The President's Message - 25 June 2015

COLLEGE SHOWS LEADERSHIP ON KEY PUBLIC HEALTH ISSUES


Lancet Commission on Climate Change and Health

Yesterday, the College hosted the launch of the Lancet Commission on Health and Climate Change’s 2015 Report. The report provided further evidence that climate change is a not just an environmental and economic emergency, it is also medical emergency.

The event was a reminder that we have a responsibility, as clinicians, to acknowledge the scientific reality of climate change and take any and all actions that minimise its health consequences.

I am proud of our College for showing leadership on this important topic and we will continue our advocacy in this area to minimise the health consequences of climate change.

Australian Border Force Act – RACP coordinates health group advocacy

On Saturday, 20 June 2015, World Refugee Day, the College released a joint media statement from 12 health organisations calling for changes to be made to the Australian Border Force Act 2015. This Law, which passed quietly through parliament last month, includes appalling secrecy provisions which threaten health professionals with up to two years imprisonment, simply for speaking out about poor conditions or standards of care that they witness in immigration detention centres.

Having written my Opinion Piece for Fairfax a couple of weeks earlier, I was proud that our College showed leadership and courage in bringing health groups together to voice our collective concern about this law.

This is a matter of principle. No law should seek to silence health professionals from speaking out about harms to their patients. No Government should consider it reasonable that harms to innocents go unremarked and unknown. It is thanks to health professionals including doctors that Australians are aware of the severe impacts to health of immigration detention. This attempt to intimidate us into silence is contrary to our duty to advocate for our patients. We are calling for urgent changes to be passed to remove this gag on health professionals.

Our strong media coverage on this issue is outlined in the recent media activity highlighted below.

New Ethics Committee holds inaugural meeting

On Tuesday this week, the newly appointed Ethics Committee held its inaugural meeting. The committee was appointed following the recommendations of the RACP Ethics Review, conducted by independent expert in ethics, Dr Jeff Blackmer, and an Expression of Interest process. The committee serves to provide the Board with advice in areas that raise ethical considerations in the context of policy and advocacy, education, research and financial investment.

Chaired by AFPHM President, Dr Greg Stewart, the Committee includes Fellow and trainee representatives from Australia and New Zealand with diverse backgrounds, including Associate Professor Jillian Sewell (RACP past-President, paediatrics), Dr Alastair Macdonald (nephrology), Dr Alina Iser (general paediatrics), Dr Danielle Ko (palliative medicine), Associate Professor Ian Kerridge (haematology) and Dr Linda Sheahan (palliative medicine and bioethics).

The Committee has begun developing its work plan and will meet via teleconference in August to finalise their priorities for the next 12 months. I look forward to communicating the work of this important Committee to Fellows and trainees in future eBulletins.

EGM – it’s time to vote

By now, through my President’s Message and other communications, you would be familiar with the information regarding the Extraordinary General Meeting (EGM). With only two weeks to go to have your say, I ask that every one of you exercise your right as members and be informed on what’s being proposed and the implications. Only one vote will be counted, however, you can change your vote online, up until 4.00pm on Tuesday, 7 July, or, if you attend the EGM in person on Thursday, 9 July, you can change your vote at the meeting.

The EGM has been called by a group of members and asks Fellows and trainees to consider four motions that seek to change the College’s Constitution. It’s important to stress that these motions are not related to the governance reforms that our College has been discussing with members over the last 12 months but they are important to the future of our College. It is my personal belief that voting 'no' will allow the Board to get on with the job of creating an active, innovative member focussed organisation. Four of my predecessors have outlined a very strong case below for the 'no' vote, which I urge you to read.

Laureate Professor Nicholas Talley
RACP President

CLIMATE CHANGE IS A MEDICAL EMERGENCY

Yesterday, the College proudly hosted the launch of the Lancet Commission on Health and Climate Change’s 2015 Report. The event was held in Sydney and broadcast to audiences in Melbourne, Brisbane, Adelaide, Perth and Wellington.

Attendees heard from three global experts on climate change and its impact on health; Professor Anthony Costello, Director UCL Institute for Global Health (UK) and Associate Professor David Harley, epidemiologist, public health physician, GP and zoologist.

Direct health impacts of climate change include significant increases in heat-related illnesses and deaths and indirect health impacts appear in a myriad of ways across the population.

In short, climate change is not just an environmental and economic emergency, it is also a medical emergency. We have a responsibility, as clinicians, to take any and all actions that minimise its health consequences.

The College released a position statement in 2013 on climate change and health and continues to advocate for action to be taken at individual, local, national and global levels to reduce greenhouse gas emissions and adapt to climate change. The College’s position is based on the overwhelming weight of scientific evidence which shows that climate change is a health issue. That is why the College is showing leadership on this issue, leadership that will be ongoing and will take many forms.

Last month, for example, the College decided to divest itself of all investments directly and materially involved with fossil fuels. We are also establishing a new working group to continue to take a lead on climate change policy and advocacy. Our Fellow-led Green Sustainability Working Group continues to look for ways to reduce the College’s carbon footprint.

With the United Nations Climate Change Conference of Parties (COP21) to be held in Paris in November, the RACP believes now is the time to come together as a global health community to call on the world’s leaders to commit to a meaningful response.

The RACP is reaching out to our partners around the world for endorsement of a Consensus Statement highlighting the severe health impacts of climate change and calling for meaningful action.

The College will lead a day of online action around the world on Monday, 12 October 2015 – 50 days before COP21 – to highlight the urgent need to tackle the health impacts of climate change.

This is an opportunity to demonstrate the collective recognition by the global health community for clear action to address climate change and – in doing so – save lives. Further details will be released shortly and I encourage you to participate in this campaign.

If you were unable to attend the event, the presentation will be available on the RACP YouTube channel shortly.

 

PAST PRESIDENTS UNITED IN SUPPORT FOR BOARD AND “NO” VOTE FOR THE EGM

As past Presidents of the RACP we have had a keen interest in the current debate stimulated by a group of Fellows who have requisitioned an Extraordinary General Meeting (EGM) to propose four resolutions. If those resolutions are passed at the 9 July EGM, specifically worded changes will be inserted into the Constitution of our College.

We would wish to make the following points;

  • Like others engaged in this debate, we too are totally supportive of democracy and transparency in the College. The President is elected by the total membership which since 2012 has included trainees. The Presidents of Divisions, Faculties and Chapters are elected by their respective groups.
  • In the last decade, tremendous progress has been made in introducing into our College policies and procedures that enhance openness, transparency and procedural fairness including consistency in decision-making. This reflects the fact that successive Boards have been cognisant of the need to continue to enhance these qualities in our College. For example, when new committees are needed, the Board calls for expressions of interest from the membership, thus inviting all College members to be involved in policy development and committee decisions. Having said that, a review of the College activities some ten years ago revealed that we had too many committees and thus some less active committees ceased.
  • Our College is a large and complex organisation with an annual turn-over of more than AU$50m and a staff of more than 300. It is unrealistic to expect such an organisation to function effectively and efficiently with only physician volunteers. To ensure that the strategic plan of our College developed by the Board, is effectively implemented, highly skilled and dedicated staff have been employed. This then means that the pro-bono contribution of Fellows and trainees is used for tasks that only Fellows or trainees can undertake. These professional staff members support the functioning of numerous committees which are made up of Fellows and trainees. The introduction of standard business practices to ensure the efficient and effective use of College funds, the majority of which come from Fellows and trainees in the form of subscriptions and training fees, is surely something that should be applauded. It is assuredly in all our best interests that our College is an effective, responsive and professional organisation equipped to deal with 21st century challenges.
  • If our College is to continue its role in education, it needs to meet the standards set by the Australian Medical Council and the New Zealand Medical Council. To ensure that these standards are met has required the employment of staff with educational, administrative and other skills. In 2004 the then Council of our College was aware that accreditation was threatened if major upgrades were not made to education in our College. Indeed initial AMC accreditation was granted for only a limited period pending improvements to education in our College. The success of the changes which have taken place in the area of education is evidenced by our College achieving maximum duration of accreditation in 2015. This success would not have occurred without staff, Fellows and trainees working collegially and collaboratively in the best interest of our College. This highly effective working relationship should not be denigrated by the use of highly emotive and inaccurate descriptors.
  • Fellows proposing the four motions have tried to link their proposed changes to the College Constitution with an article they have had published in the MJA entitled "The scourge of managerialism and the RACP" wherein they refer to recent management changes in hospitals and universities that have undergone management changes as "a business enterprise rather than a social one, funding is tied to reduction in bed stays and all decision making is subject to review relating to time and money". To link these practices to the operation of the RACP is a distraction from the issue being debated and a furphy.
  • We would also remind the authors of that article that we are a trans-Tasman College. There are two countries engaged; not just Australia, as suggested in the recent MJA article.
  • There is an expectation that all members of the RACP Board will undertake the Australian Institute of Company Directors course. As such, each Board member is well aware of their fiduciary and other responsibilities as directors. As others have pointed out, the proposed changes would preclude members of the Board from discharging these responsibilities. Amongst these responsibilities is a requirement that every member of the Board has to act in the best interest of the whole College at all times; not just in the interest of the group that they may "represent" and certainly not in the interest of small groups of self-selected Fellows.
  • Decision making in our College can still be a challenge despite the changes that have been made in the last decade. The proposed constitutional changes open the door to the possibility of small groups voting at General Meetings to remove some or all of the Board, and/or to make substantial changes to our College's function through a vote "to direct and authorise the Board to develop or implement certain policies or undertake certain actions". If the proposed motions are accepted, decision making in our College could be paralysed and subsequent progress could grind to a halt.
  • In any major change process, one would not expect every member to be immediately comfortable with change or for every alteration to be perfect first time. It is to be expected that adjustments and further changes will be necessary from time to time, changes which might be proposed from within the new Board or from its committees or from the general Fellowship. This is indeed what democracy is all about and what the Board encourages.
  • The Board has indicated that it is happy to work with Fellow and Trainee Members to make appropriate changes which would improve the running of our College on a day to day basis and to do this in a democratic and transparent manner. The initial proposal before us "to provide a democratic and transparent setting within which physicians can come together for their common benefit" is a motherhood statement about which no-one would object. The Board recognises that the additional proposed changes would be regressive and disruptive and as such the Board asks members to vote against all four motions. 

We support the Board in its recommendation to vote "NO" on all four motions.

PROFESSOR NAPIER THOMSON, PRACP 2006 - 2008
PROFESSOR GEOFFREY METZ, PRACP 2008 - 2010
PROFESSOR JOHN KOLBE, PRACP 2010 - 2012
ASSOCIATE PROFESSOR LESLIE E BOLITHO, PRACP 2012 - 2014

 

EXPRESSIONS OF INTEREST

EOI: Australia’s National Disability Insurance Scheme (NDIS) Working Party, deadline extended to 26 June 2015
Applications are invited from Fellows and trainees of the College who are interested in becoming a member of the College’s National Disability Insurance Scheme (NDIS) Working Party.

Australia’s NDIS is a new way of providing community links and individualised support for people with permanent and significant disability, their families and carers. Under the NDIS, people with a disability will have greater control over government funded disability support services. Individuals will exercise choice and control over a needs-based funding envelope to purchase supports that will most effectively meet their needs.

The RACP has been approached to contribute physician’s perspective and expertise at various stages of the NDIS roll-out, and is establishing a Working Party to lead this work.

Fellows who are interested in joining the NDIS Working Party are invited to complete the attached Expression of Interest form by COB Friday, 26 June 2015. The NDIS Working Party Terms of Reference are also attached for your information.

Please email your completed EOI form and CV to policy@racp.edu.au, or for further information please contact Alexander Lynch at Alex.Lynch@racp.edu.au.

 

CONFERENCES AND EVENTS

The ANZ Society of the History of Medicine 14th Biennial Conference - Missions, Methods and Management, 30 June to 4 July 2015, Sydney

Join delegates for lectures by distinguished international and local speakers, attend a witness seminar focusing on changes in the administration of health services over the past 50 years, and hear researchers present their original work.
Venue: Australian Catholic University, North Sydney
Date: Tuesday, 30 June to Saturday, 4 July
Registration: Please visit the ANZSHOM Conference website.

Australasian Symposium on Perioperative Medicine, 15 to 17 October 2015, Noosa

The Australian and New Zealand College of Anaesthetists will host the 4th Annual Australasian Symposium on Perioperative Medicine, themed “The post-operative period: from recovery into the unknown”.
Venue: Outrigger Little Hastings Street Resort & Spa, Noosa, Queensland
Date: Thursday, 15 October to Sunday, 18 October 2015
Registration: Please visit the conference website.

Australasian Doctors Health Conference 2015, 22 to 25 October 2015, Melbourne

In line with our theme of “Pathways and Progress”, we will focus on proactive and reactive approaches to optimising physician health. Our two day academic program will appeal to all who have an interest in the health and welfare of our profession. We will discuss and showcase some of the advances in understanding the health of medical professionals and some of the great initiatives in improving welfare and support systems for doctors and medical students.

Venue: Pullman Mercure Albert Park, Melbourne Victoria
Date: Thursday, 22 October to Sunday, 25 October 2015
Registration: Please visit the conference website.

RACMA E-dgy Issues Webinars, various dates in 2015

The Royal Australasian College of Medical Administration in conjunction with the Rural Health Continuing Education Stream is hosting a set of E-dgy Issues webinars based on contemporary and ‘e-dgy issues’ that are current to health services. The programs provide doctors in rural and remote areas opportunities to enhance their CPD and sustain best practice in medical leadership and management.

July 2015 – Playing ball: Embracing collaborative care and reducing load on rural practice through multidisciplinary integration
August 2015 – Conquering fragmented rural mental health and other specialist medical services (telehealth)
October 2015 – Ageism, sexism, bullying, respect or un-esteemed collaborations between medical professionals. Are we duplicating what is taught in medicine?

For enquiries regarding the E-dgy Issues Program contact Carmel at COHea@racma.edu.au

  

RACP FOUNDATION

Nominate now for a variety of Awards

Nominations are now open for a range of awards for Fellows and trainees.

2016 Travel Grants 
The RACP Foundation is offering several Travel Grants  for 2016 to support short periods of research or study. Funding values range from $5,000 to $25,000 and may be used:
• to cover travelling and re-establishment costs for those taking up a postdoctoral Fellowship overseas, or 
• for those wishing to pursue up-skilling or further education.

Further details and application forms are available on the website or contact the RACP Foundation 
Applications close Monday, 6 July at 5.00pm AEST.

Research Entry Scholarships 
These Scholarships provide stipend support to assist Fellows and trainees who are at the start of their research careers and enrolled in a Masters, PhD or equivalent research higher degree.

Go to the RACP Foundation webpage for full details and application forms, or contact the RACP Foundation 
Applications close Tuesday, 14 July 2015 at 5.00pm AEST.

The Eric Susman Prize 2015
Fellows are invited to submit nominations for the award of the Eric Susman Prize for the best contribution to the knowledge of any branch of internal medicine. 
Nominations close on Wednesday, 30 September 2015.

RACP Mentor of the Year 2016
Fellows and trainees are invited to submit nominations for the RACP Mentor of the Year Award2016 for a Fellow who has made an outstanding contribution to mentoring or provided a high level of support and guidance throughout training. 
Nominations close on Saturday, 31 October 2015.

RACP Trainee of the Year 2016
Fellows and trainees are invited to submit nominations for the RACP Trainee of the Year Awardfor a trainee who has made an outstanding contribution to College, community and/or trainee activities during 2015 and earlier.

Please visit the RACP Foundation website to download nomination forms and for further details about each award. Nominations close on Saturday, 31 October 2015.

WEBSITE OUTAGE SATURDAY, 27 JUNE

The College website and all training portals will be unavailable this coming weekend, on Saturday, 27 June from 8.00am to 5.00pm AEST. We apologise for any inconvenience that this may cause; this is due to important work being carried out as part of the final stages of preparation for the forthcoming launch of the new College website.

There will be further communications in the coming days about the launch of the site. The new website is a significant achievement for the College and an important step on a much longer journey to improve and enhance our digital presence. The site will lay the foundations for a series of projects over the next few years that will create a range of new features and functions for our membership. While the Basic and Advanced Training Portals remain unchanged for this launch, improvements to these and some other portals will be part of a longer chain of developments on our digital journey to come.

The structure and design which you will soon have the opportunity to see and use have been put together with in-depth research across the College's membership, and will readily serve the functions required for our Fellows, trainees, future physicians and broader stakeholder groups who use the site. Division, Faculty and Chapter pages have been simplified and improved to enhance the cohesiveness and usability of the site. Intuitive navigation, improved search functionality and responsive filtering throughout will all serve to enhance your experience with the website.

The performance of the new site will be monitored in the days following the launch and any technical issues that arise will be addressed. 

RECENT MEDIA ACTIVITY

Australia must act on climate change: doctors
Climate change - health impacts require urgent action
Australian doctors call for legal right to speak about asylum seeker health risks
Med groups want free speech on detainees
RACP unites health groups to fight gag on doctors

 

TELEHEALTH TECHNOLOGY WORKSHOPS

Are you interested in using telehealth technology for education and to support your patients?

The colleges of Physicians, Pathologists, Ophthalmologists and Dermatologists are holding joint workshops in Hobart and Port Macquarie to give Fellows ‘hands on’ experience with telehealth technologies. These include videoconferencing setups, imaging software, cameras, 3D printers and more.

These free workshops will be delivered in two parts:
1. Presentations from specialists on how they use telehealth
2. Free time for you to experiment with equipment and software, and see it demonstrated by specialists and telehealth providers

We hope to inspire you to get involved with telehealth or find new and innovative ways to upgrade your practice. These sessions will also be recorded for future use.

To register, please click on the relevant link below:
• Port Macquarie: 2.00pm to 5.00pm, Saturday 25 July, The Glasshouse 
• Hobart: 11.00am to 2.00pm, Saturday 1 August, University of Tasmania (TBC)

Please contact Krista Recsei on + 61 2 8247 6239 or krista.recsei@racp.edu.au for more information.

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