WA News Have You Heard?
Have You Heard
September 2017
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Perinatal anxiety can kill

Medical Forum has been looking into the issue of perinatal anxiety (see August edition and P36) and next month it will be the subject of two days of workshops and social events put on by both government and non-government organisations. The Gidget Foundation Australia, Fiona Stanley Hospital, King Edward Memorial Hospital and the Big Pram Walk are putting on a symposium, dinner and workshop on October 6 and 7 for health professionals and the public. According to Gidget data, nearly one in five mothers and one in 10 fathers are said to experience perinatal anxiety and depression and 50% of all parents experience adjustment disorders. On Friday October 6, FSH will host a one-day symposium with Dr Nicole Highet, Centre of Perinatal Excellence (COPE), launching the National Perinatal Mental Health Guidelines in WA. She is joined by Prof Vera Morgan, Prof John Newnham, Prof Rhonda Marriot and Prof Andrew Whitehouse. www.wnhs.health.wa.gov.au/symposium2017 Dinner will be held that evening at Fraser’s. The following morning there will be workshops for GPs, allied health and consumers at KEMH with Prof Megan Galbally, Dr Sarah Moore, Dr Richelle Douglas, Dr Leanne Priestly, Kirstin Bouse, Dr Sue Jackson, Dr Leon Levitt doing the honours. To book for the worshop www.trybooking.com/RSHZ

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Kids and depression

While talking about vulnerable populations, last issue we looked into the Origins Project being run by the Telethon Kids Institute and Joondalup Health Campus. One of the project leads, paediatrician Dr Desiree Silva, told Medical Forum that she was seeing children as young as seven expressing suicidal thoughts. Australian Rotary Health has invited psychiatrist Prof Michael Sawyer, from the University of Adelaide, neuropsychiatric epidemiologist Prof Vera Morgan and eating disorders expert A/Prof Susan Byrne, both from UWA, to speak at a forum, Lifting the Lid: Mental Health and Our Kids, at 6pm September 13 at the University Club at UWA. www.australianrotaryhealth.or.au/events

PAYG med school

As WA’s three medical schools head towards final exams for the year, including Curtin Medical School in its inaugural year, there’s upset and controversy on the other side of the country with Macquarie University preparing to accept its first cohort of full fee-paying students in 2018. Domestic students will pay $64,000 a year for tuition and international students, who are expected to make up a third of the cohort, will pay $70,000. It will take the number of medical schools in NSW to eight and many professional and students groups say that is way too many. Macquarie medical students will also be required to spend five months of their clinical training in India.

TGA ups the mesh ante

Last month we reported that a class action had begun in Sydney against Johnson & Johnson, the manufacturer of transvaginal mesh. Now the TGA has said it will follow a decision by the European Commission to implement a number of medical device reforms, including to ‘up-classify’ all surgical mesh medical devices (such as gynaecological mesh) to Class III (high risk) and to provide patient implant cards and consumer product information for all implantable medical devices. The TGA has released a consultation paper regarding its decision to reclassify all implantable surgical mesh medical devices and is looking for views from industry, healthcare professionals, and current and future recipients of medical devices on the proposed implementation of these changes.

Thumbs up for drug monitoring

Still with the Feds, the Australian Government has committed $16 million to roll-out national real-time prescription monitoring of controlled drugs. The system will provide an instant alert to doctors and pharmacists if patients received multiple supplies of prescription-only medicines. The RACGP threw its support behind the move. President Dr Bastian Seidel said new data showed accidental overdoses of prescription opioids were greater now than from heroin overdoses. The Tasmanian GP said prescription monitoring was standard in his state and it was a vital tool for every GP and pharmacist to identify and help vulnerable people. He also urged pharmacists to back moves to restrict codeine sales saying “the consumption of these medications is currently running out of control with over 16 million items being sold over the counter in pharmacies every year.”

A performance-data future

There is sure to be a lot more conversations such as Dr Rebekah McWhirter’s article and podcast on MJA Perspective last month regarding the release of performance data. Her thesis was that increased health care data collection and broader expectations of transparency might lead to a legal duty to disclose performance data as part of informed consent. Dr McWhirter, who works at the Menzies Institute for Medical Research and the University of Tasmania’s Centre for Law and Genetics, said currently there was no general duty to disclose performance data, but there could be in the future. A spokesperson for the Royal Australasian College of Surgeons (RACS) said that there had been little advance on the legal duty to disclose performance data since the Chappel v Hart test case in 1998 and he through it was “probably a stretch too far…certainly in Australia, for it to happen anytime soon. However, the issue of data and information sharing and comparative data was a live concern.” The Chappel v Hart case indicated that, where a patient asked about a surgeon’s experience in a particular procedure as part of the consent process, the surgeon may have a duty to inform the patient of their experience, but that the decision did not extend to a general duty to provide performance data. However the RACS spokesperson said if any surgeon was asked about their performance data, there was an onus on them to provide the information as “clearly, fairly and transparently” as possible. The spokesperson added that performance data needed to be risk-adjusted for the complexity and difficulty of procedures.

Pain in the hip pocket

August was a month of out-of-pocket scrutiny following data released by RACS and Medibank Private regarding variations in surgery costs. Urology came under particular scrutiny with the CEO of Cancer Council Australia, Prof Sanchia Aranda, saying "out-of-pocket costs for these procedures show unwarranted levels of variation across Australia and at times are likely to cause significant financial hardship for patients unaware of alternatives to paying these high fees… It was reported in the RACS/Medibank report that the average cost of a radical prostatectomy ranged from $14,553 to $55,928 depending on the surgeon. In WA 73% of patients were out-of-pocket for this procedure. The highest percentage was in the ACT with 100% of patients followed by 88% in NSW. Only 35% of patients in Victoria had out-of-pocket costs. Prof Aranda said the situation is even more concerning when aligned with evidence suggesting expensive robotic surgery offered little benefit to patients. The Cancer Council wants an improved standard of financial consent that ensures surgeons and other clinicians disclose all of the out-of-pocket costs associated with a planned treatment, along with treatment alternatives that may carry lower or no out-of-pocket costs. This issue and more will no doubt be thrashed out in the final report of the Senate Committee inquiry into the value and affordability of private health insurance due to be released on November 27.

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Website kicks goals

The painHEALTH website developed by a consortium including people from WA Health, Curtin University and UWA and led by A/Prof Helen Slater and pain medicine physician, Dr Stephanie Davies, announced during Pain Week that it had recorded more than 8.1m hits since its launch in 2013. It has had about 620,000 visitors from more than 150 countries averaging about 410 visitors a day. The website now has improved interface for use on smart devices. https://painhealth.csse.uwa.edu.au/

By the Numbers: Burden of Respiratory Diseases

70.3%

The percentage of the overall respiratory disease burden in 2011 that was non-fatal

(There has been a 7% reduction in the overall burden from respiratory conditions between 2003 and 2011, Years of Life Lost (YLL) has decreased 13%; Years Lived with Disability (YLD) has decreased 4%)

  • 92.3% of interstitial lung disease burden was fatal
  • 91.8 of pneumoconiosis burden was fatal (Recent reports of Coal Workers’ Pneumoconiosis in Australia cite six confirmed cases in the Queensland coal industry between May 2015 and February 2016 (MJA).)
  • 47% of COPD burden was fatal
  • 6.8% of Asthma burden was fatal
  • COPD constituted 42.8% of the respiration conditions burden; Asthma was 28.6%
  • Women experienced a higher percentage of the burden (YLD) – Asthma 54%; COPD 55%; upper respiratory 52%
  • Tobacco use is an attributable risk factor in 36.2% of all respiratory conditions

(Source: The Burden of Chronic Respiratory Conditions in Australia 2011, AIHW)   

 
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