WA News Have You Heard?
Have You Heard
June 2017
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Recession proof medicine (for some)

07062017-Finance-graphs-blackboardBankwest’s national overview of the Medical and Other Health Care Services, which excludes hospitals, is a chronicle of our times. On one side of the ledger, it tells a story of industry expansion and growing employment and salaries, on the other, the inevitable consequence of the former, an increased cost burden on the taxpayer. It studied data from private sector GPs and specialists, pathology, allied health and other services. It is a sector responsible at this time, within the broader health care and social assistance industry, for 65.9% of its income, 80.1% of its profits yet only 36.6% of its employment. Even with this said, employment had risen 83.6% over the past 10 years in this subset, its profit margins were 33.2% higher than the all-industry average of 10.9% (finance sector excepted). In 2014-16 the total costs of the subset had risen to $41.8b while income had grown to $60.2b. There were 9564 operators in WA in this period, 5056 had turnovers of between $200,000 and $2m (or 3.8%). WA employment data indicated 5469 were non-employing, 3962 employed 1-19 people, 124 employed 20-199 and nine had 200+ employees. This is an 8% contraction of the workforce The report projects a five-year growth rate of 3.3% a year to $68.2m driven largely on the back of the ageing population, government expenditure (which is expected to rise to $79.2b in 2020-21), higher disposable income, a higher birth rate and more people visiting GPs. Apparently in 2014-15, 83.7% of the population aged over 15 visited a GP once a year or more or 15.9m visits up from 15.6m the previous year.

Budget for sceptics

There’s been summaries, analyses and theories in abundance since the Federal Budget was brought down. The Government aimed for a muted response and it gave almost enough to get it, though it has left some very big questions pending. The pathology rental decision called a draw between independent GPs and Pathology Australia – the winner was the bureaucracy which will get $18m over the next five years to ensure that the parties comply with the law (which gives a fluctuation of 20% of market price of rentals). Health Care Homes – the policy that no one except the corporate practices says they are ready for. Some conspiracy theorists believe that the government is giving a free kick to Primary and IPN which are both getting up to 50% of the initial funding for the trials. Malcolm Parmenter, who we report below has left IPN for Primary, was a member of the Government’s Primary Health Care Advisory Group on chronic and complex illnesses which recommended the Health Care Home model. Then there’s MyHealthRecord and another $350m for little to show for the $1b investment so far. And so the circle turns.

Crescent rising

The Sydney based Crescent Capital has been busy in the dental space in the past few months. Its National Dental Care ‘roll-up’ has acquired DB Dental and its 17 multi-surgery practices in Perth for an undisclosed sum. In June 2015 Crescent Capital bought up Healthscope’s pathology business. Its other health interests include National Hearing Care which has branches in WA and is also backer of the largest after hours provider National Home Doctor Service (see p16 for a run-down on GP after hours).

e-cigs out of puff

The Federal Court has ordered three online e-cigarette retailers Joystick, Social-Lites and Elusion to pay penalties for breaching the Australian Consumer Law, which the ACCC understands is the first time any regulator globally has successfully taken action for false and misleading claims about the presence of carcinogens in e-cigarettes. The Court ordered Joy Stick and Social-Lites to pay a fine of $50,000 each with Joystick’s director and Social-Lites’ CEO being fined $10,000 each. Elusion was fined $40,000 and its director, $15,000. The Acting Chair of the ACCC Delia Rickard said consumers were led to believe that by using these products they would not be exposed to harmful chemicals found in ordinary cigarettes. “In fact, they were exposed to the same chemicals, including a known carcinogen that has no safe level of exposure,” she said.

Corporate deckchairs

Last month we learnt about Henry Bateman’s launch into GP corporate land, in another twist the CEO of Sonic Clinical Services, Dr Malcolm Parmenter, has resigned to become the CEO of rival Primary Healthcare. Dr Parmenter, who also heads up IPN, Sonic’s primary care division, will take up his new role in September. But what is a blow for Sonic, could be a boon for MediTracker, the smartphone app developed by Precedence Health Care for patients to view their medical summary. IPN is rolling out MediTracker across its 180 practices nationally over the next few months giving two million people the chance to have mobile access to their GP medical record summaries. Dr Parmenter might just see the benefit of rolling it out at Primary too.

Political sweetners

The anti-sugar lobby was hoping to get some action when Australian and New Zealand ministers responsible for food safety met last month. If there’s any movement, it’s at a snail’s pace. In November, Ministers agreed to a program that would investigate labelling to inform consumers about sugars contained in their food. Now they have agreed to “further evidence gathering activities” by Food Standards Australia New Zealand (FSANZ) which would report in November. A tax seems a long way away. Health Minister David Gillespie in response to a Grattan Institute report urging a sugar tax said he regularly told his patients to lose weight by going on the ELF (East Less Food) and the DME (Do More Exercise) program. "You are what you eat but also a result of how often and how much you eat. We are not food fascists, we let people choose what they eat. We are trying to help people make better, wiser, more nutritious choices.” That sounds like a no from him.
Whoever pays the piper…
The Grattan Institute’s Health Program Director Stephen Duckett is on the chronic disease bandwagon, saying simple health system reforms could save over $320m each year by stopping unnecessary hospital admissions and providing better care for people with diabetes, asthma, heart disease and other chronic conditions. At $1000 a day or thereabouts it doesn’t take the prevention of many hospital admissions to demonstrate benefit. And if they recur that’s even better! The Institute says the government spends over $1 billion each year on planning, coordinating and reviewing chronic disease management, yet many people with chronic conditions do not receive best care and end up with unnecessary hospital stays. Medicare’s fee-for-service should be changed for payments to health teams for integrated, long-term care of patients with chronic conditions. GPs would be financially rewarded for outcomes, rather than for seeing patients more often. Primary Health Networks should be held accountable for making improvements.

HaDSCO – who cares?

HaDSCO’s annual report for 2015-16 said it handled 1,777 complaints about health services in WA. The gender mix was about 50:50 with 70% of complaints from the affected adult (while 16% came from a child or parent, and 8% came from a partner or spouse). Nearly half complaints involved more than one issue, and the most popular complaints were about ‘Treatment’ (32%; mostly outcomes or complications), ‘Fees and costs’ (14%; mostly billing practices) and ‘Communication and information’ (14%; mostly wrong attitude and manner). Private and public complaints were roughly the same in type and not-for-profits took longer to resolve things. Complaints about disability services and mental health services were small in comparison.

Penis enlarging made hard

Medical Forum subscribes to TGA safety information and has noticed a flurry of warnings about medications presumably coming out of Africa or China. But this one takes the cake: “XXXL Penis Enlarging Ointment poses a serious risk to your health and should not be taken.” Does this mean your son can’t take it to the school camp or he shouldn’t swallow the ointment but just rub it on the old fella as was intended. Apparently it contains the active ingredient of Cialis (see www.tga.gov.au/alert/xxxl-penis-enlarging-ointment).

By the Numbers

53,420... The number of separations paid by private insurance companies in public hospitals in WA in 2015-16. This represents an increase on average of 10.5% each year between 2011-12 and 2015-16

Admitted Patient Care 2015-16

·         Public hospitals in WA recorded 630,739 separations (a 5% increase on 2014-15)

·         Private hospitals in WA recorded 497,498 separations (a 3.5% increase on 2014-15)

·         Same-day separations in WA public hospitals reached 128 per 1000 population; the rate in WA private hospitals was 131.4 per 1000

·         More women than men in WA were treated in hospital in 2015-16 – 320,877 women compared with 309,860

·         Diseases of the digestive system accounted for the most presentations of specific symptoms to WA public hospitals (23,117) followed by neoplasms (15,132)

·         In WA private hospitals the most presentations were for diseases of the digestive system (40,031) followed by diseases of the eye and adnexa (30,737)


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