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Opposition Senate leader and former senior minister in the Coalition government Simon Birmingham has announced he will quit parliament at the election. Birmingham, one of the few remaining moderates in the Liberals’ ranks, is shadow foreign minister. Now , aged 50, he’s defecting to a (yet to be announced) commercial job.

He joins the podcast to talk about the highs and lows of his time in politics and the Liberal Party, as well as to share his biggest regret and a couple of anecdotes.

So why is he going?

I don’t think I have the same partisan fight in me that I probably had in the early days of my career, and so I think there is an element of recognising that perhaps politics, as is, requires and demands people to take on the fight in our system. And the team deserves people who will take on that fight. I’ve always put the team first, as much as I possibly can, and that requires compromise at all times – and in the end, after a while, you start to tire of the compromise.

So all of that together with yes, a great and exciting opportunity that sets my career up for hopefully the next ten, 20 or longer years of work life. […] and still enables my family to stay in Adelaide, where their careers and education are flourishing.

Speaking about regrets, Birmingham highlights climate change:

I wish we had better landed policies and direction around how Australia responds to climate change. It’s been the thread right throughout my career – of division and politicking. I think the biggest missed opportunity was probably the National Energy Guarantee, which Malcolm Turnbull and Josh Frydenberg came so very close to landing.

It’s actually a mechanism that could have strongly supported a nuclear energy market, for example, as well, and I wish that we had found the way to see that through because I think our policy landscape would be much better today had that been the case.

As a leading moderate within the Liberal Party, Birmingham reflects on the teal movement and where it leaves the moderates:

I think the last election, in particular, not only sent us a clear message of dissatisfaction from more moderately aligned and teal-leaning seats.

But it simultaneously left the party room less well-equipped to respond to those messages because we lost some people who were really about to come into their prime and their own. People like Trent Zimmerman and Tim Wilson and Katie Allen and Dave Sharma [Sharma has since returned to parliament as a senator], they were becoming much stronger and more authoritative voices in the party room, who I have missed greatly in this term and where I think we would have been better placed having them there.

I just hope that coming into the next election where […] we’ve got some great new candidates in different seats who I think are true custodians of the liberal tradition in the Liberal Party, I hope that we can win those seats back and restore some of that balance in the party room.

With the return of Donald Trump, Birmingham recounts his experiences when he was trade minister during the Trump Mark 1 administration:

I remember at [a] dinner with Donald Trump […] we did get into a debate about the trade balance between our countries, and I ultimately reached into some of the documents I had and handed a graph across the table that showed for how long and how significantly the US has had a trade surplus over Australia.

Whilst I don’t think trade relations should be about the binary of surplus v deficit but, in the end, if that’s what’s going to sway his thinking, we’ve got to pitch it in that regard.

He also recalls:

I was scheduled to go from Ottawa through to Washington, DC on my way back to Australia, and Joe Hockey rang me while I was in Ottawa and said, mate your New Zealand counterpart came here on his way to Ottawa and he asked to get the same exemptions to the steel and aluminium tariffs that Australia has got. And Bob Lighthizer, who was Trump’s equivalent of the trade minister, went nuts at the New Zealanders and marched them out of his office saying, ‘you’re not getting it, and Australia never should have either’. And Joe said to me, mate, I think it might be best if you have a family emergency and head back to Australia.  

Lo and behold, I took Joe’s wise advice and counsel, made my way straight back to Australia, making apologies to those in D.C. I was meant to see. Läs mer…

The drug Visanne (also known as dienogest) is the first endometriosis treatment to be added to the Pharmaceutical Benefits Scheme (PBS) in 30 years.

Endometriosis is a chronic and often debilitating condition, where tissue similar to that which normally lines the uterus grows in areas just outside the organ. It affects around one in seven Australian women and there is currently no cure.

Why has the government decided to subsidise Visanne? Here’s how this daily tablet works and who it might help.

What is Visanne and how does it work?

Visanne is a synthetic drug from a family of hormones called progestins. It works by reducing the production of another hormone called estradiol.

Estradiol regulates female reproductive cycles and is the primary female sex hormone. But it also promotes the growth of the endometrium – the tissue that lines the uterus.

Limiting estradiol’s production in the body helps to lessen the crippling effects of the condition by curbing the abnormal growth of this tissue.

In a 2023 study, Visanne was shown to be effective in controlling the symptoms of endometriosis. After a year of treatment with a once daily 2 milligram dose of the drug, women experienced an average reduction of endometrium growth by around 26%. This led to a significant reduction in the condition’s effects, particularly in alleviating period pain.

In another 2022 study (funded by the company behind the drug), researchers examined its use in nearly 900 women across six countries. They found more than 90% of them reported a drop in endometriosis-associated pelvic pain with drug treatment.

Are there side effects?

Like all drugs, Visanne has risks and potential side effects.

The most common effects include headache, breast discomfort, hot flushes, acne, hair loss, abdominal and back pain, weight gain, vaginal bleeding and unusual weakness.

In the 2022 study, two out of five patients reported side effects related to Visanne, including vaginal hemorrhage (10.4%), bleeding between periods (metrorrhagia – 7.3%) and skipped periods (amenorrhea – 6.4%).

The intensity of side effects often lessen over time. But it can mean those who decide to take Visanne may be balancing pain relief with a range of other new symptoms.

While some endometriosis treatments are associated with a loss of bone density and an increased risk of osteoporosis later in life, the manufacturer claims the drug has no, or very little, impact on bone mineral density.

How much will it cost?

Previously, the annual cost of Visanne was A$800 to patients. On the PBS, the price of the daily tablets will reduce to around $380 per year, or around $90 for pension and concession card holders.

But the Australian government will more than make up the extra expense through the benefits of increasing accessibility of the drug.

Why has it been added to the PBS?

The primary consideration for listing a drug on the PBS is its cost-effectiveness. This means the drug must provide a significant health benefit when compared with the cost of existing treatments.

Endometriosis forces many women to reduce their working hours – or even quit their jobs.
MashaSay/Shutterstock

Endometriosis has been calculated to cost the Australian economy at least $7.8 billion per year.

Half of women who have endometriosis are reported to have to manage their condition at work, with many having to reduce their working hours. A 2021 study by academics at Western Sydney University found one in six women with endometriosis have lost their jobs due to their endometriosis.

Solutions for helping women to remain and be effective in the workforce are essential to Australia closing the gender pay gap.

However the cost of Visanne remains high for many individuals, who will still be paying close to $400 a year to reduce their pain and maintain a high quality of life. And many women may need to continue to take other drugs (such as paracetamol) alongside Visanne, further adding to the cost.

Is Visanne right for you?

Visanne is just one available treatment for endometriosis.

There are other effective and safe treatments that are already listed on the PBS, such as combination oral contraceptives, gonadotrophin-releasing hormone drugs and long-acting implants that slowly release progestogens.

It is important to note for some women who take the drug, Visanne can stop ovulation and also make it more difficult to become pregnant.

If you suffer from endometriosis, and your current medications are not sufficient in reducing the pain and inflammation, speak to your doctor. They can determine if a change to Visanne is right for you. Läs mer…

Can you reach down and touch your toes without bending your knees? Can you reach both arms overhead? If these sound like a struggle, you may be lacking flexibility.

Flexibility is the ability to move a joint to through its full range of motion. It helps you perform most sporting activities and may prevent muscle injuries. And because most daily activities require a certain amount of flexibility (like bending down or twisting), it will help you maintain functional independence as you age.

Although there are many types of stretching, static stretching is the most common. It involves positioning a joint to lengthen the muscles and holding still for a set period – usually between 15 and 60 seconds. An example would be to stand in front of a chair, placing one foot on the chair and straightening your knee to stretch your hamstrings.

Static stretching is widely used to improve flexibility. But there are no clear recommendations on the optimal amount required. Our new research examined how long, how hard and how often you need to stretch to improve your flexibility – it’s probably less than you expect.

Static stretching means positioning and lengthening muscles while holding still.
Cliff Booth/Pexels

Assessing the data

Our research team spent the past year gathering data from hundreds of studies on thousands of adults from around the world. We looked at 189 studies of more than 6,500 adults.

The studies compared the effects of a single session or multiple sessions of static stretching on one or more flexibility outcomes, compared to those who didn’t stretch.

How long?

We found holding a stretch for around four minutes (cumulatively) in a single session is optimal for an immediate improvement in flexibility. Any longer and you don’t appear to get any more improvement.

For permanent improvements in flexibility, it looks like you need to stretch a muscle for longer – around ten minutes per week for the biggest improvement. But this doesn’t need to occur all at once.

How hard?

You can think of stretching as being hard, when you stretch into pain, or easy, when the stretch you feel isn’t uncomfortable.

The good news is how hard you stretch doesn’t seem to matter – both hard (stretching to the point of discomfort or pain) and easy stretching (stretching below the point of discomfort) equally improve flexibility.

Stretching doesn’t have to feel uncomfortable.
Valeria Ushakova/Pexels

How often?

If you are looking to improve your flexibility, it doesn’t matter how often you stretch each week. What is important is that you aim for up to ten minutes per week for each muscle that you stretch.

So, for example, you could stretch each muscle for a little more than one minute a day, or five minutes twice a week.

The amount of time you should spend stretching will ultimately depend on how many muscles you need to stretch. If you are less flexible, you will likely need to dedicate more time, given you’ll have more “tight” muscles to stretch compared to someone more flexible.

Can everyone improve their flexibility?

Encouragingly, it doesn’t matter what muscle you stretch, how old you are, your sex, or whether you are a couch potato or an elite athlete – everyone can improve their flexibility.

Static stretching can be done anywhere and at any time. And you don’t need any equipment. You can stretch while watching your favourite TV show, when in the office, or after walking the dog to help you relax. It’s a great way to start and end your day.

You can stretch anywhere, at any time.
Shutterstock

Although the exact stretches needed will depend on which muscles are “tight”, examples of some very common stretches include:

placing one foot upon on bench and leaning forward at the waist while keeping your knee straight to stretch your hamstrings
bending your knee and holding your ankle against your buttock to stretch your quadriceps muscles
reaching one arm while bending your elbow to stretch your triceps muscles.

However, the best advice is to visit a qualified health professional, such as a physiotherapist or exercise physiologist, who can perform an assessment and prescribe you a list of stretches specific to your individual needs.

As you can see, it really isn’t too much of a stretch to become more flexible. Läs mer…