Government launches online resource to fight antimicrobial resistance

The Federal Government has used Antibiotic Awareness Week in November to launch a new online resource for industry and the community, as part of Australia’s ongoing work to tackle the rise of antimicrobial resistance.

Antimicrobial resistance (AMR) occurs when microorganisms, like bacteria, that cause infections resist the effects of the medicines used to treat them, such as antibiotics.

As a result of antibiotic resistance, standard medical and veterinary treatments may become ineffective and infections may persist and spread to others.

The Government’s funding commitment to help tackle the rise of AMR is $27 million – including $5.9 million from the landmark Medical Research Future Fund.

The planned AMR website, is one of the first priority areas of the Implementation Plan. It will aim to provide information for the community, health professionals, animal health professionals, farmers, animal owners and the broader agriculture industry.

Australia is one of the developed world’s highest users of antibiotics – one of the main causes of AMR. In 2015, Australian doctors prescribed more than 30 million antibiotic scripts through the Pharmaceutical Benefits Scheme.

Many patients are not aware that antibiotics only work against infections caused by bacteria and should not be used to treat viruses like colds, flu, bronchitis and most sore throats.

AMA President Dr Michael Gannon said in a recent ABC interview that AMR is a concern and there needed to be: “Better stewardship in hospitals, better education for GPs, but perhaps most importantly better education for people in the community for them to understand when antibiotics are not only not required, but they’re potentially dangerous or risky.”

AMR has both a health and economic impact with infections requiring more complex and expensive treatments, longer hospital stays, and it can lead to more deaths.

The World Health Organisation (WHO) believes global urgent change is needed in the way antibiotics are prescribed and used because antibiotic resistance is one of the biggest threats to global health, food security, and development today. Antibiotic resistance can affect anyone, of any age, in any country, including Australia.

WHO also believes that even if new medicines are developed, without behaviour change, antibiotic resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practising safer sex, and good food hygiene.

“A lack of effective antibiotics is as serious a security threat as a sudden and deadly disease outbreak,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO.

“Strong, sustained action across all sectors is vital if we are to turn back the tide of antimicrobial resistance and keep the world safe.”

A recent study published in the Medical Journal of Australia shows that antibiotic resistance is on the rise and is present in our communities in Australia.

Lead researcher Dr Jason Agostino from the ANU Medical School said about 60 per cent of drug-resistant staph infections were picked up in the community, so infection control needed to shift from hospitals to the community.

“The problem of infections resistant to antibiotics in our community is not just a theoretical problem that will happen some time in the future – it’s happening right now,” Dr Agostino said.

Until the early 2000s in Australia, staph infections resistant to antibiotics mostly occurred in hospitals. The researchers found hospital infection rates are improving, with decreased infections in two of the region’s largest hospitals.

The study found that patients most at risk of the drug-resistant staph infection in the community are young people, Indigenous Australians and residents of aged-care facilities.

“We also need to improve the way we share data on antibiotic resistance to staph infections and link this to hospitalisation across health systems,” Dr Agostino said.

You can find out more about the progress of the Implementation Plan actions in the National Antimicrobial Resistance Strategy Progress Report at www.amr.gov.au.

MEREDITH HORNE

The future health curriculum

BY ROB THOMAS, PRESIDENT AUSTRALIAN MEDICAL STUDENTS’ ASSOCIATION

In many ways, the health system in Australia is on the brink of transformation. From moving away from fee-for-service as with NDIS and healthcare homes, to standardisation of private health insurance, to improving the use of personal data through information technology, disruption is clearly on the horizon.

However, in many ways medical education is still well behind when it comes to revolution. From outdated assessment methods, to courses no longer fit for purpose for the learner or the community, it is interesting to see where change must be made.

Thankfully, we have seen this year in both the Australian Medical Council (AMC) and the Medical Deans of Australia and New Zealand (MDANZ), a renewed push to improve teaching and learning into the future. But what might this look like?

I recently attended a workshop by the AMC focussing on the usefulness of programmatic assessment. Programmatic assessment as I understand it is a method of assessment where no one task is designed to ‘pass’ or ‘fail’ a learner. Instead, assessments are seen as individual data points that reflect an aspect of the learner’s knowledge at a certain time point. Through multiple assessments, at different times and through different methods, assessors can more accurately discover the strengths and weaknesses of the learner, leading to a clearer pass or fail.

While this may sound ‘softer’ than old school competencies, this may represent the opportune way of ensuring safe practice. No one OSCE or Mini-CEX assesses all aspects of the medical job, but together they give a picture of the learner. The added benefit is that programmatic assessment lends itself to more useful and more personalised feedback. Even through web-based adaptive testing, learners may now receive ‘tailored’ feedback on their performance. This is starting to gain traction in medicine, in useful teaching tools such as AMBOSS out of Germany. Question banks like those used for the USMLE are fast-becoming a way in which medical teaching is already transforming.

Another crucial part of the future health curriculum is social accountability. I was introduced to social accountability as an issue at the International Federation of Medical Students’ Associations (IFMSA) general assembly. Built upon the 5 pillars of equity, quality, relevance, efficiency and partnerships, social accountability in medical school means that students should get taught what they need to benefit their community. This may often go against the university’s business interests, in favour of providing education that is most appropriate to the learners. In an Australian context, curricular inclusions of indigenous health in context, treating those from culturally and linguistically diverse (CALD) backgrounds, and even tackling rural health issues falls under this banner. Similarly, medical school needs to be accessible to diverse members of the community, just as healthcare is.

Finally, interprofessional education (IPE) has a long way to go in Australian medical schools. Interprofessional education refers to classes or courses where learners from different health disciplines learn together. Multidisciplinary teams are now the foundation of the health unit in Australia, and yet most new medical graduates couldn’t tell the difference between an occupational therapist and a physiotherapist. Early silo-ing may be convenient but it adds to a culture of distrust and confusion, and students co-learning and co-producing their educational experience would be the key to solving this.

These are just a few of the many changes going on in medical teaching now and into the future. For me it comes down to preparation of the learner; and in medicine, we are lifelong learners. With programmatic assessment, social accountability and interprofessional education, we will hopefully continue to see the best doctors, prepared for the needs of our patients.

Email: rob.thomas@amsa.org.au

Twitter: @robmtom

AMA PHN member survey

In response to the recommendations of the Hovarth Review into Medicare Locals (the Hovarth Review), the Government established 31 Primary Health Networks (PHNs) across Australia, commencing in July 2015. These replaced Medicare Locals (MLs) that were established by the previous Labor Government.

The fundamental purpose of PHNs is similar to that of their predecessors “to facilitate improvements in the primary health system, promote coordination and pursue integrated health care.” However, GPs are expected to play a more central role in PHNs than they did in MLs. PHNs are also expected to focus more on improving the linkages between primary and hospital care.[1][2]

In 2013, leading up to the Hovarth Review, the AMA conducted a survey of GP members to gauge their views on the performance of MLs. More than 1,200 GPs participated in that survey, with members particularly critical of their engagement with GPs and the extent to which many had failed to help improve patient access to primary care services. This survey formed the basis of AMA submission to the Hovarth Review, which recommended significant reforms including a more central role for GPs.

The AMA recently conducted a similar survey to provide members with the opportunity to give us their views on the performance of PHNs to date. Participants were provided with a number of statements and, were asked to select the options (strongly agree, mostly agree, neither agree or disagree, mostly disagree, or strongly disagree) that best reflect their opinion.

A total of 399 GPs participated in the survey, which represents a much smaller sample size than the 2013 survey. Nonetheless, it does provide a snapshot of the views of those members who participated in the survey and the results should be used to provide helpful guidance on areas where PHNs need to increase their focus.

The survey results are summarised as follows:

Understanding of the role and functions of PHNs:

61.5 per cent of respondents indicated that they have a reasonable understanding of the role and functions of PHNs (comparative data is not available for MLs).
Information about activities and services:
47.9 per cent of GPs surveyed believe they have not been kept informed about the work their PHN is undertaking and the services it supports (48.9 per cent for MLs).
GPs access to information and events of relevance:
51.4 per cent indicated that they have not been provided with information and access to events of relevance to day to day practice (57.8 per cent for MLs).
PHN engagement with local GPs:
62.6 per cent indicated that their PHN had failed to engage and listen to them about the design of health services needed in the local area (68.8 per cent for MLs).
Practice staff access to useful and effective education and resources:
46.3 per cent of GPs surveyed indicated that their practice staff have not been provided with access to useful and effective education and resources (comparative data is not available for MLs).
Valuing GP contribution:
52.8 per cent believed that their PHN does not value or recognise the inputs of local GPs (60.8 per cent for MLs).
Timing of meetings and information sessions:
46.1 per cent indicated that their PHN was holding meetings and information sessions at times that were not easily attended (52.4 per cent for MLs).
Supporting targeted programs for disadvantaged groups:
50.6 per cent indicated that their PHN has not been supporting well targeted programs that could help patients, particularly those who are disadvantaged (comparative data is not available for MLs).
Facilitating services that complement existing general practice:
52.8 per cent indicated their PHN is not focused on facilitating services that complement existing general practice services s (comparative data is not available for MLs).
Practice support for MyHealth Record:
57.4 per cent indicated that their PHN had not provided effective support for practices to implement the MyHealth Record (56.6 per cent for MLs re PCEHR).
Access to psychological services:
48.0 per cent indicated that their PHN had failed to improve patients’ access to psychological services (48.9 per cent for MLs regarding improved Access to Allied Psychological Services (ATAPS)).
Accessible mental health services for ATSI patients:
35.5 per cent of GPs surveyed indicated that their PHN had not facilitated appropriately funded and accessible services to meet the mental health care of Aboriginal and Torres Strait Islander (ATSI) patients (comparative data is not available for MLs).
Delivery of mental health and suicide prevention services and supports to ATSI patients:
43.3 per cent of GPs surveyed indicated that their PHN had not been able to improve the delivery of mental health and suicide prevention services and support to ATSI patients (comparative data is not available for MLs).
Access to services for patients requiring mental health care, but who are not eligible for National Disability Insurance Scheme (NDIS) packages:
52.7 per cent indicated that their PHN had been ineffective in facilitating for the needs of patients requiring mental health care, but who are not eligible for NDIS packages (comparative data is not available for MLs).
Psycho-social supports for patients with mental health problems:
55.9 per cent indicated that their PHN had been unable to ensure effective and timely psycho-social supports to patients with mental health problems (comparative data is not available for MLs).
Overall PHN performance:
58.0 per cent indicated that their PHN had not improved local access to care for patients (73.0 per cent for MLs).
Overall delivery of primary care:
62.6 per cent indicated that their PHN had not improved the capacity to deliver better quality healthcare overall (71.6 per cent for MLs).

PHNs have an important role to play in improving the integration of health services within primary health care, enhancing the interface between primary care and hospitals, and ensuring health services are tailored to the needs of local communities. They have the potential to have a strong impact on aged care services, mental health outcomes, chronic disease management, Indigenous health services, and services for the disadvantaged.

The AMA believes that for PHNs to be successful they must: have a clear purpose, with clearly defined objectives and performance expectations; be GP-led and locally responsive; focus on supporting GPs in caring for patients and working collaboratively with other health care professionals; have strong skills based Boards; be appropriately funded to support their operations, particularly those that support the provision of clinical services; focus on addressing service gaps, not replicating existing services; not be overburdened with excessive paperwork and policy prescription; and be aligned with Local Hospital Networks (LHNs), with a strong emphasis on improving the primary care/hospital interface. [3]

They should focus on the following areas:

Population Health – Identifying community health needs and gaps in service delivery; identifying at-risk groups; supporting existing services to address preventive health needs; and coordinating end of life care.
Building General Practice Capacity – Supporting general practice infrastructure to deliver quality primary care through IT support; education and training of practices and staff; supporting quality prescribing; training to support the use of e-Health technology and systems; enhancing practices capacity and capabilities to embrace the principles in being a medical home to their patients, and facilitating the provision of evidence-based multidisciplinary team care.
Engaging with Local Hospital Networks (LHNs)/Districts – Identifying high risk groups and developing appropriate models of care to address their specific health issues (e.g. those at high risk of readmissions, including non-insulin-dependent diabetes mellitus, congestive cardiac failure, chronic obstructive pulmonary disease, and other chronic diseases); and improving system integration in conjunction with local health networks.[4]

Given that PHNs are still a relatively new feature on primary care landscape, the jury is still out on the performance of PHNs. The AMA believes that they should be given every chance to succeed and intends conducting the same survey in a couple of years’ time to see how much of a difference they are making for GPs and their patients.

Dr Moe Mahat
Manager Policy
AMA General Practice Section

[1]Ducket et al (2015) Leading change in primary care: Boards of PHNs can improve the Australian health care system.

[2] Prof. John Hovarth AO (2014) Review of Medicare Locals: Report to Minister for Health and Minister for Sport.

[3] AMA Position statement Primary Health Networks 2015 position-statement/primary-health-networks

[4] Op Cit.

Close the clean drinking water gap

BY AMA PRESIDENT DR MICHAEL GANNON

Safe drinking water is an indispensable human right. The leading national and international health bodies, such as the World Health Organization and the United Nations, all agree that safe drinking water is essential to sustain life, and a prequisite for the realisation of other human rights. The UN General Assembly explicitly recognises the human right to clean drinking water.

Having access to sufficient, safe, accessible and affordable drinking water is an important public health issue.

In developed nations such as Australia, it is often assumed that safe drinking water is accessible to all. However, this is not the case, particularly in many remote or very remote communities where artesian (bore) water is often the primary source of drinking and household water.

According to the Bureau of Statistics (2007), for discrete Indigenous communities the majority accessed bore water (58 per cent), while other sources of water included: town supply (19 per cent), river or reservoir (5 per cent), rain water tank (3 per cent), well or spring water (3 per cent), and other sources of water (2 per cent).

While the supply of potable water (defined as waterthat is safe to drink or to use for food preparation, without risk of health problems) impacts on all people living in remote areas of Australia, Aboriginal and Torres Strait Islander people are disproportionately affected.

Many Aboriginal and Torres Strait Islander people living remotely find it challenging to obtain water that is of sufficient quantity (and quality) to meet their needs.

In 2012, the Australian Bureau of Statistics estimated that there were more than 400 discrete Aboriginal communities across Australia, with the largest number in Western Australia. Data collected on over 270 remote WA communities indicated that the quality of drinking water did not meet the Australian standards, as outlined in the Australian Drinking Water Guidelines (ADWG), approximately 30 per cent of the time.

While the National Health and Medical Research Council (NHMRC) has responsibility for the ADWG, this is not a mandatory standard, with State and Territory Governments and local councils responsible for the implementation and monitoring of water quality and safety. Yet during the two year period 2012-2014, 80 per cent of remote Aboriginal communities in Western Australia failed to meet quality standard testing at least once.

There are obvious health consequences from drinking poor quality water. Some Aboriginal communities are known to have unsafe levels of chemical contaminants such as nitrates and uranium in the water. Nitrates and uranium occur naturally, and are common in the Goldfields and Pilbara regions.

‘Blue Baby Syndrome’ – where an infant’s skin shows a bluish colour and they can have trouble breathing – can be caused by excessive nitrates in the diet, which reduce the blood’s ability to carry oxygen. It can occur where prepared baby formula is made with well water. Water tested in over 270 remote communities in WA showed nitrate levels 10 times the recommended levels.

It is concerning that Aboriginal and Torres Strait Islander people living remotely often have no choice but to pay for safe drinking water. While the majority of us enjoy free, safe drinking water from the tap, those who can least afford it often have to pay just to ensure they are not drinking water sourced from rivers, streams, rivers, cisterns, poorly constructed wells, or water from an unsafe catchment.

The AMA is a member of the Close the Gap steering committee and the Public Health team has raised potable water as a Close the Gap target.

The solution may not just be in more bottled water. In communities without adequate recycling and waste disposal services, thousands of extra plastic water bottles create additional environmental problems.

Governments must invest in infrastructure, such as proper treatment facilities, water storage facilities and distribution systems to meet the changing demands of communities.

All Australians must have permanent and free access to safe water. It is a basic human right and it is difficult to understand how this hasn’t already been implemented and addressed.

[Comment] Indigenous health data and the path to healing

The health disadvantages of Indigenous peoples around the world have their roots in colonisation and discrimination and are related to a loss of autonomy over lands and culture. This history has profoundly affected social determinants of health, such as poverty and marginalisation, and contributed to higher rates of communicable and non-communicable diseases in Indigenous people, and life expectancies that are typically 5 years or more lower than in non-Indigenous populations.1,2 Despite persistent health inequities, Indigenous peoples are determining the path to healing their communities.

Indigenous health, an AMA priority

The Federal Government needs to broaden its thinking when it comes to addressing the healthcare needs of Aboriginal and Torres Strait Islanders, because the current situation is unacceptable, according to AMA President Dr Michael Gannon.

Addressing the Australian Indigenous Doctors’ Association (AIDA) conference in the Hunter Valley in September, Dr Gannon said Indigenous doctors were vital to the health of Indigenous Australians.

“The AMA has said time and again that it is simply unacceptable that Australia cannot manage the health care of the first peoples, who make up just three per cent of our population,” Dr Gannon said.

“When it comes to Indigenous health, the Federal Government needs to broaden its thinking.

“For too long now, people working in Indigenous health have called for action to address the social issues that affect the health of Aboriginal and Torres Strait Islander people.

“Education, housing, employment, sanitation, clean water, and transport – these all affect health too.

“This is clearly recognised in the Government’s own National Aboriginal and Torres Strait Health Plan 2013-2023, yet we continue to see insufficient action on addressing social determinants.

“One message is clear – the evidence of what needs to be done is with us. There is a huge volume of research, frameworks, strategies, action plans and the like sitting with governments – and yet we are not seeing these being properly resourced and funded. We do not need more paper documents. We need action.

“The AMA recognises that Indigenous doctors are critical to improving health outcomes for their Aboriginal and Torres Strait Islander patients.

“Aboriginal and Torres Strait Islander doctors have a unique ability to align their clinical and cultural expertise to improve access to services, and provide culturally appropriate care for Indigenous patients.

“But there are too few Aboriginal and Torres Strait Islander doctors and medical students in Australia.”

AIDA used its conference to celebrate the organisation’s 20^th anniversary and had a conference theme of Family – Unity – Success.

Dr Gannon congratulated AIDA on the anniversary, noting that it had “come a long way”.

He said Aboriginal and Torres Strait Islander people face adversity in many aspects of their lives.

“There is arguably no greater indicator of disadvantage than the appalling state of Indigenous health,” he said.

“Aboriginal and Torres Strait Islander people are needlessly sicker, and are dying much younger than their non-Indigenous peers.

“What is even more disturbing is that many of these health problems and deaths stem from preventable causes.

“The battle to gain meaningful and lasting improvements has been long and hard, and it continues.

“I am proud to be President of an organisation that has for decades highlighted the deficiencies in Indigenous health services and advocated for improvements.

“While there has been some success in reducing childhood mortality and smoking rates, the high levels of chronic disease among Indigenous people continue to be of considerable concern.

“For the AMA, Aboriginal and Torres Strait Islander health is a key priority. It is core business.

“It is a responsibility of the entire medical profession to ensure that Aboriginal and Torres Strait Islander people have the best possible health.

“It is the responsibility of doctors to ensure that patients – all patients – are able to live their lives to the fullest.”

This year, the AMA’s Report Card on Indigenous Health – to be released in November – will focus on ear health and hearing loss.

Aboriginal and Torres Strait Islander people in Australia suffer from some of the highest levels of ear disease in the world, and experience hearing problems at up to 10 times the rate of non-Indigenous people across nearly all age groups.

Hearing loss has health and social implications, particularly in relation to educational difficulties, low self-esteem, and contact with the criminal justice system.

The report card will be a catalyst for Government action to improve ear health among Aboriginal and Torres Strait Islander people.

Dr Gannon told the conference that at every opportunity, the AMA highlights the issues of housing, clean water, transport, food security, access to allied medical services, and other social determinants that contribute to chronic disease and act as barriers to treatment and prevention.

And he said the AMA will continue advocating for an increase in the number of Indigenous doctors in Australia.

“The AMA has been a persistent, sustained, and powerful voice on Indigenous health for decades,” he said.

CHRIS JOHNSON

PIC: Dr Jeff McMullen, Dr Michael Gannon, Charles Davison, and Karl Briscoe

Remote NT patients at risk due to high staff turnover

Half the staff working in a remote Northern Territory healthcare clinic leave after four months on the job, two-thirds leave remote work altogether every year and any one clinic can see a 128 per cent turnover of staff each year, putting patient health at risk, new research shows.

Released on the 10^th anniversary of the United Nations Declaration on the Rights of Indigenous Peoples, the study raises concerns about how the rights to health of Aboriginal and Torres Strait Islander people living in remote communities are compromised by an unstable remote health workforce.

The study’s chief investigator Professor John Wakerman, Associate Dean Flinders Northern Territory, said there was no one simple solution to this issue.

“The work to date suggests a number of possible strategies. These include increased investment in recruiting and retaining local Aboriginal Health Practitioners and consideration of utilising remote nurse practitioners where there are no doctors to provide higher level care and to stabilise the nursing workforce,” Professor Wakerman said.

“We can also learn from successful strategies used for training and retaining doctors and apply them to nursing and allied health professionals.

“This would entail prioritising remote and rural origin and Aboriginal students in undergraduate courses, early exposure and training in remote areas and developing clear career pathways for these remote area health professionals.”

Lead author of the report, Dr Deborah Russell of Monash University, said there was considerable anecdotal evidence about the difficulties remote communities faced attracting and retaining suitably skilled health staff and their increasing reliance on agency nurses.

“This is a landmark study that actually measures turnover from the perspective of a particular remote health service,” Dr Russell said.

“It shows extreme fragility of the remote workforce, confirming that there is a heavy reliance on agency nurses to provide primary health care in Northern Territory remote communities.

“Lack of continuity of care has serious implications for both patient health and staff safety in remote communities across Australia.”

“Constantly having to recruit and orient new staff is also a serious drain on resources and can make it very difficult for these health services to participate in quality improvement.”

The study was a collaboration between Flinders University, Monash University, Macquarie University, the University of Adelaide, the University of Sydney and the NT Department of Health. It is part of a larger program of research investigating the impact and cost of short-term health staffing in remote communities to determine whether fly-in, fly-out is the cure or the curse.

The study looked at data provided by the NT Government payroll and account system from 2013 to 2015 covering 53 remote clinics.

While the study looked specifically at NT health services, the authors say that extremely high turnover and heavy reliance on short-term agency nurses for supply has important implications for remote health services anywhere in Australia.

“There’s good evidence that primary health care is critically important for achieving equitable population health outcomes,” said Dr Russell.

A chronic lack of continuity of care sees people less likely to access primary health care in a timely way and to disengage from their health care altogether.

“And, ultimately, that results in poorer health outcomes.”

The paper Patterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013-2015 published in Human Resources for Health is available at: https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-017-0229-9

CHRIS JOHNSON

New boss for Health Department

Prime Minister Malcolm Turnbull has appointed career public servant Glenys Beauchamp the new Secretary of the Department of Health.

She took up the post on September 18, following the resignation of former Health Department chief Martin Bowles.

Ms Beauchamp has had an extensive senior-level career in the Australian Public Service and was most recently the Department of Industry, Innovation and Science Secretary.

Her roles before that included: Secretary of the Department of Regional Australia, Local Government, Arts and Sport (2010–2013); Deputy Secretary in the Department of the Prime Minister and Cabinet (2009–2010); and Deputy Secretary in the Department of Families, Housing, Community Services and Indigenous Affairs (2002–2009).

She has more than 25 years’ experience in the public sector and began her career as a graduate in the Industry Commission.

Ms Beauchamp has also held a number of executive positions in the ACT Government, including Deputy Chief Executive, Department of Disability, Housing and Community Services and Deputy CEO, Department of Health. She also held senior positions in housing, energy and utilities functions with the ACT Government.

In 2010, she was awarded a Public Service Medal for coordinating Australian Government support during the 2009 Victorian bushfires.

She has an economics degree from the Australian National University and an MBA from the University of Canberra.

Mr Turnbull described Ms Beauchamp as a highly experienced departmental Secretary.

CHRIS JOHNSON

Hearing health for Indigenous Australians a crisis

The Still Waiting to be Heard: Hearing Health Report has been presented to Federal Parliament and provides sobering reading – particularly in relation to Indigenous children.

The Australian Parliament’s Health, Aged Care and Sport Committee received more than 100 written submissions and held over 11 public hearings around the country to examine the hearing health and wellbeing of Australia.

The report found improving hearing health across the whole Australian community required greater prioritisation by Government.

Implementing the actions recommended in the report, it found, would improve the hearing health and wellbeing of Australians across all demographics.

Hearing loss is estimated to cost the Australian economy $33 billion per year.

Chair of the Committee Trent Zimmerman MP said: “For those who experience hearing loss, the most profound impact can be the effect on their everyday lives and relationships with family, friends, and work colleagues.

“Among working age Australians hearing loss can make it difficult to find or retain a job, and among older people hearing loss may lead to social isolation and has been linked to an increased risk of cognitive decline and dementia.”

One point stressed in the report was that it is “no exaggeration” to describe the level of hearing loss among Aboriginal and Torres Strait Islander children as at a crisis.

The report made 22 recommendations including the development of a national strategy to address hearing health in Aboriginal and Torres Strait Island communities and a significant increase in the provision of hearing services to remote Aboriginal and Torres Strait Islander communities.

Also recommended was increased support to hearing impaired Australians of working age who are unemployed or earning a low income.

A prohibition on the use of sales commissions in hearing aid clinics taking part in the Australian Government’s Hearing Services Program was another recommendation.

The implementation of a universal hearing screening program for children in their first year of school was also seen as beneficial by the committee.

The Report is available at:

http://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/HearingHealth/Report_1

The AMA urged the Committee to examine the existing, and expert, evidence on Indigenous hearing loss and hearing health problems and to support the evidence-based recommendations on best-practice responses. The AMA’s submission to the inquiry can be found here:

http://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/HearingHealth/Submissions

MEREDITH HORNE

President’s speech highlights AMA’s influential voice

BY AMA SECRETARY GENERAL ANNE TRIMMER

You might not have caught the speech given by the AMA President Dr Michael Gannon to the National Press Club in Canberra in August. It was a good speech, well-delivered, and touched on many of the major policy and advocacy debates currently being prosecuted by the AMA.

The President’s comments on the strength of the AMA brought to mind the frequently-stated truism that the AMA represents all doctors but that not all choose to pay the membership subscription. In his speech, Dr Gannon reflected on the AMA’s positioning on major community health and social issues.

“The significance of challenging social issues like Indigenous health, marriage equality, and euthanasia is that they highlight the unique position and strengths of the AMA.

We are completely independent of governments.

We rely near totally on member subscription income to survive. I can promise you, as a Board member, it is often a concern.

But unlike many other lobby groups, inside and outside the health industry, this gives us a total legitimacy to speak honestly, robustly, and without fear or favour in line with our mission – to lead Australia’s doctors, to promote the health of all Australians.

We have strong public support and respect as the peak medical organisation.

The AMA was recently ranked the most ethical organisation in the country in the Ethics Index produced by the Governance Institute of Australia.

People want and expect us to have a view, an opinion. Sometimes a second opinion.

The media demand that we have an opinion. And not just on bread and butter health issues. But also on social issues that have an impact on health.

Our view is never knee-jerk.

We consult our members and the broader medical profession. Often we encourage feedback from other health professionals – the ones who provide quality health care with us in teams.

We attract public feedback whether we like it or not. I can promise you that social media has taken this to a whole new level.”

These reflections accurately represent the contribution of the AMA to public debate on health issues, and on broader social issues that impact on the health of the community. The AMA’s Constitution spells out that the role of the AMA is to represent the interests of its members, and also to promote the well-being of patients, taking an active part in the promotion of programs for the benefit of the community and to participate in the resolution of major social and community interests.

The AMA draws its legitimacy as a powerful voice in public debate through its representation of medical practitioners across the broad sweep of the profession from medical students to retired doctors, and across all specialties and places of work. The development of medico-political policy within the AMA is robust, through the specialist councils and committees of Federal Council and then to debate within Federal Council itself. The President and Vice President are the public faces of the AMA but behind them is a substantial process that ensures a representative voice for the medical profession.