Does Tony Abbott & Co intend to shut down Medicare Locals?

ABBOTT THEN

http://www.youtube.com/watch?v=THg9v2myR1A&feature=share&list=PLn2RjxYNpcawPF8VIJgkcR5IUj115X2iA

ABBOTT NOW

ABC News 22 April 2014:

The ABC has learned a number of Medicare Local chief executives have been told the Federal Government plans to shut down the current system.

Speculation has been mounting that the local health bodies, which were set up under the Rudd government to organise community-specific health programs, will be scrapped in next month's budget.

Late last week chief executives of the 61 community-based health organisations held a series of a conference calls to discuss the Government's plans for the scheme.

Some of the Government's proposals for 2014-15 under serious consideration include:

·         ending funding to Medicare Locals

·         establishing larger statutory agencies to funnel state and federal funding

·         heavier involvement of private health insurers

·         more focus on GP involvement

·         putting services out to public tender

·         abolishing the peak body Australian Medicare Local Alliance

The potential changes have caused widespread angst among the local healthcare organisations.

A circular obtained by the ABC, sent to the heads of each Medicare Local by its peak body, urges each organisation to lobby their local member of Parliament.

"I would urge MLs [Medicare Locals] to continue to engage across the political spectrum and highlight, not only the good work of MLs but what would be lost if MLs were not there," it said.

There are concerns the changes will lead to more centralised control and a move away from the locally driven programs offered by each organisation.

Sources say communities would no longer be involved in deciding what programs would run.

"Many of the programs have been running for two years and are just starting to hit their straps and show results," one industry source said.

Hospital mortality rates - not always good news for those living in rural and regional NSW

Bureau of Health Information (December 2013), 30-day mortality following hospitalisation, five clinical conditions, NSW, July 2009 – June 2012: Acute myocardial infarction, ischaemic stroke, haemorrhagic stroke, pneumonia and hip fracture surgery:

Acute myocardial infarction - There were 91 hospitals (90%) with mortality no different to expected. Three hospitals (Royal Prince Alfred, Royal North Shore, Prince of Wales), had lower than expected mortality and seven hospitals (Milton and Ulladulla, Cessnock, Bowral, Tamworth, Hornsby, St George, and one not reportable*) had higher than expected mortality.

For ischaemic stroke - There were 57 hospitals (80%) with mortality no different from expected. Four hospitals (Concord, Prince of Wales, Belmont, and Manly) had lower than expected mortality and ten hospitals (Moruya, Tamworth, Dubbo, Lismore, Nepean, Coffs Harbour, Westmead, Royal Prince Alfred, John Hunter, and one not reportable*) had higher than expected mortality.

Haemorrhagic stroke - There were 82 hospitals (94%) within the expected range of results. Two hospitals (Fairfield, and one not reportable*) had lower than expected mortality and three hospitals (Port Macquarie, John Hunter, and one not reportable*) had higher than expected mortality.

Pneumonia - There were 126 hospitals (89%) within the expected range. Seven hospitals (Canterbury, John Hunter, Bankstown, St Vincent’s, Maitland, Shellharbour, one not reportable) had lower than expected mortality and nine hospitals (Inverell, Manning, Tamworth, Blacktown, Wyong and four not reportable*) had higher than expected mortality.

Hip fracture surgery - Results for 33 hospitals (87%) were within the expected range of mortality. One hospital (St Vincent’s) had lower than expected mortality and four hospitals (Tamworth, Orange, Gosford, and Coffs Harbour) had higher than expected mortality.

Click on images to enlarge

Australian Federal Election 2013: National Rural Health Alliance gives Coalition fail mark on health policies

http://ruralhealth.org.au/advocacy/election

About Us - National Rural Health Alliance

About that $1 billion that Abbott states was never cut from federal health funding

On 7 October 2003 the current Federal Leader of the Opposition Tony Abbott became Minister for Health and Aging in the Howard Government – a position he held until December 2007.

These are the facts about the Australian Health Care Agreements 2003-2008 :

Each of the predecessor Agreements provided indexation formulae to account for growth and ageing of the population. The 1998–2003 Agreements also recognised that there was further "utilisation drift", that is increases in utilisation were occurring in the hospital sector over and above that which can be explained by population growth and ageing. This utilisation drift was in part the result of new technologies that allowed for treatments for conditions for which there was previously no hospital treatment. Utilisation also increased because of shifts in treatment from general practitioners' rooms and other ambulatory settings to same day hospital admission.

The 1998–2003 Agreements provided an escalation factor of 2.1% per annum over and above the growth caused by the increase in the rate of population for key elements of the grant. The 2003–08 Agreements reduced the utilisation drift factor to 1.7% and narrowed the applicable components of the grant, saving the Commonwealth Government about $1 billion from that provided for in the Forward Estimates. This reduction in growth provision was vociferously opposed by States and also by clinicians who were experiencing significant financial pressures on hospitals as a result of State Government funding constraints

In a 26 October 2007 radio interview with Mike Carlton, Tony Abbott admitted that there had been “a forward estimates adjustment” and agreed that “the share of federal government [health] funding has gone down from 45 per cent to 41 per cent since 1996”.

Only one NSW Northern Rivers hospital met the state 2013 National Emergency Access Target, Jan-Mar 2013

The 2013 NSW target is for 76% of all patients to depart hospital emergency departments within four hours of arrival by the end of the year.

The NHPA Media Backgrounder released on 25 July 2013 shows that only a handful of hospitals have met the lower state target set for the first quarter, with only one Northern Rivers hospital listed:

In the 2012 the New South Wales performance time target for emergency departments was 69%.

Figure 4: Percentage of all patients departing ED within four hours of arrival, regional NSW and the cities of Tweed Heads and Wollongong, 2011–12

The truth about Grafton Hospital funding

From The Daily Examiner letters to the editor pages in April-May 2013.

HE SAID:

Truth about hospital

I take deep umbrage to the statement by Shirley Adams that Janelle Saffin is the only one to do anything for Grafton and the Valley.
Shirley has never been backward in blowing her own trumpet but she knows very well what was achieved in my time as member.
The community centre, South Grafton levee, the hockey complex, the Airport Road, upgrades to state and private schools, a new railway station, the tourist centre, the list can go on.
The Grafton hospital is a good case in point. John Howard asked me to identify a project in my electorate to be funded from the surpluses we were achieving in government. I chose Grafton Base Hospitable because the State Labor Government had been promising upgrades but nothing ever happened.
The estimated cost of upgrade at the time was $18million.
John Howard came to Grafton and announced that the Federal Government would provide $18million to upgrade the hospital but he would give the money to a local committee because he did not trust the State Labor Government to spend the money on the hospital. If John Howard had not made this commitment, there would have been no interest from Labor.
These commitments were made because we had money in the bank, not the legacy from Janelle Saffin - at present $272billion of debt. Interest alone on this debt is $8billion a year. How many Pacific Highways would that fund?
Shirley Adams, Dr Allan Tyson and The Daily Examiner were all at that press conference and heard the statement. None has had the decency to acknowledge that as fact. There was no election called and the money was immediately available.
Remember, hospitals and highways are state responsibilities under the constitution and John Howard was the first prime minister to offer federal help for health, the Pacific Hwy and money to local councils for rural roads.
The very fact that Janelle Saffin claims there was interest accumulating proves the money was in a dedicated account for Grafton hospital and not part of the budget process of the new government.
I am delighted that Grafton Base Hospital has finally been upgraded, but an outbreak of the truth in these matters, instead of blatant politics, would be a pleasant change.

 Ian Causley

Chatsworth

SHE SAID #1:

Unrealised promise

Ian Causley (The Daily Examiner, letters April 23) stated; "John Howard came to Grafton and announced that the Federal Government would provide $18 million to upgrade the hospital but he would give the money to a local committee because he did not trust the State Labor Government to spend the money on the hospital.
The very fact that Janelle Saffin claims there was interest accumulating proves the money was in a dedicated account for Grafton hospital and not part of the budget process of the new government."
Yes, John Howard was reported as making that announcement on October 10, 2007.
Four days before he announced his intention to call a federal election and seven days before the writs were issued, Parliament dissolved and the caretaker period commenced. (Australian Electoral Commission 2012).
Additionally, this promised hospital upgrade funding was not included in the Howard Government 2007 budget papers, in October there was no "local committee" for it to go to if it had actually been allocated and, on October 11, 2007 the NSW Government rejected this "election promise" (ABC News).
Then on November 24, 2007 the Coalition lost government and John Howard lost his seat. So Mr Causley's $18 million existed only as an unrealised promise and it is wrong of him to suggest otherwise.
Especially as in June 2008 the then NSW Nationals MP for Clarence identified federal Grafton Hospital upgrade funding as being provided by the Rudd Government.

Judith M. Melville

Yamba

SHE SAID #2:

The real truth

It is a bit sad that former member for Page Ian Causley (DEX April 23) feels the need to claim credit from retirement for delivering the Grafton Base Hospital redevelopment.
I acknowledge that Ian, after years of inaction, elicited an $18 million commitment out of former prime minister John Howard in the dying days of that government.
However, that pledge was unfunded and had strings attached. Mine was funded and came with no strings.
The big difference here is that my 2007 election commitments of $18 million for stage one and $5 million for the Grafton GP Super Clinic, made with former prime minister Kevin Rudd's full support, were rock solid.
I was the politician who actually delivered the goods. Federal Labor's $18 million was in the 2008-09 budget, the money went to the then NSW Labor Government, where it earned $1.2 million in interest while the project was being planned.
Ian is plainly wrong when he suggests that the money was in some dedicated federal account. It was not.
I lobbied former NSW health minister John Della Bosca for the interest to be directed to the project, which was unprecedented, and for his government to contribute a further $500,000 to planning.
I got both for our community.
I made sure, with Dr Allan Tyson's attention to detail and Shirley Adams OAM's vigilance, that a total of $19.7 million in funding was wisely spent on building a first-class emergency department, operating theatres, and some extras.
Ian's attack on Shirley, who is widely respected as one of the Clarence Valley's leading citizens, was unwarranted and petty.
He should know that it is not just about the funding.
Hard-working MPs then work with their community to bed down the project with bureaucrats, construction managers and staff.
This is how we, as a united local community, fought for and won first-class health facilities offering high standards of patient care.
And for the record, I secured and delivered a further $10 million for stage two of the Grafton Base upgrade, made up of $6 million from this federal government and $4 million from the then NSW government.

Janelle Saffin MP

Federal Member for Page

How we see our public hospitals on the NSW North Coast

 

Even though Hospital Performance 2012 shows New South Wales has some of the longest emergency department waiting times in the country and the Healthcare in Focus 2012 report indicates that we are more likely to die than our metropolitan cousins within a month of public hospital treatment for heart attack or stroke in regional NSW, it appears that the majority of patients are relatively satisfied with the care they received as outpatients.

 

Comparisons of standardised ratings of outpatients’ overall ratings of care in NSW public hospitals, February 2010*

 

 

*Outpatient care module of the NSW Health Patient Survey 2010

 

 

Patient Care Experiences: Outpatient services in NSW public hospitals  August 2011

 

Skinner: Now I'm Health Minister It's Not A Dumb Idea

The Northern Star asked a hard question which resulted in more than a petticoat showing on 11^th December:

“STATE Health Minister Jillian Skinner has been forced to defend a cost-cutting proposal to allow single-crew ambulance cars to transport patients to hospital during her visit to the Northern Rivers today.

The new proposal will allow single-crew ambulance cars currently in use to transport willing and able patients.

Ms Skinner said such cars were staffed by senior paramedics and often first on scene, but currently unable to transport any patients, even those with light injuries.

She stressed that the move would enable a more efficient use of resources without compromising patient care….

Mr Hayes also labelled the proposal as a backflip by Ms Skinner, since in 2010 she called a similar proposal by then Labor Health Minister Carmel Tebbutt as "one of the dumbest"…. “

Growing old in the Lucky Country

ABC News 3rd October 2012

Never trust a North Shore townie with the NSW Health portfolio

On the 15th September 2012 The Daily Telegraph ran this:
“HEALTH Minister Jillian Skinner is prepared to push people out of hospital early to help achieve a $3 billion budget cut.
Explaining the government's cuts to the health portfolio yesterday, Ms Skinner said that "most of the money" saved would be through "better models of care, through, for example, not keeping patients in hospital as long as they should be".
"I think a lot of people are very pleased not to be kept in hospital longer than they need to," Ms Skinner said.
"I have a brand new granddaughter. Her mother was in hospital for two nights, she spent the next two nights in a five-star hotel room. This is a private hospital, this is what they do now ... It's actually better for the mum ... and more efficient for the hospital to pay for a five-star hotel room than a $2000-$3000 acute bed."
Jaysus wept! Since when was country NSW littered with posh hotels? Where are patients in the Northern Rivers going to find a five star hotel near one of the public base or district hospitals? And what makes Skinner think that NNSWLHD CEO Chris Crawford will put his hand in his pocket to pay for one, when even getting into hospital in the first place can be a minor miracle due to closures and cost cutting.
Coraki’s public hospital went AWOL in 2011 and is now presumed dead, no in-house doctors in A&E at some other hospitals, and I’m told that mental health nurses and sexual assault counsellors are considered an endangered species in the Lower Clarence.

Deaths from major trauma in NSW trauma centres have declined since 2003 - but you're still more likely to die in regional NSW

Deaths from major trauma in NSW trauma centres have declined since 2003, and definitive care at a Level 1 trauma centre was associated with a survival benefit according to a recent article in The Medical Journal of Australia.

Level 1 trauma centres are confined to large metropolitan centres. On the NSW North Coast in 2009 there were 'adult patient' regional trauma centres listed at Coffs Harbour Base Hospital, Lismore Base Hospital and The Tweed Hospital. These appear to remain the only trauma centres in the region.

During the period studied the number of interhospital transfers between regional trauma centres and Level I centres did not increase significantly despite such transfers being shown to potentially halve the mortality rate.

Because of the systematic neglect of regional NSW by successive state governments and across the board cuts to public service delivery by the current O’Farrell Coalition Government, this is the risk North Coast residents are exposed to if they are involved in a serious motor vehicle/work/sports/in home accident:

Regional trauma centres play an important role in the delivery of trauma care, but often lack specialty resources. Most are located outside Sydney, and road travel time from regional trauma centres to a Level I centre ranges from 30 minutes to 2 hours. In a recent single region study in NSW, morbidity was significantly higher in a regional trauma centre compared with a Level I centre.10……..

Patients admitted to a regional trauma centre had a significantly higher mortality rate compared with those admitted to a Level I centre. The survival benefit at Level I centres could be explained by the presence of greater resources, such as the availability of surgically trained staff 24 hours a day, a multidisciplinary trauma service14,15 and higher patient volumes, resulting in enhanced expertise in trauma care.16 Deficiencies in trauma care, regardless of trauma centre level, may occur at multiple points of care and are more likely to occur when there is failure to comply with protocols, poor communication and/or delayed referral.10,14,17,18 However, without reviewing each of the deaths in this study, it is not possible to comment on factors contributing to mortality.

The benefits of primary transport or early interhospital transfer of patients with major trauma to a Level I trauma centre are confirmed in our study. In 2008 Ambulance NSW introduced “Protocol T1”, which specifies that patients with major trauma should be taken directly to a Level I centre, bypassing lower-level centres, if transport time is within 1 hour.19 The impact of Protocol T1 on patient transport practice and outcomes requires evaluation.

The geography of NSW means that regional trauma centres will continue to play an important role in initial stabilisation of patients with trauma. Our study suggests that improved adherence to transfer guidelines will contribute to improved patient outcomes consistent with the experience in Victoria17 and the United States.20 In recent years, a series of standardised transfer guidelines for patients with major trauma have been implemented in NSW, with variable compliance.10,21 The low numbers of transferred patients could also result from some patients with critical injuries being deemed too unstable for transfer, transfer being considered futile, or patients dying before a transfer decision was made.10,21

Initial trauma response and hospital transfers in regional areas are under pressure as the Ambulance Service of NSW is being asked to respond to increased demand with existing staff numbers.

Trauma services are one aspect of the true cost to local communities and local families of public service job cuts currently underway in the Clarence Valley and elsewhere and, why the almost cavalier attitude of North Coast Nationals MPs to these cuts is unacceptable and offensive.

STATEMENT BY JANELLE SAFFIN MP ON CLOSURE OF BONALBO HOSPITAL 24/7 EMERGENCY DEPARTMENT & NURSING SERVICE

Statement by Janelle Saffin MP on Bonalbo Hospital

I express my dismay at the actions of the Northern New South Wales Local Health District’s administration in closing the 24/7 nursing operation at Bonalbo Hospital, and call upon the Board to immediately reinstate it.

I was at Bonalbo Hospital on Saturday with the nurses and I promised them that in addition to my earlier letter to the Chief Executive Chris Crawford and the Board, that I would make a public call for the immediate reinstatement for the 24/7 nursing operation.

I realise it is a matter of state administration, but I take a very strong interest in health, securing much needed Federal funds locally, so I cannot stay silent when a community is left abandoned, as is the case in Coraki as well.

I question what is going on with our local health services?  

I was at the public meeting in Bonalbo last year, discussing how to handle the departure of the local GP.

With the permanent GP gone, it is important to keep as many of the health services as possible, and give the community a sense of security regarding their health.

This also allows them to keep faith in the health service, while attempts to attract another GP or two GPs to the Bonalbo township and district are continuing.

When the decision was taken to cease the 24/7 nurses’ shifts in Bonalbo, without consultation about how things would work with the 11.00 pm to 7.00 am shift axed, I let Mr Crawford know that I was appalled.

I said in my letter to him, that: “There is fear now in our small communities, both Bonalbo and Coraki, that you and the Board are set on closing their hospitals and neither community believes you when you say that you will restore their health services.”

I have now told the nurses, the SOS Action Committee and locals to go to the Board, as they are our community representatives.

 

The current interim Bonalbo model of operation, with doctors brought in from neighbouring towns, has been lauded by health representatives, including Board members, as a good model for  the residents of Coraki and district, who have not only lost their hospital due to the disrepair of the facility, but have been left without alternative services.

I am waiting to hear the announcement that some emergency services will be reinstated there while a health services plan is done.

.

There have been so many calls for the immediate reinstatement of the 24/7 service from concerned community members and key representative organisations.  These include Kyogle Shire Council, the NSW Nurses Association, the local NSW Nurses Association members, the Aboriginal and Torres Strait Islander Peoples’ representatives and all Bonalbo and district residents.

 

The NSW Nurses Association has said that: “People usually only call on health services during the night when things are serious, so it is important that this community has sufficient capacity to respond during the night.”

The local nurses, through the NSW Nurses Association, have asked a list of some 29 questions which raise serious issues that need to be addressed immediately, including that of nurses’ security.

The list includes critical questions such as:

• Who will carry the hospital and drug cupboard keys and how would they be passed from one nurse to the next; for example, to get keys from evening shift nurse to morning shift nurse where the morning nurse will usually be a different nurse?
• Once the nursing night shifts cease, where does the Local Health District plan to keep the key for the alternative helipad if a helicopter evacuation was required through the night as the usual helipad has been flooded four times in the past 10 years? Is the Health District aware that it takes an average of four hours to mobilize helicopter retrieval?  

It is bad enough to axe the 24/7 nursing operations, but to then not manage the process is negligent.

 

Kyogle Shire Council, in its letter to Mr Crawford, has stated categorically that: “The decision to cease the provision of Emergency Services at Bonalbo Hospital between 11.00 pm and 7.00 am will result in unacceptable risk to the health and well being of our community and is completely at odds with previous guarantees provided to the Bonalbo community at public meetings that there would be no reduction to health services.”

It is clearly up to the Board members to ensure that there are no reduction to health services and I am asking them to continue this service of 24/7 coverage with nurses.

Contact: Janelle Saffin 0418 664 001.   

Gender difference in number of hospital inpatient days 2005- 2010

Australian Institute of Health and Welfare HEALTH SERVICES SERIES Number 40  Australian hospital statistics 2009–10 (April 2011):

Between 2005–06 and 2009–10, patient days in all hospitals increased by 9.8% for males, and by 7.4% for females (Figure 7.3). The relative size and direction of change in patient days varied by sex and age group.

Click on graph to enlarge

Stirrup the bitch! Why the medical experience is still a feminist issue

Because women as a group are constantly being told “You’ve come a long way”  when compared with their grandmothers, it is easy to overlook the fact that misogyny and chauvinism are still slyly woven into much of the female experience in developed countries like Australia.

So it is often only cases such as this which draw any mention in the mainstream media of the fact that the medical experience is frequently one fraught with the risk of physical and/or psychological damage for many females.

The Northern Star Rogue obstetrician faces 15 counts of abuse, malpractice by Natasha Wallace 13 December 2011

She alleged he forcefully put his hand on her vagina

and said, ''Who is the boss now?''

Read the rest here

A win on the board for Labor's Peter Ellem and local nurses regarding O'Farrell Government's health funding offer

It is highly likely that people in the Clarence Valley would still be waiting and, Grafton Base Hospital still be without sufficient staffing levels to open its new orthopaedic beds in 2011-12 if Labor’s candidate in the 19 November Clarence by-election Peter Ellem (with the help of local nurses) had not managed to make it an election issue.

In The Casino Times online on 24 October 2011:

COUNTRY Labor candidate for the Clarence by-election, Peter Ellem today joined Opposition Leader John Robertson and local nurses to demand State funding for orthopaedic surgery and equipment at Grafton Base Hospital.
"The O'Farrell Stoner Government must fund orthopaedic surgery and equipment to complement the new federally-funded operating theatres at Grafton Base Hospital," Mr Ellem said.
"The Commonwealth-funded theatres are a massive boost for Grafton Base, but the O'Farrell-Stoner Government down in Sydney needs to back this up with State-funded orthopaedic surgery and equipment.
"The National Party has been far too timid in their approach to Grafton Base Hospital – I am demanding the immediate funding of orthopaedic surgery for the hospital."

From a NSW Health Minister media release on 14 November 2011:

The NSW Government has allocated $1.7 million of recurrent funding to support the establishment of an Orthopaedic Surgery Service at Grafton Base Hospital, the Minister for Health and Minister for Medical Research, Jillian Skinner, announced today…..

“This funding will allow additional nursing staff, a physiotherapist and an occupational therapist to be recruited to treat orthopaedic surgery patients,” Mrs Skinner said……

This $1.7 million allocation will complement the redevelopment of the Grafton Base Hospital operating theatres and the establishment of dedicated orthopaedic surgery beds, which have been jointly funded by the Federal and State Governments.

Although, given how the O'Farrell Government and its candidate Chris Gulaptis fudged their earlier health announcements, one may have to wait and see if this claimed new funding isn't actually Federal Government money being announced by the NSW Coalition as its own.

The highs and lows of public hospital outpatient care according to NSW consumers

Source: Outpatient care module of the NSW Health Patient Survey 2010
Click on graphs to enlarge

In August 2011 the NSW Bureau of Health Information released Patient Care Experiences (part of the Insight series) a survey of patients using outpatient services in NSW public hospitals during February 2010.

Not surprisingly, consumers on the North Coast had mixed feeling about their experience in the larger regional public hospitals and these scored in both the higher and lower satisfaction bands.

In comparison with all public hospitals in this survey, Murwillumbah and Grafton performed well and Tweed, Lismore and Coffs Harbour performed poorly.

When compared with other non-metropolitan hospitals in the survey most fell in the middle of the rating band with only Tweed Heads in the lowest ranking.

How the emergency department experience in non-metropolitan hospitals is rated by NSW Health can be found in Performance Profiles Emergency department care Major non-metropolitan hospitals Hospital Quarterly: January to March 2011.

Clarence Valley worry that Coalition cronyism is about to bleed health dry has NSW Health Minister throwing counter punch

The Daily Examiner  Health is bled dry  4 July 2011:

TWO members on the North Coast health advisory board have been dumped and replaced by two failed former Coalition political candidates on the re-titled Northern NSW Local Health Board District, leaving the Clarence with only one representative on the 10-member board.

Yamba-based solicitor Bob Thompson and Tweed-based doctor David Hodgson were both dropped from the board appointed under the former Labor government and replaced with former Liberal Party candidate for Page Malcolm Marshall and former National Party candidate for Richmond Dr Sue Page Mitchell.

Former board member and Grafton radio station manager Ron Bell resigned a few weeks ago for personal reasons and has not been replaced by another representative from the Clarence Valley.

It leaves the Clarence area with only one member on a board dominated by members from the Richmond area, and has raised serious concerns the health needs of the Clarence will be swept aside because of the political strength of representation in the Richmond……….

The lack of representation from the Clarence area was a major concern and he cited the recent appointment of an orthopedic surgeon to Grafton as an area of potential problems.

…. that surgeon would treat patients who previously would have been treated at Coffs Harbour or Lismore, but the funding needed for those operations now needed to be transferred from Coffs and Lismore to Grafton.

Taking money from the Coffs and Lismore budgets would be difficult, because of the strong Richmond area representation on the board.

Mayor Richie Williamson, Mr Bell and chairman of the Grafton Base Hospital Medical Staff Council Dr Allan Tyson all expressed similar concerns about the composition of the board and the lack of representation from the Clarence Valley.

The Daily Examiner NSW Health District Board changes 5 July 2011:

“There were people who were not re-appointed.
“In some cases, that was simply due to other applicants being more experienced and skilled in the required areas of governance and finance.
“In other cases, it was because those people were not performing adequately.”

Ouch....

Feeling unwell? Take two aspirin and stay away from NSW hospitals

While bureaucrats are happily busy preparing to collate personal health information (supplied to them by everyone from doctors through to chemists and optometrists) in order to satisfy Federal Health Minister Roxon’s unnatural desire for a great big database on Australian citizens, this is one of the computer systems from which this data will be drawn. It is said to be installed in 59 hospitals having an estimated 80 per cent of all NSW public hospital beds.

The Sydney Morning Herald 7 March 2011:

THE computer system that runs emergency departments in NSW hospitals is compromising patients' care, according to the first systematic review of the troubled project that found it was crippled by design flaws.

The FirstNet system allows treatment details and test results to be assigned inadvertently to the wrong patient, according to the review. It is based on a technical study of the software and interviews with directors of seven Sydney emergency departments.

The system is so compromised it should be scrapped, a specialist doctors' group said yesterday.

Difficulties retrieving patient records could delay treatment, and the system - on which $115 million has been spent - automatically cancelled pathology and radiology requests if the person was transferred from the emergency department without checking whether these were still needed, according to the study by Jon Patrick, the director of the University of Sydney's health information technology research laboratory.

Sally McCarthy, the president of the Australasian College for Emergency Medicine, said Professor Patrick's findings confirmed that the system, loathed by doctors and nurses, was unsuitable for its purpose.........

The project, part of a 10-year electronic medical records plan intended to make patient histories, X-rays and test results accessible from any hospital in the state, had proceeded too fast - apparently because of contractual obligations - for clinicians' feedback to influence it, Dr McCarthy said.

The potential for records to be linked to the wrong patient raised a serious risk they would be given incorrect treatment, she said, and the inability to compile multiple patient records into reports meant doctors could no longer evaluate new treatments or disease epidemics. "Simple audits and research projects are just impossible now," she said.

Really inspires confidence doesn’t it?

These difficulties are not confined to large metropolitan areas as this 2010 quote from the North Coast Area Health Service indicates:

In response to the difficulties our small sites experienced in using FirstNet, NCAHS continues to work with HSS to develop a FirstNet work flow for small rural sites.

Little appears to have changed since the 2009 implementation of this e-health software on the NSW North Coast.

If the reader happens to live in communities covered by the Hunter Urban Division of General Practice this sick software system is probably informing e-discharge summaries etc. forming part of the data collection trial run currently underway in the Newcastle and Hunter Valley region.

Building on these shifting sands, on 1 March 2011 Roxon’s baby, the National E-Health Transition Authority (NEHTA), awarded IBM a $23.6M dollar contract to develop nation-wide authentication system for electronic health records.

Looking for Mr. Good Stork

The Australian Federal Government’s My Hospitals website is up and running and I decided to see what is said about hospitals on the NSW North Coast.

With a bit of nudging the lists from the mid to far North Coast came up here and here. Then the fun began when linking to hospitals in the Clarence Valley.

According to the new website there were no births at Maclean District Hospital in the financial year 2008-09, which was to be expected as its maternity section was closed down years ago despite community protests.

Grafton Base Hospital had 478 births + <10 births in the same financial year. Again something to be expected as it is the only relatively large hospital in the area and it usually records births it the vicinity of four hundred or so.

Wondering how these figures compared with the Australian Bureau of Statistics (ABS) regional profile for the Clarence Valley local government area I went looking.

I found that birth numbers didn’t quite add up when one compares My Hospitals and ABS data, even when the former is operating on financial year dates and the latter on calendar year dates.

The ABS has 278 births recorded in Grafton Statistical Area for year ended 31 December 2008 and no births recorded for the Clarence Valley Local Government Area in the year ending 31 December 2009.

An official 2009 zero birth rate was taking things a bit too far, so who isn’t keeping accurate records? The ABS, local court houses, someone else? Or did bad weather blow The Stork off course?

Well Clarence Valley residents may actually in part be the culprits when it comes to accurate record keeping. Because it appears that Australians don’t always promptly register the births of those little bundles of joy.

Elsewhere on the ABS website it states:

Of the 295,700 births registered in Australia during 2009, 88% occurred in 2009. A further 9% occurred in 2008, and the remainder (3%) occurred in 2007 or earlier. It is expected that some births, particularly those that occur in November and December, may not be registered until the following year.

Now in New South Wales parents are responsible for registering the birth of their newborn within 60 days.
However, somewhere in Australia in 2009 (presumably including NSW) over 8,000 people probably turned up at the court house or registry office with a one and a half to three year-old child in tow and told the clerk that the toddler holding their hands actually existed. Others obviously went in after the Christmas and New Year’s Eve parties were over to inform the world that their family had grown.