2020 Summit

Ah the joys of a new government. Under Kevin 07 we have Nicola Roxon who is the Minister for Health but, as she is at pains to point out, "Not the Minister for Doctors". Power to you sister. Go girl. Forgive me for being naive, but isn't politics about being clever enough to get people to do what you want using a carrot and stick, give and take, don't burn your bridges approach?

So we are going to have a 2020 summit. I suppose it is better than 3 x 5 year plans. Now you may be wondering who is going? There are apparently 88 individuals invited for the 2 day event. Was the Australian Medical Association (representing circa 25% of doctors) invited?.....uhm no. Oh well we all know the AMA is just a lobby group for overpaid specialists but with 88 places up for grabs it might have been politic to at least invite them. Now many of us know, that amongst the many crises in medicine, there are big problems with medicine in the bush. So was anyone from the Australian College of Rural & Remote Medicine invited?.....uhm no. Well how about the Rural Doctors Association of Australia?.....uhm no. OK so given about 10-15% of the future medical workforce is currently training was a representative from the Australian Medical Students' Association invited?.....uhm no.

To me this is not a good start. The neglected groups mentioned "represent" about 50% of the doctors in Australia and have, to put it in the vernacular, been given the shaft. Yes there are lots of very clever and distinguished people going but were places so tight that there no room for the AMA, ACRRM or RDAA or AMSA but there was room for a female junior hospital doctor, who in her own words says: "I am attending as a private citizen. I was nominated by Nicola Roxon because of my work in health workforce and training, and my advocacy of public hospitals. I am not officially representing anyone." I think not.

So let's ignore the fact that half of medicine has been excluded from a presumably inclusive process. Let's consider what 88 people can do over 2 days. 2 days/7 hours per day is 14 hours or 840 minutes. With 88 luminaries that gives each one 9.5 minutes. Call it 5 minutes to talk and 2 questions. Hello? There is a reason we have a representative democracy. There is simply not time for every man and their dog to put in their 2c worth. The way it works is that groups of us elect representatives and they represent us. Sure they don't do what I personally want all the time, nor do they express my personal view all the time. But if enough of us don't like it we turf them. That is why the AMA, ACRRM, RDAA and AMSA should be there and at least 50% of the other delegates should not be. They don't represent anyone! With so many voices, offered so little time, no one will be heard and nothing will be resolved. 2020 is we are listening, feel good political bullshit at its worst.

So perhaps you think I am being unkind? Let's read the questions that have been sent to delegates. Here are the areas of health around which the government would like to see some conversation and brainstorming. These are the questions delegates are being asked:

1. What public conversation do we need around the broader population health challenges?

2. What are the responsibilities of the individual and the state in behavior related illnesses?

3. What should be the balance of investment between treatment and prevention?

4. What strategies will improve health outcomes and the disease risk factors in the general population, and in high need groups?

5. Why are healthy lifestyle messages regarding exercise, diet, smoking and alcohol abuse not being heeded more?

6. How can sectors outside 'health' contribute to a healthier population? For example, can we design cities in a way that promotes a healthier lifestyle?

7. Where should clinical research focus its energies?

8. How do we plan for emerging health challenges?

9. What is the future of health education in Australia, and the role of foreign-trained workers?

10. What can be done to improve safety and quality standards, including clinical protocols?

11. To what extent are the challenges in the health system resolved by extra monies rather than structural reform?

12. What strategies need to be considered to ensure equitable access to health services?

While some of the questions for the 2020 summit are sentient, others would appear to be almost laughable. It is disturbing to realise some committee, somewhere, presumably identified these 12 as the critical issues facing medicine.

So it's easy to poke holes in things. Anyone can do it. It only helps if there is a viable alternative. There is. Stay tuned for the next exciting episode but do not adjust your mind, there is a fault in reality.