Sleep on it: Disorders, research, medicine. - AMA WA

80 Pages·2014·22.3 MB·English

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006483 Medicus Full Page Ad.indd 1 30/04/2014 1:13 pm
Council
President
May 2014
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
Honorary Secretary
Dr Omar Khorshid
Assistant Honorary Secretary
Dr Janice Bell
Honorary Treasurer
Professor Bernard Pearn-Rowe
Councillors
Division of General Practice (WA)
Prof Bernard Pearn-Rowe
A/Prof Rosanna Capolingua
Division of Specialty Practice
04
Dr Tony Ryan
Prof Mark Khangure
Division of Salaried and State
Government Service
Dr Cassandra Host
Dr Daniel Heredia
President’s Cocktail Party
Dr Dror Maor
Ordinary Members Strong AMA-Govt ties lauded
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
Dr John Zorbas 42 20
Dr Melita Cirillo
Dr Ian Jenkins
Prof Ian Puddey
Prof Shirley Bowen
Dr Alexandra Welborn
Mr Sebastian Leathersich Profile: Dr James Fitzpatrick Sleep on it
Ms Molly Kehoe A foot soldier for FASD Disorders. Research. Medicine.
AMA (WA) Office
Executive Director
Mr Paul Boyatzis
Director: Industrial & Legal
Ms Marcia Kuhne FEatU rES
Executive Officers
Mr Michael Prendergast
Ms Christine Kane
Ms Josphine Auerbach
IRRESISTIBLE TEMPTATION 17 No place to call Home 18 Immunisation update
14 Stirling Highway Homelessness is on the rise AMA (WA) action on
IRRESISTIBLE TEMPTATION Nedlands WA 6009 in WA immunisation and child care
MEETS IMPECCABLE TIMING [phone]
enrolment
[email protected]
MEETS IMPECCABLE TIMING www.amawa.com.au
Medicus rEGUL arS
Rarely do opportunities align so perfectly. Four of the most desirable and dynamic Comparison Editor and Director of
Communications
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irnatteel*.li gDernivt.e S tehee ycoaurr y Loeux’vues Dalewaaleysr bweafnotreed J,u wnieth 3 a0 .financial offering that is equally Advertising Inquiries 03 From the Editor 42 Profile: 63 Food
Phone Mr Des Michael [phone]
intelligent. See your Lexus Dealer before June 30. Copy Submissions 04 Event: Dr James Fitzpatrick 65 Wine
Phone Ms Janine Martin [phone]
President’s Cocktail Party 45 For the Record:
or [email protected] 67 Drive
Prof Gavin Frost
07 Industrial
Services 68 M ember Benefits
47 Opinion
Business Services Manager 09 News 69 O n the Town
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Mr Anthony Boyatzis 20 Cover Story: 53 Opinion & Positions Vacant
lexus.com.au Health Training Sleep on it 57 AMA in the Media 74 Greensheets
Australia Manager
Mr Geoff Jones 31 Opinion 58 Technology
359 Scarborough Beach Road, Osborne Park WA 6017
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must be received and approved between 1/5/2014 and 30/6/2014 and vehicles registered and delivered by 30/6/2014. Maximum  nance term of 36 months applies. A balloon  nal payment option is available up to a maximum of 40%. Additional interest charges accrue whenever a balloon  nal payment and neither the AMA (WA) nor its agents
option is selected. Conditions, fees and charges apply. Comparison rate based on a 5 year secured consumer  xed rate loan of $30,000. WARNING: This comparison rate is true only for the examples given and may not include all fees and charges. Different terms, fees or other loan amounts might result in
*a 1d.8iff%er ecnotm cpoamripsaornis roante r aatvea. iLlaebxleu st oF ianpapnrcoiavle Sde Prveircseosn iasl aA dpipvilsicioann tos fa Tnody oat 1a.8 F%ina anncneu Aalu psetrracleian Ltaimgeit eradt eA iBs Nav a4il8ab 0le0 t2o 4ap3p5r o18ve1,d A BFuSsLin aensds AApusptlricaaliannts C ofr eLdeixt uLsic Feinnacnec 3ia9l 2S5er3v6ic.e Lse fxour st hree se nravnecsi nthge o rfi gnhetw to C eTx,t EenSd ( 2a0ny13 o fbfeuri.l dF ionnalnyc),e G noSt a tnod b Re Xus medo dine clso wnjhuinlec stitoonc kwsi tlha stth. eE xLcelxuudse Cs doermpoornastetr aPtroorgs.r aFmina. nce 0ap5p0li6ca14tio-2n7s will have any liability for any information
must be received and approved between 1/5/2014 and 30/6/2014 and vehicles registered and delivered by 30/6/2014. Maximum  nance term of 36 months applies. A balloon  nal payment option is available up to a maximum of 40%. Additional interest charges accrue whenever a balloon  nal payment contained therein.
oa pdtiifofenr eisn st ecloecmtepda.r iCsoonn draittieo.n Lse, xfeuess F ainnadn cchiaalr Sgeersv aicpepsl yis. Ca odmivipsiaornis oonf T roayteo tbaa Fsienda nocne a A 5u syteraalri as eLcimurietedd c AoBnsNum 4e8r 0 x0e2d 4ra3te5 l o18a1n, AofF $S3L0 a,0nd0 A0u. WstrAalRiaNn ICNrGed: iTt Lhiisc ecnocmep 3a9ri2so5n3 r6a.t eL eisx tursu ere osnelryv efosr t thhee r eigxhatm top leexst egnivde na nayn do fmfear. yF ninoatn icnec lundoet taol lb feee uss aendd in c hcaorngjuens.c Dtioifnfe wreitnht ttherem Lse, xfeues sC oor roptohreart elo Panro agmraomu.n ts m0ig5h0t r6e1s4u-lt2 i7n May MEDICUS 1
006483 Medicus Full Page Ad.indd 1 30/04/2014 1:13 pm
PRESIDENT’S DESK
Fights fought and lessons learnt
by Dr Richard Choong
AMA (WA) President
The past 24 months have been research capacity, and a state that is no are more GPs, more doctors in rural
the busiest of my life – juggling longer relevant. and regional WA, and growth in some
the duties and responsibilities that Improving capacity and access to of our specialist craft groups. A new
come with being President of the care within rural and regional WA has medical school by Curtin University
AMA (WA), practising as a GP in the also remained at the top of the priority will not deliver these outcomes.
burgeoning city of Rockingham, and list during these past two years, and the Today, we are struggling to train, to
being a husband and a father. AMA has helmed a range of initiatives a world standard, the current cohort
The past two years have also been and interventions. Doctors – and their of graduates. Over the past six years,
the most rewarding – and challenging families – need to be well supported in WA’s two medical schools have rolled
– of my life and there are many life rural communities if they are to stay. out an increasing number of graduates
lessons that I have learnt. Of course, as a GP, immunisation – we now graduate 250 per cent more
From the time I was elected has, and always will be, a subject close medical students than we did in 2008.
President in mid-2012, the AMA’s to my heart. And I’m glad to report Unfortunately the training pipeline
efforts have been heavily invested in that Minister Hames shares the view within WA Health has not widened
advancing research in WA, improving that much more needs to be done to concurrently. As a result, we do
rural health, mental health and capacity resuscitate WA’s abysmal immunisation not have the short- to medium-
issues, and fighting budget cuts. We rates. term capacity to train more medical
have been undeterred in that focus The AMA supports a more robust graduates.
– continuing it in the lead-up to the review of a child’s vaccination status at The AMA has picked apart the
WA State Election and through to the school entry age, but we are working proposal put forth by Curtin University
Federal Election. on implementing legislative change to with consistent and effective arguments,
The Association has been long ensure that unvaccinated children not demonstrating why a new medical
been a vociferous advocate for a better be allowed entry to childcare centres. school is a reckless move at this time.
mental health system in WA – one It is not about penalising children, but We will continue on this fight.
that isn’t straining and at times, even of informing parents to make wiser Forgive me if I end by tooting a horn
buckling under the burden of mental choices when it comes to the health on behalf of GPs everywhere. General
disease. The AMA (WA) has engaged of their children – and the health of Practice remains the cornerstone of our
with our membership in this regard and everyone. health system and GPs represent the
the response has been overwhelming. Along with the many advances we most efficient use of the health dollar.
Our message is consistent – we need have made as an Association, there has However General Practice is also seen as
more trained psychiatrists within the been the occasional challenge. One of the softest target from which to extract
system and particularly, improved the biggest disappointments during huge savings through budget cuts.
specialist psychiatrist-based care within my term as President has been the It may well be that General Practice
the community. government’s failure to add two extra is not directly funded by the State,
Equally if not more frustrating is floors to the new children’s hospital but all of our patients utilise state
the at-times blinkered view of the at the crucial construction phase. health services every day. There is a
government towards medical research. The new building will be a massive clear relationship and this needs to be
Yes, the government has not entirely improvement on the tired and ageing nourished.
forgotten about research, having sunk Princess Margaret Hospital, but will Over my term as President, I have
some money into such projects as the it be able to efficiently and effectively greatly enjoyed the many relationships
Perkins Institute – but it’s a long way meet the surging demand for paediatric that I have forged – and to all my
from adequate. services in the State? Sadly, no! colleagues and well-wishers, I say
I am certain that the Association – The Barnett Government has missed ‘thank you’.
under the new President, whoever that the opportunity to future-proof its To the incoming President of the
may be – will regularly remind the State paediatric services, and I strongly AMA (WA), I quote the very wise
Government of its need to significantly believe that we will live to regret this. words of former US President,
commit to medical research. The Also disappointing is the Barnett Thomas Jefferson:
fallout of an inadequate commitment Government’s stunning inability to “In matters of style, swim with the
is scary – an exodus of medical recognise that WA does not need a current; in matters of principle, stand
researchers from WA, an enfeebled new medical school. What we do need like a rock.” ■
2 MEDICUS May
FroM t HE EDItor
A quick fix that will cause
further breakdowns
For a few days last month, the Australian a delight and confirmed that Australia calculations), but will stop some people
Medical Association (WA) played really does have one of the best health from accessing healthcare.
host to a visiting general practitioner and systems in the world – with skilled medical Dr Choong warned co-payments were
his wife, a practice nurse, from the United professionals, manageable costs and a bad for patients and would add to pressure
Kingdom. climate in which health issues can be on public hospitals. It would also turn
The AMA was able to organise a visit resolved early and for the benefit of both general practitioners into tax collectors and
to a busy GP clinic in Perth’s Western the individual and the nation as a whole. would have a substantial knock-on impact
Suburbs and explain some of the intricacies And yet the recent National Commission on emergency departments.
of the Australian medical system. of Audit report, released just a few days State Governments would not
The visitors talked extensively to a Perth before the 2014-15 Federal Budget, takes a tolerate the additional costs created by
GP and their practice nurse, and were able completely different view, painting a picture patients moving from bulk billing GPs
to ask whatever question they wanted, both of a health system that is unsustainable and to emergency departments and would
on medicine in Australia as well as the a universal healthcare system that needs to be forced to impose some type of charge
Australian lifestyle. be abandoned or at the very least, changed – further potentially blocking or at least
The visiting medical professionals were in a substantial manner. slowing access to care.
brought to WA by the BBC, as part of a In just over 12 pages and after a very We accept that the health system will
popular UK television program, Wanted short period of research, the report’s change – nothing is static after all.But we
Down Under, described as a series in which recommendations have surprised many. do not want to throw the baby out with the
families and couples spend a trial week in This was captured most dramatically bathwater.
Australia or New Zealand before deciding in an opinion piece by award-winning Change of something so substantial and
whether to make the move for good. journalist Cathy O’Leary in The West so Australian as our world-respected health
The popularity of the program is Australian newspaper. Cathy writes: system should only be approached carefully
renowned and it certainly captures what is “The Commission of Audit’s proposed and after due consideration by all users as
the drive of many UK residents – to move health reforms seemed based on the well as those devoted to calculators.
to either Australia or New Zealand. premise that the system is badly broken. As Cathy O’Leary writes of the Report:
In fact, every year around 50,000 British But for all its shortfalls, the system is “It acknowledges the problem –
people take the leap and move to Australia working pretty well, given the huge tug of primarily the unsustainable growth in
or New Zealand in search of a better life. demands.” demand from Australia’s growing and
This is equivalent to around three jumbo She continues: “What we need is a ageing population – but some of the
jets departing the UK every week full of real drilling down to what is pushing up simplistic solutions, such as the co-payment
people looking to make a fresh start in demand and direct money there. Our to see a GP, fall well short of anything
either country. emergency departments can still improve vaguely useful.”
As this is, basically, a reality program, but generally they are a far cry from the I wonder what our UK visitors would
the TV producer wanted the visitor to chaos of only a few years ago. Patients still be thinking as they read of the proposed
describe what his frustrations were in the sometimes wait too long but there are no changes. The very system they are attracted
UK and what he hoped he would find if doubt reforms such as the four hour rule – by is being changed on the basis of 12 pages
he did, in reality, make the move “down set up by the State, not the Commonwealth of a quick review.
under”. – have paid off.” Any change in the Australian
The GP spoke of the lack of time to Recommendations of a $15 co-payment health system should only be done
get to know his patients, of the demands for a GP visit (likely to be accepted as a after consultation with all those likely
of work, the salary, and the separation he proposal by Treasurer Joe Hockey but cut to be impacted upon by changes and
was feeling from his two children who had to either $6 or $7) seem destined to be consideration must be given to the
accompanied him to Australia. reality for Australian patients. involvement of state health systems.
His questions were expected, such as the This will, as AMA (WA) President After all we do have a Federal system
number of hours he would be required to Dr Richard Choong told a range of WA of government and states still have
work, what sort of salary he could expect media outlets over the last few weeks, turn responsibility for all hospital care.
and what hoops he would need to go Medicare on its head and will see an end to To do otherwise, or to act quickly and
through if he decided to move to Australia. the way in which we have seen our health without due consideration, is only creating
The episode will not be shown until system operate over the last four decades. more problems, more bottlenecks and
January next year but to see his face light The new co-payment will raise little likely to reduce access to healthcare by
up after each answer to his question was (less than $800 million according to many Australians. ■
May MEDICUS 3
EVEnt
Strong AMA-Govt ties
lauded at
President’s Cocktail Party
AMA (WA) President Dr Richard Choong
Senator Dr Alan Eggleston reads
out a statement from Prime Minister AMA (WA) Vice President
WA Health Minister Dr Kim Hames addresses the gathering. Tony Abbott. Dr Michael Gannon
The annual President’s Cocktail Senator Alan Eggleston read a statement were several enormous challenges facing
Party held in late April was the ideal from the Prime Minister in which everyone in the health system including the
occasion to thank Dr Richard Choong for Mr Abbott congratulated the AMA on its opening of the new Fiona Stanley Hospital,
his service as AMA (WA) President over work. “The success of our health sector and the downsizing of Fremantle and RPH.
the past two years. is due in no small part to organisations “I think the relationship that
For the always understated Dr Choong, such as the AMA, which endeavour to government, including previous
the event was an occasion to thank AMA strengthen public and community health,” governments, has with the AMA is
(WA) members, staff, well-wishers and the Senator Eggleston read out on behalf of Mr invaluable.”
media for their support and encouragement Abbott. Listening on at the State Reception
over the past two years. In his speech, Health Minister Centre at Fraser’s were some of the biggest
The outgoing President spoke of several Dr Kim Hames thanked Dr Choong for his names in state and federal politics, and
highlights during the past 24 months hard work and advocacy for the people of of course, health. Along with Dr Hames
including a record growth in membership, Western Australia. and Senator Eggleston, the AMA (WA)
the signing of the MoU with the WA “The AMA is incredibly important for was pleased to host the Minister for
Health Department in December 2012, WA, Australia, doctors and the medical Mines and Petroleum, Housing, the Hon.
the Association’s lobbying for tighter profession,” Dr Hames said. Bill Marmion; Deputy Leader of the
immunisation laws, and the ongoing debate “It does a huge amount of work in Opposition, Roger Cook; and Minister for
surrounding the proposed establishment making sure that doctors are well cared for, Mental Health, the Hon. Helen Morton.
of a new medical school in WA. He also their conditions of employment are strong, Health heavyweights at the cocktail
spoke of his intense disappointment at the that their pay is good and particularly, that function included Acting Director General
government’s failure to add additional floors we value the service they provide to the of Health, Professor Bryant Stokes;
to the new children’s hospital. patients of WA. Professor Mike Daube who was recently
“The Barnett Government has missed “I can tell you that as a government, awarded an AO for his outstanding career
the opportunity to future-proof its we do value that service and will do our as a Public Health Advocate; Associate
paediatric services, and I believe that we will absolute best to make sure that we continue Professor Rosanna Capolingua; and
live to regret this,” Dr Choong said. working together.” President of MDA National, Professor
Taking the podium after Dr Choong, Dr Hames acknowledged that there Julian Rait, among many others. ■
4 MEDICUS May
EVEnt
3.
2.
1.
4. 5.
6.
7. 8.
9.
10.
11.
12.
13.
1. Prof Ian Puddy, A/Prof Rosanna Capolingua and
Dr Brett Roberston. 14.
2. Malvina Nordstrom, Dr Michael Gannon, Dr Andrew Miller,
Carolyn Choong, Dr Richard Choong and Hon. Kim Hames.
3. Hon. Helen Morton and Dr Glenn Edwards.
4. Dr Ruth Sheen, Prof Bryant Stokes, Prof Mike Daube and Roger
Cook.
5. Dr David McCoubrie, Jacqui Robinson, Prof Bruce Robinson
and Dr Michael Quinlan.
6. Mr Jeff Vibert, Paul Scicluna and Hon Bill Marmion.
7. Prof Gary Geelhoed and Dr Paul Effler.
8. Dr Janet Woollard and Prof Lawrence Beilin.
9. Dr Alexandra Welborn and Dr Michael Jones.
10. Prof David Mackey and Prof Lou Landau.
11. John Trowbridge and Prof Julian Rait.
12. Ian Anderson and Dr David Russell-Weisz.
13. Dr Jade Acton and Dr Stuart Salfinger with Dr Richard Choong.
14. Bill Coleman and Peter Jennings.
May MEDICUS 5
Building on
healthy foundations.
On Monday 5 May the ownership of Mercy Hospital Mount Lawley
was transferred from MercyCare to St John of God Health Care.
Now renamed St John of God Mt Lawley Hospital, the acquisition will enable St John of God Health Care
to develop more integrated health care systems across metropolitan Perth.
We aim to build on the rich tradition of the Sisters of Mercy in meeting the future health
care needs of the community. To achieve this we will invest in:
E xpanding and enhancing existing hospital facilities
C ontinuing the hospital’s proud tradition of excellent obstetric care
D eveloping already strong rehabilitation services
M aintaining and improving other medical and surgical specialities
This will ensure a contemporary, hospitable patient experience, a great work environment
and quality equipment for medical specialists. Our growth in Perth also enhances our capacity
in clinical education, research, and training the future medical workforce.
For more information visit www.sjog.org.au/mtlawley
Hospitality I Compassion I Respect I Justice I Excellence
In DUStrIaL
4 June 2014
AGM set for
Members are advised that the AMA (WA) AGM AGENDA:
Annual General Meeting will be held on • Declare meeting open
Wednesday 4 June, at the Association’s • Apologies
headquarters in Nedlands, starting at 6pm.
• Confirmation of minutes
Members who attend will be invited to join
• Annual Report of Council
in the discussion on AMA (WA) business and
• Election of Auditor
enjoy the fellowship of colleagues.
• Declaration of Ballot of Office Bearers
Refreshments will be served after the
and Members of Council
meeting.
• Investiture of the President
For more information please contact the
Secretariat at 9273 3008. • Closing of meeting by President.
Queensland contract negotiations: update
Hundreds of Senior Medical Officers • The ability to decline a transfer on opportunity to fully consider the written
(SMO) and Visiting Medical Officers reasonable grounds contracts prior to finalising any decision
(VMO) attended another mass Pineapple • The ability to decline a shift roster on as to signing. As a result the deadline was
meeting on 16 April 2014, to be informed reasonable grounds extended to 31 May 2014 and a contract
about and discuss the latest developments • Limitations on the directions to use PDL hotline has been established to assist
in their contract negotiations with the for performance improvement issues only practitioners in understanding the proposed
Queensland Government. • Restricting the application of intellectual terms of the contract templates, which
In an update on 17 April 2014, the AMAQ property rights to actual duties have only recently been published on the
summarised the main changes agreed to by performed for the employer Queensland Health Department’s website.
the government as follows: • A guarantee against unilateral change http://www.health.qld.gov.au/medical/
• The provision of a binding dispute of contract conditions to the SMO’s or medical-contracts/
resolution and unfair dismissal process VMO’s detriment In the meantime the Queensland
• The re-drafting of the contracts as one • The possibility of three-yearly Health Advisory Committee is being
document (in lieu of an addendum) arbitrated increases in wages and certain formed to advise the Director-General on
• The re-drafting of the termination clause allowances the implementation of the contracts and
to remove references to “profitability”, • A safety mechanism for future contract any future reviews. The Committee will
“viability” and “reputation” changes to be negotiated through the comprise of nine members, four of whom
• The choice between a three or six months’ Contract Advisory Committee. will be doctors’ representatives elected by
notice period Due to the loss of trust and confidence secret ballot.
• Clinical support time arrangements caused by the protracted dispute, For any further information, please
• A guarantee to port option A benefits practitioners insisted on being given an contact the AMA (WA) on 9273 3000. ■
Head of Department Allowances – update
The Association has received a allowance to be based on a head count as the recommendation from the relevant
number of enquiries regarding the opposed to the FTE formula applicable Executive Director (or delegate).
timing for the implementation of the under the 2011 Agreement. Once appropriately completed, the
new rates for the Head of Department The Association can advise that form will need to be submitted to HCN
Allowances and associated back pay, the new form K10 – Doctor’s Head for the implementation of the new rates
pursuant to the Department of Health of Department Allowance has now and calculation of any back pay to the
Medical Practitioners (Metropolitan Health been published on Health Point and is first full pay period on or after 1 October
Services) AMA Industrial Agreement 2013. available for use. The K10 form will 2013.
We understand that the delay was need to be completed by each respective Further and more detailed information
due to the need for the creation of a Head of Department, but authorisation on the process can be found in the
new document in line with the 2013 for the payment of the allowance rests Department of Health’s Information
Agreement, which provides for the with Chief Executives (or delegate) on Circular IC: 0183/14. ■
May MEDICUS 7
WESTERN AUSTRALIA WESTERN AUSTRALIA