22 November 2010

Welcome to this week's edition of Health Alert.  The Health Alert is transmitted on Monday of each week (unless there is a public holiday on Monday).

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Australia. Administrative Appeals Tribunal

Smalley and Secretary, Department of Health and Ageing [2010] AATA 904 (16 November 2010)

AGED CARE – residential nursing facility care – common law damages – contribution to the cost of future care – life expectancy – statutory interpretation.

This case concerns the compensation available to the applicant, Miss Smalley ('Applicant'), for future care.  The Applicant sustained a subtrochantreic fracture of the left femur on 8 April 2000 and consequently requires specialised nursing care on a residential basis.  She subsequently made a claim which was settled on 4 March 2008 for $1.1million. The settlement figure did not provide for an apportionment for future care. 

The key issue for the Tribunal was to determine the appropriate start date of the most recent life expectancy estimate concerning the future care of the Applicant, either being 4 March 2010 (date of settlement of the claim) or 6 September 2010 (the date of expert evidence concerning the Applicant's life expectancy).  The expert evidence gave the Applicant a predicted life expectancy of five years.

The Tribunal found that the appropriate start date was 4 March 2008, and determined that the Applicant's contribution (compensation payment reduction) is $236,030.59.  This payment was for costs already incurred and paid by the Applicant for her attendance at the facility and for a further two years.

Wragg and Australian Community Pharmacy Authority and Blacker and Benton (Parties Joined) [2010] AATA 905 (16 November 2010)

HEALTH & COMMUNITY SERVICES. Application for relocation of a pharmacy. Definition of catchment area. Whether more than one pharmacy was in the catchment area.

Victorian Civil & Administrative Tribunal

Medical Board of Australia v Jabbar (Occupational and Business Regulation) [2010] VCAT 1772 (5 November 2010)

Health profession – disciplinary proceeding - unprofessional conduct by medical practitioner – Health Professions Registration Act 2005 – reprimand – suspension of registration as medical practitioner – restrictions on circumcision practice.

This case concerns complaints against a doctor in relation to a circumcision procedure on a 26 month old boy ('patient') who suffered from Type 1 Diabetes.  Subsequent to the procedure the boy did not urinate and was distressed and suffered from a high temperature.  He was rushed to hospital and admitted for surgery, where evidence of infection was found and no route for the passage of urine.  The patient developed Fournier's Gangrene and has suffered severe scarring to his groin and abdomen after six operations.

It was alleged that the doctor engaged in unprofessional conduct for inappropriately performing a circumcision procedure on the patient in his private clinical rooms, failing to correctly perform the circumcision, failing to appropriately monitor or ensure that a suitably qualified person adequately monitored the patient post-operatively, and failing to make appropriate clinical notes.

The Tribunal was concerned about the patient's age and presence of Type 1 Diabetes.  They found that the doctor's patient selection was poor and that he failed to identify and appreciate the patient's significant risk factors.  The doctor also appeared to fail to take a complete history of record details and to carry out a visual check to ensure the urethal meatus was not obstructed and was clear.

In making its determination, the Tribunal took into consideration that the function of a determination is protective not punitive, is for deterrence, and of public interest.

The Tribunal reprimanded the doctor, including suspending his general registration as a medical practitioner for three months, limiting his circumcision practice to infants up to four months of age at his clinic and children from 5 years to 18 years in a hospital or day facility under appropriate conditions and ensuring he undertakes remedial education.



National Health Security Act 2007 - Temporary Suspension of Provisions of Part 3 - F2010L03025 - Health - This instrument applies to a biological agent that is suspected Vibrio cholerae O1 in the geographic areas mentioned in the Schedule for a period of 20 business days from commencement of this instrument.

New South Wales

Health Services Amendment (Local Health Networks) Act 2010 No. 97 - assented to on 16/11/2010

Surrogacy Act 2010 No. 102 - assented to on 16 November 2010

Health Legislation Further Amendment Act 2010 No. 96 - assented to on 16 November 2010


Australia. Department of Health & Ageing

Media releases

18 November 2010 - Historic Health Prevention Agency a Reality - The fight against preventable diseases has been given a boost after Parliament passed on 17 November the historic Australian National Preventive Health Agency Bill 2010.

17 November 2010 - Internet Tobacco Advertising to Face New Tough Restrictions - Prohibiting retailers from peddling cigarettes as 'cheap' or 'tax-free' on the internet is the latest step in the Australian Government's hard hitting and comprehensive action to reduce Australia's smoking rates.

15 November 2010 - 10 Million Aussies now have Private Hospital Insurance - For the first time since December 1982, more than 10 million Australians have private hospital insurance. Figures released on 15 November also showed that a high proportion of Australians were continuing to take out private health insurance, demonstrating the strength of the sector.

14 November 2010 - World Diabetes Day: Education and Prevention is the Key - Diabetes education and prevention is the theme of World Diabetes Day, held on 14 November.

Private Health Insurance Circulars

PHI 81/10 - Hospital Information

PHI 80/10 - National Hospital Cost Data Collection (NHCDC) Round 14 (2009-10) for private and same day hospital facilities

PHI 79/10 - Private Health Insurance (Benefit Requirements) Amendment Rules 2010 (NO. 7A) and Private Health Insurance (Complying Product) Amendment Rules 2010 (NO. 5)

PHI 78/10 - Hospital information

PHI 77/10 - Implementation of Lifetime Health Cover (LHC) 10 year provision

PHI 76/10 - Release of the National Hospital Cost Data Collection (NHCDC) Round 13 (2008-09)

Australia. Therapeutic Goods Administration

Review to improve transparency of the TGA (media release, The Hon Catherine King MP, Parliamentary Secretary for Health and Ageing)

Australia. National Health & Medical Research Council

$125.7 million to support 296 of Australia's Top Health and Medical Researchers - 18 NOVEMBER 2010 - Dementia care and mental health treatments are two areas that will benefit from an injection of $125.7 million into health and medical research, announced today by Mark Butler, Minister for Mental Health and Ageing. Two hundred and ninety six researchers across Australia have been awarded NHMRC awards and fellowships that will enable them to develop their research careers - View Media Release (includes a full list of recipients) - State/Territory Media Releases: ACT NSW QLD SA TAS VIC WA

Call for public comment - Draft consensus-based guideline on the management of volatile substance use - 17 NOVEMBER 2010 - Comments are being invited on the draft consensus-based clinical practice guideline for the management of volatile substance use (VSU) - View Media Release

$447.5 million boost to medical research - 12 NOVEMBER 2010 - Minister for Mental Health and Ageing Mark Butler today announced $447.5 million for medical research, through the National Health and Medical Research Council. Mr Butler made the announcement while opening two new research facilities at the Baker IDI Heart and Diabetes Institute. - View Media Release - Successful Project Grants - 2010 ( 582KB PDF)

Australian Researcher in International Virus Research - 5 NOVEMBER 2010 - Minister for Mental Health and Ageing Mark Butler, and Member for Fraser Dr Andrew Leigh today announced that Professor Suresh Mahalingam, a University of Canberra Professor, has been awarded a National Health and Medical Research Council - European Union grant - View Media Release

Tracker – 12 November 2010 edition

Australian Institute of Health & Welfare

Weight loss surgery in Australia - This report shows that there was a substantial increase in weight loss surgery in Australia, from approximately 500 separations in 1998-99 to 17,000 in 2007-08, growing to 90% in 2007-08. Published 19 November 2010.

Australian Health Practitioners Regulation Authority

Tasmanian Board and Committee Vacancies - 17 November 2010

Annual Report 2009 to 2010 for the National Boards and AHPRA - 12 November 2010

Australian Capital Territory. Department of Health

Media releases

Community celebrates ACT 2010 Health Promotion Awards Katy Gallagher, MLA 19 November 2010

Health Minister announces over $950,000 in Health Promotion Funding Katy Gallagher, MLA 17 November 2010

Five ACT workplaces chosen to improve employee health Katy Gallagher, MLA 17 November 2010

Significant Incident Reporting Policy - The Significant Incident Reporting Policy defines the criteria that constitutes a "significant incident". It has now been updated to align with changes to the Australian Institute of Health and Welfare definitions for Sentinel Events. Significant Incidents includes all Catastrophic, Sentinel and Major Incidents under the following categories of People; Clinical; Property & Services; Financial; Information; Business Process and Systems; Reputation; and Environment. It defines the time frames for reporting and the governance arrangements for reporting using the Significant Incidents reporting system on RiskMan. Significant Incident reporting is more commonly known as a SIB which stands for Significant Incident Brief. ACT Health-Wide - Patient Safety and QualityCED10-032 Significant Incident Reporting Policy (PDF File 73k)

The ACT Health Corporate Plan (2010-2012) gives strategic direction to ACT Health business units to support the achievement of ACT Health's overarching organisational vision and corporate values. The vision for the Plan is "your health our priority". The Plan has seven key performance areas - Consumer Experience; Sustainability; Hospital and Related Care; Prevention; Social Inclusion and Indigenous Health; Community Based Health; and Aged Care. ACT Health-Wide - Chief ExecutiveCED10-033 Act Health Corporate Plan 2010-12 (PDF File 1151k)

Digital Health Enterprise Technology Strategy And Implementation Plan - The Digital Health Enterprise (DHE) technology strategy and implementation plan outlines how technology will support and enable ACT Health's transformation programme (Your health – our priority). The transformation programme is developing new service delivery methods and models so that ACT Health can continue providing quality health services in an environment of rapidly rising demand. The transformation programme encompasses new models of care, new and refurbished facilities, workforce planning and enhanced technology capabilities. ACT Health-Wide - Information Services BranchCED10-034 Digital Health Enterprise Technology Strategy And Implementation Plan And Appendices

New South Wales. Department of Health

Media releases

New program attracts doctors to regional hospitals [18 November 2010]

Improving Services For People With Chronic Illness [17 November 2010]

Policy directive

Electroconvulsive Therapy (ECT) PD2010_068 17/11/2010

Information bulletin

Commonwealth Paid Parental Leave Guidelines for NSW Health IB2010_057 18/11/2010

Queensland. Department of Health

Media releases

18/11/2010 First building opens as part of Mackay Base Hospital redevelopment

18/11/2010 Report card does not paint true picture of Queensland hospitals




17/11/2010 Targeted campaign sees more women screened for breast cancer

16/11/2010 Changes deliver better and faster patient care

12/11/2010 Queensland drives national agenda at Health Ministerial Council


Quarterly Public Hospitals Performance Report - September Quarter 2010 (PDF, 616 KB)

Statement regarding cholera outbreak in Papua New Guinea

South Australia. Department of Health

Media releases

11 November 2010 - Country Health SA and KI Doctors reach agreement

10 November 2010 - Improved health services in the community

Commonwealth role for SA Health Chief - Thursday, 18 November 2010 - Health Minister John Hill has congratulated the Chief Executive of SA Health, Dr Tony Sherbon, on his appointment to a new role leading health reform for the Commonwealth Government. Read more...

Tasmania. Department of Health & Human Services

Media releases

Positive Signs in Hospital Report Card Minister for Health 18 November 2010

More Women Screened for Breast Cancer Minister for Health 18 November 2010

Victoria. Department of Health

The Victorian Health Service Performance Monitoring Framework 2010 - 11 Business Rules (PDF File 493KB)

17 November 2010 Management of locust spray contamination: information for health professionals - November 2010

Western Australia. Department of Health

Media releases

16 November 2010 - WA Health exercise to test response to simulated terrorist incident

15 November 2010 - New muscular dystrophy registry to provide hope for thousands

19 November  2010 Barnett - WA extends partnership with national depression initiative

19 November 2010 Jacobs - New recovery centre for mental health services in Broome

17 November 2010 Hames - $24.14million medical imaging contract for Bunbury Hospital

17 November 2010 Hames, Jacobs - New Hedland Health Campus to open today

16 November 2010 Hames - New $1.4million facility for tuberculosis and humanitarian patients opens

A guide to the use of pesticides in Western Australia (PDF 2.54MB)

Western Australia. Office of Health Review

Health Review #10 - 17 November 2010 - Issue #10 of our newsletter Health Review is available for reading and downloading.  This will be our final edition of Health Review. In early 2011 we will be publishing a revamped newsletter - please keep visiting our site for future updates. Click here

New Zealand. Ministry of Health

17 November 2010: National Opioid Substitution Treatment Providers Training Programme - The workbook provides an overview of the knowledge, attitudes and skills required to effectively provide opioid substitution treatment in the specialist service, the prison setting, the Primary Health Care/general practice setting and the community pharmacy.

16 November 2010: The Use of Coloured Filters and Lenses in the Management of Children with Reading Difficulties - This paper summarises the current literature on Irlen syndrome (Scotopic Sensitivity Syndrome).

New Zealand. Medsafe

Consultation - Outcome of the consultation on proposed updates to the New Zealand Good Clinical Research Practice Guideline

United Kingdom. Department of Health

New site section: Energise for Excellence (E4)

Statistical release: smoking at delivery, GP recorded smoking and GP recorded obesity, quarter 2, 2010-11

Statistical release: breastfeeding initiation and prevalence at 6 to 8 weeks, quarter 2, 2010-11

Advanced level nursing: a position statement

Improving care for people with long term conditions: 'at a glance' information sheets for healthcare professionals

A consultation on proposals - Transparency in outcomes: a framework for adult social care

A Vision for Adult Social Care: Capable Communities and Active Citizens

Professional Standards Programme: Transfer of social work regulation

Professional Standards Programme: Whistle blowing

National Apprenticeship Advisory Committee: Making apprenticeships an important and sustainable part of the health sector workforce - final report and DH response to recommendations

A question of balance: independent assurance of information governance returns

Cancelled Operations statistics for the quarter ending September 2010

Accident & Emergency attendances; total time spent in A&E from arrival to admission, discharge or transfer; and waiting for emergency admission through A&E, quarter ending September 2010

United States of America. Department of Health & Human Services

Statement by Kathleen Sebelius, Secretary of Health and Human Services, on the Great American Smokeout - Tobacco use ─ which is responsible for more than 440,000 deaths per year in the US alone ─ is the leading preventable cause of death in this country.

Medicare finalizes new rules to require equal visitation rights for all hospital patients - The Centers for Medicare & Medicaid Services (CMS) today issued new rules for Medicare- and Medicaid-participating hospitals that protect patients' right to choose their own visitors during a hospital stay, including a visitor who is a same-sex domestic partner.

United States of America. Centres for Disease Control

CDC Spotlights Global Efforts to Address Antibiotic Resistance  - Antibiotic resistance is one of the world's most pressing public health threats. To bring attention to this increasing problem, the Centers for Disease Control and Prevention and other government partners will observe its third annual Get Smart about Antibiotics Week on November 15-21, 2010. (Published: 11/15/2010)

Australian Medical Association

AMA seeks applicants for Indigenous Medical Scholarship 18 November 2010 - 1:30pm - The AMA today opened nominations for the 2011 AMA Indigenous Peoples' Medical Scholarship. The scholarship was established in 1995 to help increase the number of Indigenous doctors in Australia. AMA President, Dr Andrew Pesce, said today that the AMA believes that an essential part of closing the gap in Indigenous health is to build an adequate workforce that includes doctors and health professionals who are Indigenous.

AMA submission to the 2010 review of the Medicare provider number legislation 18 November 2010 - 3:00pm - The AMA has made a submission to the review of the Medicare provider number legislation. We have called for a number of measures including medical training initiatives; the introduction of a single Medicare provider number for all practice locations; and the grandfathering of pre-1996 non-vocationally registered general practitioners who were accessing GP Medicare rebates prior to 1 November 1996 and have predominantly been in general practice for a minimum of five years since that date.

MJA appoints new editor 17 November 2010 - 3:00pm - The Medical Journal of Australia (MJA) has appointed Dr Annette Katelaris as its new Editor, taking over from Dr Martin Van Der Weyden, who has been Editor since 1995. Dr Katelaris is a practising general practitioner with a strong record in medical publishing, including as Medical Editor for Australian Doctor magazine and the 6 minutes medical newsletter. She has also been involved for many years in developing and editing medical educational material for doctors.

Little improvement in public hospital capacity and performance despite extra funding 18 November 2010 - 11:30am - AMA Public Hospital Report Card 2010 - AMA President, Dr Andrew Pesce, said today that there had been little improvement in public hospital capacity and performance despite significant extra Commonwealth funding as part of the National Healthcare Agreement and specific funding for an elective surgery 'blitz'. The AMA Public Hospital Report Card 2010 is an analysis of the most recent publicly available national data on public hospital performance plus more recent feedback from doctors working in public hospitals in all States and Territories.

AMA supports ban on Internet tobacco advertising 17 November 2010 - 12:15pm  - AMA President, Dr Andrew Pesce, said today that the AMA supports Government moves to ban the advertising of tobacco products on the Internet and other electronic media. Dr Pesce said that the AMA wants a ban on all forms of tobacco promotion to reduce the harms that smoking causes. "The Government's strong action to restrict advertising of tobacco products must be backed by the Parliament," Dr Pesce said.

AMA response to Medicare Locals discussion paper on governance and function 17 November 2010 - 12:00pm - AMA has supported the need for reform to Australia's health system, particularly the issue of responsibility for public hospitals and the linkages with other parts of the health system such as primary care and aged care. The Government has said Medicare Locals are the mechanism to improve these linkages. Our usual preference would be for less bureaucratic mechanisms than are suggested in the discussion paper. We represent doctors who like to behave in an efficient manner, responsive to the needs of their patients, to be independent and accountable to their patients and free, to the maximum extent possible, of bureaucratic red tape.

AMA Public Hospital Report Card 2010 18 November 2010 - 11:30am  - The AMA Public Hospital Report Card 2010 is an analysis of the most recent publicly available national data on public hospital performance plus more recent feedback from doctors working in public hospitals in all States and Territories. There has been little improvement in public hospital capacity and performance despite significant extra Commonwealth funding as part of the National Healthcare Agreement and specific funding for an elective surgery 'blitz'.

Australia's defence against infectious diseases is at risk 14 November 2010 - 12:00pm - MJA release - The nation's public health response capacity is at serious risk because the Australian Government has decided not to renew funding for an epidemiology program, according to an article in the Medical Journal of Australia. Emeritus Professor Robert Douglas, visiting fellow at the National Centre for Epidemiology and Population Health at the Australian National University, and co-authors discuss the importance of the Master of Applied Epidemiology (MAE) program and its role in preventing the spread of epidemics.

One-third of doctors consider giving up medicine due to medicolegal concerns 14 November 2010 - 12:00pm  - MJA media release - Medicolegal concerns are affecting how Australian doctors practise medicine, according to an article published in the Medical Journal of Australia. Dr Louise Nash, coordinator of the postgraduate course in Psychiatry and Master of Psychiatry at the New South Wales Institute of Psychiatry, Sydney, and co-authors conducted a survey of Australian doctors to explore the perceived impact of medicolegal concerns on how they practise medicine, and to compare doctors who have experienced a medicolegal matter with those who have not.

Review of GP subsidies for teaching medical students is needed 14 November 2010 - 12:00pm - MJA media release - The lack of adequate training subsidies for undergraduate medical student training is costing general practices, according to an article in the Medical Journal of Australia. Dr Caroline Laurence, Research and Development Manager of Adelaide to Outback GP Training Program, and co-authors conducted a study to identify the financial costs and benefits associated with teaching in private general practice.

Bicycle helmet laws should be maintained and enforced 14 November 2010 - 12:00pm - MJA media release - Mandatory bicycle helmet laws should be maintained and enforced as part of overall road safety strategies, according to a study outlined in a letter to the editor in the Medical Journal of Australia. Dr Michael Dinh, Emergency Physician and Co-Director of the Department of Trauma Services at the Royal Prince Alfred Hospital (RPAH), Sydney, and co-authors reviewed a study conducted by the RPAH that summarised long-term trends in cyclist head injuries and determined the odds of any skull fracture or intracranial bleed associated with not wearing a helmet.

Good first step but health ministers must do more on mandatory reporting laws 12 November 2010 - 5:30pm - AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Health Ministers' decision to ask the Australian Health Ministers' Advisory Council (AHMAC) to commission independent work on mandatory reporting requirements. Dr Pesce said the decision is a great recognition of the AMA's concerns about the effect of the requirements on doctors accessing health care when they need it.

Positive move by Minister on care for people with diabetes 12 November 2010 - 11:30am - AMA President, Dr Andrew Pesce, said today that the AMA welcomes Health Minister Nicola Roxon's revised approach to implementing a new scheme for care for people with diabetes. Dr Pesce said the Minister has consulted closely with the AMA and the medical profession and has proposed a trial of the scheme so it can be properly assessed and evaluated.

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