Health Alert is a summary of the critical judgments, legislation, press releases and news items which have come to our attention each week. Many of the summaries will contain a hyperlink.
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The DLA Phillips Fox Health Team
Patients frequently consult one practitioner for a medical condition and then (for a variety of reasons) consult a different practitioner for the same condition (at a later stage or in the same period). This investigation by the Coroner of Tasmania looked at one of the potentially fatal consequences of this trend of mixing practitioners and mixing the medications they prescribe.
A man with a long history of PTSD and depression died from multiple drug toxicity after taking a combination of medications of different classes, namely venlafaxine and fluoxetine with moclobemide. These drugs were prescribed separately by different treating psychiatrists. The deceased changed psychiatrists and did not inform the first psychiatrist of his decision to see somebody else. The GP who referred the deceased to the second psychiatrist asked him if he was prescribed any medication, and the second psychiatrist asked him the same question. He said he was not. The second psychiatrist prescribed a different set of medications which the man subsequently took alongside the medications prescribed by the first psychiatrist.
The Coroner found that the second psychiatrist acted reasonably in relying on the advice of the deceased and his GP that he was not taking any other prescription medications. Because the second psychiatrist was not aware the deceased had been prescribed contra-indicated medications it was reasonable that did not warn the deceased about the risks of combining these particular medications.
This case highlights the difficulties of managing patients that consult multiple practitioners for complex medical problems. The coroner recommended that specialist clinicians and medical practitioners use caution when prescribing medication to those with mental illness especially when their psychiatric history is extensive. The coroner encouraged practitioners to contact previous practitioners or pharmacists about the medications prescribed and encouraged practitioners to educate patients on the risks of combining medications.
Health Insurance (Radioactive Seed Implantation of Prostate) Determination 2010- F2010L02204 - Health - This Determination corrects an error in the drafting of the item descriptor for item 37220, the implantation of radioactive seeds where there is localised prostatic malignancy, where item 55603 (anaesthesia) also applies.
National Health (Highly specialised drugs program for private hospitals) Special Arrangements Amendment Instrument 2010 (No. 1) (No. PB 75 of 2010) F2010L02201 - Health - These Arrangements amend the National Health (Highly specialised drugs program for private hospitals) Special Arrangements Instrument 2010 (No. PB 64 of 2010) to provide for changes to highly specialised drugs available at private hospitals to non-admitted patients, day-admitted patients or patients on discharge.
Private Health Insurance (Prostheses) Rules 2010 (No. 2) - F2010L02191 - Health- These Rules revoke the Private Health Insurance (Prostheses) Rules 2010 (No.1) and determines benefits for listed prostheses and medical treatments.
Private Health Insurance Circulars
(An upcoming seminar)
Australian Public Assessment Report (new)
Psychiatric symptoms, including suicidal behaviour, continue to be reported with varenicline
Drugs designated as orphan drugs (added everolimus (AFINITOR))
Access to IV Thiamine (new)
The Hong Kong Department of Health issued an alert concerning a product known as 1 Body Beautiful which had been found to contain the undeclared pharmaceutical substances sibutramine and phenolphthalein.
The Therapeutic Goods Administration (TGA) is aware that some Australian consumers have purchased the product 1 Body Beautiful over the internet or from an Australian retailer, and that the product claims to be 100% herbal in origin.
Incidence of Type 1 diabetes in Australian children 2000-2008 - Type 1 diabetes is a serious, life-long disease which causes a major health, social and economic burden for individuals with the disease, their families and the community. There were over ... Published 5 August 2010.
Conditional authorisation for generic medicines code proposed - The ACCC proposes to grant conditional authorisation for three years to the second edition of the... Issued: 3rd August 2010 Release # NR 158/10
30 Jul 2010 - New Factsheets: Membership Arrears and Exclusions/Restrictions - Facts and advice about your policy.... - READ MORE
06 Aug 2010 - Statement from the Nursing and Midwifery Board of Australia - English language skills needed to provide safe care to Australian community - 5 August 2010 (332 KB,PDF)
In July 2010 a new national registration and accreditation scheme for health professions was introduced. Each of Professional Board have set an English language skills standard and this media release sets out the standard to be required for nurses and midwives.
Certification of documentation and new proof of identity requirements - The Medical Board of Australia has developed a Proof of Identity Framework and Requirements document for the purposes of applicants seeking medical registration in Australia. These new requirements have come into effect from 1 July 2010. The AMC has always maintained identification requirements consistent with those set by medical boards in Australia. Because the AMC is aware that applicants applying directly from overseas cannot meet some of the new requirements set by the Medical Board of Australia, the AMC has developed its own proof of identity requirements that must be met when applying under the AMC assessment pathways. Applicants will still be expected to meet the Medical Board of Australia (MBA) identification requirements as set by the MBA when they seek medical registration with the MBA. In addition to this, the Department of Foreign Affairs and Trade (DFAT) have recently advised the Australian Medical Council (AMC) that Australian Embassies and Consulates overseas will no longer provide the service of certifying photographs. DFAT have confirmed that they will be able to continue certifying copies of original documents, for example a person?s passport. Upon review of its policy on certification of photographs, the AMC has decided that candidates will no longer be required to have photographs certified before submitting their application to the AMC. The AMC is satisfied that proper identification will continue to be confirmed by passport and other similar documentation that contains a photograph of the candidate. All documentation apart from photographs will continue to be required to be certified before submission to the AMC. Please click here to access the new Proof of Identity Requirements for the AMC Assessment Pathways (including photograph requirements).
Canberra Hospital receives
donation from local familyKaty Gallagher,
MLA August 5 2010
Review confirms public maternity services delivering quality care to women Katy Gallagher, MLA August 5 2010
Move and Groove to help prevent osteoporosis! Katy Gallagher, MLA July 31 2010
Intravenous Immunoglobulin (ivig) Administration Sop ? The purpose of this document is to provide a systematic and consistent approach for the safe and appropriate administration of Intravenous Immunoglobulin IVIg across ACT Health. All staff involved in transfusion of IVIg are responsible for maintaining and updating their knowledge and practices. ACT Health-Wide - Population HealthCED10-017 Sop- Ivig - Policy (PDF File 525k) - Sop- Ivig - Administration (PDF File 556k) - Sop - Ivig - Approval (PDF File 564k)
Nurse Practitioner, Emergency Department - Clinical Practice Guidelines -In accordance with ACT Health policy and current legislation this guideline defines the clinical practice of the Emergency Department (TCH) Nurse Practitioner within the Emergency Services. As required this clinical practice guideline has been approved by Portfolio Executive, ACT Health. ACT Health-Wide - ACT Chief NurseCED10-020 Nurse Practitioner, Emergency Department, Tch, Clinical Practice Guidelines (PDF File 1970k)
Immunisation warning as severe flu cases reported [04 August 2010]
New protection for paramedics starts today [30 July 2010]
Health Executive Service - Notional SalaryPD2010_051 05/08/2010
Notification of Obsolete Policy Directives and GuidelinesIB2010_038 05/08/2010
Discussion Paper on Implementing the National Health Reform in NSW - Feedback is now encouraged on the proposed LHNs configuration.
Kon Vatskalis ? Improving the Health of Children in Remote Areas - The health and development of children living in remote areas will be boosted with the launch of a new educational tool that provides important information for health professionals.
Kon Vatskalis - New Urgent Care Clinic Opens - Health Minister Kon Vatskalis today officially opened the Darwin Private Hospital?s new urgent care medical clinic.
06/08/2010 Twin research to reveal more about epilepsy
04/08/2010 NO SUN SHINING ON LNP HOSPITAL COMMITMENT
04/08/2010 Doctors deserve a better deal from union
03/08/2010 NEW LOCAL PAYROLL MODEL PROGRESSING WELL
30/07/2010 CONGRATULATIONS TO QIMR RESEARCHERS
NEW healthcare standards and information about VMO compliance - Our updated healthcare standards (version 2.0) are now online! You can browse through everything you need to know about our standards on our website or download the complete edition or just the information you need. The updated standards are easier to use and we've reduced hospital reporting requirements by almost half. We're keen to get your feedback - complete the feedback form to tell us what you think or suggest improvements. Attention VMOs and private hospitals - read our position statement on Visiting Medical Officer compliance with our healthcare standards
5 August 2010 - Community Clostridium difficile infection in Community settings (PDF 38Kb) - Public Health Information
30 July 2010 - Suspension of flu vaccine in young children lifted (PDF 41Kb) - Public Health Alert
New health hub for QEH - Friday, 30 July 2010 15:54 - Demolition has begun on the old Maternity Building at The Queen Elizabeth Hospital, making way for the next stage of the hospital?s redevelopment. Read More...
New CEO appointed for Country Health SA - 3 August 2010 - SA Health has today announced that Ms Belinda Moyes has been appointed as the new Chief Executive Officer (CEO) of Country Health SA. read more...
New car park for Ceduna District Health Services - 4 August
The car park has been extended and improved as part of the $36 million redevelopment of Ceduna District Health Services. read more...
Older People 2010 - 2016 The health policy for older people provides advice and guidance to all staff when developing or reviewing health care relevant to older people, their family and family carers
Guideline for the Use of Clinical Trial Agreements in Research A guideline that proposes the endorsement of two standard agreements for use in clinical research trials across SA Health sites and institutions.
New guide for councils - 30 July 2010 - A new handbook for Environmental Health Officers has been distributed to councils.
New family room at Monash announced - 30 July 2010 - Southern Health has unveiled plans for a new family room to be built at the Monash Medical Centre in Clayton later this year.
Hospital circular - Publication Number 17 / 2010 - 5 August 2010 - Date Issued: 30 July 2010 - Subject: Highly Specialised Drugs Program
04 Aug 2010, Marmion - New study to tackle early detection of Alzheimer?s
30 Jul 2010 Grylls, Hames - New defibrillator for Tom Price Hospital
6 Aug: Saving Lives: Amenable mortality in New Zealand, 1996 - 2006 - This report analyses trends in amenable mortality (deaths potentially avoidable through health care) in New Zealand over the past decade. It concludes that amenable mortality can serve as a useful health system performance measure, provided its limitations are understood.
3 August: Food and Nutrition Guidelines for Healthy Older People: A background paper - This background paper provides up-to-date evidence-based information to support health practitioners in improving nutrition for older people.
2 August: Practice nurse cost benefit analysis: report to the Ministry of Health - The aim of the study was to explore the financial benefits to primary health organisations and general practices of employing practice nurses. To achieve this, the project explored how, or whether, improved practice nurse utilisation increased general practice cost effectiveness and value for money. The report presents the results of a literature review and data collection from nine primary care practices in New Zealand.
30 Jul: Physical Activity - New content and guidance - The physical activity section has been relaunched with revised information about the New Zealand Physical Activity Guidelines and advice on how to become more active.
30 Jul: Nurse Prescribing in Diabetes Services - A discussion document - Submissions are invited on proposed changes to enable suitably qualified nurses working in diabetes services to prescribe a limited range of medicines for people with diabetes.
Consultation on the listing of various pharmaceuticals on the Pharmaceutical Schedule. Closes Friday 20 August 2010 - class="smaller">05 Aug 2010
Direct-To-Consumer Genetic Tests: Misleading Test Results Are Further Complicated by Deceptive Marketing and Other Questionable Practices - GAO-10-847T July 22, 2010 - Highlights Page (PDF) Full Report (PDF, 33 pages) - In 2006, GAO investigated companies selling direct-to-consumer (DTC) genetic tests and testified that these companies made medically unproven disease predictions. Although new companies have since been touted as being more reputable--Time named one company's test 2008's "invention of the year"--experts remain concerned that the test results mislead consumers. GAO was asked to investigate DTC genetic tests currently on the market and the advertising methods used to sell these tests.
Coalition Health Policy - strong initiatives to stimulate
the health debate -
5 August 2010 - 5:20pm -The AMA welcomes the Coalition?s health policy, which will stimulate debate and bring the health policy bidding war alive in this election campaign. AMA President, Dr Andrew Pesce, said today that the Coalition has made some strong commitments on hospital beds, support for GPs, and clinician involvement in hospital governance arrangements through community boards, all of which are consistent with AMA policy.
Transcript: AMA President, Dr Andrew Pesce, with Alex Sloan, ABC Radio 666 Canberra 5 August 2010 - 9:00am - Transcript: AMA President, Dr Andrew Pesce, with Alex Sloan, ABC Radio 666 Canberra, Tuesday 3 August 2010
AMA calls on all parties to publicly support world's
best anti-smoking action -
4 August 2010 - 11:40am - The AMA today called on all parties to support the introduction of plain packaging of tobacco products in Australia and to publicly condemn the reported tobacco industry advertising campaign against this groundbreaking public health initiative. AMA President, Dr Andrew Pesce, said that Australia is set to lead the world with strong anti-smoking measures that will save lives and improve the health of the population, and urged all parties and politicians to get behind the plain packaging plan.
President's email - 3 August 2010 - 2:10pm - Here we are in week three of a five-week election campaign and still no sign of the major comprehensive health platforms from the major parties. Yesterday we had the Greens National Health Plan, but that was understandably and predictably aimed at prevention, with no big picture policies for hospitals or primary care. The AMA has this week been pushing general practice issues at every opportunity, with GP Super Clinics a major focus of the media. Our view is that we support GP Super Clinics where they do not compete with existing general practices and where they meet a real community need for primary care services. We insist that local GPs in the area are consulted prior to any decisions about locations for the Clinics. Our preference is for more funding to go to existing general practices to help them expand their services before any consideration is given to establishing a GP Super Clinic.
President's Blog, Tuesday 3 August 2010 - 3 August 2010 - 2:00pm - The AMA has been calling on the Government to review its GP Super Clinics program since it became a reality after the 2007 Federal election.
Greens National Health Plan - strong on public health, weak
on bigger picture -
2 August 2010 - 5:35pm - AMA President, Dr Andrew Pesce, said today that the Greens National Health Plan includes some positive public health initiatives but has little to say about the major issues affecting our public hospitals, medical workforce, or general practice and primary care. Dr Pesce said that the Greens? policies on cigarettes, alcohol, food labelling, junk food and obesity are very similar to the positions held by the AMA. "The proposed 1.5 per cent levy on junk food and alcohol advertising would be a welcome first step but any revenue raised from the levy must be used for alcohol and obesity education, prevention and treatment programs," Dr Pesce said.
Transcript: AMA President, Dr Andrew Pesce, with David
Speers, SKY News -
2 August 2010 - 2:55pm - Transcript: AMA President, Dr Andrew Pesce, with David Speers and panel, Australian Agenda, SKY News, Sunday 1 August 2010
Misleading claims about vaccination putting Australian lives at risk - 2 August 2010 - 2:15pm - AMA Vice President, Dr Steve Hambleton, said today that the AMA is greatly concerned that groups that are promoting discredited theories about immunisation are exposing Australians to the devastating effects of preventable illnesses. Dr Hambleton said that recent media reports outlining the views of the Australian Vaccination Network (AVN) show that this organisation has drawn the fire of the NSW Health Care Complaints Commission (HCCC). "It is important for parents to have their children immunised. Immunisation saves lives," Dr Hambleton said.
More aged care beds welcome, but medical care for older Australians ignored - 1 August 2010 - 4:45pm - AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Coalition?s commitment to provide incentives to free up more beds for residential aged care, but is disappointed that the medical care needs of older Australians have been ignored in today?s policy announcement. Dr Pesce said that the Coalition policy has failed to support the medical care needs of people being cared for in aged care facilities. "We know that older Australians have significant medical service needs, and these are not being adequately met in our aged care facilities," Dr Pesce said.
Australian workers significantly affected by
co-workers' drinking habits -
1 August 2010 - 12:00pm - MJA media release - Australian workers are significantly affected by other people?s alcohol drinking and at a considerable cost, according to a study published in the Medical Journal of Australia. Caroline Dale, from Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine, and Michael Livingston, from Turning Point Alcohol and Drug Centre, Melbourne, conducted a study to estimate the cost of extra time worked by Australian workers due to their co-workers? alcohol drinking. Mr Livingston said that around a third of Australian workers have experienced negative effects from their co-workers? alcohol drinking, with 3.5 per cent of workers reporting having to work extra hours to cover for others.
Personality traits linked to mental illness and hazardous alcohol usage in Australian doctors - 1 August 2010 - 12:00pm - MJA media release - Certain personality traits, demographic and work related factors increase the likelihood that doctors will develop mental illness or hazardous alcohol habits according to a study published in the Medical Journal of Australia. Dr Louise Nash, from the New South Wales Institute of Psychiatry and University of Sydney and co-authors conducted a study to identify factors associated with psychiatric morbidity and hazardous alcohol use in Australian doctors. A total of 2999 doctors participated in the study. Dr Nash said that the mental health of medical practitioners is crucial to the quality of care their patients receive.
Fracture patients have low awareness of osteoporosis risk - 1 August 2010 - 12:00pm - MJA media release - Only 40 per cent of patients with a fragility fracture are aware of their osteoporosis risk – a level that is likely to remain a barrier to patients seeking medical review and managing their risk, according to research published in the Medical Journal of Australia. Dr Charles Inderjeeth, Geriatrician and Rheumatologist at the North Metropolitan Area Health Service, Perth, and co-authors implemented and evaluated a multimodal intervention to improve osteoporosis treatment in patients discharged from an emergency department (ED) after presentation with a fragility fracture. Dr Inderjeeth said that, after implementation of the intervention, the rate of bone mineral densitometry investigations improved from three per cent to 45 per cent, the number of patients receiving calcium and vitamin D supplementation increased from 12 per cent to 33 per cent and from 12 per cent to 37 per cent, respectively, and initiation of specific osteoporosis treatments increased from six per cent to 30 per cent.
Broadband network offers new and improved opportunities in
health care -
30 July 2010 - 4:20pm - AMA President, Dr Andrew Pesce, said today that the National Broadband Network offers exciting new and improved opportunities in the provision of health care, especially in rural, regional, and remote areas of the country. Dr Pesce said that the availability of high speed, broadband internet access would allow rural and remote Australians to have access to medical services that they would otherwise have to travel hours to access.
Aged care policies must include medical care - 30 July 2010 - 3:30pm - AMA President, Dr Andrew Pesce, said today that the AMA was pleased to hear Opposition Leader, Tony Abbott, announce this morning that the Coalition?s aged care policy would be released ?in the next few days?. Dr Pesce said that aged care has so far been ignored in this election campaign
GP Network News Issue 10, Number 26 - 30 July 2010 - 30 July 2010 - 12pm - Support Family Doctors campaign materials; Updated advice on the use of seasonal influenza vaccine for children; Collaborative arrangements will provide better care for patients; A national disability insurance scheme must be at the core of any national disability strategy; Labor increases mental health investment but more needed
Most Doctors Will Face Malpractice Suit, AMA Says - Media Alert, Aug. 5, 2010 - More than 60 percent of doctors over the age of 55 have been sued at least once, according to a new survey by the American Medical Association (AMA). Read the story from ABC News
CMA paper pulls health care sustainability issue from shadows - August 3, 2010
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