Good policy? Adolescent lock-up
Late in June, the WA Government introduced legislation to impose mandatory jail sentences on children (16 years +) and adults convicted of assaulting youth custodial officers, even though Corrective Services Minister Joe Francis admitted the frequency of such assaults was “relatively low”. Youth and mental health advocates have cried foul. Mental Health Carers Arafmi has lobbied to have those with mental impairment exempt. The legal fraternity is always uncomfortable with mandatory sentencing laws – they take away magistrates’ and judges’ discretion to sentence on merits, and there is the murky concept of politicisation of the judiciary to counteract. Arafmi says training youth and adult custodial officers in how best to deal with people with mental illness is more appropriate. This proposed legislation comes hard on the heels of intense lobbying over the Mentally Impaired Accused Act [Search Margaret Doherty at]..


Disabilities and footy
WAFL has launched Integrated Football for people over 16 years with an intellectual disability to encourage involvement in community football, either playing or supporting coaches. High Wycombe, Kingsway, Lynwood Ferndale, Fremantle CBC and Warnbro clubs are participating and can cater for those with higher needs [Greg Gilbee on 0419 934 382]. With around 70 kids in six teams involved so far, another grade of competition has been created within the main league. Separately, 100 amateur sporting and non-profit groups are set to receive defibrillator packs from St John Ambulance and Lotterywest ($2900 each) – offer closes August 16; see Heart Start Giveaway website.

CF drug approved
The press release announced Australian approval for Kalydeco™ (previously ivacaftor), said to be the first medicine to treat the underlying cause of cystic fibrosis, in this case a particular mutation of the cystic fibrosis transmembrane conductance regulator gene (1800 known mutations). USA FDA approval in January 2012 and US$75m for development from the US Cystic Fibrosis Foundation has helped. Efficacy outside the 8% of cystic fibrosis patients in Australia with the G551D mutation (n=250) is unknown so TGA approval is for those aged six or more with this mutation. Not PBS listed, The West Australian has carried stories of parents lamenting the $25,000 per annum drug cost. In his interview with Medical Forum last December, Prof Steve Stick said economics meant ivacaftor would probably never be trialled in young children where it has the greatest potential; he said only a 20% restoration of function would alleviate a lot of CF problems.

The numbers game
Australian Institute of Health and Welfare reports cover many things. One said 2011-12 new medical indemnity claims and closed claims in the private sector (~1750 in both cases) exceeded the public sector (~1300 in both cases); 54% of closed claims were for less than $10,000, compared with 41% for $10-500,000 and 5% for $500,000 or more. A report on prisoner health confirms Medical Forum’s story with the deputy director of Prison Health Services Dr Cherelle Fitzclarence, that inmates leave jail healthier; at the time of incarceration 32% reported a chronic disease with 20% testing positive to both Hepatitis C and B, and 80% were smokers. And the latest report on the National Bowel Cancer Screening Program continues to show low uptake; 38% in 2011-12, then 35% of 930,000 invitations in 2012-13.

Med schools need teleheath
Curtin Uni researchers say online video technology in Australian primary care is limited to government-subsidised consultations involving specialists or to small numbers of privately funded schemes. In June, we ran the story on ETS, run by State Health to some smaller regional hospitals, with low useage by local GPs. Chair of Health Innovation in the Faculty of Health Sciences at Curtin, Prof Moyez Jiwa, said their three-month pilot study showed video consultation techniques needed to be taught in medical schools and more investment made to encourage use of technology in rural and regional areas.

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