Issue 10 / 24 March 2014

I ATTENDED my first protest march in a pram. The introduction of Sunday trading in pubs in the 1960s was something to which my mother strongly objected.

My older sister and I still laugh about the sign she carried on the day. “We want our dad home on Sundays” took on special irony given that our father was a Methodist minister juggling a portfolio of tiny congregations in rural NSW. He was never home on Sundays!

The ability to take a stand — publicly and about almost anything — is something to celebrate in Australia. In the midst of a period of particularly robust public debate across the nation, this week’s MJA InSight reminds us of ways in which Australians have shown leadership in medicine and public health, and are well positioned to do so in the future.

The prominence of Australian researchers and clinicians in melanoma prevention and treatment has been born of necessity in a sunburned country with by far the highest melanoma rates in the world. A recently published “practice-changing” study from Queensland, looking at the risk of developing a second invasive primary melanoma in patients who have already had an encounter with the disease, forms the basis of InSight’s first news story.

Australia provides vital data to inform global efforts in influenza control via the WHO Collaborating Centre for Reference and Research on Influenza. Australian researchers have also been involved in the ongoing debate about the quality of the research that is used worldwide to inform policy and practice in influenza treatment. Given this wealth of expertise, we knew who to call on for our news story about a recent large multinational study on outcomes for hospitalised patients treated with neuraminidase inhibitors that has stirred up some controversy.

On a lighter note, MJA Editor-in-Chief Stephen Leeder is in fine form in InSight this week, with an exhortation that Australians should literally stand up for themselves. As the evidence mounts about the detrimental effects of prolonged sitting, he has some practical advice on how those in sedentary occupations should respond.

Tuberculosis is not widely regarded as a major threat to Australia’s health but a recent MJA editorial highlighted that it is a formidable problem at our doorstep: the Asia−Pacific region carries 58% of the global TB burden, including 54% of the estimated 680 000 multidrug-resistant (MDR) cases. The authors suggested that: “While ‘ownership’ of the DR-TB response should be in the hands of the countries most affected, Australia is presented with an opportunity to show regional leadership and collaboration, serving a pivotal coordinating function.”

This suggestion, which the authors have taken to Parliament House to mark World TB Day today (24 March), includes strengthening Australia’s commitment to The Global Fund to fight AIDS, TB and malaria via our aid budget. It is the subject of another InSight news story.

Their actions may be timely, with a Senate inquiry into Australia's overseas aid and development assistance program due to report its findings later this week

Concern about cuts to Australia’s foreign aid budget and the way it will be administered was among the multiple issues that prompted the recent “March in March”. An article published on the health news website Croaky last week has highlighted the health-related concerns that drew tens of thousands of people onto the streets on an early autumn weekend to voice their disquiet.

My sister and I reprised our double protest act with 4000 others in the city of Newcastle on the day. We were a motley crew among whom I was able to identify nurses, dock workers, human rights advocates, environmental activists, families, elderly people, political organisations and the odd confused-looking cyclist who had strayed too far from a nearby triathlon.

As we all shuffled companionably through the city I couldn’t help but take a moment to be grateful to be in a place and a time where ordinary people still have the ability and the will to take a stand.

 

Dr Ruth Armstrong is the medical editor of MJA InSight.

9 thoughts on “Ruth Armstrong: Taking a stand

  1. Antony Sara says:

    Hi

    i was a little surprised to NOT see reference to the dispute between the profession and the queensland government mentioned in this article. various epithets aplied to it have incuded “a war on the medical profession by Springborg” (sean mcmanus, cairns, courier mail) and “the greatest single threat to the medical profession in living memory” (me, courier mail).. mass meetings of 540, then 950, then 15–1700 of doctors is fairly demonstrative??

  2. Dr Margerie Linton says:

    Good on your Ruth.  I also attended a March in March.  I even made a banner – which could have been larger to put all on it that I wanted to say.  What a great weekend it was – stopped me feeling so angry!

  3. rarmstrong@mjainsight.com.au says:

    To the first commenter: Thanks for mentioning the Queensland doctors’ dispute as another important piece of activism that is going on at the moment. It was certainly in my mind when I began writing but I didn’t feel I could do it justice in a few words. MJA InSight will seek an update on this soon.

  4. C Hamilton-Craig says:

    The ability and freedom to be upstanding and demonstrate for what you believe in is central to a democracy.

    The Queensland State Government’s actions to legislate against medical officers, removing rights of access to the Queensland Industrial Relations Commission, in order to pave the way for forcing doctors onto individual contracts without IR protection, is a sleight against democratic process.

    The fact that almost 2,000 doctors in QLD demonstrated against the unfair and unjust actions of the Government is worthy of mention, as it is one of the largest medical disputes in Australian history.

    As doctors and colleagues, we need to support SMOs and VMOs in Queensland, as if the Government is successful in removing basic rights to binding arbitration and process for unfair dismissal, then the rest of the country and the entire healthcare workforce will be next. This would be terrible for the Australian public health system, and for health care in this country.

    This is NOT about remuneration. This is about basic rights of a workforce to have a job which is protected under appropriate legislation, and a contract which is agreed between parties and not subject to unilateral variation at the whims of politicians or administrators without recourse (as is currently the case in the QLD government contracts)

  5. Ulf Steinvorth says:

    The current political decisions in Queensland regarding doctors’ rights and contracts are posing a threat to the public health system, few would argue that. My question is whether the government actually minds as much as we all believe.

    Ramsay Health, a private Health company, has been the biggest private donor to the QLD Liberal party pre-election and even in federal politics it is suggested that it might be high time to change to more private health cover and less public funding & services. Might be an ingenious way to shift towards this new lucrative model by making doctors walk from the public sector through unpalatable contracts? Maybe to let the private sector mop it up with increased bills and profits – what goes round comes round?

     

  6. Wendy Webb says:

    Hi Ruth. I love your story about your first protest! My father is also a Methodist minister, still preaching at 87 and proud of it. He was hardly at home at all, let alone on Sundays, so I get the irony of the banner in many ways. Times have changed, as my parents now happily go to a club for meals including Sundays, but we still bemoan the effect of alcohol on society and family life so I suspect your mother was right.

     

  7. Elliot Rubinstein says:

    To be meaningful, taking a stand on public issues must be in the place where it counts. I can take a stand on the ills of the world at my dinner table; who cares, on a soap box at Hyde Park, who cares, in a crowd marching down Bourke St. who cares? It is only the threat of action that will cause some sort of pain that will galvanize our rule makers to modify their actions. Re Queensland, at present they are causing doctors pain we have to change that. Expressing displeasure, even hundreds or thousands of people, is not enough.

  8. Saul Geffen says:

    Motley crew? I saw professional protestors, arts students, union organizers and ratbags. All with one thing in common a hatred of the policies put in place by our recently elected government. I hope our dear Editor wasn’t holding one end of a “Tony Abbott is a dickhead” sign. Whilst she has every right to protest as an individual her characterisations of the crowd involved at the very least are rose coloured. I certainly am uninterested in her political activism in my medical journal. 

     

  9. rosemary o'brien says:

    thanks for the article . Taking a stand is what I feel compelled to strive for having recently returned from Manus detention centre . Am not sure how many Australians are aware that we ( as a nation ) have agreed to 1300 young men being placed in a shoddy camp where they have been attacked while supposedly under our care and protection – one killed and more than 60 injured,  – 2 months later there are still people with displaced fractured noses, fracture dislocation of jaw , broken teeth  – as well as  many with increased mental health issues  – whose needs have not been rectified . Australia is spending large amounts of money to keep these men in a state of indefinite detention – not one claim has been processed in more than 12 months and when they are processed no one is certain what follows .Mr  Morrissey says they will be resettled in Manus  – one of the poorest provinces in PNG , with no industries and almost total traditional land ownership – as well as being the home of the majority of people who attacked the transferees. There was no evidence of any reconciliation happening on either side following the riot , yet we are proposing that somehow these people will be settled here! To see 19 year olds , being medicated with antipsychotics because they are unable to sleep for fear of being attacked , or overwhelmed by the thought of spending the rest of their lives in incarceration for no criminal act was heartbreaking – yet this is being done in my name as an Australian . How many times are we going to leave our descendants having to say sorry .

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