Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Thursday, October 16, 2014

Review Of The Ongoing Post - Budget Controversy 16th October 2014. It Just Rolls On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Some more this week.
Here are some of the more interesting articles I have spotted this 20th week since it was released.
The big news from last week is a clear cut back-down on some of the more draconian changes proposed in May. The Mid Year Economic Forward Outlook - confirmed as due in December by Mr Hockey on-Sunday  will show us what other nasties have been dreamt up to replace the budget holes!
During last week we have seen Mr Hockey become more and more shrill in his concerns about the fate of his budget. The House of Reps returns 20th October and the Senate 27th October so we will see how we go!

General.

Intergenerational Report will reveal massive cost growth: Hockey

David Crowe

A MASSIVE spending burden threatens to tip the nation into decades of deficits, according to new government findings that will be released early next year to jolt parliament — and the public — into accepting another wave of budget reform.
Setting a new strategy in the political fight over difficult ­savings, Joe Hockey has decided to hold back the official analysis to maximise its impact on national debate when parliament sits in February.
The findings will set off a debate over the nation’s long-term challenges by feeding into the tax reform white paper, which will consider the GST, and influencing the federation white paper on key issues such as the mounting cost of healthcare.
Mr Hockey considered publishing the long-range Intergenerational Report this year but rejected the option in favour of timing the new Treasury analysis to prepare the ground for further savings in the May budget.
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‘All budget options open’, says Mathias Cormann

David Uren

THE Abbott government is sticking to its promise to get the budget back into balance by 2017-18, with a big surplus achieved by 2023-4, despite the softening in global growth and a difficult Senate.
Finance Minister Mathias Cormann says he cannot rule out tax increases or more spending cuts as the government prepares a December update of the budget.
“We will be looking right across government for opportunities for additional savings in order to make up for the additional expenditure or the cost of late savings,” Senator Cormann told Sky News’s Agenda program.
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Treasurer Joe Hockey says falling commodity prices will hurt budget

Date October 7, 2014 - 11:33AM
Falling commodity prices will hurt Australian government efforts to rein in its budget deficit, spurring possible new savings measures, Treasurer Joe Hockey said.
"Lower commodity prices in iron ore and coal are going to have an impact on our budget bottom line," he said in an interview in New York.
"There are many variables at play but there will be a negative impact."
The price of iron ore has fallen 41 per cent in China this year, according to Metal Bulletin, while steelmaking coal is trading at the lowest level in six years.
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Foreign aid faces cut to fight terror, plan national security

David Crowe

FOREIGN aid is set to be cut to help pay for military operations in Iraq and stronger national security at home, as the Abbott government hunts for new savings while standing by unpopular reforms now stymied in the Senate.
Amid warnings from Joe Hockey of additional cuts in the next budget update, The Australian has been told a two-year pause in ­future aid increases is the leading option to cover the cost of a fight against terrorism that is aimed at saving lives.
The government is canvassing the new measures as it rubbishes talk of a retreat on more than $20 billion in savings on the age pension, university reforms, medical fees and fuel tax increases.
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The War On Spending: Hockey And Abbott Beat A Hasty Budget Retreat

By Ben Eltham
The Abbott Government has backed down on another key component of their budget. Ben Eltham explains.
The Abbott government is backing down on some of its welfare changes.
Employment Minister Eric Abetz has signalled that the government will drop its controversial new requirement for job seekers accessing unemployment benefits to search for 40 jobs a month.
“We have listened to the community feedback, we do understand that for business this would be a burden,” Abetz told the ABC's AM program.
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Greens deal opens door to action on Joe Hockey’s budget savings

David Crowe

CLIMATE change concerns will be used to reopen talks on at least $2.2 billion in budget savings as Joe Hockey honours a deal with the Greens to address some of their claims in a long-range review of the nation’s fortunes.
Greens leader Christine Milne has written to the Treasurer in recent days to list the climate change factors to include in the forthcoming Intergenerational Report, clearing the way for consultation on the budget outlook. Mr Hockey will link the talks to one of the key structural savings in the budget, urging the Greens to support an increase in petrol excise that will lift federal revenue while putting an impost on a fossil fuel.
The Intergenerational Report will be released early next year to show the state of the budget over the next 40 years, revealing the commonwealth’s long-term spending burdens as well as the benefit of early decisions on savings that can build over time.
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Treasurer Joe Hockey pressures Labor to pass stalled budget measures to pay for Iraq war

Date October 9, 2014 - 11:07AM

Latika Bourke

National political reporter

Treasurer Joe Hockey has called on Labor to pass blocked budget measures if it is genuine about supporting the mission in Iraq and its associated costs.
Prime Minister Tony Abbott has ruled out introducing a war tax to pay for the Iraq mission, which is roughly estimated to cost $250 million for every six months the operation runs.
Speaking in Washington, Mr Hockey said the Australian government would be able to fund its commitment and would reveal how in the December budget update.
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Cormann to woo Palmer on budget

  • Staff Reporter
  • October 10, 2014 7:45AM
Finance Minister Mathias Cormann has been deployed to Queensland to try and negotiate a deal with Palmer United Party leader Clive Palmer to pass billions of dollars worth of stalled budget measures, The Australian Financial Review reports.
According to the newspaper, Mr Palmer has ruled out backing the $3.6 billion Medicare co-payment or $5 billion in higher education cuts, and is also seeking support for his own climate change plans.
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Seniors stuck in hospital awaiting aged care, inquiry hears

By Linda Belardi on October 10, 2014 in Consumers, Government, Industry
Delays in hospital transfers to aged care, the under-utilisation of nurse practitioners and calls to expand medicare-funded GP teleheath services are among the key issues that have been put to a senate inquiry into health policy and expenditure.
State and territory governments have voiced their concern over unnecessary hospital stays by older people who are ready to move into residential aged care.
The ACT Government told the Senate Select Committee into Health that on average 30 public hospital patients each day were waiting to access aged care services, at a cost of $1,200 per day.
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Seats held by Tony Abbott and Joe Hockey are among least affected by budget: report

Date October 10, 2014 - 5:21PM

Lisa Cox, Tom Allard

Voters in electorates held by Prime Minister Tony Abbott, Treasurer Joe Hockey and senior government ministers Julie Bishop and Malcolm Turnbull will be the least affected by the federal budget by 2017-18, a new analysis shows.
Fifteen of the 16 hardest hit electorates, meanwhile, are held by the Labor Party, with low and middle income households in western Sydney and the outer suburbs of Melbourne overwhelmingly the worst off.
According to the report, Communications Minister Malcolm Turnbull's electorate is least-affected from the budget. Photo: Rob Homer
The University of Canberra's National Centre for Social and Economic Modelling (NATSEM) published the figures on Friday, breaking down the immediate and long-term impacts of Mr Hockey's May budget by region, suburb and electorate.

Medical Research.

Pressure on PM to deliver $20b fund

  • Brigid O’Connell
  • Herald Sun
  • October 09, 2014 12:00AM
HAROLD Mitchell is leading a charge by Australia’s universities and research institutes to push the Federal Government to follow through on establishing the $20 billion Medical ­Research Future Fund.
The media buyer used a meeting with Tony Abbott in Melbourne last night to reiterate the need for this perpetual fund to propel further medical research breakthroughs, amid fears it could be slashed to $10 billion when it goes before Parliament later this year.
Then proposed fund, which the Government has said was conditional on the $7 Medicare co-payment being passed, would double spending on medical research by distributing $1 billion a year after 2022.
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GP Co-Payment.

Dutton denies $7 co-pay plan scrapped

7 October, 2014 Paul Smith
Claims of a budget retreat on the $7 GP co-payment policy cuts have been rubbished by the Federal Health Minister.
Last week it was claimed that plans to introduce legislation underpinning the reforms had been "pulled at the last minute" by Health Minister Peter Dutton (pictured) after he cancelled a briefing with the Coalition Policy Committee.
Mr Dutton's office, according to the Australian Financial Review, had told the committee the legislation was being withdrawn until a later date.

GP co-payment would crush NSW emergency departments: report

Date October 8, 2014 - 12:15AM

Nicole Hasham

State Politics reporter

EXCLUSIVE
An extra 500,000 people a year would choke NSW emergency departments at a cost of $80 million if the federal government proceeds with its GP co-payment, internal health department documents show.
The analysis by NSW Health has been backed by doctors and health groups who say a $7 Medicare fee for GP visits would be a disaster for the state's health system, blowing out emergency department waiting times and hurting society's sickest and poorest.
Scenarios prepared for the NSW government in May, obtained by NSW Labor, assumed a $6 co-payment, lower than the $7 fee later proposed by the federal government.
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EDs to 'flood' under GP co-payment

8 October, 2014
Emergency departments in NSW will be flooded with an extra half a million people a year if the federal government introduces its GP co-payment, internal health department documents reveal.
The move would increase emergency department costs by $80 million a year according to a preliminary study prepared for the NSW government in May.
The analysis by NSW Health was based on a $6 GP fee, rather than currently planned $7 fee.
NSW Opposition Leader John Robertson says the co-payment would be a "disaster".
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Medicare bulk-billing rates are highest in Labor-held electorates

Sean Parnell

LABOR holds the seats with the highest bulk-billing rates and Coalition MPs represent areas where patients are most accustomed to paying to see a doctor, according to Medicare figures that deliver a political headache for the Abbott government.
The political divide over controversial budget plans for a $7 GP co-payment is laid bare in figures released by the Health Department after a Freedom of Information request from The Australian.
Before the May budget, Joe Hockey made the case for a co-payment by declaring, repeatedly, that his electorate of North Sydney had “one of the highest bulk-billing rates in Australia (despite being) one of the wealthiest electorates in Australia’’.
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Abbott must ditch the GP tax and seek healthier budget solutions

Date October 9, 2014 - 12:15AM
EDITORIAL
You don't need to be a union sympathiser within NSW Health – as federal Health Minister Peter Dutton labelled the source of the data – to know that poorer people and the elderly will struggle to pay more for GP visits.
The Abbott government's proposed co-payment for visits to general practitioners has suffered another telling blow – and rightly so.
In a first budget replete with unfair, untested, ideologically driven measures not justified or even explained well to the people, the GP tax stands alongside extra interest on deferred student loans at the pinnacle of overreach, with entirely predictable negative consequences.
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Hospitals warned government on casualty crush, documents show

Date October 9, 2014 - 12:15AM

Nicole Hasham

State Politics reporter

EXCLUSIVE
Senior staff at three Sydney hospitals warned the NSW government a $7 fee for GP visits would leave emergency departments swamped, and children, the poor and the elderly would be worst affected, internal documents reveal.
Health Minister Jillian Skinner has been accused of failing to take the federal government to task over its proposed Medicare co-payment despite a report by her department finding the state's hospital system would be overrun by 500,000 extra patients a year if it proceeds.
Federal Health Minister Peter Dutton on Wednesday claimed the data, which will do little to help his government's embattled proposal pass the Senate, was "cooked up by obvious union sympathisers" in the NSW health system.
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GP tax to hit cancer patients

Date October 8, 2014 - 10:30PM

Mark Kenny

Chief political correspondent

Cancer and other chronic disease sufferers will be hit with significant advance costs for medical imaging and other pathology testing under the government's proposed $7 GP co-payment, according to evidence given to a parliamentary committee on Wednesday.
The Australian Diagnostic Imaging Association has warned that previously undiscussed impacts of the fee mean people with the greatest need to get access to complex medical services will be the worst affected.
And many will remain worse off even after rebates are received.
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Shock slug for cancer patients

Andrew Tillett Canberra The West Australian October 9, 2014, 4:55 am
Patients face being hit with up-front bills of up to $2200 for cancer tests under little-known changes linked to the Abbott Government's plan for Medicare co-payments.
Details of the shock slug emerged at a Senate inquiry yesterday looking at the unpopular patient co-payment announced in the May Budget.
While the Government stresses $7 is a modest amount for patients to pay to see a doctor or have a scan or blood test, the Australian Diagnostic Imaging Association warns the financial burden will be much bigger for patients using expensive services such as X-rays and MRIs.
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Premier Mike Baird refuses to take on Prime Minister Tony Abbott over GP co-payment despite emergency room warning

Date October 9, 2014 - 9:57PM

Nicole Hasham

State Politics reporter

NSW Health Minister Jillian Skinner has rejected federal government claims that forecasts of long emergency department queues under a proposed GP co-payment were "cooked up" for political gain.
But Premier Mike Baird on Thursday refused to call on Prime Minister Tony Abbott to drop the proposed $7 GP fee, even as South Australian officials warned of a casualty crush in that state if the measure proceeds.
Speaking at the opening of the Westmead Millennium Institute for Medical Research in Sydney, Mr Abbott said the GP fee would allow "investment in the treatment and cures of the future", by largely funding a $20 billion Medical Research Future Fund.
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Senate health inquiry: GP co-payment will increase SA hospital visits 'by 290,000 people'

October 9, 2014, 9:02 pm
The Federal Government's planned $7 GP co-payment would result in an extra 290,000 presentations a year at hospital emergency departments, South Australian health officials have told a Senate inquiry.
SA Health deputy chief executive Steve Archer told the select committee on health in Adelaide that the co-payment would also push waiting times from 20 minutes to 66 minutes.
He said the measure, proposed in the federal budget earlier this year, would cost the State Government an additional $80 million.
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Co-payment costings uproar in NSW

8th Oct 2014
NSW Health Minister Jillian Skinner has brushed aside the prospect of a GP co-payment after revelations that her department predicted the policy would be a disaster for the state's health system.
Under a co-payment scenario modelled by NSW Health bureaucrats before the May federal budget, an extra 500,000 patients would flood into NSW hospital emergency departments at an additional cost of $80 million a year. 
The modelling, contained in a government briefing paper, warned of a blowout in ED waiting times as more patients deferred GP visits, leading to the potential loss of millions in Commonwealth National Emergency Access Target (NEAT) funding.
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Cancerous co-payment

Friday, 10th October 2014
General practitioners are not often portrayed as the heroes of our public health system, but they save lives every day. I’m not a GP. I’m training to become a specialist obstetrician & gynaecologist and I work in a tertiary hospital. Every shift I’m reminded by my patients of the importance of quality primary health care.
Take Carrie. She’s a mother of three teenagers and she has cervical cancer. Her hospital visits are more frequent now. At first there were the specialist visits and biopsies, and then the chest X-rays, CT scans, MRIs. After that came the chemo-radiotherapy, the complications, the multiple admissions and the counselling. One of her kids dropped out of school to look after her. The younger two are having a hard time focusing on their studies and they’re not doing so well.
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Pharmacy Related Articles.

Australians pay up to 21 times more for prescription medicines than Britain

  • 7 hours ago October 07, 2014 12:00AM
  • Sue Dunlevy National Health Reporter
  •  News Corp Australia Network
AUSTRALIA is paying up to 21 times more than Britain for 19 of the 20 most commonly used prescription medicines seven years after a government policy was meant to end the rort.
It means Australian taxpayers are wasting at least $400 million a year on generic medicines and that general consumers are paying more for their medical treatments than they should.
The biggest selling prescription medicine in Australia is the cholesterol lowering treatment Atorvatstatin costs Australian patients $19.69 a pack, nearly twice the $10.45 paid by the British.
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Pharmacists accused of 'price-gouging' the sick

7 October, 2014 Christie Moffat
Pharmacists have been accused of overcharging Australian patients for medicines, in a series of articles featured in News Limited publications.
The reports, published across the News Limited stable, argued that Australian patients were forced to pay “more for their medical treatments than they should”, despite pharmacists being given supposedly generous discounts from drug companies.
“Under Australia’s pharmaceutical benefits subsidy scheme the government sets the price it pays chemists for medicines, but drug companies sell the pills cheaper to chemists who make profits of up to 80%,” a report in the Daily Telegraph stated.
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An open letter to the Health Minister

7 October, 2014 Christie Moffat
A community pharmacist has penned an open letter to Health Minister Peter Dutton, arguing for the Government to allocate funding for pharmacists to work in medical clinics.
In assisting GPs with the early identification of medication issues, the author, who wished to remain anonymous, believes that working in a medical clinic would help save the Government money.
The letter is below.
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Guild ad campaign almost upon us

8 October, 2014
The Pharmacy Guild of Australia's innovative new PR campaign is due to kick off next week.
The ‘Discover More.Ask Your Pharmacist’ campaign will commence with prime time advertising on free-to-air and subscription television.
The advertisement will demonstrate to the public that there is a whole lot more that their local pharmacies do for their health in addition to dispensing prescriptions.
Consumers will be encouraged to "discover more" by asking their pharmacist how they can assist with health checks, pain management, after-hospital care and in-home care.
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PBS price comparisons too simplistic: Medicines Australia

9 October, 2014 Christie Moffat
Claims that the Australian Government is paying more for PBS medicines compared to other countries are a “simplistic comparison” and do not account for ongoing savings achieved by simplified price disclosure, according to Medicines Australia.
In a statement, the organisation took aim at comments from health economist Dr Philip Clarke, who has said the Government is overpaying $400 million a year on PBS-listed medicines.
Dr Clarke’s comments were featured in a series of articles published by News Limited earlier this week, where he said that Australians paid more for 19 of the top 20 most commonly prescribed medications, compared to patients in Britain.
Dr Martin Cross, chairman of Medicines Australia, said that the current price disclosure policy was delivering significant savings to government and patients.
“Professor Clarke has fallen into the same trap as the Grattan Institute by cherry picking a few medicines to demonstrate his point. He is not taking into account that PBS price disclosure reforms are permanent, ongoing and unfinished, and that simple price comparisons of a small list of medicines ignore the overall effect across the PBS,” Dr Cross said.
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Pharmacy plan for painkillers

By HOLLY MONERY
Oct. 8, 2014, 8:13 p.m.
NUROFEN, Voltaren and Naprogesic are just some of the anti-inflammatory medications that will require consultation with a pharmacist before you can buy them if changes proposed by the Therapeutic Goods Administration go ahead.
The TGA recently completed a review of the cardiovascular risks associated with the use of the non-steroidal anti-inflammatory drugs, and the results have prompted the proposed changes.
Another option being proposed is labelling changes to improve upon consumer education.
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Rebel doctor group calls for ban on drug reps

Date October 9, 2014 - 7:30PM

Harriet Alexander

Health reporter

A rebel group of doctors is lobbying colleagues to ban drug company representatives from their surgeries.
Concerned about the level of influence that pharmaceutical companies have over doctors' prescribing habits, the group is challenging doctors to pledge not to entertain "educational" visits by marketing representatives for a full year.
Representatives typically provide sandwiches and distribute branded paraphernalia while discussing their latest products, and studies indicate that doctors who routinely see them are more likely to prescribe more often and prescribe pricier drugs.
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Pharmacists want to be paid to provide GP style consultations

  • October 11, 2014 12:00AM
  • Sue Dunlevy National Health Reporter
  • News Corp Australia Network
PHARMACISTS want to be paid to provide GP type consultations to deliver flu vaccines and contraceptives, conduct weight checks and treat minor ailments.
The controversial plan is being proposed by the Pharmaceutical Society of Australia which is the professional and standards body for the nation’s 27,000 chemists, most of whom work as employees in pharmacies.
It is contained in a discussion paper likely to form the basis of a submission to the government for the next five year Community Pharmacy Agreement, which will cost taxpayers over $15 billion.
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Medibank Private Sale.

Medibank Private sale a chance to rethink healthcare

Economic briefing
Alan Mitchell Economics editor
Floating Medibank Private makes sense if the private sector can run the business more efficiently than the government can, but don’t confuse the privatisation with real reform of the healthcare system.
The pressure for reform of Medicare is increasing, and not just because of the current need to get the budget back into surplus.
Rising health costs are projected by the Treasury to push the federal budget back into structural deficit over the next 40 years.
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Patients the losers with Medibank privatisation

Date October 10, 2014 - 12:15AM

Toby Hall

When Medibank is privatised, will it really advocate for patients or just a stronger share price?
There is no doubt when it comes to healthcare quality, affordability is a key consideration and one we should all strive to achieve. However, two big ticket items on the health agenda at present could combine to create the perfect storm that discriminates against the poor and the very sick.
The first item; the GP co-payment, will act as a disincentive for the poor to access the care they need. Similarly, the notion of a sharemarket-listed Medibank – focused on establishing contracts exclusively with cheaper health providers –  could see Medibank patients who are very sick unable to access the private hospitals that have the expertise and infrastructure to treat their specific needs.
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Medicare Locals.

Regional concerns aired over new Primary Health Care Networks

Mon 6 Oct 2014, 12:31pm
The National Rural Health Alliance says the needs of regional communities must be considered under new Primary Health Care Networks.
The Federal Government announced earlier this year that Medicare Locals would be scrapped in favour of the Networks, as of July next year.
Alliance chairman Tim Kelly says it is vital the networks allow for local input.
He says it recently met federal Health Minister Peter Dutton to discuss its concerns.
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$2m bill to axe Geelong Medicare Local

By JOHN VAN KLAVEREN
WINDING up Geelong’s Medicare Local will cost $2 million, a Senate hearing has been told.
Barwon Medicare Local, which co-ordinates local primary health care services and works to fill gaps in service provision, will close when its funding ceases mid-next year.
Federal Government will replace it with a primary health network stretching to Warrnambool.
The Senate Select Committee on Health held public hearings in Geelong this week.
Barwon Medicare Local chief Jason Trethowan told the hearing long-term leases on two offices contributed to the high wind-up cost.
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Health clinics back under scrutiny over missing funds

Sarah Martin

A CENTRAL Australian network of health clinics will be again investigated for financial mismanagement, two years after the federal government ordered an audit into its accounts.
The Central Australian Aboriginal Congress, based in Alice Springs, is at the centre of claims that funds are “mysteriously disappearing” inappropriately.
The complaint to the Department of Health comes two years after an l audit found $208,000 had been misappropriated , and former chief executive Stephanie Bell resigned.
Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day. Maybe the next few weeks of parliament will clarify this time.
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.

Wednesday, October 15, 2014

How Can It Be That The E-Health Community Is Being So Mushroomed By Government?

First a definition - to be Mushroomed is to be “Kept in A Dark Place and Fed Smelly Excreta”.

To me that is what is happening to the e-Health Community . We have all sorts of meeting where there are lots of e-Health research presentations but where is NEHTA and DoH explaining the big picture and what the future is? Pretty well absent I guess.

With the ONC in the US we have a weekly e-mail newsletter and in Canada regular, is slightly selfserving, material from Infoway. Here all we hear about is AMT and SNOMED releases and about publicity ventures when a dead duck is being pushed on unsuspecting allied health professionals, nurses or administrators.

No futures, no strategy, no analysis of practical success has been forthcoming. Just why might that be?  Emperor and nudity flicker to mind.

I really don’t think the cone of inactive silence is good enough. Do you?

David.

Tuesday, October 14, 2014

This Astonishing Article Appeared A Few Days Ago. $400Million Just Blown Up!

I was just blown away ( no pun intended) when I read this article.

Defence blows up $400m worth of missiles

PUBLISHED: 10 Oct 2014 00:05:55
Brian Toohey
The Australian Defence Force has disposed of almost 100 AGM-142 stand-off missiles, costing about $400 million, by blowing them up or, as Defence put it, they were “disposed of by explosive demolition”.
The F-111 strike fighters only operated the US-manufactured missiles for about a year before the big jets were retired in 2010.
The Israeli-designed AGM-142 missile was meant to give the F-111s a formidable new supersonic precision-guided weapon with a 350 kilogram warhead and a range of 78 kilometres.
Because of the severe difficulties Boeing experienced in Australia ­trying to integrate the missiles into the F111, they only became operational available nine years later than intended.
Defence says the total project cost for “approximately” 100 missiles and the integration process was $406 million.
The retirement of the 28 F-111s left the Australian Defence Force with almost 100 near-new missiles it didn’t consider suitable for use by the air force’s 24 new Super Hornet or 72 new F-35 fighter planes.
The Super Hornets cost $32,000 an hour to fly, more than double the cost for the RAAF’s 71 “classic” Hornets.
Read more of this incredible story here:
So somehow Defence managed to blow up what seems to be the cost of the first year of the new war in Iraq or the cost of 2-3 new Hospitals and so on.
One must really wonder why there were not some others who could extract value from these and work out how to usefully integrate them.
The parallel with the PCEHR seems rather obvious to me. Over $1.0B spent and to date it still has not been effectively integrated with the national health system, it is still hardly used almost 2.5 years later, and now seems to be at similar risk of just being ‘blown up’.
The ways Governments can get rid of our money for no real benefit or accountability is just astonishing!
David.

Monday, October 13, 2014

Weekly Australian Health IT Links – 13th October, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Another quiet week where we heard no useful information about what the Government is up to in e-Health. Maybe the Rural Medicine Conference at the end of the month will reveal something.
See here:
Ehealth reform in Australia
Innovation Stream Session 2
31 October, 2014
Session 1 :   (10.30am – 11.0am)
Beyond the Hype – PCEHR in action in rural general practice.
Simulation/demonstration
Presenter:  Dr Ewen McPhee
Session 2 :   (11.00am – 11.30am)
National eHealth reform and priorities – a National approach
Panel includes:
Dr Steve Hambleton, NeHTA;  Mr Peter Fleming, NeHTA;  Mr Paul Maddon, DOH; Dr Jeff Ayton, ACRRM ; Dr Ewen McPhee, RDAA
Session 3 :  (11.30am – 12.30pm)
Whole of health sector : What’s happening in My State
Chair:  Dr Jeff Ayton
State and Territory Health Departments’ overview of ehealth/telehealth goals, programs and achievements.
We can all look forward to hearing what is said!
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Digitising healthcare: The state of e-health in Australia

Several health organisations give examples of how digitisation is transforming healthcare
If there is one industry experiencing rapid change right now, it is healthcare. Whether it’s the shift from paper to electronic records, face-to-face consultation to telehealth diagnosis, or instructing patients to empowering them, the industry is evolving fast.
Here, we look at several examples of how digitisation is transforming the healthcare industry.

Integrated digital hospital

UnitingCare Health is rolling out Australia’s first fully integrated digital hospital, which will connect up e-medical records, X-rays, pathology results, vital sign machines and other health information.
St Stephen’s digital hospital in Hervey Bay, Queensland is set to open on 13 October and is receiving $47 million from the Federal Government's Health and Hospitals Fund, with UnitingCare contributing $49m.
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Experts question the value of some new medical technologies

Date October 8, 2014 - 11:45PM

Elisabeth Rosenthal

Medical technology is finding a vast number of new data-gathering techniques but many professionals are questioning the value of all that information, Elisabeth Rosenthal says.
As a former physician, I shivered a bit when I heard Dr Vivek Wadhwa say he would rather have an artificial-intelligence doctor than a human one.
"I would trust an AI over a doctor any day," he proclaimed at a health innovation conference in San Francisco, noting that artificial intelligence provided "perfect knowledge". When asked to vote, perhaps a third of those in attendance agreed.
In some cases, the ability to collect data has outpaced medical understanding. 
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Health apps 'useless' says health app expert

Date October 9, 2014 - 10:28AM

Matthew Hall

Amid claims that healthcare applications from Apple and Samsung will assist in propelling the health hardware industry to be worth $3 billion by 2019, an Australian expert in eHealth systems has described recent health apps as 'useless'.
Dr George Margelis, from the University of Western Sydney, told ITPro that health apps like Apple's HealthKit were of little use to medical professionals unless the collected data could plug into other digital platforms like the Federal government's eHealth systems.
Margelis called for app developers to collaborate with the health profession to make more functional and practical platforms.
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Unresolved Ethical Challenges for the Australian Personally Controlled Electronic Health Record (PCEHR) System: Key Informant Interview Findings

The American Journal of Bioethics (Impact Factor: 3.6). 08/2014; 5(4):30-36. DOI: 10.1080/23294515.2014.919972
ABSTRACT Background: A national Personally Controlled Electronic Health Record (PCEHR) system was made available across Australia in July 2012. While the technical, policy, and commercial aspects of the new Australian PCEHR system were examined thoroughly by the National E-Health Transition Authority in developing the new e-health record system, little attention was given to examining the related ethical implications of PCEHR advances. This article reports on ethical concerns about the new Australian electronic health record system identified by expert stakeholders.
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Telemedicine
Stuck in the waiting room

A long-touted health-care revolution may at last be about to arrive

Oct 11th 2014 | ROME | From the print edition
THE idea of telemedicine—health care provided using telecommunications equipment—has a lengthy history. Radio News, an American magazine, devoted its cover to a patient at home consulting a doctor in his surgery via a television link as long ago as 1924. When NASA began monitoring astronauts in space in the 1960s, fantasy became reality. It has been touted as health care’s future ever since.
But even smartphones and tablets have failed to usher in the telemedicine revolution: most health care still happens face to face. Now, enthusiasts think the wait is nearly over. Governments have been slow to embrace an approach that could improve coverage and outcomes, as well as saving money. But they are under increasing pressure from ageing populations and a surge in chronic diseases, just as public budgets are being squeezed.
At an industry conference in Rome on October 7-8th, participants discussed the problems that must be solved if telemedicine’s day is to come. They include redesigning laws and payment systems set up for face-to-face care, and finding ways to keep patients’ data secure and private.
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Pharmacist ‘alert fatigue’ blamed for woman’s death

10 October, 2014 Christie Moffatt
The failure of a pair of pharmacists to identify an adverse interaction between two prescription drugs has led to a Canadian woman’s death, according to investigators.
As reported by CBC News, 76-year-old Helena Lambert was healthy and active for her age, when she was prescribed allopurinol to treat her gout. However, Ms Lambert was already taking mercaptopurine for colitis.
The adverse interaction led to a bacterial infection that spread quickly and resulted in respiratory failure, resulting in Ms Lambert’s death in 2012.
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Trish Greenhalgh

Trish Greenhalgh is Professor of Primary Health Care and Dean for Research Impact at Barts and the London School of Medicine and Dentistry. read more
OCT 8, 2014 0

Is Evidence-Based Medicine Broken?

LONDON – Evidence-based medicine, as David Sackett and his colleagues wrote in 1996, is “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” At first glance, this seems entirely logical; indeed, many would say that this simply could be called “medicine.” But the approach is generating considerable controversy, with many asserting that it is “broken.” Last month, when the British Medical Journal asked its readers whether evidence-based medicine is malfunctioning, the responses were almost evenly split: 51% answered positively, and 49% negatively.
The controversy stems from the kind of evidence that is used. Sackett implies, but does not stipulate, that epidemiological evidence (findings from randomized controlled trials and large-cohort studies carried out over many years) should underpin doctors’ decisions about patients – and, one hopes, in consultation with them.
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Cambridge, analytics and all that: Melb Health's Dr Gareth Goodier

With a quarter century of experience as a healthcare chief executive under his belt, Dr Gareth Goodier, Chief Executive of Melbourne Health, has some critical ideas about the way healthcare systems can become more efficient, save money and deliver better patient outcomes.
“The real challenge these days is not new treatments,” he tells eHealthspace.org. “It’s affording existing treatments and making sure that they can be used across the community in an equitable manner.”
Dr Goodier’s most recent post before Melbourne Health was as Chief Executive at Cambridge University Hospital, a 600 bed facility attached to the famed university.
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Question: Using #FHIR Medication Resources

Posted on October 7, 2014 by Grahame Grieve
Question:
To what extent should FHIR Medication resources be reused? Should they be reused across multiple patients’ records?
Answer:
The general answer is that they should re-used as much as possible. The general expectation is that either a system has a formulary or drug dictionary, in which case there would be one medication resource per entry, and these commonly re-usable medications would be used across many patients, or that you are prescribing by some external code. In the second case, you wouldn’t re-use the medication resource at all.
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AUSTRALIAN research has found internet-delivered cognitive behaviour therapy (iCBT) was associated with reduced self-reported absenteeism in employees with depression, anxiety and social phobia. The study, published in the MJA, reanalysed data from five randomised controlled trials (RCTs) of iCBT between 2008 and 2010. The study included 284 participants from the trials, with a mean age of 43 years (range, 18–68 years). About 70% were women. In each of the five RCTs used in the study, the intervention group received relevant iCBT and the control group was drawn from people on waitlists for the same therapy. The iCBT course for each condition was completed over 11 weeks in six online lessons, guided by clinical psychologists, with assignments, automated emails and resource guides.
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New app shines the spotlight on the importance of breast checks for men and women

By Grayce Keen

Oct. 8, 2014, 11:52 a.m.
It is not every day that someone gets to see their life’s work recognised in Federal Parliament before being released to a global audience. And it is not every day that someone discovers they have cancer. 
Camden’s Roz Hill is that someone. Diagnosed with cancer at the age of 29, she knew the disease wouldn’t beat her.
Even when cancer claimed the life of her son, Peter, she did not lose her drive or motivation.
Instead, she founded the Young Adults Program (YAP), a not-for-profit organisation that has developed an app that takes teens and young adults through the steps of a self-examination to check for signs of breast cancer.
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Analytica launches fund raising

Wednesday, October 08, 2014 by Proactive Investors
Analytica (ASX:ALT) has initiated a 1 for 8 rights issue priced at $0.03 to raise $3.17 million.
This is a discount of 23% to Analytica's 15 trading day VWAP of $0.0388 to 2 October 2014, and the offer is partially underwritten by Patersons Securities to the value of $1,645,000.
Halonna Pty Ltd, which is controlled by Non-executive Chairman, Dr Michael Monsour, has agreed to sub-underwrite up to an amount of $200,000.
Funds will be directed to its lead product, PeriCoach – an e-health treatment system for women who suffer Stress Urinary Incontinence.
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3D printers: changing lives one hand at a time

3rd Oct 2014
WHEN trauma surgeon Dr Albert Chi gave a talk last year about advanced prosthetics and was asked what was easy, available and affordable, he was stumped. So he began to hunt for more basic options.
He turned to the 3D printer, one his wife bought him for Father's Day and with sheets of coloured plastic, free designs and advice found online, he made a hand for about $23.
"One of the first kids we fitted was a 2-year-old," Dr Chi said.
"We thought the child was too young. But we weren't even able to finish strapping it on and the kid was picking an object up."
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IT fault throws E-scripts into chaos

8 October, 2014 Chris Brooker
A faulty electronic prescribing system may have caused UK pharmacies to dispense thousands of unintended prescriptions.
A report in UK pharmacy newsletter Chemist + Druggist claims that  between August 24 and September 20, an estimated 1259 pharmacies downloaded 3600 repeat prescriptions that prescribers had tried to cancel but could not because of a technical error with an electronic prescription service.
In a letter sent to affected contractors on September 23, the health and social care information centre (HSCIC) warned that pharmacists "may have dispensed medication to patients that the prescriber did not intend".
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VIC Minister for Technology Gordon Rich-Phillips has announced that a delegation of 23 Victorian life sciences organisations will participate in the Victorian Medical Technology Mission to the AdvaMed 2014 conference in Chicago, United States.
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Australians demand faster internet speeds: ABS

David Ramli
Consumers want faster internet, according to Australian Bureau of Statistics research that appears to contradict a government report that says Australians don’t need more than 15 megabits per second.
More than two million Australians have internet access faster than 24 megabits per second in June, the bureau of statistics found.
The number of people with advertised speeds between 8Mbps and 24 Mbps rose by 1.27 million to 6.25 million last financial year.
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These Countries Have The Fastest Internet Speeds

October 6th, 2014
by Felix Richter, Statista.com
According to Akamai's most recent State of the Internet Report, South Korea boasts the highest average internet connection speed in the world.
Korea's internet users surfed at an average speed of 24.6 Mbps in the second quarter of 2014 according to Akamai's measurements (click here for details on their methodology).
Korea is trailed by Hong Kong, Switzerland and Japan who each saw average speeds around 15 Mbps. The United States ranked 14th with an average connection speed of 11.4 Mbps, which is still way above the global average of 4.6 Mbps. To add a little perspective on what these speeds mean: At 10 Mbps it takes around 50 minutes to download a 2-hour movie in HD quality.
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It's official: HP will break itself in two

CEO Meg Whitman will head Hewlett-Packard Enterprise, while PC and printer business head Dion Weisler will run HP Inc.
One of the companies, comprising HP's enterprise hardware, software and services businesses, will be known as Hewlett-Packard Enterprise, the company announced Monday. The other, made up of its PC and printing businesses, will be called simply HP Inc., and will keep the HP logo.
Both of the new companies will be publically traded, and HP shareholders will be given shares in both firms. HP expects to complete the break-up by the end of its 2015 fiscal year, which ends on Oct. 31 next year.
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Enjoy!
David.

Sunday, October 12, 2014

Could It Be True A Proper Audit Of NEHTA and How It / Has Been Performing Is About To Be Conducted?

My various informants who attended to RACGP Conference last week noted that there was a rumour running around that the Victorian Auditor General was soon to be asked to review NEHTA with respect to how it had done and how it was going in terms of providing value to the community and whether it should continue or not. The rumours seem to suggest the review is to happen quickly and not take a long time.

It is worth noting that Victoria, like a number of other States, have not paid their recent contributions to NEHTA's running!
In terms of background we learned last year that the Royale Review had recommended major changes regarding NEHTA with the creation of a new governance entity for Australian E-Health to replace and augment their utility and benefit and improve connections with all of the wide range of stakeholders.
We also know the Victorian Auditor General has a good track record in reviewing Health IT Projects - having done a great (insightful and damning) review of HealthSMART.  
Here is the link:
There is commentary here:
And here:
In case it is true a review is planned - and I have been suggesting such a review for ages - I thought assembling the responses to some of the recent polls on the blog might help the AG understand that, at the least, the relatively interested and expert readers of this blog, think how well NEHTA and eHealth Branch of DoH are performing, might be useful.
Here are the results of a few polls
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 AusHealthIT Poll Number 239  – Results – 12th  October, 2014.
Here are the results of the poll.

Have DoH And NEHTA Contributed To The Progressive Degradation Of Australian E-Health Standards Setting Processes?

Yes 91% (218)
Probably 1% (3)
Neutral 0% (1)
Probably Not 0% (1)
No 6% (15)
I Have No Idea 1% (2)
Total votes: 240
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AusHealthIT Poll Number 237  – Results – 28th  September, 2014.
Here are the results of the poll.

Do DoH and NEHTA Understand The Issues Of Clinical Safety That May Surround The Deployment And Use Of Health IT Systems?

For Sure 4% (6)
Probably 5% (7)
Neutral 15% (22)
Probably Not 33% (47)
No Way 41% (58)
I Have No Idea 1% (2)
Total votes: 142
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AusHealthIT Poll Number 235  – Results – 14th  September, 2014.
Here are the results of the poll.

How Would You Rate The Federal Government's First Year In Power As Far As E-Health Is Concerned?

Excellent 3% (3)
Not Too Bad 2% (2)
Neutral 15% (13)
Not Too Good 22% (19)
Awful 53% (46)
I Have No Idea 5% (4)
Total votes: 87
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AusHealthIT Poll Number 233  – Results – 31st August, 2014.
Here are the results of the poll.

Do You Believe The NEHTA Leadership Should Be Held Accountable For The Slow Progress In E-Health Over Almost The Last Decade?

For Sure 48% (79)
Possibly 34% (56)
Neutral 6% (10)
Probably Not 5% (8)
No Way 4% (7)
I Have No Idea 2% (3)
Total votes: 163
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AusHealthIT Poll Number 232  – Results – 24th August, 2014.
Here are the results of the poll.

Do You Believe The Present Leadership Of NEHTA and DoHA E-Health Initiatives Will Be Able To Deliver A Successful PCEHR?

For Sure 15% (41)
Probably 4% (10)
Neutral 2% (4)
Probably Not 14% (36)
No Way 65% (172)
I Have No Idea 1% (2)
Total votes: 265
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I think that the message that flows from all these questions is pretty clear. E-Health has been a fiasco for the last few years led by NEHTA and DoH. The Poll currently running will be very interesting as well.
David.

AusHealthIT Poll Number 239 – Results – 12th October, 2014.

Here are the results of the poll.

Have DoH And NEHTA Contributed To The Progressive Degradation Of Australian E-Health Standards Setting Processes?


Yes 91% (218)

Probably 1% (3)

Neutral 0% (1)

Probably Not 0% (1)

No 6% (15)

I Have No Idea 1% (2)

Total votes: 240

This is a pretty clear and enthusiastic outcome. Most are sick of Government interference in the Standards setting process and believe they have not helped.

Again, many, many thanks to all those that voted!

David.