Writer
John Dwyer
Professor John Dwyer is an Emeritus Professor of Medicine at UNSW and the founder of the Australian Healthcare Reform Alliance.
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JOHN DWYER. Punishing and jailing the mentally ill.
A 37-year-old Sudanese woman has been sentenced to 26 years in jail for murdering three of her children by deliberately driving her car into a lake. The story is a tragic one and has nothing to do with criminal behaviour. It raises, yet again, the appalling way in which we treat those with a seriously Continue reading »
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JOHN DWYER. Policy mayhem is stifling efforts to have more Australian doctors “in the bush” – part one
In this two part article, I am reviewing the basis for the serious problem we have in providing adequate health care for Australians who live in rural, and particularly, remote areas. Good intentions are, as ever, intertwined with political machinations which make policies for solutions harder to implement. Currently, yet another government review is soon Continue reading »
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JOHN DWYER. Policy mayhem is stifling efforts to have more Australian doctors “in the bush” – part two
In this two part article, I am reviewing the basis for the serious problem we have in providing adequate health care for Australians who live in rural, and particularly, remote areas. Good intentions are, as ever, intertwined with political machinations which make policies for solutions harder to implement. Currently, yet another government review is soon Continue reading »
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JOHN DWYER. The parlous state of strategies to protect consumers from health care fraud. Part 3 of 3.
Credible scientific evidence of clinical effectiveness should underpin the delivery of health care. Satisfactory health outcomes and cost effectiveness require this approach. In Australia however pseudoscience flourishes as regulatory bodies fail to protect consumers from health care fraud. Continue reading »
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JOHN DWYER. The parlous state of strategies to protect consumers from health care fraud. Part 2 of 3.
Credible scientific evidence of clinical effectiveness should underpin the delivery of health care. Satisfactory health outcomes and cost effectiveness require this approach. In Australia however pseudoscience flourishes as regulatory bodies fail to protect consumers from health care fraud and a massive industry prospers as it convinces consumers to use expensive supplements they do not need. Continue reading »
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JOHN DWYER. The parlous state of strategies to protect consumers from health care fraud. Part 1 of 3
Credible scientific evidence of clinical effectiveness should underpin the delivery of health care. Satisfactory health outcomes and cost effectiveness require this approach. In Australia however pseudoscience flourishes as regulatory bodies fail to protect consumers from health care fraud and a massive industry prospers as it convinces consumers to use expensive supplements they do not need. Continue reading »
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JOHN DWYER. A shared vision for restructuring primary care in Australia.
At last the clouds are dispersing, the sun is shining through and one can see a splendid vision of a restructured primary health system that meets the needs of contemporary Australia. For the first time that I can remember, there is a consensus among informed consumers and health professionals that enthusiastically supports the introduction Continue reading »
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JOHN DWYER. Medicare and the 45th Parliament.
Clearly the future of Medicare was the election issue of greatest importance for most Australians. Community concern was focussed on the possibility that the primary care they receive from their general practitioner might be privatised such that a superior service would be available to those who paid more, either directly or though the extension Continue reading »
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JOHN DWYER. Restructuring the governance of health care in Australia. Part 1
Part One. Structural reforms for better health outcomes from a redesigned more cost-effective health care system. The most important pre-election health care initiative has received very little publicity. Labor has committed to establishing a “Healthcare Reform Commission” if elected. While not likely to generate much discussion in one’s local pub it represents an acceptance by Continue reading »
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JOHN DWYER. Restructuring the governance of health care in Australia. Part 2
Part Two. Structural reforms for better health outcomes from a redesigned more cost-effective health care system. There is broad agreement that in the near future our General Practitioners and their teams will earn the majority of their income from capitation payments that will require, for the first time in our Primary Care system, the documentation Continue reading »
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John Dwyer. Structural reforms to healthcare – two major reforms.
Does the government understand the structural reforms to health care needed by modern Australia? Political pre-election posturing at the moment has involved many debating the question that asks ’Do we have a spending or a revenue problem in Australia?” Certainly when it comes to our health system we should first be asking what structural reforms Continue reading »
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John Dwyer. ‘Health’ products and treatments that are often unproven and sometimes dangerous.
Health Care Advertising and Consumer Protection There are far more irritations than pearls available currently to those of us trying to champion the importance of having our health care underpinned by credible scientific evidence of clinical effectiveness. Though we live in the most scientific of all ages it is cause for concern that practices Continue reading »
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Why we don’t want private health insurance for primary care
The worst possible outcome from the current review of Private Health Insurance would be changes that resulted in the best-resourced Primary Care being only available to those who have such insurance. Continue reading »
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John Dwyer. Wasting precious health dollars.
In the last eighteen months our coalition government has repeatedly warned that the rate at which we are increasing health related expenditure is unsustainable. The attempt to extract a co-payment from Australians visiting their GP was justified using this concern. However it is the better use of the currently available health dollars that should Continue reading »
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John Dwyer. Pseudoscience and health care.
Current Affairs The catalyst for my need to share with you frustrations associated with the penetration of pseudoscience into Australian health care and the poor protection of consumers from same, was generated by the release of the details of the long awaited Free Trade agreement between Australia and China. We now know that Chinese medicine Continue reading »
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John Dwyer. Politics trumps health policy yet again.
Current Affairs. Health. A new medical school in Perth will create more problems than it will solve. As must also be true for many colleagues who have been focussed on evidence based solutions to the serious shortage of Australian trained doctors working in rural communities, I am frustrated and annoyed by the Prime Minister’s capricious Continue reading »
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John Dwyer. Sliding down the slippery slope to two-tiered health care.
Private Health Insurance gets a foothold in primary care. Imagine the following scenario. You are checking in with your GP’s receptionist for your scheduled appointment and are asked to produce your Medicare Card and, if you have one, your private health insurance membership card. If you have both you move into the waiting room on Continue reading »
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John Dwyer. Health Policy Reform Commentary – Part 2
In the first part of my commentary on John Menadue’s Health Policy Reform in his blog, I discussed the barriers frustrating any reform agenda. In this second part I will comment on John Menadue’s suggestions for “overcoming these obstacles to health reform” and provide my own thoughts on what a reformed health system might look Continue reading »
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John Dwyer. Commentary on John Menadue’s blogs on the barriers to health policy reform in Australia. (Part 1)
As I suspected would be the case with many readers who enjoy “Pearls and Irritations”, I experienced in equal measure, satisfaction and frustration as I absorbed John Menadue’s informed and insightful analysis of the problems that beset our health system and prevent urgently needed structural reforms. His three essays accurately explore the major issues. He Continue reading »
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John Dwyer. Medicare changes – why on earth would a young doctor want to be a GP?
In case you missed it, this is a repost of a blog that I posted on 12 December last year. It is highly relevant to the continuing debate about copayments and general practice. John Menadue. The most distressing feature of the government’s determination to have us pay more for a visit to our GP is Continue reading »
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John Dwyer. The structural reform of Medicare rather than its funding is the real challenge.
Part 2: Attracting the future work force needed to provide Primary Care. There is another imperative for introducing Integrated Primary care (IPC),the new model of primary care described in part one of this review; the recruitment of the next generation of GPs. Recent surveys of the career intentions of medical graduates show only 13% are Continue reading »
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John Dwyer. The structural reform of Medicare rather than its funding is the real challenge.
Part 1; The model of primary care we need for contemporary Australia. For months the federal government has been telling us that a mandatory co-payment for a visit to our GP was essential to afford the $19 billion we currently spend on Medicare each year and projected increases. There would be an added benefit in Continue reading »
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John Dwyer. Primary healthcare in Australia reaches the crossroads.
When I graduated some 50 years ago more than 50% of my class pursued careers as General Practitioners. In the last available survey of the career intentions of graduating medical students only 13% said they were interested in Primary Care and only 13% of those who would consider a career in rural Australia. Currently more Continue reading »
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John Dwyer. Cutting waste and costs in health.
Tactics and strategies for a six year journey to sustainable, equitable excellence (1) Move to a single funder for our national health scheme (The Commonwealth). The funder would contract with States and other potential providers to deliver integrated patient focused care. The health bureaucracy would be reduced by 80% with greater efficiency, better outcomes Continue reading »
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The mooted $6 fee for GP visits trivialises the problem. Guest blogger: John Dwyer
There is a lot that is disturbing about the federal government’s flirtation with a $6 co-payment for a service from a GP. Most commentators have rejected this approach as poor public policy as it will act as a deterrent for poorer Australians to seek the care they need to provide paltry savings in a 120 Continue reading »
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No vision for the health system we need. Guest blogger Prof. John Dwyer
In this election the Coalition has provided dollar promises for worthy projects but no new health policy initiatives while only two of note have been forthcoming from the government; a long-term investment in stem cell research and the threat to remove family tax benefits from parents who put their children and the community at risk Continue reading »
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Health care reform remains a prisoner of Federalism. Guest blogger: John Dwyer
The intractable problem that sees a very wealthy country unable to provide cost effective and equitable health care is a political one. We are the only OECD country in which the provision of health care is illogically and inefficiently divided between two levels of Government. The Federal government is charged with funding, but not providing, Continue reading »
