August 2014

Healthscope raises capitalStockmarket-listing
Back in 2005, the ACCC took a close look at Healthscope’s purchase of the 90-bed Mount Hospital before giving the green light. The purchase was part of Healthscope acquiring 14 hospitals across Australia from Ramsay Health Care, which had agreed to divest these hospitals after it acquired Affinity Health (previously Mayne Health). Healthscope has since sold off its pathology interests to Clinipath in WA but lists 11 general practices still under its management here. Healthscope had floated on the ASX in 1994 but performed below expectations for investors, including administration of the public Modbury Hospital in South Australia. Healthscope has now lodged an IPO for a float worth up to $2.5 billion, with a similar amount raised from private investors. The company has been owned by US private equity firms since 2010, which is the same year Robert Cooke (previously Mayne Group) was appointed MD.

Protecting Dr X
The ACCC authorised the 17th edition of the Medicines Australia (MA) Code of Conduct from January 2012, with the expectation that more transparency about payments or other transfers of value from pharmaceutical companies to healthcare professionals would ensue. MA has now submitted its revised Code (v18) to the ACCC and submissions closed August 1. MA wants to improve some things but also wants to stop reporting hospitality, transport and parking reimbursement, and venue costs. It says the naming of health professionals should be voluntary (citing Privacy Law), the reason the surgical audit stalled until the surgeons’ college made it mandatory. In October, 2012, our poll of 250 doctors in WA had the majority saying that declaring sponsorship of individual doctors would not wrongly damage their independence.

Psychosocial assessment overlooked
WorkCover WA has just sent its report on the legislative review to the Minister for Commerce, Michael Mischin, and it attracted 66 submissions including doctor groups including State Wide Pain Services WA. The pain fraternity is disappointed by the apparent rejection of a routine assessment of psychosocial risk factors using the Orebro questionnaire. The Australian Pain Society submitted to WorkCover that it was the ‘bare minimum’ required for evidence-based management of work injuries. Given that the idea didn’t make the cut raises questions why a specific medical assessment and management strategy should be so contentious for stakeholders, particularly as it is standard in other states.

Hospital admissions and ADHD
The chicken or egg debate has been fuelled by Telethon Kids Institute work showing a significant association between children later diagnosed with severe ADHD and higher rates of early childhood hospital admissions. Their findings showed a strong association between the rates of injuries and illnesses in the first four years of life – middle ear disease, tonsillar and adenoid disease, epilepsy, and more than twice the risk of poisoning. Sleep disorders, burns and respiratory diseases were also higher in this cohort (about 12,000 children).

hip-op-3D-simulationSign of the Times
In other Telethon Kids Institute news, for the first time, fundraising has become the institute’s biggest source of funds. Last year $8.9m came from donations, bequests and sponsorship (or 20.5% of its funding pie). Next biggest was competitive grants totalling $8.1m or 18.5%, previously the greatest source of income. The Institute also made $4m from commercial contracts and $7.5m from government contracts.

Another hip in spotlight
We wrote about the problems with metal-on-metal hip prosthesis and the 2009 recall of the DePuy ASR J&J product implanted into an estimated 500 West Australians. This prosthesis was developed in Australia. The latest controversy is from another Australian manufactured product, this time by Global Orthopaedic Technology, which, after issuing a hazard alert with the TGA, has withdrawn from sale the femoral stem component of the MSA Hip System. Figures to December 2012, showed it suffered a cumulative revision rate of about 11% at two years. According to GOT’s spokesperson, only four have been implanted in WA.

Disability in focus
Those with disabilities in our community are waiting to see what is coming their way next. While the national insurance scheme is being worked out, here in Perth both people with disabilities and their carers were part of focus groups organised by the Disability Health Network. They are aimed at improving care coordination wherever people with disabilities contact the health system. Unfortunately, the demise of Medicare Locals has created uncertainty. Apparently there is a huge amount of health consumer interest in this topic and we hope to involve readers in its progress. So far, longevity of coordinators, hospital discharge planning and flexibility in coordination have been flagged.

Preterm birth strategy
Hard on the heels of the research breakthrough by Prof Jeffrey Keelan that a new generation antibiotic – solithromycin – has potential to cross the placenta and kill infections responsible for many preterm births, the Women’s and Infants Research Foundation (WIRF) is sharing the info with clinicians. It is holding a ‘Stars Event’ on September 24 at 6pm at the UWA Club to explain its Preterm Birth Prevention Initiative, which it hopes will safely lower the rate of preterm birth in WA. Register at www.wirf.com.au/stars2014