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AHSRI's Professor Alan Owen Lectures are not only a tribute to our dear colleague and friend Professor Alan Owen (1952-2012), but also provide an opportunity for an informed and engaging presentation to the general public on a significant health or social issue.

Professor Alan Owen (1952—2012)

A life devoted to better outcomes for patients

Professor Alan Owen was a passionate advocate, a social networker extraordinaire, a humble teacher and an inspiration to us all. He died on November 25, 2012, aged just 60.

Alan came to work at the Centre for Health Service Development – or CHSD – in 1996. He was soon joined by his wife Linda Adamson. There were just a handful of us back then. We soon formed a successful working partnership and (what is now) the Australian Health Services Research Institute (AHSRI) is a legacy of our partnership over the last 16 years.

Alan had a consistent interest in health services policy and planning in general, and community health in particular. He was committed to promoting the capabilities of community-based health services and their integration and coordination with other services at a local level. He made important contributions to service design and evaluation projects in the areas of community support and aged care, mental health, palliative care and disability.


Career

Early in his career, Alan contributed to campaigns to influence resource allocation and to achieve community health representation more formally through the state and national Community Health Association, by serving on Boards, producing newsletters, submissions and policy papers. He also had a critical role as health policy advisor role for the Australian Council of Social Service.

A consistent theme across many of his projects was the importance of collecting and sharing information that can be used to improve the capacity to actively plan a service system. His research interests focussed on developing methods to match patient/client characteristics to the level and type of services commensurate with an individual’s needs. This led to further research questions; for example, how best to control for the variability of patient characteristics so as to be able to examine differences in service provider behaviour and referral decisions; and how to examine differences in client outcomes resulting from different service interventions or models of care. In community care, this work led to improvements in routine assessment systems through the use of standardised measures of service user characteristics.

Throughout his career Alan contributed to a range of community service activities as well as to collective efforts in health services research. He had a continuing interest in NSW and national community health services, from the beginnings of the program in the 1970s to our last review in 2008. Alan had a number of NSW Ministerial appointments, including the review of the privatisation of Port Macquarie Base Hospital in 1993, as a part-time member of the NSW Guardianship Tribunal from 1996-2009 and as a part-time member of the Mental Health Review Tribunal in NSW since 1994.


Legacy

Alan leaves a lasting professional contribution. He was a strong advocate for better mental health, aged care and community care. He believed passionately in consumer empowerment underpinned by strong public policy that emphasises fairness and decency. His work with the guardianship board and the mental health tribunal is evidence of that.

He used his extensive networks to help position us firmly in the wider strategic and policy context. His strategic thinking and sense of what is important helped shape how we work. Alan’s command of the “big picture” enabled him to see connections that were not immediately obvious to others. He was always generous in sharing these insights and providing guidance, encouragement and, often, relevant literature that would become instrumental in shaping our thinking on an issue.

In an environment where the next deadline is always looming, Alan helped us place our work in context and see its implications more clearly. He always had an eye to the next project, and was alert to future directions in which we should actively seek further work in order to build on our strengths. Borrowing from his brother Neville Owen and his colleague Adrian Bauman, Alan spent the last 16 years stressing to all of us the need to balance “realism with rigour”. We think he taught us well. His other professional legacy is that Alan supported and mentored multiple staff and students as well as aged, community and primary care professionals over many years. Alan always said that he had many more important things to do than to spend his days completing his PhD. And he was right. But that did not stop him quietly encouraging and mentoring so many other people to further their education and to set their professional goals high.

Alan had a sharp intellect and a quick wit. His clear values and his understanding of the complexity of the health system made it easy for him to work out what was important. He didn’t write a paper. He crafted it. He made us laugh. We continue to miss him every day.

PROFESSOR ALAN OWEN'S OBITUARY

Choices at end of life: palliative care, euthanasia and other end of life decisions

Friday 24 November 2017, 4:30pm, Lecture Theatre, ITAMS Building, Innovation Campus, University of Wollongong


The speaker: Senior Professor Kathy Eagar

Senior Professor Eagar is a health services researcher with a background in psychology and public health. She has over thirty five years of experience in the health and community care systems and has a detailed understanding of the broader Australian health system and good knowledge of aged care services and policy. She is the lead author of the only Australian text on health planning (Eagar K, Garrett P and Lin V (2001) Health Planning: Australian perspectives. Allen and Unwin, Sydney).

She is Director of the Australian Health Services Research Institute (AHSRI) and is involved in all aspects of the Institute’s work. AHSRI has a team of over 50 researchers covering 19 disciplines and includes eight research centres including the Centre for Health Service Development (CHSD), the Australasian Rehabilitation Outcomes Centre (AROC), the Palliative Care Outcomes Collaboration (PCOC) and the National Casemix and Classification Centre (NCCC). Kathy has a very strong track record in research translation. She has authored over 350 articles, papers and reports on management, quality, outcomes, information systems and funding of the Australia and New Zealand health and community care systems.


The lecture

Public conversation and media coverage about death and dying is increasing in response to the ageing of the baby boomers and in light of both the euthanasia debate and concerns about increasing health care costs. With an ageing population and increasing rates of chronic illnesses, end of life care is a critically important issue. Yet we are living in an ever more death-defying society and many people have little experience of death or of the options and decisions at end of life that make a difference.

Most contemporary health media coverage focuses on the extremes. On one extreme, the health system is portrayed as one that delivers life-saving procedures and miracle cures. On the other, the current focus on euthanasia portrays a health system that is demonstrably unable or unwilling to relieve pain and suffering. The key argument is that, left in intolerable pain, some patients have no choice but to elect to end their life. Neither extreme reflects the day to day reality for the significant majority of people at end of life.

This lecture explored the issues involved in decision-making at end of life from the perspective of patients and families as well as the broader health system and society. It provided an overview of the choices we should all be discussing with our loved ones – not just euthanasia but also advanced care directives, palliative care and organ donation as well as who we want to make our decisions if we are not able to. In also considering clinical issues and research perspectives, this lecture argued that our society and our health system should be ultimately judged not just by how many heroic rescues occur but also by how we care for people at end of life.


 

Lessening the burden of cancer across our community

Friday 25 November 2016, 4:30pm, Lecture Theatre, ITAMS Building, Innovation Campus University of Wollongong


The speaker: Professor David Currow

Professor David Currow is the Chief Cancer Officer in New South Wales and CEO of the Cancer Institute New South Wales, the state government’s cancer control agency. Initiatives include prevention, screening and early detection systems, development and funding for research infrastructure. David has a particular emphasis on chronic breathlessness, and in improving health service delivery in palliative and supportive care. He has a strong track record in competitive research funding (NIH, NHMRC, Cancer Council) and publishing research that influences practice and policy. He leads the Palliative Care Clinical Studies Collaborative (PaCCSC), the world’s largest palliative care phase III clinical studies collaborative. This has generated several randomised, placebo controlled trials of off-label use of off-patent medications frequently used in symptom control internationally.

He is also a leader in the Palliative Care Outcomes Collaborative, a national program for point-of-care data collection and service improvement in palliative care. He was a leader in the creation of the first patient-defined section of the Australian Pharmaceutical Benefits Scheme – the Palliative Care section.

He continues to supervise doctoral candidates from a variety of clinical backgrounds. He is senior associate editor of the Journal of Palliative Medicine and is on the editorial boards of Journal of Oncology Practice, Journal of Pain and Symptom Management and BMJ Supportive and Palliative Care.


The lecture

Although the absolute number of people with cancer continues to increase across the community because of an ageing population, the rates of many cancers remain relatively stable or are falling. This is in the context of continuing increases as the population ages because other clinical conditions are treated more effectively.

To lessen the impact of cancer across the community it requires a whole-of-system response.

In prevention, the biggest single lifestyle factor in the Australian population is smoking. It accounts for twenty percent of all deaths and each year, the number of cancers where this is likely to be a factor continues to increase. Reducing smoking rates has co-lateral benefits in respiratory disease, cardiovascular disease and in cancer. Vaccine preventable viral disease including human papillomavirus and hepatitis B at the forefront of primary prevention in our community.

National screening programs include breast, cervical and bowel cancers. Each of these has demonstrated a reduction in mortality across the community in a way that justifies the investment that the community makes. It is likely in the years ahead with improving technology several other cancers are likely candidates for national screening programs.

In treating people with diagnosed cancer the biggest single factor is a systems-wide approach to ensuring that there is timely access to the clinical disciplines required to diagnose, evaluate and treat each cancer. A multi-disciplinary cancer care team is the corner stone around which care should be built. Applying to knowledge we have today will significantly improve cancers without any further development of new therapies or new clinical approaches. Despite the promise of targeted therapies, the vast majority are targeting advanced disease rather than in the adjuvant setting.

Both survivorship and palliative care are integral to good cancer care. A community that understands the emotional and existential turmoil of a diagnosis of a cancer is a community that ensures that there is excellent care for people who have had the experience of cancer. There is a particular need to focus on people whose lives will be shortened because of cancer. Palliative care is, and remains, an investment by a community that has compassion and concern for all of its members.

Ultimately, cancer outcomes can continue to improve as a direct result of the investment that are being made today to drive models of care that better address the ongoing complexity of cancer.

Climate Change: an enabling truth

What hope an adequate response to the global climate problem?

20 November 2015, ITAMS Building, Innovation Campus, University of Wollongong


The speaker: Adjunct Professor Nick Rowley

Nick Rowley is an Adjunct Professor at the Sydney Democracy Network at the University of Sydney and continues to work internationally on climate change and sustainability. After arriving from the UK, twenty years ago Nick worked with Alan Owen in the NSW Office on Ageing. Their friendship endured until Alan’s final weekend.

For nine years Nick was an advisor to Premier Bob Carr working primarily on the environment, urban development and medical research. He then worked at 10 Downing Street for two years helping guide Prime Minister Tony Blair’s domestic and international policy interventions on climate change and sustainability. Nick helped initiate the seminal Stern Review into the Economics of Climate Change. For the two years prior to the 2009 UN climate meeting in Copenhagen Nick was Strategic Director of the Copenhagen Climate Council; a powerful affiliation of climate scientists, business CEO and policy practitioners brought together to make the case for a more adequate global climate treaty.


The lecture

Ten years ago Al Gore released his film 'An Inconvenient Truth'. Along with a number of severe climate events, this played a vital role in raising climate change to the top of the public and political agenda.

Nick’s lecture focused on how, although inconvenient for some, as a humanly induced problem, climate change is also an enabling truth. We have the capacity to take the decisions that will reduce the risks from a warmer, more unstable climate.

With the major 2015 Paris Climate Conference (‘COP 21’) taking place a matter of days after the lecture, Nick’s lecture focused on:

  • What hope is there that there will be a more adequate human response to the risks of climate change?
  • How should we think about climate change as a political, policy and societal challenge?
  • What implications might climate change have for human health?
  • How can one build a more creative, effective and inclusive climate policy agenda in Australia and elsewhere?

Nick also reflected on his professional and personal relationship with Alan Owen: what he learnt from Alan and has tried to apply.


 

Youth Mental Health: A Best Buy for Mental Health Reform

21 November 2014, 4:30pm, Leon Kane-McGuire Lecture Theatre, AIIM Building, Innovation Campus, Wollongong University


The speaker - Professor Patrick McGorry AO

Professor Patrick McGorry is a leading international researcher, clinician and advocate for the youth mental health reform agenda. He is Professor of Youth Mental Health at The University of Melbourne and Executive Director of Orygen Youth Health (OYH) a world-renowned mental health organisation for young people that put Australia at the forefront of innovation in the prevention and treatment of mental illness.

In addition to his significant contributions to the field of early psychosis and schizophrenia research, Professor McGorry has conducted important research in several other areas of psychiatry including the mental health needs of the homeless, health needs and treatments for refugees and torture survivors, and in recent years, the broader youth mental health field, including youth suicide, youth substance use, and the treatment of emerging personality disorder.

In 2010 Professor McGorry was selected as Australian of the Year and was awarded Officer of the Order of Australia in the Queen’s Birthday Honours list. In 2012 he was awarded the Dublin Prize from the University of Melbourne. In 2013 Professor McGorry was honoured with the National Alliance on Mental Illness Scientific Research Award, the first time the award has been bestowed upon a researcher outside of the United States.


The lecture

Mental and substance use disorders are among the leading health and social issues facing society, and now represent the greatest threat from non-communicable diseases (NCD) to prosperity, predicted by the World Economic Forum to reduce global GDP by over $16 trillion by 2030. This is not only due to their prevalence but critically to their timing in the life cycle. They are by far the key health issue for young people in the teenage years and early twenties, and if they persist, they constrain, distress and disable for decades. Epidemiological data indicate that 75% of people suffering from an adult-type psychiatric disorder have an age of onset by 24 years of age, with the onset for most of these disorders – notably psychotic, mood, personality, eating and substance use disorders– mainly falling into a relatively discrete time band from the early teens up until the mid 20s, reaching a peak in the early twenties. While we have been preoccupied with health spending at the other end of the lifespan, young people who are on the threshold of the peak productive years of life, have the greatest capacity to benefit from stepwise evidence-based treatments and better health care delivery. A substantial proportion of young people are being neglected and consigned to the “NEET” scrapheap with disastrous human and economic consequences.

In recent years, a worldwide focus on the early stages of schizophrenia and other psychotic disorders has improved the prospects for understanding these complex illnesses and improving their short term and longer term outcomes. This reform paradigm has also illustrated how a clinical staging model may assist in interpreting and utilising biological data and refining diagnosis and treatment selection. There are crucial lessons for research and treatment, particularly in the fields of mood and substance use disorders. Furthermore, the critical developmental needs of adolescents and emerging adults are poorly met by existing conceptual approaches and service models. The paediatric-adult structure of general health care, adopted with little reflection by psychiatry, turns out to be a poor fit for mental health care since the age pattern of morbidity of the latter is the inverse of the former. Youth culture demands that young people are offered a different style and content of service provision in order to engage with and benefit from interventions. The need for international structural reform and an innovative research agenda represents one of our greatest opportunities and challenges in the field of psychiatry. Fortunately this is being explored in a number of countries and has the potential to spread across the world as a dynamic health reform front.

Healthy Ageing in Australia: Environment, Lifestyle, Human Biology and Emerging Preventive Opportunities

22nd November 2013, Innovation Campus, Wollongong University


The speaker: Professor Neville Owen

Neville is a National Health and Medical Research Council Senior Principal Research Fellow, an Honorary Professorial Fellow in the Melbourne School of Population Health at the University of Melbourne and in the School of Population Health at the University of Queensland; he is also an Adjunct Professor in the Central Clinical School at Monash University. Prior to his most-recent move to Melbourne he was Director of the Cancer Prevention Research Centre at the University of Queensland; Professor of Health Psychology and Exercise Science and Associate Dean in the Faculty of Health and Behavioural Sciences at the University of Wollongong; and, Foundation Professor of Human Movement Science at Deakin University.


The lecture

Much of the escalating burden of chronic disease in our ageing Australian population can be linked to physical inactivity and weight gain. Musculoskeletal disorders, depression, type 2 diabetes, cardiovascular disease and breast and colon cancer have multiple adverse (and potentially avoidable) consequences for individuals, families, the workplace and the health system. Broad-reaching preventive health approaches, informed by relevant research evidence, are needed. Studies in Australia have begun to join some of the dots linking environments, lifestyle and biology with the development of major chronic diseases. This is through a better understanding of the built-environment, social and economic factors that can influence the normal habits and choices of everyday life. We can take heart from having made internationally-leading progress in tobacco control over the past 40 years. The next big population-health challenges are to build the bases for comparable progress in relation to physical inactivity and the food supply. This lecture deals with emerging evidence, issues and implications for disease prevention and health promotion in the Australian population.

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