The Australian Capital Territory has become the latest jurisdiction to move towards allowing medicinal cannabis.
On 1 August, doctors in NSW became the first in Australia to be allowed to prescribe medicinal cannabis for their patients, following trials. Three days later, the ACT Government announced it would establish a medicinal cannabis scheme.
Federal parliament passed legislation earlier this year, making it legal to grow marijuana under licence.
The Therapeutic Goods Administration (TGA) recently issued an interim decision to reschedule cannabis from Schedule 9 (prohibited substance) to Schedule 8 (controlled drug) of the Poisons Standard.
The ACT is moving straight to establishing a medicinal cannabis scheme, rather than starting with a trial.
Assistant Health Minister Meegan Fitzharris said the ACT Government was working to develop a considered and consistent framework to support the scheme as soon as possible.
“Establishing a Medicinal Cannabis Scheme in the ACT is a priority for the ACT Government, but we need to do it in a way that is evidence-based and that supports people when they are at their most vulnerable,” Ms Fitzharris said.
“Now the Commonwealth has acted, we can establish a scheme in the ACT that will treat medicinal cannabis products in the same manner as we treat other medicines.
“At the moment, there are no clinical guidelines on what types of conditions medicinal cannabis can and should be prescribed for.
“The ACT Government will develop evidence-based guidelines to inform and support medical practitioners in how to best prescribe medicinal cannabis products.”
It is unlikely that the scheme will be in place before the Territory election in October. But the Liberal Opposition Leader Jeremy Hanson has said that, if elected, a Liberal Government would establish a medicinal cannabis scheme.
Victoria has legalised medical marijuana from next year for patients with severe childhood epilepsy. Tasmania will also legalise its use for a broader range of conditions.
In Queensland, children with severe drug-resistant epilepsy can take part in a medicinal cannabis clinical trial.
Federal Government legislation to overhaul the nation’s organ donation strategy is due to be introduced to Parliament.
A Bill to change the governance arrangements of the Australian Organ and Tissue Donation and Transplantation Authority by appointing a Board of Governance to “operate alongside a Chief Executive Officer” is slated for debate in the Spring session.
The legislation follows the Government’s decision to implement several of the recommendations of a review it commissioned into the nation’s organ donation strategy, including the operation of the Organ and Tissue Authority (OTA).
Then Rural Health Minister Fiona Nash commissioned the review citing dissatisfaction with the Authority’s progress in lifting the nation’s organ donation rate, currently around 16 donors per million.
Though the rate was a substantial improvement from the 10 per million when the Authority was established in 2009, the review found the OTA suffered from several failings of governance, including that its advisory council did not provide any strategic oversight, performance monitoring, succession planning or CEO mentoring.
The announcement of the review prompted the Chair of the advisory council, television presenter David Koch, to resign in disgust, blaming the “tripe dished out by a whole bunch of rich lobbyists”, and calling on Senator Nash to “get a backbone”.
Releasing the findings of the review early this year, Senator Nash said the Government accepted a recommendation for the appointment of a Board of Governance to “provide stronger oversight and support for the work of the…Authority”.
“Further, the report notes ‘defensiveness’ in the sector and calls for ‘open and transparent dialogue’,” Minister Nash said at the time. “I hope more transparency helps foster open dialogue. However, let me be clear: I’m not interested in personalities. I’m interested in saving lives through organ donation.”
In its 2016-17 Budget, the Government reaffirmed the OTA’s goal to lift the organ donation rate to 25 per million by 2018, including by having trained donation specialists on hand to talk with the families of potential donors, and fostering interstate cooperation, including between hospitals and practitioners.
These efforts would be supplemented by the establishment of a one-step online registration process for donors, the automation of a nationwide organ matching system and the publication of donor data State-by-State and hospital-by-hospital.
Dear Prime Minister May, Chancellor Merkel, President Obama, President Putin, and all other Heads of State and Heads of Government of the International Syria Support Group (ISSG),
Australians are living longer than ever but with higher rates of chronic disease, the latest national report card shows.
According to the Australian Institute of Health and Welfare’s Australia’s Health 2016 report, released today, Australian boys can now expect to live into their 80s (80.3), while the life expectancy for girls has reached the mid-80s (84.4).
The single leading cause of death in Australia is coronary heart disease, followed by:
dementia
stroke
lung cancer
chronic obstructive pulmonary disease.
Grouped together, cancer has overtaken cardiovascular disease (heart disease and stroke) as Australia’s biggest killer. Cancer is also the largest cause of illness, followed by cardiovascular disease.
Chronic diseases are becoming more common, due to population growth and ageing. Half of Australians (more than 11 million) have at least one chronic disease. One quarter have two or more.
The most common combination of chronic diseases is arthritis with cardiovascular disease (heart disease and stroke).
Australians have high rates of the biomedical risk factors that increase the risk of heart disease and stroke. Almost a quarter (23%) of Australian adults have high blood pressure and 63% have abnormal levels of cholesterol.
Lifestyle choices
From Jackson-Webb, Health + Medicine Editor, The Conversation
The good news is Australians are less likely to smoke and drink at risky levels than in the past.
Australia now has the fourth-lowest smoking rate among 34 OECD countries, at 13% in 2013. This is almost half that of 1991 (24%).
The volume of alcohol Australians consume fell from 10.8 litres per person in 2007–08 to 9.7 litres in 2013–14. This is the lowest level since 1962–63. But 16% of Australians are still drinking to very risky levels: consuming 11 or more standard drinks on one occasion in the past 12 months.
Around eight million Australians have tried illicit drugs in their lifetime, including 2.9 million in the last 12 months. The most commonly used illicit drugs are cannabis (10%), ecstasy (2.5%), methamphetamine (2.1%) and cocaine (2.1%).
Use of methamphetamine has remained stable in recent years. However, more methamphetamine users are opting for crystal (ice) rather than powder (speed).
The bad news is Australians are still struggling with their weight. Around 63% are overweight or obese, up from 56% in 1995. This equates to an average increase of 4.4kg for men and women. One in four children are overweight or obese.
Junk foods high in salt, fat and sugar account for around 35% of adults’ energy intake and around 39% of the energy intake for children and young people.
Most Australians (93%) don’t consume the recommended five serves of vegetables a day and only half eat the recommended two serves of fruit. Just 3% of children eat enough vegetables, though 70% consume the recommended amount of fruit.
Almost half (45%) of adults aged 18 to 64 and 23% of children aren’t meeting the national physical activity recommendations. These are for adults to accumulative 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity each week. Children are advised to accumulate at least 60 minutes of moderate to vigorous physical activity every day.
Lifestyle choices have a huge impact on the risk of chronic disease; an estimated 31% of the burden of disease in Australia could have been prevented by reducing risk factors such as smoking, excess weight, risky drinking, physical inactivity and high blood pressure.
Preventing chronic disease
Rob Moodie, Professor of Public Health, University of Melbourne
This report outlines a number of positives in Australia’s health – our life expectancy, the health services at our beck and call, major declines in tobacco and road deaths. We’re doing well, it says, but we could do better.
If we took prevention and health promotion far more seriously, we could do a lot better.
The report nominates tobacco use, alcohol, high body mass and physical inactivity as the chief causes of preventable illness and the chief causes of our increasing level of chronic illnesses. Yet national investment in prevention is declining.
Tobacco use is rapidly declining because of really effective measures (plain packaging, advertising bans and increasing price through taxes) that save lives and enormous amounts of money over a lifetime for people who used to smoke.
However, we can’t seem to make any major dent in the commercial, industrial and lifestyle diseases related to junk food and drinks, harmful consumption of alcohol and car dependency.
We’ve known what will work for many years but the power of some of these unhealthy industries is still overwhelming – a situation in which our politicians fear these industries and their associations more than they fear the voters.
Our collective health would have been much better if we’d been able to follow the guidance of our own national task forces and learnt from other countries. The report card should read, “Doing well, but could have done a lot better”.
Inequities
Fran Baum, Matthew Flinders Distinguished Professor and Foundation Director at the Southgate Institute for Health, Society & Equity, Flinders University
Australia’s Health 2016 shows many Australians are not getting a fair go at health. There is a gradient across society whereby the richer the area you live in, the longer you can expect to live. The difference between the highest and lowest is four years.
The gradient is evident from early life. Children most at risk of exclusion – those from poor areas who experience problems with education, housing and connectedness – are most likely to die before they reach 15 years from potentially preventable or treatable causes.
Our most glaring inequity is the ten-year life gap between Aboriginal and Torres Strait Islander Australians and others. Indigenous life expectancy is 69.1 years for males and 73.7 years for females.
Compared with the non-Indigenous population, Indigenous Australians are:
3.5 times as likely to have diabetes and four times as likely to be hospitalised with it or to die from it
five times as likely to have end-stage kidney disease
twice as likely to die from an injury
twice as likely to have heart disease.
Australians living outside major cities have higher rates of disease and injury. They also live in environments that make healthy lifestyles choices harder (such as more difficulties buying fresh fruit and vegetables) and so their risk of chronic diseases is increased.
The data on who has private health insurance coverage points to the emergence of a two-tiered health system, where those who can afford to pay receive better access and quality of care. Just 26% of those in the lowest socioeconomic group have cover compared to about 80% of the top group.
Cost of care
Professor Stephen Duckett, Director of the Health Program at Grattan Institute
Over the last decade, health expenditure grew about 5% each year, above the 2.8% average growth in Gross Domestic Product (GDP). As a result, health took up an increasing share of GDP.
Spending more on health means Australia spent less on other things. This is not necessarily bad, as long as the benefits from that increased expenditure – such as increasing life expectancy or increased quality of life – are worth the increased costs.
But spending above GDP growth cannot continue indefinitely. And the last few years saw an increase in rhetoric about health spending increases being “unsustainable” from so-called “futurists” and politicians.
Australia’s Health 2016 shows a slowing of the real growth rate in the most recent two years to about half that of the previous decade – 1.1% from 2011-12 to 2012-13 and 3.1% from 2012–13 to 2013–14.
This suggests the “unsustainability” rhetoric is at least overblown and potentially prompting budget decisions which are counter-productive, such as introducing a co-payment for general practice.
Commonwealth government expenditure was more or less stable over these most recent two years, declining 2.5% initially then increasing 2.4% in the last year.
Savings to the government came from shifting costs to consumers, by slowing the growth in government subsidies to private health insurers, and also by slowing spending on pharmaceuticals.
This latter slowdown was achieved through tighter controls on payments to drug manufacturers and because some big-selling drugs came off patent, resulting in falls in prices.
What is the future for Africa? A bleak case is made powerfully by Tim Marshall in his book Prisoners of Geography (Elliott and Thompson, 2015). His premise is that the land on which we live shapes us all. “The physical realities that underpin national and international politics are too often disregarded”, Marshall writes. Geography explains the why of nations. It is the “decisive factor in the course of human history”. That truth is the reason geography is ignored by those concerned with improving health.
The AMA has been appointed as a key adviser to the Federal Government on reforms aimed at boosting competition in the private health insurance industry and reining in premium hikes.
An AMA representative will sit on the Private Health Ministerial Advisory Committee (PHMAC), which has been tasked by Health Minister Sussan Ley with overseeing the implementation of reforms including the introduction of a simplified ratings system for health policies and regulatory changes to reduce the upward pressure on premiums.
Ms Ley announced the reforms earlier this year after a Government-run survey identified widespread consumer dissatisfaction with private health insurance, including skyrocketing premiums, confusing and complex policies, arbitrary changes to cover and inadequate disclosure of exemptions, limits and out-of-pocket costs.
“Private health insurance is a fundamental part of our national health system, but the majority of the 40,000 consumers who responded to last year’s survey told us the current system is frustrating and didn’t offer good value for money,” the Minister said.
The Government announced its reform plans, including a three-tier system to rate cover, a mandatory minimum level of cover, standardised definitions for medical procedures, simplify billing and tougher disclosure rules, after the AMA released a Report Card on the private health industry.
The Report Card showed many insurers offered ‘junk’ policies that only covered public hospital treatment, and identified big variations in the benefits paid for similar procedures, in many instances leaving policy holders to pay large out-of-pocket costs.
AMA President Dr Michael Gannon has accused the major health funds of putting the pursuit of profits before the interests of patients.
In a speech to the National Press Club last month, Dr Gannon said that, “increasingly, we are seeing behaviour by large private health insurers that reflects that their ultimate accountability is to their shareholders”.
The AMA President warned that insurers were trying to assert an ever-greater role in the conduct of clinical care, to the detriment of both patients and doctors.
“If the actions of the funds continue unchecked and uncontested – especially their aggressive negotiations with hospitals and their attacks on the professionalism of doctors – we will inevitably see US-style managed care arrangements in place in Australia,” he said.
Signalling the seriousness of the Government’s intent to reform the private health insurance industry, Ms Ley has appointed experienced public servant Dr Jeffrey Harmer to Chair the PHMAC.
Dr Harmer, a former Departmental secretary who has been involved in several large scale government reviews including the Henry tax review and the 2008-09 Harmer review on the adequacy of the age and disability pensions, is considered a strong choice for the role.
PHMAC’s work will be complemented by a separate Government initiative to cut down on the amount private health insurers pay for prostheses.
The Government regulates the price of a wide array of medical devices from pacemakers and artificial knees to orthopaedic screws, and concerns have been raised that prices for medical devices in Australia are too high. In addition, health funds have complained that they are being charged substantially more than public hospitals for such devices and prostheses, and have blamed to discrepancy for helping drive the relentless rise of premiums.
Ms Ley has announced that a revamped Prostheses List Advisory Committee will be tasked with improving the transparency of medical device pricing, making prostheses more affordable, and reducing duplication in official device approval processes.
The Committee will be chaired by University of New South Wales Professor of Medicine Terry Campbell, who is also Head of the Department of Medicine at Sydney’s St Vincent’s Hospital, and has been a long-serving member of the Pharmaceutical Benefits Advisory Committee.
The following is AMSA President Elise Buisson’s address at the 2016 AMSA Global Health Conference in Newcastle. Ms Buisson spoke to 700 medical students about Australia’s treatment of asylum seekers and refugees, and the responsibility of doctors to take action against indefinite detention.
I want you to imagine that were somewhere nice and warm. You’re in France, lying safe and at home on a sunny beach in Nice, wearing long loose, comfortable clothing and soaking up some sun. That is until armed police showed up and require you to take off parts of your clothing. It sounds like a dystopian future, doesn’t it? But we all know it happened this week in France. Because in France, the burkini, is outlawed. And it’s outlawed on the basis of the fact that it’s believed in France that wearing it means that you’re not “adhering to good morals and secularism”. Now I have just one question about that, and that is, are you kidding me? That is exactly the same rhetoric used in other parts of the world to force women to wear the exact same piece of clothing; that they’re not “adhering to good morals and religion”. And I think we all know that the clothing was never the problem. The item of clothing has no inherent moral value. The problem was always whether or not women had a choice that they wanted to wear it or that they didn’t. Whether you’re politicising women’s bodies for religion or for secularism, you’re promoting division either way.
Meanwhile, in the Australian Senate, Pauline Hanson has mostly moved on from the Asian and then Indigenous peoples that she vilified in the earlier parts of her career, to claiming that it’s now Muslims who are ruining our way of life. Now if Pauline ever does come down to visit me in Campbelltown, Western Sydney, and partake of a Halal Snack Pack, I’d love to ask her: what is that way of life that you’re protecting? What do we most value and want to preserve about being Australian? Is the Australian way of life the Cronulla riots? Is the Australian way of life the Reclaim Australia rallies? Because I think we all know that we’re proud to be Australian for the opposite of those reasons. Proud because the national code of conduct is one of working hard, looking out for your mates, and not taking life, or yourself, too seriously. Is that the way of life that Pauline Hanson embodies? When a politician taps into something you fear, don’t fall for the rhetoric. Refuse to be used against yourself.
We find ourselves living in a time when all around the world, we are seeing the rise of the politics of fear, and policies of division. When our nation’s Treasurer frames the Australian population as the lifters and the leaners. The taxed and the taxed-nots. The leaders of our nation are trying to take human beings and put them into two clean columns and label just one of them as worthwhile. I want to take a moment to reflect on the fact that as a group of people who are at the hospital without pay during working hours, then studying lectures and tutorials after-hours, and therefore rarely working enough to pay tax and often instead receiving a student Centrelink payment, as defined by your politicians the people in this room are the taxed-nots. In a divided society, we’re the leaners.
I believe that we, as the future of the medical profession, have a significant role to play in reversing the politics of fear. Our profession inherently stands for unity. We treat people regardless of their race, religion, gender, sexuality, political affiliation, and bikini, burkini or mankini. No matter who a person is, when they walk into a clinic or an office or a theatre, we will do our best for them. Now that is the Australian way of life. No matter who you are, we will do our best for you. There’s a question I want to ask you: in a political environment when a nation is being encouraged to turn in on itself, what do you think becomes of the most vulnerable in that society? You already know the answer. We’ve heard the answer over and over again already at this conference. We heard it when Julian Burnside spoke on the first morning.
We live in a time where the Supreme Court of Papua New Guinea says “indefinite detention of asylum seekers is illegal”, the United Nations says “Australia is violating the Convention Against Torture”, the Nauru files say, “children are being abused”, and the Prime Minister of our country says… “can’t be misty eyed”. In this, our role is clear. The medical profession stands for the physical and mental health of all. Indefinite detention harms health, so indefinite detention is not acceptable public policy. It has been tried, and it has failed, and the Australian public has been failed by all sides of politics who have allowed this practice to continue. We can try to make it sound more complicated than that by deferring to the wisdom of the political powers that be or referencing lives lost at sea. But nations are culpable for what they allow their political leaders to do when they do those things in plain sight. And our national conscience isn’t unburdened if people are now dying in their homeland instead of drowning off our shores.
So where does the buck stop? Is it with the guards who stand accused of witnessing and even perpetrating abuses of those in their care? Is it with the media who report on asylum seekers as potential terrorists? Is it with our politicians, who call asylum seekers “illegals”, in full knowledge of the fact that it is legal to seek asylum, even to Australia, even by boat, even without papers? The answer, it seems obvious, is yes, and yes, and yes. And yet the buck has not stopped and neither has the indefinite detention of persecuted people who have done nothing wrong.
Whenever terrible things happen in the world, at some point a little later on, the world reflects and says, “how could that possibly have happened? How could a whole nation possible have allowed that to go on, right under their noses?” People ask those questions again and again because they’re looking for an explanation for how a whole nation of people turns out to be just awful. But that’s just it. Atrocities throughout history didn’t happen because nations were awful. They happened because people read it in the papers and heard it on the news, but they convinced themselves that it wasn’t their problem, and they stood idly by. There’s this technique that politicians use in interviews, you’ve all seen it. The interviewer asks them a question that, as a leader of our nation they should rightfully be able to answer. But they don’t answer. Instead they say over and over again, “It was the other party that caused this problem” as if that abdicates the current leadership’s responsibility to fix the problem now. If you want to lead this country, you get it with all its victories and all its failures, and you lead us as a nation forward from wherever you find us.
Now, in a funny way, we as medical students find ourselves in a similar position. Doctors and nurses and allied health, we lead the health of this country and we do it from the coalface. Now we can say that indefinite offshore detention is a problem created by the government, which is absolutely true. But regardless, we’ve chosen to take a position of responsibility for this nation’s health – every doctor has – and asylum seekers are under the care of our nation. So even though we aren’t responsible for the creation of this problem, it’s going to be on us to help solve it, and get these people to conditions where they are safe, and well.
If we do not take the lead in protecting the health of the most vulnerable people in our society being put at risk, we have squandered the respect afforded to our profession. We pledge when we become doctors: “I will maintain the utmost respect for human life.” That isn’t a passive requirement, it’s a powerful one. I will maintain the utmost respect for human life. I will not allow human life to be locked up indefinitely without cause and deprived of hope.
Being the President of AMSA this year has taught me a lot of things, but maybe even more importantly, it’s left me with a lot of questions. First and foremost being, “Why are we here?” Here in AMSA, here at this conference, here in medical school. Are we here to fight for our jobs, our education, our quality of life? There’s nothing wrong with caring about those things. Everyone cares about those things. But if that’s all that we’re here for, we should just about pack up and go home. In a fair society, you only get to ask for more for yourself when you’re putting what you currently have to good use.
And what do we already have? We have a bright future. We have a world-class education. Since the release of the Nauru files, we have more insight into the situation facing our asylum seekers than ever before. And we have an opportunity, when historians re-examine this period of time looking for what went wrong, not to be the people who stood idly by.
It’s time that we showed that the Australian way of life, and the courage of the medical profession, are alive and well. I know the people in this room care about this issue, it’s why we’re here. But we’re not a higher moral class of bystander if we come to a global health conference, or if we know that we care about the issue deep down inside. We need to put our actions where our ideals are and do something.
Or better yet, let’s do something together. Be a part of a united voice: we are the future of the medical profession in this country, and we will not stand idly by. You’re about to get a notification on your app during this conference – if you’re ready to take action, it’ll show you how you can do it with me. The day I first watched Julian Burnside speak, he was asked a question from the crowd about what he believes the future holds. And he said, “This issue will not be resolved in my time. But I’ll die knowing I did my best for them.” Let’s do the best we can for them. After all, that’s the Australian way of life.
Elise Buissonis a medical student at Western Sydney University.
The MBS Review Taskforce has sounded a warning on assertions that doctors are blowing out health costs by issuing sick certificates, ordering prescription repeats and writing specialist referrals.
Two-thirds of health professionals responding to an online survey run by the Taskforce called for MBS rules to be reviewed, particularly regarding the use of referrals and restrictions on eligible providers, seemingly lending weight to claims that GPs were wasting much of their time on ‘routine’ tasks like filling out medical certificates and writing referrals.
Health Minister Sussan Ley seized on the claims, telling ABC radio that “if the Government is paying effectively too much for small appointments that aren’t necessarily adding to a person’s overall health, particularly if they have chronic conditions, then that money does need to be reinvested”.
Extending her attack on primary health care, Ms Ley said a quarter of patients believed they had been recommended tests or treatments that were unnecessary.
The suggestion has fuelled calls, including from the Pharmacy Guild of Australia, for pharmacists, nurses and other allied health professionals to be granted an increased scope of practice to ease the burden on family doctors.
But the Taskforce itself has cast doubt on the extent of the problem, and has instead inferred that its prominence was being driven by health groups like pharmacists and nurses keen to expand their scope of practice.
“Many health professional respondents argued that referrals through GPs were unnecessary, particularly when accessing allied health services,” the Taskforce said in an interim report on its consultation. “It should be noted that the prevalence of this issue may reflect the skew towards allied health providers in the respondent group”.
AMA President Dr Michael Gannon dismissed the claim that valuable health dollars and GP time was being wasted on writing out certificates and referrals.
Dr Gannon said that not only was general practice very cost effective – accounting for just 6 per cent of total health spending – but performing such services was often a valuable opportunity to undertake preventive health care such as performing blood tests and assessing for diabetes and heart disease risk.
In its discussion of the results of the online survey and stakeholder consultations, the Taskforce notably avoided the issue and turned its focus elsewhere.
It backed proposals for greater transparency on Medicare fees, and endorsed the idea of giving practitioners data on their own Medicare item usage, benchmarked against their peers.
But it flagged a cautious approach to changes to Medicare pay arrangements and MBS items.
In consultations there were calls for the fee-for-service model to be scrapped and replaced with an outcomes-based payment system.
But although expressing interest in pay for performance as a complement to fee-for-service in supporting multidisciplinary care, it was lukewarm on a wholesale change.
“The evidence suggests that clinically-based outcomes linked to payment have mixed success and may not be superior to activity-based payments in driving high-value care,” the Taskforce said. “Indeed, the MBS itself has many examples where incentive payments directed to addressing service deficits have had undesirable outcomes.”
And, while the Government has emphasised the scope for the MBS Review to axe Medicare items, the Taskforce indicated it would be moving with careful deliberation.
It noted that its terms of reference “do not preclude” recommending new items, and was considering “the addition of temporary item numbers to be used specifically for the acquisition of evidence to support the long-term retention or removal of items from the MBS”.
The case to remove items will depend on more than simply how often it is used.
“The Taskforce recognises that low usage of an item is not in itself conclusive evidence of obsolescence,” the Taskforce said.
For the AMA, Aboriginal and Torres Strait Islander health has been, and will remain, a priority. It is our responsibility to advocate for and support efforts to improve health and life outcomes for Australia’s First Peoples.
The AMA works closely with Aboriginal and Torres Strait Islander people in a number of ways to contribute to our mutual goal of closing the health and life expectancy gap between Indigenous and non-Indigenous Australians.
We have close relationships with NACCHO, the Australian Indigenous Doctors’ Association and the Close the Gap Steering Committee, through which we collectively contribute to the national debate on Indigenous health issues. The Taskforce on Indigenous Health, which I Chair, is another way that the AMA works in partnership with Indigenous people.
Each year, through the Taskforce, the AMA produces an annual Report Card on Indigenous Health – a landmark publication that makes practical recommendations to governments on how key Aboriginal and Torres Strait Islander health issues should be addressed.
This year the Report Card will have as its focus the eradication of rheumatic heart disease (RHD). RHD is an entirely preventable, third world condition that is wreaking havoc on the lives of Indigenous people in remote communities, primarily those in central and northern Australia. The 2016 Report Card on Indigenous Health will be a vital contribution to addressing RHD – a disease that should not be seen in Australia in the 21st century.
The AMA also supports policies and initiatives that aim to reduce other chronic and preventable diseases – many of which have an unacceptably high prevalence in remote Indigenous communities. An example of this is the little-known blood-borne virus HTLV-1, which in Australia occurs exclusively in remote Aboriginal communities in central Australia.
The AMA recognises that Aboriginal people living in Central Australia face many unique and complex health issues, and that these require specific research, training and clinical practice to properly manage and treat.
The AMA, as part of our broader 2016 election statement, called on the next government to support the establishment of a Central Australian Academic Health Science Centre. This is a collaboration driven by a consortium of leading health professionals and institutions, including: AMSANT, Baker IDI Heart & Diabetes Institute, Central Australian Aboriginal Congress, Central Australia Health Service, Centre for Remote Health, Charles Darwin University, Flinders University, Menzies School of Health Research, Ngaanyatjarra Health Service and Nganampa Health Service.
The AMA sees the proposed Health Science Centre as a very significant endeavour to improve the health outcomes of Aboriginal people living in remote communities. There are already tangible benefits from this type of collaborative and multi-disciplinary approach to health services and research.
The aim of the AHSC is to prioritise their joint efforts, principally around workforce and capacity building and to increase the participation of Aboriginal people in health services and medical research.
Some examples of achievements include: the Central Australia Renal Study, which informs effective allocation of scarce health resources in the region; the Alice Springs Hospital Readmissions Prevention Project, which aims to reduce frequent readmissions to hospital; and the Health Determinants and Risk Factors program, which better informs health and social policy by understanding the relationship between health and other factors such as housing, trauma and food security.
Having a designated Health Science Centre would be a massive boost for research, clinical services, and lead to greater medical research and investment. The Centre would likely see more expertise and opportunities to develop Aboriginal researchers and health care workers.
Establishing and operating this Centre would cost $4 million a year – a modest ask considering the potential benefits it could deliver.
The AMA recognises that Aboriginal and Torres Strait Islander people have a lead role in identifying and developing solutions to respond to their health needs – the proposed Central Australian Academic Health Science Centre is a clear example of this. The AMA will continue to support the efforts of Indigenous people to improve health outcomes and urges governments to do the same.
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