Influenza is Coming – Vaccinate! - AMA WA

80 Pages·2013·21.29 MB·English

M E D I C U S
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cia Journal of the Australian Medical Association WA | May 2013 Volume 53 / Issue 4 | amawa.com.au
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Council
President
Dr Richard Choong May 2013
Immediate Past President
A/Prof David Mountain
Vice Presidents
Dr Michael Gannon C o n tE n t S
Dr Andrew Miller
Honorary Secretary
Dr Omar Khorshid
Assistant Honorary Secretary
Dr Janice Bell
Honorary Treasurer
Dr Simon Towler
Councillors
Division of General Practice (WA)
Prof Bernard Pearn-Rowe
A/Prof Rosanna Capolingua
Division of Specialty Practice
Dr Tony Ryan 22
Prof Mark Khangure
Division of Salaried and State
Government Services 4
Dr Cassandra Host
Dr Daniel Heredia
Cover Story: Influenza season is coming
Ordinary Members
Prof Gary Geelhoed Vaccination remains the single best means to
Dr Stuart Salfinger prevent influenza infection
Dr Marcus Tan President’s Cocktail Party
Co-opted Members
Dr Steve Wilson Dr Richard Choong talks
A/Prof Frank Jones membership and GP matters
A/Prof Peter Maguire
Prof Geoff Dobb
Dr Cassandra Host
Dr Melita Cirillo
Dr Ian Jenkins
Prof Ian Puddey
Prof Gavin Frost
Dr Alexandra Welborn
Ms Lee Fairhead
Ms Tahira Bhatti
AMA (WA) Office
Executive Director
Mr Paul Boyatzis 20 46
Director: Industrial & Legal
Ms Marcia Kuhne
Executive Officers
Mr Michael Prendergast
Ms Christine Kane
The Boyatzis touch! Profile: Ricky Burges
Ms Clare Francis
Mr Gary Bucknall AMA (WA) Executive Director WALGA’s CEO on health and
Paul Boyatzis celebrates 25 years of service local government
14 Stirling Highway
Nedlands WA 6009
[phone]
[email protected] FEatU rES
www.amawa.com.au
Medicus
Editor and Director of
Communications 17 Lack of rigour in early 49 Eradicating Polio
Mr Robert Reid
childhood development The Global Poverty Project
Deputy Editor
policy concerning fights to end poliovirus
Ms Janine Martin
Advertising Inquiries Dr David Roberts has his say
Phone Mr Des Michael [phone]
Copy Submissions
Phone Ms Janine Martin [phone]
or [email protected] rEGUL arS
Services
Business Services Manager
Ms Noelle Jones
Financial Services Manager 02 President’s Desk 46 Profile: Ricky Burges 65 Food
Mr John Gerrard
Medical Products Manager 03 From the Editor 50 Clinical Edge 66 Drive
Mr Anthony Boyatzis 06 Industrial 53 Dr YES 67 Obituary: Associate
Health Training
Australia Manager 07 News 55 Snippet Professor Jon Rampono
Mr Geoff Jones 31 Opinion 57 Event: Barefoot Bowls 68 Member Benefits &
The publication of an advertisement, 40 Tomorrow’s Health: The 59 Bookshelf / On the Town
article or inclusion of an insert does not future of Medical Indemnity AMA in the Media 70 Classifieds
imply endorsement by the AMA (WA) of
the views, service or product in question, 42 Beyond Borders 62 Travel Professional Appointments
and neither the AMA (WA) nor its agents
45 For the Record: 64 Wine & Positions Vacant
will have any liability for any information
contained therein. Dr Allan Pelkowitz
May MEDICUS 1
PRESIDENT’S DESK
Dumb, desperate attempt to
save dollars
by Dr Richard Choong
AMA (WA) President
Regular readers of these monthly reports would know that than just mining? How will it help?
overall I have been impressed by our elected officials, Within hours of the decision being announced I was calling
and many of my previous views and concerns about the base this decision “stupid”, “sneaky”, “dumb”.
personal makeup of politicians as a profession have fallen On the basis of this one decision alone, Australia is in the
away. After seeing them up close over the last year, including final for a gold medal in the Dumb Nation Olympics, and
working closely with a number of them, I changed my view. proves that the only thing to discuss in the run-up to the
I actually began to believe that the great majority of our next election is whether the current Federal Government is
politicians were – basically – attempting to work for the good attempting a “scorched earth” policy.
of their state or their nation. Many doctors must do at least one course a year in order to
Until now that is! With just one decision, my frustration, maintain their qualifications, which can often cost in excess of
suspicion and fear about politicians has returned and it may $3000.
never recover. I can once again understand the views of many For example, the Australian and New Zealand Surgical
of my patients that the definition of politician should include Skills Education and Training (ASSET) program costs
the words ‘stupidity’ and ‘selfishness’. $3280, the Care of the Critically Ill Surgical Patient course
Steps being taken by the Federal Government to limit the costs $2735, and a GP attending a Clinical Emergency
tax deduction for work-related education expenses actually Management Program (CEMP) workshops can face costs of
stagger my mind. Under these so-called “reforms”, it would over $3000.
appear the tax deduction for work-related self-education Medical students have also been vocal in their opposition to
expenses will be limited to just $2000 from 1 July 2014. the decision, calling them “irresponsible and ill-considered”.
How will this move assist in Prime Minister Julia Gillard’s President of the Western Australian Medical Student
repeated proclamation that her administration will be marked Society (WAMSS), Lee Fairhead, said the decision,
by a concentration on education? How will it assist us become along with continued cuts to higher education, was part
a clever country? How will it assist in us planning a national of a “systematic erosion of funding and respect for higher
future based on more education”.
I am not aware of any person apart from members of the
current Federal Government forced to argue the indefensible
and defend this stupid decision who have supported this
decision.
As I said to the media, this decision will seriously affect
the quality of health care in Australia and drive medical
professionals from our shores. I also demanded that the
Federal Government reconsidered its ill-advised changes.
My prediction is that this issue will be a ‘slow burn’. It will
hurt a range of all professionals who need to continue their
training and their education throughout their careers. But it
may be some time until the message gets through to much of
the Australian population.
AMA (WA) members can be confident that we will not
only be attempting to change this decision in the run-up to
the September 14 Federal election but we will also be arguing
our case to the Liberal Party.
We have already called on the Federal Opposition
to pledge to immediately reverse the decision if it wins
government later this year and we have met with senior
opposition spokespeople to argue our case.
While the decision on this matter staggers me and
destroys any nascent views I may have been developing that
politicians are basically aware of the impact of any policy
Lesson not learned: The Labor Government targets Health
once again. In 2011, Medicus’ April cover was devoted to the Prime decision on the Australian society, your Association will never
Minister’s threatened cuts to research funding. stop fighting this ridiculous decision. ■
2 MEDICUS May
FroM tHE EDItor
Change brings
fear of the unknown
It is often said within these pages that the Australian Medical this new technology.
Association (WA) has public health as one of its major roles The Report, as its first recommendation, agreed that
in Western Australian society. TV should be introduced in Australia but “on a gradual
The famous quote “If not us, who?” comes to mind when basis.” The Report believed there should be strong control
we are approached by members of the public or media over any programming and that there should be a strong
organisations for comments about public health. Christian message, while two of the five commissioners
In the past few months for example, the AMA has taken believed TV broadcasts should be limited to a maximum of
a strong stand on a myriad of issues – from the importance 30 hours a week.
and value of immunisation; the dreadful decision taken by the Some of the material in the report is frightening
Federal Government to “dumb down” Australian universities particularly in its fear of televised violence – a message
by spending cuts; and the dreadful practice of female genital commonly heard today.
mutilation and the strong action by the WA State Government. For example, it details research done in Chicago
We not only spoke to the media and the public about these from one Christmas morning to New Year’s Eve, which
important issues, but we advised the profession about changes measured violence during children’s programming.
in health including the legal responsibilities of GPs. According to the research, “There were 295 violent
On these and other issues, if it wasn’t the AMA taking a crimes including 93 murders, 78 shootings, 9 kidnappings,
strong common-sense medical stance there would be no one in 9 robberies, 44 gun fights, 2 knifings, 33 sluggings, 2
the health space, with the possible exception of the WA Health whippings, 2 poisonings and 2 bombings.”
Department with its myriad of PR people – whose sole aim it On this sort of evidence it is no wonder the Royal
sometimes appears, is to reduce the amount of information Commission recommended strong censorship, especially
available about health. during children’s programming while one Commissioner
And as an organisation that is involved in the provision of even argued there be a blank screen shown for one hour
health and especially public health issues, part of the AMA’s after a children’s program to ensure that any child would
role is identifying new or neglected areas that need public and leave the immediate TV environment.
government examination and action. The Royal Commission came to mind when reading
For example, our award-winning organisation Dr YES the article on page 53 of this month’s Medicus about social
has identified an issue of growing importance – the impact media, its use and its impact on young people. There is no
and spread of social media in the community, and the special way we can block access to social media – it is a wonderful
pressures, social media can create for the younger members of and in fact, fantastic way for people to connect with each
society including cyberbullying. other around the world.
The impact of technology on society is fascinating to watch. Social media has already had a major impact on the
And at times, very predictable. globe and the world’s population, not just socially but
There is a natural human aversion to change and through politically and economically. But like the introduction
history, people have feared the impact of technological change of almost every new technological development there are
on their lives. negative impacts.
Just as an example, when libraries began in England in the With change – it seems – comes fear of the unknown.
1800s, publishers warned about the social impacts of making But the example of Dr YES in this space is a good one.
information too freely available, nervous about their bottom The Dr YES students involved identified the negative
line if books were made available for free! impact of social media years before it became fodder for
When radio was first introduced, the gramophone industry commercial TV current affair programs and took action by
tried to fight it. developing tools for young people to handle this growing
One of my best bookshop purchases in recent years was the part of their lives.
report of the little known Australian Royal Commission on The issue is once again not to try and ban a
Television, held in 1954 – almost 60 years ago. technological change in our lives but to identify an issue
The Royal Commission was established to look at and to provide ways to handle the negatives as well as enjoy
whether, and if so how, television should be introduced in the positives.
Australia. The Report gives a fascinating mirror into the And once again it has been the role of the AMA to
very real community and industry fears of the impact of identify and act on an important public health issue. ■
May MEDICUS 3
EVEnt
Catching up: AMA (WA) President
Dr Richard Choong with Deputy Leader
of the Opposition, Roger Cook MP.
(Below) Sean L’Estrange, A/Prof Rosanna
Capolingua, Don Randall MP and
David Malone.
President’s Cocktail Party
Dr Richard Choong chose the occasion of the annual Randall. The Association was especially honoured to welcome
President’s Cocktail Party to remind attendees that his newly-elected Members for Alfred Cove and Churchlands, Dean
presidency of the Australian Medical Association (WA) was Nalder and Sean L’Estrange respectively.
based on the tenet of representation of the whole medical Health heavyweights at the cocktail function included
profession, but with a particular focus on General Practice and Professor Mike Daube, Associate Professor Rosanna Capolingua,
membership. Professor Geoff Dobb, Dr Shane Kelly, Peter Mott, Dr David
“I believe that General Practice is essential to the delivery of Russell-Weisz and Dr Michael Stanford, among many others.
health care in WA; however General Practice remains outside of During his speech, Dr Choong highlighted that for the first
the health focus in this State,” Dr Choong told the 150-strong time in WA’s history both positions of Health Minister and
gathering. AMA (WA) President were being held by GPs – a fact which
Listening on at Matilda Bay Restaurant were some of the encouraged him to believe that change for General Practice in
biggest names in state and federal politics, and of course, health. particular, was imminent.
The AMA was pleased to host Minister for Environment and Dr Choong also pointed out that much work was still needed in
Water, the Hon. Bill Marmion who also represented the Premier; the areas of Research and Rural Health.
Deputy Leader of the Opposition, Roger Cook; Minister for “During my second term as President, I will continue to push
Mental Health, the Hon. Helen Morton; Federal Member for these issues for they are key to sustaining and improving the
Durack, Barry Haase; and Federal Member for Canning, Don health system that we all enjoy,” Dr Choong said. ■
4 MEDICUS May
EVEnt
1. 2.
4.
3.
5.
7.
6.
8.
9. 11.
10.
13.
12.
14.
1. Dr Michael Stanford and Dr Keith Woollard. 2. Phil Aylward and Commissioner Eddie Bartnik 3. Dr Lachlan Henderson, Peter Mott and
Dr Simon Towler 4. Dr Cassandra Host and Dr Sam Messina 5. Dr Neale Fong and Prof Paul Johnson 6. Professor David Mackey and
Bill Marmion MP. 7. Dr Rob McNamara, Dr Melita Cirillo and Dr Ruth Blackham. 8. Don Randall MP and Dean Nalder MP. 9. Dr Marcus Tan
and Mrs Carolyn Choong. 10. Dr Dror Maor and Dr Daniel Heredia. 11. Lynnie Butler and Barry Haase MP with Dr Richard Choong. 12. Dr David
Russell-Weisz, A/Prof Dave Mountain and Prof Mark Khangure. 13. Prof Michael Quinlan and Prof Bernard Pearn-Rowe.
14. Dr Scott Blackwell and Dr Janice Bell.
May MEDICUS 5
In DUStrIaL
NegotiatioNs
for New eNterprise agreemeNts at
the royal flyiNg Doctor service aND
at st JohN of goD hospital, murDoch
The AMA (WA) is about to commence negotiations
to replace current agreements that apply to medical
practitioners employed at
St John of God Hospital, Murdoch and at the Royal Flying
Doctor Service.
The current agreements that apply are the St John of
God Hospital Murdoch AMA Medical Practitioners Industrial
Agreement 2011 (the SJOG Agreement) and the Royal Flying
Doctor Service of Australia (Western Operations), Medical
Practitioners Industrial Agreement 2011 (the RFDS
Agreement).
Both agreements expire on 30 September 2013.
The AMA is interested in the views of members
covered by the above agreements as to:
• What salary adjustments should be made
• The effectiveness of the current agreement
• Whether there are areas for improvement
• New matters that you think need to be addressed or
rectified in some way.
The AMA is simultaneously negotiating a Agreement and the other public sector agreements
replacement agreement for the Department of Health mentioned earlier will inform negotiations for the SJOG
Medical Practitioners (Metropolitan Health Services) and RFDS Agreements.
AMA Industrial Agreement 2011 (the MHS Agreement) The Association will keep members informed of
that will cover all medical practitioners employed in progress as the process unfolds. In the meantime we
public hospitals. At the same time other public sector would welcome member comment about key issues of
agreements are also being negotiated for Clinical concern to you in current SJOG and RFDS Agreements.
Academics, doctors working for WA Country Health If you would like to seek information or feedback about
Services, the Department of Health and the Drug and progress in any set of negotiations or to make a comment,
Alcohol Office. please contact Marcia Kuhne or Clare Francis at the
The result of negotiations for the replacement MHS Association on 9273 3000. ■
Workforce
survey
As part of the national registration process, the The AMA has been working with HWA to improve
Australian Health Practitioner Regulation Agency the quality of data with respect to postgraduate training
(AHPRA) and the National Boards make available positions for this year’s medical registration process. More
a workforce survey, which each health practitioner robust data will allow more accurate quantification of the
is requested to complete at the time of their annual number of trainees in the system and will provide some
registration renewal. estimation of latent training capacity.
Health Workforce Australia (HWA), in collaboration If you can spend 10-15 minutes completing the online
with AHPRA and the relevant National Board, is survey and providing feedback, please email [email protected].
responsible for managing the content of the workforce au or phone Deborah Brown on [phone] for further
survey. details. ■
6 MEDICUS May
nE wS
PCEHR Indemnity Insurance policy (PIIP), subject to the policy’s terms
and conditions.
update
While the policy already responds to most of these risks, from
1 July this year, the policy will be extended to cover the
The Personally Controlled Electronic Health Record replacement and restitution of destroyed, deleted, corrupted or
(PCEHR) has been gradually rolled out to the medical modified electronic documents and data pertaining to the health
profession since the end of 2012. To be eligible for the PIP care services.
e-Health Incentive, practices are required to meet specific However before you opt in or decide to participate in the
requirements, including having applied to participate in the PCEHR, you should also consider that if your practice (entity)
PCEHR. It is recommended to visit http://www.medicareaustralia. is a party to the PCEHR contract, the entity itself along with
gov.au/provider/incentives/pip/updates.jsp. your employees may be exposed. The MDA National Insurance
Practice Indemnity Policy (http://www.mdanational.com.au/
MDA NATIONAL HAS IDENTIFIED SOME KEY RISKS:
apply-now/practice-indemnity-policy.aspx) is designed to cover
As the PCEHR program is still in the very early stages, the extent
health care entity and its employees for such risks, subject to the
of the exposures that face medical practitioners who participate
terms and conditions of the policy.
in the initiative are not fully known. However MDA National
has identified some key risks. While not unique to the PCEHR,
BE AWARE OF YOUR OBLIGATIONS: Another possible
the following risks are worth consideration in the context of this
exposure facing medical practitioners participating in the
new mode of storing, communicating and accessing patient
PCEHR are fines and penalties that relate particularly to the
information:
administration of the PCEHR. You should be aware of the
• Privacy breaches
obligations that apply to you and your staff before opting in.
• Intellectual property disputes
As with all contracts, if you have any doubts about what you
• Allegations of negligence for failing to detect critical patient
are agreeing to, it may be worthwhile taking legal advice. MDA
information contained within the PCEHR
National Insurance policies do not provide cover for fines and
• Loss or corruption of electronic documents or data.
civil penalties.
GOOD NEWS FOR MDA NATIONAL MEMBERS: The Please contact MDA National’s Medico-legal Advisory Services
good news for MDA National members is that from 1 July 2013, for further clarification on 1800 011 255 or
there is cover for each of these risks under the Professional [email protected]. ■
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nE wS
AMA (WA) President discusses FIFO health
with Tony Windsor MP
The health impacts of Fly-in, Fly-out have been
an issue of great importance to the Australian
Medical Association (WA) over the past two years
– and it remains on your Association’s radar as an
area of key interest to all medical professionals.
In recent weeks the AMA took part in a major
seminar on FIFO, organised by The University of
Western Australia (UWA), and also had a formal
meeting with the Chairman of the Parliamentary
Committee that has recently released its report on
the practice.
Since the announcement in 2011 of an inquiry
by the House of Representatives Committee on
Regional Australia into FIFO/Drive-in, Drive-
out (DIDO), we have taken a strong and active Sharing concerns: AMA (WA) President, Dr Richard Choong and
involvement in the subject. Chairman of the Parliamentary Inquiry into FIFO, Tony Windsor MP.
When the Parliamentary Inquiry into FIFO/
DIDO was originally established by Federal at a UWA event, chaired by the editor of WA Business News, Mark
Parliament, its focus was business and not health. Beyer; the CEO of Roebourne Shire, Chris Adams; a spokesman
By the end of the campaign spearheaded by the AMA (WA), of the Chamber of Minerals and Energy, Bruce Campbell-Fraser;
health and health-related issues were at the forefront of the debate. the Head of the UWA School of Earth and Environment, Professor
In fact, eight of the final 21 recommendations of the Committee’s Matthew Tonts; and Director, FIFO Families, Nicole Ashby.
report, related to health – many of them mirroring the AMA After the forum, the opportunity was taken to meet the
(WA)’s arguments. Chairman of the Inquiry, Tony Windsor, and discuss progress of
As the AMA (WA) has always said, FIFO is a reality. It is not the inquiry’s recommendations and a range of other issues around
something we can turn away from. After all, it has existed in WA as FIFO, especially the need for further research into the use of FIFO
long as we have been a State. and its health impacts.
But as we have also said repeatedly, it’s the impact of FIFO While Mr Windsor has become particularly well-known in
that needs to be examined – on individuals, on employees, on recent years mainly due to his power as one of the four independent
communities and on medical professionals, whether they be members of Federal Parliament currently supporting the
General Practitioners battling to find staff or pay high rent in a Government, his involvement in the FIFO issue has given him a
mining community or an emergency expert in a public hospital new national prominence.
handling an influx of mining personnel. AMA (WA) President Dr Richard Choong used the meeting
This advocacy is ongoing, with recent meetings with the with Mr Windsor to argue that without research, all those involved
Committee Chairman and other politicians to ensure that the in FIFO were talking without firm empirical evidence and it was
Federal Government reacts to the Committee’s recommendations important to encourage the Federal Government to fund research
as quickly and as fully as possible. projects as quickly as possible.
Just a few weeks ago, the AMA was able to make its view known This could be done, Dr Choong said, quickly and did not need
the Federal Government to oversee
the research projects. This could be
achieved by directing money directly
to universities or to the NHMRC for
distribution, based on the quality of
proposed research projects.
Fly-in Fly-out has always been
an important part of business and
corporate life in WA – and has
become vital to the continuing
economic health of our State.
However it is also an area of health
Varied views: Panelists at the FIFO seminar included (L-R) Chamber of Minerals and and therefore, we are strongly
Energy spokesman, Bruce Campbell-Fraser; FIFO Families Director, Nicole Ashby; CEO
involved in advocating on the
of Roebourne Shire, Chris Adams; and Head of UWA School of Earth and Environment,
Professor Matthew Tonts. issue. ■
8 MEDICUS May