There are exciting plans ahead in 2010 as ACT by xak10506



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There are exciting plans ahead in 2010
as ACT Health Minister Katy Gallagher explains
“Canberra Doctor” intends                                                           Building a third hospital is        members of the Legislative               port disadvantaged groups and
                                                                               not the best option either because       Assembly who are elected to rep-         improve access to general prac-
to invite guest editorials in                                                  this would inevitably lead to the        resent the interests of the com-         tice. Applications for the first
2010. The first of these                                                       death of Calvary Hospital. Some          munity. The ramifications of this        round close on 26 February with
editorials is by Health                                                        commentators have suggested the          decision will be felt for many           the second round to commence
                                                                               Government pursue compulsory             years as the proposal was undeni-        in early May. If you are interested,
Minister, Katy Gallagher,                                                      acquisition, however, this would         ably the most cost effective and         you can find more information by
MLA                                                                            undoubtedly cause significant            sustainable way forward.                 logging on to the ACT Health
                                                                               conflict and tie the hospital up in           So it’s back to the drawing         website:
     It’s been a busy start to 2010                                            legal action for years. This would       board. We will have to revisit all       gpdevelopmentfund .
and there are some exciting plans                                              not deliver the outcome that we          the options and explore every            At the hospital….
ahead for Health this year with                                                need which is a new and revital-         possibility. The injection of funds           Late last year I opened a new
construction set to begin on a                                                 ised hospital campus built within        needed in the hospital is the same       Oral and Maxillofacial and Ear
range of new health facilities.                                                the next six years.                      but the question is how we do            Nose and Throat Clinic which
There’ll be a hive of construction                                                  We also have to accept that         that. What hasn’t changed is the         brings these services together
activity at the Canberra Hospital                                              our vision for an integrated health      Government’s unwavering com-             with enhancements such as a new
with the start of works on our                                                 care system under the one pro-           mitment to delivering a sustaina-        state-of-the-art Audiology Booth,
new Women’s and Children’s                                                     vider is lost. We now have to            ble health system for the people         providing the community with
Hospital and the new Adult Acute      the Board of LCMHC remain of                                                      of Canberra and we will continue
                                      the view that the proposal is the        work out how we deliver an inte-                                                  another avenue for hearing tests
Mental Health Inpatient Unit. A                                                grated system with two providers.        our billion dollar plan to rebuild       and reducing waiting times for
range of new facilities will also     best way forward. However, the                                                    our public hospital system to pre-
                                      Sisters have made a decision not         This will form part of the next                                                   these services.
open including our Neurosurgery                                                round of negotiations with               pare for the peak in demand over              In December the Chief Mini-
Suite, Walk-in Centre, Mental         to seek Vatican approval for the                                                  the coming decade.
                                      deal in light of opposition from         LCMHC which will involve dis-                                                     ster Jon Stanhope opened 24 new
Health Assessment Unit and the                                                 cussions about how we make the                While there are clearly some        beds at the Canberra Hospital on
new multi-storey car park.            within the Church and an under-                                                   challenges ahead, I’d also like to
                                      standing that approval could take        investments required, LCMHC’s                                                     my behalf bringing the total number
     The Government also recog-                                                role in palliative care and its role     reflect briefly on the past few          of public hospital beds to almost
                                      a number of years, prolonging                                                     months and the many successes
nises the need for investment on      the uncertainty for the commu-           as a private health care provider.                                                900 – that’s an increase of more
the north side of Canberra and                                                 As we grow our health system to          in the Health portfolio.                 than 200 since our Government
                                      nity and staff.
will this year open a new Intensive        What is clear is that the status    cater for increased demand the           Supporting GPs…                          came to office. We will continue to
Care Unit at Calvary Hospital         quo cannot remain as the Govern-         Government will inevitably need               Just before Christmas I was         invest in the capacity of our public
which is already under construc-      ment needs to invest around $200         to resume the area of the public         pleased to announce that the ACT         hospitals with a further 24 beds and
tion. We know that more invest-       million in the Calvary Hospital          hospital currently used by               had secured an additional five gen-      25 ‘bed equivalents’ funded in the
ment is needed at Calvary. The        campus. Under the current                LCMHC to provide private hos-            eral practice training places for        2009-10 Budget.
challenge the Government faces is     arrangements, this would result in       pital services. These are not insig-     Canberra. This will take the number           I was also pleased to launch
how we do that now the proposal       a grant to a third party. While          nificant challenges.                     of Canberra GP registrars in train-      our new webcam service in the
to purchase the hospital from         some have sought to trivialise the                                                ing to more than 30 in 2010.             Canberra Hospital’s Centre for
Little Company of Mary Health                                                       It is very disappointing that
                                      financial impact, this does create       the interests of a few were placed            The first round of the ACT          Newborn care in January. The web-
Care (LCMHC) won’t go ahead.          enormous challenges for the ACT                                                                                            cams are installed above the cots
                                                                               above the interests of the broader       Government’s GP Development
Calvary update                        Budget. If we were to make that          community – a community of               Fund has also opened for appli-          allowing families who aren’t able to
     LCMHC has discontinued           investment under the existing            600,000 people from across the           cations. This $4 million grants          regularly visit the hospital to log on
discussions on the proposal to        arrangements, we would need to           region who use our public hospi-         program is part of the                   to a secure website and view their
sell Calvary Public Hospital to the   spend around $30 million every           tals. It is disappointing that the       Government’s $12 million pack-           babies on their home computer.
Government and buy Clare Holl-        year for the next six years. This        people of Canberra haven’t had a         age of initiatives to support gen-            In December I announced an
and House. This is a very disap-      would come straight off our              chance to have their say about the       eral practices here in Canberra.         additional $7.37 million in funding
pointing decision but by no           operating result and would mean          future of their health system.           The Fund provides one-off                for the new Women’s and
means is it the end of the matter     either increasing our deficits or        This has been determined for us.         incentive payments of up to              Children’s Hospital bringing the
and I continue to meet with           reducing our recurrent spending          It is also disappointing that the        $50,000 to general practices for         total budget for this innovative
LCMHC to discuss future               capacity on other services by the        Sisters never got the support they       initiatives that attract and retain      new facility to $97.37 million.
options. The Government and           same amount.                             should have received from the            staff, establish new services, sup-      Continued page 2.

                                        Dr Iain Stewart | Dr Malcolm Thomson | Dr David McKenna | Dr Rauf Yousaf | Dr Robert Greenough | Dr Paul Sullivan | Dr Fred Lomas | Dr Anusha Naidoo

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  February 2010                                                                                                                                                          Volume 22, No. 1
From the President’s pen…
Where to for Calvary                      positions round the Walk-in                National Conference, Sydney               and enhance this, not erode and
                                          Clinics as a proposed solution for         Emergency Physician and President         detract from it.
Public Hospital?                          the pressure on Emergency                  of ACEM, Dr Sally McCarthy                     The reasons (although not the
     It’s been announced that the         Departments. Mind you, the emer-           looked at the published evidence          official ones given) for these clinics
sale of Calvary is not proceeding on      gency physicians repeatedly tell us        around        Emergency        Nurse      in my view boil down to expediency.
the terms originally agreed between       that their problems are “access            Practitioners and concluded that:         Expediency in that it is alleged to
Little Company of Mary and the            block, access block, staffing and               “In summary, the literature indi-    improve access for patients, expedi-
ACT Government. The task for              access block”, NOT hordes of               cates:                                    ency in offering governments a sim-
everyone with an interest now will        people with minor ailments. I                                                        ple cheap solution to the workforce
be to find ways to continue to pro-                                                  „ paucity of evaluation of doc-
                                          would address the “turf war”                   tor to nurse substitution in          shortage they have created over
vide services to the people of the        proposition this way: Firstly, I                                                     many years and expediency in pro-
northern parts of Canberra and to                                                        Australian context
                                          deeply resent the implication that         „ Expensive unless substantially          viding nurses with some degree of
grow those services to meet the           my patients, our patients, are a                                                     so-called “autonomy”.
needs of the community.                                                                  lower ENP salaries (not the
                                          bowling green or golf fairway to               reality in Australia)                      We as a profession, need to
     The way forward should com-          be “carved up” according to their
mence with a clear definition of                                                     „ Mores tests, more referrals,            assert our place in the care of our       Dr Paul Jones.
                                          possible diagnostic group or the                                                     patients without in any sense being
what the services actually are that we    degree of seriousness of their ill-            longer consultations
need to have provided for us. How                                                    „ Variability on LOS, DNW                 derogatory towards the skills and        better than other health profes-
                                          ness. Would that it were so simple                                                   training of our colleagues in other      sionals, but different”.
that is to be delivered will then need    (except of course with hindsight)!         „ Quality not an issue for
to follow.                                                                                                                     professions in the health workforce.           We as a community, don’t need
                                          Secondly, I reject the charge that it          minor procedures                      It’s worth quoting from a talk also      to substitute health professions for
Dr Who Will See You                       is we, the medical profession, who         „ Confusion over what the                 given on the same subject by Dr          one another but to train enough of
Now?                                      are opposed to co-operation and                advanced/ENP roles do, site           Hamish Meldrum, Chairman of              all the professions to meet the twin
     A big talking point both in          collaboration when it is very clear            to site variation                     Council, British Medical Association,    challenges of ageing population and
medical circles and in the wider          that the model of clinics such as          „ Significant educational and             particularly when the UK is so often     ageing workforce. We don’t need to
community recently has been the           Revive is not to co-operate at all             supervisory expectations of           touted as a successful model which       set up a variety of competing sys-
announcement of the planned               with local GPs. In fact there is               senior medical staff                  we should emulate, mostly by pro-        tems of primary care in general
opening of Revive nurse practi-           some doubt about the process of                 = Roll-out driven by other fac-      ponents of change, but not in my         practices, pharmacies, walk-in clinics
tioner clinics in the ACT. We are         “consultation” which was suppos-           tors”                                     experience by a single person with       and nurse-practitioner clinics. We
also expecting to see the opening         edly followed. Thirdly, I deplore               Later, in addressing the future,     first hand knowledge of being a          don’t need to destroy co-operation,
(no doubt with plenty of fanfare          the rolling out of these “inde-            Dr McCarthy suggested a need to           patient in both systems.                 we need to enhance it.
and many promises of outcomes)            pendent” models when there is so           “Forget about ‘autonomous’ prac-               Dr Meldrum argued that we                 I believe that Governments,
of the $10 million dollar Walk-in         little evidence of better clinical (or     tice in the teamwork environment          should clarify the role of doctors,      both Federal and ACT have a
Clinic at the Canberra Hospital.          for that matter economic out-              that is the ED” I would argue that        that we are leaders, that our train-     responsibility to facilitate this by
The AMA has been accused, as is           comes). The AMA will continue to           this applies equally to the teamwork      ing is science-based, that we are        putting in place sensible training
so often simplistically put when          advocate for co-operation and for          environment that is General               diagnosticians with an ability to        systems and sound structures to
these issues arise, of merely “pro-       robust evaluation.                         Practice. Upwards of eight and a          work from first principles and live      produce a well-trained workforce in
tecting our turf ”. We have, in fact,           In a recent address to the policy    half thoursand Nurses currently           with uncertainty, that we advise         all disciplines with a teamwork ethos
worked very constructively with           session from which I took the title        work in General Practices round           and support patients in their deci-      at its heart. This is what our patients
ACT Health to find compromise             of this column at 2009 AMA                 Australia and we need to expand           sion-making, that we are “Not            expect and are entitled to have.

Katy Gallagher continues
From page 1.                              In the Assembly….                          recommendations made by the                „ clarify that consumers can only       is to ensure we have the service
The extra funding will allow for a             I am pleased that the Legislative     ACT GP Taskforce in its final                  ask for a copy of their health      capacity to meet increasing demands
                                          Assembly has supported the                 report. The bill seeks to do the fol-          record and not an original;         over the coming decade and deliver
range of enhancements such as                                                                                                   „ clarify the timeframes around
                                          Government’s efforts to reduce the         lowing:                                                                            policies that help Canberrans make
an increase to the ratio of single                                                                                                  when a requested copy of a
                                          harmful effects of tobacco smoke                                                                                              healthy choices and lead healthy and
bed rooms, inclusion of a                                                            „ require practices to provide a               record must be provided; and
                                          by backing new legislation to ban                                                                                             active lives.
Pneumatic Tube System to allow                                                          period of four weeks notice to          „ require practices to notify
                                          smoking in outdoor eating and                 consumers and the community                 ACT Health when a practice          Katy Gallagher MLA
for fully automated medication            drinking areas. The legislation will                                                      closes, merges or relocates.        ACT Health Minister
dispensation and improved logis-          come into effect later this year.             before a closure, merger or
                                                                                        relocation of the practice;                  2010 is set to be another excit-     Next month we’ll publish the
tics, integral venetian blinds                 In the December sitting I also                                                   ing and busy year as we continue to
enhancing infection control               introduced a bill to amend the             „ enable the prioritisation of                                                       editorial from Opposition
                                                                                                                                progress our health infrastructure        Spokesperson, Mr Jeremy
measures and higher environ-              Health Records (Privacy and                   urgent requests for the trans-          plans and deliver on our health poli-
mental standards.                         Access) Act 1997 in response to               fer of health records;                  cy agenda. The Government’s goal          Hanson, MLA.

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  2                                                                                                                                                                             February 2010
New students welcomed by AMA ACT

                                The AMA ACT President, Dr Paul        Brill, Membership and Partner Relations
                            Jones and Federal AMA President, Dr       Manager, Elizabeth Hunter, Kirk
                            Andrew Pesce recently welcomed the new    Coningham, GM Communications,
                            ANU medical students at the annual        Market and Membership and Alissa Lang,
                            AMA welcoming reception. The Dean         Membership and Marketing Coordinator,
                            of the ANU medical school, Prof Nick      from the Federal AMA.
                            Glasgow, AMA ACT councillors - Drs              Also present to welcome the new
                            Jo-Anne Benson, Iain Dunlop, Jeff Looi    students was AMSA President, Mr Ross
                            and Ashish Srinivasan also attended       Roberts-Thomson and AMSA CEO, Ms
                            together with AMA ACT CEO, Christine      Shayne McArthur.

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February 2010                                                                                                     3
Calvary sale proposal will not proceed, so where to from here?
LCM Health Care                         Archdiocese. They drew from the        after careful, prayerful considera-       needed – commencing in the next           The future
                                        communication that any Vatican         tion.”                                    two to three years,” he said.                  “Despite what we and, indeed,
announced recently the                  approval, if granted at all, would           The proposal for the transfer       The search                                Archbishop Coleridge, have identi-
proposal that it transfer               take a number of years. Accordingly,   of Calvary to the government was
                                                                                                                         for a resolution                          fied as significant risks to their long
                                        they believe it would not be in the    conditional on a number of
Calvary Hospital to the                 interests of the community of          approvals, including the local and              Since the 2001 Reid Report on
                                                                                                                                                                   term sustainability, the Board of
                                                                                                                                                                   LCM Health Care is committed to
ACT Government would                    Canberra, to apply for approval for    governing Provinces of the Little         the future directions of Canberra’s       continuing to operate all of our
                                        the sale to the Holy See,” Mr          Company of Mary, the Holy See             health care system, the LCM Health
not go ahead.                           Brennan said.                          and the ACT Legislative Assembly.         Care Board has sought to address
                                                                                                                                                                   works in Canberra as a work of the
                                                                                                                                                                   Holy Spirit Province of the Little
     “We have advised the ACT                “Rather than draw out an                “At the outset and as we went       three fundamental structural issues       Company of Mary, which itself is
Government that we are unable to        already protracted process and pro-    through the stages of the process         in Canberra:                              an important part of the Australian
continue discussions on the current     long the uncertainty at the hospital   last year, we believed it likely, based   „ to provide a framework that             Church and its heritage. We remain
                                        and for the community, the Sisters     on close consultation with the                 secures the very substantial         committed to delivering the best
proposal,” Little Company of Mary
                                        felt they should take it no further,   Sisters, our Canon Law advice and              capital investment required in       possible quality of health and aged
Health Care Chairman, Tom               given the view they now have of        on both public and private state-
Brennan, said.                                                                                                                the public hospital so that it       care to the people of Canberra.
                                        the chances of a timely resolution     ments of the Archbishop and his                might become the public hos-              “The Calvary Bruce commu-
     The Australian Province of the     in Rome.                               Vicar General, that the Church
Little Company of Mary, whose                                                                                                 pital that the residents of the      nity has been very patient since the
                                             “They were mindful that the       approvals would be secured in a                north side of Canberra               proposal came to light publicly in
approval is one of those necessary      proposal was strongly opposed by       reasonable time frame. We and the
for the transfer, decided not to pro-                                                                                         deserve;                             April last year. Those who work at
                                        some members of the Church in          Sisters are now of the view that          „ to sustain a viable and vibrant         the hospital have steadfastly contin-
ceed with the recommendation            Canberra and elsewhere, and did        this is no longer the case,” Mr
from the LCM Health Care board                                                                                                private hospital that meets          ued to focus on providing quality
                                        not want to deepen those divisions     Brennan said.
to accept the proposal.                 and risk their actions causing dam-          “The LCM Board agrees with               standards that patients, doctors     care to the people of Canberra and
     “The Sisters took this decision    age to the Church.                     the Sisters that a lengthy delay would         and staff find acceptable;           we are of course regretful they have
in the light of very recent commu-           “The Sisters have said they are   prevent us from delivering the capi-      „ to provide a sound basis for            been put through these months of
nications from Archbishop Coler—        disappointed to have had to make       tal investment needed in the public            the LCMHC mission in pallia-         uncertainty. We will be talking to
idge of the Canberra Goulburn           this decision and have made it only    and private hospital at the time it is         tive care.                           the doctors, nurses and staff at the
                                                                                                                               “Contrary to some commen-           hospital in coming days to ask for
                                                                                                                         tary, since 2001 we have developed        their continued support.
                                                                                                                         and discussed with government                  “The ACT Government has
                                                                                                                         numerous options to address these         worked extremely hard to get the
                                                                                                                         long term, structural issues.             current proposal to a stage where
                                                                                                                               “The Board’s view, reached          we could put it up for the necessary
                                                                                                                         after extensive deliberation, consul-     approvals, and we are very grateful
                                                                                                                         tation and discernment, was that          for all the work that has gone into
                                                                                                                         the Government offer to buy the           it and also wish to thank all the
                                                                                                                         public hospital and to sell to us         members of the Canberra commu-
                                                                                                                         Clare Holland House was the               nity who care about the hospital’s
                                                                                                                                                                   future and made their views known.
                                                                                                                         option which delivered on all the
                                                                                                                                                                        “Once the government has had
                                                                                                                         structural issues that were needed        an opportunity to consider this
                                                                                                                         – that is: firstly, providing the basis   change of position by us, we will
                                                                                                                         for the investment by Government          seek further discussions with the
                                                                                                                         of $200m in the public hospital           government as it develops its further
                                                                                                                         whose current building stock is           options for health and hospital serv-
                                                                                                                         worth about $80m; second, provid-         ices in the north of Canberra and
                                                                                                                         ing the land and the financial            our place in those options. We com-
                                                                                                                         resources to enable us to build a         mit to working with the govern-
                                                                                                                         state of the art new private hospi-       ment, our doctors and staff and the
                                                                                                                         tal; and third, providing a sound         Canberra community to advance the
                                                                                                                         basis for the ongoing operation of        interests of the community within
                                                                                                                         Canberra’s public palliative care         the constraints we each face.
                                                                                                                         services as a mission of the Church.           “The Board also wishes to
                                                                                                                               “That remains the Board’s           thank our executives and staff who
                                                                                                                         view,” Mr Brennan said.                   have worked with great skill and

  4                                                                                                                                                                        February 2010
                                                                                                                          issues facing our health system           chase Calvary Hospital have been
                                                                                                                          today, as well as the demands of the      unsuccessful, the ACT Government
                                                                                                                          future”, said Mr Hanson.                  should be seriously considering
                                                                                                                                                                    compulsory acquisition.
                                                                                                                          The ACT Greens
                                                                                                                                                                         “Suggesting that a third hospital
                                                                                                                          put their view
                                                                                                                                                                    be built presents a great challenge. It

                                                                                                                               “The ACT Greens support the          will potentially require withdrawing
                                                                                                                          sale of Calvary Hospital. We believe      of resources from the current
   W                                                                                                                      that public health should be in pub-
                                                                                                                          lic hands”, Health spokesperson,
                                                                                                                          Ms Amanda Bresnan wrote for
                                                                                                                                                                    Calvary Hospital; cause greater
                                                                                                                                                                    uncertainty for staff; and possibly
        December 200
                                                                                                                                                                    require a rethink of the Capital Asset
                                                                                                                          “Canberra Doctor”.                        Development Program. We already
                                                                                                                               “Linking the sale of Calvary to      have a functioning hospital site in
                                                                                                                          the sale of another public health         Bruce, and it makes sense to concen-
                                                                                                                          asset understandably raised signifi-      trate efforts for future hospital plans
                                                                                                                          cant concerns from a number of            on the existing site. Of course, no
                                                                                                                          community organisations and the           options should be ruled out.
dedication on this proposal,” Mr       Holland House was being used as a         accounting arguments dictate the         public. The Greens don’t believe
Brennan said.                          bargaining chip and should never          level of investment in Calvary.                                                         “The Greens have never
                                                                                                                          that you solve one problem by cre-        expected a ‘perfect’ outcome and
     Where to from here? – Canb-       have been contingent upon the                  “The alternative models for         ating another.
                                       purchase of the hospital.                                                                                                    each party to the sale has expressed
erra leading politicians respond to                                              allowing the ACT government to                “There is a significant propor-      different ideas about what is the
this question                               “The Canberra Liberal’s do not       invest in Calvary Hospital should        tion of the community which has to        ‘perfect’ outcome. We were work-
     Given the sale will not now       agree with the Government’s justi-        be looked at openly instead of dis-      be considered in regards to the entire    ing to broker an outcome that
proceed, Canberra Doctor sought        fication for the purchase of Calvary      missed because it is politically         Calvary sale equation. At any given       addresses the concerns raised by
the views of the Health Minister,      that they must own the hospital           uncomfortable for the minister to        time, over 200 people in the ACT          the community, and entered into
Katy Gallagher, and the Minister’s     prior to investing in the hospital.       admit that her proposal was poorly       receive palliative care at the hospice    negotiations with the ACT
comments are included in her guest     This is a bookkeeping argument            thought out and presented, and           or in the community. We treated the       Government in good faith.
editorial, the Opposition Health       that should not be used to dictate        there are in fact preferable options     concerns raised about the sale of this
Spokesperson, Mr Jeremy Hanson                                                                                                                                           “The Greens previously put a
                                       public health policy.                     available.                               health asset on their merits.             proposal to the ACT Government
and Greens Health Spokesperson,                                                       “I am now calling for the
Ms Amanda Bresnan.                          As for future options, the                                                         “Now that the sale of Calvary        and LCM in December 2009 for
                                       Canberra Liberals will continue to        debate to move back to health out-       is not progressing, the ACT Greens        LCM to be provided with the oppor-
Canberra                               oppose any moves by the Govern-           comes.                                   are strongly advocating for the           tunity to purchase a 30 year crown
Liberals position:                     ment to compulsorily acquire the               “Canberra has a growing and         ACT Government to consider                lease for the hospice rather than a 99
     Mr Hanson wrote to Canberra       hospital, to defund the hospital and      aging population and demand for          compulsory acquisition of the             year crown lease, and for the 30 year
Doctor “When looking at the way        allow it to ‘wither on the vine’, or to   hospital services in Canberra will       Hospital as an option. It has been        service contract to involve only the
forward for Calvary Hospital, we       build a third public hospital. I          increase significantly in coming         acknowledged by all parties               19 public beds at the hospice, and
must understand the events that led    understand that all of these options      years. The Canberra Liberals believe     involved in the sale process that this    not community palliative care.
to the current situation.              amongst others are being consid-          that there is a compelling need to       situation may eventuate anyway.           Decisions pertaining to the provision
     “The process adopted by           ered by the Minister.                     expand and enhance public hospital            “We believe that it is in the best   of community palliative care would
Health Minister, Katy Gallagher             “There are improvements that         services in the north of Canberra.       interests of ACT taxpayers and            be subject to an independent review
was that of a poor idea, poorly        can be made to the current agree-              I have recently released a health   health consumers if the northside         of palliative care services in the ACT.
explained to the general communi-      ments between the Little Company          discussion paper, “The State of          public hospital is under public           Unfortunately, this proposal was not
ty, and poorly executed in consulta-   of Mary Health Care (LCMHC)               Our Health”, that outlines the           ownership. The Health Minister            accepted.
tion with the specific groups more     and the Government, and I con-            Canberra Liberals’ vision for            has already indicated that the ACT             “The Greens believe an inde-
intimately involved in Calvary and     sider that it is time for both sides to   enhancing Canberra’s health sys-         Government is likely to invest $200       pendent review of palliative care in
Clare Holland House.                   sit down and develop a compre-            tem and I will be conducting a           million in Calvary, despite not being     the ACT is still relevant, given our
     “When we considered all the       hensive long term agreement that          series of forums seeking input           able to purchase the hospital.            aging population, the concerns
arguments put forward, the             addresses funding issues, service         from the community. The Calvary               “The Greens have received a          expressed by the community
Canberra Liberals opposed this         agreements, and future capital            purchase fiasco has sadly distracted     briefing from the former CEO of           around one service provider being
proposal on three grounds. First,      development. We should indeed             much attention away from the real        ACT Health and the Chief Solicitor        responsible for the delivery of over
there was no evidence that             look to agreements and options            issues affecting our health system       where we were advised that com-           200 palliative care places, and as it is
Canberra’s health outcomes would       that would nullify or mitigate the        and I look forward engaging in a         pulsory acquisition is legally possi-     something that peak health groups
be improved at all, second; that the   impact of future capital invest-          more positive debate about the           ble. Given the situation the ACT          in the ACT had been calling for
financial arguments simply did not     ments in Calvary on the Territory’s       broad range of improvements that         Government is in, and given the           prior to the Calvary sale”, conclud-
add up, and third, that Clare          accounts, but we should not let           need to be made to address the           current and past attempts to pur-         ed Ms Bresnan.

  February 2010                                                                                                                                                                                        5
Changes to DVA Cards                                                         AMC launches new support
All Department of                      Veteran Access to                     for exam candidates
Veterans’ Affairs (DVA)                Services                              In December last year, the Australian Medical Council                      NEW
Repatriation Health                         The magnetic stripe on the
                                       cards will contain the following
                                                                             (AMC) released three new initiatives to support                            BROCHURE
Cards (DVA Cards) are                  information: full name; file          International Medical Graduates (IMGs) as they pre-
due to expire during                   number; card type; and expiry         pare for Australia’s medical screening exam.                               FROM THE
2010. From March 2010                  date.
                                            This change is expected to
                                                                                  The AMC is an independ-          and standard of AMC MCQ              MYOSITIS
DVA will begin reissu-                                                       ent national standards body for       examinations. All questions are
ing all cards. As part of
                                       improve provider satisfaction, as     medical education and training        accompanied by commentaries          ASSOCIATION
                                       this will enable providers to         and one of its core functions is      on each response, details of
this reissue there will be             swipe DVA cards in the same           to assess international medical       best practice principles and
some improvements                      way Medicare or private health        graduates who wish to practise        correct answers.
                                       fund cards are currently utilised.    medicine in Australia.                     AMC President, Professor
made to DVA cards.                     By improving the claiming expe-            The AMC has produced a
                                                                                                                   Richard Smallwood AO, said
                                       rience for the providers it will      major new publication designed
    All eligible veterans, war                                               to assist IMGs to prepare for         the new MCQ handbook could
widows/widowers and depend-            increase the likelihood of pro-                                             be used for both self-directed
                                                                             the AMC’s multiple choice
ants will be issued with a new         viders accepting DVA cards.           question (MCQ) examination,           learning and as a self-test
card.                                       All eligible clients living      the AMC Handbook of Multiple          instrument.
    Changes to DVA Cards will          overseas will, for the first time,    Choice Questions. It also launched         “We hope the handbook
not reduce eligibility for current     be issued with a DVA card. This       a new on-line trial examination,      will greatly assist those prepar-
DVA card holders.                      will remove the need for veter-       which aims to provide prospec-        ing for AMC Multiple Choice
    The changes being made to          ans to contact DVA to receive a       tive MCQ candidates with a            Question         examinations,”
the cards are to increase:             “letter of authority” when            responsive and up-to-date             Professor Smallwood said.
„ veteran access to services;                                                exam experience that signifi-
                                       receiving medical treatment                                                      “Feedback on our previous
„ provider satisfaction; and                                                 cantly upgrades the previously
„ security of the cards.               within Australia.                                                           publications suggests that it
                                            Entitlement to treatment         available MCQ-trial facility.         will also be a useful resource
„ Specialised descriptions on                                                The AMC has also upgraded its
   DVA Gold Cards will remain          overseas is limited to veterans                                             for Australian university medi-
                                                                             On-line Store, where all AMC
   unchanged, these descrip-           that have an accepted disability/     publications can now be pur-          cal students,” he said.
   tions include but are not           disabilities and DVA funds treat-     chased easily and efficiently.             The handbook is a com-
   limited to:                         ment of those accepted disabili-           The AMC Handbook of              panion to the AMC Handbook
„ Totally and Permanently              ties only. This process for receiv-   Multiple Choice Questions pro-        of Clinical Assessment pub-
   Incapacitated;                      ing treatment while overseas will     vides information covering all        lished in 2007, which contains
„ War Widow/Widower; and               not change.                           disciplines and clinical catego-      a representative selection of
„ PoW.                                                                       ries examined in the MCQ and          clinical assessment tasks (sce-
                                       Security Upgrade
Cards expiring                             All DVA cards will have
                                                                             aims to facilitate IMG entry to       narios) drawn from the AMC
                                                                             the medical workforce in              clinical examination, accompa-
between now and                        microprinting and a DVA regis-        Australia. It updates and             nied by performance guidelines
June 2010                              tered hologram added as security      expands on the highly regarded        and commentaries to help can-        Contact the Secretary,
     Temporary DVA cards will          features. The microprinting and       1997 AMCQ Handbook and                                                     14/10 Albany Lane,
                                                                                                                   didates prepare for the AMC
be issued between now and June         hologram are added security fea-      represents three years work by                                             Berry NSW 2535
2010 with a short expiry date.                                                                                     Clinical examination.
                                       tures to ensure non entitled per-     AMC examiners. The hand-                                                   Phone: 02 4464 2043
These cards will work the same                                               book contains almost 600                   Copies of the AMC               Email:
                                       sons cannot reproduce a card.                                               Handbook of Multiple Choice
as current DVA cards and offer                                               Multiple Choice Questions                                        
DVA clients the same access to         Expected Arrival Date                 drawn from the AMC examina-           Questions and all other AMC
services. DVA clients who are              The reissue of all cards is       tion banks.                           educational resources, includ-
issued a temporary card will be        due to commence in March                   As with the previous AMC         ing books, DVDs and reports,
issued a new look card before          2010. This process is expected to     publications, it is a comprehen-      can be purchased online at
their card expires.                    take 10 - 15 weeks to complete.       sive guide to the format, scope

                                                                                                          AMA ACT
 New Account Manager
 at Corporate Express                                                         PRACTICE MANAGERS’ NETWORK                                                    PUBLIC
 for AMA members                                                                                                                                            FORUM
                                                                                   2010 WORKSHOPS – Mark Your Diary                                            Hosted by
The AMA is pleased to introduce Michael Micallef, Michael will be                  DATE                   TOPIC                      LOCATION               Jeremy Hanson,
the new Corporate Express account manager for AMA members.                   Start Time: 6pm                                                            Shadow Health Minister
                                                                             Tuesday           Industrial Relations         AMA House
Corporate Express supply an extensive range of stationery, office
                                                                             February 16       National Awards Introduction 42 Macquarie St Barton
                                                                                                                                                         Getting Serious About
products, canteen supplies, facility supplies, IT hardware & software and
furniture.                                                                   Wednesday         Informed Financial Consent      TBA
                                                                                                                                                          Primary Health Care
Over 1800 commonly used items have been significantly reduced for AMA        March 17          2 hour workshop                                                 in the ACT
members to purchase and Corporate Express’ extensive range of over                             (in association with AAPM)
                                                                                                                                                                6:30 PM,
20,000 items are also available at very competitive prices. User friendly    Thursday          Public Health/Infection         AMA House
online ordering and next day delivery is guaranteed. Place one order,        August 12         Control                         42 Macquarie St Barton
                                                                                                                                                        Tuesday 30 March 2010
receive one delivery and pay one invoice for everything you need at your                                                                                    Reception Room,
place of business!                                                           Tuesday           TOPIC - TBA                     AMA House
                                                                             October 12                                        42 Macquarie St Barton   ACT Legislative Assembly
If you would like more information or set up an account with Corporate
Express please contact Michael on                                            Wednesday         Christmas drinks Jointly with   TBA                              RSVP on, 0404 041 802 or                                  December 15       AAPM & ACTDGP
                                                                                                                                                            (02) 6205 0133
download an order form                                    Email to join the network

  6                                                                                                                                                        February 2010
“KEEP THE MEN ALIVE: Australian POW doctors
in Japanese captivity”– by Rosalind Hearder, military historian, Allen and Unwin 2009
Reviewer:                                                                                                              tured by distilling river water and             British officer. The Australians
                                                                                                                       adding rock salt. Coconut milk                  showed no enthusiasm for salut-
Peter D Hughes.                                                                                                        was infused intravenously, usually              ing anyone.
      With the fall of Singapore in                                                                                    accompanied by high fevers.
                                                                                                                                                                           Sometimes there was friction
February 1942, 22,000 Australian                                                                                            “Tropical ulcers” involving                between the officers and other
soldiers became prisoners of the                                                                                       the lower leg were a major prob-                ranks, on the basis that officers
Japanese; 36% died in captivity                                                                                        lem; these were wide and deep                   might be getting more and better
including more than 90% of those                                                                                       and resistant to treatment. Many                food, and better conditions. From
in the Sandakan march. This com-                                                                                       leg amputations were carried out,               time to time the Japanese issued
pares with 3% mortality of the                                                                                         but there was considerable dis-
8,000 Australian servicemen who                                                                                                                                        paper money, with which prison-
                                                                                                                       pute as to whether or not this                  ers could purchase cigarettes or
were prisoners in Europe , and                                                                                         should be done.
60% of Russians* who were pris-                                                                                                                                        food; in many , but not all, camps
                                                                                                                            In some camps a doctor was                 the officers would contribute half
oners of the Germans, during                                                                                           appointed Commanding Officer
World War II. Amongst the Dutch                                                                                                                                        or three quarters of this to a pool
                                                                                                                       by the combatant officers. When                 to buy food and medicine for
prisoners of the Japanese the mor-                                                                                     there was only one doctor in a
tality was 23%, many having lived                                                                                                                                      hospital patients. At one stage the
                                                                                                                       camp his situation was particu-                 other ranks refused to build a
for years in the tropics. Of the 106
Australian doctors who were                                                                                            larly difficult, as he had no-one               new mess hall for the use of
POWs, ten [16%] died in captivity.                                                                                     with whom to discuss the many                   Australian officers in Changi.
The high mortality amongst pris-                                                                                       difficult cases. Australian doctors
                                                                                                                       got on well with doctors of all                     Not surprisingly, psychologi-
oners of the Japanese during WW                                                                                                                                        cal problems have been a big
II contrasts with the low mortality                                                                                    other nations. They got on par-
                                                                                                                       ticularly well with the Dutch doc-              problem for those who were pris-
of German prisoners of the                                                                                                                                             oners of war for three and a half
Japanese during WW I when Japan                                                                                        tors to whom they often turned
                                                                                                                       to for advice on tropical medicine              years. One ex-prisoner who had
was an ally of Australia and Britain.                                                                                                                                  sent his diary in advance of being
During that time the Japanese ,                                                                                        problems, for which the
                                                                                                                       Australian doctors were ill pre-                interviewed , stated that he been
prior to the Geneva convention of                                                                                                                                      beaten once. When the inter-
1929, punctiliously observed inter-                                                                                    pared. All doctors seemed to con-
national law, but during the 1930s                                                                                     sult freely, and many medical dis-              viewer pointed out that his diary
Japanese culture underwent                                                                                             cussion and tutoring sessions                   described four severe beatings, he
intense nationalism and militarisa-                                                                                    were set up.                                    responded “I’ve managed to for-
tion. During WW II posting to a                                                                                             There were some differences                get those”. The Repatriation
POW camp was regarded as severe                                                                                        between the different national                  Department has made great
demotion for a Japanese soldier.                                                                                       groups. The British officers were               efforts to help in this area, and
      The initial major problem for                                                                                    very annoyed because the                        continues to do so.
combatants taken prisoner of war                                                                                       Americans refused to salute any                 [* - WIKIPEDIA]
was psychological, they suddenly        death was malnutrition with all its     which of the prisoners were least
having no purpose in life, for an       sequelae, including Avitaminosis,       unfit for work, to fill the quotas
indefinite period of time, whereas      huge leg ulcers, Beri-Beri, Pellagra,   demanded by the camp command-
doctors, dentists and chaplains         Typhus, Dysentery and the very
                                                                                                                         Now is a great time to consider your staff
                                                                                ers. This often lead to confronta-
had the advantage that they were        contagious and rapidly fatal            tion between a doctor and the            training options for 2010 so talk to us first!
able to keep busy carrying out          Cholera, as well as Malaria and         camp commander, sometimes
their usual professional duties,                                                                                                        Join practices around Australia
                                        frequent brutal bashings. The           resulting in the doctor being bashed                receiving fully funded training and give
albeit under very difficult circum-     Geneva Convention was com-              with a baseball bat. Another dilem-                 your staff the recognition they deserve.
stances.                                pletely ignored. In one camp, in        ma for the doctors was the alloca-
      The Japanese initially confis-    Japan, a tragic complication was        tion of food and medicines, par-
cated all drugs and supplies, as well   obstructive anuria from crystallisa-    ticularly when faced with a patient
as all Red Cross brassards, the lat-    tion of sulphonamides , when
ter to deny identification as non-                                              who seemed certain to die. In many
                                        some of these became available.         cases a point was reached when it
combatants . The conditions in
the main POW camp, Changi, on                Food and some vital medica-        was apparent that nothing further
Singapore Island, were compara-         tions such as the antimalarial          could be done, and that the end was
tively reasonable, but large num-       Atebrin could sometimes be              near; the doctors and medical
bers were soon moved out into           bought on the black market by           orderlies adopted a policy that no
labour camps, where the condi-          trading watches with local villag-      man would be left to die alone.
tions were atrocious. The prison-       ers who took great risks by com-             Great ingenuity was demon-
ers were forced to work very long       ing to the camp fence.                  strated, such as fashioning intrave-
hours, often when sick, in a tropi-          One of the most stressful tasks    nous needles out of thin bamboo.
                                                                                Intravenous saline was manufac-               Health	Training	Solutions	courses	provide	your	staff,	from	medical	receptionist	
cal climate. The major cause of         of the doctors was the choosing                                                      through	to	practice	manager	(existing	and	new	employees,	including	jobseekers)	
                                                                                                                                     with	the	skills	needed	to	perform	in	a	modern	medical	practice.
                                                                                                                             Benefits:                                      Study Modules include:
                                                                                                                             •	 Flexible	training	options	–	at	the	         •	 patient	records
                                                                                                                                practice	or	off	site                        •	 medical	accounts
                                                                                                                             •	 Contemporary	Health	Industry	study	         •	 infection	control
                                                                                                                                materials                                   •	 confidentiality	&	privacy
                                                                                                                             •	 On	the	job	skills	development	with	         •	 senior	first	aid
                                                                                                                                optional seminars
                                                                                                                                                                              To express your interest,
                                                                                                                             •	 Recognition	of	Prior	Learning                 phone Elizabeth on 6270 5410
                                                                                                                             •	 ‘User	Choice’	funding	for	eligible	           or email
                                                                                                                             •	 Australian	Apprenticeship	incentives	for	   * Employee eligibility is determined by an Australian
                                                                                                                                eligible	new	and	existing	employees*        Apprenticeship Centre

                                                                                                                                (   ) LIMITED

  February 2010                                                                                                                                                                                                                     7
Insider Trading: Perspectives on the international organ trade
It is timely during Organ                       C. Waiting lists for transplantation     were once used for transplantation,      would exploit the desperation of the        Knowledge Base on Transplantation.
                                                are growing, yet the number of           accounting for more than 65% of          poor on a larger scale.                     The Declaration of Istanbul of
Donor Awareness Week                            donors has stayed the same.              donors. Kidneys and corneas were         Quality Control                             2008 defines organ trafficking, trans-
to publish this article by                           Commercial organ trafficking        removed without consent and there             Currently, graft and survival          plant commercialism and transplant
                                                represents in some respects, the         were reports of organ harvesting
ANU medical student,                            incapacity of healthcare systems to      prior to execution. In recent years,
                                                                                                                                  rates are lower in overseas commer-         tourism, proposing principles of
                                                                                                                                  cial donation. Although there is a          practice.
Morgan Hee.                                     provide the care needed. Combining       China has taken steps in the right       better long-term prognosis versus                The prohibition of organ trad-
                                                a lack of regulatory frameworks          direction. In 2007, the Human            cadaveric donation, complications
     Organ donation and transplan-              abroad and the effects of globaliza-                                                                                          ing forces it elsewhere or inflates
                                                                                         Transplantation Act was adopted,         from surgery are more common                prices on the black market. With the
tation can transform lives especially           tion, the international organ trade is   banning the sale of organs and
with the advancement of medical                                                                                                   and include higher infection rates of       banning of organ sales, China
                                                one solution to a worrying problem.      enforcing donor consent. Last            HIV, cytomegalovirus, hepatitis B
technology. With demand for organ               In 2007, WHO estimated organ             August marked the launch of a                                                        reduced its number of transplants to
transplantation outstripping supply,                                                                                              and C. Donors need better care and          foreigners, which coincided with a
                                                trafficking to account for 5-10% of      national organ donation system that      their rights should be protected.
paid living non-related organ trans-            kidney transplants performed. The        will encourage fairness in organ allo-   Those from disadvantaged back-              spike in the Philippines. Regional
plantation has become more com-                 foreign exchange earnings generated      cation and procurement.                  grounds cannot afford haemodialy-           differences in financial compensa-
mon. This booming trade has lead                by health services are an asset to the                                            sis or transplant surgery if the            tion will promote competition.
to unacceptable breaches of human               economies of countries like India        Desperate Times,                                                                     Therefore, a uniform and transpar-
                                                                                                                                  remaining kidney were to fail.
rights and ethics and this article aims         and China. A major concern is that       Desperate Measures                       Therefore follow-up care must be            ent approach needs to be taken to
to address some of these issues.                wealthy foreigners are preferentially         The WHO’s Guiding Principles        prioritized.                                develop a regulatory framework that
Market Forces                                   allocated organ donors, bypassing        on Organ Transplantation state that
                                                                                                                                  The Iranian Model                           protects the rights of donors and
     Organ transplantation has revo-            waiting lists.                           living donation should only occur                                                    recipients.
                                                                                         with free consent. Sadly, the illegal         The case of Iran is of particular
lutionized the treatment for end-               News from Abroad                                                                  interest, when in 1988, began reim-         The Outlook
stage organ failure and is practiced                 Although law prohibits trade of     organ trade exploits the vulnerable.
                                                                                         Conditions of poverty, debt and          bursing living unrelated donors and              In order to improve the global
widely. Supplies of organs and tis-             human tissues in Australia, it contin-                                            remains the only country where the
sues have never been able to meet               ues elsewhere, exploiting global         starvation are powerful coercive                                                     situation of organ trafficking, it is
                                                                                         forces. The organ trade widens the       practice is legal. As a result, the wait-   important to engage governments
demand. This is especially the case,            inequities as organs flow from the                                                ing lists for transplants have
with improved anti-rejection regimes            third to the first world. China has      gap because it is perpetuated by the                                                 to establish transplantation regula-
                                                                                         existence of poverty. India contin-      decreased steadily and the costs are        tions. For the moment, preventative
and widened transplantation criteria            been heavily involved in the contro-                                              lower than for long-term dialysis.
to include patients over 70, diabetics          versy surrounding the organ trade.       ues to be a major organ exporter.        The system does have its limitations,       measures should take priority. In the
and seropositive for Hepatitis B and            Organs from executed prisoners           The idea of selling a ‘spare part’ is    there are no restrictions on the pric-      developed world, the most common
                                                                                         ubiquitous. In parts of rural India,     ing of organs, leaving the practice         causes of chronic kidney disease
                                                                                         fathers can trade kidneys for a          open to exploitation.                       requiring transplant are diabetes
                                                                                         dowry. Proponents of paid organ               There is considerable disagree-        mellitus and hypertension. Disease
                     The Lounge                                                          donation argue in support of indi-       ment on whether the rest of the             progression can be slowed with
                                                                                         vidual autonomy. Has the notion of
                     – your choice,                                                      non-maleficence fallen in favour of
                                                                                                                                  world should adopt a similarly regu-        proper long-term management.
                                                                                                                                  lated market. Legalizing the trade               In the mean time, it is impor-
                     business or leisure                                                 a person’s rights over their body?       would eliminate the brokers that            tant to promote existing infrastruc-
                                                                                         This line of reasoning is steeped in     profit but does not ensure fair trans-
                                                                                         Western principles and it is unrea-                                                  ture. Donation registries and cadav-
                                                                                                                                  actions. A lawful commercial market         eric donation are an important step
The Lounge allows you to mix business and leisure. There are a great                     sonable to think the same applies to     is likely to disrupt existing organ
variety of work zones, from private meeting rooms to work stations                       someone in the third world.                                                          to ensure as many patients on wait-
and open-planned meeting areas; all supported with free access to
                                                                                                                                  donation programs and decrease the          ing lists are treated. Countries like
wireless broadband. With The Lounge’s free-flowing hospitality and a                      Asking Price                             number of cadaveric donations. In
                                                                                                                                                                              Spain and Denmark have systems
relaxed ambience, you’ll also find plenty of room to catch up and be                           What is a fair price to place on    the third world, it would be difficult
                                                                                                                                  to enforce rules where the trade is         of presumed consent for organ
entertained.                                                                             an organ? Currently, the illegal organ
                                                                                         trade is profit-centric and patient      rampant.                                    donation, which have gone some
The AMA is proud to offer its members significantly reduced                                                                                                                    way towards remedying demand.
rates to Virgin Blues The Lounge.
                                                                                         care is secondary. Kidneys can trade     The State of Affairs                        The global organ trade is an issue
                                                                                         anywhere between US$18000 in                  A number of international bod-
Joining Fee: $0.00 (Save $199)                                                           Pakistan to $150000 in Israel, in        ies and non-governmental organiza-          that can be resolved with responsi-
                                                                                         addition to broker fees and in return,   tions have recognized organ traffick-       ble policy making requiring interna-
Annual Fee: $269 (Save $100 per year)                                                                                                                                         tional cooperation. But before
                                                                                         the donors receive a pittance. This      ing as an issue. Resolutions of the
To take advantage of this great AMA rate please email                                    raises the question of equity; any       World Health Assembly request that          appropriate action can be taken, the or call 1300 133 655 with your full                            price excludes those of low socio-       data be collected on all aspects of         state of the organ trade needs to be
name details and Velocity* membership number handy.                                      economic status, who generally have      transplantation. The WHO has                known, especially concerning trans-
*No Velocity number – apply at for free.                           poorer health. Any established price     recently established the Global             plant practices.

                                    AMA ACT

 PRACTICE MANAGERS’ NETWORK                                                                                                                               Assisting Canberra
in association with the Australian Association of
               Practice Managers
                                                                                                                                                          Doctors and their
                      Invites you                                                                                                                         families too!
               to attend a WORKSHOP                                                                                                                       The Medical Benevolent Association is an aid
           on Informed Financial Consent                                                                                                                  organisation which assists medical practitioners,
                                                                                                                                                          their spouses and children during times of need.
                     Date: Wednesday 17 March
                                                                                                                                                          The Association provides a counselling service and
                          Time: 6:00 – 8:30pm
          Venue: Level 3, AMA House, Macquarie St, BARTON                                                                                                 financial assistance and is available to every registered
                                                                                                                                                          medical practitioner in NSW and the ACT.
 FREE to members of AMA ACT Practice Mangers’ Network or AAPM
                                                                                                                                                          The Association relies on donations to assist in caring
                    FEE (non-members): $44
(AMA ACT members welcome – with or without their practice manager)                                                                                        for the loved ones of your colleagues.
                                                                                                                                                          For further information please phone
                       Catering and materials provided
                                                                                                                                                          Meredith McVey on 02 9987 0504
                         RSVP: Elizabeth 6270 5410

  8                                                                                                                                                                                   February 2010
The WHY, WHEN and HOW of exiting your practice?
Many practice owners,                       money to cease working full           „ What exit plan will yield the             ers. These advisers can assist     future support for their patients
                                            time?                                     best results for both you per-          you to understand the market       and staff.”
dream of setting a retire-              „   What do the other partners/               sonally and the practice –              place and the real value of             “To help you plan your prac-
ment date and living on                     key individuals within your               once you have left?                     your practice so you can           tice exit strategy visit our website
                                            practice want to do in the                Are you going to withdraw               negotiate the best price.          - The site hosts
their superannuation                        future? Their plans may dic-
                                                                                      gradually so that someone                                                  a free e-Paper – Extracting value
                                                                                                                               Carol Hull, partner at leading
from that date onwards                      tate how you shape your                   else can be groomed to take        accountancy and business advi-          from your business. The paper,
for personal funding.                       practice goals.                           your place or are you going        sory firm PKF states “About 45          written by PKF is a practical
                                        „   What do you want to do in                 to withdraw completely on a        percent of business owners              guide to exiting your practice on
Without proper plan-                        your retirement? Do you                   specific date?                     advise us that they want to retire      your terms. Our website also
ning, this simply is not                    want to work part time as a           „   Are you likely to enjoy good       early. Yet the owners of small          hosts free classifieds to help you
                                            consultant or are you intend-             health until your retirement       practices, tend to work later in        sell your practice. We have over
possible.                                   ing to to take a permanent                age is reached?                    life, mostly because they gain per-     6,000 health practitioners’ visit
                                            holiday?                              „   As the practice owner, you         sonal satisfaction from running         our website per month, so it’s
    To help you plan, here are          „   How will your retirement                  are the only person who can        their own practices.”                   worthwhile posting an advert”
few questions to consider:                  income be funded and will                 answer the above questions.              David Roberts is Medfin           David Roberts continues.
„ When do you want to stop                  your current superannuation               The answers will form the          Finance’s Western Australian                 If you need more informa-
   working? Do you have a spe-              be sufficient?                            basis of your exit planning        State Manager. “Our clients are         tion on retirement strategies and
   cific age in mind or a life          „   If a shortfall exists in your             strategy.                          all health professionals so they        finance your local Medfin
   stage? For example does your             projected income, how much            „   You only exit your practice        have a unique set of retirement         Relationship Manager can be
   retirement date correspond               are you going to rely on the              once. Your chances of              needs. Often they are looking for       contacted on 1300 361 122 or to
   with when your children leave            proceeds from your practice               achieving a good deal will be      a succession plan in their early        talk to a PKF accountant phone
   home or when you feel that               sale to supplement your exist-            considerably enhanced by           40’s that will allow an exit at the     1300 753 222.
   you have made enough                     ing superannuation?                       using a team of great advis-       right stage in life, whilst providing   Copy supplied by Medfin.

General practice pharmacies
– a positive health reform for patients
The AMA is calling on                   under the ownership of the doctor            “It would allow each health              “Importantly, patient medica-      Government. We are also confi-
                                        – would provide significant benefits    professional to work to their full       tion management would improve           dent that it will be an attractive
the Federal Government                  and convenience to patients.            potential in a well-supported            through the close cooperative           option for individual pharmacists,
to legislate to allow doc-                   “Incorporating pharmacy            environment.                             relationship between the doctor         especially younger pharmacists
                                                                                     “Patient care would be inte-        and the pharmacist.                     setting out on their careers,” Dr
tors to own and operate                 services into general practice
                                                                                grated and patients would be seen             “It is an arrangement that fits    Pesce said.
                                        would improve patient care by
pharmacies.                             allowing GPs to lead a team of          by the right health professional, at     within the GP Primary Care                   In order to co-locate services,
                                        co-located health professionals,        the right time, for the right treat-     Centres proposal that is outlined       the current restrictions on phar-
     AMA President, Dr Andrew           including pharmacists and general       ment and health care advice.             in the AMA’s Priority Investment        macy location and pharmacy
Pesce, said that co-locating pharma-    practice nurses, in providing multi-         “The pharmacists would              Plan for Australia’s Health System.     ownership need to be lifted to
cies within, adjacent to, or in close   disciplinary health care to patients    retain the professional responsi-             “The AMA believes that this        allow ownership by medical prac-
proximity to a general practice –       at the local community level.           bility for dispensing medicines.         proposal should appeal to the           titioners.

Review into O&G at Canberra Hospital
There has been signifi-                 understood from media reports                A number of VMOs wrote to
                                        that the Minister of Health, Ms         the Minister last December follow-
cant local media coverage               Katy Gallagher, has promised two        ing advertisements in the national
of the issues raised by                 external reviews: the result of alle-   press for VMO O&Gs. Several
privately practising O&G                gations by medical practitioners of     obstetricians and gynaecologists
                                        workplace bullying and poor patient     informed the Minister that they
specialists centred prima-              outcomes.                               would consider applying for a VMO
rily on the O&G depart-                     The Minister has committed to
                                                                                appointment, but the culture pre-
                                                                                vailing in the unit was a deterrent to
ment at TCH.                            the review being independent of         actually making an application.
                                        the hospital and under way within
     At the time of printing the        four weeks. The Minister has also           As recently reported in the
details of the review into bullying     committed to making the findings        media, the O&Gs met with the
and care complaints at the O&G          public and to providing protection      Minister on 22 February and the
department at Canberra Hospital         for those involved in order to          enquiries are outcomes from that
are not finalised. However, it is       encourage them to speak up.             meeting.

  The President, Council, staff and members of the AMA ACT extend condolences and
  best wishes to the families of the following colleagues who have recently died:
  Dr Mirghani Ali
  Dr Ronald Hoy
  Dr Hugh Anderson
  and to the family of Dr Peter Quach on the recent death of Mrs Anne Quach
  For an obituary on Dr Ronald Hoy, please visit,
  and click on the “Canberra Doctor” icon.                                                                                                               $120 (including GST + delivery)
  Obituaries are invited from medical practitioners for Dr Ali and Dr Anderson.                                                                          AMA members call 6270 5410
                                                                                                                                         (   ) LIMITED

  February 2010                                                                                                                                                                                 9
       This new resource will be
       mailed to all financial AMA
       member practice principals
       shortly and is available on
       request to other financial
       The Awards include the new
       “Health Professionals and
       Support Services Award
       2010”,”Medical Pracittioners
       Award 2010”, “Nurses Award
       2010” and the “National
       Employment Standards”.

      A News Magazine for all Doctors in
              the Canberra Region
                 ISSN 13118X25
     Published by the Australian Medical
     Association (ACT) Limited
     of the AMA Ltd
     42 Macquarie St Barton
     (PO Box 560, Curtin ACT 2605)
     Christine Brill
     Ph 6270 5410 Fax 6273 0455
     DFS Design Graphix
     PO Box 580, Mitchell ACT 2911
     Ph 6238 0863
     Editorial Committee:
     Dr Ian Pryor – Chair/Editor
     Dr Jo­Anne Benson
     Dr Keith Barnes
     Mrs Christine Brill – Production Mngr
     Dr Ray Cook
     Dr John Donovan
     A/Prof Jeffrey Looi
     Dr Peter Wilkins
     Dr Alex Stevenson
     Mr Konrad Reardon
     Dr Helen Doyle
     Ph 6270 5410, Fax 6273 0455
     Copy is preferred by Email to
     or on disk in IBM “Microsoft Word”
     or RTF format, with graphics in TIFF,
     EPS or JPEG format. Next edition of
     Canberra Doctor – March 2010.

     The Australian Medical Association
     (ACT) Limited shall not be responsible
     in any manner whatsoever to any
     person who relies, in whole or in part,
     on the contents of this publication
     unless authorised in writing by it.
     The comments or conclusion set out
     in this publication are not necessarily
     approved or endorsed by the Aust­
     ralian Medical Association (ACT)

10         February 2010
Proposals invited for                                                             AMA urges medical board to
GP aged day service                                                               recognise thousands of vocationally
The ACT Government is
inviting proposals for a
                                              The Budget provided $12 mil-
                                         lion to support and grow the gen-
                                                                                  registered GPs as ‘specialist GPs’
                                         eral practice workforce through a        The AMA is urging the                  some Fellows of the Australian                “Any move to exclude these
new GP Aged Day Service                  range of initiatives including ANU                                              College of Rural and Remote              GPs from the specialist register
to improve access to gen-                Medical Graduate Scholarships, a         recently established                   Medicine (ACRRM) will be recog-          would be inequitable and would cre-
eral practitioners for eld-              GP Development Fund, teaching            Medical Board of                       nised as ‘specialist general practi-     ate two classes of general practi-
                                         incentive payments for doctors                                                  tioners’.                                tioner.
erly Canberra residents,                 and the establishment of rotations
                                                                                  Australia to ensure that                    AMA President, Dr Andrew                 “It would potentially under-
Chief Minister and                       of junior doctors into general           the new national registra-             Pesce, said that such a decision         mine the public’s confidence in
                                         practice.                                tion arrangements for                  would leave thousands of highly          nearly half the nation’s GPs despite
Acting Health Minister,                                                                                                  qualified GPs shunned and profes-        the fact that they practise within
Jon Stanhope, announced                      “I expect a strong interest          doctors do not discrimi-               sionally out in the cold.                established quality frameworks and
                                         from potential providers of this         nate against 11,000 voca-                   “The AMA has made a submis-         have been doing so for many years.
recently.                                new service and look forward to                                                 sion to the Board suggesting a com-           “Vocationally registered GPs
     Mr Stanhope said the business       the outcome of the procurement           tionally registered general            mon sense approach to this issue,”       have met all obligations placed
hours GP Aged Day Service would          process,” Mr Stanhope said.              practitioners.                         Dr Pesce said.                           on them and they have a legiti-
provide primary health care serv-                                                                                             “The Board must formally rec-       mate claim to specialty status,”
                                             Lodgement of Proposals will               The Board is currently finalis-
ices to elderly residents of aged                                                                                        ognise the high quality patient care     Dr Pesce said.
                                         close on Monday 15 March 2010,           ing the criteria that will determine   that is being provided by the hard            The AMA Council of General
care facilities or residents who are     and the Service is expected to be
housebound, helping to reduce                                                     which GPs will be included on its      working vocationally registered GPs      Practice met in Canberra over the
the pressure on other parts of the       up and running by 1 July 2010.           specialist register.                   across the country who do not hold       weekend and resolved to support
health system and improving serv-            For further information on                The AMA has welcomed the          the Fellowship qualifications. For       the vocationally registered GPs to
ices for our older citizens.             the GP Aged Day Service, includ-         decision by the Board to formally      historical reasons, these doctors        be recognised as specialist GPs.
     “Older housebound Canb-             ing the Request for Proposal             recognise GPs as specialists.          have not been required to hold a         The AMA recognises the value
errans and those living in our local     documents, please visithttp://           However, there is concern about        Fellowship.                              and importance of the RACGP
residential aged care facilities can’t              reports in the medical press of a           “They have 18 years or more         and ACRRM Fellowships and
always get to a GP for a range of                                                 recommendation that only Fellows       experience in general practice and       believes these should be the
reasons such as reduced mobility,”       tenders_advertised/open_ten-
                                                                                  of the Royal Australian College of     have clearly demonstrated the skills     benchmark for recognition of
Mr Stanhope said. “In these cir-         ders or call ACT Procurement
                                                                                  General Practitioners (RACGP) and      to be considered medical specialists.    specialist GPs in the future.
cumstances, the new service will         Solutions on (02) 6207 6248.
provide GPs who will be available
to make house calls.
     “The GP shortage here in
the ACT also makes it difficult           Qantas Club membership
for many doctors to make home
visits quickly.
     “We want our aged popula-
                                          rates for AMA members
tion to have access to an emer-                              1 Year Membership: $300
gency backup service so that if a                            2 Year Membership: $530
GP believes the problem could
be serious and they are unable to
                                                               (all rates are inclusive of GST)                           What’s on for general practice
get to their patient quickly, they            To renew your Qantas Club Corporate Membership contact the
                                                                                                                           Tuesday 23       Orientation program for nurses new to general practice
can call the GP Aged Day Service                 secretariat to obtain the AMA corporate scheme number.                    & Wed 24         – 2 day workshop. $120 course fee, great variety of
which can provide the home visit                                                                                           February         topics to be covered. For more information please email
on their behalf and report back            For new memberships download the application from the member’s
                                                                                                                                            Dawn at
about the patient’s condition.                  only section of the AMA ACT website:
                                                                                                                           Thursday         Early recognition and treatment of complex pain
     “This is just one element of               For further information or an application form please contact the          25 February      – Guest speakers Dr’s Lorimer Moseley, Garth Eaton
the ACT Government’s efforts                    ACT AMA secretariat on 6270 5410 or download the application               6:30 for 7pm     and Mr Gerard Rees, Slater & Gordon, ACT. For more
to support general practices                                                                                                                information please email Bronwyn at b.parsons@
through a suite of initiatives                           from the Member’s Only section of the ACT-AMA website
announced in our 2009-10
Budget,” Mr Stanhope said.                                                                     Monday           ASPREN Presentation Night – Information on
                                                                                                                           1 March          the collection of de-identified data from general
                                                                                                                           6:30 for 6:45    practitioners of the occurrence of Influenza Like Illness
                                                                                                                                            and other conditions seen in general practice.
                                                                                                                                            For more information please email Hailey at
                                                                                                                           Wednesday        NPS Case Study – Management options to maximize
 Want to make a                                                                                                            10 March         sleep – Guest speakers Dr Stuart Miller and Assoc Prof

  difference?                                                                                                              6:30 for 7pm     Jeff Looi. For more information please email Rick at
     Are you a                                                                                                             Tuesday          Healthy doctors, healthy patients – Guest speakers
  Paediatrician or                                                                                                         16 March         Prof Beverley Raphael, Dr’s Lev Fridgant and Phil
 Ophthalmologist?                                                                                                          6:30 for 7pm     Barraclough (repeat of 21 October 2009 event – due
                                                                                                                                            to popular demand). For more information please email
   If you are, and if you want to                                                                                                           Rosemary at
 make a difference, then Winnunga                                                                                          Thursday         Men’s Health – Dr Rosie King – Renowned medical
  Nimmityjah Aboriginal Health                                                                                             18 March         sexologist will launch our 2010 series on men’s health
Service, would like to hear from you.                                                                                      6:30 for 7pm     issues. For more information please email Bronwyn at
    Winnunga Nimmityjah AHS                                                                                                       
     is an Aboriginal Community                                                                                            Monday           Early diagnosis of inflammatory arthritis – Guest
Controlled Health Service located in
             Narrabundah.                                                                                                  22 March         speaker Dr Anna Dorai Raj. Hosted in conjunction
    Sessions are available and you                                                                                         6:30 for 7pm     with Arthritis ACT. For more information please email
  are invited to contact the medical                                                                                                        Bronwyn at
     director, Dr Peter Sharp, on
 6284 2222 or mobile 0418 203 856                                                                                           Please visit our WebCalendar at
        for further information.                                                                                                             to RSVP to any of the above.

   February 2010                                                                                                                                                                                11
                                                                                                                           the Surgery at Jerra
                                                                                                        Requires a GP – VR, PT or FT to join David Yates at this state
                                                                                                        of the art practice. Excellent remuneration negotiable at this privately
                                                                                                        billing surgery. Practice nurse, in-house podiatrist, massage therapist,
                                                                                                        physiotherapist and dietitian.
                                                                                                        Anne Davis 0417 438 423

                                                                                                            PROFESSOR GEOFF FARRELL
                                                                                                                     CONSULTANT HEPATOLOGIST
                                                                                                                                 Suite 14, Calvary Clinic
                                                                                                            We advise that Professor Geoff Farrell is now available
                                                                                                            for referral of patients with liver disease in Dr James
                                                                                                            Riddell’s rooms:
                                                                                                                               Suite 14, Calvary Clinic
                                                                                                                            Mary Potter Circuit, Bruce ACT
                                                                                                                                  Phone: 6251 0255
                                                                                                                                   Fax: 6251 0977
                                                                         colposcopy & laser                 Professor Farrell is an international authority in the
                                                                        endoscopic surgery                  assessment and treatment of hepatitis B and hepatitis C,
                                                                                                            fatty liver disease, abnormal liver function tests and
                                                                      specialist gynaecology
                                                                                                            liver tumors.
                                                                       treatment of prolapse

                                                                      Dr. P.M.V. Mutton
                                                                          MBBS, FRCOG, FRANZCOG

GP Required                                                           for prompt, personalised
FT / PT VR GP                                                             experienced care

                                                                           6273 3102
m Established and
                                                                      39 GREY STREET DEAKIN ACT 2600
  busy practice                                                               FAx 6273 3002
m Private billing
m Computerised
m RN support
m Physiotherapists, phychologists and
  pathology onsite
m Located only 15 minutes to Canberra CBD
                                                                     Psychological treatment of
       Contact Dr Bernard Leung on 0414 989 811                      depression, anxiety disorders,
                                                                     insomnia, drug and alcohol,
              or                                eating disorders, and
                                                                     management of chronic
                                                                     pain, as well as counselling for
                                                                     interpersonal problems.

                                                                                                           Dr Christopher Allada
                                                                     Psychologists and Clinical

                                                                                                           is re-locating his practice
                                                                     Open all year.

                                                                     Located in the
                                                                     AMP Building, Civic
                                                                           Dr Christopher Allada would like to announce that he will be relocating
                                                                     Ph (02) 6247 5485                       his cardiology practice to the Canberra Heart Clinic, Lidia Perin
                                                                                                             Medical Centre, Suite 1, 12 Napier Close, Deakin, ACT, 2600.
                    Dr Nicole Sides
          Fertility Specialist and Gynaecologist                     VRGP needed for                       Referrals can be made either on (02) 6162 1886 or the priority number
                                                                                                           (02) 6162 2024. Faxes can be sent to (02) 6162 1887.
                                                                     very busy modern family
Offering a holistic, Canberra based approach to becoming pregnant
                                                                     practice. Flexible hours              A comprehensive cardiac investigative service including
                                                                                                           Echocardiography, Stress testing, Ambulatory blood pressure monitoring,
  I   Ovulation tracking and induction – Intrauterine Insemination   no A/HRS and excellent                and Holter and Event monitoring is available and there is ample free
  I   IVF – IVF/ICSI for male infertility including vasectomy        renumeration.                         parking to assist patients in attending their appointment.
  I   Known donor program                                                                                  Dr Allada also has appointments at Canberra Hospital and National
                                                                     Phone: Jamison Medical Clinic
                                                                                                           Capital Private Hospital where patients requiring inpatient management
       Dr Sides’ rooms located in Deakin, Clinic located in Barton          Macquarie ACT
                                                                                                           will be treated. P 02 6282 5577 F 02 6282 5622
                                                                            6251 2300

12                                                                                                                                                         February 2010

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