation is both safe and it saves lives,” Mr Hunt said.

The effectiveness of the Government’s No Jab No Pay policy is to increase vaccination rates has been supported by another report that shows an increase in an uptake in Australia of a vaccine containing measles.

The National Centre for Immunisation Research and Surveillance (NCIRS) report found the proportion of children fully immunised at one and five years of age had reached the highest levels ever recorded in mid-2016 (at 93.9 per cent and 93.5 per cent respectively), just after the introduction of the No Jab No Pay policy.

Dr Frank Beard, public health physician, and head of coverage and surveillance at NCIRS explained: “While Australia has been certified free of local measles, we need to maintain high immunisation rates as we are constantly at threat from measles coming into the country from overseas and spreading locally.”

He added that: “Measles catch-up vaccination in adolescents is particularly important, as recent outbreaks have disproportionately affected this age group due to inadequate vaccination.”

Last year Europe faced a four-fold increase in measles, with 20,000 cases and 35 lives lost.

“Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated… a tragedy we simply cannot accept,” warned Dr Zsuzsanna Jakab, WHO Regional Director for Europe.

The other part of the AIHW data released related to HPV vaccination rates and showed an increase for both girls and boys in the uptake of the HPV vaccine among Australian teenagers.

Professor Karen Canfell from Cancer Council Australia welcomed the increase: “As well as helping protect girls against cervical cancer in the future, increasing rates of vaccination across both teenage males and females will help reduce our population’s overall risk of a range of cancers linked to the HPV virus.”

Unfortunately, boys are falling behind in the fight to eradicate HPV. Nationally, 80.1 per cent of girls aged 15 were fully immunised against HPV, compared to only 74.1 per cent of boys aged 15.

Mirroring the childhood immunisation rates, the AHWI data also revealed: where you lived effected the likelihood of being vaccinated. HPV immunisation rates ranged from 85.6 per cent of girls fully immunised in Central and Eastern Sydney (NSW) to 69.2 per cent in Tasmania.

“It is concerning that one in five teens still aren’t directly protected through vaccination and there are some communities where uptake remains lower. We need more research to understand these trends,” Professor Canfell said.

She also believes both vaccination and cervical screening are necessary to combat HPV.

“To further work towards a future without cervical cancer, we encourage parents to ensure their teenagers get vaccinated, and we recommend all eligible women participate in cervical screening,” she said.

Australia was the first country to introduce a free HPV vaccine program, starting with girls in 2007, and including boys from 2013. Later this year the new HPV vaccine is being rolled out which protects against additional strains of HPV making it even more effective.

Details about the AIHW report can be found here: https://myhealthycommunities.gov.au/our-reports/immunisation-rates-for-children/march-2018

And here: https://myhealthycommunities.gov.au/our-reports/HPV-rates/march-2018

MEREDITH HORNE

Tobacco addiction grows from dirty deeds

A damning report launched at the 17th World Congress of Tobacco (WCTOH) shows the tobacco industry is increasingly targeting vulnerable populations in Africa, Asia, and the Middle East where people are not protected by strong tobacco control regulations.

The figures in The Tobacco Atlas are nothing short of alarming. In 2016 alone, tobacco use caused over 7.1 million deaths worldwide (5.1 million in men, 2.0 million in women).

Most of these deaths were attributable to cigarette smoking, while 884,000 were related to secondhand smoke. But while tobacco-related disease and death grows in some communities, so do tobacco industry profits.

The combined profits of the world’s biggest tobacco companies exceeded US $62.27 billion in 2015. This is equivalent to US $9,730 for the death of each smoker, an increase of 39 per cent since the last Atlas was published, when the figure stood at US$7,000.

“The Atlas shows that progress is possible in every region of the world. African countries in particular are at a critical point – both because they are targets of the industry but also because many have opportunity to strengthen policies and act before smoking is at epidemic levels.” said Dr Jeffrey Drope, co-editor and author of The Atlas.

In sub-Saharan Africa alone, consumption increased by 52 per cent between 1980 and 2016 (to 250 billion cigarettes from 164 billion cigarettes). This is being driven by population growth and aggressive tobacco marketing in countries like Lesotho, where prevalence is estimated to have increased from 15 per cent in 2004 to 54 per cent in 2015.

José Luis Castro, President and Chief Executive Officer of Vital Strategies, co-author of The Atlas said it: “Shows that wherever tobacco control is implemented, it works… People benefit economically and in improved health. And the industry rightly suffers.”

Gender inequity was also address at the WTCOH, highlighting the negative economic impacts of tobacco use on women – not just in healthcare costs resulting from tobacco-related illness, but also in the diversion of family income, from food and education to tobacco. The emphasis was that tobacco use drives families into poverty.

WHO Regional Director for Africa, Dr Matshidiso Moeti, said: “The tobacco industry views this region as virgin territory to be exploited. They are targeting women and girls specifically and interfering in the adoption of tobacco control policies that will protect health when properly enforced.”

Tactics of fear by tobacco companies were also heard at the conference from several tobacco control advocates who had bravely fought violence or threats because of their advocacy against the expansion of smoking in their countries, including Indonesia and Nigeria.

Dr Lekan Ayo-Yusuf, Chair of the WCTOH Scientific Committee, said the research showed the need to look at the totality of the supply chain of tobacco products, and to follow the whole process from farming, through to taxation, through to point-of-sale restrictions.

WHO launched new guidance at WCTOH on the role tobacco product regulation can play to reduce tobacco demand, save lives and raise revenues for health services to treat tobacco-related disease, in the context of comprehensive tobacco control.

Many countries have developed advanced policies to reduce the demand for tobacco, but Governments can do much more to implement regulations to control tobacco use, especially by exploiting tobacco product regulation.

Dr Douglas Bettcher, WHO’s Director of the Department for the Prevention and Control of Non-communicable diseases (NCDs), said: “Tobacco product regulation is an under-utilised tool which has a critical role to play in reducing tobacco use.”

“The tobacco industry has enjoyed years of little or no regulation, mainly due to the complexity of tobacco product regulation and lack of appropriate guidance in this area. These new tools provide a useful resource to countries to either introduce or improve existing tobacco product regulation provisions and end the tobacco industry ‘reign’.

“Only a handful of countries currently regulate the contents, design features and emissions of tobacco products and tobacco products are one of the few openly available consumer products that are virtually unregulated in terms of contents, design features and emissions,” Dr Bettcher said.

A copy of The Atlas can be seen here: https://tobaccoatlas.org/.

MEREDITH HORNE

Aged Care Commission needed to address workforce issues

The AMA has made a detailed submission to the Government’s Aged Care Workforce Strategy Taskforce, arguing that the aged care workforce does not have the capability, capacity and connectedness needed to provide quality care to older people.

It calls for an Aged Care Commission to be introduced.

Australia has an ageing population that has multiple chronic and complex medical conditions, but older people face major barriers in accessing appropriate and timely medical care.

Medical practitioners must be supported by the Government and aged care providers to enhance and facilitate much needed access to medical care for people living in residential aged care facilities.

The submission argues that aged care providers need to be supported to ensure access to an appropriate quantity of well-trained staff who work in a rewarding environment with a manageable workload.

“This would ensure older people’s care is not neglected due to shortages of appropriate staff,” it states.

An Aged Care Commission could streamline the aged care system and to help ensures there is an adequate supply of appropriate, well-trained staff to meet the demand of holistic care to a multicultural, ageing population.

An Aged Care Commission would also ensure the aged care workforce has clear roles and responsibilities.

“Australia has an ageing population that is experiencing chronic, complex medical conditions that require more medical attention than ever before,” the submission states.

“For example, 53 per cent of residents in Residential Aged Care Facilities (RACFs) have dementia. This proportion will continue to grow over time, with projections reaching up to 1,100,890 people with dementia by 2056, which is estimated to cost Australia $36.85 billion by the same year.

“A recent study identified that residents of RACFs with dementia had direct health and residential care costs of $88 000 per year. Currently, the aged care system as a whole, and its workforce, does not have the capacity or capability to adequately deal with this growing, ageing population.”

The aged care system needs a strategy, the submission states, to ensure the workforce is appropriate to meet the demands of older people in the future. In order to improve the quality of the aged care workforce, the following is required:

An overarching, independent, Aged Care Commission that provides a clear, well communicated, governance hierarchy that brings leadership and accountability to the aged care system;
Medical practitioners need to be recognised and supported as a crucial part of the aged care workforce to improve medical access, care, and outcomes for older people; and
Aged care needs funding for the significant recruitment and retention of, and support for, nursing staff and carers, specifically trained in dealing with the issues that older people face.

Care of an older person involves a diverse range of professions. All providers of aged care services need to collaborate together to ensure the optimal level of care for the older person. The strategy will be able to provide an ultimate goal for the whole aged care workforce, which should include access to the older person in order for each workforce profession to be able to provide quality care for that older person.

There needs to be a focus on prevention to ensure older people remain healthy for as long as possible to remain in their own home, the submission states, but also to reduce demand and pressure on the aged care workforce.

“Medical practitioners, in particular GPs, regularly incorporate prevention methods as part of providing holistic health and medical care,” it says.

“This includes immunisation, screening for diseases, providing education and counselling to their patient, and also referring the patient to a specialist or allied health professional if required. It is therefore imperative that older people have access to a GP and other services provided by health professionals.”

In its submission, the AMA stresses that the current policy settings do not support GPs visiting RACFs, working after hours, or being available to answer telephone concerns about their patients.

“Our members report that continuity of care goes generally unacknowledged in many RACFs and a resident’s care management plan is not well known,” it says.

“This creates an environment where the default step for RACF staff may be to refer the patient to a hospital emergency department (ED). In a study of 2880 residents of RACFs presented to the ED, one third of presentations could have been avoided by incorporating primary care services.

“Reasons for decisions to transfer residents to an ED include limited skilled staff, delays in GP consultations, and a lack of suitable equipment.”

Medical practitioners also need to be supported within the broader health care system to provide high quality care in RACFs. For example, by local hospitals providing secondary referral, timely specialist opinion, specialist services and rapid referral pathways to advice and services.

Older people are often burdened with complex and multiple medical disorders that requires the regular attention of medical practitioners, quality nursing care and allied health care professionals.

Embracing Information and Communication Technology (ICT) potentially has huge benefits for the aged care sector. It can increase communication between healthcare providers, reduce administrative burden, and assist to improve the health and independence of older people.

Aged care providers require improved ICT systems that are interoperable with the My Health Record, in particular its Medication Overview feature. This would ensure medical health professionals have the tools in place to access all relevant medical information with all relevant stakeholders to improve prescribing and to reduce the risk of adverse reactions and interactions between medications.

“Although working with older people is generally a rewarding experience, it comes with multiple challenges,” the submission states.

“For example, older people can be highly reliant on an aged care worker, and many have behavioural conditions that make day-to-day tasks difficult, and sometimes dangerous for the carer to carry out if the older person’s mental health is not appropriately managed.

“Carers are known to have high rates of moderate stress and depression. The health and wellbeing of aged care staff must be considered for the wellbeing of the workers, and so this stressful environment does not deter people from wanting to work in the aged care sector, or force existing workers to leave.”

Many of the issues outlined in the submission can be rectified by improving the capability, capacity and connectedness of the aged care workforce. Currently, this workforce is not adequately trained to be able to care for older Australians, as older peoples’ care needs are growing in both complexity and volume.

In addition, although medical practitioners are well-equipped to provide quality medical care to residents living in RACFs, they are not adequately supported or remunerated to do so due to the range of issues described above. This has resulted in an unnecessary barrier to quality medical services for RACF residents.

“The aged care workforce needs clear leadership and accountability, which an Aged Care Commission could provide,” the statement says.

“Many aged care governance (and workforce) issues described above have already been addressed in recommendations to the Government as a result of the multiple aged care reviews. Now is the time to act on these recommendations to prevent more unacceptable examples of neglect and bad quality care in RACFs, and to give people living in RACFs the quality of life that they deserve.”

The full submission can be viewed at: ausmed/aged-care-commission-needed-address-workforce-…

CHRIS JOHNSON

[Comment] Disease Control Priorities, 3rd edition—from theory to practice

In 2013, the Lancet Commission on Investing in Health published the report global health 2035: a world converging within a generation.1 The authors showed how governments and donors could achieve a “grand convergence” by bringing preventable infectious, maternal, and child mortality rates to low levels universally by 2035, within a generation. Additionally, the report pointed to major reductions in the incidence and consequences of non-communicable diseases that can be achieved in such time, and that progress towards Global Health 2035 can be accelerated through universal health coverage (UHC).

[Editorial] China through the lens of health in 2018 and beyond

On March 11, China’s National People’s Congress, the top legislative body, approved major constitutional changes that would enable President Xi Jinping to stay in power for more than two terms in office. The healthy China strategy was reviewed in the annual government work report, released by Chinese Premier Li Keqiang at the National People’s Congress on March 5, with several key aspects highlighted.

AMA Federal Council formally condemns Bupa move

The AMA Federal Council has passed two motions against private health insurer Bupa over plans to change to its policies and coverage.

Meeting in Canberra on Friday March 16, the Federal Council held lengthy discussions about Bupa’s recent announcement to rework its medical gap scheme.

A third of Bupa’s Australian customers were told their cover for a range of procedures will change from a minimal benefit to total exclusion.

And patients would only qualify for gap cover if treated in Bupa-approved facilities.

Bupa softened its position slightly after the AMA sharply condemned the announcement, but the AMA believes the move is still far too harsh and is heading towards a US-style managed care system.

It formally rebuked the private insurer with the following two motions:

“Federal Council expresses its concern at recent changes to health insurance products announced by Bupa. These changes threaten member choice and access to health care. Federal Council calls on Bupa to reconsider these changes and to act in the interests of its members and the broader Australian community.”
“That Federal Council recommends that the AMA advises Australian citizens how they can change their private health insurance.”

The AMA has already forced an investigation into Bupa, after AMA President Dr Michael Gannon called on the Government to look into the legality of the private insurer’s move.

Federal Health Minster Greg Hunt subsequently ordered the Private Health Insurance Ombudsman to do exactly that.

The punitive changes were announced just weeks after Mr Hunt approved a 3.95 per cent increase to private health insurance premiums.

“The fact that the change has occurred straight after a premium increase, straight after agreement was made to retain second tier rates for non-contracted facilities, and straight after an announcement by Government to work collaboratively with the sector on the issue of out-of-pocket costs, is unconscionable,” Dr Gannon said.

“The AMA will not stand by and let Bupa, or any insurer, take this big leap towards US-style managed care.

“The care that Australian patients receive will not be dictated by a big multinational with a plan for vertical integration.”

The affected procedures include hip and knee replacements, IVF services, cataract and lens procedures, and renal dialysis.

Bupa made the announcement initially via letter to medical practices, suggesting to them that: “Prior to the commencement of any treatment, patients should be encouraged to contact Bupa directly to confirm their cover entitlements, and any possible out-of-pocket expenses that may be applicable.”

Bupa’s Head of Medical Benefits Andrew Ashcroft also wrote: “Customers affected by these changes will be given an opportunity to upgrade their cover should they wish to receive full coverage for services that were previously only restricted cover.”

Dr Gannon said customers were right to be concerned with the new list of exclusions, but that there was even more bad news hidden in the fine print of Bupa’s new business plan.

“From 1 August 2018, no-gap and known gap rates will now only be paid to the practitioner if the facility in which the procedure takes place also has an agreement with Bupa,” he said.

“Medical benefit rates outside those facilities will now only be paid at the minimum rate that the insurers are required to pay – that is, 25 per cent of the MBS.”

Dr Gannon has written to all AMA members to explain the changes and why they are bad for patients and the medical profession (the full letter can be viewed at ausmed/bupa-decision-bad-news-patients-and-profession).

CHRIS JOHNSON

PICTURE: AMA Federal Council passing motions condemning the Bupa changes.

New vaccines for improved coverage against flu in Australia

Two new ground-breaking flu vaccines will be given to more than three million Australians.

The Federal Government recently said it will provide the new vaccines to those Australians aged 65 years and over who want them.

In making the announcement, Health Minister Greg Hunt said: “This is a direct response to last year’s horrific flu season, which had a devastating impact around the world, and aimed squarely at saving lives.”

More than 90 per cent of the 1,100 flu related deaths in 2017 were of people aged over 65 years of age. While less than one to two per cent of people who get influenza will end up with a complication from it, it is the elderly who seem hardest hit.

“The medical advice, both from the vaccine producers, the World Health Organisation and the Chief Medical Officer is that the mutation which occurred last year in many countries will be specifically addressed by these new vaccines,” Mr Hunt said.

The new vaccines – Fluad® and Fluzone High Dose® – were registered in Australia to specifically provide increased protection for people aged 65 years and older.

From April 2018, both vaccines will be available through the National Immunisation Program following a recommendation from the Pharmaceutical Benefits Advisory Committee.

“Annual vaccination is the most important measure for preventing influenza and its complications and we encourage all Australians to get vaccinated. We encourage all Australians aged over six months old to get a flu vaccination this year before the peak season starts in June” Mr Hunt said.

The Chief Medical Officer, Professor Brendan Murphy, believes the new ‘enhanced’ vaccines will be more effective.

However, Professor Murphy said: “No flu vaccine is complete protection, the standard vaccine seems to protect well in younger people, but we are confident this will give better protection for the elderly.”

The Department of Health believes the new trivalent (three strain) vaccines work in over 65s by generating a strong immune response and are more effective for this age group in protecting against influenza.

There is now a mandated requirement for residential aged care providers to provide a seasonal influenza vaccination program to all staff as well as the Aged Care Quality Agency continuing a review of the infection control practices of aged care services across the country.

Under the National Immunisation Program, those eligible for a free flu shot include people aged 65 years and over, pregnant women, most Aboriginal and Torres Strait Islander people, and those who suffer from chronic conditions.

The following four strains will be contained within this year’s Southern Hemisphere vaccines:

A(H1N1): an A/Michigan/45/2015(H1N1) pdm09 like virus;
A(H3N2): an A/Singapore/INFIMH-16-0019/2016(H3N2) like virus;
B: a B/Phuket/3073/2013 like virus; and
B: a B/Brisbane/60/2008 like virus.

Allen Cheng, Professor in Infectious Diseases Epidemiology at Monash University, has warned: “Despite the common perception that the flu is mild illness, it causes a significant number of deaths worldwide. To make an impact on this, we need better vaccines, better access to vaccines worldwide and new strategies, such as increasing the rate of vaccination in childhood.”

AMA President Dr Michael Gannon welcomed the Government’s announcement because it was targeting vaccine coverage for “a particularly vulnerable group”.

MEREDITH HORNE

Right to put the spotlight on private health insurance

The news about Bupa is timely. With large numbers of people discontinuing their private health insurance, the AMA and consumer advocate organisations, such as CHOICE, should be revealing that companies such as Bupa and Medibank Private have shareholders, who receive a dividend each year, and they sponsor major sports such as tennis, cricket and golf. Such activities use large amounts of members’ contributions, which could be used to provide more comprehensive cover for their health needs.

It is time for the AMA and other consumer advocate organisations to point out that non-profit health insurers provide much better value, and the federal government should be urged to make all health insurers non-profit.

Some 40-50 years ago health insurers were branches of church and community groups such as lodges – IOOF, Hibernian, etc. – and other societies and employers which were non-profit. The Doctors’ Health Fund is a good example of such an insurer. A return to non-profit status would reduce the current trend to ‘Americanise’ our health services.

Dr John A. Crowhurst B.Pharm., MB BS, Dip.(Obst.)RCOG, FANZCA, FRCA.
Consultant Anaesthetist (Ret.)
Linden Park, SA

CANADIAN MILITARY PATTERN TRUCKS

BY DR CLIVE FRASER

During World War II under-utilised Canadian automotive factories produced 815,729 military vehicles for the Allied war effort.

Half a million of these vehicles were British-designed light trucks fondly known as Blitzes.

As a child in the 1960s I can remember seeing hundreds of them parked in old Commonwealth Government stores.

As they were designed to travel cross-country many of them went on to serve in the outback, mining and forestry applications.

It wasn’t so long ago that Tangalooma tourists would be taken to the Moreton Island sand blow in an ex-army Blitz.

After all Moreton Island had been equipped with artillery to protect the shipping channel to Brisbane from Japanese invasion.

A colleague with a collection of military vehicles owns a C60L from 1943.

My colleague was also born in 1943 which makes them both 75 years of age and neither have any retirement plans and both seem built to last.

The C60L was made in the Chevrolet factory in Oshawa, Ontario.

And, if one Blitz is never enough my colleague also has a 1942 F60L which was made in the Ford factory at Windsor, Ontario.

During the war there was a remarkable degree of co-operation between the competing automotive plants with most body parts being interchangeable.

The main point of difference was that the Chevy Blitz had a 216 cubic inch OHV six cylinder engine producing 85 horsepower (63 kW).

The Ford Blitz had 238 cubic inch side valve V8 producing 95 horsepower (71 kW).

Both had four speed non-syncromesh transmissions.

Neither needed a heater because the engine was sitting in the middle of the cabin.

Driving a Blitz does require a tutorial before venturing off.

The main issue is that on first inspection there are only two pedals, an accelerator and a clutch.

The brake pedal is out of view and high up under the dashboard above the accelerator pedal.

The transfer case has high and low ranges as well as a shaft for a power take-off driving a winch.

After the war many Blitzes were fitted with jib cranes and became tow trucks.

My dear Uncle Bob served as a mechanic in the British Army in 1943 working on Blitzes in the North African campaign.

He became adept at improvisation in the desert as patching up the Blitzes kept supplies moving up to the front line.

One day he was bashing a shaft with a hammer when he was distracted by another worker.

He turned slightly, but kept swinging the hammer only to end up striking a blow to his forearm which smashed his watch.

With no end in sight to the war and Bob not carrying a spare watch he was resigned to not knowing the time of day for the rest of his deployment.

The next morning he woke up to see that someone had drawn a cartoon of him smashing his watch and had pinned it above his workbench.

The caption read: “Bob, killing time!”

Whilst long departed I think that my Uncle Bob would be smiling if he knew how many Blitzes were still on the road.