"In particular we welcome the commitment to provide more transition beds to assist people in moving from hospitals to aged care facilities. This is something that AHHA has called for previously and will help reduce the numbers of older Australians who are forced to stay in hospitals unnecessarily. We also welcome the workforce initiatives, such as the increase in medical training places, GP and specialist training positions and funding for more nurses. Workforce shortages are some of the most serious problems facing Australia's health system - we cannot have a high quality hospital system unless we have high quality staff to provide care.

"The commitment to strengthening primary care in the policy is also a positive. Better access to comprehensive primary care will assist in improving the prevention and management of chronic illness in the community and should result in a decrease in the number of avoidable hospital admissions. Funding for practice nurses to visit older Australians in their place of residence should also assist in keeping older people healthier and out of hospitals.

"However, AHHA remains concerned that the Coalition's proposal to introduce hospital boards will not improve the management of hospitals and could in fact reinforce the current fragmentation of our health system. We have not seen any evidence from the Government to support its argument that a local board of management is more likely to meet the community's expectations than the current system.

"The proposed increase in funding for hospital infrastructure will be welcomed by hospitals; however, we believe that there should be a more transparent and accountable process for allocating the funds, to ensure that it is provided to hospitals on the basis of need. We also support the increased provision of information to consumers on hospitals' performance, provided that it is adjusted to take into account the complexity of work undertaken in public hospitals and does not create a disincentive for hospitals to treat high risk patients.

"While there are some positives in this policy, overall we are disappointed that the Coalition has made no attempt to reform health funding arrangements which has resulted in an inefficient and uncoordinated health system. AHHA believes that the only way to end the blame game is to introduce a single level of funding and accountability for all health care. We urge the Coalition to commit to pursuing this option if they are successful in the upcoming election," Ms Power said.

Plan For A Healthy Election - AHHA
The Australian Healthcare and Hospitals Association (AHHA) launched its Election Manifesto 2007 and First 100 Day Plan which outline practical strategies to improve access to quality health care for all Australians.

"Australians want and deserve a health system that provides them with the best possible health care in the most appropriate setting. However despite the many dedicated and highly skilled professionals working in the health system, far too many people are missing out on the care they need to help them maximise their well being and quality of life," Ms Prue Power, Executive Director said today.

"This is due to several underlying factors including a lack of funding and poor integration and coordination between different areas of the health system. In fact, instead of a health "system" we have a poorly coordinated collection of services, characterised by duplication and fragmentation. This has resulted in compromised continuity, efficiency and quality of care.

"Addressing these problems will require making some major changes to the ways in which health care is funded and delivered, including reforming our current system of hospital funding grants to the States and Territories. This should occur in the context of the renegotiation of the Australian Health Care Agreements (AHCAs), which are due to commence mid 2008.

"The next AHCAs need to break down the current silos in funding between sectors of the health system and place prevention squarely at the centre of health care delivery. Unless these changes are made, our health system will struggle to continue to meet the community's demands for high quality care. The post-election period will be vital in progressing the negotiations for the ACHAs and AHHA calls on both major parties to commit to commencing discussions with stakeholders immediately after the election.

"We have also proposed a number of clear, practical and evidence-based strategies for improving quality and access in the health system and a First 100 Day Plan which outlines the steps which should be taken immediately after the election to progress these strategies. AHHA will be assessing the incoming government on its performance against this plan after its first 100 days in office.

"AHHA believes that Australians are entitled to expect world class health care from our public health system. We are a wealthy country which can afford to invest in high quality health care in order to increase the quality of our lives and improve our well-being and productivity. There is good evidence that this would be supported by the community, in preference to tax cuts. This election provides an opportunity for political parties to address the challenges facing our health system by committing to evidenced-based strategies to increase quality and access and to working with stakeholders to reform our health funding system to establish a strong foundation for the future," Ms Power said.

AHHA Election Polls
The Federal election campaign is nearly at an end with one week until polling day. The results of our election surveys are informing our campaign strategy (see the AHHA Campaign Statement above) and we will report them back through e-healthcare brief as well as through the Publications section of our website.

By participating in our polls you get entered into a weekly draw for a bottle of fine Australian wine!

Poll 1 – Coalition Health Policy
Take part now in our first poll on the Coalition's public hospital policy if you haven't already responded.
Poll 2 – ALP Health Policy
Take part now in our second poll which asks what you think about the policy for public hospitals and the National Health Reform Commission put forward by the Australian Labor Party.

This special AHHA policy forum will bring together members of our regular Think Tank group with two of our Policy Think Tanks on the Australian Health Care Agreements (AHCAs) and Dental Health. We are also inviting others to join us on the day. The forum will present a great opportunity for all participants to discuss these critical policies in the post-election environment.

Participants will hear from three key speakers:

• Dr David Panter on the AHCAs
• Dr Martin Dooland on dental and oral health
• Professor Chris Baggoley on safety and quality in healthcare

Participants will break into three topic sub-groups to discuss policy directions under the new government. The day will conclude with a summary session followed by our 60th birthday celebrations including a cocktail reception and our birthday dinner! Entertainment will include a n after dinner presentation by Professor Chris Baggoley and some fun with well-known comedian Rod Quantock.

AHHA Think Tank Exchange (includes morning/afternoon tea and lunch)
Time: 9.30am to 4.30pm, Thursday 29 November
$120 for AHHA and Think Tank Members
$150 for non-members

Cocktail Party and 60th Birthday Dinner
Time: 5.30pm to late, Thursday 29 November
$50 for AHHA and Think Tank Members
$75 for non-members

Please visit our website to download a registration form and post or fax back to us by 12 November. You will need to book accommodation separately on the Rydges website.

Expressions Of Interest For AHHA National Council – coming soon
Would you like to join the National Council of the Australian Healthcare and Hospitals Association and participate directly in influencing the development and implementation of Australia’s health policy at a national level?

We are approaching the time of year when the AHHA calls for expressions of interest from members interested in joining the Council for a 12 month term. While Councillors are elected for 12 months, there is no limit on the number of terms a Councillor may serve. Expressions will be sought through upcoming branch meetings, so please keep your eyes peeled here to find out when a meeting is happening in your state/territory.

As the national industry body representing the public healthcare sector, our National Council is made up of 24 members elected from each state/territory plus two members representing Associate and Personal members and the Immediate Past President. National Council members elect the Association’s office-holders who form the National Board.

The Council is responsible for the Association’s highly influential policy agenda. It meets regularly by telephone conference and also face-to-face (there will be 3 face-to-face meetings in 2008). Councillors are also provided with regular industry news and information and have the opportunity to represent AHHA on various industry bodies.

If you work in an area, regional or district health service, hospital, community or primary health centre, or aged and extended care facility that is a member of the AHHA, you will be able to nominate. If you have any questions please ring the AHHA Executive Director, Prue Power, or email us.

Federal Labor Releases Blueprint For Reform Of Early Childhood Services
The Leader of the Opposition, Kevin Rudd, said a Labor Government will invest $35 million over four years to introduce a Healthy Kids Check for all four olds as part of sweeping improvements to early childhood services. Federal Labor will provide a $45 Medicare Rebate for a Healthy Kids Check for four year olds will include measuring eyesight, hearing, and height and body mass index. The Healthy Kids Check will be delivered: by GPs or practice nurses through a new Medicare item, claimable in conjunction with the four year immunisation - approximately 70% of children have their immunisations at the GP; and by local councils and community health centres which run immunisation clinics, for the 30% of children who receive their immunisation from these services.

Labor Support For Allied Health In Rural Areas
The Shadow Minister for Health, Nicola Roxon, said Labor Government will provide $2.5 million over three years for the establishment of an Australian Allied Health Rural and Remote Clinical Placement Scholarship Plan. This plan will provide a much-needed boost to the allied health care workforce in rural Australia. Federal Labor's plan will provide rural clinical placement scholarships for students in allied health disciplines such as psychology, occupational therapy, physiotherapy and podiatry, starting in the 2009 academic year.

National Primary Health Care Strategy
A Rudd Labor Government will develop a National Primary Health Care Strategy. Primary care – like GPs and allied health professionals - is crucial to keeping people healthy and out of hospital. The best way to equip our health system to deal with the challenges of the future is to boost primary care services – the frontline of the health system which provides health care to local communities. Allied health professionals like physiotherapists and dieticians do great work – but that work needs to be enhanced by a long term strategy for delivering this care into the future.

Elements of Federal Labor’s strategy will include: 1) incentives for GPs to practice quality preventative health care; 2) increased focus on multi-disciplinary care from primary care teams; 3) review of the MBS red tape burden on GPs; 4) $2.5 million for the establishment of an Australian Allied Health Rural and Remote Clinical Placement Scholarship Plan; 5) $220 million investment in GP Super Clinics; 6) reforming the Rural Medical Infrastructure Fund to ensure funding gets to the communities that need it.

Extra Nurses And Specialists For Rural And Regional Areas
The Leader of the Opposition, Kevin Rudd, the Shadow Minister for Health, Nicola Roxon, and the Shadow Minister for Education and Training, Stephen Smith, announced announced a plan to boost the number of registered nurses and specialists providing outreach services in rural and regional Australia. Under the Rural and Regional Nurses and Specialists Plan: at least 400 of the additional 1,000 nursing places Labor will offer each year under our $81 million nursing plan will be dedicated to universities offering clinical experience in regional and rural hospitals; and an additional $9 million over three years will be provided to support medical specialists delivering outreach services to rural and remote communities.

Abbott Admits Government Neglected Doctor Training For 11 Years
Figures from the Department of Health and Ageing show 12 million Australians are in an area with a health workforce shortage. According to the Shadow Minister for Health, Nicola Roxon this means the Government has failed to train enough doctors in its 11 years in office.

GP Super Clinic For Wallan
The Shadow Minister for Health, Nicola Roxon, said a Rudd Labor Government's investment of $1 million in a new GP Super Clinic in Wallan will provide infrastructure to boost health services and help attract doctors and health workers to the area, helping to combat local health workforce shortages. Labor has chosen this area for a GP Super Clinic because it is one of the fastest growing towns in regional Victoria: the current population of approximately 6,000 residents is expected to grow to 20,000 over the next ten years.

Lismore Radiotherapy
The Shadow Minister for Health, Nicola Roxon, unveiled a plan to fast-track the completion of radiotherapy services at Lismore Base Hospital. A Rudd Labor Government will invest a total of $15 million in radiotherapy services at Lismore Base Hospital. Federal Labor will honour the $8 million previously committed by Minister Abbott but it will provide an extra $7 million to bring forward the construction of the radiotherapy unit from the current completion date of March 2011.

Federal Labor Supports James Cook University Dental School In Cairns"
Federal Labor will support James Cook University’s proposal for the Cairns School of Tropical Dentistry, building on Labor’s Commonwealth Dental Health Program. Federal Labor will commit $52.5 million over 4 years towards this project. This funding will include: $33 million in capital funding; $11 million to provide 60 commencing dentistry places each year; and $2 million each year to provide outreach services so that dental students can undertake practical training in remote Northern Australia. After eleven years of neglect, lack of planning by the Howard Government has resulted in chronic shortages in Australia’s dental workforce, particularly in outer metropolitan, regional and rural areas.

Better Health Services In Port Stephens And The Hunter
The Shadow Minister for Health, Nicola Roxon, said health services in the Hunter will receive a boost from Federal Labor's National Health and Hospitals Reform Plan. This includes two GP Super Clinics; commitments to MRI and PET machines which are important in diagnosing conditions such as cancer; a Medicare office in Belmont; and support for local dementia services.

Labor Announces Improved Services And Benefits For The Ex-Service Community
Labor has continued to set the agenda with the release of its Plan for Veterans' Affairs. The Shadow Minister for Veterans' Affairs, Alan Griffin, announced a series of measures to reform and improve the way the Government engages with and provides services to the ex-service community. Alan Griffin announced that in addition to Labor's existing commitments, a Rudd Labor Government will establish a Prime Ministerial Advisory Council on Ex-Service Matters, which will give Australia's veterans and ex-service organisations a voice at the highest level of Government and a greater say with decision makers. To further empower the ex-service community, Labor will also provide an additional $8 million over four years for ex service organisations to provide essential services for members through the Building Excellence in Support and Training (BEST) and the Training and Information (TIP) programs.

COALITION
Costello Sidesteps Question On Hospital Board Pay
Federal Treasurer Peter Costello has brushed aside questions about whether the Coalition has included pay for members of its proposed hospital boards in its policies submitted to the Finance Department for costing. Labor has attacked the Government's plan to introduce a local board management system for hospitals around Australia, and criticised suggestions that board members could be unpaid volunteers. The Coalition says its policy states that decisions on whether hospital board positions will be paid will be a matter for each state and territory. Speaking on Channel Nine this morning, Mr Costello was quizzed about whether pay for board members had been included in the policies being costed. "We spend $42 billion at the moment under our health care agreements," he said. "Can I say to you, payments for board members is not a significant item of expenditure."

Strengthening The Assessment Of Overseas Trained Doctors
The Minister for Immigration and Citizenship, Kevin Andrews, announced that a re-elected Coalition Government will strengthen the assessment of overseas trained doctors wishing to work as a medical practitioner in Australia. A re-elected Coalition Government will require all new visa applicants seeking to work as a medical practitioner to be screened and cleared by: an Australian registered medical practitioner with at least ten years post-internship experience; or the relevant medical college as nominated by the Australian Medical Council.

Helping Children With Severe Allergies
The Minister for Health and Ageing, Tony Abbott, said a re-elected Coalition will help establish a nationally consistent approach to the education of parents and key health, education and children's services professionals on the management of severe allergies in children by providing $1 million to Anaphylaxis Australia. The number of children diagnosed with severe allergies has increased dramatically in recent years. The Coalition will ensure that there is a national approach to improving the awareness and management of severe allergies so that children with this condition can be cared for safely both at home and outside of their own home.

Better Support For Carers
The Prime Minister, John Howard, announced measures to assist the thousands of Australians who provide care for older people and people with disabilities. From 1 January 2008, a re-elected Coalition Government will significantly boost respite services for Australian carers and the people they care for. The Coalition will provide 120,000 extra individual days and 10,000 additional full weeks for round-the-clock respite care each year, at a cost of $223.5 million over four years.

Help For Young Diabetics And People With Parkinson's Disease
The Prime Minister, John Howard, announced that a re-elected Coalition Government would help 3,000 more young Australians with diabetes and also 500 more Australians with Parkinson’s Disease to gain access to expensive medication pumps.

The Coalition's Plan For Better Public Hospitals And Health Care
The Prime Minister, John Howard, announced the Coalition's plan to take pressure off public hospitals and to provide better health care for all Australians. The policy addresses: local hospital management and more accountability; more Australian-trained doctors, nurses and specialists; more alternatives to public hospitals and emergency departments; more public hospital beds; and support for rural and regional communities.

The package consolidated the Coalition's health policy, with its centrepiece the creation of local boards to run hospitals. The Coalition has announced that, if re-elected, it would use the next round of five-year Australian Health Care Agreements between the commonwealth and states to introduce more community involvement in hospital administration by making funding dependent on the establishment of local boards. "It will be a condition of our funding negotiations with the states next year in a re-elected Coalition government to establish those boards to give communities a real say in the day-to-day running of their hospitals," Mr Howard said.

The policy would also fund an extra $248million to allow 13,000 more elderly Australians to leave hospital beds and live in the community plus a doubling of the current capital funding for nursing homes. Under the plan, 2000 new transition-care places will be created a year, costing $117million over four years. The money pays for places in aged care facilities and hospices and is aimed at helping older people who require care and support to be treated in a non-hospital environment, freeing up hospital beds. At-home care for an extra 4200 older Australians would be facilitated by funding an additional 1000 aged care places in the community, at a cost of $86million over four years. It will include 200 high-care places, 200 for dementia-specific high care and 600 low-care places.

Mr Howard also announced a doubling of existing capital funding for nursing homes, providing an extra $46million over four years to existing aged care capital programs to help residential aged care operators to respond more quickly to the increasing demand for high-care aged care places.

Cairns Private Hospital
The Prime Minister, John Howard, announced that the Cairns Private Hospital will be the location for the first four of the additional medical specialist training places and the establishment over the next three years at a cost of $4.5 million of a National Cardiac Registry.

OTHER ELECTION NEWS
Greens Launch Indigenous Health Policy
The Australian Greens launched their Aboriginal and Torres Strait Islander health initiative. Greens spokesperson for Aboriginal Affairs Senator Rachel Siewert said it is an international embarrassment that there is a 17 year gap in life expectancy between Aboriginal and non-Aboriginal Australians. The Australian Greens' policy aims to close the gap within a generation, with an interim target of less than ten years difference by 2015. The Greens are calling for an extra $460 million per annum to be spent on Aboriginal and Torres Strait Islander primary healthcare. Aboriginal Australians should have equal access to affordable and appropriate primary health care by 2012, said Senator Siewert.

AHCRA Scorecard Reveals Gaps In Health Policies
The Australian Health Care Reform Alliance released its federal election scorecard in which it measured the election promises of each political party against its six priority policy areas. The 45 organisations in AHCRA have agreed that their priority areas for reform are universality of the health system, access and affordability, citizen engagement, Indigenous health, planning for the future and an improved health workforce. The Coalition has scored only three points out of a possible 12, with Labor slightly ahead on six. The Greens and Democrats each score 12 which AHCRA hopes will influence the policy ideas of the major parties in the future. Of considerable concern is the failure of the major parties to commit explicitly to a universal health system funded through taxation, with equity, access and affordability as its key principles.

Ban Junk Food Advertising On Children's TV
Kerrie Tucker, Greens Senate candidate for the ACT, has called for a ban on junk food advertising during children’s television viewing hours, in the light of the front page news identifying the growing obesity problems in Australia. “The public health implications of processed and junk food are well known” Ms Tucker said. “There is no reason to allow advertising of junk food on children’s television other than some implied right of advertisers. And while an ad ban won’t solve growing problems such as childhood obesity; along with healthy eating and regular exercise, it is an important part of the solution” Ms Tucker said. The Labor and Liberal parties voted down Greens’ amendments in the past to ban junk food advertising during children’s television viewing hours. Despite polling that has shown 86% of Australian parents want a complete ban on junk food when their kids are watching television.

The Major Parties – A Summary
[Source ABC Health & Wellbeing by Peter Lavelle]. Health is the number one issue on voters' minds, according to Morgan polling. Asked what the Federal Government could do to most benefit them and their families, 27% of voters nominated health. It's also one of the few policy areas where there's a difference between the two parties.

The policy differences are very well set out in a series of articles published in the 5 Nov edition of Medical Journal of Australia.

Professor Stephen Leeder, Professor Bruce Armstrong and others set out the challenges currently facing health policy makers in Australia:

• too few doctors, dentists, and nurses to look after a population increasing in numbers and age
;
• health services that geographically don't cover enough of the population – especially in rural areas and Indigenous communities
;
• a health system that is too geared towards hospital services for acute illness and not enough to chronic and age-related illnesses in the community
;
• a public hospital system in crisis with long waiting times for elective surgery, staff shortages and overcrowded wards and emergency rooms
;
• disparities between states and federal governments in funding and administration of heath services leading to inefficiencies, cost shifting, and overlapping bureaucracies
;
• rising costs from new drugs and new technologies – costs that are outstripping increases in funding
;
• too much emphasis on treating illness and not enough on preventing it
.

The Coalition's Policy, as set out by Mr Abbott, defends Australia’s health system as one of the best in terms of the cost and the benefits as measured by our life span and infant mortality.

The 30% rebate for private health insurance premiums and other incentives, which have lifted the private health insurance uptake from 30% of the population in 1996 to about 43% now, will remain. In addition, Medicare has been strengthened, Abbott argues, with the Medicare Safety Net (providing a 80% rebate of the gap between the schedule fee and the fee doctors charge) and rebates for visits to dentists, psychologists and other allied health professionals. As well, Medicare is now paying doctors to implement preventative health programs in their practices.

The Government has opened nine new medical schools and 14 rural clinical schools, boosted training places for nurses in hospitals, and offered incentives for doctors to work in regional areas.

Problems in public hospitals (long waiting times, staff shortages and overcrowding) are due to mismanagement by the states and hospital bureaucracies, Abbott says. So the Coalition is proposing that public hospitals be managed and run by individual hospitals with input from doctors, rather than by state governments and area health services. But there'll be no additional money for public hospitals.

Instead to ease some of the pressure on them, there will be $248 million over four years for at-home care for 1000 older people, and for 2000 'transition care' beds in the community. And there will be $37 million for 320 community programs promoting healthy and active lifestyles; Medicare funding for aged patients to see geriatricians; more money for breast cancer screening and research; $2.1 million to improve eye care, and 13 new Medicare funded MRI scan centres.

Federal Labor’s Policy features a cash injection of $2 billion over four years to be invested in hospital and primary care infrastructure for more beds, staff and facilities to relieve pressure on emergency centres and decrease waiting times for elective surgery. There'll be money for hospitals and no-interest loans to operators of nursing homes to boost the numbers of age care beds. Labor would also establish 50 large 24-hour super clinics with GPs, nurses and physios on staff to take pressure off hospital EDs and help manage chronic disease in the community.

A Labor Federal Government would work together with states/territories to cut down cost shifting, inefficiencies and overlapping bureaucracies in public hospitals. If the states won't cooperate, a Labor Federal Government would hold a referendum seeking approval to take over the funding (but not the day-to- day operation) of all public hospitals.

Health promotion programs would include a National Preventative Health Strategy focusing on obesity, tobacco and excessive consumption of alcohol; the Healthy Kids' Check including an assessment of a child's basic health, and the Stephanie Alexander Kitchen Garden Program to teach healthy food habits in 190 primary schools across Australia.

The Medicare Safety Net would stay plus more funding for public dental health programs (the Commonwealth Dental Health Program), for Indigenous health and cancer centres in Sydney and Adelaide. As well, programs would be established targeting post-natal depression, bowel cancer screening and autistic children.

ACT
ACT Health Minister Katy Gallagher today announced a new campaign to attract and retain GPs in the ACT. In partnership with the ACT Division of General Practice, ACT Health will provide $281,000 over four years to fund a marketing and support officer with the sole aim of attracting GPs to the ACT. 2005-06 figures from the Report on Government Services identify that the ACT has only 63.3 GPs per 100,000, 22.5 fewer than the national average of 85.8.

ACT Health Minister Katy Gallagher announced plans to ensure children and parents awaiting emergency care at Canberra Hospital do so in a safe and child friendly environment. At a cost of $250,000 over four years, the current waiting room area will be redesigned to incorporate a children’s waiting and play area. The area will be furnished in a child friendly manner and will include interactive activities, a television, DVD player and assorted age appropriate and infection control approved toys. Two Clinical Initiatives Nurse (CIN) or “waiting room” nurses will provide ongoing monitoring and care for waiting patients. The nurse will be present over peak periods of demand in the waiting area to look after children and talk to parents. The associated capital works should be completed in the first half of 2008, with staff to commence shortly after.

The ACT Minister for Health Katy Gallagher announced that 89% of ACT public sector nurses and midwives had voted in favour of the new ACT Public Sector Nursing and Midwifery Staff Union Collective Agreement 2007-2009. Ms Gallagher said she had been very heartened by the spirit of cooperation that had permeated negotiations between ACT Health and the ACT Branch of the Australian Nursing Federation (ANF). The Agreement provides for: salary increases of 4.5% from the first pay period after 23 March 2007, and 3.75% in March 2008 and 2009; increases in the annualised salary loading from 25%-35% for midwives employed in the Canberra Midwifery Program; various flexible shifts duration from 4 to 12 hours subject to mutual agreement; establishment of a new classification – Assistant in Nursing; and implementation of the Enrolled Nurse Level 2 classification.

NSW
Royal North Shore Hospital:
A parliamentary inquiry into Sydney's Royal North Shore Hospital has heard of cockroaches in operating theatres, ageing operating tables breaking and finance systems in a mess. The inquiry has head that the hospital has been told it is running at dangerously high occupancy levels – 95% of capacity. Dr Antony Sara from the Australian Salaried Medical Officers Federation told the inquiry international research demonstrates hospitals running at more than 85% can not cope.

The troubled Hospital has admitted responsibility for an accident that resulted in the death of 90-year-old Joyce Batterham but has refused to acknowledge any wrongdoing or apologise to Mrs Batterham's family. The Australian newspaper revealed that Mrs Batterham died on November 16 last year from a stroke suffered during surgery to repair injuries she sustained after being dropped on the floor at the hospital. An amputee who had been admitted to RNSH to have her medication assessed, Mrs Batterham broke her hip when a nurse attempted to lift her unaided from her wheelchair on to a bed.

NSW public hospitals will be given $30 million to boost the number of acute beds and provide for more emergency specialists, NSW Health Minister Reba Meagher has announced. The top priorities of the $30 million package would be 150 new acute care beds, and more than $3.6 million for 22 additional emergency specialist positions. A campaign will be undertaken to recruit medical staff to areas of shortage. Emergency department nursing would also be promoted as a specialty through scholarships and targeted education programs. The $30 million package was developed after discussions with the Emergency Care Taskforce, set up in October to examine the pressures on the state's emergency departments. The rollout of the new acute beds would focus on hospitals with large numbers of patients, and double digit growth in emergency department presentations and admissions. Hospitals in this category include John Hunter, Liverpool, RPA (Royal Prince Alfred), Bankstown, Campbelltown, St George, Wollongong, St Vincent's, Nepean, Westmead, Royal North Shore and Gosford.

The state has announced a new policy limiting the sale of junk food and soft drinks that can be sold in cafeterias and vending machines at all public health facilities. State Health Minister Reba Meagher says the Government wants to tackle obesity by encouraging healthy food choices. Foods that are high in salt, fat and sugar will comprise no more than 20% of the available choices in vending machines, cafeterias and other food outlets. NSW."

NT
The Royal Darwin Hospital has invested in a new initiative to help with the movement of patients around the Darwin campus. The Health Minister Chris Burns officially launched the hospital’s first patient transport vehicle. The former ambulance is used to transport patients from the palliative care hospice to the main hospital building for treatment. “This simple but effective idea has meant a saving of $30,000 to the hospital,” Dr Burns said. “Previously, stretcher patients had to be moved to the main building via St John Ambulance. Dr Burns said the vehicle had also been used to transfer a patient to Katherine Hospital and an aged care patient to Tennant Creek. Staff drivers have also received training to drive the vehicle onto the Darwin International Airport tarmac for patient transfers. The new patient vehicle is part of the Government’s Better Hospitals plan to upgrade programs, services and infrastructure at Royal Darwin Hospital.

A coronial inquest into the death of an Aboriginal man has been told there was no accessible water or telephone at the remote Territory airstrip where he was left stranded. The inquest is examining the adequacy of the Territory's patient transport system after the death of 78-year-old Julama Limbunya in August last year. He died after being flown to and left at the Kalkarindji airstrip, 750 kilometres south-west of Darwin, after treatment for pneumonia in Katherine Hospital. His family wanted him to be escorted but the request was denied by the Health Department. Katherine West Health Board has told a coronial inquest it is not to blame for his death.

QLD
The Royal Brisbane and Women's Hospital is conducting a trial to see if the earliest stages of lung cancer can be detected by a breath test. The physician leading the experiment, David Fielding, says 70 patients have volunteered to take part. Breath-testing equipment is already being used to detect large tumours. But Dr Fielding believes it is capable of easily finding tiny lung tumours that can not be picked up by CAT scans or X-rays, but only by an intrusive bronchoscopy.

Queensland Health says it has been forced to immediately close the cardiac surgical unit at the Townsville Hospital in north Queensland because of staffing problems. The district executive director of medical services, Dr Andrew Johnson, says four surgeons and two trainees have been stood down on full pay while their behaviour is investigated. The 37 patients now on waiting lists will have to travel to Brisbane to undergo heart surgery. Dr Johnson says after several years of allegations and reviews it is evident the cardiac team can not work together.

The Queensland Government has ordered an independent review into the death of a three-year-old boy who was allegedly left untreated for up to 30 hours at a regional hospital. The boy was suffering stomach pains and was taken to Emerald hospital by his parents on October 25. He was later transferred to Rockhampton following fears he may have a twisted bowel where, it is alleged, he was not treated for more than 24 hours. He died the next day. Queensland Health Minister Stephen Robertson said the case had been forwarded to the coroner and an independent review would also be carried out. The minister said the findings and recommendations of the independent review would be made available to the family.

Premier Anna Bligh announced in Parliament that the Government would invest an additional $50 million to further tackle record patient demand in Queensland hospitals. Ms Bligh said the recurrent funding, approved as part of the Government's mid-year review process, would enable Queensland hospitals to carry out more elective surgeries and enable clinicians to take immediate action to relieve pressures in other essential areas. "The funding increases Queensland Health's annual budget this year from $7.15 billion to a new record of $7.2 billion - $700 million more than last year and more than double the 1997-98 budget allocation," Ms Bligh said. Queensland Health will allocate the funds to hospitals across the state as part of its own annual mid-year review process. The Premier also recognised the significant inroads achieved since the Government's $10 billion Health Action Plan began two years ago - highlighted in Queensland Health's Quarterly Public Hospitals Performance Report released last Thursday. Queensland public hospitals set a record for the most number of patients admitted and the most number treated in emergency departments during the three months to the end of September, Health Minister Stephen Robertson said. The Report showed a record 216,258 patients admitted to public hospitals and a record 379,969 patients treated in EDs during the September quarter 2007. More than half a million people were treated as either inpatients or emergencies and a record 886,385 patients were seen and treated as outpatients. Public hospitals also performed the most amount of elective surgery (29,404 patients) since major reforms to the health system began in 2005.

SA
THE South Australian Government has banned circumcision and some cosmetic surgery in the state's public hospitals. State Health Minister John Hill said that the ban, which would come into effect this month, would ensure surgery was carried out only when there was a clear medical need. SA joins four other states in no longer providing male circumcisions for non-medical reasons. Other procedures include tattoo removal, breast implantation, liposuction and reversals of sterilisation. Mr Hill said the bans would lessen the demand on hospital beds and extend clinical resources and theatre time.

TAS
The Tasmanian Health Minister Lara Giddings says there is no reason why the Federal Government's takeover of the Mersey Hospital cannot go ahead immediately. The Federal Health Minister, Tony Abbott, says he cannot guarantee the transfer will be finalised by the election because he is still waiting for assurances from the Tasmanian Government. Ms Giddings says everything Mr Abbott's raised has been addressed. ``There is no reason right now that Tony Abbott could not pay the dollar that we've asked for and take over the title of the Mersey Hospital right now," she said. "The advice I continue to receive is that there is nothing that would impede the transaction from going ahead just as I said on the 1st of November," Ms Giddings added.

The dispute between the Tasmanian Government and public sector nurses will returned to the Industrial Commission in the weekend, making it be the second time nurses and the Government had been in the Commission during the week. Nurses had suspended their industrial action on Monday afternoon to allow for negotiations for increased pay and improved conditions. But, according to Neroli Ellis from the Nursing Federation, none took place. Meanwhile, the Health Minister Lara Giddings accused the Federation of attacking the independence of the President of the Commission during a closed hearing. On Wednesday afternoon nurses resumed their bans and have warned they could escalate. The Government maintains all work bans need to be permanently lifted to enable genuine conciliation.

VIC
A VicHealth report shows life expectancy has jumped about six years in the past two decades, but hospital admissions for diabetes, heart disease, stroke, cancer, chronic obstructive pulmonary disease, depression and dementia have soared. The disturbing trend revealed by VicHealth research fellow Dr Peeters came as a VicHealth survey showed 85% of Victorians believed health should be the top priority of government. The telephone survey of 1000 people, marking VicHealth's 20th anniversary, also showed 90% backed spending on health promotion. VicHealth chief executive Todd Harper said Australia spent less than 2% of its health budget on promoting health, and this had changed little in 40 years, despite an increase in preventable illnesses. Dr Peeters found hospital admissions for diabetes and other metabolic disorders had doubled in the past 10 years. Arthritis and other muscular and skeletal problems had jumped 40%, while circulatory system diseases such as heart disease and stroke had increased 20%. Dr Peeters said while changes in illness classification and improvements in identifying health problems partly explained the rises, the data suggested chronic diseases were increasing.

Victoria's district nurses have called off industrial action due to start tomorrow after an 11th hour agreement on staffing arrangements. The nurses look after more than 40,000 patients across Melbourne. They were upset over plans by the Royal District Nursing Service to allow personal carers to do some of their work. The Nursing Federation says a new four-year agreement includes a pay rise and an assurance that there will be no reduction in the number of qualified staff employed to provide clinical nursing care and medication to patients.

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Health Minister Tony Abbott argues the 50 Family Emergency Medical Centres being proposed by the Coalition would complement existing clinics, unlike Labor's plan for GP super-clinics on predetermined sites, which he claimed would compete with established practices.

The report questions the Government's ability to address the maldistribution of doctors in outer metropolitan areas. Three initiatives are used to fill outer metropolitan vacancies: pay Australian-trained doctors a Relocation Incentive Grant of up to $40,000; force GP registrars to undertake a six-month placement in those areas; and offer to fast-track overseas-trained doctors into areas of need. Whilst these initiatives have been successful to a degree, evidence suggested that they had not been fully subscribed, and that more recent uptake of the RIG in particular was declining, the report found.

Bulk-Billing Report
The total number of GP bulk-billed visits in the September quarter increased by 1.5 million compared to the corresponding quarter in 2006. The latest Medicare statistics show continuing strong demand for bulk-billing, even though the proportion of bulk-billed services in the September quarter remained broadly stable. After a strong growth of 0.8 of one percentage point in the June quarter 2007, GP bulk-billing decreased by 0.2 of one percentage point to 78% on the June quarter 2007. The 78% bulk-billing rate for GP visits was the highest September quarter rate since the September quarter 2000. The GP attendance bulk-billing rate has increased 11.5 percentage points since the Commonwealth Government introduced the $4 billion Strengthening Medicare reforms in 2004. The GP attendance bulk-billing rate in rural and remote areas was 73.2% in the September quarter 2007, an increase of 20.4 percentage points on the December quarter 2003.

Antarctic Division Struggles To Find New Doctors
The Australian Antarctic Division cannot find two doctors to fill critical positions at its Antarctic stations and with time running out, its research program is under threat. Dr Jeff Ayton, chief medical officer with Australia's Antarctic Division, says it is urgently looking for two doctors to spend nine months in Antarctica at Casey or Davis station. "We have a critical ... departure time of February in 2008," he said. He says the Antarctic Division does have some unique requirements. "That's having some procedural skills, and in the worst case scenario the ability to undertake an appendectomy on the ice," he said.

As Dr Pam McGrath explains: "The study shows that there is a mistaken belief that staff are legally bound to engage in cardiopulmonary resuscitation (CPR) with all dying patients, even when deemed medically futile". The research found that the health professionals were inhibited in their care by fear of the legal consequences of their actions. This research highlights the need for mental health practitioners having a thorough understanding of the legal context of their practice to reduce the fear of litigation and address incorrect assumptions.

The findings indicate the need for policy development to improve the integration of best practice palliative care into mental health care delivery. Further information on this and other IPP-SHR studies are included in IPP-SHR’s quarterly newsletter, ‘Psych-Social Update’ Volume 2 Issue 3.

Welfare To Work 'Unfair' On Mentally Ill
The Mental Health Council of Australia says the Government should change its Welfare to Work laws to better suit the needs of mentally ill people. In a report released last Monday, the council says only 29% of people with mental illnesses are working, which is about half the rate of peop, le with a physical disability. Council CEO David Crosbie says the penalties imposed under the Welfare to Work program put unfair pressure on people with mental illnesses. "Its fine to say people should be encouraged to look for work, but we shouldn't link that to their income and we should be putting in place the programs that will support people to get them back into work," he said.

Vioxx Class Action Numbers Surge
Local victims of the arthritis drug Vioxx have rushed to join an Australian class action in the wake of a $5 billion weekend settlement for U.S. Vioxx users. Yesterday more than 170 people called law firm Slater & Gordon which is conducting the Vioxx class action for more than 1000 others (including more than 250 from New South Wales). Others inquired on-line, setting a new record for one-day traffic on the law firm’s web site. To cope with the demand, the firm will now provide video legal advice on the Vioxx class action on its website, believed to be a first for an Australian law firm. Slater & Gordon lawyer James Higgins says the Federal Court of Australia has already encouraged lawyers for Australian claimants and the manufacturer’s Australian subsidiary, Merck, Sharpe and Dohme, to consider mediation.

Survey Shows Many Australians Failing To Connect Obesity And Health Risk
Many Australians are failing to make the connection between obesity and the risk it poses to their health, according to the latest MBF Healthwatch survey. The national survey of 1,200 people found that 70% rated their health as excellent, very good or good. But at the same time nearly two thirds described themselves as being overweight or obese. Only a third of people with a Body Mass Index (BMI) that placed them in the obese category believed that they were actually obese. MBF chief medical officer, Dr Christine Bennett, said the survey results were disturbing because they supported concern that being obese was now regarded as the norm in society.

Australia Is Fifth-Highest In Adult Obesity Rates
The Organisation for Economic Co-operation and Development's Health at a Glance 2007 report has found Australia had the fifth-highest adult obesity rate in the developed world (21.7%) trailing the US (32.2), Mexico(30.2), Britain (23) and Greece (21.9). But Australians were gaining weight faster than the top-weight Americans. Using consistent measures of obesity over time, the rate of obesity has more than doubled over the past 20 years in the United States, while it has almost tripled in Australia, the report said. World Health Organisation Collaborating Centre for Obesity Prevention director Prof Boyd Swinburn, from Deakin University, said the findings should ring alarm bells. "We may see life expectancy dropping, as well as diseases like diabetes, sleep apnoea and a number of cancers increasing, unless we get programs in place now." The review of key health data from 30 OECD countries also showed almost one in four Australians has a body mass index over 30.

Babycino - A Therapy
More than 200 of Victoria's smallest premature babies have been having tiny drinks of caffeine to reduce their chances of cerebral palsy and cognitive disabilities. The results of a trial to be announced today have been so successful that daily doses of caffeine are now routine treatment for Victorian babies as tiny as 500g, mixed with milk or given through an intravenous drip. Prof Lex Doyle of the Royal Women's Hospital said caffeine was the first treatment ever shown to reduce disabilities common in severely premature babies. "Very premature babies tend to forget to breath and drop their oxygen and heart rates, but if you give them caffeine they have far fewer of those pauses and you can reduce the time they are needed on a ventilator,” he said. More than 200 babies from the Royal Women's and Mercy Women's hospitals took part in a five-year trial involving more than 2000 pre-term births in Australia, the US, Canada, Europe and Israel. The baby’s chance of death or disability drops 6% when having caffeine.

La Trobe Cell Death Research Leads To Novel Anti-Cancer Drug
Scientists at La Trobe University have discovered how a new drug that targets proteins that inhibit the normal process of cell death (a process known as apoptosis) kills cancer cells. The research has important implications for the next generation of cancer treatments and highlights the key mission of the University's new Australian Institute for Molecular Medicine. A research team led by Dr John Silke and Professor David Vaux has discovered that a new drug targets a cell death inhibitor protein (cIAP1) and can cure laboratory mice bearing human cell cancers.

Transport And Falls Responsible For Most Spinal Cord Injuries
Transport-related injuries and falls accounted for over three-quarters of all cases of traumatic spinal cord injury in Australia in 2005-06, according to a new report released by the Australian Institute of Health and Welfare. The report, Spinal Cord Injury, Australia 2005-06, presents national statistics on 374 cases of persisting spinal cord injury (SCI), 284 of which were due to traumatic causes and 90 of which were due to disease.

The Cost Of Muscular Dystrophy
A new report commissioned by the Muscular Dystrophy Association shows the disease costs the Australian community an estimated $1.5 billion a year. The report was prepared by Access Economics and focuses on the prevalence of muscular dystrophy, the loss of life and well-being and the economic impact of the disorder.

Australasian Faculty of Public Health Medicine
The Australasian Faculty of Public Health Medicine (AFPHM), a division of the Royal Australasian College of Physicians (RACP), released the recommendations and outcomes of Finding Solutions That Work, a forum held in August this year which examined how public health physicians can improve the health of Aboriginal and Torres Strait Islander people. AFPHM President Professor George Rubin said the workshop brought together more than 100 health professionals and Indigenous leaders from around Australia. “By far the strongest message from the workshop was the need to look beyond traditional clinical solutions to resolve the poor health outcomes of Indigenous Australians. One clear goal is to close the life expectancy gap. Health measures must be accompanied by investment in education, housing and increased rates of employment in order to achieve sustained health improvement. “With Indigenous infant mortality rates hovering around three times the levels of non-Indigenous children, and a life expectancy gap of over twenty years, this is clearly an ongoing crisis, not a sudden emergency.”

Report Highlights Economic Toll From Allergies
A new report has put the cost of allergies to the Australian economy at more than $7 billion a year. Allergies affect one in five Australians, with direct medical costs reaching $1.2 billion of the national figure, the remainder is due to losses in productivity and health system expenditure. The report, by Access Economics and the Australasian Society of Clinical Immunology and Allergy, shows those most affected by allergies are young adults and young families with children.

Allergy specialist Professor Raymond Mullins says governments need to pay more attention to the damage allergies are doing to the economy. "This is hard evidence that it's common, that it is going to increase dramatically over the next 40 odd years”. Professor Mullins says on average, Australians wait between 13 and 18 weeks to see an allergy specialist. He says many families cannot afford the proper treatment. "Many of the medicines used to treat allergies are not subsidised by the PBS, they're not counting towards Medicare safety nets," he said.

Irregular Heartbeat Volunteers Needed
DOCTORS in Australia are calling for volunteers with irregular heartbeats to take part in the world's largest trial of new generation stroke prevention medication. The trial would look at the effectiveness of a new blood-thinning agent, which prevents blood clots forming, against the traditionally used warfarin, said trial investigator Andrew Lowy. Dr Lowy, an expert in cardiovascular pharmacology and director of the Australian Clinical Research Centre, said that if successful, the new blood-thinning agent – known as a Factor 10A inhibitor could replace warfarin entirely. “This could be the biggest advance in clot and stroke prevention associated with atrial fibrillation medications for more than 50 years," he said. Dr Lowy urged people who wish to participate to call 1800 883 888. “We are looking for people with atrial fibrillation, with or without symptoms, who are currently on warfarin for blood thinning, or who have been advised by their doctor to start taking the medication,” Dr Lowy said. Stroke is Australia’s third most common cause of death and the leading cause in disability, with more than half caused by blood clots escaping from the heart or blood vessels and lodging in the brain. Atrial fibrillation (irregular heartbeat) affects about 1.5 million Australians and is the single most common cause of stroke. The most common form of irregular heartbeat, atrial fibrillation results from abnormal electrical signals which cause heart muscles to contract out of time with each other. The condition causes pooling of the blood within the heart which in turn leads to clot formation.