ACCC talks tough
As we reported [September edition], there was considerable backlash against the apparent lack of transparency in the relationship doctors have with pharma under the proposed edition 18 of Medicines Australia’s Code of Conduct. The Code sets the standards for the marketing and promotion of prescription pharmaceutical products in Australia by member companies. The ACCC planned to endorse the Code with the proviso that any ‘transfers of value’ to individual healthcare professionals must be reported, rather than be ‘opt-in’ under the proposed Code. The AMA, which originally supported MA’s edition 18, has reportedly told the ACCC that any new transparency regime should be delayed for a year so doctors can ‘think about and plan for their ongoing relationships’ with pharma. The profession has had five years to consider it, given the ACCC approval of edition 17 was interim, to introduce greater transparency and increase disclosure.
Transparency is not the first word that springs to mind when talking about the proposed Primary Health Networks either. Medical Forum has not heard of any other WA bidder than the three we wrote about in the November edition but there could be others. There’s been speculation in other states about private health funds coming on board. While bidders are racing to submit their applications, there is no public information about governance, which is crucial. How will these massive organisations translate care to patients to improve health outcomes? No detail. How will outcomes be measured? What will be their KPIs? Again, no detail. The Government is scheduled to make its decision sometime this month (or perhaps the New Year, who knows) and then it’s six months of hard slog to have the PHNs ready for business by July 1. In the last edition, we wrote incorrectly that Panorama Health was the largest MedicareLocal with 1.2m people and 1000GPs. In fact those figures are for the proposed North Metro PHN.
SJGHC’s watershed year
It’s been a massive year for St John of God Health Care with stage one of the $236m Murdoch Hospital redevelopment complete, the acquisition of Mercy Hospital in Mt Lawley and the Midland public/private health campus on time and on budget. There was also good news on the business side as well with its annual report showing the Not-For Profit had posted revenue of $1.16b in the 2013-14 year, up from $1.07b the previous year. Its surplus rose 47% to $76.7m.
Readers will be familiar with the work of Geraldton GP Dr Kathleen Potter’s research into deprescribing for the elderly in Aged Care Facilities [most recently, November edition]. The October edition of the TGA’s Medicine Safety Update shows what timely research it is. For instance, up to 30% of hospital admissions for patients older than 75 are medication related (and up to 75% preventable); 82% of people in RACFs take on average seven different medications (20% take more than 10); polypharmacy in the elderly is associated with worse physical and social functioning, more falls, delirium etc, and reduced adherence to essential medicines. An MJA article seems to come to the same conclusions as Kathleen that deprescribing is likely to produce more benefits than harms overall, with caution needed on some drugs.
Search is on for pain lead
About a year ago, we reported that Rossmoyne couple Geoff and Moira Churack had donated $1m to the University of Notre Dame for the establishment of The Churack Chair of Chronic Pain Education and Research. Geoff has chronic neuropathic pain. The university is on a nationwide hunt for a medical specialist to take the lead. Also contributing to the project is SJGHC. A ND spokesperson said there was no timeline at this stage for the decision though earlier the better. The university is hoping to raise a further $1m to ensure the longevity of the chair and program.