MEDICUS FEBRUARY 2016

A

WESTERN AUSTRALIA

Journal of the Australian Medical Association WA | February 2016 Volume 56 / Issue 1 | amawa.com.au

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Council President Dr Michael Gannon Immediate Past President Dr Richard Choong

FEBRUARY 2016

Vice Presidents Dr Andrew Miller Dr Omar Khorshid Honorary Secretary Dr Janice Bell Assistant Honorary Secretary Dr Marcus Tan Honorary Treasurer Professor Bernard Pearn-Rowe Councillors Division of General Practice (WA) Dr Steve Wilson A/Prof Rosanna Capolingua Division of Specialty Practice Dr Tony Ryan Dr Martin Chapman Division of Salaried and State

34

Determination wins the day UND Graduation Ceremony

Government Service Dr Mark Duncan-Smith Dr Dror Maor Ordinary Members Dr Daniel Heredia Dr Stuart Salfinger Dr David McCoubrie Prof Geoff Dobb Co-opted Members Dr Steve Wilson Dr Tim Koh A/Prof Peter Maguire

18

Dr Michael Page Dr Chris Wilson Dr Ian Jenkins

Prof John Newnham Prof Shirley Bowen Mr Daniel Dorevitch Mr Sid Narula AMA (WA) Office Executive Director Mr Paul Boyatzis Director: Industrial & Legal Ms Marcia Kuhne Executive Officers Mr Michael Prendergast Ms Josphine Auerbach

Managed Care by Stealth Are private health funds removing choice from consumers?

FEATURES

9

30 48

Bold Innovation in Public Policy Insights from an unusual source

East Metropolitan Health Service Dr Kim Hames on the reasons behind the new health service and the changes it will trigger

Mr Simon Bibby Ms Leah Pantelis

14 Stirling Highway Nedlands WA 6009 (08) 9273 3000 mail@amawa.com.au www.amawa.com.au Medicus Editor and Director of Communications

40 REGULARS

Reaching out with Lions Outback Vision

Pull on those sea boots! The life lessons you can learn from the tall ship Leeuwin

There is still plenty of work left to be done for remote eye healthcare in WA

Mr Robert Reid Deputy Editor Ms Janine Martin Advertising Inquiries Phone Mr Des Michael (08) 9273 3000 Copy Submissions Phone Ms Janine Martin (08) 9273 3009 or janine.martin@amawa.com.au Services Business Services Manager Ms Noelle Jones Financial Services Manager Mr John Gerrard Medical Products Manager Mr Anthony Boyatzis Health Training Australia Manager Mr Geoff Jones The publication of an advertisement, article or inclusion of an insert does not imply endorsement by the AMA (WA) of the views, service or product in question, and neither the AMA (WA) nor its agents will have any liability for any information contained therein.

56 Membership 58 AMA in the Media

38 Clinical Edge 40 On the Road:

02 President’s Desk 03 From the Editor 04 Industrial 06 Letters 09 Comment 10 Immunisation 13 News 18 Cover Story: Managed Care by Stealth 30 Opinion: COGP – Prof Jeanette Ward 33 Opinion: RACGP – Dr Tim Koh 34 Event: UND Graduation Ceremony

Lions Outback Vision

60 Drive 62 Travel

42 For the Record:

Dr Bernadette Lee

65 Food 67 Wine 68 Member Benefits & On the Town 71 Classifieds : Professional Appointments, Positions Vacant, Rooms for Sale/ Lease

44 Research 46 Opinion: Dr Michael Page 47 Opinion: Dr Jemma Hogan 48: Feature: Sail Training Ship Leeuwin 50 Opinion: Daniel Dorevitch 51 Opinion: Sid Narula 53 Dr YES 55 Comment: AMA Benevolent Fund

75 Greensheet

F E B R U A RY 2 0 1 6 M E D I C U S 1

P R E S I D E N T ’ S D E S K

Australia’s Private Health Industry has caught a cold

Dr Michael Gannon AMA (WA) President R egular readers of the business pages of newspapers recently might have come across the smiling face of Mr George Savvides, CEO of Medibank Private. The insurance company is one of the darlings of a currently troubled market with profits way ahead of predictions. I have no doubt that those of you who availed themselves of a piece of the float would be delighted. It was only a few months ago that Medibank Private used its substantial buying power to bully the relatively small Calvary Health Care into accepting its terms. St John of God Health Care has announced that it has signed a similar contract. Ramsay Health Care has indicated its desire to fight on behalf of some of the smaller players in the market.

piece for The West Australian where I encouraged readers to think twice before accepting the latest private health insurance (PHI) deal offered to them. Significant proportions of PHI policy holders are being dudded. The industry’s own data shows that PHI is not a privilege reserved for the wealthy. Many people on low and fixed incomes appropriately prioritise their health above other spending and take out insurance. They are entitled to better. The Commonwealth Department of Health needs to develop the capability to help patients make choices. It is their job to legislate against junk products. As a profession, it is our responsibility to try to reward those patients who have taken out insurance. In my view, gaps upwards of $10,000 to $15,000 for an afternoon’s work are unprofessional, unethical and often vulgar. Australia’s public/private mix is a big part of our world-class health system. It would benefit few to emulate US-style managed care. I have had enough experience of the NHS in the UK to see the failings of a system that has no competitor to shake it up. The value proposition of private medicine in Australia is either better care, quicker care or both. Otherwise why would you potentially pay gaps in addition to the costs of private pharmacy, private physiotherapy, a private health insurance levy and income tax? A private system that is better and more innovative will

‘ junk’ policies. WA Health Minister Dr Kim Hames has stated his desire to see cash-strapped public hospitals in our state get something like the levels of revenue enjoyed by his ministerial colleague in New South Wales. Of course, the reason why public hospitals in Sydney enjoy double the revenue of those in WA is because they do not have anything like the wonderful private hospital infrastructure we do here, predominantly those owned by SJGHC and Ramsay. While this might be good for the business manager of the public hospital, it does nothing to improve access to health services, and potentially reduces the access of public patients who have no choice. Unfortunately many insured patients have policies that are hardly worth the paper they are written on. You might get TV rental and a toothbrush, but this is not the kind of policy that supports an efficient health system with a healthy mix of public and private care. It hurts universality. Policies which exclude your newborn baby from care in the Special Care Nursery if the problem affects the cardiac or respiratory system are as ludicrous as they are inhumane. Policies that pay the surgeon a pittance above the MBS and are designed to do nothing but help the policy holder escape an income tax penalty do not improve the quality of healthcare that the community enjoys.

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Against this background, we have seen the proliferation of a whole series of

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I recently wrote an opinion

2 M E D I C U S F E B R U A RY 2 0 1 6

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F R O M T H E E D I T O R

Secret squirrel business and nutty outcomes

G overnment secrecy can act like a cancer on democracy, eating away public confidence in our system of government, at the same time reducing our support for the government of the day. People rarely want to know everything about every particular project or issue – but what they really don’t appreciate is a refusal by government to tell them anything. They are also suspicious when it seems clear to them that the media is being misled. The old adage – what does the government have to hide? – is especially galling as it involves public money, or in other words, money supplied by taxpayers to run the state or the country. With Freedom of Information legislation becoming more a case of Freedom FROM Information, it is getting harder for members of the public and the media to discover what is actually happening with our money. A recent front page of The West Australian newspaper carried a story about the lack of transparency of a government report. Every word and every dollar amount was blanked out by some public servant before it was released to the newspaper. Later the same day however, the full report, untouched by anyone’s pen, was leaked to the ABC and reported on the national broadcaster’s multiple platforms.

The government didn’t fall, the state is unlikely to have been financially embarrassed and the sun rose the next morning. In another case, highlighted once again by our major morning newspaper, Energy Minister Mike Nahan refused to disclose arrangements of an agreement with a mining operator. Sure enough, full details of the agreement were released in the company’s annual report. The Australian Defence Force rejected a suggestion last month that the public should know what aircraft had been purchased from the US Airforce, citing the too often used “security concerns”. Again, the US Armed Forces revealed the information in their usual – and open – report to the US Congress. Without the bloody-minded decision to hide run-of-the-mill information, none of this would be news. The refusal of information, often just because it CAN be refused by a nameless departmental officer, is the news, and is the base of so much public and media frustration. Secrecy is a negative for public debate and confidence in our system of government. Even more importantly, it promotes cynicism and even deters people from turning up at the polls each election.

have seen not just obfuscation about the number or impact of spending cuts on care in WA, but have faced a barrage of misinformation and secrecy. From original denials about any job cuts in health, to a mixed message of either 200 or 250 voluntary redundancies to the final admission from the Health Minister that there would be 1,100 FTE axed positions, we have seen it all. To make a small alteration to a well- known movie line, in this case “we can handle the truth”. It is interesting to note that the AMA (WA) was once again right about the number of job cuts, despite repeated denials from the government and an effort to “attack the messenger”. So what did the government get from this? And what about some sectors of the media who were too willing to accept the government’s misinformation? The AMA is willing to admit that there are efficiencies which could be made and spending that could be saved. Cutting positions without careful consideration of the likely impact of such decisions only adds to this suspicion and fear. Morale of the wider medical profession suffers and public confidence in the health system is reduced, almost like dominos falling. And we are ALL the weaker for it as a result. ■

I raise these concerns because in the health arena over recent months, we

Continued from page 2

Dr Michael Gannon Australia’s Private Health Industry has caught a cold

continually lift the quality of the public system which will maintain an equal or near equal standard of care, because of the instruments of our democracy which include letters to newspaper

editors, talk-back radio and chewing the ears of Members of Parliament. The current system of private medicine has caught a cold. I can only hope that the mutuals behave better than the

for-profits. If the private system fails patients, we potentially lose our unique mix, and diminish access to the public hospital system for the neediest. We all have to be part of the solution. ■

F E B R U A RY 2 0 1 6 M E D I C U S 3

I N D U S T R I A L SNAPSHOTS

JOB CUTS

THE AMA WROTE to all metropolitan hospitals in November and December 2015 reminding them of their obligation to consult with and provide information to the AMA about the introduction of major changes likely to have significant effects on practitioners following government announcements about job cuts and a recruitment freeze. All hospitals have replied to the AMA letters and meetings have been held or scheduled. In discussions held to date, hospital managers have indicated they will attempt to secure budget savings without abolishing jobs. It is claimed that savings will be achieved in the first instance through improved rostering, reduced overtime and reviewing the need to backfill leave. The AMA is being advised that

changes will be identified following consultation with medical staff and that the recruitment freeze will not prevent the filling of positions provided the required process is complied with.

The AMA urges members to contact the industrial team at (08) 9273 3000 with any concerns about threats to jobs or changes being made without consultation. ■

2016 PUBLIC SECTOR SALARIES CLAIMS

FURTHER TO THE AMA (WA)’s article in the November edition of Medicus , the Association is in the final stages of preparing comprehensive claims for new agreements to replace the following: • Department of Health Medical Practitioners (Metropolitan Health Services) AMA Industrial Agreement 2013 • Department of Health Medical Practitioners (WA Country Health Services) AMA Industrial Agreement 2013 • Department of Health Medical Practitioners (Director General) AMA Industrial Agreement 2013 • Department of Health Medical Practitioners (Drug and Alcohol Office) AMA Industrial Agreement 2013

• Department of Health Medical Practitioners (Clinical Academics) AMA Industrial Agreement 2013. The claims are informed by the surveys sent to members in 2015, feedback from the Inter Hospital Liaison and the Doctors in Training Committees, and issues raised by members from time to time. The AMA expects to serve the claims on the Minister for Health by the end of February 2016. Negotiations are due to commence by 1 April 2016. The industrial team will post industrial updates on the website to keep members informed of progress throughout the negotiation process. Members who would like to discuss any issues they have in relation to the coming round of bargaining should contact the AMA (WA) industrial team on (08) 9273 3000. ■

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I N D U S T R I A L

OUTER METRO AND RURAL EMERGENCY PHYSICIANS ATTRACTION AND RETENTION PACKAGE

THE AMA (WA) is concerned about the sudden and unilateral change imposed by the Department of Health to withdraw longstanding arrangements to pay incentive packages to attract and retain emergency physicians to rural and outer metro areas. Discussions held to date have not yielded a change in position from the DOH on the principal issue. However, the AMA has been able to secure an assurance that back payments will be calculated and paid to practitioners who have not had their allowance indexed and escalated in line with wage increases under the AMA Agreement since 2012.

The AMA will also continue to advocate on the principal issue. ■

CLOSURE OF SWAN DISTRICT HOSPITAL

2016 PRIVATE SECTOR SALARIES CLAIMS

THE AMA (WA) understands that doctors who transferred from Swan District Hospital to St John of God Midland Public Hospital should have been paid all their entitlements (as agreed) in the pay period commencing 3 December 2015, being the first pay period following closure of the hospital. Any member who did not receive their correct entitlements should contact the AMA industrial team at (08) 9273 3000. ■

THE AMA (WA) will commence consultation with members employed under private sector enterprise agreements early in 2016 to seek member feedback about key issues and priorities for replacement agreements. The relevant agreements are: • Royal Flying Doctor Service of Australia (Western Operations) Medical Practitioners Industrial Agreement 2013 • St John of God Murdoch Hospital AMA Medical Practitioners Industrial Agreement 2013 • Australian Red Cross Blood Service Medical Officers Enterprise Agreement WA 2013. The AMA will schedule teleconferences commencing early 2016 to seek member feedback. ■

TRANSFER OF LEAVE – DOCTORS IN TRAINING

AFTER AN EXTENSIVE period of negotiation with the Department of Health/WA Country Health Service (WACHS) about the transfer of accrued leave for doctors in training (DiTs) transferring to WACHS from a metropolitan site, the AMA (WA) has been advised that WACHS will now agree to accept transfers of up to one year’s entitlement to annual leave which has been accrued during applicable service with a Metropolitan Health Service (MHS).

from the MHS. Transfers of leave in excess of one year’s entitlement may be agreed, in extenuating circumstances, on application from individual practitioners. While it is counter-intuitive that the same logic for leave transfers from a WACHS site to an MHS site would not apply, this appears to be the case. Hence, the AMA is continuing to seek agreement whereby leave is transferred to and from a WACHS site for all DiTs transferring between sites. ■

Consequently, any balance of leave in excess of one year’s entitlement would be paid out on separation

F E B R U A RY 2 0 1 6 M E D I C U S 5

L E T T E R S

IN HIS COMMENT on the AMA Report Card on Aboriginals in custody, WA State President, Michael Gannon, correctly states that the high rates of imprisonment of Aboriginal and Torres Strait Islanders should be a priority health, social justice and human rights issue. ( Medicus, December 2015, p17, Urgent action needed on Indigenous prison rates ). In the early 1970s, I was a GP in the far west of New South Wales. During the years 1971-72, 50 per cent of the Indigenous men and 8.5 per cent of the Indigenous women aged 15 years and over, were arrested and kept in the – always full – local lock-up. Most arrests were for disorderly behaviour when drunk. The resultant magistrate-ordered fines further depleted the already low incomes of Aboriginal families and contributed to the poor nutrition of their children. The Aboriginal Legal Service was, in part, born out of this law and order discrimination against Aborigines in NSW. The Royal Commission into Aboriginal Deaths in Custody in Australia (RCADC) reported, that in 1988, the ratio of Aboriginals to non-Aboriginals in custody was 20:1. The predominant crimes were drunkenness, disorderly behaviour and assault, i.e. fighting. In 2012, the Law Council of Australia reported that one in 52 Aboriginal adults were in prison compared with one in every 775 non-Aboriginals. When a problem has been in urgent need of a solution for four or more decades. it has either been ignored, been too difficult to solve or as in this case, a bit of both. As a GP who does remote area locums, I see the worst of this unchanging, revolving door problem. I do not have any magic solutions.

Neither do the affected Aboriginal families or the long- suffering police, ambulance services, nurses and doctors who are all aware that we run a thankless band-aid service. If there is to be any solution to reducing the Indigenous prison rates, we (Aboriginals and non-Aboriginals) must replace our long-failed punitive methods with innovative and experimental approaches. Lessons can be learned from the successes of drug courts as an alternative to incarceration and family breakdown and through examining other areas of reported success. One example is the empathic approach to young Aboriginal recidivists practised by Antoine Bloemen when he was the resident magistrate in the Kimberley.¹ Political will is also important and well-publicised biennial AMA Report Cards on Aboriginals in custody can help bolster it. Emeritus Professor Max Kamien Retired GP

Reference: 1. Antoine Bloeman. No Regrets, A Bicycle Dreaming from Belgium to Broome.

Wise beyond years

CONGRATULATIONS DR ATTREE ( Medicus December, p52, To advise or not to advise? That is the question... ) on your attitude to enquiries outside your areas of competence or comfort. Wise beyond your years. You have a strong supporter in Bob Dylan. Tell me where it hurts you honey, and I'll tell you who to call. Dr Warwick Ruse Long-gone President, AMA (WA)

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6 M E D I C U S F E B R U A RY 2 0 1 6

L E T T E R S

Mental Health Act WA MEDICUS (DECEMBER 2015 , Curtains Rise on New Act to Little Applause ) has rightly raised the question of training for the new Mental Health Act which has been appalling with bland political denials. We should be asking why such training extending to several hours is necessary to achieve the simple professional task of ascertaining that a person’s mental illness requires treatment and prevents the sufferer from being aware of the need, while providing protection in the grave situation of such deprivation of liberty. There is an answer. The formulation of the Act was strong on consumers and carers and very deficient on the input of us poor psychiatric hacks who have to make these decisions (also denied by the Minister). The result was a massively bureaucratic document of hundreds of pages and over 50 forms. The fact that this detracts from the care of sick people was also an example of denial of the undeniable. There are also obligations to submit many professional management decisions to the panoply of devoted but non-professional carers. Why? For ‘carers’ mostly read ‘mothers’. One can hardly blame them for their distress, which has unfortunately been projected on to the Psychiatrists who are caring for their offspring. Sadly this makes the professional task much harder with deflection from the professional tasks to bureaucratic ones to the serious detriment of the patients. This is both in day-to-day care as well as generating attrition of Psychiatrists. Over a half century ago, it was Psychiatrists who spearheaded

Professor Paul Skerritt Psychiatrist & Former AMA (WA) President the laudable move from the large institutions that largely held people for a lifetime, to care in the so-called community. This was great for politicians who could save the money for expensive inpatient care but fail to fund the adequate follow-up in the overworked community clinics. Hence violence from psychiatric patients, previously contained in the institutions was deflected largely to unsupported families, particularly the mothers. It gets worse. A century ago, Sigmund Freud and followers introduced the idea that mental illness had its origins in the family, particularly the mothering. In the radical 1960s, the antipsychiatry movement pushed the idea that the insane were really the sane ones reacting against an insane environment, again the mothers. Even in more scientific circles, when I was being educated in the same decade and the complex causes of schizophrenia were being struggled with, a widely-held view of causation was the ‘schizophrenic mother’ who damaged brain development according to the ‘double bind hypothesis’ So we can understand the mothers of schizophrenic patients treated so poorly by the system blaming Psychiatrists and wanting to restrict them by burying them in paper. The tragedy is that none of the hundreds of pages of the Act or the 50 forms will add anything to the proper care of the patients. Yours faithfully are once again encouraged to take a strong interest in the coming AMA (WA) elections, not only by voting, but by getting involved and nominating for a professional Special Interest Group. Included in this edition of Medicus is a nomination form for the positions of Chairman of Special Interest Groups within the Division of Specialty Practice, and the Division of General Practice. In addition, there are a number of positions within the Division of State Government Service. Nominations are now open, and must reach the AMA (WA) Returning Officer no later than 5pm on Monday, 7 March, 2016 . This is an opportunity to increase your involvement in the AMA (WA) and to assist in serving your fellow members. Coming issues of Medicus will detail information about office bearer nominations. ■

AMA (WA) 2016 Elections – get involved!

WESTERN AUSTRALIA HEALTHCARE EXPERIENCED MAJOR stress during 2015 in terms of funding for services and access. Doctors were yet again pressured to do even more with diminishing resources.

WESTERN AUSTRALIA

The Federal Government froze GP patient rebates and then told GPs they would lose their IT PIP if they did not curate and upload patient records onto an electronic record they do not trust, with uploading costs shifted onto their already financially struggling practices. Salaried doctors and doctors in training also faced significant industrial and training concerns with the new hospital campus’ coming on line during 2015/16. Private insurers are also looking at managed care/financial behavioural models to control private practitioners. This is why Australian Medical Association (WA) members

F E B R U A RY 2 0 1 6 M E D I C U S 7

WESTERN AUSTRALIA

WESTERN AUSTRALIA

C O MM E N T

East Metropolitan Health Service and reform of WA Health governance

Hon Dr Kim Hames MLA WA Minister for Health

T he introduction of statutory Health Service Boards was one of the key recommendations of the WA Health Transition and Reconfiguration Steering Committee, chaired by former acting Director General of Health, Professor Bryant Stokes. Perth’s expanding eastern corridors will soon have their own, dedicated health service, but why is it so important to have one? As Minister for Health, I announced, in November 2015, that a new East Metropolitan Health Service (EMHS) would be established from 1 July 2016 with the aim of strengthening the coordination, integration and efficiency of clinical services for communities in Perth’s burgeoning eastern corridor. Under the new legislation, the boards will oversee the health services and public hospitals within a networked area, rather than individual public hospitals as existed in the past. These changes form part of broader reforms to the governance of WA Health involving the establishment of each of our Health Services as separate, board-governed statutory authorities from 1 July 2016.

Act 1927 , these reforms will bring greater local focus, expertise and innovation to the delivery of health services to our communities. The aim is to clarify roles, decision-making responsibilities and system-wide accountabilities. As part of the division of hospitals in the EMHS, the new board will oversee Royal Perth, Bentley, Kalamunda and Armadale Kelmscott Memorial hospitals, as well the new St John of God Midland Public Hospital. The establishment of an additional health service will benefit patients by enhancing the focus on the quality of healthcare delivery in Perth’s eastern metropolitan corridor, particularly as demand in this area continues to grow. Smaller health services across the metropolitan area will allow for greater transparency and better understanding of activity and budget allocations, while being more agile in meeting service demands. The advantage is a focus on a smaller number of hospitals and targeted, quality service. With Royal Perth Hospital more logically placed within the East Metropolitan Health Service than its southern counterpart, Perth’s eastern

suburbs will have their own tertiary facility and access to services which cover every spectrum of health need. A model of co-ordinated and integrated clinical services means a capacity for more efficient workflows, service delivery and budgeting between the hospitals. Funding for the new health service will be through the Department of Health’s existing budget. The transition to these arrangements, and ongoing operations, will be delivered within current and future activity and budget parameters, and within the clinical services as outlined in the WA Health Clinical Services Framework 2014-2024. In establishing this governance model, assessments will be conducted to identify key capability and capacity gaps in the system, supporting the transition of health services to operate as separate statutory authorities and to make decisions at a local level to meet local need. Work is currently underway to define the EMHS catchment area, along with detailed service agreements for activity, funding levels and expected levels of performance. ■

Subject to new legislation to replace the Hospitals and Health Services

F E B R U A RY 2 0 1 6 M E D I C U S 9

I MM U N I S A T I O N Pertussis remains public health priority I n the wake of the tragic and high profile death of Riley Hughes from pertussis in March 2015, and to date with information in this area. • Babies born to mothers who have had a pertussis vaccine in pregnancy

closely spaced (e.g. <2 years apart). The optimal time for pertussis vaccination is between 28-32 weeks of pregnancy, but the vaccine may be given at any time in the third trimester. Women who have received pertussis vaccine during or after a previous pregnancy should be re-vaccinated in the third trimester of their current pregnancy. • Antenatal pertussis vaccination is currently offered by WA Health for all women during their third trimester of pregnancy. Since the start of the program in March 2015, approximately 60 per cent of pregnant women in WA have received the vaccine (13,000 doses administered); no significant vaccine-associated adverse events have been reported. ■

with pertussis notifications active in Western Austtralia, the Communicable Disease Control Directorate (CDCD) has issued a vaccination update encouraging practitioners to promote pertussis vaccination to all pregnant clients. Increasing vaccination coverage has dramatically reduced the incidence of whooping cough among Australian children. However pertussis, or whopping cough, continues to be a highly infectious and dangerous disease, and remains a public health priority for WA. The AMA (WA) encourages all doctors with pregnant patients to promote pertussis vaccination, and to stay up

have higher levels of antibodies against the disease than babies whose mothers were not vaccinated and these antibodies are passed to the foetus in the womb. • These maternal antibodies can help protect the newborn during the first months of life when they are most vulnerable to severe pertussis infection and still too young to be vaccinated themselves. • The Australian Technical Advisory Group on Immunisations recommends pertussis vaccine (dTpa) be given during the third trimester of every pregnancy, including pregnancies which are

Number and rate of pertussis notifications in Western Australia, by month and year of disease onset, January 2011 – January 2016

Year Jan Feb Mar

Apr

May June July Aug Sept Oct

Nov Dec Total

Rate*

2011 187 144 101 104 152 146 245 386 530 535 765 710 4,005 169.9

2012 727 472 334 247 262 254 204 200 180 142 196 165 3,383 139.7

2013 150 121 135 112 109 104 120 160 159 171 159 143 1,643 66.4

2014 138 113 102 126 128 132 138 161 178 233 166 138 1,753 68.0

2015 141 120 117 94 111 137 143 186 171 185 237 174 1,816 68.4

12^ -

-

-

-

-

-

-

-

-

-

-

12

-

2016

* Rate = annual crude rate per 100,000 population. Rates only provided for those years with complete data. ^Data for current and most recent reporting periods may be incomplete.

You can order the pertussis vaccines through the online vaccine ordering system https://dhswaonline.csldirect.com.au/

For more information on pertussis vaccination in pregnancy, please visit http://ww2.health.wa.gov.au/Articles/N_R/ Pertussis-vaccination-for-pregnant-women

10 M E D I C U S F E B R U A RY 2 0 1 6

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IN BRIEF

A new service established as part of the State Government’s telehealth initiative will allow expectant parents in the Great Southern to access free antenatal education classes via video link. participate in antenatal and birth preparation classes, which will be beamed to their homes via secure videoconferencing software or they can link in at their local telehealth service. The service has been made possible by the State Government’s Royalties for Regions program and the Southern Inland Health Initiative as part of the Maternal Health Improvement Program. Manjimup and surrounding areas will soon see the start of forward works to build the new Warren Health Service . The construction of the new hospital in Manjimup is part of the Southern Inland Health Initiative’s $300 million capital works program to improve hospital infrastructure in 37 towns across the Wheatbelt, Great Southern, Mid-West and South-West. The fresh face of Katanning Health Service has been unveiled in architectural drawings, which detail the new emergency department, medical imaging and outpatient care building. The redevelopment is more than cosmetic with a new ED, medical imaging and outpatient care facility also on the cards. Pregnant mothers and their partners can now

THE AUSTRALIAN MEDICAL Association (WA) has paid tribute to the work of those West Australians recognised for their contribution to healthcare in the annual Australia Day honours list. “It is an honour to call some of the individuals who were officially recognised on Australia Day as medical colleagues and friends. Their work in medicine is a testament to their character and dedication,” AMA (WA) President Dr Michael Gannon said. “In particular the Association is extremely proud of three of its members, who were each awarded Membership of the Order of Australia,” he said. Associate Professor David Watson was awarded an AM for significant service to medicine, and to medical education, to professional organisations, and to the community. Dr Watson is a former President of the AMA (WA). Dr Timothy Cooper was awarded an AM for his significant service to medicine in the field of plastic and reconstructive surgery as a clinician, and to professional medical associations. Dr Peter Pratten was awarded an AM for significant service to medicine, particularly in the field of Radiology

as a practitioner, to education, and to professional bodies. “All three AMA (WA) members epitomise the calibre of professionalism and conduct the Association strives to emulate,” Dr Gannon said. “As well as the members listed above, the Association applauds the exceptional work of the other WA health professionals and even those beyond the scope of clinical medicine who were named on the 2016 list. “Dr Susan Jenkins, Nola Cecins and Geraldine Hogarth were all recognised “Tonya McCusker in particular has, over many years contributed to making WA a healthier place through her roles in the McCusker Foundation. “It is West Australians like these that make our health system one of the best in the world,” Dr Gannon said. ■ for the significant service and contributions to healthcare.

A/Prof David Watson.

Dr Timothy Cooper.

Dr Peter Pratten.

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N E W S New test predicts heart disease in those with diabetes

WESTERN AUSTRALIANS WILL help determine the accuracy of a genetic test believed to be able to predict which people with diabetes will go on to develop heart disease, a leading cause of death of those with the condition. A $75,000 grant from Diabetes Research WA is paving the way for Professor Grant Morahan, the head of WA’s Centre for Diabetes Research, to put the test through its paces locally. “Together with international colleagues, we have successfully developed a test that can predict what people are at high risk of having a heart attack or stroke. Importantly, this test can be applied years – or even decades – before symptoms show up. This means that these people can be helped so that they can avoid these serious conditions,” Prof Morahan said. “Right now, people at higher risk are identified by taking into account risk factors such as smoking and hypertension, but Let’s talk about last year’s resolutions. Don’t let another resolution get you down. doctorportal Learning is the best resource to help you get on top of your continuing professional development in 2016. Log on to www.doctorportal.com.au, register now, it’s free for AMA members.

early research shows our test outperforms this current ‘gold standard’ method.”

The genetic test has been created using health information from the National Institute for Health and Welfare in Finland in collaboration with Dr Veikko Saloma. “In Finnish patients who had type 2 diabetes and were over 50 when recruited, those with a high genetic risk as shown by the test were more than three times more likely to have a cardiovascular issue such as a heart attack or stroke within 12 years,” said Prof Morahan. “It is critical we now validate the test’s accuracy in Australia, and this new grant allows us to do that by drawing on information from the Fremantle Diabetes Study and the Royal Perth Hospital Diabetes Clinic Survey Database.” According to Diabetes Research WA, another Australian develops diabetes every five minutes and the cost impact of it each year in the country is about $14.6 billion. ■

Find out more at learning.doctorportal.com.au

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Volunteers sought for ovarian cancer trial

ST JOHN OF God Subiaco Hospital is seeking ovarian cancer survivors interested in volunteering for a trial evaluating the effectiveness of mindfulness meditation courses to help manage fears about their cancer recurring. The pilot study is being led by St John of God Subiaco Hospital Director of Gynaecological Cancer Research Dr Paul Cohen in collaboration with The University of Western Australia and Cancer Council Western Australia. Dr Cohen said this important study will examine if mindfulness-based cognitive therapy (MBCT) assists the psychological wellbeing of those who have completed chemotherapy for ovarian cancer. “It is well known that women who

have survived ovarian cancer can become very concerned and anxious about their cancer recurring, which can impact on their psychological wellbeing,” Dr Cohen said. “Known as the Fear of Recurrence in Ovarian Cancer Survivors study, we are initially undertaking a pilot study on the effectiveness of MBCT to assist participant’s wellbeing.” MBCT combines the formal practice of mindfulness meditation with elements of cognitive-behavioural therapy. Those interested in participating will be required to attend an eight-week MBCT course run by Cancer Council WA from early February at either Shenton Park, Fremantle or Duncraig. The free course runs for two hours each week and provides practical

coping techniques aimed at helping to reduce anxiety and improve mood, quality of life and sleep. Participants will be asked to undertake each day the activities recommended in the course, including a 40-minute meditation session. In addition participants will be asked to complete questionnaires immediately before and after the course as well as six months later. Each questionnaire will take about 30 minutes to complete. Those interested in participating in the study, or seeking further information, can contact the Clinical Trial Unit at St John of God Subiaco Hospital on ClinicalTrials.Subiaco @sjog.org.au or (08) 6465 9204. ■

A NEW SERVICE in Perth’s north-east is giving women and children who are escaping family and domestic violence, the option to stay safe in their homes. Child Protection Minister Helen Morton said the Ellenbrook Safe at Home program addressed a gap in services in the growing north-eastern suburbs. She added that women and children experiencing domestic violence should not be forced to flee, while the perpetrator remained in the family home. “For victims, being at home means their support networks and job security are maintained and, where it is safe to do so, this service will support victims to stay at home,” she said. “This Ellenbrook Safe at Home service, the seventh of its kind to be rolled out in Western Australia, assesses victims’ support and safety needs, including referrals to support services and security upgrades to the home. “Where staying at home is not a safe option, victims will be assisted with the cost of finding new accommodation, setting up home and starting children at new schools.” The service is delivered by The Patricia Giles Centre and will become part of the Ellenbrook Women’s Refuge when it opens in early 2016. ■ New Ellenbrook domestic violence service

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Murdoch ED repeats top score

ST JOHN OF God Murdoch Hospital’s patients have voted its emergency department as the top private ED in Australia for the third year running. In 2013, 2014 and now in 2015, the department is ranked the best compared with other private departments of a similar size by global health organisation surveyors, Press Ganey. Director of Emergency Medicine Dr Paul Bailey said patients gave top marks for the compassionate care given by doctors and nurses. “Our patients love that we care about them as individuals; that they are not just another number to us,” said Dr Bailey.

Triple treat: The medical team at SJG Murdoch Hospital’s emergency department.

The department has a strong focus on staff education and quality improvement and is involved in numerous research projects. ■

“Our team works hard to reduce waiting times and deliver excellent care, whilst also ensuring patients are informed of what’s happening with their care along the way.”

Australian cancer prevalence exceeds 1 million: new estimates

THE NUMBER OF Australians living with cancer or having survived a diagnosis has exceeded 1 million for the first time, highlighting a change in how we should manage the disease, according to Cancer Council Australia. Professor Sanchia Aranda, CEO of Cancer Council Australia and President Elect of the Union for International Cancer Control, said the new estimate of 1.1 million, released by Cancer Council on World Cancer Day (4 February), reflected progress in healthcare but presented new challenges. “The main reason for the increase in cancer prevalence is that we are living longer in general and more people with cancer are surviving,” Professor Aranda said. “Around 130,000 Australians are likely to be diagnosed with cancer this year and more than 65 per cent will survive for five years, with many going into permanent remission.” Professor Aranda said despite the good news, the burden of life years lost to cancer was increasing relative to other disease groups, in Australia and globally.

demographic groups and also between people with different cancer types and experiences. “Governments in Australia have performed pretty well in delivering public health programs, but we’ve barely scratched the surface on

Cancer Council Australia CEO Professor Sanchia Aranda.

these trends. New health system efficiencies, targeting expenditure to highest need, addressing issues like the cost of cancer medicines – these challenges are mounting. “There’s a robust health reform debate in Australia at present. More than a million Australians living with or having survived cancer should be at the forefront of the discussion. We also need to do practical things on the ground to support our survivors, as a community,” Prof Aranda said. This year’s World Cancer Day theme was “We Can. I Can”, highlighting how communities and individuals could help to reduce cancer burden. ■

“There is also a stark inequity in outcomes – and addressing inequity has to be a priority. Inequities exist between

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All the right moves

Dr Michael Levitt joins SJGHC board

THE TRUSTEES OF St John of God Health Care have appointed leading Western Australian colorectal surgeon Dr Michael Levitt (pictured) to the SJGHC Board. He replaces long- standing board member Dr Tony Baker, who has retired after 10 years of service.

staff at St John of God Subiaco Hospital since 1990. During that time, he has been Director of Medical Services from 2005 until 2013, and was a long-serving member of the Medical Advisory Committee (MAC) for 13 years, including four years as Chairman. Dr Levitt joins other clinicians on the board including Drs Julie Caldecott, Rosanna Capolingua and Michael Stanford. Dr Levitt’s appointment took effect from 1 January 2016. ■

Dr Michael Levitt.

Dr Levitt has been a member of clinical

New CEO for Lifeline

Brightwater announces New Chief Executive

Lorna MacGregor, former Chief Operations Officer with Perth North Medicare Local, has been appointed the new Chief Executive Officer of Lifeline WA. Highly regarded in the mental health sector, she replaces Fiona Kalaf who has been Lifeline WA’s CEO for the past four years. Ms MacGregor’s appointment took effect from January 12, 2016. ■ Lorna MacGregor.

Brightwater Care Group has announced the appointment of

Jennifer Lawrence (pictured) as its new Chief Executive Officer effective from March 2016 Jennifer Lawrence joined Brightwater in 2003 as the General Manager, Care Operations and has more recently held the position of General Manager, Disability, Research and Risk. Ms Lawrence will replace long-serving CEO Dr Penny Flett. ■ Jennifer Lawrence.

“Why I recommend BreastScreen WA to my patients” Dr Sherine Silva, Stirling GP

• It is a free service for my patients. • Two radiologists review each screen independently. • It is convenient with nine metropolitan clinics, one in Bunbury and four mobile screening units touring WA. • BreastScreen WA is equipped with the latest digital technology. It has been shown when a woman’s GP recommends regular breast screening it is one of the main reasons women book their mammogram appointment. Please join me in recommending regular breast screens to all asymptomatic women aged 50-74 years old. It could save their life. For more information, to download the electronic referral form or to order your BreastScreen WA referral pad please visit www.breastscreen.health.wa.gov.au

Jan 2016

Women may book online - www.breastscreen.health.wa.gov.au - or phone 13 20 50