Author Archives: Stephen Leeder

Stephen Leeder

About Stephen Leeder

Stephen Leeder is an Emeritus Professor of public health and community medicine at the University of Sydney.  Steve has 45 years of experience in epidemiological research, medical education reform and in mentoring young investigators. Most of his research has been collaborative and he has always sought ways of ensuring the career development of members of his teams. Steve is currently Editor-in-Chief of the International Journal of Epidemiology. He held the position of Chair of the Western Sydney Local Health District Board from 2011 until 2016 and was Editor-in-Chief of the Medical Journal of Australia from January 2013 until April 2015.

Caring for older Australians

Covid has blown the cover on much of what we need to maintain credibility as a humane nation. Care of older Australians is of priority concern.

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STEPHEN LEEDER: The public health discipline after Covid-19

The Coronavirus pandemic draws our attention to the importance of public health in maintaining global human health. Public health as a discipline is distinguished by taking the entire community into account rather than individual patients, and seeking out what can … Continue reading

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STEPHEN LEEDER.We’ve flattened the curve, but the nation’s health is still in danger

2020 is not panning out to be the Year of Tranquillity in Australia.

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STEPHEN LEEDER. The ambiguity of herd immunity and the coronavirus

In the US, the first formal clinical trial of a drug to treat coronavirus and  of a vaccine give us a good moment to reflect on the immunology of this illness.

Posted in Health | 2 Comments

STEPHEN LEEDER. Health guidelines may be necessary but are not sufficient for optimal medical care.

There is a common belief that medicine in all it variety would be better practised according to strict rules and guidelines.

Posted in Health | 1 Comment

STEPHEN LEEDER. Is the Climate right for Discussions about how to Adapt?

Whatever the cause of our changing climate – natural variation or human-made – we should invest in adaptation.

Posted in Environment and climate | 6 Comments

STEPHEN LEEDER- Global Change and Us

Recent fires in Australia and California have provoked discussion about the effects of climate change. These extreme events, not unknown in times past, seem to be more frequent now and suggest that the recorded changes in global temperature may be … Continue reading

Posted in Environment and climate | 6 Comments

STEPHEN LEEDER – GRETA THUNBERG- A child shall lead them.

Swedish teenager Greta Thunberg has changed the conversation about global heating. Her passionate concern and emphasis on its likely impact on people her age has stirred public concern in a fresh way. How dare we, she asks of us older … Continue reading

Posted in Environment and climate | 1 Comment

STEPHEN LEEDER. Private-public partnerships – the good, the bad and the ugly.

Partnerships between public agencies and private providers demand unusual degrees of vigilance of both parties to ensure that the contract between them explicitly states – in great detail – their individual expectations and accountabilities.  Values will differ.  The agreement should, … Continue reading

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STEPHEN LEEDER. Health and wealth travel together.

Self-contained health programs directed at infectious diseases such as HIV, TB, malaria have wrought miracles, saving lives and enhancing prosperity. But a new challenge is looming globally, as subtle as climate change.  No self-contained ‘vertical’ programs work for non-communicable disease: … Continue reading

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STEPHEN LEEDER. Employing less qualified people in aged care

The Royal Commission announced this week will have a full agenda. If it can help us get aged care back on track we will all be the richer.

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STEPHEN LEEDER. The Evil You Cannot See.

Concern about air quality in Australia popularly centres around two topics:  exhaust stacks from city road tunnels and climate change.  Neither are as critically important as the effects of small particle pollution.  

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STEPHEN LEEDER. Reviewing the Book of Kells’ schedule of medical fees.

Government contributions to medical fees are set out in a large book of rules. It is under review. But are rules for individual fees for individual services the way to go? Fee-for-service may be running out of date.

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STEPHEN LEEDER Taming the nuclear tiger

Among major threats to human and planetary survival, none comes close to nuclear war.

Posted in World Affairs | 1 Comment

STEPHEN LEEDER. Home (not so) sweet home

Medical homes, where you as a patient are known personally by name and history and where a team of health professionals, generally led by a general practitioner, arrange and provide your care, have not taken off as expected. Why? 

Posted in Health | 2 Comments

STEPHEN LEEDER. Morality And Health.

Writing last Thursday in the Conversation about the South African cricket scandal, Michelle Grattan pointed to politicians “who would prefer to overlook awkward parallels with conduct in politics – for instance the endemic tampering with the ball of truth.” 

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STEPHEN LEEDER. Two roads converge in a yellow wood

Two roads converge in a yellow wood when it comes to preventing obesity – blaming the victim (eat less sugar, exercise more, you lazy sloth) and thinking that if we focus on children all will be well.  Follow either and … Continue reading

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STEPHEN LEEDER. Forget the Dog: make 2018 the Year of the Sceptic.

Much medical research is incomplete or wrong. The participation of drug companies in sponsored research and continuing education for doctors whereby the results of research are communicated to them demands healthy scepticism.  

Posted in Health, Politics | 3 Comments

STEPHEN LEEDER. Alcohol and sport. A REPOST

Queensland’s victory over NSW in the 1 June  game lin 2016 was reported as the highest rating State of Origin match ever and ‘the top TV event of 2016.’  Both teams carried alcohol advertising on their clothing into the match. … Continue reading

Posted in Health | 2 Comments

STEPHEN LEEDER: A little bit of sugar may (or may not) make the weight go down.

The statistics do not support the view that there are big differences in sugar consumption between the fat and the thin.  We need to define our enemy clearly in the battle against obesity.

Posted in Health | 2 Comments

STEPHEN LEEDER. Social causes of illness are not immutable: they are amenable to change.

Modifying our own behaviour in health-promoting directions is sensible but for sustainable, nation-wide change we need to take action of a different kind.

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STEPHEN LEEDER. The double-ended spoon and how to meet our health needs

The Productivity Commission has recognised how joined up care for people with serious and complex illnesses can enhance their quality of life. Opportunities to prevent these problems abound and the time for action is now.

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STEPHEN LEEDER. Comparing health systems in 11 countries

A new report comparing health systems in eleven countries gives Australia a pat on the back but not for equity. What’s going on?

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STEPHEN LEEDER. Review of the Medicare Benefits Schedule.

  The Medicare Benefits Schedule, or MBS, is the basis for Medicare payments made for medical care in the community. It runs to over 900 pages and contains 5,700 items. Well over $2Ob pass through its ledger each year. It … Continue reading

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STEVE LEEDER. Health care: getting it right the first time

Ronald Reagan once famously quipped that the nine most terrifying words in the English language are ‘I’m from the government, and I’m here to help’. But that doesn’t, for one moment, stop Michael Horrocks, Professor of Postgraduate Surgery at the … Continue reading

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STEVE LEEDER. A welcome review of the Medicare Benefits Schedule

In 2015 Sussan Ley, then the Minister for Health, established a review of the schedule of fees for medical benefits. The review of the schedule’s 5700 items, involving a rigorous evidence-based process, is now around half way through. When completed … Continue reading

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STEPHEN LEEDER. Over-servicing in health.

Abuse of Medicare or other reimbursement schemes is much easier if the regulations surrounding it are lax. That is what makes the current review of Medicare so important so that the rules are clear and make the best match possible … Continue reading

Posted in Economy, Health | 1 Comment

STEPHEN LEEDER. Looking forward to a national health policy and not ignoring the community.

  Health policies presented as part of the election campaign should address our expectations for prompt, courteous and effective high-quality care when we need it and not be a random collection of thought balloons – from a child’s birthday? – … Continue reading

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STEPHEN LEEDER. Alcohol and sport.

Queensland’s victory over NSW in the June 1 game was reported as the highest rating State of Origin match ever and ‘the top TV event of 2016.’ Both teams carried alcohol advertising on their clothing into the match. The association … Continue reading

Posted in Health, Politics, Sport | 1 Comment

Stephen Leeder. The takeover of the Medical Journal of Australia.

A quick glance at the last page of the most recent issue of the MJA reveals that there is as yet no replacement editor-in-chief and that two of the most senior medical editors – Janusic and Armstrong – are missing … Continue reading

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