Health care in Australia seems to lurch from one crisis to another. Symptomatic of this perpetual state of confusion and conflict is the recent community unrest at the government’s slashing of the Medicare rebate for cataract surgery, and the uncertainty surrounding the roll-out of the pandemic (H1N1) 2009 vaccination program, allegedly because of safety issues and failure to indemnify doctors administering the vaccine. These examples of disarray and discontent are but the tip of the iceberg.
Why all this recurring turmoil? Its root causes are multifactorial, but prominent among them must be the quality of the Australian Government’s ministerial advice, be it from the Treasury or the Department of Health and Ageing. Few in the bureaucracy or politics have any clinical background, and most are largely consumed by the imperative to slash expenditure. These shortcomings are further compounded by a political failure to connect and consult with organised medicine.
In other countries, things are done differently. In the United States, when the President and Congress want objective evidence on health issues, they call on the Institute of Medicine. In the United Kingdom, when the Prime Minister and Parliament require similar advice, they turn to the Academy of Medical Sciences. Likewise, the Canadians turn to the Canadian Academy of Health Sciences.
Composed of a representative array of distinguished leaders in the health disciplines, these bodies address issues in health which require expert analysis that is independent of vested interests. They are capable of providing a rapid response, at arm’s length from political considerations.
Instead of the cavalcade of recent inquiries and their pending pandemic of reports, would we not be better served by investing in an Academy of Health Sciences? Indeed, in addition to the aforementioned countries, France, Germany, Italy and Japan also consult the collective expertise of such academies. They are viewed as a valued part of the solution.
However, in any democracy, the recommendations of these academies will ultimately require both community and professional debate.
“Medicine is a social science and politics is nothing but medicine writ large.”
The Medical Journal of AustraliaMartin B Van Der Weyden, Editor.
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