Writer
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.
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Do we continue down the pathway of privatisation of health by stealth?
Loss of public funding for specific aspects of health care despite overall (public and private) increases in expenditure, as detailed recently by John Menadue, has already happened out of sight. Continue reading »
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It’s not only us, Mr Morrison:the government must also play a part in fighting Covid
The pandemic has weaponised the argument that individual responsibility for one’s health is best – free from government edicts. This is pathetic. Continue reading »
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COVID-19 and Poverty
That health and illness are close associates of wealth and poverty is well known. This dictum applies to covid-19 both within and among nations. Continue reading »
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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. Continue reading »
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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 be done to protect and promote human flourishing for all in that community. 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. Continue reading »
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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. Continue reading »
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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. Continue reading »
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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. Continue reading »
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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 responsible. Blame – a common feature that follows disasters – is variously ascribed to political Continue reading »
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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 generations, respond with complacency, arrogance and inertia to such a threat? Wisdom, concern, and attention Continue reading »
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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, if possible, be tested component by component before “going live.” 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: here we need health systems that span conditions and facilities, linking hospitals to general practice 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. Continue reading »
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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. Continue reading »
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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. Continue reading »
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STEPHEN LEEDER Taming the nuclear tiger
Among major threats to human and planetary survival, none comes close to nuclear war. Continue reading »
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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? Continue reading »
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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.” Continue reading »
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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 you will end up in the same sulphurous place – lost. 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. Continue reading »
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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. The association of alcohol with sport is deep, complex and profitable. Sport provides a lucrative Continue reading »
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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. Continue reading »
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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. Continue reading »
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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. Continue reading »
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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? Continue reading »
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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 includes long and short clinical consultations and surgical procedures ($17b), pathology tests ($2.65b) and x-ray 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 University of Bath and a former President of the Vascular Society of Great Britain and 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 it will provide an opportunity for more cost-effective health care and a saving of public 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 between cost and benefit. This will result in less temptation to overuse useless procedures that Continue reading »
