• Maiy Azize

17 March 2010The National Pain Summit took up the challenge of improving the way the system deals with pain, writes Maiy Azize

LAST WEEK, over 130 representatives of the health sector came together at Parliament House to discuss the treatment and management of pain in Australia. The National Pain Summit brought together clinicians and health practitioners, consumers, carers and national stakeholders to contribute to building a National Pain Strategy. The summit was facilitated by Dr Norman Swan, a brilliant public health advocate.

The summit featured a range of presentations, diverse delegates and international speakers reporting on progress in North America and the United Kingdom. Delegates learned about the economic impact of chronic pain, which amounts to several billion dollars a year in health care costs, lost income and lost productivity. Some figures put the costs at over $30 billion in Australia, with comparable costs recorded in countries such as Canada and the United Kingdom. Work is also being done in both Canada and the United Kingdom to develop strategies to address chronic pain, and, to alleviate the cost on health systems.

Although the international speakers and clinicians provided important insights, the most powerful material was presented to delegates at the beginning of the day.

The summit began with the first-hand story of a patient, delivered by Helen Owens, a prominent health economist with a long background in the health sector. She was diagnosed with breast cancer in its late stages, beginning a lifelong journey of managing and treating the chronic pain that accompanied her condition. Helen ultimately had to leave her job as a result of the persistent pain she suffered. She acknowledged that she received high quality care at times, but described a personal experience that was characterised by poor communication with practitioners and contradictory advice.

The next presentation was a carer’s story, delivered by Olympic swimming champion Kieran Perkins. Kieran spoke about the persistent migraines suffered by his wife Samantha and the years spent by their family travelling between hospitals, clinics, doctors and specialists. Like Helen, Kieran acknowledged that he and his wife received excellent care at some points in their journey, but that the care was completely fragmented. The lack of communication and empathy between the many doctors they came into contact with compounded their stress, and time and time again he reported being ignored by the practitioners that were providing treatment.

These two stories set a powerful tone for the rest of the day. After these two presentations, Norman Swan issued a challenge to the rest of the presenters and all of the summit’s delegates: If a woman as well-connected in the health sector as Helen Owens, and a family as high-profile as the Perkins, cannot access high-quality treatment for chronic pain, who can? How can the summit and its delegates build a plan that’s focused on frontline implementation?

It was a formidable challenge. One practical model was presented by a non-clinical presenter, Tim Piper of the Australian Industry Group. He reported on an innovative model focused on building a healthy workplace, where the experience of chronic pain can sometimes be compounded. He called it “Empathetic Doctors,” and it involves full, free access to a general practitioner in the workplace one day per week to gain their trust and assist them to manage their pain within their workplace. Over time, the doctor came to intimately understand the health issues facing the employees.

In this workplace, employees were healthier, happier, more satisfied and able to manage their pain at work with the assistance of the doctor. In this case, the model was supported by all stakeholders, including the employees, the employers and their union. This is an innovative approach that helps to support pain management, not just at home and in a clinical setting, but critically, at work, where Australians spend one third of their time.

When it came to building an action plan based on the Draft National Pain Strategy, organisations committed to work together to build a national coalition, modelled on beyondblue, aimed at destigmatising chronic and persistent pain. Given how well beyondblue was championed nationally, delegates agreed that identifying a champion or ambassador to represent the coalition was a priority.

Other actions included identifying local service providers to enable self-management amongst patients and consumers. Strategies were also developed to improve lobbying to Government and research bodies. A preliminary taskforce was formed to build a national research agenda to engender some direction to group.

From my perspective, the most encouraging thing about the summit from was the commitment from everybody to ensure that responses to chronic pain were centred around consumers and their needs. Given the extent to which patients suffering with chronic pain have been stigmatised, here’s hoping the summit will help to put pain on the health agenda, and, that consumers will be at the centre of it. •

Maiy Azize works in health social policy development in Canberra.

Photo: Andrew Jeffrey