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Brexit has silenced those who want to break up the NHS | Denis Campbell

Last week, one of the country’s most senior doctors explained over lunch how he had reluctantly come to believe that scandalous underfunding, catastrophic understaffing and the service’s resulting inability to deal properly with the rising tide of illness mean that “the NHS is dying”.

Certainly there is plenty of evidence of stress and overburdening – long A&E waiting times, dangerous bed occupancy rates and delays in treatment are testament to that. But in the year that the NHS celebrates its 70th birthday, reassuringly few people think the health service has had its day.


Voters blame ministers rather than the service itself for its inability to be good all the time

At a recent private discussion co-hosted by the King’s Fund and pollsters Ipsos Mori as part of a major joint research project on the public’s relationship with the NHS, a roughly representative sample of the population was asked which statement most closely captured their views: the NHS remains crucial to British society and we should do everything we can to maintain it, or the NHS was a great project but one that probably cannot be maintained in its current form. About 75% chose the former, in line with the 77% who did so in more scientific polling undertaken by the two organisations last autumn.

Although last month’s latest British Social Attitudes survey results shows a big drop in public satisfaction with the NHS, voters blame ministers rather than the service itself, and especially not its beleaguered staff, for its inability to be good all the time.

Unexpectedly, Brexit is protecting the NHS from malign political moves – by having a pledge for £350m for the NHS emblazoned on its battlebus, leave campaigners have ensured the argument is about how to get more money for the health service, not break it up.

There is growing public support for a hypothecated tax to give the NHS more money, an idea the government is now seriously considering. Despite the mindset among some Tories that extra money for the NHS is like pouring water on to sand, the government has stuck its hand in its pockets. The budget in November 2017 saw the chancellor give the NHS an unplanned £2.8bn rise over two years, while last week’s spring statement hinted at more to come this autumn. Health union leaders hope they have the broad outline of a deal that is sellable to their members but fear that a grassroots revolt against giving up a day’s holiday in return for a payrise could scupper any prospect of an agreement. The voices in Westminster that advocate irrevocably changing the NHS’s unique taxpayer-funded model are silent, for now at least. That is a birthday gift worth receiving.

Denis Campbell is the Guardian’s health policy editor

Brexit has silenced those who want to break up the NHS | Denis Campbell

Last week, one of the country’s most senior doctors explained over lunch how he had reluctantly come to believe that scandalous underfunding, catastrophic understaffing and the service’s resulting inability to deal properly with the rising tide of illness mean that “the NHS is dying”.

Certainly there is plenty of evidence of stress and overburdening – long A&E waiting times, dangerous bed occupancy rates and delays in treatment are testament to that. But in the year that the NHS celebrates its 70th birthday, reassuringly few people think the health service has had its day.


Voters blame ministers rather than the service itself for its inability to be good all the time

At a recent private discussion co-hosted by the King’s Fund and pollsters Ipsos Mori as part of a major joint research project on the public’s relationship with the NHS, a roughly representative sample of the population was asked which statement most closely captured their views: the NHS remains crucial to British society and we should do everything we can to maintain it, or the NHS was a great project but one that probably cannot be maintained in its current form. About 75% chose the former, in line with the 77% who did so in more scientific polling undertaken by the two organisations last autumn.

Although last month’s latest British Social Attitudes survey results shows a big drop in public satisfaction with the NHS, voters blame ministers rather than the service itself, and especially not its beleaguered staff, for its inability to be good all the time.

Unexpectedly, Brexit is protecting the NHS from malign political moves – by having a pledge for £350m for the NHS emblazoned on its battlebus, leave campaigners have ensured the argument is about how to get more money for the health service, not break it up.

There is growing public support for a hypothecated tax to give the NHS more money, an idea the government is now seriously considering. Despite the mindset among some Tories that extra money for the NHS is like pouring water on to sand, the government has stuck its hand in its pockets. The budget in November 2017 saw the chancellor give the NHS an unplanned £2.8bn rise over two years, while last week’s spring statement hinted at more to come this autumn. Health union leaders hope they have the broad outline of a deal that is sellable to their members but fear that a grassroots revolt against giving up a day’s holiday in return for a payrise could scupper any prospect of an agreement. The voices in Westminster that advocate irrevocably changing the NHS’s unique taxpayer-funded model are silent, for now at least. That is a birthday gift worth receiving.

Denis Campbell is the Guardian’s health policy editor

Brexit has silenced those who want to break up the NHS | Denis Campbell

Last week, one of the country’s most senior doctors explained over lunch how he had reluctantly come to believe that scandalous underfunding, catastrophic understaffing and the service’s resulting inability to deal properly with the rising tide of illness mean that “the NHS is dying”.

Certainly there is plenty of evidence of stress and overburdening – long A&E waiting times, dangerous bed occupancy rates and delays in treatment are testament to that. But in the year that the NHS celebrates its 70th birthday, reassuringly few people think the health service has had its day.


Voters blame ministers rather than the service itself for its inability to be good all the time

At a recent private discussion co-hosted by the King’s Fund and pollsters Ipsos Mori as part of a major joint research project on the public’s relationship with the NHS, a roughly representative sample of the population was asked which statement most closely captured their views: the NHS remains crucial to British society and we should do everything we can to maintain it, or the NHS was a great project but one that probably cannot be maintained in its current form. About 75% chose the former, in line with the 77% who did so in more scientific polling undertaken by the two organisations last autumn.

Although last month’s latest British Social Attitudes survey results shows a big drop in public satisfaction with the NHS, voters blame ministers rather than the service itself, and especially not its beleaguered staff, for its inability to be good all the time.

Unexpectedly, Brexit is protecting the NHS from malign political moves – by having a pledge for £350m for the NHS emblazoned on its battlebus, leave campaigners have ensured the argument is about how to get more money for the health service, not break it up.

There is growing public support for a hypothecated tax to give the NHS more money, an idea the government is now seriously considering. Despite the mindset among some Tories that extra money for the NHS is like pouring water on to sand, the government has stuck its hand in its pockets. The budget in November 2017 saw the chancellor give the NHS an unplanned £2.8bn rise over two years, while last week’s spring statement hinted at more to come this autumn. Health union leaders hope they have the broad outline of a deal that is sellable to their members but fear that a grassroots revolt against giving up a day’s holiday in return for a payrise could scupper any prospect of an agreement. The voices in Westminster that advocate irrevocably changing the NHS’s unique taxpayer-funded model are silent, for now at least. That is a birthday gift worth receiving.

Denis Campbell is the Guardian’s health policy editor

Brexit has silenced those who want to break up the NHS | Denis Campbell

Last week, one of the country’s most senior doctors explained over lunch how he had reluctantly come to believe that scandalous underfunding, catastrophic understaffing and the service’s resulting inability to deal properly with the rising tide of illness mean that “the NHS is dying”.

Certainly there is plenty of evidence of stress and overburdening – long A&E waiting times, dangerous bed occupancy rates and delays in treatment are testament to that. But in the year that the NHS celebrates its 70th birthday, reassuringly few people think the health service has had its day.


Voters blame ministers rather than the service itself for its inability to be good all the time

At a recent private discussion co-hosted by the King’s Fund and pollsters Ipsos Mori as part of a major joint research project on the public’s relationship with the NHS, a roughly representative sample of the population was asked which statement most closely captured their views: the NHS remains crucial to British society and we should do everything we can to maintain it, or the NHS was a great project but one that probably cannot be maintained in its current form. About 75% chose the former, in line with the 77% who did so in more scientific polling undertaken by the two organisations last autumn.

Although last month’s latest British Social Attitudes survey results shows a big drop in public satisfaction with the NHS, voters blame ministers rather than the service itself, and especially not its beleaguered staff, for its inability to be good all the time.

Unexpectedly, Brexit is protecting the NHS from malign political moves – by having a pledge for £350m for the NHS emblazoned on its battlebus, leave campaigners have ensured the argument is about how to get more money for the health service, not break it up.

There is growing public support for a hypothecated tax to give the NHS more money, an idea the government is now seriously considering. Despite the mindset among some Tories that extra money for the NHS is like pouring water on to sand, the government has stuck its hand in its pockets. The budget in November 2017 saw the chancellor give the NHS an unplanned £2.8bn rise over two years, while last week’s spring statement hinted at more to come this autumn. Health union leaders hope they have the broad outline of a deal that is sellable to their members but fear that a grassroots revolt against giving up a day’s holiday in return for a payrise could scupper any prospect of an agreement. The voices in Westminster that advocate irrevocably changing the NHS’s unique taxpayer-funded model are silent, for now at least. That is a birthday gift worth receiving.

Denis Campbell is the Guardian’s health policy editor

Brexit has silenced those who want to break up the NHS | Denis Campbell

Last week, one of the country’s most senior doctors explained over lunch how he had reluctantly come to believe that scandalous underfunding, catastrophic understaffing and the service’s resulting inability to deal properly with the rising tide of illness mean that “the NHS is dying”.

Certainly there is plenty of evidence of stress and overburdening – long A&E waiting times, dangerous bed occupancy rates and delays in treatment are testament to that. But in the year that the NHS celebrates its 70th birthday, reassuringly few people think the health service has had its day.


Voters blame ministers rather than the service itself for its inability to be good all the time

At a recent private discussion co-hosted by the King’s Fund and pollsters Ipsos Mori as part of a major joint research project on the public’s relationship with the NHS, a roughly representative sample of the population was asked which statement most closely captured their views: the NHS remains crucial to British society and we should do everything we can to maintain it, or the NHS was a great project but one that probably cannot be maintained in its current form. About 75% chose the former, in line with the 77% who did so in more scientific polling undertaken by the two organisations last autumn.

Although last month’s latest British Social Attitudes survey results shows a big drop in public satisfaction with the NHS, voters blame ministers rather than the service itself, and especially not its beleaguered staff, for its inability to be good all the time.

Unexpectedly, Brexit is protecting the NHS from malign political moves – by having a pledge for £350m for the NHS emblazoned on its battlebus, leave campaigners have ensured the argument is about how to get more money for the health service, not break it up.

There is growing public support for a hypothecated tax to give the NHS more money, an idea the government is now seriously considering. Despite the mindset among some Tories that extra money for the NHS is like pouring water on to sand, the government has stuck its hand in its pockets. The budget in November 2017 saw the chancellor give the NHS an unplanned £2.8bn rise over two years, while last week’s spring statement hinted at more to come this autumn. Health union leaders hope they have the broad outline of a deal that is sellable to their members but fear that a grassroots revolt against giving up a day’s holiday in return for a payrise could scupper any prospect of an agreement. The voices in Westminster that advocate irrevocably changing the NHS’s unique taxpayer-funded model are silent, for now at least. That is a birthday gift worth receiving.

Denis Campbell is the Guardian’s health policy editor

Does my nose look big in this? Plastic surgeons reassure those worried by selfies

If a penchant for selfies has left you worried about the size of your nose, you might want to consider a selfie-stick.

Researchers say selfie-lovers should be aware that snapping a picture with the camera close to your face distorts the proportions of your features.

“If the camera point is closer to something that projects out, like your nose, it is going to make everything that is closer to that camera look bigger compared to the rest of the face,” said Boris Paskhover, co-author of the study and a facial plastic surgeon at Rutgers New Jersey Medical School.

To illustrate the point, Paskhover and colleagues combined a simple mathematical model with average values for several facial measurements previously gathered for a large number of men and women in the US.

The results show that a face-on portrait taken from 12 inches away makes the nose’s breadth appear about 30% larger – compared to width of the face – than it really is. In such photos the tip of the nose also appears 7% bigger, compared to the rest of the nose, than it is in reality. By contrast, an image taken five feet away results in facial features appearing in the same proportions as they would in the flesh.

Selfie distance

“[That] is actually a standard photographic distance – photographers take portraits at five feet; when I take pictures of patients, I take them at five feet,” said Paskhover.

According to a survey published in January by the the American Academy of Facial Plastic and Reconstructive Surgery, 55% of facial plastic surgeons report that patients have said they want to improve their looks in selfies.

“I, for years, have seen that patients – and family members of mine and people in general around me – always say ‘hey, my nose looks so big’,” said Paskhover. But, he added, when they take out a picture, it is usually a selfie on their phone.

Paskhover noted that cosmetic nose surgery is more common in the younger population, typically young females. But, he said, the message was not just for people seeking surgery.

“Kids need to know that is not what you look like: you look great, don’t worry about that,” said Paskhover. “The selfie is kind of like a fun-house mirror.”

Does my nose look big in this? Plastic surgeons reassure those worried by selfies

If a penchant for selfies has left you worried about the size of your nose, you might want to consider a selfie-stick.

Researchers say selfie-lovers should be aware that snapping a picture with the camera close to your face distorts the proportions of your features.

“If the camera point is closer to something that projects out, like your nose, it is going to make everything that is closer to that camera look bigger compared to the rest of the face,” said Boris Paskhover, co-author of the study and a facial plastic surgeon at Rutgers New Jersey Medical School.

To illustrate the point, Paskhover and colleagues combined a simple mathematical model with average values for several facial measurements previously gathered for a large number of men and women in the US.

The results show that a face-on portrait taken from 12 inches away makes the nose’s breadth appear about 30% larger – compared to width of the face – than it really is. In such photos the tip of the nose also appears 7% bigger, compared to the rest of the nose, than it is in reality. By contrast, an image taken five feet away results in facial features appearing in the same proportions as they would in the flesh.

Selfie distance

“[That] is actually a standard photographic distance – photographers take portraits at five feet; when I take pictures of patients, I take them at five feet,” said Paskhover.

According to a survey published in January by the the American Academy of Facial Plastic and Reconstructive Surgery, 55% of facial plastic surgeons report that patients have said they want to improve their looks in selfies.

“I, for years, have seen that patients – and family members of mine and people in general around me – always say ‘hey, my nose looks so big’,” said Paskhover. But, he added, when they take out a picture, it is usually a selfie on their phone.

Paskhover noted that cosmetic nose surgery is more common in the younger population, typically young females. But, he said, the message was not just for people seeking surgery.

“Kids need to know that is not what you look like: you look great, don’t worry about that,” said Paskhover. “The selfie is kind of like a fun-house mirror.”

Those who need it most don’t get psychiatric care. It’s a mental health crisis | Vyom Sharma

What, precisely, is a crisis? Generally, things have to get pretty bad to be defined as one. “Housing”, “North Korean”, and ”global financial” have all seemed to earn that suffix. The problem with defining “crisis” is partly one of banality through overuse – if you believe even half of what you read, we are perpetually beset by it, in one form or another. So hearing the c-word in a context anything less than epic tends to be accompanied with a faint echo of hyperbole, and twinges of cynicism.

This cynicism can be a trap – it certainly was for me. Within the last decade of practicing medicine, I felt like if I had a dollar for every time I heard the words “mental health crisis”, I could single-handedly fund its fix. The phrase became a cliché. Over time, experience within the system bred familiarity, which spawned complacency.

Crisis is a word without a standard metric, common barometer, and sharp threshold. Its precise definition is akin to asking how long a piece of rope is. The only true answer is that it depends. But you know when you have enough to tie a noose. This week we’ve learned precisely how long that piece of rope is: a Victorian man who killed his mother amid a psychotic episode had to wait 14 months for a bed in a psychiatric hospital.

This is a new low. It’s bad enough that people die without getting adequate psychiatric help. But it turns out even killing someone else isn’t enough to qualify for psychiatric care. This is about as clear a demonstration of a “mental health crisis” as we will get.

To attribute this failure to an unfortunate lapse is to deny the very real, systemic problems that arise from mental healthcare being underfunded. This event did not occur in a vacuum. A deeper look exposes how the system, in its current state, is geared to end in such horrors.

Often the people most seriously afflicted by mental illness are the poorest, who cannot afford private psychiatric care. The problem is that publicly funded outpatient clinics are in very short supply. So often the only way to access psychiatric care out in the community is through “Catt” – Crisis Assessment and Treatment Team. That’s right, the only guaranteed way to be quickly linked in with publicly funded psychiatric care is to be in crisis. That’s how the system works.

Many patients have only this option available because they are in a strange chasm – not unwell enough to warrant a 000 call, but too unwell to wait weeks to see a private psychiatrist even if they can afford to see one. So the Catt service is often overburdened. GPs around Australia have a morose, longstanding joke about this; we say that the letters in Catt stand for “Can’t Attend Today Team”. When the “crisis” team is too busy to attend, you know there’s a problem.

This is not an indictment on the service – far from it. To say it is “overloaded” is like calling an acrobatic plate spinner “busy”. It is a job requiring a rare constitution – infinite patience, high stakes decisions, the ability to treat people who are of threat to themselves and others, and being firsthand witness to tragedy after tragedy. I’ve often seen Catt workers as patients for their own mental health. It might be a crisis in and of itself.

Depressingly, it seems the people viewing the situation with most clarity might be our youngest. Findings from Mission Australia Survey published this week show that Australians aged 15 to 19 ranked mental health as the issue of greatest national concern. Most worryingly, they identified mental health as an impediment to their future pursuits. The nurturing of at-risk adolescents through mental healthcare ought to bolster their optimism, but the failings of our system might be eroding it.

Statistics and position statements fail to capture these moments of clarity about our health system. And sometimes, reading cold statistics on per-capita funding, or wait times, without having to personally experience their impact, lulls you into the trap of confusing complaints for hyperbole.

There is another trap we can fall into. It’s one I was in for years. That trap is the belief that Australian healthcare, ranked consistently within the top-ten in the world is, overall, brilliant. That statement is undeniably true, and yet the key word here is “overall”.

If you forget those with mental illness, Indigenous Australians, LGBTIQ community, refugees and other at-risk groups, we’re doing spectacularly. The problem is that we are a country largely composed of at-risk groups. If you aren’t marginalised in this country, chances are you once were, or are descended from someone who was, or are shoulder-to-shoulder with someone who stands at the margins. And it’s at the margins where crisis thrives. That’s where we have to look to see the crisis for what it truly is.

Dr Vyom Sharma is a GP in Melbourne and a health commentator

Those who need it most don’t get psychiatric care. It’s a mental health crisis | Vyom Sharma

What, precisely, is a crisis? Generally, things have to get pretty bad to be defined as one. “Housing”, “North Korean”, and ”global financial” have all seemed to earn that suffix. The problem with defining “crisis” is partly one of banality through overuse – if you believe even half of what you read, we are perpetually beset by it, in one form or another. So hearing the c-word in a context anything less than epic tends to be accompanied with a faint echo of hyperbole, and twinges of cynicism.

This cynicism can be a trap – it certainly was for me. Within the last decade of practicing medicine, I felt like if I had a dollar for every time I heard the words “mental health crisis”, I could single-handedly fund its fix. The phrase became a cliché. Over time, experience within the system bred familiarity, which spawned complacency.

Crisis is a word without a standard metric, common barometer, and sharp threshold. Its precise definition is akin to asking how long a piece of rope is. The only true answer is that it depends. But you know when you have enough to tie a noose. This week we’ve learned precisely how long that piece of rope is: a Victorian man who killed his mother amid a psychotic episode had to wait 14 months for a bed in a psychiatric hospital.

This is a new low. It’s bad enough that people die without getting adequate psychiatric help. But it turns out even killing someone else isn’t enough to qualify for psychiatric care. This is about as clear a demonstration of a “mental health crisis” as we will get.

To attribute this failure to an unfortunate lapse is to deny the very real, systemic problems that arise from mental healthcare being underfunded. This event did not occur in a vacuum. A deeper look exposes how the system, in its current state, is geared to end in such horrors.

Often the people most seriously afflicted by mental illness are the poorest, who cannot afford private psychiatric care. The problem is that publicly funded outpatient clinics are in very short supply. So often the only way to access psychiatric care out in the community is through “Catt” – Crisis Assessment and Treatment Team. That’s right, the only guaranteed way to be quickly linked in with publicly funded psychiatric care is to be in crisis. That’s how the system works.

Many patients have only this option available because they are in a strange chasm – not unwell enough to warrant a 000 call, but too unwell to wait weeks to see a private psychiatrist even if they can afford to see one. So the Catt service is often overburdened. GPs around Australia have a morose, longstanding joke about this; we say that the letters in Catt stand for “Can’t Attend Today Team”. When the “crisis” team is too busy to attend, you know there’s a problem.

This is not an indictment on the service – far from it. To say it is “overloaded” is like calling an acrobatic plate spinner “busy”. It is a job requiring a rare constitution – infinite patience, high stakes decisions, the ability to treat people who are of threat to themselves and others, and being firsthand witness to tragedy after tragedy. I’ve often seen Catt workers as patients for their own mental health. It might be a crisis in and of itself.

Depressingly, it seems the people viewing the situation with most clarity might be our youngest. Findings from Mission Australia Survey published this week show that Australians aged 15 to 19 ranked mental health as the issue of greatest national concern. Most worryingly, they identified mental health as an impediment to their future pursuits. The nurturing of at-risk adolescents through mental healthcare ought to bolster their optimism, but the failings of our system might be eroding it.

Statistics and position statements fail to capture these moments of clarity about our health system. And sometimes, reading cold statistics on per-capita funding, or wait times, without having to personally experience their impact, lulls you into the trap of confusing complaints for hyperbole.

There is another trap we can fall into. It’s one I was in for years. That trap is the belief that Australian healthcare, ranked consistently within the top-ten in the world is, overall, brilliant. That statement is undeniably true, and yet the key word here is “overall”.

If you forget those with mental illness, Indigenous Australians, LGBTIQ community, refugees and other at-risk groups, we’re doing spectacularly. The problem is that we are a country largely composed of at-risk groups. If you aren’t marginalised in this country, chances are you once were, or are descended from someone who was, or are shoulder-to-shoulder with someone who stands at the margins. And it’s at the margins where crisis thrives. That’s where we have to look to see the crisis for what it truly is.

Dr Vyom Sharma is a GP in Melbourne and a health commentator

Those who need it most don’t get psychiatric care. It’s a mental health crisis | Vyom Sharma

What, precisely, is a crisis? Generally, things have to get pretty bad to be defined as one. “Housing”, “North Korean”, and ”global financial” have all seemed to earn that suffix. The problem with defining “crisis” is partly one of banality through overuse – if you believe even half of what you read, we are perpetually beset by it, in one form or another. So hearing the c-word in a context anything less than epic tends to be accompanied with a faint echo of hyperbole, and twinges of cynicism.

This cynicism can be a trap – it certainly was for me. Within the last decade of practicing medicine, I felt like if I had a dollar for every time I heard the words “mental health crisis”, I could single-handedly fund its fix. The phrase became a cliché. Over time, experience within the system bred familiarity, which spawned complacency.

Crisis is a word without a standard metric, common barometer, and sharp threshold. Its precise definition is akin to asking how long a piece of rope is. The only true answer is that it depends. But you know when you have enough to tie a noose. This week we’ve learned precisely how long that piece of rope is: a Victorian man who killed his mother amid a psychotic episode had to wait 14 months for a bed in a psychiatric hospital.

This is a new low. It’s bad enough that people die without getting adequate psychiatric help. But it turns out even killing someone else isn’t enough to qualify for psychiatric care. This is about as clear a demonstration of a “mental health crisis” as we will get.

To attribute this failure to an unfortunate lapse is to deny the very real, systemic problems that arise from mental healthcare being underfunded. This event did not occur in a vacuum. A deeper look exposes how the system, in its current state, is geared to end in such horrors.

Often the people most seriously afflicted by mental illness are the poorest, who cannot afford private psychiatric care. The problem is that publicly funded outpatient clinics are in very short supply. So often the only way to access psychiatric care out in the community is through “Catt” – Crisis Assessment and Treatment Team. That’s right, the only guaranteed way to be quickly linked in with publicly funded psychiatric care is to be in crisis. That’s how the system works.

Many patients have only this option available because they are in a strange chasm – not unwell enough to warrant a 000 call, but too unwell to wait weeks to see a private psychiatrist even if they can afford to see one. So the Catt service is often overburdened. GPs around Australia have a morose, longstanding joke about this; we say that the letters in Catt stand for “Can’t Attend Today Team”. When the “crisis” team is too busy to attend, you know there’s a problem.

This is not an indictment on the service – far from it. To say it is “overloaded” is like calling an acrobatic plate spinner “busy”. It is a job requiring a rare constitution – infinite patience, high stakes decisions, the ability to treat people who are of threat to themselves and others, and being firsthand witness to tragedy after tragedy. I’ve often seen Catt workers as patients for their own mental health. It might be a crisis in and of itself.

Depressingly, it seems the people viewing the situation with most clarity might be our youngest. Findings from Mission Australia Survey published this week show that Australians aged 15 to 19 ranked mental health as the issue of greatest national concern. Most worryingly, they identified mental health as an impediment to their future pursuits. The nurturing of at-risk adolescents through mental healthcare ought to bolster their optimism, but the failings of our system might be eroding it.

Statistics and position statements fail to capture these moments of clarity about our health system. And sometimes, reading cold statistics on per-capita funding, or wait times, without having to personally experience their impact, lulls you into the trap of confusing complaints for hyperbole.

There is another trap we can fall into. It’s one I was in for years. That trap is the belief that Australian healthcare, ranked consistently within the top-ten in the world is, overall, brilliant. That statement is undeniably true, and yet the key word here is “overall”.

If you forget those with mental illness, Indigenous Australians, LGBTIQ community, refugees and other at-risk groups, we’re doing spectacularly. The problem is that we are a country largely composed of at-risk groups. If you aren’t marginalised in this country, chances are you once were, or are descended from someone who was, or are shoulder-to-shoulder with someone who stands at the margins. And it’s at the margins where crisis thrives. That’s where we have to look to see the crisis for what it truly is.

Dr Vyom Sharma is a GP in Melbourne and a health commentator