Mental Health Crisis: WA's burden, WA's shame - AMA WA

84 Pages·2013·21.9 MB·English

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WESTERN AciaUSTRALIA WESTERN AUSTRALIA
tio Journal of the Australian Medical Association WA | November 2013 Volume 53 / Issue 10 | amawa.com.au
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Untitled-2 1 30/10/13 4:00 PM
Council
President
Complimentary November 2013
Dr Richard Choong
Immediate Past President
A/Prof David Mountain
Vice Presidents
Dr Michael Gannon C o n tE n t S
Dr Andrew Miller
travel insurance Honorary Secretary
Dr Omar Khorshid
Assistant Honorary Secretary
Dr Janice Bell
Honorary Treasurer
Professor Bernard Pearn-Rowe
Councillors
not only for you but for your family as well – Division of General Practice (WA)
Prof Bernard Pearn-Rowe
now that’s out of the ordinary A/Prof Rosanna Capolingua
Division of Specialty Practice 54
Dr Tony Ryan
Prof Mark Khangure 34
Division of Salaried and State
Government Service
Dr Cassandra Host
Dr Daniel Heredia Dr YES Charity Golf Day
Dr Dror Maor
Operation Burn-Out
Ordinary Members
Prof Gary Geelhoed
Dr Stuart Salfinger
Dr Marcus Tan
Co-opted Members
Dr Steve Wilson
A/Prof Frank Jones
A/Prof Peter Maguire
Prof Geoff Dobb
22
Dr Cassandra Host
Dr Melita Cirillo 44
Dr Ian Jenkins
Prof Ian Puddey
Prof Gavin Frost
Travel should be something you enjoy to the full, so
Dr Alexandra Welborn
Cover Story:
Investec has come up with a credit card that allows Ms Lee Fairhead
Ms Tahira Bhatti The Mess of Mental Illness Profile: Dr Edwin Kruys
you to do just that.
AMA (WA) Office
Not only will you receive uncapped Qantas Points* on every
Executive Director
dollar of eligible spend, but if you use your card to buy your Mr Paul Boyatzis
Director: Industrial & Legal FEatU rES
return travel tickets too, you will receive complimentary travel Ms Marcia Kuhne
insurance for you and your family^ when travelling together. Executive Officers
Mr Michael Prendergast
Ms Christine Kane
Ms Clare Francis 40 Tomorrow’s Health 63 Vision, determination, dignity
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www.amawa.com.au
Medicus rEGUL arS
Editor and Director of
Communications
Mr Robert Reid
Deputy Editor
02 President’s Desk 40 Tomorrow’s Health 63 History
Ms Janine Martin
Advertising Inquiries 05 From the Editor 44 Profile: Dr Edwin Kruys 64 Travel
Phone Mr Des Michael [phone]
Copy Submissions 06 Industrial/Policy 49 Opinion
66 Food
Phone Ms Janine Martin [phone]
09 AMA Medical Products 51 For the Record:
or [email protected] 67 Wine
Professor Tim Jones
Out of the Ordinary™ Services 11 AMA Recruit 69 Drive
52 Opinion
Business Services Manager 12 Events 70 M ember Benefits
Ms Noelle Jones 54 Dr YES Charity
Financial Services Manager 14 News & On the Town
Golf Day
Mr John Gerrard 22 Cover Story: The Mess 72 Classifieds
Medical Products Manager 59 Mailbag
Mr Anthony Boyatzis of Mental Illness Professional Appointments
HCoommem leoracniasl a| n Cda irn fdinuastnrciael p| r Torpaenrstay cfitnioannacle b a| n Ekqinugip amnedn ot vaenrdd rfaitf-tosu t| fSinaavnincges |a nSdM dSeFp loesnidtsin g| aCnredd dite cpaorsditss | | F Inocreoimgne epxrcohteacntgioen | a Gndo olidfew iinlls aunradn pcreactice purchase loans HAuesatltrhal iTar aMinainnagger 31 Opinion 60 AMA in the Media & Positions Vacant
Mr Geoff Jones 34 Special Feature: 61 WAGPET 77 Greensheets
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Terms and conditions, fees and charges may apply. We reserve the right to cease offering these products at any time without notice. Investec card Insurance is underwritten by ACE Insurance Limited Operation Burn Out 62 Technology 80 AMA Report Card
(ABN 23 001 642 020, AFSL No. 239687) (ACE) and is subject to the terms, conditions and exclusions contained in the Investec Credit Card Insurance policy of insurance between Investec The publication of an advertisement,
(ABN 55 071 292 594, AFSL & ACL 234975) (Investec) and ACE. This promotion does not take into account your objectives, financial situation or needs. It is important for you to read the Terms and Conditions article or inclusion of an insert does not
available at http://investec.com.au/cards and consider the appropriateness of that insurance in relation to your individual requirements. When you purchase your return travel tickets on your Investec card imply endorsement by the AMA (WA) of
you, your family if travelling together, will automatically have access to travel insurance for trips of up to 90 days. ^ Definition of family includes your spouse and dependent children.
the views, service or product in question,
*Qantas Points are earned in accordance with the Investec Qantas Rewards Program Terms and Conditions available at investec.com.au/cards. You must be a member of the Qantas Frequent Flyer program
and neither the AMA (WA) nor its agents
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Untitled-2 1 30/10/13 4:00 PM
PRESIDENT’S DESK
GPs frustrated by
floundering NeHTA
by Dr Richard Choong
AMA (WA) President
Ia m frustrated. And what’s worse than one
frustrated GP? Twenty-eight thousand
frustrated GPs.
I speak on behalf of most of my
colleagues when I say that contrary to its
name, the National eHealth Transition
Authority (NeHTA) is a bonafide study in
‘inexpertise’.
NeHTA has sunk a mass of money to
develop the digital capability of Australia’s
health system, but to what end? In the
absence of a use for the capability, all
that technology is as useful as a pair of
board shorts in Tony Abbott’s closet. As
technology continues its incredible march
forward, what is current today could be to see each day. could be progressively expanded, in keeping
worthy of the museum tomorrow. It appears the SHS shifts the focus from with infrastructure and capability.
About 650,000 patients around the caring for the patient in front of you to the To put things into perspective – we
country have been enrolled into the creation of a ‘shared’ document. Many wanted a cart, we were delivered a very
Personally Controlled Electronic Health patients will find it confronting that details expensive sportscar. What we’ve really
Record (PCEHR), and as of August 2013, of their health management will be open for created, however, is an elephant and if I was
just 5000 Shared Health Summaries had scrutiny and review by others. a betting man, I’d wager a fair few dollars
been created. There still exists a healthy cynicism that elephant is as pale as the paper I am
The role of the Shared Health Summary that notching up user numbers to justify writing on.
(SHS) is to assist in the management of the its expense remains the real driver behind We have now reached a point in the
chronically ill, those suffering from mental the PCEHR’s promotion – not its clinical lifecycle of NeHTA and the PCEHR – a
health illnesses, locums and ‘frequent usability. defining moment if you will. Our new
flyer’ patients. While these numbers have There is a glut of information which is Federal Government has questioned the
probably changed over the past couple of expected to be loaded onto these Shared program, the clinical leads – our colleagues
months, they still represent only a smidgeon Health Summaries. For example each year – have walked out en masse, and NeHTA is
of the community. there are 8 million discharge summaries floundering.
Perhaps of greater concern is that and 130 million consultations. The volume Earlier this month, Federal Minister for
although 80 per cent of those general of information generated by these episodes Health the Hon. Peter Dutton announced
practices which are eligible for the PIP have of care is enormous. a review into the PCEHR. I welcome it, but
become complaint for the ePIP initiative, However the Department of Health will stop short of expressing any hope. Like
and 98 per cent of General Practice is (DoH) expects even more information to so many other reviews and inquiries, this
computerised to some extent, this has not be crammed into the SHS. It proposes that too will only tell us what we have known
translated to the promotion of the PCEHR. all results from radiology and pathology from the very beginning – the PCEHR as
Only 0.02 per cent of the population has an investigations be loaded onto the system designed is a lost cause.
SHS, which begs the query: why have GPs – not by the providers, but by general Yet the review will contain much rhetoric
not engaged with this process? practices. about the good intent to unify health on one
The answer lies in the question itself – What makes all of this so disappointing technological platform and what the future
GPs have not been engaged. is that while the founding concept of an will hold.
There has been token engagement, but I electronic health record is sound, delivery In this case, I’m quite certain that the
am certain the 28,000 GPs who practise in has been flawed. The development of future of the PCEHR will remain rooted in
Australia feel neither involved nor valued. a health record should be a progressive its confused past.
What they do feel – and strongly too – is venture. A reasonable starting point would So I conclude this column just as I began
that the SHS will likely not benefit GPs. have been simple functionality such as – one frustrated GP.
In fact, it is expected that the SHS will patient allergies. Once the systems are in
increase a GP’s workload and as a result will place, and both patient and doctor have For more on the PCEHR, see pages
reduce the number of patients a GP is likely become used to the process, functionality 17 & 44. ■
2 MEDICUS Novemeber
Apology and Retraction
TO: The Australian Medical Association (WA) Incorporated
Mr Paul Boyatzis
Associate Professor Rosanna Capolingua
Professor Bernard Pearn-Rowe
We, Dr Robert McEvoy, Ms Jenette Heyden and Rakabee Pty Ltd [being the company through which we publish
Medical Forum WA magazine (Magazine) and maintain the website at www.medicalhub.com.au (Website)]
published an article in April 2011 concerning the AMA WA, Mr Boyatzis, Associate Professor Capolingua and
Professor Pearn-Rowe.
We each now accept that the article contained some material that was without foundation and that we
unreservedly retract and which may have led readers to draw damaging conclusions about AMA WA,
Mr Boyatzis, Associate Professor Capolingua and Professor Pearn-Rowe.
We apologise for any damage the article has caused AMA WA, Mr Boyatzis, Associate Professor Capolingua and
Professor Pearn-Rowe.
We also accept that Mr Boyatzis, Associate Professor Capolingua and Professor Pearn-Rowe were hurt and
distressed by some subsequent articles we published and we regret this.
Dr Robert McEvoy Ms Jenette Heyden Rakabee Pty Ltd
Date: September 2013
The AMA (WA) is pleased to report that legal proceedings in the Supreme
Court of WA has been settled on commercial terms satisfactory to all parties
and without any admission as to liability. An apology has been provided as
printed above. AMA (WA) has recovered its costs.
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EDItor ’S LEttE r
new
What really makes a
new hospital?
hospital?
An ewly-built hospital is a marvel of performed during a surgical procedure.” If only we had the same number of
modern medicine. Every new piece Of course, there would be public press releases issued about the number of
of equipment, every door, every floor outrage if the State Government saw staff or the division of beds – but that is
tile, food court, operating theatre or bed fit to announce that the world’s best another argument.
gleams as though their very construction equipment was not being purchased or The AMA (WA) does not begrudge
alone can help patients get well. had been sourced from another state or the many spinmeisters of the Health
Even before patients, doctors and an overseas health system, or indeed that Department their days in the sun – we
nurses move in, the equipment and fit- “high quality” fixtures were not being welcome the construction and fitting out
out seem to be ready to heal and provide installed. of any new medical facility with all the
health benefits beyond the dreams of The use of robotic equipment for energy, support and excitement that we
most of us even a few years ago. example is now an accepted and expected can summon. The fact that we as a state
Interestingly the roll-out and opening procedure. Still worth trumpeting in a and as a society can afford to purchase
of each new hospital brings with it an press release? Absolutely, but not entirely the very best equipment for our new
avalanche of press releases. Every day unexpected all the same. hospitals, themselves some of the very
new announcements from doctors – best in the world, is something to be
spin doctors in this case – arrive in our Let us not forget celebrated.
inboxes, both real and electronic. that state-of-the-art However it is vital that we also
In fact it is now accepted that before remember the reality of all this new
medical technology
you can even start the construction of a equipment.
and equipment still needs
new hospital, you must first put together Let us not forget that state-of-the-art
an even more highly-skilled
a suitably skilled team of public relations medical technology and equipment still
professionals, not to build, but to spin! pair of hands to use it needs an even more highly skilled pair of
In Western Australia over the last hands to use it.
few months we have seen press releases Since the construction of the Fiona These hands and brains have to be
from the public affairs departments of Stanley Hospital was announced by a trained not just in the basic physiology
each new hospital pushing their song of Labor Government some years ago, but how to best use some of the most
more money, more machines, and more governments of both parties have complicated equipment ever placed in
“advanced medical equipment” worth claimed it would be one of the most any building in our State.
many millions of taxpayers’ dollars. technologically-advanced hospitals in the These hands and minds are trained
As an example, Health Minister Kim world, so the purchase and installation over many years so they can not only
Hames issued a press release early in of the most technologically-advanced operate this equipment and make it work
October proudly proclaiming more high- equipment in the world has therefore at the very best level but to explain to
tech equipment – in this case for Fiona somewhat been expected. those who have arrived at the hospital as
Stanley Hospital. And these press releases will continue patients, what the results actually mean.
“The high-tech imaging equipment over the next 12 months as the staged The AMA (WA) has supported health
and a powerful X-ray system for opening of FSH is rolled out. professionals for more than a century and
cardiology and vascular procedures are We will hear repeatedly that FSH is will continue to do so into the future.
among more than 300 pieces of major the centrepiece of the government’s $7 We will therefore always remind the
equipment already purchased for the billion hospital construction program spin doctors (who seem to be multiplying
hospital,” the release said. and the FSH includes almost 6500 in the health system quicker than a virus
According to the press release, Fiona rooms, more than 100km in power and in a petri dish) and the government itself
Stanley Hospital is the first public cable lighting and 4400 timber doors! that while good equipment is important,
hospital in WA to install the Siemens Expect soon to read about the number skilled, properly-remunerated and fully-
Artis Zeego imaging equipment in a of light bulbs, nails, glue guns and paint trained individuals are the real key to
hybrid operating theatre, “which allows brushes used as the final touches are excellence in healthcare into the 21st
high-quality radiological imaging to be applied. century. ■
November MEDICUS 5
InDUS trIaL/PoLICY
Travel, conference and sTudy leave
sponsorship invesTigaTions
The issue of health staff attending referred to in the letters, namely the to work with the Department to produce
educational activities sponsored ‘Attendance at Functions and the simpler policies to alleviate the burden on
by various companies, particularly Acceptance of Gifts, Prizes or Inducements practitioners.
pharmaceutical companies, is again Policy’. This policy is no longer MDA National legal advisors are of
under scrutiny. A number of doctors operational. the view that the letters practitioners have
are understood to have recently received The Association is aware that the been receiving could be construed as
letters from the Corporate Governance policies mentioned above are cumbersome unfair, given that the sponsorship referred
Directorate requesting: and has been working with the Department to in the letters occurred some time ago,
• Confirmation of receipt of a of Health to simplify the processes. The and that, due to complicated and overly
particular gift or benefit AMA (WA) has recently been successful bureaucratic processes, practitioners were
• Identification of the steps taken to in persuading the Department of Health confused as to requirements imposed
obtain approval of the gift or benefit to remove the requirement whereby under the applicable policy at the time.
• Explanation of the circumstances practitioners attending self-funded The Association plans to write to the
relevant to the offer and acceptance conferences needed to complete travel Acting Director General on these matters
of the gift or benefit forms. It is hoped that more improvements and hopes to work with the Department to
• Disclosure of all information will be adopted by the Department before improve the current policy so practitioners
concerning the receipt of any other the updated policy is released. have a clear understanding of their
previously undisclosed gift or The numerous policies have, obligations under the policy.
benefit. understandably, resulted in some confusion In the event that you have received
These letters follow an audit conducted for practitioners, many of whom have correspondence from the Corporate
by the Auditor General on pharmaceutical indicated to the Association and MDA Governance Directorate relating to this
company sponsorship. The Association has that they were not aware that acceptance matter asking you to provide evidence
spoken with the Director General about of sponsorship to attend professional of compliance, the Association advise
these letters and has been assured that development events came within the scope that practitioners should endeavour to
the audit did not identify any fraudulent of the gift policy. reply to the correspondence in the form
behaviour on behalf of doctors. It appears Practitioners have also expressed requested as soon as is reasonably possible.
that these letters have in the main been sent their general frustration that acceptance If practitioners are having difficulties
to those practitioners who did not complete of sponsorship to attend professional responding within the timeframe
the relevant paperwork at the time of events is being questioned. Attendance at requested, please do not hesitate to contact
attending the conference or event. these events forms an integral part of the the Association or MDA National who will
The Department of Health currently practitioners’ obligation to participate in assist with drafting and applying for an
requires practitioners to adhere to ongoing professional development, and extension if necessary.
the following policies when receiving results in the practitioners gaining valuable Given the politics surrounding
sponsorship to attend conferences or education and knowledge in their field, this issue, if members are concerned,
events: which in turn benefits their patients and the please seek professional advice from the
• WA Health Acceptance of Gifts WA Health system. From the Association’s Association and/or your medical defence
Policy standpoint, subject to appropriate organisation to assist in drafting an
• WA Health Staff Air Travel Policy safeguards, sponsored attendance is a cost- appropriate response.
• WA Health Managing Conflict of effective means for health professionals Any enquiries should be directed to
Interests Policy to maintain and enhance their skills for Marcia Kuhne, Clare Francis or Nicola
There was also an additional policy the betterment of the WA Health system. Bazzoni at the AMA (WA) or Philippa
which applied during the timeframe The Association will, therefore, continue Nash at MDA National. ■
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