WA News Have You Heard? July 2017
July 2017
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Health and sustainability

In the Letters pages we published a GP anaethetist’s dismay at the unnecessary waste in the public system. The Health Minister Roger Cook said that her concerns would be referred to the Sustainable Health Review, which was an election promise and, just before we went to press, was announced as a goer. The panel will be chaired by Robyn Kruk, a former NSW Director General of Health who is well versed in government reform. The terms of reference include:

  • A review of WA health system to put patients first, embrace innovation and technology, and improve financial sustainability;
  • Expressions of Interest for Reference Groups are open and it will consult widely with consumers and carers, front-line staff, health leaders and others;
  • The final report is due by March 2018.

The Health Minister’s statement said the review would rein in expenditure, which has apparently tripled to $9b in a decade. Other members of the panel include the Director General of the Department of Health, the Under Treasurer; an employee nominee, and a nominee of the Minister for Health. Roger Cook was at pains to stress that this wasn’t a toe-cutting affair but an attempt to flatten the cost trajectory to sustainably deliver future health services.

Best for Baby, Best for Dad27062017-Healthy-Men-winner-2016

Men’s Health Week may have come and gone but the love lingers on the St John of God Health Care Facebook page with 254 pictures of children and the significant men in their lives. The photo comp was part of SJGHC’s Healthy Men, Healthy Minds competition as a way of raising awareness of perinatal mental health. Helen McAllister, director of SJG Raphael Services said one in 10 men experienced anxiety or depression when they welcomed a new baby or when their partner was pregnant. “Men don’t access the same support services as women do during pregnancy so there is less opportunity for men to speak about their concerns or seek further help and we suspect that the real number of men who experience perinatal anxiety or depression is much higher,” she said. Seeing a GP was the first step to get in touch with services that can help.

Medihotel checks in

Five bidders have been shortlisted to build Labor’s first Medihotel next door to Fiona Stanley Hospital. The successful tenderer will be announced soon. LandCorp received 11 submissions for the new facility. The Medihotels were an election promise and designed to support recuperating patients and allow family members to stay with patients, while freeing up hospital beds. Lands Minister Rita Saffioti said that over a 10 to 15-year period, the Murdoch Health and Knowledge Precinct would deliver 1200 residences, about 175,000sq m of floor space including commercial, health, research, residential, and short-stay or hotel accommodation.

SIHI funded till 2019

There was consternation in the ranks about the pending expiry of the Southern Inland Health Initiative which has rejuvenated general practice medical services for people living in the South West and Southern Gascoyne regions, particularly the neglected Wheatbelt. The Labor Government announced last month that it would continue to fund the medical workforce incentives until June 2019. The Royalties for Regions funding was due to run out on June 30, 2017, but the Government announced it would provide a baseline commitment of $33m a year for GP incentives. The Commonwealth also contributes funds through the PHN. There are now 133 GPs in the SIHI region, 36 more than before the incentive scheme was in place.

Bowel screening uptake slows

We are not a poo nation it seems. The pick-up rate for the swabbing of faeces and sending a sample off is in the minority – two in five eligible people are participating in the Australian Government’s National Bowel Cancer Screening Program (NBCSP), which began in 2006, targeting 50 to 74-year-olds. Yet Australia continues to have among the highest rates of bowel cancer in the world representing 8.6% of all cancer related deaths (second only to lung cancer). If detected at the earliest stage, the five-year survival rate for bowel cancer is 93%, we are told. Men are more likely to be diagnosed with, and die, from bowel cancer, and men are less likely than women to participate in bowel cancer screening. Modifiable lifestyle risk factors include overweight and obesity, lack of physical activity, inadequate dietary fibre, high intake of some foods such as processed meat, high alcohol consumption and smoking. Other risk factors include a personal history of bowel polyps and family history of bowel cancer.

Moody blues

Still with the poo talk, at the recent congress of Royal Australian College of Physicians, A/Prof Patrick Charles explored some of the emerging observations of people who had undergone faecal transplants. Faecal transplants have become increasingly popular for the treatment of multiple conditions including chronic fatigue, irritable bowel syndrome, Parkinson’s and autism. Patrick says there is also anecdotal evidence of recipients mimicking the mood and other characteristics of their donor such as changes to body shape (either weight gain or loss) and depression. He said while human DNA usually only varies between 0.1-0.5% per cent the mixture of microbiome varies as much as 80%. “As the health sector continues to experiment with faecal transplants for various conditions, careful selection and screening of the donor has to remain a focus,” he said. Food for thought that may make you look sideways next time you ride a bus or take a train.

Welfare and boutique hospitals

Also at the RACP congress, physicians who do addiction medicine think the testing of welfare recipients for illicit drugs is both impractical and ineffective. Research and experience shows this is likely to fail because forcing addicts into treatment is an ineffective way of combating illicit drug use. It is a health care issue for which there should be adequate funding of treatment and support services. These moves might catch votes but the worry is that people looking for help will end up standing in a longer queue. Another interesting opinion was voiced at the congress from Brisbane doctor A/Prof Ian Scott who said big budget mega hospitals (his words were Taj Mahals like the new Adelaide hospital at a cost of $2.1b and we could probably add FSH) were set to become a thing of the past, with smaller hospitals focusing on one or just a few specialties (for example, a cardiovascular hospital) or a demographic (aged care) set to become more commonplace. The downsizing and specialisation of hospitals will be more cost effective and provide better levels of health care for patients, he said.

Promoting organ donation

The sad truth is that road traffic accidents provide most of the live organ donors. And with 90% of immediate family of those registered to donate going through with it, plus the opt-in system we have in Australia, the federal government has recently awarded $430,000 in Community Awareness Grants to encourage more people to join the Australian Organ Donor Register. They want prospective donors to discuss their donation decision with family and friends, while they are with it, because it is the relatives who obstruct by objecting (10% of the time). The funds will help finance 16 national and local community projects. For the first five months of this year, 211 organ donors and their families saved and transformed the lives of 582 people but about 1400 Australians are on the wait-list for a transplant. The register can be accessed at www.donatelife.gov.au.

New oversight of OTA

After the upheavals over the past couple of years within the organ and tissue donation bureaucracy, the Federal Government has announced new oversight with the establishment of the Australian Organ and Tissue Donation and Transplantation Board with WA’s Dr Mal Washer as chair. The board, said Minister Ken Wyatt’s statement, would “govern the Australian Organ and Tissue Donation and Transplantation Authority (OTA)”. Its creation was a recommendation of last year’s review by Ernst and Young.

Back in their cage27062017-Cage-fight-men

Despite vocal opposition from some in the medical profession, including AMA WA, the Labor Government has reversed the former Government’s ban on Mixed Martial Arts bouts in cages. The cage is back and there is an equally loud voice to say it makes the sport much safer. In 2013, Dr Paddy Golden, who has been a ringside doctor for MMA bouts, spoke to Medical Forum about his concerns how unsafe it would be for fighters to compete without a cage. That year the Barnett Government banned the ‘cage’ or Octagon against the safety advice of WA’s Combat Sports Commission. The Sports Minister Mick Murray said while MMA was not “everyone’s cup of tea”, he wanted to make it as safe as possible. “It makes no sense to continue with a ban that is only good for putting athletes at risk. MMA is already legal and taking place across Perth at a grassroots level, but athletes and promoters have been left frustrated that they can’t use the standard safety equipment for their sport.”