2023 | Volume 24 | Issue 5

We regularly advocate for these positions across several different mediums, including through the media, public campaigns, engaging directly with government or through written submissions.

Read on to find out more about our advocacy work in Australia and Aotearoa New Zealand.

President’s Canberra meetings, parliament and Australian Department of Health

In early August, RACS president, Associate Professor Kerin Fielding and RACS manager for Policy and Advocacy, Chesney O’Donnell, held several face-to-face meetings with senior federal government representatives and ministers in Canberra, Australia.

Over two days, during parliament sitting week, they met: Ged Kearney, Assistant Minister for Health; Blair Comley, Department of Health Secretary; Eamonn Fitzpatrick, Senior Political Special Advisor to Government; Dr Mike Freelander, Chair of House Standing Committee on Health, Aged Care and Sport; Dr Anne Webster, Shadow Assistant Minister for Rural and Regional Health, and Malarndirri McCarthy, Assistant Minister for Indigenous Health.

The main topics discussed were:
•    Specialist International Medical Graduate
•    rural maldistribution and workforce
•    low-value care
•    National Climate and Health Strategy
•    more RACS positive news stories via traditional media outlets i.e., television and radio
•    cosmetic surgery endorsement model.

Future actions include Ged Kearney, Assistant Minister for Health, to meet with RACS representatives to discuss the National Health and Climate Strategy. RACS will also meet the House Standing Committee on Health, Aged Care and Sport to highlight our main policy concerns impacting the surgical profession and patient care.

Protection of title in Australia

RACS has actively advocated for protecting the title of ‘surgeon’, which took many years to accomplish. Tough national laws were introduced first in Queensland in April 2023 to help regulate the medical profession. Incorrect use of the title ‘surgeon’ will incur penalties of up to three years imprisonment and a $60,000 fine. Laws will be rolled out to other states and territories. Exemptions still apply i.e., maxillofacial, ophthalmologist, and obstetrics and gynecology.

Australian National Climate and Health Strategy consultation

The Australian federal government has developed its first National Health and Climate Strategy. One main focus relates to how climate change impacts our healthcare system, public healthcare policy, and First Nations people.

RACS wrote a submission analysing resource-intensive areas relating to any hospital that contributes to high carbon emissions. Strategies have been developed, which target for example, operating theatres and waste management initiatives.

Surgery backlog of elective surgery waiting list in Australia

RACS collaborated with the Australian Medical Association (AMA), Royal Australian and New Zealand College of Ophthalmologists, and Royal Australian and New Zealand College of Obstetricians and Gynaecologists to write a letter to the Australian federal minister for health.

Reform to the National Health Reform Agreement (NHRA) to which RACS made a submission in a recent consultation, won’t come into play until 2025. The AMA and the medical colleges are pushing for 50–50 funding in the new NHRA and the removal of the 6.5 per cent cap on funding growth, together with the reintroduction of performance funding. RACS additional concerns relate to for example, identifying problems in maintaining our training pipeline, re-evaluating elective surgery categories, public in private surgery, nurse retention, operative space and beds, impact on rural services, and a definition change from elective to essential surgery.

The action plan to make Aotearoa smokefree by 2025

Authors: Dr Sarah Rennie and Professor Spencer Beasley, Aotearoa New Zealand Surgical Advisors 

Manatū Hauora - Ministry of Health has released its action plan, which describes how the harm smoking causes can be reduced.  

Smoking rates in Aotearoa New Zealand overall are heading downwards but smoking-related inequalities remain, especially among Māori, Pacific peoples, and those living in the most disadvantaged communities.   

The Smokefree Aotearoa 2025 Action Plan aims to achieve the following key outcomes:

1. Reduce inequalities (demographic variance) in smoking rates and smoking-related illnesses for people living in the most deprived areas.

2. Ensure our tamariki (children) and rangatahi (young people) never start smoking and remain smokefree (including living in a smokefree environment).

3. Increase the number of people who successfully quit smoking.

Six focus areas describing how this can be achieved have been identified:

1. Ensuring Māori leadership and decision-making across all components of the Action Plan.

2. Increasing funding for health promotion and community activities to motivate and mobilise people to get behind the smokefree goal and to assist those trying to quit.

3. Providing more wrap-around support for those who wish to quit that is tailored to a specific community’s needs.

4. Having only low-level nicotine smoked tobacco products for sale and reducing their appeal by restricting attractive product design features.

5. Making smoked tobacco products harder to access by reducing the number of retail outlets.

6. Making sure the tobacco industry and retailers follow the law.

Fact sheets providing more detail, including expected outcomes, have been produced for each focus area: https://bit.ly/3EOmRs0
A positive step but does it go far enough?

While RACS applauds any steps to curb smoking and the harm caused by smoked tobacco products, there are questions as to whether the government’s plan goes far enough.

For example, no specific mention is made of educating school children or enforcing the minimum age to whom smoked tobacco products can be sold (although focus areas 2 and 5 may indirectly address this point).

More worryingly, it does not address the potential harms of vaping, or its role as a gateway to smoked tobacco products. While tougher rules on vaping were introduced in 2021, restricting the flavours available in general retailers and imposing age limits, specialised vape stores are still able to sell flavours that appeal to younger people, including peach, watermelon, and bubble gum.

Should we be advocating for flavours to be restricted to mint, menthol, or tobacco across all retailers?  

Should we also be calling for stricter nicotine limits on vapes? Or follow Australia’s measures and only make vaping available on prescription?

We note Labour unveiled a significant pre-election vaping law reform proposal last month—promising to cap the number of stores nationwide and ramp up penalties for those who sell to underage people—and that National is broadly supportive and favours even tighter restrictions.

As a country we have made huge strides in cutting smoking rates and thus improving community health but there is a fear that the disturbing rise of vaping will quickly undo this great work.