John Dwyer

Professor John Dwyer AO, is an Immunologist, Emeritus Professor of Medicine at UNSW and for many years heavily involved in efforts to improve the delivery of healthcare in Australia. He was the founder of the Australian Healthcare Reform Alliance.

John's recent articles

Covid controversies continue to hinder our efforts to end a deadly pandemic - Part 1

It is truly lamentable that in this most scientific of all ages, so much of the world is making a mess of tackling the worst public health challenge in a hundred years.

The hindering of our efforts to control the spread of Covid-19

We face social fatigue and misconceptions about social distancing; irresponsible public behaviour; and a widespread lack of appreciation of the long-term clinical consequences of an encounter with this virus.

Where politics trumps public health

We are six months into the Covid-19 (C19) pandemic. A year ago, we would have expected the United States to play a major leadership role in countering any pandemic. Instead, is has suffered at least 2,700,000 infections, resulting in 128,000 deaths .

Political ambition demands we play the Covid Blame Game while Rome still burns

President Donald J Trump claims that carelessness in the Wuhan Institute for Virology saw the Covid-19 virus, which, he insists, was being grown in the Institute, escape, resulting in a disastrous pandemic.

JOHN DWYER. Palmers Pills, all 32 million of them!

Sydney Morning Herald, March 3, 2022. A grateful nation rewards Clive Palmer with the Prime Ministership for using his personal fortune to save Australia from a Covid catastrophe. President Trump tweets his congratulations noting that the two men are kindred spirits.

JOHN DWYER. Trump, Xi and the WHO.

President Trump, always blaming someone to hide his own inadequacies, has vented his fury on both China and the WHO. The WHO, for one precious week, had accepted Chinas advice that the novel respiratory infections were not transmitted from human to human.

JOHN DWYER. Questions we need answered before we can safely ease COVID-19 restrictions.

COVID decisions at the cross roads; which path will Australia take?

JOHN DWYER.Exploring COVID-19 controversies. Part Two.

How do we safely ease social distancing restrictions and reignite our economy?

JOHN DWYER. Exploring COVID-19 controversies. Part 1

As we settle into the longest winter of our lives, strict containment strategies are provoking controversy fuelled by misinformation or insufficient knowledge of COVID realities.

JOHN DWYER. Health care professionals want a lockdown now.

In sharper focus than ever this week is the danger health professionals experience in caring for seriously ill patients infected with COVID-19.

Trump declares he is convinced we now have a drug to terminate the epidemic

As I write Boris Johnson has just locked down the UK and ordered police officers to enforce the lockdown. Almost simultaneously Donald Trump has declared that there is a great weariness among Americans for this social distancing business and he wants it to end in two weeks.

JOHN DWYER. There is still a lot more that needs to be done to minimise harm in Australia from COVID-19.

Australian governments are taking a measured approach to minimising the impact of the COVID-19 epidemic adding new tactics/restrictions as the numbers grow. Far better to use all available measures now to minimise that growth.

JOHN DWYER. Understanding the public health imperatives required to minimise infection with the Corona virus. (Part Two).

Providing communities with accurate, timely and logical information about the control measures required to minimise harms associated with infectious diseases is essential to avoid both complacency and panic.

JOHN DWYER. Understanding the public health imperatives required to minimise infections with the Corona virus. (Part One).

Providing communities with accurate, timely and logical information about the control measures required to minimise the harm associated with infectious diseases is essential to avoid both complacency and panic.

JOHN DWYER. Americans desperate thirst for affordable health care might just ensure they dont get it!

In this Presidential election year, poll after poll report that Americans number one concern is affordable health care.

JOHN DWYER.The Opioid crisis should focus attention on the inadequacy of Primary Care in Australia.

John Menadues insightful essay on urgently needed reforms to health care in Australia ( P&I Feb 7) correctly emphasised that a priority area for implementation and funding should be primary care with the rollout of multi-disciplinary primary health care clinics across Australia.

JOHN DWYER. The lack of truth in Medicine and Science.

Opioid addiction is pervasive and growing rapidly. Medicine and Science are threatened by the phenomenon.

JOHN DWYER. What a mess! Insurance for health care, both public and private, is increasingly dysfunctional with sensible and equitable solutions held hostage by vested interests. PART TWO

At least 50% of the money private health insurers pay out annually to those insured is absorbed by just 5% off their customers. Most of these patients have chronic medical problems and have multiple admissions per year .While private hospitals need bottoms on beds to be profitable, public hospitals and private insurers are desperately in need of a reduction in hospital admissions. Numerous strategies for achieving this are being floated but sensible reforms are difficult as those with vested interests in the status quo have undue control of government initiatives.

JOHN DWYER. What a mess! Insurance for health care, both public and private, is increasingly dysfunctional with sensible and equitable solutions held hostage by vested interests. PART ONE

We Australians have for decades now made it clear that we want a health care system that delivers quality care in a timely manner with availability based on need not personal financial wellbeing. Increasingly it is obvious to all that the system should better fund programs to prevent illness not just treat it.These are the principles we wish to see Medicare embrace and we are willing to have our tax-dollars pay for the benefits.

The barbaric nature of the human condition

It was a right hook in the third round that sent the 26 year old boxer to the canvass. The crowd cheered with excitement; after all, this is what they had hoped to see. On the referees count of five the man struggled to his feet and was directed to the ring side doctor. That professional shook his arms looked at his pupils and asked if the man wanted to continue. Yes, he said, upon which he was allowed to return to the slaughter. Twenty-seconds later he was back on the canvass, 24 hours later he was dead. Numerous small...

JOHN DWYER Australia's opioid epidemic

The Opioid epidemic that has so devastated America is now well established in Australia.

JOHN DWYER. Another hard to believe example of the weakness of our regulators in protecting consumers from healthcare fraud.

When I was much younger I often dipped into Ripleys Believe it or not for a laugh, amazement and even enlightenment. I had a look at their website recently as I prepared to tell you a story that would fit well into their library and found that Ripleys is alive and well, daily producing their remarkable vignettes; Frederic Baur, creator of Pringles chips had his ashes buried inside one of his cans, the common Swift can stay in the air for 10 months without landing, men only blink half as often as women, cats can be allergic to humans! Well,...

JOHN DWYER -Failed regulation in health.

When I was much younger I often dipped into Ripleys Believe it or not for a laugh, amazement and even enlightenment. I had a look at their website recently as I prepared to tell you a story that would fit well into their library and found that Ripleys is alive and well, daily producing their remarkable vignettes; Frederic Baur, creator of Pringles chips had his ashes buried inside one of his cans, the common Swift can stay in the air for 10 months without landing, men only blink half as often as women, cats can be allergic to humans! Well,...

The crisis in Private Health Insurance arrangements in Australia is a symptom of our public health failures.

Australias private health insurance (PHI) industry fears it is in a death spiral, and politicians need to rethink whether or to what extent taxpayers should continue to subsidise the industry the Grattan Institute tells us as they call for a review of the purpose of PHI in Australia. The Grattan report emphasises what is already widely appreciated that, Australians are increasingly dissatisfied with private health insurance, and policy reform is urgent. Premiums are rising much faster than wages or inflation. People are dropping their cover, especially the young and the healthy. Those who are left are more likely to get...

JOHN DWYER An open letter to Minister Greg Hunt

The majority of Labors plans for our health system were greeted with enthusiasm herein and elsewhere as they addressed major current inadequacies that diminish the equity and cost effectiveness of the health care available to Australians. Labor did seek and act upon advise re health reform priorities provided by health professionals and informed consumers. They took to the election an ambitious plan (too ambitious say many post election pundits) that would have facilitated needed structural reforms (An Australian Health Care Reform Commission) and address a range of imperatives I present here in an open letter to health minister Greg Hunt

JOHN DWYER The "Canterbury Model" in health

Australias health care system needs restructuring to see it meet the contemporary and future needs of its citizens. A consensus view has emerged which argues that a long term (perhaps ten year ) plan is required for the full implementation of the desired changes. The status quo is unacceptable as the system is not resourced or organised to improve the health of the nation and is not cost effective. Its also unfair as Increasingly personal financial well-being, not need, is determining health outcomes.As a Federal election is focussing our attention on the health care initiatives envisioned by our politicians do...

JOHN DWYER. Politics and anti-science. Hunts patheticFlip-Flop on the use of Taxpayers dollars to pay for Alternative Medicine

The National Health and Medical Research Council (NH&MRC) is Australias pre-eminent provider of advice on science and health to government and the community. Concerned that taxpayers dollars might be wasted subsidising private health insurance payments for a range of Alternativeclinical services, the federal government asked the NH&MRC in 2015 whether there was credible scientific evidence of benefit to support this subsidy.

JOHN DWYER - Will the health initiatives announced last week significantly and sustainably improve health care for Australians?

Given that polls constantly have Australians saying that healthcare is a top issue in every election, expectations are high that our politicians will describe a commitment to those structural reforms so badly needed to improve equity of access to excellent health care that is cost effective. While Labor had made a number of important announcements over the last few months that were not presented in Bill Shortens speech (worrying) the Coalition only announced one major new program that is problematic to say the least.

JOHN DWYER Chiropractic manipulation of infant's spine

Recently social media and then the mainstream media exploded with outrage following the publication of a photo showing a Melbourne chiropractor treating a newborn baby by suspending the child in midair, holding its foot high as it thrashed around in protest.

JOHN DWYER. Health Reform's "Holy Grail";Medicare must fund the "team Medicine" approach to Primary Care.

Surely my disgust at the Coalitions decision to spend more than a billion dollars re-opening the Christmas Island detention centre to make sure that none of those nasty murderers, rapists and paedophiles ever get to real Australia for any medical care, is widely shared. There is so much real health that could be purchased with those dollars.

JOHN DWYER. Labor unveils the health care reform initiatives to be pursued if elected.

Shadow health minister, Catherine King, in an address to the National Press Club, has detailed the major health initiatives Labor would embrace if elected in May. Her plans indicate that she has heard and accepted many of the priorities for reform proposed by would be health reformists. The status quo is unacceptable. Most encouraging was her recognition that patient-centred reforms, which must include truly integrated care, was impossible if the current jurisdictional division of responsibility for health care continued. The portfolio of reforms she presented are welcomed and would be readily understood by electors if they could hear these...

JOHN DWYER. Health care reforms and the Federal election: A guide for voters

Our health care system provides, at least for metropolitan based Australians, world class management of medical emergencies. A stent in a coronary artery in the middle of the night can save a heart in danger and our dedicated stroke units routinely dissolve blood vessel blockages that could have proved fatal or caused major permanent disabilities. While we can be grateful for these interventions the reality is that the management of the majority of health issues that trouble us do not meet this standard of excellence.

The extraordinary determination of China to have the world embrace its traditional medicine. (Part 3 of 3.)

Theartemisia annuaplant has been used for centuries in China to fight malaria. In 2011 a Chinese scientist, Tu Youyou, discovered how to extract the ingredient responsible for the anti-malarial effect (now called Artemisinin) and her reward was a Nobel Prize. Where there is good anecdotal evidence that something in a herb or plant can help with certain diseases, it's more than appropriate for modern scientific techniques to be used to try and identify, purify and standardise the responsible chemical. This has nothing to do with the concepts associated with Traditional Chinese Medicine (TCM). Many of the drugs we use today...

JOHN DWYER. The extraordinary determination of China to have the world embrace its traditional medicine. (Part 2 of 3)

Remarkably and unfortunately politics, not clinical effectiveness, is powering the global penetration of Traditional Chinese Medicine into health care systems. The term Traditional Chinese Medicine (TCM) was dreamt up by Chairman Mao Zedong in a cynical response to the Communist Party's inability to provide evidence-based health care for the then 500 million Chinese. Mao knew that TCM was largely useless and was derogatory about TCM practitioners but he none-the-less set about its expansion. This saw a reversal of a progressive acceptance of scientific medicine in China which started in the 19th century.

JOHN DWYER. The extraordinary determination of China to have the world embrace its Traditional Medicine. (Part one of three)

The child was six years old. His parents were struggling to manage his Diabetes. He had Type 1 diabetes, the most serious form of the disease caused by his own immune system destroying his pancreas. As a result he could no longer produce required amounts of Insulin to control his blood sugar levels. Regular injections of Insulin were keeping him alive. The heartbreaking tragedy that descended on this vulnerable child and caused his death involved the practice of paidalajin, an alternative Chinese medicine technique that involves slapping, pulling and stretching the skin until it bruises.

JOHN DWYER. How are we going to water the farm now that copious life sustaining rain is but a memory?

The change in the worlds climate is currently on full display with equatorial deluges, hurricanes and typhoons causing destruction and misery while the the rest of the world burns and experiences record temperatures further North than ever recorded before. As a 78 year old Australian I am well aware of the frequency with which our framers have had to deal with droughts but the current drought that has stripped so much of the country of its fertility for more than six years, is extremely alarming when viewed in the context of the changes in global weather. While we must do...

JOHN DWYER. Health care reform - Part 2.

Without acceptance of a ten year plan and the creation of an instrument to implement that plan we will not be able to engineer the evidence based structural reforms to our health care system that will improve quality, equity and cost effectiveness.

JOHN DWYER. Health care reform - Part 1.

Without acceptance of a ten year plan and the creation of an instrument to implement that plan, we will not be able to engineer the evidence-based structural reforms to our health care system that will improve quality, equity and cost effectiveness.

JOHN DWYER. Health Care Homes, set up to fail and doing so spectacularly.

Touted by Minister Hunt as the biggest health care reform initiative since the introduction of Medicare, the Health Care Home model for the better management of patients with two or more chronic diseases is floundering, beset with predictable organisational and resource inadequacies. As is so often (too often) the case with health policy initiatives, a laudable concept collapses at the implementation phase (e.g. Primary Health Networks). The boldness of the plan is not matched by the necessary resource boldness.

Profit trumping professionalism! All too often the case in Australian pharmacies

On May 3, Health Minister Greg Hunt spoke at a conference organised by the Pharmacy Guild of Australia. This is the pharmacy owners association (all pharmacists) which in 2011, notoriously, entered into a deal with the vitamin and supplement provider, Blackmores, to have 5000 pharmacies try and sell a Blackmores product to clients picking up prescription medicines. Once revealed the subsequent opprobrium, of course, resulted in the deal being cancelled.

JOHN DWYER. Poor oral health in Australia; a costly chronic problem getting worse and which current strategies have no chance of resolving.

Australias health system, such as it is has two Achilles Heels. The left one is our lack of emphasis on the prevention of disease while the right one concerns our incompetence in integrating health services in a patient-focused way. Both were on vivid display recently with the release of a new report by the Australias Oral Health Tracker.

JOHN DWYER. The curse of political mediocrity; The informed, bold, courageous policies that Australia needs in health are nowhere to be seen. (Part 3 of 3)

This fair go mate country of ours is wealthy but in reality ever less egalitarian. Increasing Inequity is palpable and most notable in the problems we have with housing, education and health. Health outcomes for Individuals are increasingly dependent on personal financial wellbeing. Australians are spending about 30 billion dollars a year to supplement the care available from our universal health care system. Many, of course, do not have the resources to to cover out of pocket expenses. Many of these problems have become chronic as political intransigence inhibits the development of bold, informed and even courageous policies. Policy development,...

The curse of political mediocrity; The informed, bold, courageous policies that Australia needs in health are nowhere to be seen. (Part 2 of 3)

This fair go mate country of ours is wealthy but in reality ever less egalitarian. Increasing Inequity is palpable and most notable in the problems we have with housing, education and health. Health outcomes for Individuals are increasingly dependent on personal financial wellbeing. Australians are spending about 30 billion dollars a year to supplement the care available from our universal health care system. Many, of course, do not have the resources to cover out of pocket expenses. Many of these problems have become chronic as political intransigence inhibits the development of bold, informed and even courageous policies. Policy development, such...

The curse of political mediocrity; the informed, bold, courageous policies that Australia needs in health are nowhere to be seen (Part 1 of 3).

This fair go mate country of ours is wealthy but in reality ever less egalitarian. Increasing Inequity is palpable and most notable in the problems we have with housing, education and health. Health outcomes for Individuals are increasingly dependent on personal financial wellbeing. Australians are spending about 30 billion dollars a year to supplement the care available from our universal health care system. Many, of course, do not have the resources to to cover out of pocket expenses. Many of these problems have become chronic as political intransigence inhibits the development of bold, informed and even courageous policies. Policy development,...

JOHN DWYER. The devastating effects of Trumpism on science and medicine.

While the Fire and the Fury surrounding the chaos at the White House dominates media reporting on the Trump presidency, the power of the office is being utilised to implement a myriad of bad decisions that will have very long-lasting effects. Nowhere is this more obvious than in the plans Trump has to slash funding for science and medicine.

JOHN DWYER: When will we seriously tackle the Inequity associated with the delivery of health services to rural and remote Australians? Part 2 of 2.

Health outcomes for Australians living in rural or what are characterised as remote areas are far inferior to those of their city cousins. If you dont live in metropolitan Australia your life expectancy is reduced by about four years. You are four times more likely to die of a stroke. Rates of obesity, infant mortality, mental health disorders, and diabetes are all much higher than is the case for our urban population. There is nothing new here, we have known about these realities for decades as well as the strategies needed to address the problem. At least five major enquires...

JOHN DWYER: When will we seriously tackle the Inequity associated with the delivery of health services to rural and remote Australians? Part 1 of 2.

Health outcomes for Australians living in rural or what are characterised as remote areas are far inferior to those of their city cousins. If you dont live in metropolitan Australia your life expectancy is reduced by about four years. You are four times more likely to die of a stroke. Rates of obesity, infant mortality, mental health disorders, and diabetes are all much higher than is the case for our urban population. There is nothing new here, we have known about these realities for decades as well as the strategies needed to address the problem. At least five major enquires...

JOHN DWYER. The folly of looking at private health insurance as a single issue . Part 2 of2

So Private Health insurance is in the DNA of the Coalition government we hear from Minister Hunt. That may well be the case but there is no evidence to suggest that the delivery of equitable, quality health care to all Australians is so programmed. Indeed many have commented that the recent focus on private health insurance and the need for younger Australians to embrace a very poor deal is couched in rhetoric which suggests that Private Hospital care is better than Public Hospital care and, in any case, the public hospital system may not be there for you when you...

JOHN DWYER. The folly of looking at private health insurance as a single issue rather than a policy failure .Part 1 of 2

So private health insurance is in the DNA of the Coalition government, we hear from Minister Hunt. That may well be the case but there is no evidence to suggest that the delivery of equitable, quality health care to all Australians is so programmed. Indeed many have commented that the recent focus on private health insurance and the need for younger Australians to embrace a very poor deal is couched in rhetoric which suggests that private hospital care is better than public hospital care and, in any case, the public hospital system may not be there for you when you...

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