The breadth and depth of AMA advocacy

6 Apr 2017

I came under fire recently because of comments I made about the closure of the power plant at Hazelwood in Victoria, which were misinterpreted in The Guardian.

The story in The Guardian set off a chain of emails and social media posts, instigated for the most part by Doctors for the Environment Australia (DEA), which were critical of my reported comments and claiming that the AMA President was downplaying the health impacts of pollution and climate change.

Nothing could be further from the truth.

I do not blame DEA members for their actions. That is their job. They read something that they believed was against their charter, vision, values, and purpose, and responded accordingly. I admire and support the work of DEA. Many of their members are also AMA members.

Let me set the record straight. When asked by the Guardian journalist to comment on the Hazelwood closure, I clearly referenced and reiterated the AMA’s strong and long-held position on climate change and health, embodied in the AMA Position Statement on Climate Change and Health 2015, which has been championed by myself, and former AMA Presidents and Vice Presidents. No story there.

As a responsible health advocate, I also raised the issue of care and concern for the people who lost their jobs because of the closure, and the broader impacts on their families and communities. I acknowledged the long-term effects of pollution in the Latrobe Valley. I also cited the work of doctors, led by DEA, in highlighting the health effects of the Morwell fire in 2014.

I raised the very real outcomes that stem from unemployment such as mental health, loss of self-esteem, alcohol and drug misuse, domestic violence, self-harm, suicide, and on it goes. These health effects are well documented in scientific studies around the world. Here is a handy summary:

I also told The Guardian that I believed that governments and industry must be aware of, and make plans for, the impacts of transition – from employment to unemployment, from old energy sources to new energy sources, and for the ongoing impact of climate change on public health.

Sadly, only a few of these observations made it into the story.

Unfortunately, the Guardian story wrongly projected that I, as AMA President, was more concerned about job losses at Hazelwood than about the global impacts of climate change or the transition from heavily polluting brown coal to renewable energy sources.

Again, nothing could be further from the truth. I was simply and responsibly pointing out that there were health impacts and societal impacts on many levels, at varying degrees, from situations like the Hazelwood closure. This is the job of the AMA.

AMA advocacy is very broad and very deep. It has to be. No other medical or health organisation in the country can even come close to initiating or influencing change across the health system and society.

Single issue or narrow focus groups like DEA and Doctors for Refugees do great work. So do the learned Colleges, the Societies, and Associations. And the other health professions, the public health groups, consumer representatives, and other groups all do their jobs and do them well.

But the AMA’s mission goes so much further.

If you look at the AMA website, we have around 150 Position Statements, which include:

  • Workplace Bullying and Harassment;
  • Indigenous Health;
  • Sexual and Reproductive Health;
  • Women’s Health;
  • Men’s Health;
  • Obesity;
  • Human Cloning;
  • End of Life Care;
  • Family and Domestic Violence;
  • Female Genital Mutilation;
  • Concussion in Sport; and
  • Firearms.

These issues cover many facets of society and many ideologies. Some are regarded as progressive, some are conservative, but most are controversial - and therefore potentially divisive.

We do this on top of our other core business – Medicare, the PBS, public hospital funding, the PSR, medical workforce, private health, rural health, doctors’ health, and the broad range of public health issues.

The AMA has to always tread a fine line, and we do that willingly. And so it is with the issues at hand here - climate change, pollution, air quality, and renewable energy.

The AMA believes that climate change poses a significant worldwide threat to health, and urgent action is required to reduce this potential harm.

We have been vocal about the need for urgent government action, and have repeatedly called for the development of a National Strategy for Health and Climate Change.

The AMA Position Statement Climate Change and Human Health 2015 is a very strong document. It was developed from the ground up, with input from AMA members at grassroots level around the country.

The AMA wants to see a national strategic approach to climate change and health, and we want health professionals to play an active and leading role in educating the public about the impacts and health issues associated with climate change.

Human health is ultimately dependent on the health of the planet, and the AMA lobbies governments for urgent measures to mitigate the evolving effects of climate change, including the transition to non-combustion energy sources.

The evidence is clear - we cannot sit back and do nothing.

There is considerable evidence to encourage governments around the world to plan for the major impacts of climate change, which include extreme weather events, the spread of diseases, disrupted supplies of food and water, and threats to livelihoods and security. 

Our stance is not limited to the Position Statement. We are actively engaged in advocacy on climate change and health. We attended the Health Leaders Roundtable at Parliament House in 2016, where health advocacy bodies met with Members of Parliament to discuss the health impacts of climate change and the need for urgent action. 

We make regular submissions to relevant Parliamentary inquiries, where we take every opportunity to highlight the connection between climate change and human health. We have further submissions to the Parliament underway, which are in line with the AMA’s official position.

In regard to air quality, there is considerable evidence documenting the substantial health impacts of air pollution, which range from acute and chronic effects, reproductive and neuro-cognitive defects, through to premature mortality. There is strong evidence for the significant health effects of particulate matter, and that these effects are even more pronounced than was previously thought.

The AMA told the 2013 Senate inquiry into the Health Impacts of Air Quality that occupational and workplace standards for hazardous air pollution are inconsistent and poorly enforced, and major sources of hazardous air pollutants are not currently regulated, as illustrated by the lack of standards for off-road diesel engines. Our submission to that inquiry is here:

I make no apologies for speaking out about the broader health issues that come from events like the Hazelwood closure. It is unfortunate that the headline of an online article misrepresented the facts, and undermined the AMA’s strong record on climate change, pollution, air quality, renewable energy, and human health.

On the other hand, this episode has given me the opportunity to re-state our very strong credentials in this and many other areas of public health.

As doctors in training, you are the future of the medical profession and the AMA. It is my job – and that of our current cohort of AMA leaders – to pass on to you a strong policy platform and an even stronger advocacy agenda and brand. We will not let you down.

Best regards

Dr Michael Gannon

Federal AMA President