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Embrace equity?

C’mon, give us a break.

No amount of self-hugging this International Women’s Day is going to change one darn thing about the inequities experienced within our workplaces or society.

Paying lip service in this way to the not-insignificant challenges being faced is insulting.

Instead, I want to highlight the need for equal access to health care for all Australians.

Because poor health is a massive disadvantage to your ability to hold down a job, progress in your career or work at the level you’re trained for.


Indigenous vs non-Indigenous health

The biggest health inequity in Australia lies in indigenous health. This is a long-standing challenge identified by UN committees as a human rights concern.

As a final year medical student back in the eighties, I spent 6 weeks at Fitzroy Crossing in the Kimberley region of West Australia to learn about Indigenous health and the role of the Flying Doctor Service.

What I witnessed as a naïve British 25-year-old, was a world I had no idea existed. I saw patients with conditions I thought had died out long ago including leprosy, rheumatic heart disease and TB. I saw kids with the double candlestick sign (green pussy discharge from both ears and nostrils), whose medical files were thicker than those I’d seen of the elderly with chronic medical conditions in the UK. 

I visited indigenous communities living in squalid camps that lacked electricity or clean running water. I saw the local supermarket had mostly empty shelves other than a few tins of food. While there was no fresh produce for sale, there was plenty of cigarettes and soft drink.

Health practitioners on the ground today are continuing to try and overcome the rising tide of obesity, type two diabetes, alcohol, and drug abuse in the indigenous population, against a backdrop of governments who continue to believe that throwing money at a problem will make it go away, and fail to understand that inadequate resourcing, insufficient staffing and lack of community engagement lies at the heart of addressing some of the inequities present.

When specialists can only visit sporadically, it’s hard to properly manage those issues that require more immediate attention or provide chronic care.

My repeat visits to the region have confirmed that access to adequate health resources remains a challenge, forty years later.


The socioeconomically disadvantaged live shorter lives.

The other major health inequity is the difference in accessibility between the rich and the poor, and those living in major metro areas and those living in remote or rural communities

Poor housing, lower levels of income and education, and higher health risk factors including higher rates of smoking, alcohol or drug abuse, exposure to air pollution and low levels of healthy lifestyle choices including exercise, good nutrition etc. along with difficulty in accessing affordable medical and dental services lead to shorter, sicker lives.

Poor health outcomes outside major cities mean that those in the lowest socioeconomic group are 2.1 times more likely to die from a potentially avoidable disease.

This is not a small group. 3 in 10 Australians live in rural and remote areas. While not everyone in a rural or remote area is necessarily in the lowest socioeconomic group, the question to be asked is,

is it acceptable that around 7 million Australians should be disadvantaged in this way?


Promises, Promises.

One of the worst health inequities lies in the difference between what is promised and what can be delivered.

Politicians love to make pre-election promises. These frequently determine who gets into office.

The problem here, is these wonderful blue-sky promises are frequently based on faulty thinking. Yes, there is a strong desire and need to do things better, but don’t make this at the expense of reality.

In a recent conversation with the CEO of an Aged Care Group, she expressed her frustration about the proposed new legislation due to come into effect in a couple of months time that include the requirement for all aged care homes to have a registered nurse available 24/7, and later this year there will also be the introduction of mandated average minimum care minutes.

Surely this must be a good thing, right?

Absolutely. No one is disagreeing that having a registered nurse in every government-funded residential care would be great.

But the reality is, there simply aren’t enough RNs to allow this to happen, meaning that most aged care facilities won’t be able to comply. The RACGP has come out saying it estimates only 3.8% of care facilities will be able to do so.

I would love to know how the government proposes to produce a genie out of this bottle.

There is a massive shortage of nursing staff across the entire health sector. They can’t be magicked up out of thin air. The existing nursing and care staff are buckling at the knees because of insufficient resourcing and let’s face it the poor remuneration and high stress on offer, doesn’t make it an appealing job choice at present.

The cynic within sees this as window dressing, it’s about making the government look good.

Which leads me to those mandatory care minutes.

Again no one is arguing increasing the amount of time each person in aged care is attended to individually is a bad thing. More money has already been added to the system by the government for this.

The stated goal is for every resident to receive a minimum of 200 minutes per day, including 40 minutes of care from an RN, (who as we know, currently doesn’t exist.)

Trying to operate in La-La Land with compliance and auditing by the Aged Care Quality and Safety Commission, that’s associated with the very real threat of “regulatory action” is setting the aged care operators up for failure.

This is not about greedy operators fleecing the elderly.

This is about recognising there are significant challenges being faced within the current health system that are incompatible with equity of care for all.

It’s important to note that, not everything in the health system is a basket case.

There is much that is great about the Australian health system that we can all be truly proud of. I have many friends and colleagues who work in the system They are hard-working, dedicated and committed to delivering the best of care to those in their care.

They are also exhausted, overstretched and demoralised by feeling they are on a sinking ship with inadequate lifeboats available.

As various reports indicate, all is not equal and we need to do better, for every Australians sake.

So, pardon me, for not buying into the hugging equity fest.

Let’s get back to the UN official IWD theme for this year Cracking the Code: Innovation for a gender equal future and talk about the important stuff, like innovation, inclusion, education, and equal access to opportunities and pathways to create a more equitable and fair world.

How does inequity show up in your world?


Dr Jenny Brockis is a board-certified lifestyle medicine physician, keynote speaker, trainer and best-selling author. Her new book Thriving Mind: How to Cultivate a Good Life (Wiley) is available for purchase

If psychological safety, burnout prevention and mental wellbeing is something you’d like to find out more about, please contact me to set up a time for a chat.

Dr Jenny Brockis

Dr Jenny Brockis is a medical practitioner and internationally board-certified lifestyle medicine physician, workplace health and wellbeing consultant, podcaster, keynote speaker and best-selling author. Her new book 'Thriving Mind: How to Cultivate a Good Life' (Wiley) is available online and at all good bookstores.

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