For research and programs to make a positive difference for Aboriginal and Torres Strait Islander health and wellbeing, they must be based on “Indigenous ways of learning, knowing and being”. That was a central theme of the University of NSW’s fifth annual symposium on Indigenous health research, Dreaming up the future of Aboriginal and Torres Strait [...]

When academics at Bond University were planning a cultural immersion program aimed at improving medical students’ understanding of Indigenous health, their priority was to make it creative and engaging.

Associate Professor Janie Smith, who has previously worked as a remote health professional in the NT, presented on the new immersion program at the recent CRANAplus conference in Darwin (where she was also elected the organisation’s new president).

During a two-day retreat in the Gold Coast hinterland, students were asked to draw their own culture on large sheets of paper, to identify their own values and belief systems, as well as the symbols, food and other elements making up their culture.

In a later session, parts of their culture were – literally – ripped away from them, as a metaphor for how Aboriginal and Torres Strait Islander people have experienced the loss of cultural and family connections over time.

“We asked them, how does it feel to have part of your culture ripped away?” Professor Smith said.

She said the experience was extremely powerful for the students, as were the storytelling sessions where Aboriginal and Torres Strait Islander facilitators shared their own personal and family histories.

In a recent article, health policy analyst Lesley Russell suggested that Australia could learn from the achievements of public health champions in the US like Michael Bloomberg, and that we should be seeking to have public health leaders elected into positions of influence.

In responding to her article, Todd Harper, the CEO of Cancer Council Victoria, suggests that it is difficult to advance public health in Australia without addressing the argy-bargy between federal, state and local governments over where responsibility lies for public health initiatives.

We need the financial and governance structures in place to support our leaders in achieving real change, he says.

*****

How the system works against effective public health action and leadership

Todd Harper writes:

Lesley Russell argues that public health is “the poor cousin to healthcare” because there are no political champions for the cause – and certainly now is a time for champions. The wealthy philanthropist and public health-minded Michael Bloomberg is transforming health in New York and, in doing so, is inspiring others around the world.

Despite some laudable gains in areas like the plain packaging of tobacco products, public health in Australia continues to struggle for the attention that it deserves.

Public health fails to attract the investment it should partly because of a lack of leadership, but also because it battles to sustain the interest of governments beyond the next crisis in the health care. Our federal system divides responsibility between state, federal and even local governments; emancipating any of them from taking the leadership needed.

Stuck on a stubbornly low share of health spending, what can be done to boost the resources that public health needs to make long-lasting gains?

Australia’s health system faces many challenges, including waste and inefficiency, structural imbalances between public and private health insurance, and increasing supply and demand, according to speakers at a recent symposium in Canberra.

One of the questions underlying the event’s discussions seems to have been: are we better off investing efforts in system and financing reform – or focusing more on prevention and improving population health?

Thanks to Daniel Holloway, Communications Officer at the AHHA, and Sam Osborne, Project Officer at the AHHA, for providing this report.

****

The challenges of sustainable, universal healthcare

Daniel Holloway and Sam Osborne write:

In light of the recent debate surrounding the sustainability of universal healthcare in Australia in the current economic climate, the Deeble Institute held its inaugural symposium on Tuesday 24 September 2013 at Old Parliament House.

The symposium, entitled “Universal Healthcare and its challenges for the future”, provided a forum for expert speakers from both sides of the political spectrum to debate the problems with Australia’s health care system, and discuss some of the possible solutions.

Why debate universal health care now?

As we know, health care expenditure is rising rapidly. Many argue that this means that current health care spending will be ‘unsustainable’ in the future. Not so says the Grattan Institute’s Health Program Director, Stephen Duckett.

In his presentation Professor Duckett argued that contrary to popular belief, the rising cost of health care in Australia is not caused primarily by population growth, population ageing and excessive health care inflation.

Instead, he argued that policymakers need to address causes in the ‘other’ category, such as waste and inefficiency in the health system, which are driving up expenditure. He warned in particular of going into a ‘sustainability panic’ and adopting panic type solutions to the problems in our health system today. 

    By Kellie Bisset Can we avoid going to climate hell in a handbasket? As the Intergovernmental Panel on Climate Change (IPCC) published its Fifth Assessment Report, warning that preventive steps are critical to address climate warming, Australia’s  newly axed Climate Commission re-emerged as the Climate Council after a lightening speed community fund-raising drive that [...]

 Many thanks to Fran Baum for this overview of recent discussion on the innovative idea of community-owned primary health enterprises.

Professor Fran Baum writes:

On 2nd October a workshop was held in Adelaide to introduce the idea of community-owned primary health enterprises.

The idea is the brain child of Tony McBride and Rod Wilson who both have a wealth of experience as CEOs in the Victorian Community Health and NGO sectors.

Their premise is that many GP practices are being taken over by the corporate-for-profit sector and that a feasible alternative model would be for community not-for-profit organisations to run primary health care services.

Many thanks to Dr Lesley Russell, Senior Research Fellow, Australian Primary Health Care Research Institute, Australian National University for these insights into the current ‘shenanigans’ in the US.

The failure of the US Congress to agree on a federal budget because a small band of conservative Republicans insist that the budget legislation is linked to efforts to defund and halt Obamacare has led to a shutdown of the US government. Some 800,000 federal workers are furloughed and more than a million others are working without pay.

As previously noted, there has been a deal of uncertainty about the fate of Indigenous health programs and services administered by the Federal Health Department and the Office of Aboriginal and Torres Strait Islander Health (OATSIH) under the new Federal Government.

While no doubt there are still issues to resolve, at last there is some news – some programs will transfer to the Department of Prime Minister and Cabinet, as outlined below.

But funding responsibility for most Indigenous health services remains in the Health Department, to be coordinated by a new Indigenous Health Service Delivery Division (which replaces OATSIH). No doubt many will be interested in the prediction that the new arrangements will mean less red tape for service providers.

Stephen Duckett writes:

A new Grattan Institute report released this week, Access all areas, tells a mixed story about Australians’ access to general practitioners (GPs). The good news is access is getting better in many parts of Australia. The bad news is the progress is slowest where it’s needed most.

And if we continue with current policies, it will take 65 years before people in many parts of rural and remote Australia have the same level of access to general practitioner services as city dwellers do.

The facts are stark: residents in Mt Isa, for example, have access to 68 equivalent full time GPs per 100,000 people – about half the 120 available to the residents of Sydney’s eastern suburbs.

Access problems are real: people in rural and remote Australia wait longer and pay more out of their own pocket when they eventually get to see a GP. They are more likely to skip consultations because of costs and risk getting sicker before they get care.

On Friday, the Intergovernmental Panel on Climate Change (IPCC) published its Fifth Assessment Report (5AR). In summary it tells us that: The climate is warming Humans are responsible for the majority of climate warming The level of climate warming by the end of the century will be seriously bad news if we do not take [...]