CAHA member Bret Hart comments on ex-BMJ editor Richard Smith’s Ten Lessons:

It is unfortunate that a serious family illness prevented Richard Smith from delivering the Redfern Oration for the World Congress of Internal Medicine in Melbourne last year, but problems are opportunities in disguise.

He did not increase his ecological footprint but, thanks to webcasting, he delivered his address from his home in the antipodes and this has also enabled many more people than would otherwise have been the case to read and view his important 10 lessons as follows:

Lesson one: Modern clinical medicine is as out of control as the banks and is unaffordable globally.

Lesson two: Inequalities in our world are gross and need to be tackled.

Lesson three: The Victorians eventually couldn’t live with the difference between rich and poor, and we got income tax with substantial transfers of wealth within countries. We now need such transfers between countries.

Lesson four: You can’t have healthy people without healthy places.

Lesson five: We may not like to think in terms of money, but we have to pay close attention to costs—returning to the utilitarian roots of public health.

Lesson six: How we die may make a huge difference, and there are positive signs of the compression of morbidity. We must promote the idea that death is normal and a friend.

Lesson seven: New challenges need new ways of thinking and behaving.

Lesson eight: ideology can get in the way of progress.

Lesson nine: developing countries don’t have to follow the disastrous path of developed countries but can leapfrog their failures.

Lesson ten: the rich can learn from developing countries.

It is lesson 4 that has particular relevance to CAHA as Richard explains, “…healthy places will begin to disappear as our planet becomes sicker. We need a healthy planet in order to have healthy places, and luckily what is good for individuals—avoiding motorised transport and exercising more and eating more fruit and vegetables and fewer animal products– is also good for the planet.”

But all the lessons are relevant to CAHA. For example one of the key messages from the Marmot Review was that tackling social inequalities in health and tackling climate change must go together.

The message for me is that the major changes required to tackle failing health systems and the urgent need to develop alternate approaches is interconnected with the need to do the same for climate change.

You can see Richard’s presentation at http://www.3four50.com/v2/index.php?page=video2&cat=8&subcat=22&p=1 and read his full blog here

http://blogs.bmj.com/bmj/2010/07/09/richard-smith-rediscovering-public-health-through-global-health/