November/ December 2013

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The AMA ACT President, Dr Andrew Miller, Board, Staff and the Canberra Doctor committee extend Seasons Greetings to all and best wishes for 2014

November/December 2013 Volume 25, No. 10 TERRITORY TOPICALS – from President, Dr Andrew Miller So 2013 is drawing to a tory has demonstrated that we have new MOU has been agreed that Opposition in bipartisan support of been stiffed. I can think of no other respects our independence and value the National Skin Cancer Action close, and as always in way to describe the outcome. Initially in the federal AMA family. We are Week at an AMA initiative with the those brief moments the indexation decision appeared as a now working to rebuild a cooperative Cancer Council, the ACT Pollie Skin significant improvement on the gov- relationship with ASMOF; something Check; championing the public snatched between pre- ernment’s offering; but we have now that we all agree is in the best interests health message of sun protection Christmas specials the seen the whole of government enter- of both our members and the profes- and skin cancer awareness. mind drifts back over the prise bargaining outcome. I suspect sion in the ACT in general. So what does 2014 offer? I can that we will not be so meek next time. I can also report that as the year see some battle lines already being year with its early The salaried medical officer draws to a close our business affairs drawn over the border, but with the promise and the looming negotiations are ongoing, and we are show a healthy trend, and that we possibility of collateral damage here participating actively here, diligently have been able to continue to offer in the ACT. At a recent AMA Federal Dr Andrew Miller final reality. representing the interests of all our benefits to our local members Council meeting the AMA con- salaried members no matter their including agreements made recently demned the actions of the Newman The calendar was of course dom- campaign. It was the AMA which first inated by the federal election, with a status or seniority. We are not pre- with both BMW and Lexus. Infor­m­ government in Queensland. There is pared to trade the conditions of one ation regarding these member bene- an unparalleled attack on doctors’ raised the significance of the Gillard community polarised by a deeply government’s budget proposal. It was unpopular government and an alter- group against another to get an out- fits can be obtained from our mem- terms and conditions being launched come but continue to work for an bership officer, Sue Massey. We are there and clearly the possibility of a the AMA which began the public native offering that troubled many. campaign. It was the AMA which first But swirling behind and around this equitable result for all. working towards some more ann­ precedent being set should galvanise Of course, the position of our ouncements in 2014. us all. The matter is before the in­­ stitched together a diverse and at obvious reef were the many issues times fractious coalition of organisa- that kept the AMA paddling away. junior medical officers remains a We have succeeded in negotiat- dust­­­­rial court at the moment and tions and industry groups to fight the The VMO contract negotiations focus of AMA attention. In recent ing funding from AHPRA for train- you can be assured that the AMA is proposal, and the AMA which kept were concluded mid-year. Before the years we have seen such a dramatic ing for volunteers in the ACT Doctors actively involved, and that locally we them on task. We should all acknowl- arbitration phase began there was a change in medical education that the Health Advisory Service, and contin- are closely monitoring the outcome. edge that the ultimate decision by the bargaining period that saw the AMA traditional model of internship and ue to provide our active support to You may also be aware of their Abbott government to scrap the cap successfully argue for many modifica- residency before vocational training that uniquely valuable local asset. health ombudsman legislation that represents a victory for common tions to the initially proposed con- has become untenable. The AMA The AMA-ACT has also been poses a very real threat to us as pro- sense, but every one of us should tract, particularly where the condi- has been working with the govern- involved in individual cases of sup- fessionals. The AMA-ACT has previ- remember that it was the AMA that tions and rights of the VMOs were ment and ACT Health to ensure that port for members in difficulty. This of ously expressed its concern about got the job done as we attend confer- challenged in the draft document. Of adequate intern places have been course is the strength of a local mem- complaint resolution processes in the ences and courses, pay for college course these matters were concluded made available, and that the PGY1/2 bership organisation; and it is a role territory, and I have to report from training fees and exams, purchase quietly and cooperatively, so they and 2/3 transitions are smooth and that we gladly embrace. We always our conversations with government texts and subscribe to journals. never reached the public eye. These fair; and that quality training as well remain available for members with that some of these are shared, but for That is why you pay your subs, small victories demonstrate our as service remains a focus of problems, and with our relationship different reasons. We will be dealing so that we can continue to champion understanding that, professional employment. We will continue to with the DHAS, can offer support in closely with the government and the the interests of the profession; and responsibilities aside, we have rights press for results here, and to work to a wide range of personal, employ- opposition to ensure that the effective and just health policy. that should be defended, and that the ensure that Canberra remains a high- ment and professional matters. Queensland model stays just that and May I wish every one of you a issues extend beyond money in the ly regarded training centre for junior 2013 has also seen some historic doesn’t become a national one. happy and safe Christmas; and a ful- bank. When the arbitration process doctors and vocational trainees. milestones, including anniversaries Of course the biggest victory of filling 2014. Please all take advantage began we were able, unlike other par- I am happy to report that the for both Canberra Doctor and our 2013 that the AMA can justly claim, a of the break to enjoy and value your ties, to argue successfully for every relationship between the AMA–ACT long-serving CEO, Christine Brill. victory whose benefits flow widely, friends and family, and return in the one of our claims, except the indexa- and the federal AMA has been rebuilt We also brought together the well beyond the health care sector, is new year refreshed, invigorated and tion claim. Here, unfortunately, his- following a difficult period, and that a Chief Minister and the leader of the the success of the “Scrap the Cap” enthusiastic.

2 November/December 2013 GUEST EDITORIAL Reflections from the AMA Secretary General – Ms Anne Trimmer Four months into my of a few major projects of the previ- promotion. Amongst the work fore- nal governance review for many ous government. These include a shadowed for 2014 is the publication years. Federal Council of the AMA appointment as Secretary review of the Personally Controlled of an annual alert on key priorities in has agreed to put to members at its General of the Australian Electronic Health Record (PCEHR). youth health. Annual General Meeting in May a Medical Association I While the AMA supports the con- Many of the day to day health revised constitution which separates cept of a PCEHR, the proposed system issues which impact doctors the governance of the organisation have now had the record had several deficiencies, most are high on the work program for from its policy development. It is opportunity to scan across notably the lack of doctor support. the AMA including a review of proposed that a smaller board be The review needs to put forward a MSAC and its processes, streamlin- established to oversight financial and the many areas of activity way to improve clinical utility of the ing the PBS authority approval sys- corporate requirements with Federal in which the AMA is health record. tem, MBS fees indexation, and the Council to retain its core role as the involved. A review of Medicare Locals is activities of the PSR. body which develops and approves also underway - again a review which Provision for the training of AMA policy. These reforms will I started in my role on the first was sought by the AMA. While our future doctor workforce con- modernise the AMA, creating a day of the Federal election - great some Medicare Locals perform well tinues to be a priority area. The more agile body to deal with the timing as the AMA had previously in meeting the needs of their com- AMA was pleased to see that at its wide range of issues which are cur- published its election manifesto munities for better integrated prima- impact on doctors, particularly most recent meeting the Standing rently considered by Federal Council. which outlined the priorities which ry care, others have been less suc- those still undertaking training and Committee on Health signed off The AMA is a key contributor we sought to have implemented by cessful. While the review has been on the development of a five year those from rural and regional areas, to health policy debates, represent- an incoming government. anticipated for some time, the time training plan by Health Workforce Minister for Health Peter would have been significant. It was ing the interests of its members allowed for submissions has been Australia and the National Medical and working for the best outcomes Dutton has good experience in the kept very tight with responses prior poor policy and a sensible decision Training Advisory Network. These health portfolio, having shadowed it to Christmas. to do away with it. developments are supported by the for doctors and their patients. I in Opposition for several years. The AMA was delighted to see The AMA continues to be AMA to provide structure to plan look forward to staying in touch Similarly the Prime Minister, as a the early announcement by the new active in many areas of public health future training needs. The Council during 2014. former Minister for Health, has a government that it would not pro- policy - from the recent launch of on Doctors in Training has been a Best wishes for a happy and high level of interest in, and under- ceed with imposing a cap on self- the Indigenous Health Report Card key contributor in improving gov- safe holiday season and for a re­­ standing of, health policy issues. education expenses. This had been which reports on improving health ernment awareness of the need for ward­ing 2014. Most of the early focus of the new a hard-fought campaign led by the outcomes for indigenous children, training strategies. Anne Trimmer government has been on cost-con- AMA with many other advocacy to advocacy in support of policies During 2014 the AMA will Secretary General tainment with a close examination and member organisations. The which tackle obesity and alcohol embark on its first significant inter- Australian Medical Association

„„Irbesarten There were no indications of Homicide investigation, Cedar Pocket „„Quinine/Quinidine tattoos on his upper body, either front or back. After putting the fire out, it was the following information estab- The victim had no illicit drugs in The Queensland Police his system. If an AMA member or staff of Service is seeking evident the head had been severed lished during forensic examinations: any member is able to provide any just above the collar bone, the hands „„The deceased is male; Examinations have also deter- information pertaining to the iden- assistance in relation to a had been severed, and the torso was „„Aged 25 to 35 approximately; mined the deceased male suffered tity of the deceased male, please homicide that occurred at cut off just below the ribs. „„Between 180cm and 190cm in some calcification of his backbone contact Crime Stoppers on 1800 333 A female person, with shoulder height; and, and also had a slight curvature of the 000 with any information. Cedar Pocket, Queensland length or longer light coloured hair „„He had a 109cm chest, 39cm spine. Anyone with information on September 19, 2013. and approx. 30 -50 years old was also shoulder width, and 47cm-long His torso had a 3cm scar on the identified as being in the vicinity of torso. which could assist with this right side of the back, about halfway matter should contact Crime the torso and may be connected to The following drug compounds down that appeared to be old. The At about 6.45pm, rural fire the deceased. Stoppers anonymously via 1800 officers were called to Cedar Pocket were also detected from samples origins of the scar are unspecific and Investigations to date have obtained: 333 000 or crimestoppers.com. Road, Cedar Pocket after members may be due to an injury or minor au 24hrs a day. failed to establish the identity of the „„Diazepam of the public located a human torso deceased male. surgical procedure. For all non-urgent police „„Nordiazepam on fire on the side of road. Assistance is sought from mem- The deceased also had two small reporting or general police The torso was found in a rural bers of the Australian Medical Ass­ „„Temeazepam circular marks on both of his shoul- inquiries contact Policelink on area about 10km east of the Gympie ociation who may be able to assist in „„Trace amounts of Morphine ders consistent with marks incurred 131 444 or www.Policelink.qld. township. identifying the deceased male from „„Doxylamine from immunization needles. gov.au 24hrs a day.

November/December 2013 3 Travel value with an Investec credit card One of the golden rules of any business is to ensure it it easy for our clients as we facilitate clients that use them to buy the whole process for them. end of year gifts for patients is operating as efficiently as possible to maximize the Clients can then redeem their and staff!” return from every dollar spent. How attractive, then, is points on the Qantas website. Clients can choose be­­­ the option to make big-ticket business equipment and “This can be a significant ben- tween Investec Platinum or efit for clients in terms of taking Investec Signature credit asset purchases like motor vehicles on your credit card care of their travel needs for the cards. The Investec Signa­ and earn Qantas Points in the process? That’s exactly future, all by doing something as ture card offers one Qantas what’s on offer with an Investec Visa credit card. simple as using your Investec credit Point for every $1 spent on eligible card,” Lynne Kelly adds. “It could transactions in Australia, and two Investec is a specialist financial “We had one client who recent- ance contract with Investec which also be of huge benefit if the client Qantas Points for every $1 spent service provider for medical and ly purchased equipment for pays off the purchase from the cred- is taking a well earned holiday and on eligible international purchases. dental clients and has a bonus part- $400,000 on their Investec card, it card. Additionally, we allow the cli- they have enough points to upgrade The Platinum card offers one ner reward program for a range of and that meant they earned a sizea- ent to make their monthly repay- their flight. Qantas Point for every $2 spent on suppliers within the medical and ble number of Qantas Points as we ments for that contract on their “But the value of adding to the eligible transactions in Australia dental industries. offer one point for every $1 spent Investec credit card so they can earn balance of Qantas Points is not all and one Qantas point for every $1 “So even if you use the Investec Visa card to buy business consuma- with no cap on how many points even more points – generally at least about flights. For those who are not spent on eligible international pur- bles, through this deal with the spe- you can earn,” Investec’s Michelle twice as many points as the purchase interested in flying there are also chases. Gianferrariexplains alone would earn. This is a service retail store vouchers and merchan- cific partners, you can further In addition to Qantas Points, enhance your Qantas Points bal- “What we then do is simply con­ not available through most other dise that can be redeemed using the every return ticket purchased on an ­­­­­­­vert that card transaction into a fin­ financial organisation’s, but we make points on the Qantas Store. We have ance as well,” Gianferrari says. Investec card is automatically cov- “If people can earn rewards ered by up to 90 days of travel that enable upgrades or free tickets insurance, protecting the safety of or merchandise, and they can do all not only the cardholder, but also that by just using their credit card, their spouse and dependent chil- then it is a pretty easy way to travel dren when travelling together. . for free. AMA membership: Other benefits for primary “We are striving to deliver value Signature cardholders include a to our clients, with minimum fuss. the gift you give yourself Priority Pass membership, which Our clients see a real value in these opens doors for the client and a points as it opens up so many pos- guest to over 600 VIP lounges in 300 sibilities for them in the manner in Call 6270 5410 cities, as well as access to Visa which they are conducting their for information on how to join Concierge and the Visa Luxury business and personal banking and or download an application form from the website Hotel Collection for services at a they only need to carry one card – www.ama-act.com.au selection of superior hotels. the Investec card.”

Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL and, Australian Credit Licence 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charg- es may apply. We reserve the right to cease offering these products at any time without notice. The informa- tion contained in this article (“Information”) is general in nature and has been provided in good faith, with- out taking into account your personal circumstances. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, no warranties in this regard are provided. We recommend that you obtain independent financial and tax advice before making any decisions

4 November/December 2013 GPs leaders in primary care Not-so-super clinic reports confirm yet to treat a patient, Two recently released $13m later health reports – A GP Super Clinic that although almost $420 million “General practice activity promised more than six had so far been spent on to the $600 million program, only three in Australia 2012-13” years ago has still not of the 36 clinics promised in 2007 and “A decade of opened despite a $13.2 were completed on time, with Australian general million investment by seven still not operational, while just one of the 28 announced in practice 2002-03 to the Federal 2010 was fully functional. 2012-13” – confirm the Government. Echoing concerns long-held by the AMA that the program key role of GPs as the Department of Health offi- leaders in primary care in cials told a Senate Estimates hear- was poorly conceived and was a Australia. ing that the clinic in Redcliffe, bad use of scarce health funds, just outside Brisbane, was under- the Auditor-General found that Released by the Bettering the “GPs are ensuring that people “It provides patients with going renovations and was not in setting up the clinics, there had Evaluation and Care of Health are receiving the right care at the streamlined access to a broad range yet operational. been little attempt to assess the (BEACH) program, the reports right time from the right health of allied health and other support level of local need and what services and it supports a more The previous Labor Gov­ show that the Australian commu- professional. affect it might have on existing “These reports underline the proactive approach to the delivery ernment promised in 2007 that nity is relying more and more on of care. 64 GP Super Clinics would be medical services. highly skilled GPs for quality health unique leadership role of GPs in the health system. “GPs must be given greater opened across the country to “While … program guidelines care and advice. “Any moves to allow other support and scope to provide help address shortages of GPs required applications to address AMA President, Dr Steve health professionals to do the work access to multidisciplinary care and and to relieve the burden on the the extent to which a proposed Hambleton, said the reports show of a GP must be resisted. support services for patients with public hospital system. clinic could impact on existing clearly that GPs are the preferred “Instead, GPs must receive chronic and complex disease,” Dr But the scheme has been first port of call for Australians health services, this issue was not stronger support to maintain and Hambleton said. dogged by cost blowouts and explicitly or substantively consid- seeking the best possible health The AMA Chronic Disease build on their key role as commu- delays, and the Abbott Gov­ern­ ered in the overall assessment,” care, and demand is growing as the nity demand inevitably increases in Plan: Improving Care for Patients with ment is believed to be looking the ANAO report said, noting one population ages and more people coming years. Chronic and Complex Care Needs is closely at shutting it down. are experiencing chronic and com- “The AMA believes that the athttp://ama.com.au/node/5519 The AMA has called for the instance where the main patient plex conditions. Government needs to reform cur- Key findings of the BEACH access to an existing GP practice “When Australians are sick or Government to cut its losses and rent Medicare arrangements target- reports include: shut the program down, and was funnelled through the waiting want trusted health advice, they „„ ing chronic disease. In 2012-13, Australians instead direct unspent monies to room of a Super Clinic. want to see a GP,” Dr Hambleton “GPs are integral to keeping claimed 126.8 million GP The Abbott Government’s said. provide improved support for GPs. patients with chronic disease services through Medicare, at Commission of Audit is expected “As the population ages, chron- an average of about 5.6 GP In a damning assessment healthy and out of hospital, but to closely scrutinise the program ic diseases are accounting for an current Medicare-funded chronic visits per head of population released in July, the Common­ increasing proportion of a GP’s disease management arrangements or 6.6 visits per person who wealth Auditor-General found and its continuation. workload. are too limited, are difficult for visited at least once. This “There are now significantly patients to access, and involve con- equates to about 2.44 million more GP visits for depression, dia- siderable red tape and bureaucracy. GP-patient encounters per betes, atrial fibrillation, and hypo- “The AMA has a plan that week. thyroidism than a decade ago. offers patients with multiple chronic „„On average, GPs managed Dr Katherine Gordiev “GPs are dealing with more conditions and related complex care about 155 problems per 100 problems per visit. needs improved access to GP co­­ encounters – chronic problems Orthopaedic Surgeon “They made 7.6 million more ord­­inated quality primary care. accounted for 36.0 per cent of Shoulder & Upper limb referrals to other medical special- “The AMA plan enhances all problems managed, and an MBBS (Hons I) FRACS FAOrthA ists and 3.7 million more referrals existing arrangements and sup- average of 55.7 chronic Arthroscopic & Open Surgery to allied health services than a dec- ports patients to spend more time problems were managed per ade ago. with their GP when they need to. 100 encounters. of the Shoulder & Upper Limb • Shoulder Replacement • Shoulder Stabilisation Tax, Accounting • Rotator Cuff Repair & Business Services • Shoulder, Elbow, Wrist & Hand Surgery

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November/December 2013 5 Faulty syringe markings prompt Cancer Council’s wig Panadol safety concerns service is moving … The Wig Service at the Doctors and parents Dose markings should begin “Immediate medical manage- from the bottom of the syringe, ment is required in the event of hospital has closed and have been urged to be but in some cases they have been overdose, even if symptoms of will not reopen on the cautious in using the found to begin further up the overdose are not present,” the hospital campus. common painkiller syringe barrel (see accompanying TGA said. “If you think you have illustration). given too much Paracetamol, con- Excitingly a new-improved Children’s Panadol Baby The TGA said Panadol was a tact the Poisons Information one-stop Wig Service will be ready Drops after incorrect proven safe and effective treat- Centre (telephone 131 126) or call for business early in 2014 conven- ment medicine when used as iently co-located at the Cancer syringe markings raised directed, and the issue did not your doctor, or go to the nearest hospital emergency department. Council’s offices at 5 Richmond fears of a risk of affect the quality of the medicine. Avenue, Fairbairn. The new Wig But it advised parents to Do this even if your child does not seem sick.” Service will offer improved amen- accidental overdose. check any Children’s Panadol ity to its clients in a refurbished Baby Drops syringes they had, But the regulator said the risk Manufacturer GlaxoSmith­ and purpose designed space. and to ignore the dosing indica- of liver damage was limited if the In the meantime, the smaller Kline, in conjunction with the tor if the scale did not begin at medicine had been taken in accord- Therapeutic Goods Admin­istrat­ Wig Service at the Cancer Council’s the base of the syringe. ance with instructions, even using offices located at 5 Richmond ion, has issued a national recall of “Paracetomol is safe and faulty syringe markings. Avenue, Fairbairn remains open Children’s Panadol Baby Drops effective when taken as directed “Overall, if the product is used except for a short closure over the port of the Snow Foundation, the after it was found that dose mark- on the label,” the TGA said. as directed for less than 48 hours, Christmas holiday period - from Colin Telfer Memorial Foundation ings on some syringes have been “However, if taken either in over- the likelihood of infants develop- 5.00 pm on 20 December 2013 and and South Woden Uniting Church. placed incorrectly, creating the risk dose or in amounts that exceeded ing hepatoxicity is low, but not neg- will reopen at 9.00 am on Monday that children may be given an over- Any queries should be directed the recommended dose for more ligible,” the TGA said. 6 January 2014. dose of the medicine. than a few days, the unwanted With over 200 wigs and a to CEO, Joan Bartlett or Joanne Doctors, in particular, have effects can be severe.” For more information, go to: range of other headwear in stock Grant, Manager of Corporate been asked, when recommending The medicines watchdog http://www.tga.gov.au/safety/ there is something suitable for all Services on 6257 9999. Children’s Panadol Baby Drops, warned that initially there may be alert-medicines-childrens- clients. The Cancer Council Wig to make parents and carers aware no apparent harmful effects from panadol-baby-drops- Service offers a range of wig styles of the issue and to examine the an overdose, but after a day chil- syringe-131126.htm#. and colours to cancer patients on a accompanying syringe carefully. dren could become “very sick”. UpWLw8QW2kU subsidised basis, thanks to the sup- New health hub opens in Phillip Canberra Microsurgery opened Chief Minister, Katy Gallagher ers have also been very proactive in terms unveiled the new Canberra Micro­surgery of delivering innovative care. its new centre in Phillip facilities and launched Canberra Health “This is very much in line with our recently and is offering the Point. vision for Canberra Micro­surgery and Canberra Microsurgery will give Canberra Eye Laser, which is to develop ACT community access to the Canberrans access to some of the most a community dedicated to excellent, effi- latest technology and a holistic cutting edge services in the country, with cient, informed and compassionate care approach to health care. its laser surgery technology the most in a safe, high quality facility providing advanced in the southern hemisphere. the best available equipment and process- “We decided to locate our surgery at “The ACT has, and deserves to have, es for surgical and microsurgical treat- Phillip to be part of Canberra Health world-class health care,” Canberra ment.” Point,” Canberra Micro­surgery Director, Microsurgery Director, Dr Martin Canberra Health Point will house Iain Dunlop said. “Canberra Health Point Duncan said. services including osteopathy, natural is a collaboration of like-minded practi- “The ACT Government has played care, psychology, physiotherapy, den- tioners who are committed to helping peo- an important role in ensuring our com- tistry, dermatology, eye surgery and Chief Minister, Katy Gallagher and Dr Iain Dunlop ple get well and maintain wellness. munity has access to services, but provid- laser vision surgery. at the launch.

6 November/December 2013 Are you using your Food allergy and anaphylaxis: smartphone to take the need for education and training Food allergy and resources available for face-to-face involved in the care of patients with clinical photos? training. To meet these challenges, food allergy and anaphylaxis to With ready access to lish guidelines for medical stu- anaphylaxis have become the Australasian Society for Clinical update their knowledge and skills in internet and email and dents and doctors on what is cur- an increasing public and Immunology and Allergy (ASCIA) this area. In the meantime, parents rently legal and/or appropriate personal health burden has developed a number of educa- of children with food allergy/ana- widespread use of digital and what is not in terms of clinical tional resources including phylaxis are encouraged to visit their and social media, in developed countries „„Online training courses GP yearly to renew ASCIA Action photography and the use of per- over the last decade. designed for health Plans for the new school year, to be doctors are increasingly sonal mobile devices. professionals, school and re-trained in the use of their adrena- using their smart phones This will be available in the In the most accurate estimate childcare staff and the general line autoinjector device (if pre- first half of 2014. In the meantime of food allergy in Australia per- community; scribed), and check if any new to take and share clinical Avant recently ran a Webinar on formed thus far, the Victorian „„National standardised problems have arisen that might suggest the need for availability of images to assist with digital photography and doctors’ HealthNuts study food challenge emergency Action Plans; proven incidence of food allergy „„Adrenaline autoinjector an adrenaline autoinjector (e.g. new timely and appropriate medical apps in the age of smart- (FA) at age 12 months was much prescription guidelines; and regular asthma, new or more serious diagnosis and phones. The webinar canvassed higher than previously suspected; „„Updated allergy prevention allergic reaction). management and to issues relating to the use of smart- FA overall (10%); peanut allergy guidelines for schools and RESOURCES phone technologies in the provi- (3%); raw egg (8.8%) and sesame childcare. ASCIA online training enhance patient care. sion of healthcare, and strategies seed (0.8%). Effective strategies for Over the last 4 years, ASCIA https://etraining.allergy.org.au has partnered with various state for reducing your risk. Following primary prevention are lacking, and ASCIA Anaphylaxis Resources The AMA has recently agreed secondary prevention is limited to education and health departments the live webinar, a recorded version http://www.allergy.org.au/health- to partner with the Medical strategies to reduce the risk of unin- to develop the school and childcare professionals/anaphylaxis-resources will be made available on the Avant Indemnity Industry Association tentional exposure. Food immuno- e-training courses available free of ASCIA Guidelines for the of Australia to develop plain-Eng- resources page. therapy remains at the investigation- charge from the ASCIA website. prevention of anaphylaxis in al stage, with high rates of side There has been over 100,000 regis- schools, pre-schools and childcare effects in those on research trials trations for ASCIA’s school and http://www.allergy.org.au/health- and relapse in the vast majority childcare training since the pro- professionals/papers/prevent- when daily consumption of the trig- gramme was first launched in March anaphylaxis-in-schools-childcare gering food is ceased. 2010. Additional programmes have As we are currently unable to been specifically designed to meet Authors prevent or cure food allergy, educa- the needs of medical practitioners, Sandra Vale, tion regarding management is criti- nurses, pharmacists and dietitians ASCIA Project Officer cal. Unfortunately, the demand for and are accredited by professionals Dr Raymond Mullins, Chair, education outstrips the current associations. We encourage those ASCIA Anaphylaxis Committee

November/December 2013 7 Action needed to give indigenous children a healthier start to life AMA Indigenous Health fits to improve longer-term health „„support for families at risk and wellbeing. with interventions to protect Report Card 2012-13 - “Strong culture and strong infants and young children “The Healthy Early Years identity are also central to healthy from neglect, abuse and family – Getting the Right Start early development. violence; “The costs to individuals, fami- „„efforts to reduce the in Life” lies, and society of Aboriginal and incarceration of Aboriginal Torres Strait Islander children fail- people and Torres Strait The AMA Indigenous Health ing to reach their developmental Islanders; Report Card 2012-13, The Healthy potential continue to be substantial. „„efforts to improve the access Early Years – Getting the Right Start in “Robust and properly targeted of Aboriginal people and Life, was released by Assistant and sustained investment in healthy Torres Strait Islanders to the Minister for Health, Senator the early childhood development is one benefits of the economy, Hon Fiona Nash, at Parliament of the keys to breaking the cycle of especially employment and House recently. ill health and premature death entrepreneurship; AMA President, Dr Steve among Aboriginal peoples and „„ Hambleton,­­ said it is the right of efforts to keep children at Torres Strait Islanders. Assistant Minister for Health, Senator Fiona Nash. every Australian child to have the school; best start in life but in Australia “We are seeing improvements „„building a strong sense of through government commitment cultural identity and self- appropriate measures of early health-report-card-healthy-early- today not every child benefits from years-getting-right-start-life this right. and cooperation on closing the gap worth; childhood development and “In their early years, children initiatives, but much more action is „„improving the living wellbeing. Examples of good news stories in needed need to be safe, have adequate environment with better The AMA Indigenous Health addressing early childhood opportunities for growth and devel- “It is crucial for the momen- housing, clean water, sanitation adversity for Aboriginal and Torres tum to be sustained by renewing facilities, and conditions that Report Card, The Healthy Early Strait Islander children can be opment, and have access to ade- Years – Getting the Right Start in Life, quate health, child development, the COAG National Partnership contribute to safe and healthy found at https://ama.com. and education services,” Dr Agreements on Indigenous Health living; and better data, research is available at https://ama.com. au/2013-ama-indigenous-health- Hambleton said. and on Indigenous Early Childhood and evaluation culturally au/2012-13-ama-indigenous- report-card-good-news-stories “Many of our children are miss- Development for another five ing out, but none more so than years,” Dr Hambleton said. Aboriginal and Torres Strait Islander The AMA makes several rec- children. ommendations in the Report Card “There have been some im­­ to improve the health and wellbeing prove­­ments in recent years with of Aboriginal and Torres Strait many Aboriginal and Torres Strait Islander children in their early years, Islander children making a success- including: For inclusion in the… ful transition to healthy adult life, but „„a national plan for expanded there are still far too many who are comprehensive maternal and 2014 Specialist Directory being raised in community and fam- child services that covers a ily environments that are marked by range of activities including severe early childhood adversity. antenatal services, childhood “This adversity in early life can health monitoring and affect educational and social func- screening, access to specialists, …download the entry form from tioning in later life, and can increase parenting education and life the risk of chronic illness. skills, and services that target www.ama-act.com.au “Without intervention, these risk factors such as smoking, Submit to Helen Longdon substance use, nutrition, and problems can be transmitted from Fax: 6273 0455 one generation to the next – and mental health and wellbeing; the cycle continues. „„the extension of the Australian email: [email protected] “Good nutrition, responsive Nurse Family Partnership care and psychosocial stimulation Program of home visiting to can have powerful protective bene- more centres; Thank you from Canberra Doctor The ‘Canberra Doctor’ team thanks all the contributors and advertisers of 2013 for their support. It is much appreciated and we can’t do it without you.

Contributors: Dr Simon Robertson Advertisers: Dr Andrew Thomson Dr Kevin Gow Dr Thinus Van Rensberg Medical Women’s Society of Assoc Prof Jeffrey Looi Dr Stan Doumani Assoc Prof Vini Khurana, Dr Brendan Klar Dr Maciek Kuzniarz, Dr Tracey Baker the ACT and Region Assoc Prof Steve Robson Dr Steve Hambleton Canberra Neurosurgery Dr Catherine Drummond Oculoplastic and General Drs Angela Tsirbas and Mr Michael Tuite Dr Andrew Lark Dr Suzanne Davey Barton General Practice Dr Colin Andrews Ophthamology Benjamin Burt, Canberra National Capital Diagnostic Dr Andrew Miller Dr Tuck Meng Soo Bonsella Business Solutions Dr Joanna Mya, Dr Darryl Dr Omar Adham, Complete Oculoplastics Imaging (NCDI) Women’s Health Dr Annie Collins Prof Geoffrey Dobb Brindabella Endoscopy Howe and Dr Irene Giam, Erica Stephens National Capital Medical Specialists Dr Brian Morton Professor Michael Levy Centre Capital Skin Cancer Clinic Dr Omar Gailani and Dr Experien Insurance Services Dr John Saboisky Tween Low, Capital Womens’ Orthopaedics ACT Dr Doug Lee Medical Student Canberra Eye Laser Gynaecology Centres Dr John Smiles Health Parker Finances Services Dr Geoffrey Speldewinde Contributors: Canberra Imaging Group Australia Dr Judy Raymond Dr Peter Jones, Capital Sole’vita Surgery Dr Ian Pryor Ben Veness (CIG) Healthscope Medical Centres Dr Julie Kidd Respiratory & Sleep Service Southern NSW Medicare Canberra Specialist Hertz Dr Julie Carr Jae-Gon Yoo Dr Philip Mutton, Canberra Local Ultrasound Dr Katherine Gordiev Dr Julie Kidd Kate Mahoney Laser and Gynaecology Investec Specialist Bank The Foot Clinic Capital Pathology Dr Ken Tan, Dr Meiri Dr Karen Flegg Michael Ardern Robertson, Ms Tegan Ingold, Centre Jamison Medical and Skin Universal Medical Imaging Dr Marianne Bookallil Rhys Cameron Capital Specialist Centre Ms Debra Paoletti, Ms Pam Dr Rob Creer Cancer Clinic (UMI) Dr Rashmi Sharma Steven Sisifa Colliers International Craig, Canberra Fetal Dr Sue Richardson, Ageing Jirra Wines Winnunga Nimmityjah Dr Sarah Koffman Yi Fan Tang Dr A-J Collins Assessment Centre Well Clinic Jones Lang LaSalle Aboriginal Health Service

8 November/December 2013 Canberra dermatologists get under the skin of ACT politicians to promote skin health awareness AMA ACT President and Canberra dermatologist, Dr Andrew Miller, recently conducted skin checks on members of the ACT Assembly to help promote the vital importance of self-examination and early detection in the prevention of skin cancer. Dr Miller and his colleague, Dr the people of Canberra is ‘Know Catherine Drummond, checked the Your Skin’. skin of politicians including Chief “We urge people to get into Minister Katy Gallagher, Opposition the habit of self-examination and, Leader Jeremy Hanson, Deputy if they notice any changes in their Chief Minister Andrew Barr, and skin, to see their GP immediately Shadow Treasurer Brendan Smyth. for a check-up and advice. “Tomorrow we intend to get Dr Miller said that early detec- right under the skin of the ACT’s tion of non-melanoma and mela- political leaders – but for all the noma skin cancers can reduce the right reasons”. need for extensive surgery and “The Chief Minister, the Opp­ – and their skin – to help send a save lives. o­­sition Leader, the Deputy Chief powerful message to the people of Ahead of the checks, Dr Miller Minister, and the Shadow Treasurer Canberra to be vigilant about the Ms Katy Gallagher and Dr Catherine Drummond. told media, “our simple message to have generously donated their time dangers of skin cancer.” Mr Jeremy Hanson and Dr Andrew Miller. Major Federal Government fund dumps tobacco shares A major Federal Government fund is dumping public funds from tobacco com- ties to sever financial links with holdings, worth around $222 panies. the tobacco industry, and million. $100 million of tobacco company shares as the “It makes absolutely no Sentor Di Natale said the In a statement announcing Commonwealth moves to distance itself from sense for public money to be Corporation’s decision was a the decision, Chair of the the industry. invested in such an insidious welcome one. Fund’s Board, David Gonski The Commonwealth Sup­ action taken by the Future Fund industry,” Senator Di Natale The Future Fund decided said the Board had “noted er­­­­­­annuation Corporation re­­ earlier this year. said. “The announcement­ is a in February to divest itself of tobacco’s very particular char- vealed at a Senate Estimates Australian Greens health win for common sense.” shares in 14 entities involved in acteristics, including its damag- hearing late last month that it is spokesman Senator Richard Di The Greens and public tobacco production after com- ing health effects, addictive divesting itself of its tobacco Natale welcomed the move as an health groups have been cam- ing under sustained public and properties and that there is no holdings, following similar important advance in re­­moving paigning to force public enti- political pressure over the safe level of consumption”.

November/December 2013 9 Shared e-health records an exclusive club Little more than 11,000 Department of Health Secretary But Health Department offi- its usefulness and encourage greater access to information, and patients Jane Halton defended the rate of cials admitted that the limited adop- adoption by patients and the medi- can remove documents without shared health summaries take-up of the PCEHR, which she tion of the scheme so far meant cal profession. trace,” Professor Dobb said, warn- have been created under said was “reasonable” and in line that only about 400 patients could There needs to be a “fundamen- ing this was a fundamental flaw in tal change” in the Commonwealth’s the previous with experience in the Northern have their discharge summaries current arrangements that under- Territory with the adoption of its uploaded to the PCEHR by their troubled electronic health record mined the system’s clinical useful- Government’s electronic electronic health record system. hospital. system to reduce patient control if it ness. The Coalition has been highly is to be used and adopted by doc- “In terms of our expectations “To encourage use of the health record system. critical of the PCEHR and the cost tors, the AMA has warned. PCEHR, GPs, community special- about what is a reasonable take-up (so far estimated to be around $1 In a blunt assessment of the A Senate Estimates hearing rate, I think the answer is, com- ists and emergency department spe- billion) of establishing e-health sys- failings of the Personally Controlled cialists must be confident that it was told that around 1.13 million pared to our domestic experience, tems. Electronic Health Record people so far have registered for a yes, it is reasonable; and compared contains accurate, up-to-date infor- But Ms Halton said progress (PCEHR), the AMA said that the mation,” he said. “Without a funda- Personally Controlled Electronic to what I know about international overriding emphasis on patient should be measured not only in mental change to increase clinical Health Record (PCEHR), but mini- experience, yes, it is reasonable,” Ms terms of the number of shared control in the present system had confidence, the PCEHR does not mal take-up by medical practition- Halton told the Estimates hearing summaries created so far, but also come at the expense of clinical util- serve the best interests of patients. ers has meant that few shared health on 20 November. the enormous amount of work that ity, with doctors wary of relying on had gone into establishing the health records where information As a result, it would be rejected by summaries have been created. The hearing was told that 6,040 many doctors and would fail.” The result underlines AMA health care provider organisations, building blocks of a uniform may be hidden or incomplete. national electronic health system, Since the system went live in The AMA Vice President said concerns that the system as cur- including individual general prac- less patient control would not com- rently configured is too complex tices and health networks such as including the development of mid-2012, little more than one mil- unique identifiers. lion people have registered for a promise privacy, because there were and cumbersome for medical prac- the Queensland public hospital sys- “Let’s be clear. The $1 billion is PCEHR, and barely 11,000 shared already strong safeguards in the titioners to use, and there are not tem, had registered with the system. comprised of a number of ele- health summaries have been enabling legislation to prevent third sufficient incentives to encourage The number included 4,714 ments. The large majority of the uploaded by doctors, fuelling con- parties having access to electronic greater take-up. general practices. billion dollars is actually [spent on] cerns that it is in danger of becom- records without a valid reason, and things like the standards that under- ing a very expensive failure. there were heavy penalties for any pinned the use of all IT systems in In its submission to the review, breaches. the health space,” the Health which is due to report to Health In its submission, the AMA Department Secretary said. “Those Minister Peter Dutton by the mid- also recommended that the PCEHR things are fundamental to the oper- dle of this month, the AMA warned be an opt-out rather than opt-in ation of electronic systems in states the system risks being rejected out- system, as this would ensure a high and territories. The PCEHR is actu- right by many doctors unless the degree of consumer participation ally the smaller proportion of that emphasis on patient control is and encourage doctors to commit amount. The majority of it is actu- scaled back and the integrity of to using the system. ally creating the things that prevent information contained in the record “Doctors would be much more a ‘rail gauge’ problem in terms of is assured. likely to fully embrace the new sys- electronic commerce, communica- “We support people taking tem if a majority of their patients tion and clinical information.” greater responsibility for their own had a PCEHR,” Professor Dobb The hearing also heard that pri- health, and the PCEHR has the said. potential to assist with this,” AMA vate organisations hired by the Among other improvements, Department had delivered the bulk Vice President Professor Geoffrey Dobb said. “But patient control the AMA has recommended in­­ of the patient registrations to date, creas­­ed assistance for medical spe- with minimal take-up coming from should not mean that the PCEHR cialties and health care organisations public notices or information from cannot be relied upon as a trusted Medicare Locals. source of key clinical information.” in developing the capability to view The AMA’s overriding concern and upload documents to the Reduce ‘personal control’ to is that patients have the ability to PCEHR; ensuring that medical soft- make electronic health remove or restrict access to infor- ware provides seamless access to the records useful mation in the PCEHR, meaning system, as well as ease in uploading AMA President Dr Steve that it cannot be relied upon as a documents and information; and Hambleton has been appointed by comprehensive and accurate source making sure that any new functions the Abbott Government to a three- of clinical information. added to the PCEHR fit within the member panel to review the system “The current PCEHR arrange- existing workflow and do not create and advise on changes to improve ments allow patients to restrict additional work for clinicians.

Doctors’ Health Advisory Service (ACT) Here for you and your needs The DHAS (ACT) provides peer support for you and your family. The DHAS (ACT) provides a protective environment of anonymity, cultural sensitivity, confidentiality and discretion. There is no charge for using the DHAS (ACT). The DHAS (ACT) is a group of experienced Canberra-based general practitioners who are committed to providing support to colleagues and their families experiencing difficult times – which may include: l a stressful incident l workload concerns l your career plans l violence or trauma in your workplace l feelings of stress or inability to cope l personal issues l workplace issues such as bullying or l burnout l your well-being harassment l your professional life The DHAS (ACT) can link you with expert services and resources according to your needs. Privacy and confidentiality are assured. The DHAS (ACT) is fully supported by, but operates independently of, the AMA (ACT) Ltd as a community service. DOCTORS’ HEALTH ADVISORY SERVICE (ACT): Your colleague of first contact 0407 254 414 – 24 hours

10 November/December 2013 Building a medical workforce for Australia’s future AMA Position Statement on force supply, and an appreciation of cal workforce and training within “The AMA welcomes the Medical Workforce and global medical workforce trends. Australia. Training must be: work that HWA is doing to devel- Training “It takes time to train a high- „„supported by accurate data op a long term medical workforce quality medical workforce - plan- The AMA has released its and projections; training plan. ning for the future must start now,” Position Statement on Medical Workforce “For this plan to work, all Professor Dobb said. „„driven by community need; and Training 2013. Commonwealth, State and Terri­ The Position Statement addr­ „„improved by better AMA Vice President, Profess­ esses a number of key challenges co-ordination; tory governments need to reach or Geoffrey Dobb, said the health facing medical workforce and agreement on: of the Australian population relies „„enhanced by efficiency; training in Australia including: „„the number of quality medical upon care from a highly skilled, „„supported by sufficient school, intern, prevocational well-trained medical workforce. „„a global shortage of medical funding; Professor Dobb said the AMA practitioners, with some and specialist medical training specialties affected more than „„empowered by equity of places needed, based on the has spent considerable time, access; involving extensive discussion with others; analysis provided by HWA; „„underpinned by self- stakeholders, to produce a com- „„maldistribution of medical „„respective financial sufficiency; and prehensive Position Statement to practitioners, in terms of both contribution each government help guide the future development geographic distribution and „„linked to global medical will make; of medical workforce and training specialty; workforce trends. „„robust performance policies to improve community „„bottlenecks in the medical Professor Dobb said that the benchmarks to measure access to high quality medical care. training pipeline, caused by Commonwealth has significantly “The AMA believes there increasing numbers of medical increased medical student num- achievement against HW2025 needs to be unprecedented coop- graduates and a historically bers from 7746 in 2000 to 16,868 targets and COAG eration and coordination – between fragmented medical training in last year. commitments, with regular all levels of government, and system; “The Commonwealth and the reporting by HWA on between all key medical training „„systematic underfunding of State and Territory governments progress against these targets; stakeholders – to build a highly prevocational and vocational and trained medical workforce in appro- must continue to build on the sig- training positions by priate numbers to serve the future nificant investments they have „„the development, in jurisdictions, exacerbating the health needs of the Australian com- made in prevocational and special- consultation with the existing bottlenecks in the munity,” Professor Dobb said. ist training, to ensure that future profession, of performance medical training pipeline; and “Medical workforce policy and graduates can complete specialist benchmarks to ensure that the planning must align with commu- „„heavy reliance on recruitment training and deliver the medical quality of medical training is nity demand for high quality health of international medical services the community needs. sustained. care. graduates to ameliorate “There is growing pressure on Position Statement on “Planning for training our workforce shortages, the medical training pipeline, and The AMA future medical workforce must particularly in regional and Health Workforce Australia (HWA) Medical Workforce and Training aspire to maximum efficiency, suf- rural areas. is projecting that, by 2016, Australia 2013 is at https://ama.com. ficient funding, equity of access to The Position Statement out- will be facing a shortage of special- au/position-statement/ medical services for all Australians, lines the key principles that the ist training places unless urgent medical-workforce-and- self-sufficiency in medical work- AMA believes should guide medi- action is taken. training-2013

November/December 2012 11 AMA supports new scientific evidence-based resource to promote immunisation AMA President, Dr Steve “It is an important new re­­ Tribunal ordered the anti- source that will help dispel the non- vaccination Australian Hambleton, said the AMA scientific myths and misinforma- Vaccination Network (AVN) welcomes the Australian tion circulated by anti-vaccination to change its name after groups in the community. finding it was likely to mislead Academy of Science’s new “The app features strong scien- parents into thinking it Science Q&A app as an tific evidence, clear explanations, and provides fair and balanced important addition to the easy-to-understand language that information; will reassure people, including con- „„of the decision, the then NSW immunisation evidence scientious objectors, about the safety Fair Trading Minister Anthony base to help parents make and efficacy of immunisation. Roberts said “… this is about being “It is another useful tool for open and upfront about what you informed decisions about community GPs, who are the pub- stand for, not hiding behind a name the health of their lic face of immunisation for Aust­ which could mislead the community children. ralian families. about a very significant public health The decision is the latest vic- Morning Herald the ruling was an “Parents should always speak issue … the time has come for the tory in efforts to boost the nation’s important result for the community. The app – launched in Melb­ freely with their family doctors AVN to find a name which reflects immunisation rates amid warnings “This is about being open and ourne by Dr Hambleton, Academy about any concerns they may have its anti-vaccination stance ...”; that vaccination coverage in some upfront about what you stand for, President, Professor Suzanne Cory, with their child’s immunisation pro- „„in August 2013, the Australian parts of the country was so low that not hiding behind a name which and world-renowned immunolo- gram,” Dr Hambleton said. Government introduced new there was risk of a sustained out- could mislead the community about gist, Professor Sir Gustav Nossal – Australian Academy of Science rules that require children to be break of serious diseases such as a very significant public health issue,” is a companion to the highly suc- President, Professor Suzanne Cory, ‘fully immunised’, be on a measles and whooping cough. Mr Roberts said. “The time has cessful Academy booklet, “The said that the Academy is strongly recognised immunisation catch It follows the introduction of come for AVN to find a name which Science of Immunisation”, launched committed to ensuring that every up schedule, or have an new laws in NSW that, from 1 reflects its anti-vaccination stance.” jointly by the Academy and the Australian has the opportunity to approved exemption to be January, will allow childcare centres The Tribunal’s Deputy Pres­ AMA last year, which has been cir- base their decisions on the best eligible for the Family Tax to refuse enrolment for children ident, Nancy Hennessy, found that culated to more than 7,000 GPs available evidence. Benefit Part A supplement; and whose parents cannot provide proof the AVN was sceptical about vacci- nationally and accessed by hun- “This app puts the best scien- „„in July 2013, the Australian of vaccination or an approved nation, and that its main purpose dreds of thousands of people via tific evidence at parents’ fingertips, Senate supported a motion ex­emption, and comes after the was to disseminate information and the Academy website. giving them confidence that they’re from the Australian Greens nation’s Health Ministers agreed to opinions highlighting the risks of Dr Hambleton said it is impor- making the best decisions for their urging the AVN to disband, work on developing nationally-con- vaccination, yet its name suggested tant that parents have easy access to child,” Professor Cory said. condemning its ‘harmful and sistent immunisation requirements. a pro-vaccination, or at least bal- Internationally acclaimed imm­ quality scientific evidence to help unscientific scare campaign Concerns about the nation’s vul- anced, approach to the issue. unologist, Professor Sir Gustav nerability to serious infectious dis- them make informed decisions that is helping undermine Ms Hennessy suggested the Nossal, said it is important for all eases have been stoked by evidence about immunisation. national immunisation rates’. group consider adding the words “Immunisation has saved mil- parents to have their children imm­ For details on how to access that in parts of the country, particu- lions of lives around the world and unised. larly northern NSW and south-east “risks” or “sceptic” to its name to the new app, click on the Science ensure people understood what its in Australia,” Dr Hambleton said. “Not only does this safeguard Q&A icon on the Australian Acad­ Queensland, vaccination rates purpose was, the report in the “It has brought great comfort the children from serious and emy of Science website at www. among young children have slipped and security to the health of the com- potentially fatal infections, but high science.org.au to as low as 81.1 per cent – well SMH said. munity and the Australian way of life. immunisation coverage at commu- below the level considered necessary The Tribunal’s decision came “Many serious life-threatening nity level ensures that viruses and Anti-vax group ordered to ensure a level of herd immunity. more than a year after the AVN diseases are now rare because of bacteria do not have enough fertile to inject some reality into AMA President Dr Steve Ham­ won a Supreme Court appeal immunisation, but we cannot be ‘soil’ on which to grow, so that risk its name bleton said it was no coincidence that against an order by the Health Care complacent about public health. of infection is minimised by ‘herd In a victory for the NSW Gov­ low vaccination rates were recorded Complaints Commission that the “It is vital that we continue to immunity’”, Professor Nossal said. ernment, the NSW Admin­istrative in areas where anti-vaccination AVN include a disclaimer on its provide families and the communi- Dr Hambleton said that 2013 Decisions Tribunal has directed the groups were active, and he welcomed website that its information should ty with the highest quality scientific has seen strong action by govern- Australian Vaccination Network to the Tribunal’s ruling to force the not be considered as medical advice. evidence on immunisation. ments to increase Australian immu- ditch its title and develop a name AVN to be more open about its opp­ The appeal was won on a tech- “The Academy’s new app has nisation rates, including: that accurately reflects its scepti- osition to immunisation. nicality after the AVN successfully been researched and developed by „„in November 2013, the NSW cism about vaccinations after it ­NSW Fair Trading Minister argued the Commission had exceed- Australia’s leading scientists. Administrative Decisions ruled that it was misleading. Anthony Roberts told the Sydney ed its authority in issuing the order.

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12 November/December 2013 United medical profession calls on Queensland to ditch toxic contracts Senior members of the sentatives of doctors in training, an exodus of senior medical staff of fraud after misrepresenting his clear” of any offers to work in salaried medical officers and medi- that would threaten to undo recent experience and qualifications, and Queensland. medical profession from cal students, has unanimously advances in access to care. his case drew attention to the risks The Association’s Executive across the country have resolved to oppose the Queensland “The proposed new individual involved in relying heavily on over- Director Ian Powell wrote to mem- united in their Government’s decision to intro- contracts will strip away key employ- seas recruits to fill gaps in the med- bers urging them to “strongly recon- duce the “unfair and unbalanced” ment rights and undermine the pro- ical workforce. sider” plans to work in Queensland condemnation of the contracts from 1 July 2014. gress Queensland has made in grow- Following the scandal, Queens­ public hospitals, cautioning that “if Queensland At a meeting late last month, ing its public sector medical work- land Health substantially upgraded you take up a position…you will the Council considered the changes force,” the AMA President said. employment conditions for public have fewer rights, fewer protections Government’s decision to and resolved to condemn them as a The contracts remove key and less negotiating strength”. force Senior Medical hospital medical staff, boosting its retrograde step that would harm fatigue measures such as mandated ability to recruit and retain staff. The warning is particularly sig- doctors and patients in Queensland rest breaks and limits on hours, as nificant because New Zealand has Officers in the State’s Dr Hambleton said the move public hospitals. well as denying access to protections become an important source of sen- to draconian individual contracts public hospital system AMA President Dr Steve Ham­ such as unfair dismissal, dispute res- ior medical staff for Queens­land’s onto individual contracts bleton said a succession of enter- olution and grievance procedures. was a retrograde step that would public hospitals in the past six years. undermine the progress that had that strip them of basic prise agreements covering Queens­ Queensland Health’s problems Dr Hambleton called on the land’s Senior Medical Officers had attracting and retaining senior med- been made, and must be reversed. Queensland Government to recon- workplace rights and been instrumental in enabling the ical staff came to a head in the mid- The harm the Government’s sider its plans. protections. State to overcome a long-standing dle of last decade with revelations policy will inflict on the Queensland’s “Any loss of senior doctors shortage of doctors in the public about the conduct of Bundaberg ability to attract and retain staff has from the public hospital system The AMA Federal Council, hospital system. Base Hospital head of surgery Dr already become apparent. would limit patient access to medi- which brings together senior mem- Dr Hambleton warned that the Jayant Patel. New Zealand’s Association of cal care, and make it harder to train bers of the medical profession shift to unfair individual contracts Dr Patel was last month given a Salaried Medical Specialists has the next generation of doctors from all the states, territories and that did away with key employment two-year suspended sentence after issued an extraordinary warning to entering the system to provide care specialty groups, as well as repre- provisions and protections risked being convicted on several counts its members, urging them to “steer for Queenslanders.”

Private Mental Health Alliance launches principles for collaboration, communication and cooperation between private mental health service providers The Private Mental Health Alliance (PMHA) has „„The Royal Australian and „„Private Mental Health find the Principles particularly launched its Principles for Collaboration, New Zealand College of Consumer Carer Network useful for developing and deliver- Psychiatrists (Australia) ing their mental health curricula. Communication and Cooperation between Private „„Mental Health Professionals „„Australian Psychological An electronic version of the Mental Health Service Providers (Principles). Network Principles can be obtained from Society the PMHA website at: http:// These Principles have been „„General Practice Mental It stated that it had a vision for „„Australian College of Mental www.pmha.com.au/ a mental health system that Health Standards developed through a highly col- PublicationsResources/ addresses the need for consumers Health Nurses Collaboration laborative process. They have Principles.aspx and carers to have a robust referral been officially recognised as an „„Australian Association of The Principles are an impor- PMHA very much believe there is pathway and process that pro- Accepted Clinical Resource by Social Workers tant resource for mental health pro- scope to build on this work. motes better communication The Royal Australian College of fessionals Continuing Professional „„Occupational Therapy Development (CPD) programs and Feedback on the Principles and between providers of mental General Practitioners and carry health services in the private sec- Australia CPD events, particularly those that suggestions for future work and the endorsement of the follow- tor. It is confident that implemen- „„Australian Private Hospitals might relate to establishing and tools that could support the tation of the Principles will help to ing organisations. working in private practice. Principles would be very welcome improve outcomes for people with „„Australian Medical Association Education and training pro- and should be forwarded to a mental illness and their carers. Association „„Private Healthcare Australia viders including universities may [email protected]

Making a gift this holiday season to MBA will be greatly appreciated as MBA assists Canberra doctors an their families too!

The Medical Benevolent The Association provides a The Association relies on Association is an aid organisation counselling service and financial donations to assist in caring for which assists medical practitioners, assistance and is available to every the loved ones of your colleagues. their spouses and children during registered medical practitioner in times of need. NSW and the ACT.

For further information please phone Meredith McVey on 02 9987 0504

November/December 2013 13 Continued dispensing by pharmacists – an update and fact sheet ‘Continued dispensing’ Lipid modifying agents „„patient details is a joint „„Atorvastatin „„date medicine supplied Commonwealth „„Fluvastatin „„medicine details „„Pravastatin „„reason for supply by Government and continued dispensing Pharmacy Guild of „„Rosuvastatin „„Simvastatin „„declaration co-signed by the Australia initiative that The practice guidelines iss­ patient indicating their allows pharmacists to ued by the Pharmaceutical Soc­ understanding and consent supply a standard pack iety for Australia states pharma- to the supply. cists can supply these medicines Pharmacists must not supply of an eligible by continued dispensing if they these medicines to a patient if the PBS medicine to patients consider: medicine has already been sup- who request it without a prescrip- „„there is an immediate need plied by any pharmacy by contin- tion from a medical practitioner. for supply of the medicine ued dispensing in the previous 12 The Federal and State AMAs to facilitate continuity of months. lobbied hard to oppose legisla- therapy, and it is not Continued dispensing is sup- tion to allow ‘continued dispens- practicable for the patient to plementary to existing urgent or ing’ within the Pharmaceutical obtain a prescription for the emergency supply provisions Benefits Scheme, including writ- medicine from an authorised existing in each State and Terri­ ing to all Federal parliamentarians prescriber; tory. to explain the risks to patients, „„the medicine has been Feedback however the legislation was pass­ previously prescribed for the The AMA wants to hear ed last year. patient, their therapy is Legislation in the ACT about your experiences with con- stable, and there has been tinued dispensing. has now also been amended prior clinical review by the to specifically provide for prescriber that supports In particular: ‘continued dispensing’. continuation of the „„Have you been contacted by The eligible medicines under medicine; pharmacists to establish that ‘continued dispensing’ are: „„there is an ongoing need for you have recently reviewed „„ oral hormonal supply and the medicine is the patient for that contraceptives for systemic safe and appropriate for that medication? use. patient. „„Is the information provided „„ lipid modifying agents, The pharmacist must also be to you by pharmacists after specifically the HMG CoA able to identify the most recent continued dispensing has reductase inhibitors prescriber of the requested med- occurred useful? (‘statins’) as listed in the icine and their practice address. „„ Schedule of Pharmaceutical Has there been an impact on The practice guidelines also Benefits. the management of your state that pharmacists will need patient? Oral hormonal contraceptives to balance the risk to patients of Please forward any comments „„Levonorgestrel delaying review by their medical VALE to: [email protected] The President, Board, Members „„Levonorgestrel with practitioner with the benefit of and/or [email protected] continuity of therapy. and staff of AMA ACT extend Ethinyloestradiol For further information on the „„Norethisterone Pharmacists must advise their condolences to the family the patient’s medical practi- changes to the ACT legislation „„Norethisterone with tioner within 24 hours that the use the link below: and friends of late colleagues, Ethinyloestradiol medicine has been supplied with- http://www.legislation.act.gov. Dr Desmond Travers and Dr Alan „„Noresthisterone with out a prescription. Infor­mation au/sl/2008-42/current/ Merrifield. Mestranol must include: pdf/2008-42.pdf

14 November/December 2013 Careers Service reminder Winner of ama acts As we come to the close of another year the AMA Our Doctors in Training Pro­ “Art In Butt Out” competition file section of the website has Careers Advisory Service would like to thank all been very popular since its addi- is finalist in national stamp those doctors and medical students who have tion in July 2013 and we encour- accessed the service to date and welcome those who age all medical students and junior designing competition doctors to visit these profiles for “Canberra Doctor” is pleased haven’t as yet to take some time over the holiday some additional insight into the to report that the winner of the break to visit our website and check out the range of different career paths available to 2013 “Art In, Butt Out” competi- services and information available to you for use you as medical practitioners. We tion for young designers, Sally also encourage all practising doc- Witchalls, is now a finalist in a throughout your medical career. tors to share your story through national competition to design a postage stamp for Australia Post. With all employment cam- The AMA Careers Service your contributions to this section of the website and support your Sally is a year 8 student at Canberra paigns completed for 2013 we also provides advice and assistance High School. peers who have already contribut- encourage those who will be for your career pathway. For exam- Sally’s winning entry in the applying for intern, RMO and ple, if you are a junior doctor con- ed to this valuable tool. AMA ACT competition was dis- We look forward to hearing vocational training positions in sidering which vocational training tributed on 60,000 milk cartons in program you want to apply for, from you soon and best wishes Canberra during September. the 2014 campaigns to start think- and safe travels to you all over the ing about your applications now GPs and Specialists looking for a With Australia hosting the change of scene or even a change holiday season. G20 Summit in Brisbane in 2014, and get ahead of the crowd in in direction, retiring doctors who Kathryn Cassidy year 7 to 12 students from around accessing our application tools - the country were invited to show- aren’t quite ready give up work AMA National Careers resume review, cover letter review completely and looking for transi- case their creative skills by design- Consultant ing a 60 cent stamp for Australia five finalists is selected by popular and interview skills and assistance. tional employment opportunities Each of these services can be pur- AMA Careers Advisory Service Post. The commemorative stamp vote from the public. etc. the AMA Ca­reers Service can will be released in conjunction Sally is the only student from chased at either the member or provide information and assis- Website: www.careers.ama.com.au with the G20 Summit in 2014. the ACT who is a finalist. There are non-member rate via the website tance on how best to approach Sally’s G20 stamp design has been no prizes in the competition, only along with further information these queries and the options avail- Hotline: 1300 884 196 selected as one of 5 national final- the accolade of having the design about each service. able to you. Email: [email protected] ists. The winning design from the utilised for such a good purpose.

Qantas Club

A News Magazine for all membership rates Capital Specialist Centre Doctors in the Canberra Region ISSN 13118X25 for AMA members ATTENTION ALL SPECIALISTS Published by the Australian Medical Association Joining Fee: $230 (save $140) Part time sessions available at 3 Sydney Ave, Barton with full secretarial & typing support. (ACT) Limited 1 Year Membership: $372 (save $113) 42 Macquarie St Barton We currently cater for both medical and surgical (PO Box 560, Curtin ACT 2605) 2 Year Membership: $660.30 (save $214.69) specialists, and are co-located with the busy multi Editorial: (all rates are inclusive of GST) doctor Barton General Practice. Christine Brill To renew your Qantas Club Corporate Membership contact the Ph 6270 5410 Fax 6273 0455 secretariat to obtain the AMA corporate scheme number. A very cost effective solution without the of ce [email protected] management concerns. For new memberships download the application from the Typesetting: Members’ Only section of the AMA ACT website: Phone 6253 3399 Design Graphix Ph 0410 080 619 www.ama-act.com.au Editorial Committee: For further information or an application form please contact Dr Ian Pryor – Chair the ACT AMA secretariat on 6270 5410 or download the Dr Jo-Anne Benson application from the Members’ Only section of the AMA ACT Mrs Christine Brill website: www.ama-act.com.au – Production Mngr Dr Ray Cook Dr James Cookman Dr John Donovan A/Prof Jeffrey Looi Careers Advisory AMA Staff Assist Dr Peter Wilkins – helping you get the right staff for your practice Mr Jonathan Sen Advertising: Service Ph 6270 5410, Fax 6273 0455 AMA ACT is pleased to announce its new [email protected] Copy is preferred by Email to Are you are a doctor service “AMA STAFF ASSIST” [email protected] looking for a change in This new fee-for-service initiative has been designed to assist or on disk in IBM “Microsoft Word” or RTF format, with graphics in TIFF, career, in either the clinical AMA members recruit nursing, admin and book keeping staff. EPS or JPEG format. Next edition of or non-clinical setting? AMA STAFF ASSIST will advertise the vacancy, assess the Canberra Doctor – February 2014. competencies required for the position, recommend a Not sure where to start and minimum salary rate, assess candidates and recommend a how your current skill set short-list of candidates for interview. Following the successful Disclaimer will apply? selection of a new staff member, AMA STAFF ASSIST will The Australian Medical Association (ACT) Limited shall not be responsible in any provide the employing member with a template workplace manner whatsoever to any person who relies, agreement if desired. in whole or in part, on the contents of this Contact your AMA Careers Consultant via the online feedback form at: publication unless authorised in writing by it. http://careers.ama.com.au by email at: [email protected] For further details on this new service, please The comments or conclusion set out in this or by phoning our hotline: 1300 884 196 publication are not necessarily approved or contact Christine Brill on 6270 5419 or endorsed by the Australian­ Medical Association (ACT) Limited. by email: [email protected]

November/December 2013 15 Holistic Medical Care full time/part time needed Suite 11 Lidia Perin Medical Centre for very busy computerised Dr Julie Kidd 12 Napier Close Deakin ACT 2605 modern practice. Flexible The following GERIATRIC SERVICES available: hours and full time nurse GP Hypnotherapist ~ Comprehensive Geriatric Assessment on site. No A/Hrs and good (Including falls assessment, cognitive assessment and medication review) conditions to right Smoking, alcohol, binge-eating, stress, anxiety etc. ~ Nursing home visits ~ Home visits for frail elderly

VRGP candidate. Geriatricians: Dr Sabari Saha, Dr Sasikala Selvadurai, Dr Anil Paramadhathil Phone Jamison Medical & Skin Canberra Complementary Health Practice For Appointments: Phone: (02) 6154 5030 Fax: (02) 6169 4437 Suite 4, Playoust Bldg, Hawker Pl, Hawker Email: [email protected] Web: www.holisticmedicalcare.com.au Cancer Clinic – 6251 2300 www.jamisonmedicalclinic.com.au 0425 300 233 | www.canberrahypnosis.com.au

ARGYLE ROOM OffiCe SPaCe MEDICAL CENTRE FOR RENT Dr Tween Low - GOULBURN Small medical consulting suite for rent to let Gynaecologist Infertility Specialist at John James Medical Centre of 37 Geils Court, Deakin West The dynamic group of doctors at the approximately 40m2. Dr Omar Gailani Argyle Medical Centre in Goulburn is Secured building. Rent $1860 per month, 222 metres, Obstetrician and Gynaecologist seeking graduates in general practice available immediately. first floor office suite. Urodynamics and pelvic surgery to join them. Ample free car parking for patients. Fitted out as one or two units. Contact: Dr Tween Low $330/metre ex GST Canberra Fetal Assessment Centre Argyle Medical Centre is an or Kate Jackson on 02 6162 1649 Gynaecological Imaging accredited and teaching practice Phone Maria: 6282 1783 located one hour from Canberra. Capital Women’s Health in Deakin provides a complete and unique specialist If you are interested, please contact service to women in Canberra and the surrounding region. Dr Tween Low Dr Ivan Wilden-Constantin on For rent provides expert gynaecology and infertility treatment; Canberra Fetal 02 4821 1188 To Advertise Assessment Centre provides complex obstetrics and gynaecology ultrasound Consulting suite, with Dr Ken Tan specialising in high risk obstetrics; and Dr Omar Gailani in Canberra provides specialist private obstetrics care, urogynaecology service and John James mediCal Centre, affordable urodynamic study. Doctor deakin, to rent on sessional email basis up to four days a week. 21 Napier Close DEAKIN ACT 2600 newly fitted out. P: 02 6162 1649 F: 02 6162 1659 execofficer@ [email protected] ama-act.com.au ContaCt tom Sutton 02 6260 7744

Dr Colin Andrews, Complete Neurologist Women’s is pleased to offer ealtH Dr. A-J Collins MB BS FRACS same week assessment H for rst seizure. Dr Omar Adham Breast and Thyroid Surgeon This will involve an EEG followed Dr Peter Jones ~ Obstetrician ~ Gynaecologist M.B.B.S.(Hons), F.R.A.C.P. by a consultation. ~ Gynaecology Endoscopic Surgeon Oncoplastic Breast Surgery – including: Respiratory & Sleep The advantages of this service are Complete women’s health is w Immediate breast reconstruction and as follows: Physician guided at all times by the values 1. Higher yield of abnormality on Specialist consultation service of compassion and respect for the breast reduction techniques the EEG soon after a seizure. Home based sleep studies dignity of every patient. Our w Breast Cancer surgery 2. Reduction of risk of subsequent mission is to care for the mind, the (bulk billed) w seizure. body and spirit of each client. Sentinel node biopsy In-lab sleep studies 3. Reduced anxiety and ~ Obstetric Care better compliance with the (bulk billed) ~ Pelvic Pain & Endometriosis Thyroid and Parathyroid surgery management plan. Complex lung function testing ~ Prolapse & Incontinence Bronchial provocation testing Correspondence: Suite A8 Suite 3-7, John James Medical Centre Canberra Specialist Centre Bronchoscopy 175 Strickland Crescent Address: Suite 3, 161 Strickland Crescent 3/18 Bentham Street, Deakin ACT 2600 National Capital Private Hospital DEAKIN ACT 2600 Yarralumla ACT 2600 T: 02 6282 2033 P: 6260 3663 F: 6260 3662 F: 02 6282 2306 Phone: 02 6222 6607 Telephone: (02) 6282 4807 www.completewomenshealth.com.au Fax: 02 6222 6663 Facsimile: (02) 6285 3609 www.canberrasleep.com [email protected]

Eyelid Surgery l Thyroid Eye Disease Periocular and Orbital Tumours Endonasal Lacrimal Surgery colposcopy & laser endoscopic surgery Committed to timely and effective specialist gynaecology care for your patients treatment of prolapse Consulting and operating weekly and incontinence Dr. P.M.V. Mutton Over 30 years of MBBS, FRCOG, FRANZCOG combined for prompt, personalised Specialist and experience experienced care Dr Angelo Tsirbas Dr Benjamin Burt Capital Specialist Centre 6273 3102 Suite 9, 3 Sydney Ave Barton ACT 2600 Podiatrists: Paul Fleet | Krystle Mann | Joanna Milgate | Matthew Richardson 39 GREY STREET DEAKIN ACT 2600 Phone: 1300 37 87 47 FAx 6273 3002 Fax: 02 8362 9441

16 November/December 2013