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Preference: Government and politics

Terminator says health is collateral damage of fossil fuels

Hollywood actor and former Governor of California, Arnold Schwarzenegger, has used a United Nations gathering in Germany to describe fossil fuels as a public health hazard.

At a sideline event of the 12-day UN climate talks in Bonn in November, Mr Schwarzenegger delivered a well-received speech that issued a challenge to world leaders.

A long-time outspoken environmental activist, the star of such blockbusters as The Terminator, Total Recall, Collateral Damage and Predator, urged governments everywhere to start labeling fossil fuels with a public health warning.

That health warning should state, he said, that their use could cause illness and death.

He praised the World Health Organization (WHO) for delivering on a 164-nation tobacco control deal in 2003 that resulted in health warnings on tobacco products.

But he added that a similar deal could be reached with regards to oil and coal products.

“Wouldn’t it be great now if they could make the same pact with the rest of the world to go and say, ‘let’s label another thing that is killing you – which is fossil fuels’,” he said.

“If you went to a gas station, it says that thing you’re pumping into your car is killing you.

“Pollution kills more than nine million people a year. Over 300,000 people will die over the course of this conference. That’s the population of Bonn.

“This is a massive tragedy. And as depressing and terrifying as it is, we are not talking about it enough,” he said.

WHO Director-General Tedros Adhanom Ghebreyesus called on conference delegates talk about building climate resilient health facilities in their home nations by 2013, which is a stipulation of the Paris Agreement.

He added that more investment was needed in the health sector.

“Climate change strikes at the heart of what it means to be human,” Dr Ghebreyesus said.

“Climate change is not a political argument in Fiji and other island nations. It’s everyday reality – whether that’s in the form of destructive storms, rising sea levels or increased risk of infectious disease.

“These communities need assistance to cope with a world that is changing in front of them.”

The Paris Agreement global climate treaty aims to limit rising temperatures to below 2˚C by reducing greenhouse gas emissions.

Fiji presided over the Bonn conference and was also the beneficiary of an initiative launched by WHO and the UN climate secretariat aiming to triple international financial support for action on climate-related health issues in the developing small island nations.

CHRIS JOHNSON

 

EU driving e-health

Estonia, which is coming to the end of its presidency of the Council of the European Union, has recently sought to bring together EU countries that would be willing to launch a project concerning the cross-border movement of healthcare data.

The Digital Health Society, initiated by the Estonian Presidency of the Council of the European Union and ECHAlliance, have assembled an e-Health Declaration that includes more than 100 European organisations’ proposals for developing e-health in Europe.

The Declaration describes the bottlenecks that hamper the development of e-health, such as the lack of people’s trust in e-services in Europe, the lack of interoperability between different information systems, the lack of a clear legal framework, inadequate training of health-care professionals. Proposing solutions for overcoming these obstacles, the document emphasizes the need for unified approaches to the development of data exchange infrastructure, raising people’s awareness of the use of e-health solutions and implementing the European Union Data Protection Regulation in a way that it does not create unnecessary obstacles to the free flow of data between member states.

At the recent e-health conference held in Estonia, European Commissioner for Health and Food Safety Vytenis Andriukaitis called for a strong partnership within the EU to move towards simplified public e-services and formalities.

This would make interactions between citizens and public administrations easier.

“Let us all work together with governments, health professionals, businesses, and researchers, but above all with the patients to make digital health in Europe a reality,” he said.

Central to the EU’s agenda on digital innovation in healthcare is: the right of citizens to access, manage and control their health data electronically in a convenient and secure manner; to better use health data, in particular for research and innovation purpose; and the better use of health data, in particular for research and innovation purposes.

Clemens Martin Auer, Director General of the Austrian Federal Ministry of Health and Women’s Affairs, said that using the opportunities of information technology in healthcare, or e-health, is one of the most important innovative drivers in the healthcare sector: “Especially for organizing the continuous care in the fragmented world of healthcare services.”

The EU acknowledges that at that level, although health competence remains the responsibility of each member state, there is a goal for a common understanding to be formed into an agreement that fixes common components and common infrastructure that enables the free flow of health data.

A number of European member states have already designed their healthcare system in order to digitalise data. The remaining member states should implement strategies and policies for the creation of electronic health records across their country in order to stimulate the innovation for health and exchanges data with other EU countries.

MEREDITH HORNE

[Perspectives] Agnès Buzyn: France’s Minister for Solidarity and Health

Curiously, a career in politics is of little interest to Agnès Buzyn, distinguished haematologist and Minister for Solidarités et de la Santé in France’s Government under Prime Minister Edouard Philippe and President Emmanuel Macron. “I would not have accepted this post in another government. It is a real shift in our democracy to try and get people working together across the political spectrum. I accepted this position as I am philosophically in line with President Macron, and I want to see scientific rationality brought into our political decision making”, Buzyn says.

[Comment] Can the Antimicrobial Resistance Benchmark blaze a new trail?

A year has passed since the landmark declaration at the UN General Assembly on antimicrobial resistance (AMR), acknowledging the threat to people, animals, agriculture, and the environment.1 On Oct 12–13, 2017, a conference organised by the Wellcome Trust in partnership with the UK, Ghanaian, and Thai governments and the UN Foundation, in support of the work of the Antimicrobial Resistance Inter-Agency Coordination Group (IACG), aimed to accelerate efforts to tackle rising drug-resistant infections.

[Perspectives] Picturing health: Rohingya refugees in Bangladesh

Since August, 2017, when violence broke out in Myanmar’s northern Rahkine State, it is estimated that more than 600 000 Rohingya people have fled to Bangladesh. To accommodate the steady flow of people, vegetation on steep hillsides and between swathes of paddy fields in Bangladesh has been razed to build spontaneous settlements. Although Bangladesh is planning to build a camp that would house 800 000 people, Rohingya refugees are currently trying to survive in these crowded, haphazard camps. Humanitarian assistance is being provided by the Bangladesh Government, non-governmental organisations (NGOs), UN agencies, WHO, volunteers, and others, but conditions in the refugee camps are difficult.

Spike in mandatory reporting of doctors

 

As stakeholders get ready for mooted changes to mandatory reporting procedures, AHPRA has announced a dramatic increase in the number of doctors reported in 2016/2017.

In its newly released annual report, the regulatory authority records a 32.1% increase in the number of mandatory notifications of health practitioners, totalling 1,142 notifications, compared with 980 the previous year.

Just under 300 doctors were on the wrong end of a mandatory notification, up from 272 the previous year.

On investigation, around half of those cases required no further action. Forty-three doctors received a caution or reprimand, 15 accepted a specific undertaking, and 32 had conditions imposed on their practice.

Six doctors agreed to surrender their registration, five had their registration suspended and two had their registration cancelled.

The majority of doctors were reported for poor standard of clinical care, with a further 57 reported for impairment, 11 for drug or alcohol misuse and 29 for sexual misconduct.

In its report, AHPRA said that this year it had received the highest number of general notifications overall in any financial year since the national scheme was set up.

Nearly 6,000 complaints were logged against doctors, up considerably from 5,371 the previous year. Around three-quarters of these were about significant departures from standards of clinical care.

Around 5% of all doctors were subject to a notification in 2016/2017.

Immediate action was taken in 259 cases. No further action was taken in two thirds of cases, while 2% of cases ended in a surrendering or cancellation of registration.

The top three reasons for notification of a health practitioner were clinical care (43%), pharmacy or medication (12%) and health impairment (8%).

Nearly 30% of health, performance and conduct matters resulted in regulatory action, and over 90% of matters decided by tribunal resulted in regulatory action.

AHPRA monitored over 3,000 practitioners for health, performance and/or conduct during the year.

You can access the full AHPRA report here.

Doctor groups welcome marriage equality vote

 

Medical colleges and associations were quick to welcome the overwhelming vote in favour of legalising marriage equality in the national postal survey, whose results were announced yesterday morning.

Within minutes of the announcement in Canberra, the Australian Medical Association released a statement from its President Dr Michael Gannon. “It is time to end the discrimination and lift the health burden from our LGBTIQ population,” he said.

“Along with the majority of Australians, as shown by today’s survey result, the AMA believes that two loving adults should be able to have their relationship formally recognised.

“This is not a debate about same sex parenting or religious freedom or the school curriculum – it is about ending a form of discrimination. There are evidence-based health implications arising from discrimination.”

Dr Gannon said the AMA hopes to see an end all forms of discrimination against LGBTIQ Australians.

“It is now up to our Parliament to act,” he said.

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) also rushed out a press release welcoming the majority yes vote in the postal survey.

“The RANZCP anticipates improved mental health outcomes for same-sex attracted people and their children with appropriate legislative change,” said its President Dr Kym Jenkins.

The Royal Australasian College of Physicians tweeted that “the postal survey has confirmed what we already know: LGBTI Australians should be able to marry the person they love.”

The College, like the AMA and RANZCP, had already come out strongly in favour of marriage equality in statements prior to the postal survey, as had the Australian College of Rural and Remote Medicine, which tweeted: “A momentous day for Australia, and a cause we’re proud to support”.

Conspicuous in its absence from the festivities, at the time of writing, was the Royal Australian College of GPs, which has not put out a statement or tweeted since the announcement. Nor has its president, Dr Bastian Seidel.

The RACGP had originally tried to remain neutral on the issue of same-sex marriage, but executed a dramatic U-turn under intense pressure from some of its members.

Dr Pansy Lai, a Sydney paediatrian and leading light of the “no” campaign said she hoped people’s parental rights would be protected.

“Now that the result of the marriage survey has come out, people will see the consequences that we have warned about (that will hopefully) not come about in a way detrimental to people who have a personal view about traditional marriage,” she told news.com.au.

Dr Lai said she hoped people’s livelihoods were not taken away if they believed in traditional marriage. She herself has been the target of a campaign to deregister her, following her appearance in a “no” television advertisement.

Democracy Inaction

BY ROB THOMAS, PRESIDENT AUSTRALIAN MEDICAL STUDENTS’ ASSOCIATION

“The tyranny of a prince in an oligarchy is not so dangerous to the public welfare as the apathy of a citizen in a democracy.” – Montesquieu

The position of AMSA President has been rewarding in many ways for me. I’ve had the opportunity to learn and be inspired by those around me, and come to high-level meetings, often several decades younger than the next person in the room. I get to hear the many views of my peers and on my best days, hope to represent 17,000 young people.

It’s fair to say that this year has been an incredible learning curve, beyond that of an average medical school year. I’ve learnt more about health and the education systems and have advocated for improvements in both. But perhaps most interestingly, I’ve learnt much more about leadership and the democratic process.

I find young people in general get a bad rap when it comes to political engagement. It’s true, there is less identification with traditional party politics among young people, but engagement through petition-signing or demonstrations is much higher. I find this very interesting in an age where political leaders are torn down just as quickly as they emerge. Perhaps we demand too much from our leaders, particularly if we’re not engaging them in traditional ways.

With the information revolution also comes the need to be discerning, and to protect oneself. I’ve seen this myself in the marriage equality debate, one that I have a stake in and at times need to actively block from my mind. On issues such as climate change and health inequity overseas and at home, young people can be discouraged by inaction from our leaders and in so doing disconnect.

One very interesting thing I’ve found about the advocacy sphere is how lonely it can be. Organisations such as the AMA and AMSA, and of course the Government, rely on facts and opinions from their constituents. We do this through survey or election, but often we only get half the picture. Worse still, some representatives receive feedback only when it’s negative, and I feel for those who don’t get the thanks they deserve.

On the other hand, representing any large group of people will involve strong differences of opinion, especially when it may involve life and death. The success of the National Rifle Association in America depends on the simplicity of their message – “no” to any information or regulation on gun ownership. The larger the organisation and more diverse its mandate, the more power it may hold; but it may start to represent more differences of opinion than similarities. On leadership, it’s important to be aware of these differences, as I believe it only legitimises your stance to show respect to the other side. As health professionals, we need to be able to flex and adapt to new information, and that only comes when we refuse to switch off. By our very nature we should challenge our assumptions and our preconceived notions to achieve the best for the public.

At the top I left a quote about the danger of apathy. Yes, democracy has its flaws, as we seem to witness time and time again. However, the only answer I can come up with is to engage in it – for those in power to make themselves available to opinion, and for those not in power to realise that there is power in that too. There is no good in burying one’s head in the sand. Democracy inaction is democracy in disaster.

Email: rob.thomas@amsa.org.au
Twitter: @robmtom