President’s perspective

Our health systems are under stress. The continuation of COVID-19 and the early onset of the influenza season in our winter are resulting in a huge surge of patients presenting to primary care and hospitals around Australia and Aotearoa New Zealand. We also continue to have staff shortages with many health workers either sick, on furlough or in need of a break from the relentless demands on them. Workforce availability will continue to be a challenge for some time to come. As a result of these, many hospitals are making the difficult decision to defer surgery, including urgent category-one procedures in Australia. In some regions of Aotearoa New Zealand, everything except urgent, non-deferrable surgery is on hold in public hospitals; whereas private surgery continues depending on staffing levels. Many primary care clinics in Aotearoa New Zealand are reporting that they are understaffed and patients are struggling to get appointments. We are seeing a definite increase in the use of telehealth consultations and this will certainly be the way of the future. We as surgeons must remember that we can undertake many of our consultations by technology assisted methods and this has the benefit of less travel for patients and possibly shorter consultations for the surgeon. I hope that we will once again overcome these pandemic challenges as spring comes and the warmer weather hopefully minimises the spread and impact of COVID-19 and influenza.

On a more positive note, RACS Council approved the Aotearoa New Zealand Regional and Rural Health Equity strategy, which focuses on tailoring solutions to address the country’s specific issues and apply a Māori health lens as per the principles outlined in Te Tiriti o Waitangi (The Treaty of Waitangi) and Te Rautaki Māori (RACS Māori Health Action Plan). This is supplementary to the College’s Rural Health Equity Strategy, which has successfully been running activities in both countries for the past 18 months. The strategies aim to improve health equity for remote, rural and regional or provincial people in our countries by increasing the surgical workforce and building sustainable surgical services in these areas. Promoting rural equity is a key priority in the College’s strategic plan and we have asked for rural representation on all RACS committees and the inclusion of a rural health equity standing item on all relevant agendas. I recently participated in the Urological Society of Australia and New Zealand’s (USANZ) annual scientific meeting held at the Gold Coast in Queensland. It was an impressive well attended event with excellent education sessions and many

national and international presenters. I noted that all Trainees in urological surgery were required to attend and there was a significant urological nurses conference. Well done, USANZ. Our vice president Professor Chris Pyke and I look forward to attending more specialty society scientific meetings and we regret not being able to attend all of them. In June, we celebrated two significant events in both of our countries. In Aotearoa New Zealand, we had our first ever Matariki public holiday. Matariki celebrates the Māori New Year, a time for celebration, growth and renewal and for communities to come together. It also symbolises the government’s willingness to acknowledge events and celebrations of importance to Māori. In Australia we also celebrated NAIDOC Week and held several events at the College to remember the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. I would like to mention that World Sepsis Day is on 13 September. The major health problem of sepsis is a concern to all of us in medicine including all of our surgical specialties. Recently at June Council we approved the Australian Commission on Safety and Quality Health Care ACSQHC Sepsis Clinical Care Standard 2022 (Australia). Aotearoa New Zealand also has standards for sepsis care based on the National Institute for health and Care Excellence (NICE) guidelines 2016 (bit. ly/3S5juT6). This is part of the National Sepsis Program (Australia) which aims to improve early recognition, treatment, outcomes and post-discharge support for people at risk of or diagnosed with sepsis. I encourage you to look at the guidelines. I have many people to congratulate and will start with our new Fellows who have joined the College. Welcome and congratulations on your achievement. I encourage you to be active members of the College by learning more about what we do and volunteer for one of our many initiatives we have.

Souella Cumming My warm congratulations also to our recipients of the 2022 Queen’s Birthday Honours, including Souella Cumming, our Aotearoa New Zealand Expert Community Advisor.

I would like to welcome our incoming chair of the Younger Fellows Committee, Dr Shehnarz Salindera.

Congratulations also to our three elected 2023 rotating members of Council Executive: Professor Mark Ashton, Dr Christine Lai and Professor Owen Ung who will join Council Executive in January 2023 for a period of 12 months. I look forward to working with you all. On a final note, I would like to extend my warmest birthday wishes to Dr Durham Smith who this year celebrated his 100th birthday. What a momentous milestone! Dr Durham Smith is a past president of the College and is one of those names that have always stood out. I remember doing my elective in paediatric surgery as a sixth-year medical student at the Royal Children’s Hospital in Melbourne where he was based. Please take time to read his story on page 10 and learn more about this amazing surgeon and leader.

Dr Sally Langley President