WA News Have You Heard?
Have You Heard
December 2017
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Home trial jitters

The Health Care Home trial kicked off on December 1 in WA. The WA Primary Health Alliance has the task of overseeing it for the Commonwealth here. These practices in the Primary Health Network North have signed on for the trial: Bayswater Medical Centre, Beechboro Family Practice, Belridge Medical Group, Brookside Medical Centre, Claremont Medical Centre, Cottesloe Medical Centre, Craigie Medical & Dental Centre, DR7 Medical Centre, GP Superclinic@Midland Railway Workshops, Joondanna Medical Centre, Lindisfarne Medical Group, Maylands Medical Centre, Mobile GP and Homeless Healthcare, Rudloc Road Medical & Dental Centre Morley, Walter Road East General Practitioners and Yanchep Medical Centre. WAPHA told us that five more will be signing on for the December 1 deadline. There seems to be a lot of concern in GP land over the HCH concept. We have had a number of GPs contact us voicing fear over the potential risks to their businesses. Some thought HCNs were a slippery slope to capitation and fundholding that will increase administration without any proof of it leading to better chronic disease management. Others believed HCHs could restrict incomes and signal the demise of some smaller GP-led practices and those practices that subspecialise. The trial will be watched with interest.

RACGP and assisted dying

The RACGP’s official endorsement of voluntary euthanasia has caused a ripple in the membership with high-profile members threatening to quit because of it and the fact that the College consulted no one. The President Dr Bastian Seidel said if the Victorian Parliament passed the legislation (awaiting Upper House approval at the time of us going to Press) it should form a blueprint for other states. Australian Doctor surveyed GPs and GP registrars who appear to have disliked how the College went about the policy saying it was the few speaking for the many. It could also be said of the survey itself which was only 420 GPs and registrars from a membership of more than 26,000. Medical Forum’s own polls in 2008 and 2013 show a roughly even split of doctors for and against voluntary euthanasia with almost a quarter undecided. With WA’s own inquiry taking place currently, this certainly won’t be the last word on this significant topic.

Computer says yes

201712-qoctorIt’s all about convenience via the internet. One of our editorial panel sent us a promo they had received from www.qoctor.com.au, which suggested that as a health consumer they “could get simple things like medical certificates, prescriptions and referral letters without queuing to see a doctor”. Moreover, medication could be express delivered to home or office, or a paper prescription sent to home or the local pharmacy, or on online medical certificate obtained with one of their doctors. The operators of this national business have satisfied the RACGP’s need for knowing, is cherry picking OTC and prescriptions that don’t usually require a face-to-face consultation and referrals where the health consumer gets to choose a ‘regular GP’ and specialist for a group of predetermined conditions and the qoctor doctor does the rest! We’re not sure how rigorous they are about giving a ‘regular GP’ because handing over their name is so the specialist can communicate with the GP! When we surveyed specialists way back, this was one strong comment – that patients who obtained referrals of convenience this way didn’t want to disclose their regular GP because they were embarrassed to do so. The cost of this episode is referred to “as little as $19.99” on the brochure. The website has a running total of what it says it has saved Medicare.

Two for one

With a title like: Keeping patients safer: Australian-UK research collaboration shapes the future of regulation, only good can come of it, surely? AHPRA announced last month that it was collaborating with the UK’s Health and Care Professions Council (HCPC) to target the issue of patient safety in practitioner regulation “head on”. The regulators are mooting a research relationship to share data of over one million registered health practitioners across the two nations. AHPRA CEO Martin Fletcher said their research seminar in Melbourne last month would explore how both regulators could learn from data to improve regulatory effectiveness, patient safety and professional standards internationally. Martin said: “The research would look at complaint hotspots across health professions, preventing harm and using behavioural insights in the work that we do to protect the public.” They say two heads are better than one, or it could be heavier handedness. We’ll be watching.

PEDs and National Law

Still with AHPRA, it has signed a Memorandum of Understanding with the Australian Sports Anti-Doping Authority (ASADA) to “align” the two agencies when performance enhancing drugs (PEDs) are provided by registered health practitioners without genuine therapeutic need. The pair will work closely on investigations and ‘align’ is probably better read as a crackdown on the inappropriate prescribing of PEDs. In not so many words, AHPRA CEO Martin Fletcher said the weight of his organisation would go a significant way in deterring the inappropriate use of PEDs or practitioners would “held to account under our National Law.”

Mobile stroke unit trial

The Victorians are following the Europeans with the introduction of a mobile stroke unit complete with CT scanner to treat those people having a stroke in double-quick time. The Victorian Government has invested $1.5 million into the ambulance, which will work within a 20km radius of the Royal Melbourne Hospital in Parkville, which leaves those outside the perimeter to observe the basics – F.A.S.T. (Facial drooping, Arm weakness, Speech difficulties and Time to call emergency services) Only some people have strokes amenable to early intervention (about 40%). We are yet to find out if this stroke ambulance, which is fitted with CT scanner and a stroke nurse, radiographer and paramedics, will be funded long term. The Victorians are to be applauded for this early treatment in the field. They have the traffic jams and suburban sprawl to determine its efficacy. This four-year research trial will tell them if faster diagnosis and treatment can save lives and reduce disability (Victorians suffer over 14,000 strokes a year). The Mobile Stroke Unit has been delivered by Victoria Government in partnership with the Stroke Foundation, Royal Melbourne Hospital, Ambulance Victoria, the University of Melbourne, The Florey Institute of Neuroscience and Mental Health and the RMH Neuroscience Foundation.

Standards and fees

Just a few weeks before former Kalamunda GP Dr Mike Civil jumped on a plane to take up a medical position on Christmas Island, he tabled the latest edition of the RACGP’s practice accreditation standards. The fifth edition will require GPs to warn patients about potential out-of-pocket costs associated with their referrals, without necessarily giving a detailed cost breakdown. The standards suggest that GPs could provide patients with a contact list so they can compare costs and select their own specialist – we wish them luck. It’s easier to pass a camel through the eye of a needle than to get a specialist’s receptionist to spill the beans on out-of-pocket expenses. The standards require GPs to always reveal their fee structure before providing treatment. Most GPs do this as a rule with posters on billing information posted in waiting areas. Other changes include the explicit requirement for practices to manage seriously abnormal and life-threatening test results after hours.

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