Australia: Health Related Critical Judgments, Legislation, Press Releases and News Items

Health Alert 30 August 2010
Last Updated: 30 August 2010
Article by Mark Williamson

Health Alert is a summary of the critical judgments, legislation, press releases and news items which have come to our attention each week.

The summaries contain links to more detailed information and many items of special interest will also contain commentary.

Health Alert is a quick and effective means of ensuring that you are aware of significant recent changes.


New South Wales

Lindsay v Health Care Complaints Commission [2010] NSWCA 194 (19 August 2010)

MEDICAL TRIBUNAL – disciplinary proceedings – whether s 37 of the Medical Practice Act 1992 in its pre-2008 form, permits the Tribunal to find that examples of unsatisfactory conduct cumulatively justify a finding of 'professional misconduct' – whether a finding of impairment necessarily leads the Tribunal to the decision that a medical practitioner is not competent to practice medicine. PROCEDURAL FAIRNESS – whether the Tribunal denied an unrepresented medical practitioner procedural fairness by limiting cross-examination of witnesses and rejecting questions as irrelevant – whether the Tribunal denied procedural fairness by limiting the evidence that the medical practitioner could adduce where the medical practitioner failed to comply with directions - whether Tribunal gave medical practitioner adequate warning that his conduct during the hearing could be taken into account in making findings. NON-PUBLICATION ORDER – whether Court of Appeal should modify the non-publication order made by the Tribunal.

The medical practitioner in this matter was removed from the NSW Register of Medical Practitioners by an order of the medical Tribunal of NSW. One of the complaints upheld by the Tribunal was that the practitioner suffered from an impairment that detrimentally affected his mental capacity to practice medicine. The impairment was described as a 'delusional disorder of a persecutory type'.

The medical practitioner appealed the Tribunal's decision to the New South Wales Supreme Court on a point of law and arguing that he was denied procedural fairness.

The practitioner argued that the Tribunal had failed to connect his particular impairment with an inability to competently practice medicine. The Court of Appeal of the Supreme Court were critical of the Tribunal's lack of explanation about how they came to their conclusions but found that the Tribunal found a sufficient link reasoning that the delusional disorder affected communication with patients and could lead to errors of clinical judgment.

The appellants other grounds of appeal were also rejected. This case and the case below highlight the weight given to 'bedside manner' and non-medical capabilities by tribunals considering a practitioners fitness for medical practice.

Victorian Civil & Administrative Tribunal

Medical Practitioners Board of Victoria v Schnapp (Occupational and Business Regulation) [2010] VCAT 1352 (17 August 2010)

Medical Practice Act 1974, Health Professions Regulation Act, section 3, whether professional conduct of a lesser standard that expected by peers, performance assessment including simulation exercises.

The Victorian Civil & Administrative Tribunal had to ask whether flaws in an anaesthetist's practice over a period of years went beyond reasonable 'human frailty' which requires us to be tolerant of 'occasional lapses, particularly if these lapses do not form a consistent course of conduct or, if taken separately, are insufficiently serious to warrant intervention' (quoting Morris J in Vissenga v Medical Practioners Board of Victoria [2004] VCAT 1044 at 33).

The tribunal found that only one of three incidents that were reported to the Tribunal fell below reasonable conduct. However they found that a pattern of inadequate judgment and poor performance emerged when considering these reported incidents together with a performance assessment performed at the request of the Medical Board of Victoria.

Following the reported incidents the anaesthetist had agreed to undergo a Medical Board voluntary performance assessment involving observations of two operations and various simulation scenarios. These conclusions from this assessment process were given significant weight by the tribunal in attempting to assess the practitioner's non-clinical capabilities.

The Tribunal was particularly concerned about what was revealed about the practitioner's perception of his own skills and limitations, his uncompromising justification of his own methodology, his ability to manage emergency situations, leadership skills and vigilance. The Tribunal were concerned by evidence that the anaesthetist appeared to be isolated within the anaesthetic community and did not consult with other practitioners to consider alternative anaesthetic options.

The tribunal found that these deficiencies in practice were serious enough to warrant intervention but no final orders were made.



Corporate reforms ease the burden: new audit, reporting and dividend rules

Recent amendments to the Corporations Act 2001 (Cth) have eased the burden on many companies limited by guarantee (CLGs) by way of a tiered audit and reporting structure, but also now prohibit certain CLGs from paying dividends to their members.


North-West Regional Hospital (Radiation Oncology Services) 31 of 2010


Mental Health Amendment Regulations 2010 - S.R. No. 81/2010

Civil Procedure Act 2010 enacted to reform the process for resolving and dealing with civil disputes in Victoria. Commences 1 June 2011


Australia. Department of Health & Ageing

Private Health Insurance Circulars

Australia. Senate Community Affairs Committee

Food Standards Amendment (Truth in Labelling – Palm Oil) Bill 2009

National Health Amendment (Pharmaceutical Benefits Scheme) Bill 2010

Plain Tobacco Packaging (Removing Branding from Cigarette Packs) Bill 2009

National Health and Hospitals Network Bill 2010

Australia. Therapeutic Goods Administration

Reminder to sponsors - child-resistant packaging requirements (new)

Withdrawal of Panvax Junior (new)

Safety advisory: CORE HIV Rapid Test (new)

Australian Public Assessment Report (AusPAR) for prescription medicines (added Brimonidine tartrate, Plerixafor

Australia. Private Health Insurance Administration Council

10/16 27 August Standard Operating Procedure - Giving Council Directions CURRENT EDITION 10/16

Statistical release – June 2010 - 17 August 2010

Australia. National Health & Medical Research Council

Leading Women in Science - 25 August 2010 - The NHMRC congratulates the three winners on the 2010 L'Oreal Women in Science Fellowships. The recipients of the $20,000 awards are: *Rowena Martin of ANU, an NHMRC Biomedical Fellow working in the fight against malaria. *Marie-Liesse Asselin-Labat of the Walter and Eliza Hall Institute, who has participated in NHMRC-funded research into breast cancer. *Deanna D'Alssandro, of Sydney University, developing technology to capture carbon dioxide emissions. » View Media Release NHMRC Tracker 20 August 2010

Australia. National E-Health Transition Authority

NEHTA Blueprint - The NEHTA Blueprint describes the major e-health capabilities

NEHTA is promoting for national adoption. Read More

Australian Capital Territory. Department of Health

Media releases

New South Wales. Department of Health

Media releases

Policy directives & guidelines

Information bulletins

New South Wales. Therapeutic Advisory Group Inc

Position Statement Update: Safe Use of Heparins and Oral Anticoagulants for Venous Thromboembolism Prophylaxis in Adults - August 2010. Please click here to download the updated document.

Queensland. Department of Health

Media release

Tasmania. Department of Health & Human Services

Media releases

Victoria. Department of Health

Media releases

Doors open at new Belmont Ambulance Station - 20 August 2010 - Health Minister Daniel Andrews has officially opened the new Belmont Ambulance Station to service residents in Geelong's southern suburbs. Read More

Quit creates positive campaign - 20 August 2010 - Quit has launched its first positive anti-smoking campaign in almost two decades, urging smokers to Never give up giving up.

Evaluation of the Victorian HIV, STI and Hepatitis C Strategies - The Department of Health (previously Human Services) currently has three strategies to guide the implementation of Victoria's response to HIV, hepatitis C and Sexually Transmissible Infections (STI) being evaluated. (26 Aug 2010)

Report on Youth/STI Prevention Initiatives funded in 2007 - he report outlines the projects, including their aims, target audiences, outcomes, evaluation methods, and outcomes. (24 Aug 2010)

Victorian Infectious Diseases Bulletin available for download - The new issue of the Victorian infectious diseases Bulletin is now available online. It contains notifiable infectious disease surveillance data, and articles and news relating to infectious disease control in Victoria. (24 Aug 2010)

Swine Influenza A (H1N1) virus - Information about the new strain of Influenza A, including links to related resources. (24 August 2010)

2010 Influenza season: updated information for health professionals - July 2010 - This update is provided to health professionals for guidance on the 2010 influenza season on 26 July 2010. (24 August 2010)

Victoria. Health Services Commissioner

New law: Complaints involving registered health professionals and student health professionals

Western Australia. Department of Health

Media release

New Zealand. Ministry of Health

26 Aug: Health Targets end of year results

23 Aug: Unequal Impact II: Māori and Non-Māori Cancer Statistics by Deprivation and Rural-Urban Status - This publication provides specific information about the unequal distribution of cancer outcomes for Māori and Non-Māori.

New Zealand. Medical Council of New Zealand

The Medical Council and DHB have signed a Memorandum of Understanding - The document signed by Dr Don Mackie, chair of the DHB chief medical officer group and Mr Philip Pigou, the Medical Council's chief executive enable DHBs and the Council to work collaboratively together, clarifying their respective roles and responsibilities on the regulation of doctors in New Zealand.(MoU). Press Release

Patient advisory - Dr Suresh Vatsyayann - Waikato District Health Board, local primary health care organisations, and the staff at 'The Family Clinic', have made arrangements so that Dr Vatsyayann's patients still have access to primary health care services. Enrolled patients of suspended Hamilton GP Suresh Vatsyayann, will still have access to primary health care services. More details on where patients can receive medical care be found at this link:

United Kingdom. Department of Health

End of Life Care Strategy: Second Annual Report

Best Practice Guidance for managing Appointment Slot Issues within Choose and Book

Annual independent review of the UK Government's global health strategy

Manual for Cancer Services 2008: Psychological Support Measures

Draft Acute Oncology Measures

CSO Bulletin, Issue 7 - August 2010

United States of America. Department of Health & Human Services

Secretary Sebelius announces $32 million to support rural health priorities - HHS Secretary Kathleen Sebelius announced today more than $32 million in FY 2010 funds to increase access to health care for Americans living in rural areas.

Review calls for new federal approach to medical countermeasures- U.S. Department of Health and Human Services Secretary Kathleen Sebelius today released an examination of the federal government's system to produce medications, vaccines, equipment and supplies needed for a health emergency, known as medical countermeasures.

Australian Medical Association

Corporatisation of General Practice - Decision Support Kit for Doctors 27 August 2010 - 9:00am - This information package will assist a General Practitioner to make a decision about moving into a corporate practice. This covers many of the issues you need to consider when making the decision. This tells you what a corporate is, what matters you need to think about in closing your existing practice, what will life be like working for a corporate and maybe afterwards.

Medical internship shortage at crisis point - AMA 25 August 2010 - 12:45pm - The AMA shares the concerns of Australia's biggest medical schools that the national shortage of medical internships has severe implications for the future medical workforce and its ability to meet the health care needs of a growing and ageing population, with more people suffering chronic and complex conditions. Dr Pesce said the internship shortage has reached crisis point and all Australian governments, including the next Commonwealth Government, must work together to find solutions.

Dr Pesce, Speech to CHA National Conference 24 August 2010 - 9:15am -Supporting the medical workforce - The topic of the Conference – '10 Years From Now' – is very appropriate given the era of health reform in which we are all operating at the moment. We do need to plan for the future. This session is titled 'Medical Practitioner Registration and Training – issues for CHA facilities in 2010 and beyond'. An important part of the future of our health system is the medical workforce.

Primary Health Care - 2010 23 August 2010 - 10:00am - This Position Statement examines the role of general practice in the delivery of primary care services in Australia.

Canadian Medical Association

08/26/2010 - Mixed Martial Arts ban part of extensive action list for CMA</p>

08/26/2010 - Incoming CMA president well versed on health system's shortcomings

08/26/2010 - CMA delegates show unity in resolving to transform system

08/24/2010 - Lessons on accountability from an expert

08/24/2010 - In final speech, Doig focuses on patients - and the need for patient-centred care

08/24/2010 - Moving the patient-centred agenda forward

08/24/2010 - Ottawa still key player in health care, CMA delegates told

08/24/2010 - Concern about decline in general medicine growing, Members' Forum reveals

08/24/2010 - Session launches patient-centred care debate at CMA annual meeting

08/24/2010 - Defining value, sustainability key to HCT initiative's success

08/23/2010 - Lessons on accountability from an expert

Palliative Care Australia

PCA e-bulletin - August 2010 - The August 2010 edition of the PCA e-bulletin is now available. - Read the PCA e-bulletin August 2010

United States of America. Bureau of Labor Statistics

Health Care Spending: 1998, 2003, and 2008 - How have rising health care costs affected household budgets? That question was raised many times before the passage of the Affordable Care Act, whose goal—as the act's name implies—is to make health care more affordable for American families. This analysis of Consumer Expenditure Survey (CE) data from the 1998, 2003, and 2008 Interview Surveys provides a picture of nominal out-of-pocket health care spending among households categorized by the age of the reference person. The expenses analysed were total health care and its components: health insurance, medical services, prescription drugs, and medical supplies. Among the findings are the following: *Among households nationwide with medical expenses, the mean share of a household's total budget spent on health care was higher in 2003 than in 1998 and was virtually unchanged in 2008 compared with 2003. *Households' spending changed over the decade. In 2008, the mean share of medical expenses that was spent on health insurance was higher than in 1998, and the share spent on medical services was lower. *Households whose reference person was 65 or older spent about twice as much of their budget on health care compared with the national average in all years studied.

United States of America. Society of Actuaries

Society of Actuaries Study Finds Medical Errors Annually Cost at Least $19.5 Billion Nationwide - Findings from a new study released today estimate that measurable medical errors cost the U.S. economy $19.5 billion in 2008. Commissioned by the Society of Actuaries (SOA) and completed by consultants with Milliman, Inc., the report used claims data to provide an actuarially sound measurement of costs for avoidable medical injuries. Of the approximately $80 billion in costs associated with medical injuries, around 25 percent were the result of avoidable medical errors. + Full Report

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