June 2010

Green purpose 

Perth GP Dr George Crisp has announced he is flying the Greens banner by running against Julie Bishop in the seat of Curtin, under an environmental ticket. He wants to put health and the environment back on the political agenda, and says the best place to start is locally. Public health issues will be raised – climate change, peak oil, etc – to get people talking. But it seems George needs to get with the social media. Googling his name brings up a dead actor, an out of date Greens website that has him standing against Liz Constable, and little else.

Pharma-doc change

US pharmaceutical firms spend about $US60 billion annually in marketing, about double their R&D expenditure. Litigation, on-line information access for consumers, government squeeze on subsidised drugs, and restrictions on promotional activities are all changing the face of the pharma-doctor interaction. At the recent college of surgeons national conference in Perth, pens and other giveaways were noticeably absent. So was the interest amongst delegates in the exhibitors’ area. Companies more exposed to the US Medicaid changes, like Johnson & Johnson, Eli Lilly, Abbott, Amgen and Gilead, are expected to feel the crunch more than companies like Bayer, Sanofi-Aventis, Novartis and Roche that have a relatively low focus in the US market.

Researchers research

Yet another opening by a pollie, cutting the ribbon on a $9.4m clinical trial facility at QEII as part of Prof Klinken’s WA Institute of Medical Research. It’s a 24-bed facility where healthy volunteers will be tested for side effects against pharmaceuticals as early-phase clinical trials. Why? Local companies will benefit by not having to go interstate or overseas. Scientists of renown will be attracted to WAIMR. Hospital-based principal investigators and individual researchers will benefit. The pharmaceutical industry will likely increase its $15m annual input to WA’s coffers. Clinicians and scientists will be able to compete better with the rest of the world in medical research. It will lead to more phase-II and III trials in WA. And we suspect a number of CVs will also look better. There are four other early phase clinical trial centres in Australia.

Mother-baby interventions

To help women with drug and alcohol dependence issues, who also have children, the Saranna Women and Children’s Program (a residential therapeutic community) has been expanded to 14 housing units to ensure mothers and children are kept together during treatment. The program supports children and aims to strengthen the relationship between mother and child and reunite families. Mental Health Minister Graham Jacobs said $1.37m was granted under the government’s Crisis Accommodation Program. He also announced the Healthy Mother-Infant Relationship Initiative, a resource developed by the North Metropolitan Area Health Service’s Clinical Application Unit. It will help mental health clinicians, GPs, hospital staff and community health clinics identify during pregnancy or child birth those mothers with mental illness who are far more likely to have problems with their baby. They can then be referred to the appropriate service.

Here we go again…

The federal AMA says it is opposed to Primary Health Care Organisations (PHCOs) announced by Rudd & Co but will seek input to  ensure the primary care role of GPs is preserved and supported. It is the old managed care and choice-of-doctor debate. PHCOs are to focus on areas of unmet need by providing additional services like allied health, amongst other things. The RACGP is in favour. The AMA wish list is for no increase in bureaucracy or red tape for GPs, all patient care decisions to remain with the GP, and GPs to lead PHCOs. Given the way things are heading with pharmacists and nurses, they have a fight on their hands.

Gene Geney

They have been out for awhile now. The NHMRC and Privacy Commissioner got together to outline circumstances in which a doctor who tests a patient can pass genetic information to a genetic relative, without the original patient’s consent. The doctor can even seek out the relatives to do this but only in situations where they reasonably believe that disclosure is necessary to lessen or prevent a serious threat to the life, health or safety of the patient’s relative. The guidelines are good – with clinical scenarios and what-ifs mapped out. You can find them at www.nhmrc.gov.au/publications/synopses/e96syn.htm