In This Issue

Politics, politicians, doctors and health

Australia is currently in the grip of election fever. After months of very public squabbling, grandstanding, scaremongering and posturing by politicians of every persuasion, you could be forgiven for wondering why the MJA would weigh in to the election debate. On the other hand, health, the (mainly socioeconomic and environmental) determinants of health, and the provision of health care are issues that are greatly affected by the actions of government. Rather than standing by and bracing ourselves to adapt to the policies that will affect our lives and our work, we believe that health care professionals need to be informed and involved. With this in mind, we asked some of our leading health policy thinkers to spell out the main issues for Australians’ health over the next few years. A few stand out, say Armstrong et al, and the characteristic unifying most of these is inequity, in a country that can afford to be fair (→ Challenges in health and health care for Australia). We also asked the Australian Medical Association to outline their Key health issues for the 2007 federal election, and some potential solutions (→ A mandate to strengthen the health system). How will the next federal government’s policies hold up against these well articulated problems? The incumbent Minister for Health and Ageing, Tony Abbott, outlines the strategies favoured by the Liberal Party in “Good health systems, getting better”, while Labor’s Shadow Minister for Health, Nicola Roxon, articulates her Party’s plans should they take government, in “Taking leadership — tackling Australia’s health challenges”. Why should MJA readers think about health when voting in the upcoming election? Van Der Weyden urges us to become political in striving to do the best for our hospitals, health services and patients (→ Health and the federal election, 2007).

Doctors and poverty

This issue, the MJA is one of 233 science and medical journals worldwide that are participating in a global initiative by the Council of Science Editors to publish articles on the theme of Poverty and Human Development. It’s a wide-ranging topic, and we encourage you to visit the Council’s website to explore some of the facts, opinions and ideas that have been brought to light by the initiative (http://www.councilscienceeditors.org/globalthemeissue.cfm). For our part, we asked Saunders and Davidson from the Social Policy Research Centre and the Australian Council of Social Service to write about poverty and health in Australia (→ Rising poverty is bad for our health); Leeder et al to discuss Australia’s leadership role in a truly global concept of health (→ The need for leadership in global health); and Fox et al to outline the activities of our altruistic medical students who have become leaders in international health (→ Medical students, medical schools and international health).

Melanoma management falling short

Despite the publication of Australian guidelines for the management of melanoma in 1997, many patients in Victoria have had inadequate treatment, say Kelly et al (→ The management of primary cutaneous melanoma in Victoria in 1996 and 2000). A survey of clinicians involved in the management of more than 700 melanomas of various thicknesses identified by the Victorian Cancer Registry in 1996 and 2000 revealed that more than a third were excised with inadequate margins. The use of partial biopsies increased over the period, although the guidelines state that this is rarely indicated, and many patients seem to have had inadequate follow-up.

Prostate cancer media myths

Despite almost universal agreement by expert bodies that population screening for prostate cancer is not warranted, newspaper and television reports continue to urge men to undergo testing, say MacKenzie et al (→ “The news is [not] all good”: misrepresentations and inaccuracies in Australian news media reports on prostate cancer screening). The group analysed more than 400 TV and newspaper reports and found 44 inaccurate or misleading statements about the prevalence and severity of the disease, expert support for screening, the accuracy of PSA testing, the importance of early detection, and minimisation of the adverse effects of treatment. The report provides examples, so you can see for yourself why many of your patients are confused.

Another time . . . another place

Medicine is a social science and politics is nothing but medicine writ large.