Indigenous health

Jan 31, 2012


Could special recognition for Aboriginal and Torres Strait Islander people in the Parliament and in the Constitution bring benefits for Indigenous health?

In the article below, Dr Enrico Brik, the pseudonym of a self-employed consultant and sometime writer and blogger who has worked for over a decade in various roles in health services policy and planning, suggests these are measures that should be considered.


How the Parliament could help improve Indigenous health

“Enrico Brik” writes:

Australian society is a beautiful youth with a disfiguring scar. It is a scar that shames us most because it was inflicted by our forebears.

Yet our gaze will not be averted: repeated surgery has failed to fade it; no amount of make-up or finery conceals it. We are on show with it to ourselves and the world.

That scar is the problem of Aboriginal health.

It is not the only wound on the Australian body politic, but it is surely the one that most disturbs and disgraces us.

If ever there was a case study for the social determinants of health, Australia’s failure over Aboriginal health is it: a young, rich, successful, first world nation-state, with an enviable health, medical and scientific system.

And what do have? By far the worst Indigenous health of all the OECD nations built on colonising occupation. Continue reading “Using Constitutional change to improve Indigenous health”

health financing and costs

Jan 31, 2012


Dr Lesley Russell writes:

Since 2006, Australian governments have committed to spending around $8 billion of new money on mental health.  Given the huge burden of mental illness and the unmet needs for mental health services, proper accountability for this expenditure is crucial to ensure that it is targeted at the areas of greatest need and is delivering better outcomes for people with mental illness.

As outlined in a paper published this week by The Medical Journal of Australia (, my colleagues Sebastian Rosenberg and John Mendoza and I found that establishing this accountability is not easy.

Federal and state budget announcements (and re-announcements) and the lack of publicly available reports perpetuate an environment characterised by opacity rather than transparency.

Despite dozens of plans and policies, spending between jurisdictions continues to be uncoordinated, lacking both accountability and a focus on patients’ needs.  It is impossible to verify whether jurisdictions really did spend what they reported.  Continue reading “Mental health funding: well targeted or just well meant?”

child health

Jan 31, 2012


Public health advocate Professor Mike Daube writes:

The finals this weekend of the KFC T20 Big Bash could have been better (especially if the Perth Scorchers had won), but the cricket was lively and would have made exciting viewing for many children as they watched all the KFC promos, as well as seeing their sporting idols associate themselves with KFC products in a steady flow of advertisements throughout the game.

But was it necessary for Foxtel to interrupt its telecast of the game for an interview with the Chief Marketing Officer of KFC, so that she could promote the product as an essential feature of the Australian summer, and tell us all about the modest charitable donations KFC makes as part of its promotional program?

Amazingly, the interview ran not only during the periods between play, but while the game itself was on – preventing the commentators from deliveries during the game. Continue reading “Junk food promotions by Foxtel: it’s just not cricket”

health reform

Jan 27, 2012


The National Mental Health Commission held its first meeting in Sydney this week, and one of its first priorities, according to Minister Mark Butler, is to deliver the first annual National Report Card on Mental Health and Suicide Prevention

In a related interview with the Sydney Morning Herald, the Commission’s chair, Professor Allan Fels, highlighted an issue whose importance extends well beyond mental health: the dominance of “the supply side” in health care.

“I’m very aware of what economists would call the demand side of the equation – the needs of the consumers and carers – and it’s important that mental health is not just led from the supply side,” he said.

Professor Fels said the Commission will hold six meetings a year – three in capital cities and three in rural and regional areas.

One of many questions about the new body is how it will work with its state counterparts.

Meanwhile, Dr Matt Fisher, Research Officer at the Southgate Institute for Health, Society & Equity at Flinders University, has been examining the draft roadmap for mental health reform that was released recently for public comment.

He suggests that it needs to harness the potential for wider social and economic policies to contribute to better mental health, particularly for those groups most at risk. Continue reading “Improving mental health: beyond a framework driven by health care suppliers”

health financing and costs

Jan 27, 2012


As the Government mounts its case for means testing of private health insurance rebates, a new report urges the Government to withdraw all support for private health insurance, on equity and efficiency grounds.

The report says private health insurance should be viewed as a form of industry assistance which subsidises queue jumping. It “is administratively expensive (technically inefficient in economists’ terms), distorts incentives and choices (allocatively inefficient), and does not satisfy any reasonable criteria of equity.”

Published by the Centre for Policy Development, the discussion paper, titled Private health insurance: high in cost and low in equity, is by John Menadue AO, a former Secretary of the Commonwealth Department of Prime Minister and Cabinet, and Ian McAuley, an Adjunct Lecturer in Public Sector Finance at the University of Canberra.

They say it is strange for a government with a stated policy of “social inclusion” to provide incentives for the well-off to opt out of sharing their hospital costs with other Australians.

They call for wider health reform, and greater sophistication in public debate about health policy.

“Rather than meaningless political rhetoric about private/public options – rhetoric which does not distinguish between funding and provision, and which suggests that without private insurance there would be no private sector in health care – the public debate should be about the division between use of market mechanisms and community sharing,” they say. Continue reading “Federal Government urged to withdraw all support for private health insurance”

environmental health

Jan 27, 2012


In its latest Croakey update, the Primary Health Care Research and Information Service (better known as PHC RIS) highlights an article examining the relationship between caring for country and health.


Healthy country, healthy people: Involvement in land management has positive health benefits for Aboriginal Australians

Bradley Smith writes:

Aboriginal people have jurisdiction over roughly 20 percent of the country. It was hoped that such expansive land ownership would lead to successful agriculture and advance the economic wellbeing of Aboriginal Australians.

However, these lands are situated primarily in the Australian desert, and have limited agricultural value.

Fortunately, social expectation regarding land use has shifted from a focus on production and amenities, to a more multifaceted one, including tourism and conservation.

This allows Aboriginal people with cultural connection to the land, the opportunity to manage the country by applying Indigenous ecological knowledge (or ‘caring for country’).

Caring for country involves spending time on the land, removal of grasses through cool weather burning, gathering food and medicinal resources, protection of sacred sites, production of art and craft work, as well as intergenerational transfer of knowledge.

A paper recently published by David Campbell argues that for Indigenous Australians, being involved in caring for country can provide many advantages that are of benefit to both public and private health, and the environment. Continue reading “Caring for country is also good for Aboriginal people”


Jan 24, 2012


An ACCC investigation into breast imaging highlights broader concerns about a lack of regulation of unregistered health practitioners, writes Rebecca Johnson, Policy Advisor, Cancer Council Western Australia.


Why are health regulators leaving the heavy lifting to the ACCC?

Rebecca Johnson writes:

Early in January, the ACCC launched legal proceedings  against two commercial breast imaging operators, alleging that the operators engaged in ‘false and misleading conduct’ by marketing themselves as effective breast cancer detection services.

Both companies use devices based on electrical impedance – the speed at which mild electrical currents pass through tissue – and one uses a thermographic camera to image women’s breasts.

Neither of the devices are supported by evidence showing them to be effective in detecting breast cancer.  Yet they, and others like them, are spruiked to consumers, for a considerable fee, in a shower of pink.

Why the concern?   Continue reading “A call for regulatory action on unregistered health practitioners”


Jan 23, 2012


Croakey has a new feature: a listing of public health and health policy conferences.

Meanwhile, the organisers of a forthcoming conference on social media in healthcare have put out a call for help.


Seeking experts and ideas on social media and healthcare

Madeline Vaughan from Informa Australia writes:

Informa Australia is pleased to announce its inaugural Social Media in Healthcare conference, which will be held at the Radisson Blu Plaza Hotel Sydney, on 24-25th May, 2012.

We are currently seeking both local and international speakers and case studies for this event.

The influence of technology is pervasive in our modern world. Ours is a world of increased mobility – where smart phones and other mobile devices enable people to connect in any time and place, where a simple internet connection enables almost limitless access to content on any topic imaginable, and where individuals are communicating and sharing knowledge through social media on an unprecedented scale. Social media has infiltrated every aspect of life, and the healthcare sector is no exception.

However, the industry has been quite cautious in the uptake of these technologies, particularly in Australia.

This conference seeks to explore the possibilities that social media has for enhancing the healthcare sector.  Continue reading “Some news on health conferences. And any ideas for this one on social media and healthcare?”

health reform

Jan 23, 2012


In the article below, Sara Irvine from ShareLife Australia responds to a Croakey article about organ transplant policy by Anne Cahill Lambert that was published last month.


We should be doing better on organ donation rates

Sara Irvine writes:

The Parliamentary Secretary for Health and Ageing, Catherine King recently announced: “In 2011, 1001 Australians and their families benefited from the legacy of 337 of their fellow Australians who last year became organ donors.”

It’s an improvement, but this country should be doing so much better.

We should not be celebrating an “Australian record”, so much as aiming to emulate the record of more successful countries overseas.

The world leader, Spain, last year beat its own record raising the bar to over 35 donors per million of population. Australia is at 14.9.

At Spain’s rates, Australia last year would have seen 783 donors, not 337. Continue reading “ShareLife responds: organ donation rates should be much higher”

conflicts of interest

Jan 20, 2012


Healthy Weight Week is due to kick off on Sunday. But Professor Mike Daube, Director of the Public Health Advocacy Institute at Curtin University, wonders whose interests are really being served by this initiative.


What have Coco Pops and Froot Loops got to do with healthy weight?

Mike Daube writes:

National Healthy Weight Week runs from January 22 – 29.  A worthy objective, but beyond a few platitudes what is it really promoting?

According to the website, Australian Healthy Weight Week is run by the Dietitians Association of Australia and sponsored by Meat & Livestock Australia.

The DAA media release for Australian Healthy Weight Week urges people planning to lose weight “to consider seeing an Accredited Practicing Dietitian as a first (rather than a last) resort” – which perhaps entails a touch of self-interest.

The Dietitians Association of Australia (DAA) also boasts a wide range of corporate partners including: Dairy Australia, Fonterra, Kelloggs, Meat and Livestock Australia, Unilever Australia, Nestle Australia and the Egg Nutrition Council.  All no doubt sell products that make important contributions to humanity; but also others of more doubtful value such as Allens confectionery, Kit Kat, Milky Bar, Chokito, Rolo, Smarties, Violet Crumble, Frosties, Coco Pops and Froot Loops.

Seeking a national healthy weight is a worthy objective, but the DAA would have more credibility if it dropped some of its associations with commercial sponsors, and perhaps even played a more active role in criticising some of their promotional activities.

• PS from Croakey: The Croakey Register of Influencers in Public Health covers some related issues.