President’s perspective

We continue to be challenged by the ongoing COVID-19 pandemic and the impact it has on our patients and the health system with many healthcare workers tired and rundown. The pandemic has truly exposed many aspects of our healthcare system that need to be fixed to ensure long-term sustainability. One of the issues that we have been advocating for strongly over the last two years is that of elective surgery. Governments have been banning elective surgery without consultation with surgeons and other experts who can help inform such decisions. While it is good to see elective surgery resuming albeit in a staged manner in some jurisdictions, governments must have short-term and long-term plans to manage the community need for elective surgery in a more nuanced manner that puts patients first. As surgeons we understand the different pressures on the public and private health sectors especially in this COVID-19 environment, but we also know that elective surgery closures don’t free up hospital capacity. There is absolutely no reason why surgery cannot continue in some areas without impacting the COVID-19 response. Another recommendation we have made is for governments to develop plans that allow for individual flexibility and decisionmaking at the local level for a prompt response to patient needs. An added concern we have shared with governments is the use of terminologies such as ‘elective surgery’, which could be interpreted as meaning ‘non-essential’, which is incorrect. In time we plan to address the current categorisation system used and work towards a better system, more relevant to current requirements and to use in the future. In December 2021, we were pleased that Ahpra and the Medical Board of Australia announced that they will conduct an external review of patient safety issues in the cosmetic surgery sector.

Australians rightly expect all surgical procedures to be performed to the highest possible standards and meet nationally established surgical standards. We would like the enquiry to focus on the transparency of training. Any surgery entails risk, and it is critical that the enquiry establishes clear guidelines into the training required to conduct surgery. The practices of some health practitioners have caused significant harm to patients. We also welcomed the Australian Health Ministers’ commitment to national consultation on changing the national law to protect the title of ‘surgeon’. We have been advocating for a long time that only those registered in specialties that undergo Australian Medical Council (AMC) accredited training programs, which include a significant surgical component, should be allowed to use ‘surgeon’ in their titles.

There is much work to be done in both these areas. It is critical that we work closely together with our specialty societies and other stakeholders such as the Australian Medical Association to advocate for outcomes that will benefit our patients and the community at large. Although this is an Australian enquiry, Aotearoa New Zealand has the same concerns about use of the title ‘surgeon’. As things start to open up, I hope that we will be able to move more freely. The New Zealand government recently announced that by the end of February 2022, fully vaccinated New Zealand citizens and other eligible travellers under our current border settings can travel to Aotearoa New Zealand from Australia without staying in managed isolation and quarantine. Such returnees must have spent a minimum of 14 days in Australia and will still have to spend 10 days in ‘home isolation’ with Rapid Antigen Testing. I hope we will see some of you travelling between our countries in the next few months as the steps toward easier travel are made. I look forward to visiting Australia and seeing colleagues and our RACS staff in-person. One of the events that I am looking forward to is the 90th Annual Scientific Congress (ASC) of the Royal Australasian College of Surgeons to be held in May in Brisbane, southeast Queensland. The Congress theme is ‘Sustainability in the Dispersed Workplace’. This brings in many aspects of our surgical practice such as environmental sustainability, sustainability of the workforce and education of the workforce, as well as the use of telehealth and other information technology methods to aid delivery of surgical care. In May 2021, we held our first hybrid RACS ASC in Melbourne. Our ability to host a complex multi-stream hybrid event has been proven and has allowed more people to benefit from the presentations. The virtual congress will again be available for those who cannot attend all presentations that they wish to at the time.

Along with this year’s conveners, Professor Chris Pyke and Professor Deborah Bailey and the 2022 RACS ASC Brisbane organising committee, I look forward to welcoming you to the Brisbane Convention and Exhibition Centre from Monday 2 – Friday 6 May 2022. To register visit asc.surgeons.org In February 2022, I was pleased to host the inaugural Environmental Sustainability in Surgical Practice webinar. The webinar focused on examining the environmental impacts of surgical practice and provided practical tips for how medical professionals can reduce their own carbon footprints. It was good to see such a great turnout at the webinar. Thank you to our presenters, Dr Ben Dunne, Professor Lynne Madden and Dr Rennie Qin for sharing their knowledge and expertise in this area. For those of you who were not able to join us, the webinar will be available on our website for viewing. We certainly have a busy year ahead and I am sure there will be no shortage of challenges and opportunities ahead of us, but like many of you, I am looking forward to a more positive year. I suspect that many of you have been entertained for a few minutes each day by ‘wordle’, the stimulating and popular daily word game that has become a cultural phenomenon. I wonder whether FRACS will come up one day.

Dr Sally Langley President