Ian Webster
Ian W Webster AO is Emeritus Professor of Public Health and Community Medicine of the University of New South Wales. He has worked as a physician in public and regional hospitals in Australia and UK and in NGOs dealing with homelessness, alcohol and drug problems and mental illness.
Ian's recent articles
28 October 2024
Drug ‘summiteering’ in NSW
The second New South Wales Drug Summit will be held in regional centres for two days in October and the final two days will be in Sydney on the 4th and 5th December to be co-chaired by Carmel Tebbutt and John Brogden – a balance of politics.
8 December 2023
From Vietnam to Australia, a refugee doctors journey
On 23 November, a boatload of asylum seekers was dispatched to Nauru for offshore detention. They were found wandering the coast of Western Australia by Aboriginal people, three days earlier. This has been Australian policy for unauthorised boat arrivals since 2013; 10 arrivals in the past year. But there was a time when asylum seekers were welcome.
30 May 2023
Visiting the doctor in the age of AI
On 8 May, Four Corners (Artificial Intelligence Rising: the new reality of artificial life), portrayed an isolated man's relationship to a robotic woman and a sex doll, and in another scenario, artificial memories were generated for family members to communicate with the long dead - weird stuff.
5 February 2023
Whats wrong with addiction
As I watched the Four Corners program, Vape Haze, in 2022, I was struck by the programs focus on addiction, a bad thing. A mother spoke of her devastation when her 16-year-old daughter told her she was vaping.
16 November 2022
Reinventing the NDIS
What was in the minds of the originators of the NDIS, of the nature of disability? How did they see the role of the NDIS within existing social, health, and economic, environments?
22 September 2022
Learning from people who are homeless
A homeless person's life, burdened, as it often is, by physical and mental illness, addiction, and social disadvantage, can lead us to think their life is meaningless and of no value; but we can be so wrong, they have much to teach us.
4 January 2022
Australia must re-assert its stand on harm minimisation drug policies
Is it possible for prohibition and law enforcement to compete against the ubiquitous and increasing use of mind-altering drugs?
23 September 2021
Dealing with community despair in the time of Covid
As the public health measures work to suppress the pandemic, community relations and connections are at risk. A sense of community, togetherness and mutual support is needed, now and in the long-term.
23 May 2021
Ageism in the time of Covid
The coronavirus pandemic must cause us to re-appraise the value we attach to the lives of others, especially vulnerable people and those who are old.
1 April 2021
The 'ecology of attention' in health and social care
Every single transaction expends precious time of attention; time which is even more precious amidst the escalating claims on our attention. Those needing support and treatment are hoping to have their circumstances and problems understood, they seek attention, attention to the way their lives have been affected.
8 January 2021
Barriers to the NDIS
The planned introduction of independent assessments for the National Disability Insurance Scheme (NDIS) will further disadvantage those with complex and not obviously manifest disabilities. For marginalised people with disabilities there are questions.
18 November 2020
The people with disabilities who regularly miss out
Disability has been co-opted by bureaucracies, professional bodies and institutions, often in a harmful way ... Instead of seeing welfare as a social drain, faring well should be an act of decency, a helping hand to a contributing life.
18 August 2020
'Rage against the dying of the light' in the way we treat elderly people
The alienation of elderly people from social life is abundantly evident in the impact of coronavirus on society as it exploits the vulnerable and defenceless.
3 June 2020
IAN WEBSTER. The UK and COVID-19; lessons for the UK and some for Australia
It is with bewilderment and concern we watch as COVID-19 overwhelms the UKs health and social systems. There are lessons to be learnt for Australia, too.
13 May 2020
IAN WEBSTER: Public health and the nanny state.
Behind our backs, public health became the poor cousin of biomedicine and was dismissed as drains and sewerage. How wrong we were!
22 March 2020
IAN WEBSTER. Too many experts at a time of crisis.
This is a time when advice needs to be considered, balanced, respectful and well-founded.
26 February 2020
IAN WEBSTER. The retreat from patients, a letter to young doctors
The idea that the pressures of patient care cause doctors to withdraw from direct clinical work has been in the background of my observations of my colleagues and their work since the 1970s.
16 January 2020
IAN WEBSTER.- Advocacy is hard going against the alcohol lobby.
It is a loss powerfully felt,but subdued. Not by politicians or the alcohol industry, but by doctors and nurses in the clinics and rehab. centres. The highly respected Michael Thorn has departed from the Foundation for Alcohol Research and Education(FARE) as the CEO. What is the real story?
13 May 2019
IAN WEBSTER. US opioid epidemic: a warning to Australia?
Two ABC documentaries Opioid America, Foreign Correspondent, 19th March and on TV Tonight, Louis Theroux, April 2nd portrayed the cycle of addiction in damaged US communities with no hope or future. Both were in West Virginia where opioid deaths are 2 to 3 times higher than other US states. The people and their environments are forever written off. Alarm bells ring.
25 February 2019
IAN WEBSTER. Of minds imprisoned.
Beyond the image of the vagabond and the impaired bodies and minds of homeless people there are untapped veins of intellect and potential; this is where our focus should be. The homeless are our most important dreamers, prophets and poets for they challenge our apathy. (Sydney from Below, McCarthy F, Matthew Talbot Hostel)
8 January 2019
IAN WEBSTER. It's not mental illness, but despair
Aboriginal and Torres Strait Islanders have got it right when they frame the conditions we label as mental illness as issues of social and emotional well-being. They do not consider the endemic problems in their communities, as mental illnesses.
9 September 2018
IAN WEBSTER: Preventing suicide
The 10th September is recognised as World Suicide Prevention Day. The burden of suicide does not weigh solely on the health sector; it has multiple impacts on many sectors and on society as a whole. Thus, to start a successful journey towards the prevention of suicide, countries should employ a multisectoral approach that addresses suicide in a comprehensive manner, bringing together the different sectors and stakeholders most relevant to each context. Director-General, WHO Preventing Suicide: A global imperative, 2014.
7 August 2018
IAN WEBSTER. Drug Reform Series- Drug policy and justice
In the final analysis, drug policy based on prohibition fails to meet the test of fairness and justice in the lives of those most directly affected.
8 July 2018
IAN WEBSTER. Government and the medicalisation of disabilities
Each year two thirds of applications for a Disability Support Pension are rejected; a rejection rate which has doubled in 8 years (Christopher Knaus, Guardian, 8 June 2018).
8 February 2018
IAN WEBSTER. Welfare sanctions.
To save $204.7 million, the Government plans to impose draconian sanctions on those needing income support who miss appointments, or work interviews, or who dont take up the jobs proposed for them. That cant be the real reason, since the dollar savings count for nothing against the inestimable human and economic costs of these impediments. So much for mutual obligation.
14 January 2018
IAN WEBSTER. Policy failures in mental health
Mental health problems arising out of modern despair have to be tackled with insights gained from the day-to-day lives of societys outcasts and the social sciences. Matthew Fisher, (Australias policy failure on mental health, Pearls and Irritations, 14 December 2017) argues that Australian mental health policies have failed: (We) are subject to a deafening silence from politicians, organisations and the key individuals who shape Australias policy discourse and action on mental health. The ubiquitous mental health problems arising out of social conditions and chronically stressed lives are neglected: The social causes of mental illness and their impacts on populations, as...
20 November 2017
IAN WEBSTER. The social harm of alcohol to communities and society
The social harm of alcohol, alcohols harm to others, is a re-vitalised framework for national and international policies to control the marketing of alcohol.
30 August 2017
IAN WEBSTER. Lessons from the British National Health Scheme for Australia.
Jeremy Hunt, Health Secretary in the UK, accused Stephen Hawking of a pernicious lie: (he) is a brilliant physicist but wrong on lack of evidence. Stephen Hawking had said his survival for 75 years with motor neurone disease was due to the care he received from the British National Health Service (NHS) and he now feared it was being turned into a US-style insurance system. (Guardian Weekly, 25 August).
6 June 2017
Specialists versus generalists: A commentary on John Menadue and Peter Brooks
John Menadue and Peter Brooks have mounted powerful critiques of private specialist medical practice in a series in Pearls and Irritations. The nub of their positions is the high fee structure in (private out-patient) specialist practice is out of kilter with community expectations.
23 February 2017
IAN WEBSTER. The need for more balanced media reporting of alcohol and illicit drug problems.
To those who work in the health system, ICE is but one problem among many and pales into the background of the prevailing problems of addiction and misuse of alcohol and drugs.
22 January 2017
IAN WEBSTER. A tribute to Anne Deveson understanding the homeless mentally ill
Anne Deveson s media presence spearheaded the medias involvement in public health and mental health. She contributed at so many levels - social commentaries and documentaries -which challenged our sensibilities.
18 January 2017
IAN WEBSTER. Protecting young people from our favourite drug - alcohol.
Marketing of alcohol is out of control. 20% of those watching major sporting events on TV are under the age of 18 years.
19 December 2016
IAN WEBSTER. Standing up for Medicare.
Fair access to health care is in the zeitgeist of European countries and Australia. The political sensitivities of this issue were demonstrated in the last election with the angst generated by the Labor Partys Mediscare campaign.
29 November 2016
IAN WEBSTER. Amid chaos, ethics.
Speaking particularly of the treatment people in Manus and Nauru, Professor Ian Webster argues that in this secular and chaotic world, the values and principles of the professional codes of health workers could be used to frame their future contributions to a civil and humane society.
23 August 2016
IAN WEBSTER. Malcolm Turnbull and homelessness - reaching mentally ill people
This week our PM, Malcolm Turnbull, was admonished when he gave $5 to a homeless man in Melbourne. He was sorry if people thought he should not have done this. He said, I felt sorry for the guy.there but for the grace of God go I. George Orwell wrote after being down and out in Paris and London, Still I can point to one or two things. I have definitely learned by being hard up. I shall never again think that all tramps are drunken scoundrels, nor expect a beggar to be grateful when I give him a penny,...
22 July 2016
IAN WEBSTER. Health care for aged people is increasingly complex.
From his experience in intensive care in one of Australias busiest intensive care units at Liverpool Hospital in Southwest Sydney, Professor Ken Hillman describes the failure of specialised, super-specialised, medicine to deal appropriately and humanely with seriously ill aged persons and those whose life has run its course. (Ageing and end-of-life issues, posted 9/7/2016 in Pearls and Irritations) Ockhams Razor (1) is wielded inappropriately when there is not a single biological breakdown but many breakdowns. Ageing causes progressive erosion of the reserve capacity in all body systems; and chronic disease impairs the function of many organs. The aims in...
9 June 2016
IAN WEBSTER. Bulk-billing rates are not what they seem.
A categorical mistake: Is bulk-billing a reliable indicator of access to GPs? Where I work in regional NSW, patients have difficulty finding a GP who is prepared to bulk-bill them for their medical care. The phone call to the practice receptionist ends, so often, with, The doctors books are full. At the same time were told that 83% of Medical Benefits Schedule (MBS) services are bulk-billed. Like everyone else, I thought this fact would mean increased access and affordability for patients to a local GP. Had I thought more thoroughly about the problem and scrutinised the MBS data,...
9 May 2016
Ian Webster. Is community medicine dead?
John Menadue said in the NSW Health Council Report of 2000, Services should be based where patients and consumers live. The autonomy and dignity of each patient is best serviced by providing services wherever possible outside hospital. So a shift to community multi-disciplinary health teams is a major issue still ahead of us. He returned to this theme in a recent blog, A major aim of good health policy for Australia must be to keep people out of expensive hospitals. Two South African physicians, Sidney and Emily Kark, working in poor communities started community-based primary health care community...
10 March 2016
Ian Webster. Drugs and the problem of pain
At the centre of the drug problem is the problem of psychic and physical pain People with mental illness turn to alcohol and drugs to lessen their distress. When adolescents and young adults use a substance to ameliorate their social anxieties a pattern of lifelong alcohol and drug misuse can be set in train. People managing to live in the community with psychosis have high life-time rates of alcohol and cannabis/illicit drug abuse/dependence - 40% to 60% - with males at the top level. About one in five people experience continuing pain. Access to a specialised pain clinic...
1 February 2016
Ian Webster. Alcohol and Sport.
The facts about alcohol should stop politicians in their tracks. But they are unmoved. A quarter to a third of the work of a general hospital is alcohol-related. On Australia Day one in seven ED attendances were caused by alcohol; in some EDs it was one in three. The Senior Australian of the Year, Gordian Fulde, time and time again, has described the carnage at St Vincent's Hospitals ED late on Thursday, Friday and Saturday nights; as many as 70 percent of cases at peak periods are intoxicated. Thats only part of the medical story. The alcohol load...
14 April 2015
Ian Webster. On thin ICE.
If we wish to annihilate the junk pyramid, we must start at the bottom of the pyramid: the addict in the street, and stop tilting quixotically for the higher-ups so-called, all of whom are immediately replaceable. The addict in the street who must have junk to live is the one irreplaceable factor in the junk equation. When there are no more addicts to buy junk there will be no junk traffic. As long as the junk need exists, someone will service it. (William S Burroughs, Naked Lunch, 1959) Are we in the midst of an ICE epidemic? Was...
2 April 2015
Ian Webster. Alcohol-drenched cricket.
Michael Thorn is right; the ICC Cricket World Cup was an alcohol-drenched event (SMH Tuesday, 31st March 2015). Cricketers were once models of sportsmanship. There was even altruism and some became statesmen. Recall, Thats simply not cricket. No longer, as the game is subverted by money and alcohol. As I write, the ABC is broadcasting the performance-enhancing drug scandals in the AFL. Just as scandalous, more scandalous, is that sport is a vehicle for promoting our most socially damaging drug, alcohol. To adolescent binge drinking, we respond - they should be taught at school; the drinking age should...
15 October 2014
Ian Webster. Suicide prevention.
September 10th was World Suicide Prevention Day Suicide Prevention - One World Connected and from the 5th to the 12th October Mental Health Week ran in Australia. The weeks highlight was the ABC's Mental as which ran through the whole week. Over three nights Changing Minds the inside story on ABC TV involved us with the staff and patients of Liverpool Hospitals in-patient mental health unit. It was riveting television. The program portrayed the relationships between staff and patients with disordered minds as they slowly regained their sanity. There was much humanity. A constant thread during Mental...
3 February 2014
Ian Webster. Cutting waste and costs in health
Waste in health care conjures up several pictures. One picture is of community nurses, psychologists and Aboriginal health workers in the community centre I visit anchored to their computer screens, endlessly it seems, trying to fulfil the demands of data entry. They are obviously frustrated by the lack of relevance this has for solving the problems of their patients. It takes time away and it is disempowering. About one third of each day is lost in this way. While not so apparent, there is a certain cynicism amongst the local hospitals specialists about gaming to preserve the local...