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					                                      GP ACTion
THE BI-MONTHLY NEWSLETTER OF THE ACT DIVISION OF GENERAL PRACTICE | VOLUME 125 | APRIL/MAY 2007




                                                                              Website arrival
Unit 20, 41 Liardet St, Weston ACT 2611
PO Box 3571, Weston Creek ACT 2611
Phone: 6287 8099
Fax:      6287 8055
Email: reception@actdgp.asn.au
Web:      www.actdgp.asn.au
                                                                         The ACT Division of General Practice is proud to
                                                                      announce the arrival of the much-anticipated website.
President ...............................Dr James Cookman
Vice President ........................ Dr Rashmi Sharma
Secretary .....................................Dr Craig Brown
Treasurer...................................... Dr David Jarvis
ACT Director to AGPN ................... Dr Karen Flegg
Chief	Executive	Officer ............Richard Bialkowski
                      r.bialkowski@actdgp.asn.au
Policy and Programs ....................... Kelly Gourlay
                          k.gourlay@actdgp.asn.au
Business Services....................Deborah Cracknell
                        d.cracknell@actdgp.asn.au
LOCAL AREA NETWORKS
Northside Coordinator .................Dr Neena Sood
                                           Ph: 6242 0029
Central Coordinator .........................Dr Annie Lim
                                           Ph: 6295 2462
Tuggeranong Coordinator .........................Vacant
ACTDGP STAFF                                      PH: 6287 8099
Anne Baynes ................a.baynes@actdgp.asn.au
                                                         Aged Care
Bronwyn Parsons........ b.parsons@actdgp.asn.au
                                           Education & Quality
Carla Deluca ..................c.deluca@actdgp.asn.au
                                                   Accounts Clerk
Chrissie Arthur .............. c.arthur@actdgp.asn.au
                                                   Practice Nurse    As with all new websites, this       for their HR needs and a page
Dawn Roberts .............. d.roberts@actdgp.asn.au                  one will go through a very quick     allowing online comments and
                                                    Mental Health
                                                                     period of growth and then will       discussion about current issues
TBA .................................................... HMR/QUM
Jane Sharman ..........winmed15@winnunga.org.au                      need lots of positive feedback,      affecting general practice.
                                                         6249 7555   information and maintenance
                          The Opiate Project Team Leader
                                                                     to ensure that it reaches its full   Log on to www.actdgp.asn.
Janice Stewart .............. j.stewart@actdgp.asn.au                                                     au and have a look at this
                                               Self Management       potential.
Joanne Gunn ....................j.gunn@actdgp.asn.au                                                      new arrival. All comments on
                                   Mental Health/Reception           We have big plans for the future     current content and requests
Hailey Shaw ................... h.shaw@actdgp.asn.au                 of this site. We hope to develop     for new content are welcome.
                                                    Immunisation
Helen Kehoe.................. h.kehoe@actdgp.asn.au                  an employment section that           Please email Deborah on
                                               Aboriginal Health     will allow practices to advertise    d.cracknell@actdgp.asn.au
TBA ............................................ Chronic disease
Kerry Weller-Lewis ....... reception@actdgp.asn.au
                                                         Reception
Neeru Johar .....................n.johar@actdgp.asn.au
                                                Practice Services
Peter Wise ........................p.wise@actdgp.asn.au
                                                    Mental Health
Philip Habel ...................p.habel@actdgp.asn.au
                                                                              Inside this edition:
                                                         6247 5742
                                                 HIV/AIDS Nurse
                                                                              •	 From	the	President
Robyn Davies ................ r.davies@actdgp.asn.au                          •	 Active	Learning	Module	–	Diabetes	information
                                    The Opiate Project Nurse
                                                                              •	 Aboriginal	and	Torres	Strait	Islander	health	update
                                                                              •	 Classifieds	–	GP/PN	and	Reception	positions	around	town
        IMMUNISATION



                            Influenza vaccination
With autumn colours appearing and the return to              provided lollies and comfort to those who are not
darkness at 6pm, it is appropriate to remind everyone        so good with needles. Comments throughout the
about	influenza	vaccination.	The	focus	for	the	              Division indicate that she is perhaps the best ‘jabber’
National	Institute	of	Clinical	Studies	(NICS)	“fight	flu”	   around and ‘was so gentle I couldn’t feel a thing’. Our
campaign for 2007 is to improve vaccination coverage         President, James, also rolled up his shirtsleeves and
rates	for	influenza	across	the	health	worker	sector.	        participated in this activity (see photo below).
In previous years only 20-50 per cent of health care
                                                             Statistics provided by the National Institute for
workers have been vaccinated. This low level not only
                                                             Clinical Studies (NICS) indicate that 1,500 Australians
leaves health workers at risk, but allows for carriage
                                                             die each year from complications caused by
of the virus into the workplace and subsequent
                                                             influenza.	Less	than	half	the	people	most	at	risk	
infection of those under their care.
                                                             of developing life threatening complications from
In March 2007 Divisional staff participated in an            influenza	are	being	vaccinated	annually.	NICS	has	
onsite	influenza	clinic	with	the	final	coverage	of	the	      developed	a	website	to	provide	facts	about	influenza,	
Division staff at close to 87%. Thanks to Robyn Davies       dispel	common	myths	and	provide	tools	to	help	fight	
who supplied her expertise in injection technique,           flu.	http://www.fightflu.com.au




2 | April/May 2007 | GP ACTion
                                                                              FROM THE PRESIDENT



                              Expanding our role
                                               James Cookman

Many readers will recall the extremely successful         to	you	then	consider	flower	therapy,	crystal	healers	
cancer and palliative care day held last year at          or something called Emotional Freedom Technique
a well-known local conference venue. This was             therapy. In order to fund these therapies hospitals
organised by our LAN coordinators and I take              are removing every third light bulb and nurses are
pleasure in, yet again, renewing my congratulations       being paid half the minimum wage. And in some
to them on this achievement.                              instances being asked to work for nothing.
Some	readers,	with	good	memories	–	and	who	were	          In my view this can only be understood if we ask
paying	particular	attention	–	will	remember	the	          what motivates such funding alternatives. The only
comments of Dr Ian Prosser, staff haematologist.          answer can be that in Britain people have come to
He expressed interest in shifting the monitoring          understand	the	importance	of	primary	care	–	any	
and management of some stable haematological              Primary care! And we have to understand the sort of
conditions back to a primary care setting. These          services, which will leap into the primary breech if
include CLL and Monoclonal gammopathy of                  we	don’t	fill	it.
uncertain	significance	[MGUS].	Like	many	specialist	
clinics, haematology has many patients who could          * Rapid, Episodic, Process-Encouraged, Abbreviated, Time-
benefit	from	greater	general	practice	involvement.	         driven.
As I’m sure readers will agree, these would include
enhancement of the GP’s coordination role and the
benefit	of	the	personal	relationship,	which	develops	
between GPs and their patients.                                Spirometer Winner
Since then, the Division has been working with              Congratulations to Dr Ying Liu of Mawson
Dr Prosser on how best to progress this initiative.         Medical Centre who has won a spirometer for
I would like to invite any member with regular              her practice, kindly donated by the National
patients suffering from a stable haematological             Prescribing Service. Ying was one of ten GPs
condition such as those mentioned to contact us.            who completed the Active Learning Module
The division is keen to form a focus group to discuss       delivered by the Division September 2006
issues of protocol and up-skilling in this area. If         –	March	2007	on	Asthma	and	COPD.			Over	sixty	
you require further information about this please           GPs took part in education events offered during
contact the Division or me.                                 this ALM. The Division wishes to express its
As I have said and written often in the past,               thanks to GSK for their partnership in delivering
general practice can and must make a maximum                this education.
contribution if we are to avoid the inundation,
which the nation’s future health needs threaten. We
can only do this by expanding our role in chronic
disease management and population health. We
will not do it by practicing REPEAT* medicine.
Strange things are happening in the NHS Service
in the UK. If, like me, you love to read The Times of
London, you will have been astonished by a short
article, which appeared on March 5. It appears
that all kinds of alternative therapies are available
–	including	the	services	of	‘shamen’	who	instruct	in	
‘soul retrieval healing’, help the dead ‘continue their
journey into the hereafter’ and ‘investigate the Fairy
kingdom’. I’m not kidding. If this does not appeal

                                                                                  GP ACTion | April/May 2007 | 3
        FROM THE CEO



                                             Feedback
                                               Richard Bialkowski

As your member organisation your comments and               facilitate communication. This address allows
feedback are important to us. Our president, James          emails to be sent to a main receiver and then
Cookman and I are happy to receive phone calls              forwarded on to the appropriate board member for
that address current general practice issues, or            action and reply.
any issues dealing with the programs and services
                                                            We recently launched our new website and I invite
delivered by the Division.
                                                            all members and your staff to provide feedback to us
Another way to feedback is to write a letter to the         about the site and in particular what you would like
editor, see below. We are happy to receive letters          to see in the future as we continue to develop this
such as this and will print such letters and the            site.
response in the newsletter.
                                                            Regards,
I am also pleased to announce that we have a new
                                                            Richard
email address board@actdgp.asn.au to further




                               Letter to the Editor
Dear Editor                                                 to give you some brief background information about
I was extremely disappointed to see the front page of       the event in question.
the February/March 2007 issue of ACTion which was           The event was organised and managed by Medicare
all about promoting immunisation in general practice        Australia in conjunction with the Department of
to consumers with photos of the media event. My             Education and Training, to promote the Australian
disappointment was not in the message but in the            Childhood Immunisation Register. The event was held
messengers. Where were the GPs giving the message           at the Garran Primary School. We, along with AGPN,
about general practice on TV and on radio? Where were       were invited to attend.
the photos of GPs on the front page of ACTion?              Our longstanding policy on media issues is that the
I think the AMA has got it right in that it ONLY uses its   President is the designated public spokesperson
doctor elected representatives as spokespersons. If         for the Division. As a matter of practice all media
we as members of the ACTDGP want to get messages            and related enquiries received by the Division are
out about general practice to our ACT community, then       discussed with me before a decision is made on the
I believe our elected GP representatives should be the      appropriate course of action. In keeping with this
messengers, not ACTDGP or AGPN CEOs or staff.               policy, the CEO discussed this invitation with me and
The evidence shows the general public sees doctors          given the nature of the event I determined that in this
as the most credible experts to be giving advice and        instance it was appropriate for him to attend and deal
opinion about clinical matters.                             with any subsequent media enquiries that might arise.
Yours sincerely                                             While at the event, our CEO was approached by the
                                                            media	representative	to	briefly	discuss	the	issue	of	
Dr Jennifer Thomson
                                                            childhood immunisation. In responding to this request
                                                            I am assured by the CEO that his response focussed on
Dear Jenny                                                  promoting the role of general practice in immunisation
Thank you for your Letter to the Editor concerning          and encouraging parents to talk to their GP if they had
the lead article and supporting photographs in the          any questions or concerns about immunisation.
February / March edition of GPAction. Your letter has       I hope that this addresses your concerns. Again,
been considered by the Board and I have been asked          I thank you for your letter and would be happy to
by the Board to respond to you.                             discuss further this or any other issue with you.
You expressed disappointment in the lack of GP
attendance at a media event that promoted childhood         Yours sincerely
immunisation. In addressing your concerns I would like      Dr James Cookman, President

4 | April/May 2007 | GP ACTion
                                                                                           EDUCATION



  Education events – a timely reminder?
                                Bronwyn Parsons – Education Officer

It’s great to see that education events hosted by the   •	GPs	are	reminded	of	the	Board	policy	“the	
Division are receiving your support and attendance        responsible use of alcohol is encouraged at all
as	we	enter	the	final	year	of	the	RACGP	CPD	              Division events. The ACTDGP encourages and
triennium. Some timely reminders though to get us         expects professional behaviour at education
through the year:                                         events. Meaningful complaints should be
                                                          addressed	to	the	Division”.
•	If	you	have	faxed	back	a	reply	to	a	Division	event	
  you will always receive a reminder phone call from    •	As	a	courtesy	to	others,	GPs	are	requested	to	
  us within 24 hours of the event.                        turn their phones to silent, and leave the room
                                                          promptly when making or accepting calls at all
•	If	you	don’t	hear	from	us,	you	can	presume	we	
                                                          functions.
  haven’t heard from you (your fax may not have
  come through, it may have been delivered              •	Project	staff	are	working	hard	to	deliver	quality	
  incorrectly)	–	and	so	we	ask	that	you	call	the	         educational events, and have combined projects
  Division	to	confirm	final	details.                      to deliver numerous Active Learning Modules
                                                          throughout 2007. To ensure you receive points
•	Often	there	are	waiting	lists	for	Division	events,	
                                                          however it will be necessary that you complete
  as sponsorship dollars don’t stretch as far as
                                                          all	paperwork	–	predisposing,	post	event,	and	
  they	once	did	–	so	please	understand	the	need	to	
                                                          evaluations when supplied, as without these
  RSVP early, and attend where possible, or indicate
                                                          completed	you	will	only	be	entitled	to	Cat	2	–	2	
  otherwise.
                                                          points/hour.




                               Rotavirus Vaccine
                                                Hailey Shaw

The Australian Government will provide $124.4           Two Rotavirus vaccines will be included on the
million	over	the	next	five	years	to	include	free	       National Immunisation Program, Rotarix from
Rotavirus vaccines on the National Immunisation         GlaxoSmithKline and RotaTeq from CSL Limited.
Program.
                                                        The new vaccine will be given orally to babies from
The Acting Minister for Health and Ageing,              two to six months of age, commencing in July 2007.
Christopher Pyne, said Rotavirus gastroenteritis        All babies born from 1 May 2007 will be eligible for
caused severe diarrhoea and accounted for the           the free vaccine. Two or three doses, depending on
hospitalisation of around 10,000 Australian children    the brand administered, will generally be given at
per year.                                               the same time as other immunisations at around
                                                        two, four and six months of age.
“Rotavirus occurs more frequently in young children,
with almost half of all cases occurring in babies       Parents, carers and immunisation providers should
under 12 months of age and the majority of cases        contact their state or territory health department for
occurring	in	children	under	five	years	of	age,”	Mr	     further information.
Pyne said.
                                                        Media contact: Adam Howard - 0400 414 833
“Aboriginal and Torres Strait Islander children are
                                                        SOURCE: Acting Minister for Health and Ageing
affected	much	more	seriously	by	this	disease.”	



                                                                                GP ACTion | April/May 2007 | 5
         EDUCATION



                                     Immunisation
                                                Hailey Shaw

115 nurse immunisers, both practice nurses and            Part 2
community nurses attended Practical Immunisation
                                                          •	Recommendation	for	groups	with	special	
Procedures	–	an	interactive	session	with	Ann	Kempe	
                                                            vaccination requirements have been revised
on 13 February 2007. Ann is well known to Canberra
                                                            and expanded to include pregnant women,
being	the	first	ACT	Health	Immunisation	Coordinator	
                                                            breastfeeding women, preterm infants and
and is now working in Immunisation Research at
                                                            persons with impaired immunity.
the Murdoch Children’s Research Institute, Victoria.
Ann is also a member of the Australian Technical          Part 3
Advisory Group on Immunisation (ATAGI) who have
                                                          •	For	adults	requiring	a	primary	course	of	dT,	dTpa	
prepared the draft 9th edition of the Australian
                                                            is	recommended	for	the	first	dose,	followed	by	2	
Immunisation Handbook. Participants were given
                                                            doses of dT
an	early	“heads	up”	on	proposed	changes	to	be	
introduced in this document such as:                      •	New	chapters	including	human	papillomavirus,	
                                                            rotavirus	and	zoster.
Part 1
                                                          The draft was available for public comment until
•	Pre	vaccination	screening	checklist	and	                9 April 2007. Please note that any changes will not
  assessment have been revised                            come	into	effect	until	the	9th	edition	is	finalised.
•	Cold	chain	guidelines	have	been	updated	to	reflect	     A number of sessions for nurse immunisers are to
  ‘Strive for 5’                                          follow over the next few months (under an ACTDGP
•	Valid	consent	section	has	been	updated                  and ACT Health agreement) to include information
                                                          on Gardasil, responding to parental concerns about
•	IM	injections	for	infants	<12	months	old	now	
                                                          immunisation and St John’s anaphylaxis training.
  include ventrogluteal area as an alternative site
  for vaccine administration                              Further education sessions planned for 2007 are a
                                                          travel medicine update, rollout of funded rotavirus
•	Preferred	angle	of	IM	administration	is	90˚	(but	not	
                                                          vaccine and information on the GP HPV program as
  less	than	70˚)
                                                          it	is	finalised.	Currently	the	start	date	for	the	HPV	18-
•	Catch	up	has	been	revised	–	particularly	for	those	     26 year old female program is July 2007.
  >8 years old
•	Management	of	anaphylaxis	with	1:10	000	
  adrenaline is no longer recommended.




          Diabetes Active Learning Module
 A successful start to the ALM on diabetes care,          For those who would like to earn the 30 category
 to complement the joint Diabetes Australia               one RACGP CPD points associated with attending
 –	ACT	and	ACTDGP	annual	GP	diabetes	seminar	             3 events to end July 2007 but did not attend the
 in August, was held on Wednesday 14th March.             ADOPT night, there are still 2 scheduled education
 Associate Professor Chris Nolan gave the 34 GPs          sessions coming up:
 in attendance an overview of the recently released
                                                          Tuesday 22 May	–	Diabetes	&	Cardiac	Disease
 results from the ‘A Diabetic Outcome Progression
 Trial	–	ADOPT’.		                                        Wednesday 11 July –	Diabetes	&	Vasculopathy



6 | April/May 2007 | GP ACTion
        EDUCATION




GP ACTion | April/May 2007 | 7
        NEWS



    Accident Care Evaluation (ACE Study)
                                                Kelly Gourlay

The ACE study has been developed to determine            as part of the ACE study addressing the main
whether the health outcomes of people who have           areas	of	musculoskeletal	injury	–	neck,	shoulder	
sustained musculoskeletal injuries in a car crash,       and knee. This will happen in parallel to patient
can be improved by early referral to appropriate         recruitment into the study from Calvary and The
treating specialists. The project offers a strategic     Canberra Hospital Emergency Departments.
intervention that promotes delivering optimum
                                                         Invitations will be posted soon for education
health outcomes to injured victims of motor vehicle
                                                         evenings planned:
accidents in the ACT.
                                                         Week one       29 May        Calvary Hospital
ACTDGP are a key stakeholder in the project as a
member of the Management Advisory Group. In              Week two       5 June        The Canberra Hospital
addition, the Division, in collaboration with Planting   Week three     12 June       Calvary Hosptial
Seeds Pty Ltd will be delivering education sessions      Week four      19 June       The Canberra Hospital.



               Chronic Disease Management
                                                Kelly Gourlay

Serious and Continuing Illness Policy and                For more information on the project, or to be
Practice Study (SCIPPS) Update                           involved, please contact Dr Yun-Hee Jeon at the
                                                         Australian Primary Health Care Research Institute on
                                                         6125 9564.




As a reminder, the purpose of SCIPPS is to develop         Practice information update
policies to enable interventions to be made through        The Division has started using a new member
health service arrangements that provide optimal           database. This database will allow ease of
care for patients with chronic illness and the people      access to preferred contact details. For example,
who care for them.                                         does your practice have an email address? Do
This will involve the study of patient’s aged 45-          your GPs have email addresses? Do some of
85 with three serious and continuing chronic               your GPs work at more than one practice? To
conditions -cardiovascular disease (CVD), diabetes,        facilitate updating information from the old
and chronic obstructive pulmonary disease (COPD)           database to this new one we want to visit or
- and their precursors. This will be conducted in two      speak on the phone to a practice manager
large	communities	–	the	first	comprising	people	           from each practice over the next few weeks to
living within the Sydney West Area Health Service          make sure the information we have about your
(SWAHS) and the second in the Australian Capital           practice is up to date.
Territory (ACT).                                           It is important that this information is kept up
SCIPPS is in preparation to commence conducting            to date because being able to contact practices
focus groups with GPs and other relevant people            and	GPs	if	a	situation	like	pandemic	flu	should	
and recruiting patients with these conditions for          arise is imperative.
one-on-one interviews.

8 | April/May 2007 | GP ACTion
                                                                                                    NEWS



      New ‘Stamp Out Chlamydia’ Project
                                                   Anne Baynes

                      In February 2007, a chlamydia         Canberra Institutes of Technology. The aims of the
                      education and screening               SOC project are to assess the effectiveness and
                      project known as the ‘Stamp           financial	costs	of	this	outreach	model	to	see	if	it	is	
                      Out Chlamydia’ (SOC) project          suitable for implementing nationally.
                      commenced recruiting
                                                            Students diagnosed with chlamydia will be
                      participants in the ACT. SOC
                                                            contacted and encouraged to attend CSHC, SHFPACT
is funded under the Australian Commonwealth
                                                            or their GP for treatment and follow-up. After clinical
Department of Health and Ageing’s ‘Chlamydia
                                                            assessment	to	exclude	pelvic	inflammatory	disease	
Targeted Grants Pilot Program’. The project team
                                                            (PID) or epididymitis, management of uncomplicated
comprises staff from the Academic Unit of Internal
                                                            chlamydia	urethritis	and	cervicitis	is	azithromycin	
Medicine (AUIM) at The Canberra Hospital, the
                                                            1gram stat, with contact tracing to facilitate partner
Australian National University (ANU), Canberra
                                                            notification	and	presumptive	treatment.				In	line	
Sexual Health Centre (CSHC) and Sexual Health
                                                            with best practice recommendations CSHC will offer
Family Planning ACT (SHFPACT). The principal
                                                            all positive students a full sexual health screen,
investigator is Professor Frank Bowden.
                                                            which includes screening for gonorrhoea, syphilis,
The SOC project team is offering opportunistic              Hepatitis B and HIV.
education, health promotion, and chlamydia testing
                                                            If you would like further information about this
(urine PCR), to sexually active tertiary students aged
                                                            project, or assistance with contact tracing if patients
16-25 years. Positive results are given by telephone
                                                            attend your practice after screening through SOC,
with provision for treatment and referral as required.
                                                            please call Belinda Davis or Anne Baynes (SOC
SOC activities will be held on campus for the next
                                                            project	officers)	or	Dr	Sarah	Martin	at	Canberra	
18 months at the ANU, University of Canberra and
                                                            Sexual Health Centre 6244 2184.




          National Bowel Cancer Screening
              Project (NBCSP) Update
The NBCSP began in the ACT in August 2006 and               The Division has been liaising with the Medicare
will run until at least June 2008. Since this time          Australia ACT/South NSW NBCSP Information
it has been recognised that not all practices have          Manager, Cancer Council ACT and ACT Health to
received kits as initially the Department of Health and     deliver an update and education session on the
Ageing sent kits to PIP accredited practices only. The      program scheduled for mid 2007. This session will
Divisions network has been informed that they are           not be a bowel cancer update, but information on
not to order or distribute kits for practices, therefore:   local colonoscopy services, the program in general
                                                            and local support services for people who do have
•		The	practices	that	have	ordered	kits	via	the	Division	
                                                            bowel cancer. You will receive invitations in the mail
   should have received their kits;
                                                            as	soon	as	the	details	are	finalised.
•		Any	practice	that	has	not	received	a	kit,	or	wants	
   additional kits, please call information line to order
   on 1800 118 868. In addition, all information is
   available on-line at www.cancerscreening.gov.au
The program now has a free fax number to submit
completed program forms: 1800 115 062

                                                                                  GP ACTion | April/May 2007 | 9
        AGED CARE



   Updated ACT Health Residential Aged
      Care Facility Placement Policy
                                                 Anne Baynes
ACT Health has recently endorsed an internal              aged care facility, as those requiring low level
Residential Aged Care Facility Placement Policy to        care can usually be safely returned to their pre-
ensure that a common approach is adopted by ACT           admission environment with community services
Health staff when dealing with inpatients requiring       and supports.
placement in a residential aged care facility.
                                                          Once a patient has been approved by ACAT for
The policy applies to the management of patients          residential aged care, the patient/family will
who are:                                                  be encouraged to complete and lodge written
•	admitted	to	hospital	due	to	an	episode	of	illness,	     applications to a minimum of six residential aged
  surgery or trauma;                                      care	facilities	and	urged	to	accept	the	first	offer	of	
                                                          an available bed.
•	medically	stabilised;
•	assessed	by	the	Aged	Care	and	Assessment	Team	          Patients/families will be provided with the “5 Steps
  (ACAT) as eligible for residential aged care; and       to	Entry	into	Residential	Aged	Care”,	and	an	ACT	
                                                          Health	Patient	Information	Sheet	–	Placement	in	a	
•	unable	to	be	safely	discharged	back	to	their	pre-
                                                          residential aged care home. Patients/families will
  admission environment.
                                                          also be referred to the Residential Aged Care Liaison
Most of the patients affected by this policy will be      Nurse who, with patient/family consent, can provide
assessed as requiring high level care in a residential    advice and support through the application process.


Farewell Sandra                                           New Geriatrician: Dr Anil Paramadhathil
Dr Sandra Hogg has recently retired from General          Dr Anil Paramadhathil commenced work as a staff
Practice. Sandra has been a member of the Aged            specialist geriatrician at The Canberra Hospital in
Care Committee since its inception in 1994. She has       late January 2007. Dr Paramadhathil worked for the
worked	tirelessly	on	this	committee	and	was	the	first	    preceding two years as an advanced trainee registrar
member of the ACT’s GP Panel in 2004. GP colleagues       in the department of geriatric medicine at The
of Sandra’s talk of her work as a faithful carer of the   Canberra Hospital.
older person in her general practice.
                                                          Dr Paramadhathil is keen on community-based
The Aged Care Committee wish her well in her              geriatrics and is available to review elderly patients in
retirement and hope she now has time to pursue her        their homes or residential aged care facilities.
interests in sport and her grandchildren.
                                                          Phone: 6244 2625 Fax: 6244 4036
Recruiting GP for Aged Care Committee                     e-mail: anil.paramadhathil@act.gov.au
We are recruiting a GP who is interested in aged care
                                                          Aged Care Nurse Practitioner
issues who would be interested in representing GPs
at the bi-monthly Aged Care Committee meetings.           In February 2006 Wendy Venn was appointed
This forum has representatives from all sectors           to the position of Aged Care Nurse Practitioner.
active in aged care and facilitates broad information     Wendy works as a valued team member of the Aged
sharing, enables discussion about new initiatives,        Care and Rehabilitation Service (ACRS). Wendy
aged care projects in the ACT, and upcoming               completed her Masters of Nurse Practitioner in 2005
conferences. At present the Aged Care Committee has       and has many years experience working with older
five	GPs	attending,	with	Sandra	Hogg	leaving	there	       people in the community, residential aged care and
will be four and we need a replacement.                   in hospitals.
The	committee	meets	on	the	first	Friday	of	alternative	   Wendy’s position involves her following up patients,
months at 0800 for 1 ½ hours. If you are interested in    discharged from ACRS who are at high risk of
this position we would love to hear from you.             readmission, for a period of 4-6 weeks. During her

10 | April/May 2007 | GP ACTion
                                                                                          AGED CARE


involvement she will be monitoring medication             where the GP who provides the GP Mental Health
compliance, ensuring that support services are in         Care item is providing in-patient care: in this case the
place and are adequate, and reviewing patients’           item is claimed as an in-hospital service (at 75% MBS
clinical progress.                                        rebate).
Wendy will liaise closely with the patients’ treating     GPs are able to contribute to care plans for patients
GP, including advising them of her referral from          (including public patients being discharged
ACRS and then working in consultation with GPs            from hospital) using item 729, Contribution to a
to implement and support patient care to optimise         Multidisciplinary Care Plan, and to care plans for
patient outcomes.                                         residents of aged care facilities using item 731.
Any enquiries about the position can be made to           2.4 Are privately funded residents of aged care
Wendy Venn 0418 944 842.                                  facilities eligible for a GP Mental Health Care Plan?
                                                          Yes. A privately funded resident means a person who
GP Panel Meeting
                                                          is living independently in an aged care facility where
The GP Panel met last month. A dedicated team of          the facility is not receiving a subsidy for their care
eight Panel GPs and several Directors of Nursing          from the Australian Government under the Aged Care
from Aged Care Facilities (ACFs) discussed the            Act.
direction for the Panel. It was agreed to continue
                                                          However, the GP should not provide a GP Mental
focusing on palliative care in the elderly in
                                                          Health Care Plan or Review.
collaboration with Clare Holland House. As part
of this there will be the opportunity for a small         Service to a resident where they have already
number of GPs to attend a clinical attachment with        contributed to a care plan prepared by the facility
a specialist at Clare Holland House; more details         (item 731) for treatment of the same condition, i.e.
will be circulated soon. The Panel is also looking at     where they have already provided a service to the
developing and providing a Palliative Care resource       resident as a resident of the aged care facility for
to ACFs and interested GPs.                               treatment of the resident’s mental disorder.
All ACFs offering palliation in the ACT now have at       2.5 How does a GP establish if someone is a
least one S26 syringe driver. Several of these were       Commonwealth funded resident of an aged care
purchased as part of the Panel through funding from       facility?
the Department of Health and Ageing.                      The GP or practice staff should ask the patient and, if
Many of you are probably aware of the ‘Short term         unsure, ask the aged care facility whether the patient
Respite Project’, which has been operational for          is a privately funded resident. The advice of the
some months. If a patient requires short-term respite     patient and/or aged care facility should be accepted
in an ACF, and the resident’s own GP is unable to do      and a note made in the patient record indicating by
this, there is cover from a nominated GP.                 whom and when the advice was provided.
                                                          For more information look at the DoHA
GP Mental Health Care Medicare Items
                                                          website link http://www.health.gov.au/
As many of you will know, three new GP Mental             internet/wcms/publishing.nsf/Content/
Health Care Medicare items were introduced to the         9ECB627B553E6DB1CA2571F7000067B3/$File/Q&As
MBS on 1 November 2006. They are:                         %20GP%20Mental%20Health%20Care%20items%2
•	Item	2710	Preparation	of	GP	Mental	Health	Care	         0for%20web%201%20November%202006.pdf
  Plan
                                                          Residential Medication Management Review
•	Item	2712	Review	of	a	GP	Mental	Health	Care	Plan        update
•	Item	2713	GP	Mental	Health	Care	Consultation
                                                          There are some changes happening to Residential
Some of these will be appropriate for residents of        Management Medication Reviews (RMMRs) for
Aged Care Facilities. Following are some frequently       pharmacists, which may be useful for you to know.
asked questions and answers from the DoHA website.
                                                          •	Pharmacists	will	have	from	1/3/07	till	30/6/07	
                                                            to prepare the paperwork which involves signing
2.1 What patients are eligible for these items?
                                                            a	new	contract	–	this	will	be	a	standard	contract	
The new items are available to eligible patients in the
                                                            provided by Medicare (similar to the AACP one) but
community. GP Mental Health Care Plan and Review
                                                            it cannot be altered or have any terms varied.
services can also be provided to private in-patients
(including private in-patients who are residents of       •	The	Department	is	keen	for	as	many	RMMRs	as	
aged care facilities) being discharged from hospital,       possible	to	be	collaborative	–	they	have	no	problem	

                                                                               GP ACTion | April/May 2007 | 11
         AGED CARE



  with pharmacists prompting GPs to initiate the           its currency; nine new clinical information sheets
  service.                                                 have been added, as well as information on chronic
                                                           disease management, and new resources developed
For a resident that has more than one RMMR in the
                                                           through the Aged Care GP Panels Initiative have also
year, each successive service must be a collaborative
                                                           been included. The web version can be accessed at:
RMMR and cannot be a pharmacist-initiated RMMR.
                                                           http://nwmdgp.org.au/pages/after_hours/
The General Practitioner and Residential Aged
Care Kit                                                   Publication resource on clinical handover
                                                           The Australian Medical Association has launched
This kit is a useful resource for GPs and aged
                                                           a new publication to assist hospitals, doctors, and
care homes. The kit provides information, tools,
                                                           other health professionals improve patient safety,
strategies and resources for integrating the medical
                                                           particularly when there is a transfer of responsibility
care of residents, particularly between GPs and
                                                           for patient care. While the guide mainly addresses
aged care home staff, to ensure best practice ‘round
                                                           hospital issues, it could be applied to aged care. It is
the clock’ medical care for residents of aged care
                                                           available at: www.ama.com.au/handover
homes. The kit has recently been updated to maintain



       Urgent After-Hours MBS Items - Quick Guide
On 1 March 2007, a series of changes to the emergency        in a patient’s home or at a residential aged care
after-hours MBS items are being introduced. This             facility. Doctors who routinely provide surgery
Quick Guide provides an overview of the changes and          consultations after-hours may only claim the Round
claiming arrangements for the items.                         the Clock Medicare items (5000-5267) for in-surgery
                                                             attendances after-hours.
This information is a guide only. Providers should
refer	to	the	Medicare	Benefits	Schedule	online	for	full	   Claiming the Urgent After-Hours Items
details of the items and claiming rules.
                                                           The urgent after-hours items can only be claimed:
The Items                                                  •	 for	services	provided	in	an	after-hours	period,	
Medicare items 1, 2, 601, 602 (Vocationally Registered        meaning before 8.00am or after 8.00pm on a
GPs), 97, 98, 697, 698, (other medical practitioners),        weekday, before 8.00am or after 1.00pm on a
448 and 449 (sports physicians) provide a rebate for          Saturday, or anytime on a Sunday or public holiday;
after-hours attendances in a situation where a patient        and
requires urgent treatment.
                                                           •	 if	the	request	for	an	attendance	is	made	by	the	
How have the items changed?                                   patient or another responsible person up to two
                                                              hours prior to, or during the same after-hours
A series of changes to these items are being                  period; and
introduced on 1 March 2007. Three key changes have
been made to the items:                                    •	 if	in	the	opinion	of	the	attending	doctor	and	his/her	
                                                              peers, the patient’s medical condition requires
1. The items will now be referred to as ‘urgent’ after-       treatment within that after-hours period and could
   hours items. This change is designed to avoid              not wait until the next in-hours period to be seen;
   confusion with terminology used by specialist              and
   emergency physicians.
                                                           •	 only	for	the	first	patient	seen	on	that	occasion.	The	
2. Doctors will now be able to accept requests for            Round the Clock Medicare items (5000-5267) should
   urgent after-hours attendances up to two hours             be claimed if subsequent patients are seen on the
   before an after-hours period begins, so long as the        same occasion.
   attendance is provided in the after-hours period,
   and meets the other requirements for an urgent          Further Information
   after-hours item.
                                                           Prior to claiming an urgent after-hours attendance,
3. Doctors who routinely provide services in the           doctors should ensure they understand the rules for
   after-hours period, including Medical Deputising        the items. Full details, including item descriptions
   Services, will now be able to claim the urgent          and explanatory notes, are available: in the Medicare
   after-hours items (for VR GPs or other medical          Benefits	Schedule	online	at	the	Department	of	Health	
   practitioners as applicable) for services that are      and Ageing website - www.health.gov.au/mbsonline;
   provided outside of consulting rooms, for example       or by telephoning Medicare Australia on 132 150.

12 | April/May 2007 | GP ACTion
                                                                                              AGED CARE



    New Aged Care Rehabilitation Stream
      Rehabilitation Facility at Calvary
Introduction                                                c) remain acutely unwell (hypoxic, delirious or
A new 48 bed subacute facility opened at Calvary               otherwise medically unstable)
Hospital ACT in February 2007, comprising 28 aged           d) would be better managed in an acute rehabilitation
care and rehabilitation beds plus 12 GEM beds                  facility (eg. post moderate to severe stroke)
(Geriatric Evaluation & Management) remaining               e) are unable to participate in active rehabilitation (eg.
on 5East at Calvary as part of the Aged Care and               severe	cognitive	deficit).
Rehabilitation Stream (ACRS). The Older Persons             It should be noted that patients in category (c) and
Mental Health Inpatient Unit will also have 20 beds         (d) above may with appropriate management become
which are part of the Mental Health stream. All beds        suitable at a later date.
are managed by Calvary. The beds were commissioned
in March 2007 with patients on 5E being transferred         The Rehabilitation Unit
first	with	a	staged	opening	of	the	other	beds	in	the	       Suitable patients will:
unit.
                                                            a) be over the age of 18 years; and
The referral process has changed and the referral           b) be in need of low level care; and
form has been updated with the new information. If          c) have the potential and desire to improve
you need to discuss a referral with anyone the phone           functionally with mobility and self-care after a short
number for the unit is 6264 7000 and the fax number            term program; and
is 6264 7001.                                               d)	have	an	agreed	discharge	date,	firm	discharge	
                                                               destination and a completed discharge care plan;
Referral Criteria                                              and
The following criteria applies for referrals to the         e) be able to be discharged home or to their agreed
services.                                                      destination (other carer residence) with assistance
                                                               of community support services.
The GEM Unit
                                                            Patients will not be considered suitable if they:
Suitable patients will have:
                                                            a) need acute care; or
a) suffered from a potentially reversible decline in
                                                            b) do not have an agreed discharge destination (to
   function as the result of an acute illness for which
                                                               home or other carer residence) in the community; or
   they have already been admitted to hospital for
                                                            c) require residential respite or do not have a
   management; or
                                                               residential place post discharge from the Unit; or
b) suffered a subacute decline in function due to
                                                            d) have any form of confusion, including dementia
   medical co-morbidity where optimisation of medical
                                                               that precludes them from actively participating in a
   management together with multidisciplinary
                                                               rehabilitation program; or
   rehabilitative input is deemed likely to improve
                                                            e) are not or may not be amenable to staff and
   function	sufficiently	to	allow	the	patient	to	
                                                               program direction; or
   successfully return to their previous place of
                                                            f) are likely to impose unacceptable operational
   accommodation; and
                                                               difficulties	on	the	staff	or	management	of	the	unit;	
c)	the	potential	to	benefit	from	two	to	four	weeks	of	
                                                               or
   care at sub acute level.
                                                            g) may threaten the safety of the staff, patients and
Patients will not be considered suitable if they:              visitors.
a) are already resident in a high level care facility and   Included	in	this	newsletter	is	a	flowchart	and	the	new	
   not requiring medical and allied health intervention     referral form, which GP Panel GPs had input into.
   to return them to premorbid function; or                 The referral form can be accessed on the ACT Health
b) have already been assessed as requiring placement        website under Aged Care & Rehabilitation Services
   in high level care during present admission and will     then hospital based services. This site is currently
   not	benefit	from	further	geriatric	or	allied	health	     being updated. If anyone would like more information
   intervention and are unable to return home prior to      about this please call Helen Shephard, Operations
   a placement becoming available;                          Manager ACRS Ph 6244 2205.

                                                                                  GP ACTion | April/May 2007 | 13
        ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH



                     Health checks for Aboriginal people
Aboriginal people and Torres Strait Islanders             MBS-recognised health checks are now available for
face life expectancies 15-20 years less than other        Aboriginal people and Torres Strait Islanders of all
Australians. As primary health care providers,            ages and they are an important part of best practice
general	practices	have	a	significant	role	to	play	in	     in Aboriginal and Torres Strait Islander health care.
making a difference in Aboriginal and Torres Strait
                                                          In this article, two local service providers share their
Islander health care.
                                                          stories of how they are making these important
One important avenue for improving health is a            health interventions available to their Aboriginal
comprehensive health check tailored to the needs of       and Torres Strait Islander clients.
Aboriginal people and Torres Strait Islanders.




  Winnunga Nimmityjah Aboriginal Health Service (WNAHS)
Getting started with health checks                        the client and Winnunga staff. The checks are a means
WNAHS received Healthy for Life funding and in late       of early intervention and for helping clients gain a
2006 was able to set up a new team to focus on health     better understanding of the factors that affect their
checks, chronic disease management and preventive         health and well being. This allows clients to initiate
health care. The Healthy for Life team is made up of      positive changes for themselves.
Donna Williams, Co-ordinator, Susie Begbie, GP and        How do you get Aboriginal people and Torres
Anne Marie Quinn, Aboriginal Health Worker (AHW).         Strait Islanders to have a health check?
This has meant a change in focus from acute and crisis
                                                          WNAHS operates on a walk in system rather than
driven care to more structured client centred care.
                                                          appointments, so people often have to wait to see
Why do health checks?                                     the GP. Anne Marie uses this as an opportunity to
WNAHS staff see health checks as the starting point,      approach people, explain the health check process
an initial assessment that provides a whole picture for   and seek their consent to be involved. Although some
                                                          people are a bit apprehensive to begin with, most are
                                                          happy to participate. Everyone who has had a health
 Dos and Don’ts …                                         check has found it a positive experience. Writing to
 The WNAHS team emphasised some do’s and don’ts:          people offering the check did not get a good response
 •	Do ensure the Aboriginal or Torres Strait Islander     rate; instead WNAHS has found the opportunistic
                                                          approach works best. Anne Marie thinks word of
   client is regularly attending your practice - the
                                                          mouth is gradually spreading, and they have had
   health check should be done by the client’s regular
                                                          some people requesting a health check on their own
   GP. This is essential as the health check is really
                                                          initiative.
   the starting point for on-going and systematic care.
                                                                                                 continued on page 16 >
 •	Don’t try to solve every problem on the day of
   the health check. The health check is an initial
   assessment, and many clients may need to have
   a GP management plan or team care arrangement
   plan done as well as the health check. This will
   usually be on another day.
 •	Do take a team care approach - the GP does not
   have to do the whole health check by themselves;
   the Aboriginal Health Worker or practice nurse has
   an important role to play.
 •	Do see the time it takes to do a health check as
   time well spent. Clients appreciate “many things
   being	dealt	with	in	one	visit”	and	feel	they	are	
                                                             Left to right, Donna Williams, Anne Marie Quinn and
   being heard.
                                                             Suzie Begbie make up the WNAHS Healthy for Life Team

14 | April/May 2007 | GP ACTion
                                                 ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH



and Torres Strait Islanders
                                                        Child health check          Adult health check          Health assessment
    MBS item                                                     708                          710                         704
    Age range                                               0	–	under	15                   15	–	54                 55 years & over
    Frequency                                                  Annual                      2 yearly                     Annual
    Medicare rebate (as at April 2007)                         $167.45                     $199.60                     $167.45
    Date of effect                                           1 May 2006                  1 May 2004               November 1999
   Please note:
   • For the purposes of these health checks, a person is an Aboriginal or Torres Strait Islander person if they identify as being of
     Aboriginal or Torres Strait Islander origin.
   • This is a summary only and does not provide comprehensive information. Please read this in conjunction with the relevant item
     descriptor and explanatory notes in the Medicare Benefits Schedule Book.




                                    Rutledge Plaza Medical Centre
   Preparing the ground …                                               implemented. The Practice also included information
   The Practice bulk bills Pensioners and Health Care Card              about the Aboriginal and Torres Strait Islander health
   Holders. In response to the changes in the Third Edition             checks in their newsletter and on the website to raise
   of the Accreditation Standards, reception staff have                 awareness about this service.
   been attempting to identify Aboriginal and Torres Strait             How do you get Aboriginal people and Torres Strait
   Islander patients. For example the waiting room is                   Islanders to have a health check?
   signposted inviting Aboriginal and Torres Strait Islander
   people to inform staff of their ethnicity. Aboriginal and            The Practice had previously tried contacting Aboriginal
   Torres	Strait	Islander	status	is	then	flagged	in	PracSoft	           and Torres Strait Islander patients for other purposes
   and hence in Medical Director. Greater Southern Area                 by letter and hadn’t found it to be an effective means of
   Health Service estimates there are approximately 2,500               communication. Instead, Maree decided the best way
   Aboriginal people in the Queanbeyan area.                            to start was to approach an Aboriginal elder who had
                                                                        been a long time patient at the practice and invite her
   Getting started with health checks                                   to undertake a health check. This was very positive,
   Maree started as Practice Nurse last year, and has been              and Maree is hoping word of mouth will help to spread
   keen to assist patient care by using available MBS                   the good news. Also patients were approached
   items for health checks. She often uses the aged care                opportunistically, when visiting the GP, and invited to
   health assessment, which is available to the general                 participate in the health check.
   population at age 75, and to the Aboriginal and Torres               Who does the checks?
   Strait Islander population at age 55. She had heard
   about health checks available for younger Aboriginal                 Most visits to the clinic are on an appointment
                                 and Torres Strait Islander             basis, and if the patient has been booked in for a
                                 people and when the                    health check, Maree tries to ensure blood tests are
                                 ACT Division provided                  taken before the clinic appointment. Though not a
                                 information about this, she            requirement for the health check, the practice feels it is
                                 was inspired to give it a go.          important to have the best possible data, for example,
                                                                        knowing a fasting blood sugar level rather than a
                                   Maree’s	first	step	was	to	           random result. Then Maree does the bulk of the health
                                   run a report on Medical              check: taking height, weight, blood pressure, and
                                   Director to show all                 doing visual and dental checks as well as urinalysis,
                                   patients	identified	as	              respiratory function and ECG testing if needed. She
                                   Aboriginal and or Torres             also discusses social issues, family medical history and
                                   Strait Islander and check            modifiable	risk	factors	like	tobacco	use.		All	information	
                                   these patients were still            is	inserted	into	a	specifically	designed	Medical	Director	
                                   current. She then met                template which is printed and given to the patient. This
                                   with the Practice Manager            usually	takes	about	45	minutes.		The	GP	finishes	the	
                                   and GPs to discuss how               health check and generally requires no more than a 15
   Maree Latimer – at the ready to the checks could be
                                                                        minute consultation to do this.
   do a health check!                                                                                               continued on page 16 >

                                                                                                    GP ACTion | April/May 2007 | 15
        ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH


                        Nimmityjah
< from page 14 – Winnunga                                 < from page 15 – Rutledge     Plaza Medical Centre
              Aboriginal Health Service                   What support would be useful in doing Aboriginal
                                                          and Torres Strait Islander health checks?
Who does the checks?
                                                          Some ideas about support that could be helpful
Anne Marie or Sue Wood, the Practice Nurse, start         include:
the health check and spend about 30 minutes going         •	information	on	culturally	specific	referral	pathways	
through lifestyle issues such as smoking, alcohol           available to make referrals easier;
use and diet, as well as obtaining baseline data on       •	awareness	raising	about	Aboriginal	cultural	issues;
blood pressure, pulse, height, visual acuity, hearing,    •	phone	listing	for	patients	of	Aboriginal	and	Torres	
BSL and weight. As the GP, Susie then completes             Strait Islander contacts, services and organisations,
the health check including updating the medical             as well as mainstream services available;
history	and	medications	summary.		The	team	finds	         •	development	of	a	patient	friendly	template	showing	
it works best for issues like sexual health, mood           current assessment notes and recommendations for
and depression to be covered by the GP. The GP              follow up.
component can take up to 30 minutes depending on
                                                          Insider tips …
the complexity of the client’s issues. Other GPs at the
clinic are gradually becoming involved as the process     In Medical Director, even when Aboriginality is recorded,
for health checks is streamlined.                         it’s not visible on the main screen. Instead, Maree uses
                                                          the ‘Warnings’ box on the main screen to note ‘consider
What’s worked well?                                       Aboriginal and Torres Strait Islander health check’ as a
Donna has adapted previous guidelines for                 way of keeping attention on this issue.
undertaking the health check to meet WNAHS’ needs,
and this has been important in making sure everyone
involved in the health check is giving consistent
advice to clients. For example, it’s been agreed that
30 minutes of exercise per day is the goal. Because
of the high prevalence of chronic disease amongst
Aboriginal and Torres Strait Islander clients the
health check is often followed by care planning.


                                                             The team at Rutledge Plaza Medical Centre - left to right,
                                                             Brigeta Srbinoski, Maree Latimer, and Ann-Marie Lessels




                              Sue Wood – ACT PEPA Program Manager
 The National PEPA Program has been extended              in requests from hospitals for palliative care
to June 30 2010 and Calvary Health Care has been          education.
appointed as the nominated provider for the ACT.
                                                          Specific	funding	is	also	available	for	the	delivery	of	
The ACT component has been funded for nurses &            palliative care workshops for GPs (2 in 2008 2009
allied health primary care providers (18 places per       1 in 2010). These workshops will be free and some
year) to attend a 1 week clinical placement at Clare      resources supplied.
Holland House.
                                                          If any of you have any suggestions as to topics,
There have been many changes in the aged care             guest speakers, workshop structure etc please
sector as nurses & personal carers become more            email, phone or fax through to me :
skilled in adopting a palliative approach. All aged       Sue.Wood@calvary-act.com.au ph: 6273 0336
care facilities in the ACT now have their own syringe     fax: 6273 0338
drivers. There has also been a huge increase

16 | April/May 2007 | GP ACTion
                                                                               PALLIATIVE CARE



                      Palliative care resources
                                                Anne Baynes

May 20 is the start of Palliative Care Week and        5. Click on any of these topics to view the leaflet.
therefore a good time to review some of the               While the leaflet is open click the print button
resources available for GPs.                              to print.

Primary Care and Palliative Care Resource Kit          6. When a leaflet has been printed for a patient,
                                                          a green tick appears on the leaflet icon and
This kit has information about on-line training           the date it was printed appears to the right of
packages for GPs, and fact sheets and brochures           the leaflet name.The printing of the patient
about palliative care. The Division has a limited         education leaflet is also recorded in the
supply of these kits. Phone Anne if you are               patient’s progress notes.
interested.
                                                       Palliative Care Australia has some useful
Journeys: Palliative Care for Children and
                                                       education and resources for GPs:
Teenagers
Journeys: Palliative Care for Children and             Pamphlet on opioid medicines in palliative care
Teenagers is an information resource which             Included in this mail out is a pamphlet published
aims to better prepare and equip families and          by Palliative Care Australia: ‘Facts about
carers for the many situations and issues they         morphine and other opioid medicines in palliative
may face as they live with their child’s illness.      care’. This resource is designed for patients and
It is a starting point in identifying where to look    families to provide information on how to use
or who to go to for specific information and           opioids for relieving pain.
support which best meets their needs. Journeys
is designed in four modules each containing a          GP On-line Training in Opioid Medication in
resource list relevant to the different stages of      Palliative Care
the journey. Journeys is available on line: http://    GPs in Australia now have access to online
www.pallcare.org.au Go to ‘Our Projects’ then          training to support prescribing opioid medication
‘Paediatric Pal Care Resource’ and ‘click here’.       for palliative care patients.
                                                       Palliative Care Australia (PCA) in consultation
Patient information sheets on cancer now
                                                       with the RACGP and ACRRM, has initiated a free of
available in Medical Director
                                                       charge online education resource for member GPs
The Cancer Council Australia fact sheets on            which is now available throughout Australia. This
prevention, early detection and after diagnosis        resource is available online through the websites:
can be printed to provide to patients.                 www.gplearning.com.au and www.rrmeo.com.
How to access and print the cancer fact sheets on      Enhanced Guidelines for a Palliative
Medical Director
                                                       Approach in Residential Aged Care
1. Open the patient file.
                                                       The Enhanced Guidelines for a Palliative Approach
2. Click the academic hat button on the tool bar       in Residential Aged Care, approved by the
   or click on resource/patient education or press     National Health and Medical Research Council
   CTRL.                                               (NHMRC), are now available. This new edition
                                                       contains changes to the chapter on methodology,
3. Open the purple book titled ‘The Cancer
                                                       but does not impact on the implementation of the
   Council Australia’ 2 folders appear; after
                                                       Guidelines for a Palliative Approach in Residential
   diagnosis and prevention and early detection.
                                                       Aged Care. For a copy of the Enhanced
4. Click on category at the left of the window to      Guidelines, http://www.health.gov.au/internet/
   display a list of topics (leaflet) on the right.    wcms/publishing.nsf/Content/palliativecare-
                                                       pubs-workf-guide.htm or fax PCA 6260 2770.


                                                                           GP ACTion | April/May 2007 | 17
        PALLIATIVE CARE


Aged Care Self Directed Learning Package                program, which incorporated consultation,
                                                        participation and evaluation by GPs. The
PCA has developed a Self Directed Learning
                                                        evaluation demonstrated a positive impact on
Package based on the Guidelines to a Palliative
                                                        the issues surrounding end-of life discussions for
Approach in Residential Aged Care.
                                                        GPs.
The Package has been developed for residential
                                                        ACT Health supports advance care planning and
aged care facility staff and contains resources
                                                        in May 2006 piloted the program in three clinical
that can be used by aged care staff to familiarise
                                                        areas of the Canberra Hospital. Due to its success
themselves and other staff in their RACF about the
                                                        ACT Health has reaffirmed its commitment and a
Guidelines and a palliative approach.
                                                        community extension is planned for later in 2007.
The Package includes:
                                                        The Respecting Patient Choices Program is
•	manual	
                                                        based on systematic communication about the
•	copy	of	the	Guidelines	for	a	Palliative	Approach	     issues underlying advance care planning. It
  in Residential Aged Care and the Navigational         enables patients to reflect on what is important
  Tool                                                  to them, on their beliefs, values and goals in
•	video	on	the	palliative	approach	                     life. Especially how they would like to be cared
                                                        for if they reach a point where they cannot
•	CD	containing	a	PowerPoint		        	    	            communicate or participate in the medical
  presentation that you can use when informing          decision process.
  others in your RACF about the palliative
  approach and the Guidelines                           The Program proforma incorporates nomination
                                                        of an Enduring Power of Attorney (Medical) as
•	back	copies	of	the	Residential	Aged	Care	             well as documentation of their wishes including
  Palliative Approach Network newsletter.               life-sustaining treatments. It also includes other
To order a copy of the Self Directed Learning           wishes relating to end-of-life care, and may be
Package try, http://www.pallcare.org.au/                as specific as playing certain music, calling the
Portals/46/docs/AgedCareWorkshop/Self%20D               person’s family together or having the person’s
irected%20Learning%20Package%20flyer.pdf or             spiritual leader visit, if that is important to them.
phone Anna at PCA 6232 4433.                            http://www.pallcare.org.au/Portals/46/docs/
Enduring Power of Attorney                              AgedCareWorkshop/Self%20Directed%20Learnin
                                                        g%20Package%20flyer.pdf
Copies of the ACT’s Enduring Power of Attorney
document can be obtained from the Public                The Program recognises the significant role of
Advocate office of the ACT (PA ACT). Their website      General Practice as the hub of health care. In the
has been updated and should be available by             community implementation phase the role of the
the time you receive this newsletter http://www.        GP is central in assisting patients to discuss and
oca.act.gov.au/publications/pdfs/EPA-Form.pdf .         record their wishes.
However if you have difficulties please phone PA        The GP Module incorporated with the community
ACT on 6207 0707.                                       implementation will be advertised later this year.
Respecting Patient Choices:                             For more information visit the
The GP role in Advanced Care Planning                   Respecting Patient Choices Web site on:
                                                        www.respectingpatientchoices.org.au
The Respecting Choices program is a national
program developed at the Austin Hospital,               Or contact:
Melbourne in 2002. Since then Respecting                Denise Caldwell
Choices has been implemented in primary care            Project Officer, Respecting Patient Choices
pilot sites in all Australian States and Territories.   62443344
                                                        denise.caldwell@act.gov.au
In 2004 Austin Health developed and
implemented a community extension of the




18 | April/May 2007 | GP ACTion
                                                                                                   NEWS



                      Rheumatic Heart Disease
The National Heart Foundation of Australia (NHFA)         •	Identify	areas	where	current	management	strategies	
and the Cardiac Society of Australia and New Zealand        may not be in line with available evidence, and
(CSANZ)	have	released	Australia’s	first	national	
                                                          •		In	the	interests	of	equity,	ensure	that	high	risk	
evidence-based review for the diagnosis and
                                                             populations receive the same standard of care as
management of Acute Rheumatic Fever (ARF) and
                                                             that available to all other Australians.
Rheumatic Heart Disease (RHD).
                                                          In addition to the full review a series of quick reference
RHD	remains	a	significant	cause	of	cardiac	disability	
                                                          guides for health professionals are also available on
and death among Australian Aboriginal and Torres
                                                          the following topics;
Strait Islander peoples with incidence rates among
the highest in the world. Aboriginal and Torres Strait    1. Diagnosis of Acute Rheumatic Fever
Islander peoples are up to eight times more likely than   2. Management of Acute Rheumatic Fever
non-Indigenous Australians to be hospitalised for ARF
and RHD and are nearly 20 times more likely to die        3. Secondary Prevention of Acute Rheumatic Fever
from these conditions.                                    4. Management of Rheumatic Heart Disease
The NHFA and CSANZ have jointly developed this            5. Rheumatic Heart Disease Control Programmes
evidence-based review to assist policy makers and
                                                          The evidence-based review and quick reference guides
health professionals, including medical, nursing,
                                                          are available for downloading from the National Heart
allied health and Aboriginal Health Workers address
                                                          Foundation website; www.heartfoundation.com.au
the inadequate diagnosis and management of ARF and
                                                          (Health and Lifestyles tab;Professional; Aboriginal and
RHD in Australia. The purposes of the review were to:
                                                          Torres Strait Islander Program). Printed copies can
•	Identify	the	standard	of	care,	including		              also be ordered through Heartline on 1300 36 27 87
  preventive care, that should be available to all        (local call cost) or email heartline@heartfoundation.
  people                                                  com.au




                                                                                GP ACTion | April/May 2007 | 19
        NEWS



                                         Wee Week




In	2007	Kidney	Health	Australia’s	(KHA)	awareness	week	‘wee	week’	is	27	May	–	2	June.		You	can	order	free	
resources for patients, including fact sheets, as well as resources for health professionals such as the eGFR
desktop resource card and the MDRD GFR Calculator from the KHA website http://www.kidney.org.au/.




 HMR’s a top 10 hit                                           New play explores
              Deborah Cracknell                             impact of schizophrenia
Two years ago I was a little despondent, my program
                                                                            Dawn Roberts
Home Medicine Review (HMR) was going nowhere.
The few GPs who were referring patients for HMRs             A new play called ‘1 in 100’ about the impact of
had to wait too long for reports. Pharmacists were           schizophrenia	on	relationships,	will	premiere	
unable	to	find	accredited	colleagues	to	attend	the	          at the Street Theatre in June.
few	requests	received.	ACTDGP	didn’t	even	figure	in	         The play explores the relationship between
the statistics sent around each month by Medicare            Simon and his mother Sue, and their battle
Australia. WOW what a difference a couple of                 to maintain their relationship when Simon
years, resilient GPs and a couple more accredited            develops	schizophrenia.
pharmacists makes. The ACTDGP has reached the
                                                              The play is told with a gentle humor and
TOP 10, coming in at number 9 for the number of
                                                             focuses on Simon’s altered perception and
HMRs done per capita in the month of December.
                                                             loss of self and Sue’s grief and her questions
A big thanks to all the GPs who showed patience              of self-blame.
and understanding and to the pharmacists who
                                                              It is hoped that the play will help to increase
worked with me to encourage others to complete
                                                             community understanding of and compassion
the accreditation process. It has been a wonderful
                                                             for sufferers of mental illness and their carers.
end to my days as the HMR facilitator.
                                                             Starring Tracy Mann (AFI Best Actress and
As most of you know I have moved on from this
                                                             Logie award winner) and brilliant young actor,
role.	We	now	have	a	new	facilitator	–	Sarah	Haltiner	
                                                             Lindsay Farris as Simon.
has started work at the Division and she will be
contacting you all soon. In the meantime if you have          The season runs at the Street Theatre
any queries about the HMR process please don’t               (Childers Street, Canberra City) from 6th to
hesitate to contact Sarah on 6287 8099 or email              23rd June 2007. Bookings: 6247 1223 or
s.haltiner@actdgp.asn.au                                     www.thestreet.org.au

20 | April/May 2007 | GP ACTion
                                                                              PRACTICE SUPPORT



                                 Practice Support
                                                  Neeru Johar

CPR Training                                             EFTPOS terminals that are currently being used
                                                         in the medical practices are the only requisite to
Besides being very comprehensive, CPR training
                                                         implement Electronic Medicare claiming. The new
on 20 February also adopted a format of a mobile
                                                         system will allow practices to lodge claims directly
education program. Due to an unexpected
                                                         with Medicare. Consequently, eliminating the
interruption, half way the training we had to change
                                                         process of batching and forwarding of Medicare
rooms. Although there was some inconvenience the
                                                         vouchers.
whole incident was marked off as an interlude of
entertainment	–	“an	interesting	dimension	of	the	        Basic steps for usage
CPD	event”	as	remarked	by	one	participant.               •	Bulk	billed	patients	swipe	their	Medicare	card	
Parasol EMT limits 20 participants in each CPR             through the EFTPOS machine, check their details
training session so book early. There are still some       and press OK.
vacancies available for the next session on 29 May       •	For	most	item	numbers	practice	staff	are	required	
and a few positions for the following sessions in          to	enter	basic	information	–	about	5-10	keystrokes	
August and October. Participants attending the             into the EFTPOS terminal
Refresher course are reminded to present their
current CPR license on the day of training to the        •	Practice	will	receive	rebates	for	bulk	billed	
instructor. If you would prefer to undertake a             patients the following working day
First Aid course please send in your express of          •	Privately	billed	patients	also	benefit.	After	the	
interest ASAP so I can ascertain how many people           consultation fee has been paid, a patient is
are interested as we need a minimum of ten                 required to swipe their Medicare and bank debit
participants to commence the training. Similarly           card through the EFTPOS machine to receive
if the current CPR dates are not in falling in line to     an almost instant rebate. No more trips to the
your work calendar and timetable, CPR training can         Medicare	office.	
be delivered on the date chosen by you, provided
                                                         Medicare Online will continue to operate. However
we have ten participants.
                                                         Electronic Medicare Claiming has a greater
Infection control and sterilisation training             advantage because it serves the dual type of
                                                         clientele in medical practices- bulk billed and
Infection control and sterilisation training has
                                                         privately billed patients.
been postponed to Wednesday, 16 May from 2:00-
6:00pm. This training is scheduled on a weekday          For more information contact the Division or
and during regular working hours because the             alternatively	log	into	“Electronic	Medicare	Claiming”	
presenter is from interstate and is unavailable on       link at www.medicareaustralia.gov.au
weekends. A registration form has been faxed to
                                                         Work Choices
your practice in recent days. Please call me if you
need another copy faxed to you.                          The new federal system of work place relations,
                                                         WorkChoices came into effect on 27 March 2006.
Health IT News – Electronic Medicare Claiming            Many medical practices that were previously
You are all aware of Medicare Online now the latest      covered by State and Territory industrial laws are
Medicare’s	electronic	claiming	system	benefits	          now covered by WorkChoices. One of the aspects
medical practices in terms of reducing red tape          of WorkChoices is a requirement of employers
and time spend chasing unpaid accounts. The new          to complete and retain employment records for
system also encourages privately billed patients         their employees. If you need assistance or more
to pay upfront as they receive almost instant            information on contents of records contact me at the
rebates. This new system will be available for           Division on 6287 8099.
implementation from mid year.


                                                                              GP ACTion | April/May 2007 | 21
        ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH



                   ACTDGP Board training at
                    Winnunga Nimmityjah
ACTDGP Board members recently participated in an
awareness raising session about Aboriginal health
issues in the ACT and region.
The session was conducted by Winnunga
Nimmityjah Aboriginal Health Service (WNAHS)
at their facility in Narrabundah in February 2007.
WNAHS Board member, Ms Ethel Baxter, CEO, Ms
Julie Tongs, and Operations Manager, Mr Ray Lovett
welcomed ACTDGP Board members to the session
and provided valuable information on a range of
Aboriginal health issues.                                Left to right: Richard Bialkowski, ACTDGP CEO, Julie Tongs,
                                                         WNAHS CEO and James Cookman, ACTDGP President, at
As well as touring the WNAHS facility, Board             the ACTDGP Board training session at WNAHS.
members learned more about the services provided
by WNAHS, its holistic approach to health and the     This session builds on an earlier awareness raising
principles of community control on which WNAHS is     session undertaken by Division staff. Awareness
based.                                                raising activities for Divisional members are planned
                                                      for later this year.




         Chronic Disease Management Quick Survey –
                    Diabetes Care RESULTS
Thank you to all who responded to this survey sent     Annual Cycle of Care, however, 29% of these GPs
out in February. There was a response rate of 33%.     do not claim the SIP.
The	following	is	a	summary	of	the	main	findings,	     •	Of	the	69%	of	responding	practices	that	do	
which have helped identify areas of required            employ a practice nurse, 36% are involved in
support/further education and have used as              diabetes care at the practice. How they are
feedback to ACT health regarding the reality of         involved includes completing the foot checks,
diabetes care in general practice.                      blood tests, wound dressings/ulcer care, urine
                                                        testing, self-management/risk factor advice, recall
•	The	estimated	average	length	of	a	consultation	
                                                        patients, other measurements i.e. BP, weight.
  with a diabetic patient was 15-20 minutes (62%)
  with no GPs reporting less than 15 minutes.         •	52%	of	GP	respondents	are	not	confident	in	
                                                        initiating insulin therapy with a further 13%
•	On	average,	risk	factor	counselling	(24%)	and	
                                                        ‘unsure’.
  paper work surrounding the cycle of care (17%)
  are believed to take the most time during           •	The	top	three	barriers	to	diabetes	care	in	the	ACT	
  consultations.                                        are time, patient compliance and paper work.
•	42%	of	respondents	do	not	use	the	CDM	items.		Of	   •	The	top	three	facilitators	are	to	diabetes	care	in	
  those that do, 28% use the GPMP only.                 the ACT are ACT Health Services, practice nurses
                                                        and patient education.
•	67%	of	respondents	use	a	recall/reminder	system	
  to conduct diabetes reviews.                        •	The	most	used	services	through	Diabetes	Australia	
                                                        –	ACT	are	the	diabetes	educator	(30%)	and	NDSS	
•	79%	of	respondents	deliver	the	minimum	
                                                        (25%).
  requirements of care as set out by the Diabetes

22 | April/May 2007 | GP ACTion
                                                                                                 NEWS



GP Census – an exciting new development
                                   Dr Annie Lim, Board member
                               Marilyn Wood, eHealth Support Officer

The ACT Division of General Practice will shortly       We would greatly appreciate your prompt
be asking GPs within the Division’s geographic          completion of GP Census. Your completion online
boundaries to complete a GP Census. The census          will reduce the number of follow up calls required
is a national Divisions initiative coordinated by       and the need to send you a paper-based survey.
AGPN (Australian General Practice Network) and
                                                        Please help us to get a meaningful response rate in
is primarily an online census. It has been used in
                                                        the ACT!
Tasmania for the past three years with excellent
response rates and now we are to be the pilot site                       GP LOCUMS
on the mainland.
Data collected in the GP Census will help us to                 Are you an experienced GP?
accurately determine the current status of our GP               Would you like the freedom to work in
workforce to highlight workforce issues, which will             different places?
                                                                Would you like to work only a few
inform strategies to support GP recruitment and                 Months a year?
retention. We will be working with the Medical                  Are you looking for a career change?
Board of the ACT to encourage them to accept the                Are you feeling undervalued? Restless?
workforce survey information in lieu of their annual
survey in order to reduce your paperwork.
                                                            We are always keen to hear from reliable doctors
As part of the GP Census, participants will be               wanting to do locums and practices needing a
invited to complete a brief survey, which will assess                           locum.
GP’s emergency response capabilities to assess
                                                             25 years of experience providing locums to the
preparedness to respond to a disaster situation                            medical profession
such as a pandemic involving mass casualties.                   Recommended by AMA (NSW Branch)
We anticipate that the GP Census will be conducted
                                                                  FREE SREVICE TO LOCUMS
in July 2007 and will be available to complete                   MODEST COST TO PRINCIPALS
electronically or paper based if required.
                                                                 Call Chris Babich (02) 9918 6888
To prepare for the GP Census, the Division has
                                                                Email: chris@babichmedicos.com.au
contacted practice managers in April 2007 to                      Website: www.babichmedicos.com.au
validate our existing practice data, including               AUSTRALIAN BABICH MEDICOS
practice email details.                                               PTY LTD




                                                                             GP ACTion | April/May 2007 | 23
       Rewarding opportunity at Junction
                                            A rewarding opportunity exists for a GP to work one shift a
                                            week at one of Canberra’s most innovative and respected heath
                                            services focused on young people.
                                            Open every weekday afternoon, The Junction (located in the new
                                            Club 12/25 building on the corner of Ballumbir and Petrie Streets
                                            in	Civic)	offers	a	free	and	confidential	health	service	to	young	
                                            people.
                                            The Junction is a one-stop health ‘shop’. It coordinates the
                                            outreach services of a number of different agencies and offers
                                            a range of clinical services provided by GPs, counsellors,
                                            youth health nurses and a specialist sexual health nurse. It
  also provides referral, advocacy, brokerage and other support to young people in a non-judgemental
  environment.
  The Club 12/25 building is a purpose-built facility housing several youth services including a youth drop in
  centre, an education program, a young carers program as well as the Junction Youth Health Service.
  Dr	Tracy	Soh,	who	has	filled	the	Friday	afternoon	shift,	is	moving	interstate.	She	says	her	work	at	The	
  Junction has been professionally rewarding and good fun.
  “Working with a predominantly teenage patient group has its challenges; but there is such a potential
  to have a positive impact on young lives and incredible satisfaction at being able to help this often
  disadvantaged and disenfranchised group when their need is greatest.
  “There are few work places where a GP is supported by such a dedicated, skilled and compassionate
  multidisciplinary	team	and	I	will	miss	them	hugely,”	said	Dr	Soh.
  Young people can book appointments or just drop in and place their names on a waiting list. But the
  service is popular. We are booked out most days and unfortunately have high turn-away numbers
  particularly for doctors appointments. This has been an ongoing issue at The Junction as the reputation of
  the service has grown.
  As Dr Soh indicated, we have a great team. We support each other as much as our clients. But given the
  shortage	of	GPs	in	Canberra	finding	and	securing	committed	part-time	staff	has	not	been	easy.	
  We	are	open	to	alternatives	to	retain	staff	and	keep	The	Junction	a	fun	place	to	work.		One	option	is	to	find	
  a	number	of	GPs	prepared	to	cover	the	Friday	shift	–	that’s	currently	vacant	–	on	a	rotating	basis.	This	
  could mean that each GP is rostered just one Friday afternoon a month.
  If you are a doctor prepared to make a small
  commitment and make a real difference, please
  contact me.

  David Hekimian
  Coordinator
  Junction Youth Health Service
  david.hekimian@anglicarecg.org.au
  6232 2431 or 04394 61295




24 | April/May 2007 | GP ACTion
                                                                                                    CLASSIFIEDS


GENERAL PRACTITIONERS                                            GENERAL PRACTITIONERS

 VR GP PT/FT position in computerised and accredited              GP P/T or F/T required
 practice in Woden area adjacent medical imaging,                 Large non corporate, purpose built centre in Queanbeyan
 pathology, radiography, pharmacy. Ph 6282 1516                   with on site pathology and allied health requires the
                                                                  service of two further assistants part or full time. Modern
                                                                  facilities with friendly staff incl full time nursing support.
 Erindale Medical Practice                                        Choice of sessions available. Medical Director and pracsoft.
 Lifestyle upgrade offered for a F/T or P/T VR GP in a low        District of workforce shortage and AON available. For
 stress, private billing family practice. Relocation grant        confidential	discussion	or	to	arrange	a	meeting	please	call	
 of up to 30K may apply. Please contact Dr Doug Lee on            p/m Graeme on 0438 812 651.
 leedoug23@internode.on.net

                                                                  Looking for professional person to rent a modern equipped
 GP Wanted                                                        surgery from 7am - 5.30pm. If interested please phone
 F/T or P/T female GP for accredited computerised practice.       Chris on 0411 162 965
 Private billing, no AH or weekends.
 Phone 6280 4254
                                                                  F/T or P/T female VR GP needed for very busy modern
                                                                  family practice with attached pathology provider. Flexible
 GP opportunity in friendly Queanbeyan                            hours, no after hours and good conditions to right
 P/T or F/T GP needed for quality, family friendly, modern        candidate. Phone Jamison Medical Clinic, Macquarie
 practice. Excellent income. Private billing, paperless, large    6251 2300
 treatment room with a great support team including nurse
 and 2006 Receptionist of the Year. Adjacent to pathology,
 allied health, audiometry, physiotherapy and radiology           Fisher Family Practice – VR GP required
 in	same	street.	Lovely	atmosphere	in	offices	overlooking	        Fisher Family Practice is a well established surgery in
 parkland. Please phone 0407 011 737                              the Weston Creek area of the ACT. Accredited by AGPAL.
                                                                  Flexible hours/sessions are available. No weekend or
                                                                  after	hours	work.	Experienced	and	friendly	office	staff.	
 F/T or P/T GP wanted to joing delightful, caring, fully          Please contact the Practice Manager on 6288 5324 during
 privately billing inner North Canberra practice. Hours           business hours or after hours on Dr Liedvogel’s mobile
 and	days	flexible,	high	remuneration	guaranteed.	Fully	          0414	891	503	or	email	fishprac@grapevine.net.au
 computerised notes, on-site practice nurse.
 Call 0408 768 054 for futher enquiries.
                                                                  Female GP
                                                                  Required for a Women’s Health Centre in Queanbeyan.
 General Practitioner                                             Sessions involve papsmears, contraception, breast
 Foundation Healthcare Erindale requires F/T or P/T GP            examination, menopause management, post TOP and other
 for accredited fully computerised centre. Friendly family        female health management issues. Initially one session per
 practice with nursing support.                                   week. Please Phone: Meaghan 0412 394 502
 Please phone Nikkie Slagiannis 0403 050 538                      Email: info@gcaus.com.au

 GP Opportunity at Chapman                                        Position available – Permanent part time sessions
 Opportunity to join Drs Gow, Baker and Sansum at busy,           Need a change? Are you looking for work this is more
 friendly family practice. Fully accredited, excellent nursing    flexible?	Fed	up	with	after	hours	or	weekend	work?	Well,	
 support and reception staff in purpose built surgery.            come along and join out friendly team of drs, nurses and
 Excellent earnings and very strong potential for growth in       office	staff.
 a great area of Canberra. Sessional or full time available       We require a doctor for at least three sessions. Enhance
 Please contact Dr Gow or Dr Baker at the Practice on             your skills in student health, family planning, woman
 6288 8139                                                        health as well as sports and travel medicine.
                                                                  We provide a general practice bulkbilling service to
                                                                  Australian and International students and privately bill staff
 Female GP invited to join accredited family practice in          and visitors.
 North Canberra. Flexible hours, private billing, no after        Don’t put it off, give Andrew a call or arrange a visit and
 hours or weekends. Good remuneration with guaranteed             discover the wonderful surroundings of the Australian
 minimum. Please phone 6248 7005                                  National University whilst learning more about the services
                                                                  and provisions of the Health Service. Contact Andrew.
                                                                  Fernie@anu.edu.au Tel: (02) 6125 4110
 P/T Assistant GP
 Required for modern friendly practice in northside
 location. Private billing, no extended hours or afterhours       POSITION POSITION POSITION
 commitments. Allied health on site. 2-9 sessions available.      Are you a VR’D GP? Do you want to be your own boss? Do
 Immediate start if required. Please call Alan on 6257 3852       you want great, friendly, reliable staff doing your admin/
 or P/M Graeme on 0438 812 651                                    appointments for you? Do you want a patient base which
                                                                  has already been built? Have we got the place for you!!!
                                                                  We are a busy city practice with position position position
 GP required                                                      in Canberra, fully accredited (AGPAL), private billing.
 F/T or P/T GP needed for accredited family practice. Flexible    This position could be either full time or part-time.
 hours, no after hours or weekends. Private billing. Good         Phone Sue on 0402 867 169 or 02 6257 1000
 rates. Please contact Mawson Medical Centre 6286 2577


                                                                                        GP ACTion | April/May 2007 | 25
        CLASSIFIEDS


PRACTICE NURSES                                                 PRACTICE MANAGERS

 Jamison Medical Centre                                          Experienced Practice Manager required for busy,
 Practice Nurse required. P/T initially one day per week with    computerised expanding General Practice. Flexible hours,
 view to increase.                                               Salary negotiable. With or without bookkeeping skills.
 Please call Mandy on 6251 2300                                  Phone 6247 8785 after hours.


 Practice nurse	for	five	mornings	on	North	side.	Should	be	      F/T or P/T Practice Manager required
 experienced in sterilisation procedures, assisting in minor     For a fully computerised and accredited Family Medical
 surgery, immunisation, wound management, care planning          Practice located in Queanbeyan.
 and management of chronic diseases like diabetes. Please        For further details phone 6247 8785
 contact Dr Neena Sood, Ngunnawal Medical and Skin
 Clinic, ph. 6242 0029
                                                                 F/T Practice Manager required
                                                                 For North side practice.
                                                                 Please send CV to PO Box 9457, Deakin ACT 2600




26 | April/May 2007 | GP ACTion
                                                                                                         OBITUARY


                                   DR HUGH BRADBURY PRATT
                                           3	November	1926	–	28	February	2007
     The following extract is taken from the Eulogy, delivered by his son, Finn, at his funeral service on 9 March 2007.

Hugh passed away too soon. However,                                                 daunting. I have vivid memories of a trip
he lived an incredibly full and enjoyable                                           from Turkey to Yugoslavia in a car with
life over his 80 years. Hugh was born on                                            no brakes. I also remember Dad telling
3 November 1926 in Palmerston North in                                              me	of	a	time	when	he	was	flying	a	lot	in	
New Zealand. At a very early age, around                                            Eastern Europe and Russia, courtesy of
7, Dad spent an afternoon listening to                                              Aeroflot.	Apparently,	it	was	unusual	when	
an international health and food expert.                                            something didn’t go wrong with the plane.
It would change him for life and had a                                              I think he was half joking. Dad was nearly
significant	impact	on	his	future	family	and	                                        arrested in one Eastern Bloc country for
many who knew him. From that young age,                                             taking photos with a miniature camera.
Dad	swore	off	white	bread,	white	flour,	                                            They thought he was a spy.
white	sugar,	foods	with	artificial	colourings	
                                                                                   Dad semi-settled down in Canberra in
and preservatives, smoking, and many
                                                                                   the mid-70s and practised here for more
other things we now know are harmful.
                                                                                   than 30 years. Dad seems to have treated
Up until the 1980s, this was seen as a
                                                                                   a	significant	proportion	of	the	Canberra	
bit unusual but Dad didn’t care; he had
                                                                                   population. People constantly tell me
the courage of his convictions and would
                                                                 how much they valued him as a doctor, how much they
preach away on the subject to anyone who would listen to
                                                                 appreciated his way of dealing with his patients and his skill.
him, and to many who wouldn’t.
                                                                 He was kind and gentle, and loved helping people. He did
During World War 2, Dad had attempted to join the New            have a cold stethoscope, however.
Zealand armed forces. They would not accept him, as he
                                                                 Dad	was	a	health	and	fitness	fanatic.	He	had	the	appearance	
was 16. According to his father, Dad was not to be denied
                                                                 and	vigour	of	a	very	fit	man	in	his	early	sixties.	I	used	to	enjoy	
a chance for adventure and, in his late teens, he up and ran
                                                                 the astonishment of people when they found out he was
away to sea.
                                                                 80. Dad was scrupulous about his diet, went to the gym and
Dad’s passion for travel was born; it was a passion that he      swam daily at the Canberra Club.
indulged for the next 60 years. He joined the merchant navy
                                                                 Dad was a keen golfer or so one would think. He built his
and sailed the world.
                                                                 house on the fourth green at Federal Golf Course and was a
In the late 1940s, Dad made his way to Australia where he        member of Royal Canberra Golf Club for 40 years. He played
continued his medical studies at the University of Sydney.       golf twice. I guess it was one of those doctor things.
He maintained a long relationship with Sydney Uni: he was a
                                                                 Dad kept up his travel. I had a look in his passport and his
clinical lecturer there for many years.
                                                                 travel papers: in the last two years Dad was in Germany, the
While in Sydney, Dad met beautiful Scottish lass named           UK, the US, Honk Kong, Singapore, Japan, Canada, Cuba, the
Helen Docherty. They married in May of 1949 and were             Bahamas, the Netherlands, Austria, Italy, Greece, Estonia,
together for more than 45 years, until Mum passed away           Lithuania, Latvia, Finland, Belgium, Hungary and a few
in 1994. Dad was awarded his Bachelor of Medicine and            places where I can’t work out the country. Maybe he was a
Bachelor of Surgery from the University of Sydney and            spy. He was already talking about this year’s trip.
University of Otago in 1952 and 1953. Dad continued
                                                                 He hated bureaucracy, incompetence and injustice. Dad was
his practise of medicine right up until the morning of his
                                                                 constantly	bucking	the	system	and	was	a	prolific	letter	writer	
passing.
                                                                 to newspapers, professional bodies and governments. No
We always knew Dad would never retire.                           doubt, the ACT Government will now be able to cut back on
                                                                 its clerical staff.
He	worked	as	a	medical	officer	at	the	Greta	and	Bonegilla	
Immigration	Hospitals	and	as	a	medical	officer	or	medical	       What was my father’s secret to life? It was simple: he loved
director at a whole range of missions, consulates and            his	job	–	it	kept	him	intellectually	engaged	and	allowed	
embassies for 25 years. These included the Cocos Islands,        him to contribute; he kept physically active and was very
Austria, Denmark, Sweden, the United Kingdom, Yugoslavia,        conscious about his diet; and he had his family around him.
France, Papua New Guinea and Malaysia. Dad helped
                                                                 Dad cared about people and went out of his way to help them
thousands, maybe tens of thousands, of people settle in
                                                                 whether professionally, as a doctor, or simply as a friend.
Australia.
                                                                 Many of us here have enjoyed that care.
Wherever we were based, the whole family would frequently
                                                                 Looking back over Hugh Pratt’s life, it is clear he lived it to the
get dragged off, exploring. At the time, it seemed a bit of a
                                                                 fullest extent possible. He pursued his passions: medicine
hassle, in and out of cars, busses, trains, planes, hotels and
                                                                 and travel; he contributed to Australia’s development and
tents all the time. It was only later when we were older that
                                                                 the	health	of	Canberra’s	community	–	he	made	a	difference;	
my sisters and I realised how lucky we had been and what
                                                                 he was an endearing character who touched people’s
tremendous opportunities we were given. My father was
                                                                 lives; and he gave his family marvellous opportunities and
an adventurous and courageous traveller. Nothing was too
                                                                 supported us constantly.

                                                                                          GP ACTion | April/May 2007 | 27
Calendar of education events
Date/Time                         Event                                                                             Venue                                              RSVP/Cost

MAY 2007
Wed 9 May                         Mental Health Teams of Two:                                                       Rydges Capital Hill                                RSVP: Dawn or Peter on
6:30-9:30pm                       Joint Learning Initiative Comorbidity                                                                                                6287 8099
                                  Module - Night 1 Workshop

Thu 10 May                        Anaphylaxis and Epipen Training                                                   ACTDGP Training Room                               RSVP: Hailey on 6287 8099
6:30-8:30pm                       for Practice Nurses                                                                                                                  * Numbers strictly limited
                                                                                                                                                                       to 30

Wed 16 May                        Infection Control with Marg Jennings                                              Marquee - Rydges                                   Cost - $60
2-6pm                             for Practice Nurses                                                               Capital Hill                                       RSVP: Neeru on 6287 8099

Thu 17 May                        Immunisation Myths and Realities                                                  The Boathouse by the                               RSVP: Hailey on 6287 8099
6:30pm                            for Practice Nurses                                                               Lake
                                  Guest	Speaker	–	Dr	Julie	Leask	NCIRS

Tue 22 May                        Diabetes and Cardiac Disease                                                      The Boathouse by the                               RSVP: Bronwyn on
6:30 for 7pm                      ALM	–	Night	3                                                                     Lake                                               6287 8099

Sat 26 May                        Interpersonal Therapy Recall Day                                                                                                     More info: Peter on
                                                                                                                                                                       6287 8099

Tue 29 May                        NRMA Crash Course                                                                 Calvary Hospital, Bruce                            More info: Bronwyn on
6:30 for 7pm                      Night	1	–	with	future	dates	                                                                                                         6287 8099
                                  5, 12 & 19 June

Tue 29 May                        Cardiopulmonary Resuscitation Training ACTDGP Training Room,                                                                         RSVP: Neeru on 6287 8099
6-10pm                                                                   Weston                                                                                        $60 per person
                                                                                                                                                                       or $45 for refresher course
                                                                                                                                                                       if you have a current CPR
                                                                                                                                                                       Certificate




 CHANGE OF ADDRESS
 My mailing details have changed, and I can now be contacted at:

 Name ..............................................................................................................................................................................................................

 Practice Name ............................................................................................................................... Phone No. ........................................

 Practice Address                 .........................................................................................................................................................................................

 ..........................................................................................................................................................................................................................

 Home Address                  ............................................................................................................................................................................................

 ..........................................................................................................................................................................................................................

 Phone No. ........................................................................................               Mobile No. ....................................................................................
                                                      Please fax completed form to the Division on 6287 8055

				
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