Indigenous Medical Scholarship 2019

Applications are now being sought for the 2019 Australian Medical Association (AMA) Indigenous Medical Scholarship. Applicants must be of Aboriginal and/or Torres Strait Islander background.

Applicants must be currently enrolled full-time at an Australian medical school and at least in their first year of medicine. Preference will be given to applicants who do not already hold any other scholarship or bursary.

The Scholarship will be awarded on the recommendation of a selection panel appointed by the AMA. The value of the Scholarship for 2019 will be $10,000 per annum. This amount will be paid in a lump sum for each year of study.

The duration of the Scholarship will be for the full course of a medical degree, however this is subject to review.

Applications close 31 January 2019.

To receive further information on how to apply, please contact Sandra Riley, Administration Officer, AMA on (02) 6270 5400 or email indigenousscholarship@ama.com.au. An application package can be also downloaded from the AMA website www.ama.com.au/indigenous-medical-scholarship-2019.

The Indigenous Peoples’ Medical Scholarship Trust Fund was established in 1994 with a contribution from the Australian Government. In 2016, the Trust Fund became The AMA Indigenous Medical Scholarship Foundation. The Foundation is administered by AMA Pty Ltd.

If you are interested in making a donation towards the Scholarship, please go to www.ama.com.au/donate-indigenous-medical-scholarship.

The AMA would like to acknowledge the contributions of the following donors: Reuben Pelerman Benevolent Foundation; the late Beryl Jamieson’s wishes for donations towards the Indigenous Medical Scholarship; Deakin University; The Anna Wearne Fund and B B & A Miller Fund, sub-funds of the Australian Communities Foundation.

Funds injection to Indigenous health services

Facility upgrades and repairs are taking place to a number of Aboriginal and Torres Strait Islander health services across the nation, following a $2.7 million funding boost from the Federal Government’s Service Maintenance Program.

In total, 25 services across Australia will benefit in this round of upgrades.

Indigenous Health Minister Ken Wyatt said the funds had been allocated to improve the safety and accessibility of services in the Northern Territory, Western Australia, New South Wales, Queensland, Victoria and Tasmania.

“This includes vital support for clinics, accommodation and associated facilities, so staff can continue delivering comprehensive primary health care to First Nations people that is culturally appropriate and best practice,” he said.

“Our Government has given priority to services seeking urgent repairs and maintenance, especially facilities based in remote and very remote areas.”

The Service Maintenance Program – part of the Indigenous Australians’ Health Program (IAHP) – supports the improvement of health outcomes for Aboriginal and Torres Strait Islander people through better access to health services.

“Under the IAHP, we are committed to providing First Nations people with access to quality, comprehensive and culturally appropriate primary health care,” Mr Wyatt said.

The recent Federal Budget allocated $3.9 billion over four years to support Aboriginal and Torres Strait Islander health, an increase of about four per cent per year.

Significant projects in the current upgrade projects include:

Urgent security and safety upgrades to the Anyinginyi Health Aboriginal Corporation’s Men’s Health Clinic in Tennant Creek to include duress alarms and swipe cards;
Improving cultural appropriateness, safety and access at the Dhauwurd-Wurrung Portland and District Aboriginal Elderly Citizens Inc. clinic; and
Extending phlebotomy clean rooms at the Sunrise Health Service Aboriginal Corporation and the Maari Ma Health Aboriginal Corporation to allow immediate testing of children’s lead and iron levels.

Learn about the 1 July 2018 MBS changes

INFORMATION FOR MEMBERS

The AMA has added the July 1 Medicare Benefits Schedule (MBS) changes to its health professional education resources.

We have updated our Indigenous and MBS eLearning and education guides with the July 1 MBS changes. These education resources help you work out claiming and billing MBS item numbers.

We also have education resources about:

the Australian Immunisation Register
the Child Dental Benefits Schedule
the Department of Veterans’ Affairs
incentives programs
digital claiming
PRODA (Provider Digital Access)
HPOS (Health Professional Online Services)
Pharmaceutical Benefits Scheme (PBS)

Our eLearning programs are comprehensive, using case studies to show you how to apply the information. Check out the changes and updated education resources (humanservices.gov.au/organisations/health-professionals/subjects/education-services-health-professionals) today.

Next steps

Explore the education services for health professionals (humanservices.gov.au/organisations/health-professionals/subjects/education-services-health-professionals)
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New appointments to Cancer Australia Advisory Council

Health Minister Greg Hunt has appointed six new members to the Cancer Australia Advisory Council, including high-profile AMA member Associate Professor Kelvin Kong.

The new Advisory Council members appointed for three years are:

Distinguished research scientist Professor Joanne Aitken
Gynaecological oncologist Associate Professor Penny Blomfield
Leading Indigenous Otolaryngologist Associate Professor Kelvin Kong
Consumer advocate Lillian Leigh
Radiation oncologist Dr Serena Sia
Former NSW Minister for Health the Honourable Jillian Skinner

“I warmly welcome to the new members and look forward to working with them in the unrelenting fight against cancer,” Mr Hunt said.

“I’m confident that all members will bring their expertise in helping our country combat cancer.”

The Minister also said he was proud of the majority female representation on the Advisory Council with eight of 13 members being women.

The Cancer Australia Advisory Council provides strategic advice to support Cancer Australia in the performance of its functions.

This includes providing national leadership to reduce the impact of cancer, addressing disparities and improving outcomes for people affected by cancer.

“I am also delighted to announce that Professor Bob Thomas OAM has been reappointed as chair of the Cancer Australia Advisory Council, along with other Council members Dr William Glasson AO, Professor Dorothy Keefe PSM, and Perry Sperling PSM,” Mr Hunt said.

“I want to thank the outgoing members of the Advisory Council Michelle Ace, Keri Huxley OAM, Dianne Rule, Dr Judith Soper and Professor George Yeoh for their highly valued contribution.”

[Perspectives] Anne Chang: a champion of childhood lung health

At a health centre in Melbourne for Aboriginal and Torres Strait Islanders in the late 1980s, medical student Anne Chang had her eyes opened to Indigenous disadvantage in Australia. “The patients there had diseases not seen in mainstream medicine”, she says. “Pus from the children’s ears and chronic cough with purulent nasal discharge were common.” It was one of many experiences of health inequities that helped drive her passion for improving the health of disadvantaged groups. “People who are worse off should be given the best care”, says Chang, now Professor and Head of the Child Health Division at Menzies School of Health Research in Darwin and Consultant Paediatric Respiratory Physician at Children’s Health Queensland Hospital in Brisbane.

Need for stability in health leadership

BY AMA PRESIDENT DR TONY BARTONE

Last month’s leadership spills, which resulted in Australia having a new Prime Minister in Scott Morrison, almost delivered us the fourth Health Minister in five years. That would have been a disaster; especially with an election no more than nine months away (maybe even less).

Since the Coalition was elected in 2013, we have seen Peter Dutton and Sussan Ley come and go, and Greg Hunt resign as Health Minister amid the Government’s leadership chaos.

Prime Minister Morrison could easily have left Greg Hunt out of his new Ministry, but he chose not to. He opted for consistency and stability. He made the right call.

In January 2017, Greg Hunt became Health Minister at a difficult time. His predecessor, Sussan Ley, left the portfolio in controversial circumstances. He inherited a lot of unfinished business.

To his credit, he worked hard from day one to get across his new portfolio, one of the toughest in politics, and he went out of his way to build personal relationships with the leaders of all the major stakeholders.

He worked closely with my predecessor, Dr Michael Gannon, and I am pleased that close relationship has extended to my Presidency, talking regularly on the phone and meeting often in person.

As Health Minister you need to understand the many issues and numerous policies and all the potholes and roadblocks in health to appreciate the vital need to have consistent leadership at the top of the Health Ministry.

It takes months to get across the detail and to get to know the key people.

Greg Hunt had to almost immediately deal with the fallout of the GP co-payment fiasco and the slow burn of the Medicare rebate freeze, which were undermining all efforts by the Government to be on the front foot on a range of policies – anything but the cursed co-payment and the feared freeze.

He fought hard within Cabinet to achieve the gradual lifting of the Medicare freeze.

He has had to gain thorough knowledge of the complex MBS Review process.

There was the ongoing review of Private Health Insurance and out of pocket expenses.

The rollout of the My Health Record.

The problems with the Health Care Homes trial.

Then there were the more tricky and delicate issues of mandatory reporting, medical workforce, climate change and health, the health of asylum seekers, Indigenous health, and mental health, to name but a few.

Add to this the complexities of the PBS, immunisation, and issues pertaining to scope of practice – the so-called ‘turf wars’.

Then he had to consider contemporary major issues like aged care reform and the issue that we want him to concentrate on right now ahead of the election – general practice reform and investment.

It takes time to learn to be a Health Minister. And it takes even more time to become a good Health Minister. Greg Hunt has been easy to work with and always ready to listen.

That is why we went public with our calls for Greg Hunt to be re-appointed Health Minister in the new Ministry. Prime Minister Morrison obliged. A smart move I would say. If the Coalition had changed Ministers, their policy agenda would have drifted and left them extremely vulnerable on a sensitive policy front.

I met with Minister Hunt in the week of the election spills, when he was still the Minster, and we have spoken in the days that followed and since he was re-appointed.

Continuity of care is always important, even in politics. The AMA will build on this close relationship to improve health policy ahead of the next election.

Equally; I have also met with Opposition Leader, Bill Shorten, in recent weeks.

The AMA is in regular contact with Shadow Minister Catherine King, the Greens, and any party or Independent with an interest in good health policy.

It is important that all sides of the political divide understand and appreciate our health policies and why they are important to the Australian people. Our patients, their families and the community deserve no less.

Let me be very clear in assuring all that the AMA is in a very good position to influence health policy across the political spectrum in the months before the election, and even better placed to pass judgement on the health policies once the campaign itself is in full swing.

New taskforce to battle HTLV-1

BY AMA PRESIDENT DR TONY BARTONE

The Federal Government recently announced the formation of a new taskforce consisting of relevant health care providers, researchers, clinicians, and all levels of government to combat HTLV-1 in remote Indigenous communities.

Human T-cell lymphotropic virus (HTLV) – an oncogenic virus first discovered in 1979, and the first retrovirus to be discovered – predominantly affects CD4+T cells, which play an important role in the body’s immune system.

HTLV-1 infects up to 20 million people globally, with the virus prevalent in south-western Japan and the developing countries of the Caribbean basin, South Americ, and sub-Saharan Africa.

HTLV-1 was first detected in 1988 in Central Australia in the Indigenous population, and recent studies indicate that 45 per cent of Indigenous adults who reside in remote communities in Central Australia have been infected with HTLV-1.

Commonly transmitted through contaminated blood, unprotected sex, and breast milk, the virus is associated with a fatal haematological malignancy – Adult T cell Leukemia/Lymphoma (ATLL) – and inflammatory diseases involving organs including the spinal cord, eyes, and lungs.

In Indigenous Australians, the most typical clinical manifestation of HTLV-1 is bronchiectasis (a condition in which the airways of the lungs become damaged).

The extent and seriousness of the disease is dependent on the viral load in the blood stream.

Uveitis (inflammation of the middle layer of tissue in the eye) is another serious complication of HTLV-1, which was found through a case study done in Central Australia.

It can result in blindness, so it is important for treating professionals to be well informed about HTLV-1.

Unfortunately, there are no treatments currently available for HTLV-1 infection, but the following prevention strategies could result in the reduction of transmission and, ultimately, the eradication of the virus:

Encourage the use of condoms among the sexually active population, and routine testing for HTLV-1 in areas where the virus is prevalent.
Organ donors and blood transfusion products should be tested, and transfusions and transplantations avoided where testing shows a positive result. Monitoring and follow-up are vital in these instances.
Mothers who test positive to HTLV-1 should be advised to avoid breastfeeding or reduce it to three to six months, and alternative methods of infant feeding should be advised.
Injecting drug users should be educated and advised to use sterile needles, and regular testing for HTLV-1 should be available.
Evidence-based and up-to-date information regarding HTLV-1 should be available to health care providers so they can educate their clients on how to protect themselves.

The AMA supports an enhanced focus on Aboriginal and Torres Strait Islander people at risk of blood-borne viruses, including specific resourcing of management and research to address HTLV-1.

This is consistent with the AMA’s active participation in the Close the Gap strategy, and our series of Indigenous Health Report Cards, which have highlighted diseases such as rheumatic heart disease and otitis media, and which later this year will provide an audit of success or failure in Indigenous health policy over the past decade.

On top of this, the AMA supports other policies and initiatives that aim to reduce preventable diseases, many of which have an unacceptably high prevalence in remote Indigenous communities.

The AMA remains committed to working in partnership with Aboriginal and Torres Strait Islander groups to advocate for Government investment and cohesive and coordinated strategies to improve health outcomes for Indigenous people.

[Correspondence] On Hume and planetary health

In a plea for justice in planetary health, Richard Horton (June 9, p 2307)1 cited philosopher David Hume to argue that humans have the ability to choose their own path. Hume, however, is a source of discourse in planetary health for entirely different reasons. His bigotry, racism, and references to savages2 are, ironically, representative of the complex issues of power, elitism, racism, xenophobia, and lack of choice that Horton outlined. Hume wrote for the elites;3 his appalling beliefs about the indigenous people of the circumpolar regions and tropics as “inferior to the rest of the species” and non-whites as “naturally inferior to the whites”4 are indicative of systems of thought persistent today, built on racial and ethnic hierarchy.

Optimal Cancer Care for First Nations Australians

An Australian-first Optimal Care Pathway for Aboriginal and Torres Strait Islander People with Cancer, released in August by Cancer Australia, charts new approaches to cancer care for First Nations people, to boost their cancer treatment experience and results.

Indigenous Health Minister Ken Wyatt AM said this Optimal Care Pathway aims to tackle the growing gap in cancer outcomes between First Nations people and other Australians, by supporting the delivery of tailored, culturally safe and competent care.

“First Nations people are more likely to be diagnosed at a more advanced stage and are, on average, 40 per cent more likely to die from cancer than non-Indigenous Australians,” Minister Wyatt said.

“Cancer is the second leading cause of death and one of the biggest challenges for Aboriginal and Torres Strait Islander people, not just for those diagnosed, but also for families, carers, Elders, and communities.”

Minister Wyatt said that for services to be effective in improving Aboriginal and Torres Strait Islander health, they must operate with a fundamental understanding of, and respect for, First Nations culture.

“The new pathway provides health services and health professionals across Australia with principles and guidance to ensure that cancer care is culturally safe and responsive,” the Minister said.

“Being aware of how a person’s culture, values, and motivations can influence their decisions and preferences relating to the delivery of their care is an essential component in creating a culturally competent workforce. It is critical to better outcomes.”

The Optimal Care Pathway for Aboriginal and Torres Strait Islander People with Cancer – endorsed by the Australian Health Ministers’ Advisory Council – is accompanied by information and resources for Aboriginal and Torres Strait Islander people who may have or do have cancer, as well as for their carers, families, and communities.

Pic: Inidigenous Health Minister Keny Wyatt

Higher rates of chronic disease as Australians live longer

Australians are generally healthy and living longer lives but, as a result, rates of chronic disease and age-related conditions are rising, the latest snapshot of the nation’s health shows.

Australia’s Health 2018, released by the Australian Institute of Health and Welfare, shows that Australia is in the top third of OECD countries when it comes to life expectancy, but one in two Australians has a chronic health condition.

Fewer Australians are smoking or putting themselves at risk from long-term alcohol use than in the past, and more children have been immunised.

“But with a population that is living longer, we are now experiencing higher rates of chronic and age-related conditions,” AIHW CEO Barry Sandison said.

“Half of Australians have a common chronic health condition, such as diabetes, heart disease, a mental illness, or cancer. Importantly, almost a quarter of us have two or more of these conditions, often making our experiences of health and health care particularly complex.”

Mr Sandison said that about one-third of Australia’s disease burden is due to preventable risk factors, such as smoking, excessive alcohol consumption, and not getting enough exercise.

“Our expanding waistlines are a notable example,” he said.

“About six in 10 adults – or 63 per cent – are either overweight or obese, while carrying too much weight is responsible for seven per cent of our total disease burden.”

The two-yearly report shows a clear connection between socioeconomic position and health. Compared with people living in Australia’s highest socioeconomic areas, those in the lowest group are almost three times as likely to smoke or have diabetes, and twice as likely to die of potentially avoidable causes.

Life expectancy for Indigenous Australians has improved over time. However, the estimated life expectancy for an Indigenous boy born between 2010 and 2012 was 10.6 years lower than for a non-Indigenous boy, and for girls the difference was 9.5 years.

The report can be read in full at https://www.aihw.gov.au/reports/australias-health/australias-health-2018