News

WCLP reflection: Optimizing Health & Wellbeing

24 May 2012 By James Brown

James Brown
James Brown

The May Williamson Community Leadership (WCLP) seminar, hosted by the Monash Medical Centre in Clayton, focused on Optimizing Health and Wellbeing.

The purpose of this seminar was:

  • Discuss key health access and equity issues with a range of significant stakeholders
  • Hear from leaders balancing policy and operational challenges in the public health system
  • Gain an understanding of the issues surrounding mental health and the delivery of appropriate services and support
  • Explore current health priorities (including the growth in ‘lifestyle related illness) and for education and change in health behaviours

LV asked James Brown to reflect on the experience:

What does someone who works in the education industry know about the health system in Australia? I could write for weeks about the state of Australian education but my real understanding of health care is based largely on my personal experience: a mended broken leg as a teenager, my kids suffering from a few bouts of gastro, and the occasional stories of students’ hospitalisation.

Of course, I’ve read about lengthy waiting lists for elective surgery and the alarming statistics about increases in skin cancer and obesity in the media. As teachers, we are also faced with fairly regular and stark reminders of the growing rates of mental illness among young people, but how do we know if the system is providing the proper care that they need? While the Australian health care system is one of the best in the world, it seems there are still significant issues to address.

More than just offering Band-Aid solutions[1], our WCLP sessions on  ‘Health and Wellbeing’ offered ‘big dreams’ for our health system including cross-sector solutions and the need for a complete paradigm shift in the way we approach health care. Minister for Mental Health, Women’s Affairs and Community Services, the Hon Mary Wooldridge, reminded us by quoting Liberian President Ellen Johnson Sirleaf ‘If your dreams don’t scare you, they’re not big enough.’ The ideas expressed by our speakers were certainly that: big dreams.

Our first two speakers outlined their hopes for our health system by proposing fundamental, systemic change and challenging us to shift our entire mindset on the way we deliver healthcare. They advocated workforce reform so that VET trained nurses could carry out a range of rudimentary duties, while leaving university trained nurses to focus on the more complex and vital tasks. This would also mean more medical care could be offered in the home, especially for the elderly, freeing up money and hospital resources currently allocated on those who have little time left to live—or as some would term it ‘futile care’. The crucial question here, as Dr Brendan Murphy raised is this: if a 92 year old presents with dementia and a cancerous tumor, should we spend thousands of dollars of resources and many hours of specialist medical time removing the tumor? In the United States 25% of all medical expenses are used on the last year of a patient’s life. This is where the mindset shift is necessary. How do we best use our finite resources in the health sector? Should we try to prolong life if it is no longer considered to be of a ‘good quality’ and take up time and money that could perhaps be better spent on cutting down our hospital waiting times?

When such complex issues are raised, it’s difficult for me not to think back to our decision not to remove a cancerous growth from my arthritic, semi-blind 17-year-old Labrador. We tend not to find it so difficult to make this decision with a pet, but how will this sit with me if it involves one of my parents or, for that matter, how it will sit with my children if it involves me? I’m not even sure how it sits with me now. As our life expectancy continues to rise, we will need care over a longer period of time, but how will future generations see fit to treat us? And how will we want to be treated?

Our next speakers focussed on mental health, wellbeing and obesity. The statistics don’t lie: one in five Australians will suffer from depression and one in four Australians will suffer an anxiety disorder. The economic costs of mental health to a workplace can be seen in absenteeism and, interestingly, presenteeism: those who attend work but are not in a fit state to do so.

The obesity statistics are equally alarming: normal weight adults will soon make up only one third of Australia’s population. It is estimated that within a decade we will not be able to afford the burden of this disease. As we get fatter we are not just putting strain on our waistlines, we are also bloating our health system with the complications of obesity: diabetes, heart disease and stroke. But is there a solution? Is it even our responsibility to dictate what people eat? Is the solution a ‘fat tax’ on unhealthy foods? Is it a matter of increased education about healthy living?

The individual questions that arose from these sessions are too numerous to list, but the bigger question underlying each speaker’s presentation was clear: what would a perfect health care system look like in Australia? It’s a great question to ask yourself, but just as challenging to consider: is ‘perfect’ dreaming too big?

[1] Sorry, that really is a groan-worthy play on words but how could I resist?

 

James Brown is Head of the Senior School at Carey Baptist Grammar School and is State Reviewer in Australian Politics for the Victorian Curriculum and Assessment Authority. He considers himself to be an astute fisherman, although his three sons often remind him that astute fishermen actually catch fish.