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Back to Basics in Health in Advanced Countries Now

Clearly a new wind is blowing across in three key advanced countries, UK, Australia and USA.

People are sick, literally and metaphorically, one might say. The market-oriented policies pursued by the respective governments seem to have failed the people in a big way, nearly sparking off a major healthcare crisis. The powers-that-be are forced to reorient their strategies.

In UK health workers' unions have warmly welcomed Alan Johnson's appointment as health secretary in Gordon Brown's first cabinet and called for greater dialogue with NHS staff.

The general secretary of Unison, Dave Prentis, said the former education secretary was "someone we can do business with" and said his appointment in place of Patricia Hewitt, who announced she was stepping down, represented "a clear opportunity to make a fresh start".

Under Hewitt NHS staff have complained at the "top-down" implementation of reforms, a financial crisis led to some trusts shedding jobs and cutting back services and most recently the changes in the job application system for junior doctors led to calls for her resignation.

Following evidence in the last health commission report that hospitals were slipping in their commitment to treating patients with dignity and respect, union leaders stressed the need to improve the "patient experience".

Prentis said the new health secretary should listen more to NHS staff and "switch the focus from endless and costly reorganisations and privatisation to more compassionate, patient-centred healthcare".

Last month delegates at Unison's health workers' conference voted unanimously to ballot for industrial action, including strikes, as part of a dispute over pay. The Royal College of Nursing (RCN) also announced it would ballot its members over industrial action, and members of the Royal College of Midwives (RCM) voted to consider holding a ballot for the first time in its 125-year history.

Today both colleges joined Unison in voicing optimism following Mr Johnson's appointment.

The RCN general secretary, Dr Peter Carter, said: "We have gone on the record publicly to praise Mr Johnson's even-handed and open-minded approach. We urge him to talk to us and work with us to rebuild trust with NHS staff.

Dame Karlene Davis, general secretary of the Royal College of Midwives, said: "We are looking to the new secretary of state to put maternity issues at the top of his agenda, halt the decline in the service and deliver the first-class maternity are promised by the government."

Johnson himself had once observed, We need a proper dialogue with health workers, who still felt undervalued. The government have listened a bit too much to the British Medical Association (BMA) and not enough to unions like Unison. Maybe what we should be doing is bringing the unions in the health service much more closely into social partnership.

Meantime in far away Australia, LABOR leader Kevin Rudd's plan to up-end the health system by putting prevention ahead of cures has been welcomed by health groups.

A leaked annual government report has suggested that hundreds of thousands of hospital visits are avoidable. The report said one in 10 hospital visits should have been to a GP.

It reveals that renal dialysis to treat lifestyle-induced diabetes is the single most frequent reason for visits.

Treatments for other preventable conditions, such as heart attacks, also soak up huge resources.

Rudd said Labor would give central priority to preventive health care and better management of chronic illness.

Rudd said chronic illnesses such as diabetes and cardiovascular diseases would become more prevalent over the coming two decades.

"The rise of these diseases poses a major risk to the long-term health of millions of Australians by reducing their quality of life, restricting th eir ability to participate in the workforce and diminishing their capacity to perform at their best when at work."

Mr Rudd also linked health to long-term economic prosperity.

If elected, he would ask Treasury to analyse the economic impact of chronic disease. Labor would also redesign health care agreements with the states to move beyond hospital funding to preventive health care.

The Cancer Council's Ian Olver said the plan represented a necessary "culture change" to cut the burden on taxpayers of preventable diseases such as skin cancers and lung cancers from smoking.

Of course the healthcare crisis in US is a major concern in US, making Michael Moores stinging documentary Sicko a runaway hit.

It features memorable testimony from a conscience-stricken physician employed by a health insurance company. She refused to authorize a client's life-or-death operation to save her employer the expense. No one ever called her to account, the doctor said, because the organisation's legal framework encouraged her to focus on the bottom line of profit with cold rationality.

According to the Children's Defense Fund Minnesota, 79,000 children in the state had no health insurance in 2006.

"I'd be ashamed and embarrassed to call myself a Minnesotan if I heard that statistic," Moore said in an interview. "What society would say the children don't have a right to see a doctor and not have to worry about paying for it? I would say this to any conservative or Republican. At the very least, why wouldn't you insure the children? That's a cruel thing not to do in such a highly developed and wealthy society as we have."

Healthcare scene could tilt the scales in favour of the Democratic candidate in the next years presidential elections.

Though no one has committed himself or herself for a radical change, everyone concedes the need to make healthcare affordable and accessible to all.

Of course all this could prove illusory, as it has happened so often in the past. Still given the intensity of soul-searching some change could be expected sooner than later, hope activists.


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