Hunt for GP obstetriciansNewborn-baby-crib
WACHS is planning to re-open the obstetrics unit at the Northam Hospital and is keen to hear from procedural GPs interested in going on the roster. The unit faltered in July after the retirement of long-serving Northam GP obstetrician Dr Colin Smyth but demand in the district is the impetus for its resurrection. It is now looking to fully staff a 24/7 level 3 maternity services, including emergency caesareans. There are 21 shires surrounding Northam with an estimated combined population in 2013 of 22,679. Average total births per annum to women resident in the potential Northam Hospital maternity service catchment area for the decade 2003-2012 was 496. Of these, 14% (68p.a.) were to women resident in shires more than two hours’ drive, 29% (145p.a.) between 1-2 hours’ away and 57% (283p.a.) within an hour’s drive of Northam. Population projections give an estimated average population growth of about 2% p.a. over the next 10 years. The nearest maternity service to Northam is the SJG Midland Public Hospital, 79km away. A spokesman for WACHS says the search for well-skilled GP proceduralists at Northam is going hand in hand with hospital redevelopment including improved theatre facilities.

Bell-Janice-Dr Oct15Dr Janice BellStormy times for GP training
Last edition we reported the Federal Government finally giving the nod to WAGPET’s tender to deliver GP training in WA next year. However, the community residency program, which was rescued from oblivion by the State Government this year, has been axed. The lack of appropriate provider numbers just made it too difficult to continue – a major blow as it was an effective promotion for general practice. WAGPET’s difficult 12 months was summed up by CEO Dr Janice Bell in the latest newsletter: “The calm before the storm doesn’t begin to describe the time since May 2014…but it has been – among other things – a time of considered reflection and re-evaluation. The general practice training world has changed nationally, perhaps irrevocably, in ways we are only now beginning to fully countenance.” 160 registrars start their training in the New Year.

RACGP profile change
With WA GP Dr Tim Koh recently appointed national chair of the RACGP Council and Mandurah GP Dr Frank Jones heading into his second year as RACGP President, Sandgropers are well represented in the college. Frank, who still manages 4-6 sessions per week in his practice, is keen to lift member engagement through better use of social media and state faculties. Not before time, in our view – trying to find local GP stories in WA is too difficult. As government tries to rein in health costs, the MBS rebate freeze, better chronic disease funding, quality of care, accreditation and GP advocacy are in full focus. The plan is to make the RACGP a voice to be listened to. Increased relevancy and responsiveness is needed.

Pooling melanoma resourcesDr-Tim-Koh-and-Dr-Frank-JonesDr Tim Koh and
Dr Frank Jones

MelanomaWA is positioning itself as the go-to organisation for those diagnosed and their families. Melanoma prognosis has improved markedly with different immune-mediated treatments (drugs and vaccines). Their cost has become an issue for the relatively young patients affected. Early detection remains the key to a better prognosis and MelanomaWA says staying informed and feeling confident is important. Their Support Pack includes info on support services from them and other organisations – connecting patients to available melanoma-specific services. As well as education about prevention at schools etc, the organisation is involved with rural GP training that encourages the use of dermatoscopes. Phone Clare on 0403 829 796 to order a sample pack (www.melanomawa.org.au).

Expensive hospitals
Remember Hospital in the Home through GP divisions? The idea was to prevent unnecessary expensive hospital admissions by treating some conditions at home – anticoagulation for VTE, IV antibiotics for some infections, hyperemesis gravidarum and iron infusions for anaemia. It turns out that these savings are chicken feed compared to what can be gained from early discharge and ED referral for nursing at home or in secondary hospitals – the expanded Silver Chain Home Hospital is servicing RPH and FSH (and has employed Dr Daryl Kroschel as FT medical director), while SCGH still has its own HITH program. It costs about $750 a day to occupy a tertiary hospital bed.

I authorise you to wait
A doctor messaged us via our website, complaining of up to five-minute delays on the Authority Prescriptions phone calls. An appalling waste of time, they said, wondering if it was on purpose to reduce authority scripts by getting doctors to tire of waiting and hang up. They wondered why the lack of trust to authorise repeats without calling and why an online system for authorities didn’t exist. When we contacted the Department of Human Services they were apologetic and said the average wait time for the financial year so far was 42 seconds. There were logged problems on November 17 and 18 –carrier issues, urgently rectified. The spokeswoman also reminded us the Pharmaceutical Benefits Advisory Committee recently stopped repeat prescriptions for some PBS subsidised antibiotics.

Oral cancer robot
Hollywood hospital has four ENT surgeons offering trans-oral robotic surgery for head and neck cancers, courtesy of the latest generation da Vinci surgical robot. It goes with dexterity and improved visualisation, where no surgeon’s hand can (easily) go, for removal of tongue base and oropharyngeal cancers. The use of a robot in these cramped quarters has decreased operative time and the operators say improved recovery times and clearance margins. Contentious areas remain radiotherapy, neck dissection and disease control. HPV related oral cancer is likely to persist for a generation until the HPV vaccine program kicks in.

Surgical deaths down
The chair of the WA Audit of Surgical Mortality (WAASM), Dr James Aitken announced in the annual report that the number of deaths per 100,000 patients has decreased by 15% in the past five years from 26 in 2010 to 22 in 2014. The figure in 2002 was 35 deaths per 100,000. James, who has championed the audit said last year no adverse events causing death that were considered preventable were reported.

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