It Looks Like We Are Heading For A Lot Of Instability In the Private Hospital Sector In NSW!

This appeared a few days ago:

Healthscope in limbo for up to a year as administrators extend auction

Max Mason Senior courts and crime reporter

Jun 20, 2025 – 8.00pm

The country’s second-largest private hospital operator could be left in limbo for a year after administrators of the collapsed Healthscope business won approval to extend negotiations with prospective buyers for months.

The company, handed to lenders by asset management giant Brookfield earlier this year, was placed into receivership last month as it buckled under $1.6 billion in debt owed to a syndicate of dozens of hedge funds and banks.

The administration process has created fears among state governments that the 37-hospital portfolio could be split up, with some of the weaker operations closing down, adding to the strain on public health systems.

KordaMentha, Healthscope’s administrators, have now sought an extension of time from the Federal Court so that McGrathNicol can undertake “an orderly and considered sale process designed to maximise value for Healthscope’s creditors and benefit key stakeholders”.

Healthscope, with 5000 beds and 19,000 staff, declined to comment.

“The sale process is complex because the Healthscope group operates its 37 hospitals through various arrangements, including several leases,” KordaMentha wrote in its submission to the court.

“The receivers may be required to negotiate new rental terms with these landlords to facilitate any sale of the business … Operating the Healthscope group business also requires engagement with state regulatory bodies in relation to hospital licenses, engagement with its heavily unionised workforce of nurses with 23 separate enterprise bargaining agreements, and continual engagement with major private hospital insurers.”

KordaMentha said the sale process had already attracted interest from several bidders, and it would be completed within the year. The Federal Court this week agreed to extend the timeline for a deal to June 30 next year.

Healthscope is now run by former Qantas executive Tino La Spina. Last month, The Australian Financial Review revealed he had told staff and doctors in a frank exchange that Bupa, a major British health insurer interested in the business, would buy Healthscope “over my dead body”.

Healthscope and Bupa clashed last year after the British fund resisted pressure from Brookfield to increase how much it paid for its members’ care. Bupa has appointed advisers to look at the assets, the Financial Review’s Street Talk column has previously reported.

Healthscope has received 10 indicative offers from private hospital operators, including Ramsay Health Care.

Health Minister Mark Butler has ruled out a government bailout of Healthscope despite the risk that some of its hospitals could stop admitting patients if a buyer for the whole business cannot be found.

The Albanese government has also flagged that it would be less receptive to offshore private equity ownership than the previous Coalition government, which approved the 2019 sale of Healthscope to Brookfield.

Brookfield took on large amounts of debt to acquire Healthscope following a bidding war for the operator at a time when hospital valuations had soared. As part of the buyout, it sold 22 properties for $2.5 billion before leasing them back at rents it now says were well above market rates.

Healthscope also faces the loss of one of its largest facilities, Sydney’s Northern Beaches Hospital, in an escalating dispute with the NSW government.

“The government must be able to act decisively to avoid a prolonged dispute for members of the Northern Beaches community, staff working at the hospital and for NSW taxpayers,” NSW Treasurer Daniel Mookhey said.

Here is the link:

https://www.afr.com/companies/healthcare-and-fitness/healthscope-in-limbo-for-up-to-a-year-as-administrators-extend-auction-20250620-p5m92l

It is difficult to see that we will see this issue fixed soon – given the long -standing issues this hospital has and the issues with operating a hospital of this complexity.

It would be good if the State-Government took it over for a few years, got it up to scratch and then put back in the private sector when stabilized! Or they could just add it to the public hospital sector – which might not be a bad idea.

David.

It Looks Like We Are In For A Few Pretty Unstable Weeks As The Iranian Situation Plays Out!

This appeared a few hours ago:

Analysis:

Trump was holding back on Iran. Then he took a phone call

The Islamic Republic has become a lot weaker recently, and the US president and Benjamin Netanyahu know it. Both gave victorious press conferences on Saturday.

Jessica Gardner United States correspondent

Updated Jun 22, 2025 – 2.41pm, first published at 2.34pm

Washington | Last Thursday, US President Donald Trump gave himself a two-week option on bombing Iran, but by Saturday evening (Sunday AEST), the job was done.

What changed in those 48 hours? Was Trump handed new intelligence? Did Iran rebuff his fortnight window to negotiate? Did he finally snap over the Trump Always Chickens Out label?

His reasons for drawing the US into another war in the Middle East are perhaps many. He certainly didn’t give a detailed explanation in his brief address to the nation, warning instead of more attacks if Iran didn’t “make peace”. But what is known is that he received a tense phone call beforehand from Benjamin Netanyahu.

US media reported that Trump, Vice President J.D. Vance and Defence Secretary Pete Hegseth spoke with Israel’s prime minister, along with Defence Minister Israel Katz and military chief Eyal Zamir.

Israel was incensed that Trump could waste the opportunity to move against Iran’s crown jewel nuclear sites by giving it more time.

At the behest of Israel, probably angering voters (and some Republicans) who supported his promise to end US entanglement far from home, and very likely sparking Iranian retaliations, Trump made his move.

Iran is a repressive regime that holds little regard for the hopes, dreams and freedom of its 92 million citizens. Its rulers have pledged to destroy Israel and have threatened “death to America”. All of this has been true for decades.

The difference now is that Iran has been significantly weakened. The most recent barrage from Israel, which caught it unaware, wiped out top-ranking military and science personnel. And the regional militias Iran funds in Lebanon, Gaza and Yemen have been cut down by Israel’s unflinching attacks over the past 18 months, which have also led to widespread civilian deaths.

Iran’s stocks are down, and Trump and Netanyahu know it. Both gave victorious press conferences on Saturday night.

Nuclear weapons intelligence

The other factor that has changed, but accounts vary, is how far away Iran was from possessing a nuclear weapon. “If not stopped, Iran could produce a nuclear weapon in a very short time,” Netanyahu said on June 13 after Israel’s first strikes. “It could be a year. It could be within a few months.”

Iran was “weeks away” from creating a nuclear weapon, Trump said on June 18, without offering any evidence.

In March, Trump’s national intelligence director, Tulsi Gabbard, told Congress that Iran’s stockpile of enriched uranium was “at its highest levels” and “unprecedented for a state without nuclear weapons”. But she also said US intelligence suggested Iran had not decided to build a nuclear bomb.

Trump, on June 21, said that she was “wrong”.

The International Atomic Energy Agency said in May that Iran had amassed enough uranium enriched to potentially make nine nuclear bombs if it undertook further enrichment. But the watchdog also noted its monitoring efforts had been hamstrung by Iran’s refusal to co-operate.

While Trump danced around the prospect of an attack in the past week, some pundits mused on the similarities with George W. Bush’s invasion of Iraq. That deadly military intervention was in response to incorrect intelligence that Iraq possessed weapons of mass destruction.

Iran has been conducting clandestine nuclear enrichment operations since the 1990s, which the regime has assured were for energy production, even if much of the globe did not trust it. The most troubling facility was Fordow, located deep in a mountainside reachable only by US-owned bunker-busting bombs, and the right fighter jets to carry them.

In his Saturday night address following the strikes, Trump said Fordow, and two other sites, Natanz and Isfahan, had been “obliterated”. That will make it challenging to ascertain exactly what was going on deep underground and cloud the basis for the operation.

What we know for sure is that this is not the end.

Trump did not shy away from that in his Saturday address. “Remember, there are many targets left,” he said. “Tonight’s was the most difficult of them all, by far, and perhaps the most lethal. But if peace does not come quickly, we’ll go after those other targets with precision, speed and skill.”

Trump may characterise these operations as a simple in-and-out, but by joining the Middle East’s latest conflict, he has lit a match in one of the globe’s most combustible regions.

After styling himself as a peacemaker who was more interested in ending wars than starting them, the unpredictable president has escalated one.

Here is the link:

https://www.afr.com/world/middle-east/trump-was-holding-back-on-iran-then-he-took-a-phone-call-20250622-p5m9b8

So here we are in the middle of another war in the Middle-East:

I fear no good can come from all this and it really is time for everyone to stand back and take a few deep breaths! The implications of all this could be pretty bad if we don't work to settle things down, and fast!

Peace has to be re-established ASAP.

Let us see how it plays out in the next few days:

David.

AusHealthIT Poll Number 799 – Results – 22 June 2025.

Here are the results of the recent poll.

Do You Think There Is A Significant Risk Of The Israel / Iran Conflict Getting Out Of Control And Resulting In A Major Conflict?

Yes                                                                     18 (67%)

No                                                                        9 (33%)

I Have No Idea                                                    0 (0%)

Total No. Of Votes: 27

Clearly an overall majority think the risk for major conflict is real as we now see happening!

Any insights on the poll are welcome, as a comment, as usual!

Not bad voter turnout – question must have been too easy. 

0 of 27 who answered the poll admitted to not being sure about the answer to the question!

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

David.

A Update To Screening Approaches For Prostate Cancer. An Update After Almost A Decade.

This appeared last week:

16 June 2025

Prostate cancer screening gets revamp

By Laura Andronicos

But not everyone agrees with the recommendations, which would significantly change how GPs screen and treat patients.

---

The draft 2025 clinical guidelines for the early detection of prostate cancer have been released and some changes have sparked a strong response from the RACGP. 

The Prostate Cancer Foundation of Australia (PCFA) is replacing the current 2016 version and changing who is screened and when, who is offered active surveillance or definitive treatment, and removing biopsy as the primary test following an elevated PSA, among other things. 

“We need these new guidelines, because much has changed over the last decade in the diagnosis of prostate cancer,” said Dr Brett Montgomery, RACGP representative on the guidelines steering committee. 

He said many GPs found it challenging to counsel patients about early detection of prostate cancer, but the update will provide clear guidance about PSA testing and interpreting results, including flowcharts of action points that are easy to read and implement. 

The guideline includes new risk factors, with particular focus on recognising Aboriginal and Torres Strait Islander males as a priority population due to worse survival outcomes than the general Australian population. 

There were no specific recommendations for this population in the previous guideline, but now PSA testing is recommended every two years from the age of 40. The PCFA highlighted this as a world-first recommendation. 

Dr Montgomery told TMR that the recommendation to offer testing to males aged 50-69 is still what is best supported by evidence. However, the update offers support for starting screening earlier for people at increased risk. 

“They offer some cautious flexibility in the age of starting and stopping testing: allowing doctors to respect patient choice in testing from age 40 or beyond age 70 in people who are keen and relatively well, even though evidence of benefit in these age groups is much more slender,” he said. 

However, the RACGP expressed “major concerns” with the move, saying the disparity in mortality rates for Aboriginal and Torres Strait Islander people was likely due to access to and engagement with health systems. 

“The evidence cited in the draft guideline shows no significant difference in the age of diagnosis or spread of disease at diagnosis in Aboriginal and Torres Strait Islander men,” said Professor Mark Morgan, chair of the RACGP expert committee. 

“Therefore, while they are a priority population, the RACGP is concerned this approach may lead to more unintentional harms, such as false positive PSA tests and overdiagnosis.” 

For Aboriginal and Torres Strait Islander men aged 40-49, a PSA of 1.0μg/L or greater, or a PSA of 2.0μg/L or greater for men aged 50-69, would prompt a repeat test within three months. These age and PSA ranges also apply to other risk factors that were not identified in the 2016 guideline, such as black males of sub-Saharan ancestry, males with a BRCA2 gene mutation and a family history of prostate cancer. 

Family history specifically refers toas a brother diagnosed with prostate cancer, a father diagnosed with prostate cancer before the age of 65 and/or two or more second degree relatives who died of prostate cancer. The draft suggests that these risk factors can more than double the risk of an individual dying from prostate cancer. 

The RACGP recommended including men who take exogenous anabolic steroids as a risk factor, not because they’re at a higher risk of prostate cancer but because these medications may stimulate prostate cancer growth. 

There are also proposed changes to who should be offered active surveillance.  

The PCFA recommends reducing the PSA threshold from 20μg/L to 10μg/L and requiring a PSAD of 0.15μg/L/mL or less, an MRI PI-RADS of 3 or less and a clinical stage of T1-T2a. All criteria must be met to offer active surveillance.  

The previous guideline did not advise testing men over the age of 70, but the new guideline aims to reverse that, recommending testing based on clinical assessment rather than age alone.  

The RACGP asked for clarification, suggesting that clinical assessment should be clearly defined and include life expectancy, comorbidities, and patient values and preferences. 

It also recommended adding guidance for GPs on making a shared decision to discontinue testing in healthy men aged 70 and over with a PSA less than 1.5μg/L, as these individuals were unlikely to benefit from further screening. 

“A problem in the past has been that only a tiny proportion of participants have their life saved through early detection. And these benefits have needed to be weighed against the hazards of prostate screening, including overdiagnosis,” said Dr Montgomery. 

He said that for every 1000 people getting tested, they see around one life being saved after 11 years, two after 16 years, and perhaps four after 25 years and 14 after 40 years. These numbers were outlined in the RACGP submission, which cautioned potential overdiagnosis from the expansion of screening recommendations.  

The previous guideline had a lot of criteria for offering definitive treatment, but the update suggests that it only requires either pathological progression detected from a biopsy or based on patient preference.  

Under the new guidelines, biopsy will no longer be considered the primary testing approach after an elevated PSA. mpMRI is now the preferred first diagnostic test following a raised PSA result and will determine if a biopsy is required.  

Ultrasound-guided transperineal approach is now the preferred biopsy method to reduce infection risk, as opposed to transrectal. The optimal number of cores for targeted biopsy have been reduced from 21-24 to a minimum of 3-4. 

 The RACGP recommended the development of a national registry for prostate cancer screening be considered by the PCFA.  

“This will help avoid duplication of testing for patients who see multiple providers, as a central system will capture people who move to a different GP and/or clinic, and allow GPs to undertake the recalls and reminders for screening,” they wrote. 

They also suggested providing a clear list of changes to screening tests, such as the removal of the free-to-total ratio. 

“I would like to see the development of resources that help GPs to work with their patients to weigh the good things and the bad things about testing so that patients can reach a decision on testing that is in keeping with their own values,” Dr Montgomery said. 

“I know that good people are working on such a resource now.” 

This article was updated to include comments by Dr Montgomery.

Here is the link:

https://www.medicalrepublic.com.au/prostate-cancer-screening-gets-revamp/117609

A useful summary of the current recommended approach.

David.

This Was An Atrocity Perpetrated By The Religious Self-Rightgeous On The Innocent IMVHO!

 This appeared last week:

https://www.theaustralian.com.au/nation/world/irish-inquest-hears-indians-abortion-refusal-was-catholic-thing/news-story/802582c3959f49ff7fb66a54c023eb7e

Irish inquest hears Indian's abortion refusal was 'Catholic thing'

Updated 9:56AMApril 10, 2013

AFP

AN Irish inquest into the death of a pregnant Indian woman who was allegedly denied a termination heard from a witness who said an abortion was refused due to a Roman Catholic ethos.

Savita Halappanavar, a 31-year-old dentist originally from India, died in a hospital in Galway, on the west coast of Ireland, last October after suffering a miscarriage.

She was 17 weeks pregnant and miscarrying when she went to Galway University Hospital on October 21, complaining of backache.

During evidence on the opening day on Monday, her husband Praveen said his wife, a Hindu, repeatedly requested that doctors terminate the pregnancy when it was clear the pregnancy was not viable but they refused because there was still a foetal heartbeat.

In evidence, family friend Mrudala Vasepalli recalled being present when Savita asked if anything could be done to save her baby, and when told there was not, requested if anything could speed up the inevitable.

"We don't do that here, dear. It's a Catholic thing," Ms Vasepalli recalls being told by the midwife.

She described her friend as being in great emotional distress when she discovered her baby would not survive.

"She was crying every time. She said: 'Either way it hurts me. If the heartbeat is there, it hurts me. If it stops, it hurts me. What kind of mother am I, waiting for my baby to die'," she told the packed courtroom.

The medics who treated Savita gave evidence, with questioning focusing on whether due care was given to the risk of infection when it became clear Savita was miscarrying.

The court heard blood tests taken the night she was admitted that showed raised white blood cells -- an indication of infection -- were not acted on until three days later.

An experienced midwife, who cared for Savita in the days before her death, said she was frightened by the rate of deterioration in her condition.

"I have never seen a woman suffering a miscarriage get so sick so quickly and I have been on that ward seven years," nurse Miriam Dunleavy told the court.

The consultant doctor whom Praveen Halappanavar said on Monday refused a termination due to a Catholic ethos in Ireland also read her statement, although cross examination was adjourned until today.

Dr Katherine Astbury said she had discussed termination with Savita after she requested medicine to expedite the process after she was told the outlook on the pregnancy was poor.

Dr Astbury told the court she had explained to Savita that the legal position in Ireland did not permit her to carry out a termination at that time.

Her legal team have indicated she will strenuously deny making any reference to Catholicism in her dealings with the couple.

Abortion is illegal in Ireland unless there is a substantial risk to the life of the mother, with Astbury stating she discussed this option with Savita when her condition had worsened.

"I also informed Mrs Halappanavar that if she did not continue to improve we might have no option but to consider termination drugs."

Savita Halappanavar died on October 28 from complications as a result of septicaemia.

Praveen Halappanavar said the inquest was his last chance to discover the truth about how and why his wife was treated.

Almost 70 statements from hospital staff, police and other sources have been gathered for the inquest but not all of their authors will appear as witnesses.

The case has once again focused attention on the Irish Republic's strict abortion laws.

Dublin has vowed to introduce legislation, expected in July, to make the rules surrounding abortion easier for doctors and patients to follow.

AFP 

All I can say this was a very sad piece of Irish history which is now recognised for the wrongs it clearly caused through heartless application of Roman Catholic doctrine. There are some heartless people in the world I must say!

I hope we will never see such wrongs again!

David.

Having Had Two Of These There is Pretty Sould Advice Here I Reckon!

 This appeared last week:

 Everything I wish I had known before, and after, my hip replacement

So you’re thinking about a hip replacement. Here’s what you can learn from my experience before and after surgery, from pain management to when to get your teeth cleaned … and will you be able to manage the dog?

Natasha Robinson

15 June, 2025

When I had a total hip replacement earlier this year, like many people I had no idea what I was in for. These are all of the things I wish I’d known before and after the procedure.

Why wait? Your artificial joint might last a lot longer than you think

I was limping around for almost three years before my hip replacement, doing everything I could to delay the procedure. I figured I should wait for as long as possible before going under the knife given what I’d been told about prostheses generally lasting only around 20 years. I was stunned when I went to see my orthopaedic surgeon and he told me the new generation joint he would implant in my body could well last me a lifetime.

Nobody really knows the life of these new joints, but the prospects of them lasting a lot longer than 20 or 30 years seems high, according to orthopaedic surgeons.

One thing that many people don’t necessarily consider when they try to put off hip surgery is the biomechanical impacts on the rest of the body. Lack of mobility in the hips and an impaired gait has knock-on effects on the posture and potentially the knees.

No orthopaedic surgery is without risks, and a total hip replacement is not a decision to be taken lightly. There’s no guarantee of a perfect result, but the surgery is one of the most successful orthopaedic surgeries with a very high rate of good outcomes. Despite being relatively young for this surgery, I’m glad I didn’t wait any longer than I did.

New-generation prosthetic hips may last as long as 50 years.

The surgical approach

The traditional surgical method in a total hip replacement is the posterior approach, in which an incision is made at the back of the hip near the buttocks. During the surgery, the surgeon will split the gluteus maximus muscle to access the hip joint.

Some surgeons instead perform hip surgery via an anterior approach, where the incision is made at the front of the hip. This avoids cutting through muscle and can lead to less soft-tissue damage, less pain and a faster recovery, but it is associated with a small risk of nerve damage.

Another modern technique is hip resurfacing, which involves trimming damaged parts of the femoral head and replacing the hip socket with a metal cap. Hip resurfacing may be suitable for younger people who are keen to return to high-impact exercise after surgery (this is the type of hip surgery the British tennis player Andy Murray had before going on to continue playing professional tennis).

Preparing for surgery

In the weeks leading up to your surgery, you’re going to want to get organised with a set of crutches, a “grabber” to allow you pick things up off the floor as you won’t be able to bend down for several weeks after the surgery, and a shower chair for the first couple of weeks. A raised toilet seat is highly recommended as if you have the posterior approach, it’s recommended that your bottom is always higher than your hips when sitting – this is one of the hip precautions to minimise the risk of dislocation.

For the same reason, a wedge cushion for sitting on chairs or the couch is also very useful. Be sure to have a couple of ice packs on hand at home as well.

In the months leading up to your surgery, you should do all that you can to strengthen your lower body. This will stand you in good stead for your recovery. The stronger you go in to the surgery, the stronger you’ll come out.

Call in help

Be sure to stock your freezer with meals for the first week or two, or organise a food delivery service. If you have a dog, organise someone to walk your dog for a few weeks. Even though you’ll be walking soon after surgery, you won’t be able to manage walking a dog while you’re on crutches. If you’re on your own, as long as you have these factors organised, having a carer with you for more than a couple of days probably won’t be necessary, but be prepared to let the cleaning go for a few weeks.

The days before

Your anaesthetist should call you in the week leading up to surgery. If you’ve taken pain medicines before, make sure you tell them what has worked well for you in the past and what hasn’t. Hospitals typically give endone as pain relief immediately after surgery, but some people are non-responders to this medication and if it hasn’t worked for you in the past, you should tell your anaesthetist. It’s useful to specifically discuss with your anaesthetist what the protocols are for pain management. Oxycodone given orally is the first line of pain management in some hospitals, and believe me if it’s not doing anything for you, you’re going to want to know what the protocol is for accessing stronger drugs or an IV unit.

On the day before the operation, it’s recommended you use an antibacterial wash on your skin the night before and the morning of surgery to minimise infection risk. Make sure you stay really well hydrated the day before surgery. Some people take Gatorade for this reason.

Immediately after the surgery

You’ll typically have a spinal anaesthetic as well as general, so pain should be minimal upon waking up from surgery. Your legs may feel numb from the spinal. Nurses may give you oxycodone orally or via IV once you’re on the ward. It’s very important to stay on top of your pain relief after surgery. Doctors speak of “staying ahead of the pain”, and this means you should never wait until you’re in a lot of pain to take medication. It’s best to take pain meds continually so the pain is manageable – this is really important in order to get you up and moving as soon as possible.

Robinson was on crutches for a short time after her hip replacement. Picture: John Feder

You’ll have a urinary catheter in immediately after surgery so you don’t need to worry about navigating your way to the toilet for the first 24 hours or so.

You’ll typically be visited by a physio within 12 or 24 hours after the surgery who will help you take a small walk supported by a walking frame. Hospital stays after hip replacement are generally a few days, and during this time physios will help you learn to manage stairs and let you know when you may be ready to progress from a walker to crutches. People are generally discharged from hospital on crutches (you’ll need your own).

Don’t worry if you have stairs in your house – navigating stairs after hip replacement is really very easy, with the method being to lead up the steps with your non-operated leg, and down steps operated leg first.

You will be able to shower sitting in a chair in the hospital as soon as you’re mobile – surgical dressings used these days are very waterproof.

Be prepared to deal with constipation – oxycodone blocks most people up. The hospital will generally give you an osmotic laxative daily, but be sure to drink a lot of water and don’t be shy to ask nurses to give you a glycerol suppository if you haven’t moved your bowels after a few days. Prunes and pears are great to have on hand.

Pain and swelling

Don’t be surprised if your operated leg is black and blue after surgery. Significant swelling is also normal, and this should subside within a few weeks but sometimes can hang around a lot longer. Apply ice packs regularly in the days and weeks after surgery.

It’s difficult to predict how much pain you may experience. Hip replacement is major surgery. Some people are in a lot of pain in the days after surgery, and others not. For most people, the worst of the pain subsides within about a week.

Sleeping

For the first couple of days after surgery you’ll have to sleep on your back, which can be a challenge for side sleepers. After a few days, ask your doctor whether it’s okay to sleep on your non-operated side with a pillow between your legs. You won’t feel comfortable to sleep on the operated side until a few weeks after surgery.

Take as many naps as you need in the weeks after surgery. Many people feel a lot of fatigue.

Keep moving

Walking is the best thing you can do for rehabilitation. You can build up a little more every day, but try not to increase your step count or distance too quickly – a little more every day is the key. After two to three weeks, you may be able to walk a kilometre or even two on your crutches, but don’t worry if you’re much slower to progress. All recovery is individual.

Physios in the hospital will give you some exercises to do. Usually these include leg slides in your bed, squeezing your glute muscles in bed, and then progressing to standing lateral raises and vertical raises of your operated leg, and perhaps sitting up and down out of a chair if you’re ready.

If you are in a health fund, your policy should provide you with ongoing physio at home for a few weeks, either through a hospital in the home rehab provider or a private physio. You also have the option of choosing to go to a rehabilitation facility, although the outcomes between these two options are little different, according to the evidence.

Rehabilitation in a swimming pool after a hip replacement is highly recommended. Picture: Getty Images

Once your incision is fully healed, generally after a few weeks, you will be able to move your rehab to a swimming pool if you wish. The water provides excellent resistance during exercises such as walking in the water or performing lateral raises or kickbacks to build up your strength.

Returning to work

I was able to return to work after three weeks, working a couple of days from the office and the rest of the time at home. Some people need a lot longer. Prepare your workplace that you may need six weeks off, or more if you work a manual job.

The long term

After you see your surgeon for the six-week follow-up and get the all-clear to return to exercise, if you wish you can progress your movement to stationary-bike cycling. Avoid treadmills at first as they are too risky given the moving platform. Under the guidance of your physio you should also be able to start to increase the resistance using bands or weights in strength-based exercise to rebuild your legs, focusing on quads, glutes, abductors, adductors and hip flexors. Be sure to be gentle on yourself; after surgery, your body is still working to integrate your metal joint by growing native bone around the prosthesis. If you are a gym-goer, performing upper-body strength work as normal should be fine after six weeks but be guided by your physio.

I would stay away from gym classes for a while as they can be too fast and unpredictable. My surgeon said yoga was OK but just be careful of your hip precautions (such as avoiding too much hip flexion) and let the teacher know you’ve had a hip replacement. My surgeon also recommended never squatting below 90 degrees or deep lunging after a hip replacement, and to avoid any rotational movements for the first few months.

Expect to notice a significant difference in strength between your operated and non-operated leg for a substantial period of time. It’s likely to take a year or even more to feel fully back to normal.

As far as driving goes, you’ll need to get clearance from your surgeon before getting back behind the wheel. You won’t be able to drive until your operated leg has recovered sufficiently to be able to operate the pedals – for most people this generally takes four weeks or so.

Leg length discrepancies

Some people notice that their operated leg seems longer than the other one after surgery. It’s very rare that there is a true leg length discrepancy given that surgeons are so precise in their measurements. Usually the cause is a tilt or twist of the pelvis because of the impaired way you’ve been walking prior to having the surgery. Try not to panic if your legs seem markedly different in length. The body usually naturally balances itself out. If you feel particularly uneven in the longer term you can see a podiatrist who may recommend an orthotic, or you can wear heel lifts in your shoes. Often people may need the other hip replaced in future too – and if this is the case your legs will generally end up the same length once you’ve had your other hip done.

Red flags

There is a small risk for weeks, months or even years after surgery of an infection forming in the prosthesis. A lot of people opt to get a dental scale and clean before the surgery as this procedure can release bacteria into the bloodstream. You should be particularly careful that any cuts or scrapes don’t become infected after you’ve had surgery, and to take antibiotics promptly if you develop a urinary tract infection. If you notice any redness developing around your incision site at any point, contact your surgeon or see your doctor immediately.

Preserving the life of your new hip

Unless you can’t live without it, it’s not recommended to return to jogging or any high-impact exercise after a hip replacement. If you do so, be prepared that your new hip won’t last as long. Otherwise, life can return to normal in every other way after recovering from a hip replacement. Most people are overjoyed to be able to live a pain-free life. Oh, and you’re probably not going to set off any alarms at airport security either. The days when prosthesis triggered alerts seem to be behind us in most airports.

 Here is the link:

https://www.theaustralian.com.au/health/medical/everything-i-wish-i-had-known-before-and-after-my-hip-replacement/news-story/7d81450e275b560b01d14ebf047e7cfa 

 I thought this was a pretty useful summary, from a fellow victim of this surgery!

All I can say is that it is a fabulous operation that has made me pain free and lasted a good two decades. Amazing and just fabulous outcome from my perspective!

David 

You Really Do Sometimes See Absolute Rubbish from Some So-Called Experts!

This appeared last week:

Why Australia’s healthcare future depends on technology

13 June 2025

By Bronwyn Le Grice, CEO ANDHealth

Australia’s health system is rightly celebrated for its world-class outcomes, but beneath the surface, it is straining under the weight of rising costs, workforce burnout and shortages, and growing demand.

At the same time, the health system is being asked to deliver better and more equitable health outcomes and experiences for everyone involved; patients, clinicians, carers, the broader community and administrators.

As the demands on our system mount, it is increasingly clear that we cannot hope to achieve these objectives with the tools and approaches of the past. Technology is not a luxury or an optional extra, but rather, as Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation said, “the future of health is digital”.

The evolution of healthcare goals over recent years reflects a deeper understanding of what it will take to create a system that is not just efficient, but also equitable and sustainable. Where once the focus was on balancing health outcomes, patient satisfaction, and cost, it is now widely recognised that a thriving workforce and fair access for all are equally essential. These aspirations have become the benchmark for health system reform, and achieving them demands digital transformation at its core.

Slow to digitise

For all the sophistication of our clinical care, healthcare in Australia has been notoriously slow to digitise its operations. Paper-based records, faxed referrals, and manual phone calls remain commonplace. The opt-out approach for My Health Record has been a success with 24 million records covering 99% of the population, but only in 2023 was legislation passed mandating health data to be uploaded, starting with pathology and diagnostic imaging. which will improve the accessibility and utility of the platform.

This hesitancy is not for lack of innovation, but rather a legacy of risk-averse processes designed to protect patient safety and a lack of agreed reimbursement models. However, the events of recent years have shown that this inertia is no longer tenable.

As Chris Blake, CEO of St Vincent’s Health Australia, has observed, “At some point we have to stare into that together as an industry and say, ‘you know what, there’s no new money coming in’. We have to change the system to use the money differently.” Technology is the lever that allows us to do just that, delivering more, and better, with the resources we have.

A watershed moment

The COVID-19 pandemic was a watershed moment for digital health in Australia. Almost overnight, telehealth and remote monitoring became not just convenient, but essential. This rapid shift proved that technology could simultaneously enhance patient access, reduce overheads, and safeguard public health, delivering on multiple priorities at once. But realistically, this change wasn’t so much about embedding cutting-edge technology, rather this was a change in policy and payment settings (and a global pandemic) driving a shift to a well-established technology modality.

Thus, today there remains a disconnect between the capability of the available technologies, patient and clinician enthusiasm and the appetite of policy makers and governing entities to fully embrace a software enabled and empowered health system.

While digital solutions are playing a role in everything from appointment scheduling and e-prescriptions to clinical decision support and AI-assisted note-taking, there remains an all-pervading fear of the unknown and a focus on investigating all the possible risks in deploying a new technology, with less focus on the risks in NOT deploying evidence-based technology into healthcare settings.

As recently as this March the South Australian Government implemented a ban on the use of AI scribes in public healthcare settings due to concerns around governance and privacy . At the same time the Australian Medical Association says that one in every four or five Australian doctors use AI scribes, particularly to remove administration burden.

Safe and responsible use

Professor Shelley Dolan, Chief Executive Officer of the Royal Melbourne Hospital, recently commented, “What I know about our clinicians is that they are incredibly bright and incredibly driven. They always find innovative ways to deliver the care and productivity that is required.”

That is not to say use of unregulated or unapproved technologies should be carte blanche, but rather reinforces the need for modernised policy and governance to encourage safe and responsible use. 

These tools are not merely about efficiency; they are about enabling clinicians to focus on care, empowering patients to take charge of their health, and generating the data needed to address inequities and improve outcomes.

As Catherine de Fontenay noted in the Productivity Commission’s report Leveraging Digital Technology in Healthcare, “Australia’s health system delivers some of the best outcomes of any in the world – but the cost of this care and wait times to access it are growing. Making better use of digital technology in healthcare could help address these problems while maintaining or even improving outcomes.”

The pleasing news is that Australia is poised to lead its own transformation. According to ANDHealth’s recent report, “The Rising Giant: Creating a New Economic and Health Future for Australia,” our digital and connected health sector has experienced extraordinary growth, with more than 1,000 companies now active and a compound annual growth rate of 52 per cent since 2019.

This is not simply a story of more companies, but of a sector maturing rapidly: the proportion of mid-to-late stage companies (those at proof of concept or later) has risen from 27 per cent in 2020 to 45 per cent today, signalling a vibrant ecosystem ready for investment and impact.

Momentum continues

This growth is no accident. It reflects the convergence of world-class research, entrepreneurial talent, and a health system that has demonstrated an ability to adapt when the stakes are high. The pandemic accelerated adoption, but the momentum has continued, fuelled by both necessity and opportunity. As a result, Australia is not just keeping pace with global trends; it is poised to set them.

But just as there is often a risk averse approach to adopting technology, the same cautious policy framework results in a difficult environment for smaller Australian companies seeking to place technologies, products and services into local health systems.

Procurement policies which are designed to prioritise locally owned and developed technology or innovations ahead of international competitors would be game changing for Australia’s digital and connected health sector. 

The challenge

The challenge before us is not whether to embrace technology in heath and care, but how to do so in a way that embeds it into the frontlines of care, rather than running technology as a parallel project analogous to the in-house server racks and CD-ROM based software of old.

The second challenge is to make a conscious choice to consume our own world class innovation, putting aside the “nobody gets fired for hiring IBM” mentality and backing our home-grown, world class innovators.

Both of these require investment, policy support, defined reimbursement pathways and a willingness to reimagine how care is sourced, delivered and measured.

As “The Rising Giant” report makes clear, the sector is ready. What is needed now is a coordinated effort to procure our innovative, evidence-based technologies at scale, integrate them into mainstream care, and ensure that future generations of Australians benefit from the best health and care possible.

Here is the link:

https://www.pulseit.news/pulseit-blog/why-australias-healthcare-future-depends-on-technology/

I will leave it to my discerning readers to decide the value of Ms Le Grice’s contribution. To me she is rather re-stating the bleeding obvious......

I look forward to some insightful comments!

David.