Following the ACCC green light, Clinipath Pathology is finalising acquisition of Healthscope Pathology in WA. Apart from rebranding cars, collecting centres, stationery etc, the laboratories in Kalgoorlie, Busselton and the Mount Hospital need to be converted to Clinipath’s computer system and new chemistry analysers installed. Doctor reporting preferences and billing for Medicare rebatable tests remain unchanged. Clinipath Pathology CEO Dr Gordon Harloe cut his teeth on the Accord acquisition some years back so none of this is particularly new. He said people were his main focus, from training staff in new systems to taking on new lab staff. The cytopathology and histopathology labs have already been amalgamated as has the Kalgoorlie laboratory.
Mental health smoking
At the recent HDWA Chronic Lung Diseases forum high smoking rates were noted in mental health. Apparently, 32% of mental health patients smoke (60% of those with schizophrenia), compared with 17% in the general population. A national tobacco-free program was combating this nationally – psych hostels, inpatient wards, drop-in centres – 10 weeks at two-hours-per-week involving motivational interviewing and follow-up phone calls. Relapses and boredom were two big barriers to people quitting. Getting patients to believe in themselves is very powerful but smoking staff were a strong demotivating force – cigarettes rewards handed to patients or staff arriving early at work for a smoko. In WA, 28 people have been trained to deliver the 10-week programs (with some Mental Health Commission funding).
Private sector doctor training
WA will get funding for 40 new hospital internships from 2013. St John of God Health Care noted that 32 of these positions would be in private hospitals (federally funded) and CEO Dr Michael Stanford said there was a clear need for the private sector to complement traditional public teaching in hospitals, given future demands. Their hospital group has 64 junior medical officers starting training in 2013, 40 of whom are under the Commonwealth’s Specialist Training Program, with Subiaco Hospital offering a new medical and surgical program for training doctors. Each year, their hospitals and laboratory in WA and Victoria also provides rotations to 600 medical students.
Healthdirect value questioned
UWA’s Prof Daniel Fatovich and RPH anaethetist Dr Joseph Ng had their study into Healthdirect’s telephone triaging published in the MJA. The big finding from 2008-09 data was that 52% people who attended the RPH emergency did so after Healthdirect had advised them to stay away – around 52%. Daniel said factors around low compliance with Healthdirect advice were limited availability to after-hours primary care, and consumer attitudes to the helpline – more research was needed to justify the cost of the service on the grounds of reduced demand on EDs. Medical Forum’s GP August E-poll on Healthdirect showed over half of polled doctors thought the service was either a waste of money, had little impact on patient care or was a political tool, not a medical one. Only 8.3% thought it might lessen their load and 7.5% said it was a useful adjunct. So value to primary care is in question as well.
The ACCC has approved the 17th edition of the Medicines Australia Code of Conduct, allowing it to be implemented next January for another three years. In WA, 250 doctors polled by us on pharmaceutical sponsorship wanted greater transparency than the Code offered, putting them at odds with one of the federal AMA’s points in its submission to the ACCC. Around 43% disagreed or strongly disagreed (cw. 31% agreed) with the idea that declaring sponsorship or payments to individual doctors by pharma companies may wrongly damage the doctors’ independence. Specialists especially disagreed. And about 1 in 3 GPs and specialists said doctors would not declare to their patients any conflicts of interest arising through pharmaceutical sponsorship. There is disquiet amongst our ranks.
Peel Health Campus management has been answering questions from The Legislative Council Estimates and Financial Operations Committee, which according to the government website is investigating the recovery by HDWA from Peel Health Campus or Health Solutions (WA) Pty Ltd of overpayment of about $1.8m and whether payments for services to doctors working at the Campus included a payment for patients admitted to ED there. If you are interested in recent SAT deliberations and rulings go to www.austlii.edu.au/ and search by keyword or ‘Medical Board’