Ralph Sarich’s $20m donation for WA medical research may be sexy news but will it turn out to be as useful as his orbital engine in the long run? The property developer wants to enrich the neurosciences wing of the $360 million research centre planned for QEII in Nedlands where 1500 researchers will look for cures (and publish papers); the Telethon Institute for Child Health Research, the WA Institute for Medical Research, UWA, Lions Eye Institute and PathWest. A super hospital with a super research facility – more centralised tertiary medicine while the already discovered disease antecedents get scant preventive resources in community medicine?
Primary Health Care has been rationalising its recently acquired assets from Symbion Health, with practice mergers or closures interstate attracting media attention. WA awaits the appointment of their state manager. Meanwhile, Sanofi-Aventis is finalising its $560m acquisition of Primary’s consumer products division, to take over the brands Nature’s Own, Cenovis, Golden Glow and Bio-Organics. Pharmacy services Chemmart and Terry White Chemists are up for sale. In WA, that leaves Primary with 17 general practices, 9 of which have collecting centres for Western Diagnostics, the other new jewel in the Primary crown.
While Western Australians prescribed stimulants for ADHD fell 8.6% over the past year, we now have more adults than children taking ADHD drugs. The start up of the WA Stimulant Regulatory Scheme in 2004 is having limited effect, with 6,997 adults (0.44% of adult population) compared to 6,188 children (1.4%) now prescribed Ritalin or dexamphetamine. It is said that 60% of kids with ADHD carry symptoms into adulthood. Of the 245 registered stimulant prescribers in WA, half are psychiatrists and a third paediatricians. Interestingly, 62% of patients (n=1774) who terminated their ADHD medication did so because their authorised prescriber retired. Just 11 paediatricians treated 47% of the kids. Around half the adults were prescribed stimulants by psychiatrists specialising in child and adolescent psychiatry and just 14 doctors treated 75% of adult patients. Interesting stuff.
$1.5 million wasted?
The WA Health Dept could be pissing into the wind with a new advertising campaign to remind the public – the 21% with general practice type problems, that is – not to attend ED departments. Let’s face it, people from this subgroup prepared to put up with ED waits and the waiting room scrum are either keen to avoid paying, are too pissed to know the difference, live close by, cannot get into a GP (at the right price?), have never been told to go away, enjoy the company during the long wait, or think HealthDirect phone advice sucks. The two new metro GP Super Clinics are in for a good time. In 2007/08, 443 896 people attended metro EDs, including Joondalup and Peel.
WA RFDS CEO Tim Shackleton is happy with the $38m additional state funding over five years, even if it is half what they asked for. Some of the pressure on their services is due to a decline in specialist outreach services. $23.9m is for recurrent funding and $14.49m to replace 3 aircraft and buy 2 new planes. No hope of the badly needed jet from government but Rio Tinto has stepped in, providing $5m for a leased ‘Rio Tinto Life Flight’ jet that can transport someone from Kununurra to Perth in half the current time. Small jets are cheap at present, with the collapse of many smaller US carriers. The RFDS expects to transport 500 patients in the new jet in the first year.
What do you do when the ‘basic science’ medical research by your organisation is not translating into something clinically useful? Answer: you research the problem! It’s called Translational Research, a response to growing pressure from governments and commercial sponsors who perceive wasteful burn of research dollars without benefits for them or human health. On the other hand, seemingly good science ideas can die by the roadside, killed by the cost and complexities of bringing them to bedside usefulness. The push to limit research for researchers’ sake and encourage the useful scientists to stay on the job, has migrated from the US to Perth with the recent donation by Wesfarmers of $4.5m over 5 years to establish (you guessed it) the Wesfarmers Research Centre to be headed by Prof Peter Leedman as an offshoot of the WA Institute of Medical Research. Go Peter.