WHO discusses health strategies for our region

Low breastfeeding rates and “aggressive” baby formula marketing have been raised as an urgent issue by delegates at the World Health Organisation’s Western Pacific Regional Committee in Brisbane last month.

The annual meeting brings together ministers of health and senior officials from 37 countries and areas to decide on issues that affect the health and well-being of the Region’s nearly 1.9 billion people.

A new WHO regional action plan has been developed to strengthen protections for children from the harmful impact of food marketing.

WHO remains concerned that the baby food industry manipulates policies and practices by creating a positive public image as well as denying wrong-doing. WHO also believes evidence suggests that infant formula industry advertisements, gifts and sponsorships promote misconceptions and myths and ultimately have a negative impact on feeding practices.

Marketing of breast-milk substitutes, including infant formula, follow-up formula and growing-up milk, to caregivers continues to undermine breastfeeding in the first six months and continued breastfeeding beyond that age.

“The baby formula business is booming,” WHO’s regional director Dr Shin Young-soo said.

“And that is undermining breastfeeding.”

WHO believes that globally, 13 per cent of child deaths can be prevented with exclusive and continued breastfeeding.

Protecting children from the harmful impact of food marketing is critical in a region where more than 6.3 million children are overweight or obese. Countries were at the forum to develop a regional action plan to provide greater protection for children and support better health and nutrition, from birth onwards.

“When children are exposed to food marketing, their diets change,” Dr Shin said.

WHO and the Australian Government have also launched their first ever country cooperation strategy, on the sidelines of the 68th session of the WHO Regional Committee for the Western Pacific.

Issues discussed at the forum included: eliminating major communicable diseases, including measles and rubella, as well as mother-to-child transmission of HIV, hepatitis B and syphilis; financing of priority public health services; strengthening regulation of medicines and the health workforce; improving food safety; and health promotion for sustainable development.

Dr Shin Young-soo said the forum was important to the region because: “Our strength in solidarity is our best defence against whatever the future holds.”

It also provided a vision for WHO’s joint work with Australia over the next five years to improve the health of Australians and contribute to better health outcomes in the broader region.

Dr Shin said the strategy with Australia is the first of its kind, but it builds on a history of strong cooperation while also looking towards the future. Traditionally, country cooperation strategies are established between WHO and developing countries, where the Organisation has offices and provides direct support.

“I sincerely thank Minister Hunt and the Department of Health for their commitment to this strategy – and for paving the way for other high-income countries in this Region, with a new form of engagement that goes beyond the traditional donor country relationship,” he said.

Health Minister Greg Hunt, who attended the meeting, said the strategy: “Strengthens our systems to guard against emerging diseases at home and abroad, boosts our public health capacities and improves our already robust regulations to ensure we have safe and effective medicines and treatments.”

Australia’s breastfeeding guidelines are in line with WHO recommendations that infants up to six months should be exclusively breastfed. However, the Department of Health Australian National Breastfeeding Strategy expired in 2015.

The AMA believes that breastfeeding should be promoted as the optimal infant feeding method. AMA has also called for doctors and other health professionals to be appropriately trained on the benefits of breastfeeding, including how to support mothers who experience difficulties with breastfeeding.

AMA’s position statement can be read here: position-statement/infant-feeding-and-parental-health-2017 .

MEREDITH HORNE

Why patients need better data on how hospitals compare

Australia’s health system is an information industry – it is awash with data. Tragically, though, the data is not well collated, not put into the hands of the people responsible for acting on it. Nor is it shared with patients.

Multiple “data sets” measure the safety of hospital care in Australia, but they are rarely linked, sometimes incomplete, and almost always delayed. We have lots of data about hospital safety, but it’s not used to make us safer when we have to go to hospital.

Information on patients’ experiences with their hospital care are often not reported back to public hospitals at unit or ward level, which makes working out where to start on improving care that much harder. Information about patients’ experiences in private hospitals is rarely reported publicly at all.

A Grattan Institute report released today, Strengthening safety statistics: How to make hospital safety data more useful, analyses many of these data sources and identifies practical ways they can be improved.

The routine data – a scarcely tapped resource

One of the most underused resources to track the safety of hospital care is the “routine data”. This is the information collected on every patient discharged from every hospital in Australia. It’s a rich source of clinical information – it tells us each patient’s diagnosis and the procedures performed, as well as their demographics.

The routine data allows us to track what went wrong in hospitals, such as the rate of infections acquired in hospital, so better and worse hospitals can be identified and corrective action taken.

It is also comprehensive: the information is collected in both public and private hospitals.

Yet, inexcusably, private hospitals are left outside state safety monitoring of hospitals. The New South Wales Bureau of Health Information, for example, produces an excellent report comparing hospital deaths rates, but only for public hospitals.

A key recommendation of our report is that private hospitals be included in the standard safety monitoring approaches. Their performance should be analysed, and the results fed back to them and reported widely, in the same way as public hospitals reporting.

Clinical quality registries – separate sources

Another major resource for measuring the safety of hospital care is “clinical quality registries”. These are standalone, separate collections of detailed data about particular treatments. The national Joint Replacement Register, for example, holds information about hip and knee replacements, including revision rates when something has gone wrong.

These registries are certainly valuable. But they would be much more useful if clinical problems they identified were notified to the people who can take action to fix the problem.

Yes, some registries do that already (although often there is too long a delay before the people who need to know get to know). But some registries act like “secret squirrels”: they know about safety problems but won’t share them with anyone but the person or clinical unit who contributed the data. Hospital managers – and patients – remain in the dark.

This is unacceptable for several reasons. Patients are denied information that might be useful to them, such as the complication rates for weight-loss surgery at a particular hospital. And clinicians alone often don’t have the resources, motivation or power needed to investigate and fix problems; they need the institutional support of hospital managers.

These types of registries were often started by dedicated and enthusiastic clinicians, with the best of intentions. These registries are well supported: many now receive public funding. And the number of such registries in Australia is growing.

But there’s a problem. These registries operate independently; they are separated from other data sources. They are designed to imagine patients as isolated body parts or diseases. This means important data about an individual patient – for example, someone with a knee problem and heart disease – is housed in multiple, independent registries. Data are duplicated and the insights from one registry are not available to the other unless they are specifically linked.

So another of our key recommendations is that the information kept in these registries should be linked to the routine data, to enhance the value of both.

Making the data more useful

To make hospital data more useful, we must ensure all of it is as accurate, relevant and gets into the hands and minds of the people who need it – patients, doctors, and hospital managers. And to be truly accessible, the data needs to be presented clearly.

A surprising number of doctors struggle with statistical concepts. As a result, patients can be left confused and misled. More attention needs to be paid to displaying individual hospital results graphically, comparing them to other hospitals in a way where differences can be easily seen. Rates of hospital-acquired infections for public hospitals are published, but rates for other complications, such as pressure injuries, are not.

Better information by itself, no matter how high the quality, will not improve anything; it will only point to where action and improvement is needed. But the converse is also true: without good information, we don’t know where there might be problems.

Stephen Duckett, Director, Health Program, Grattan Institute and Christine Jorm, Associate professor, University of Sydney

This article was originally published on The Conversation. Read the original article.

Canada looks to end over-the-counter codeine

The Canadian federal government is proposing to introduce a prescription for codeine-containing drugs that are currently freely available over the counter.

The change is currently in a consultation process, and is a policy outcome of an Opioid Conference and Summit coordinated by the Canadian Health Minister late last year. Canadians have until November 8, 2017 to comment on the changes.

Canada faces a serious and growing opioid crisis. The Canadian Minister of Health, Jane Philpott believes the response needs to be “comprehensive, collaborative, compassionate and evidence-based”.

The Canadian Health Department says about 600 million low-dose codeine tablets, or about 20 for every person in the country, were sold across Canada in 2015. It notes that more than 500 people entered addiction treatment centres in Ontario alone between 2007 and 2015, with non-prescription codeine as their only problem substance.

Dr Theresa Tam, Canada’s Chief Public Health Officer, believes this is a major public health crisis.

“Tragically, in 2016, there were more than 2,800 apparent opioid-related deaths in Canada, which is greater than the number of Canadians who died at the height of the HIV epidemic in 1995,” Dr Tam said.

The opioid crisis is putting increasing pressure on the country’s health care systems with approximately 16 Canadians a day hospitalised due to poisoning, according to the Canadian Institute of Health Information (CIHI).

“It’s a dramatic increase,” says Michael Gaucher, director of Pharmaceuticals and Health Workforce Information Services at CIHI.

“The rate of hospitalisations over the past few years is very troubling and points to the deepening of the opioid crisis across Canada.”

The Canadian Health Department says the proposed changes to Canada’s regulations to require all codeine products to be sold by prescription would be in line with those already in place in many countries, including Belgium, Czech Republic, Finland, France, Greece, Iceland, India, Italy, Norway, Russia and Sweden.

The proposal was published in the Canada Gazette and is open to a 60-day comment period, after which time the government will decide whether to pass a regulation implementing the change.

Canada is close to the world leader in codeine consumption – its use is several times higher than in most other Western countries, with only Iceland reporting a bigger habit per capita.

MEREDITH HORNE

PHI reforms in right direction, but more work needed

The AMA has welcomed the Government’s reforms to private health insurance as a “start in the right direction”, but says much more needs to be done to make the sector more transparent and affordable.

On October 13, the Federal Government announced a raft of changes to the private health insurance (PHI) sector, following lengthy consultation and an ongoing consumer backlash against the industry.

The changes include encouraging younger Australians to take up PHI by allowing insurers to discount premiums up to two per cent for each year as an adult before turning 30, to a maximum of 10 per cent. This will be phased out by the time they turn 40.

Regional patients will benefit from policies that will for the first time include travel and accommodation subsidies for some hospital services.

A hierarchy of Gold, Silver, Bronze and Basic policy categories will be introduced to help consumers compare what is on offer.

But even policies under the Basic classification will provide mental health services, which are not currently covered under many policies.

Existing policy holders will be able to upgrade their cover in order to access in-hospital mental health services without having to endure a waiting period. And insurers will not be allowed to limit the number of in-hospital mental health sessions a patient can access.

Insurers will be able to keep premiums down by offering higher excess levels.

From April 2019, unproven therapies such as Pilates, yoga, homeopathy, aromatherapy, iridology and herbalism (among others) will not attract rebates.

A prosthetics deal between the Government and manufacturers aims to reduce the cost to private insurers for the devices, and subsequently pass on savings to consumers.

In announcing the changes, Health Minister Greg Hunt said reform in the sector would continue, with the Private Health Ministerial Advisory Committee still examining issues such as risk equalisation.

“And we will work with the medical profession on options to improve the transparency of medical out-of-pocket costs,” Mr Hunt said.

“The Turnbull Government is committed to private health insurance and we’re committed to supporting the more than 13 million Australians that have taken out cover.

“We are investing around $6 billion every year in the private health insurance rebate to help keep premiums affordable.”

The Opposition, however, has described the reforms as “too little, too late” and criticised the Government for not addressing the so-called “junk policies” that are hardly worth the paper they are written on.

Shadow Health Minister Catherine King said junk policies should be banned.

“The fact that the Government has broken its election promise and retained junk policies remains concerning to me,” Ms King said.

Consumer group CHOICE has also criticised the failure to ban junk policies.

AMA President Dr Michael Gannon said the announced changes to PHI would not solve the problem of a perceived lack of value in the services provided by the PHI sector.

Health fund membership has been falling by 10,000 a month, as premiums increase an annual average of 5.6 per cent.

Dr Gannon said Australia needs a strong and viable private health sector to maintain the reputation of the Australian health system as one of the world’s best.

But the reforms will need the genuine commitment and cooperation from all stakeholders to deliver real value and quality to policyholders.

“The framework for positive reform of the private health insurance industry is now in place,” Dr Gannon said.

“The challenge now is to clearly define and describe the insurance products on offer so that families and individuals – many of whom are facing considerable cost-of-living and housing affordability pressures – have the confidence that their investment in private health delivers the cover they are promised and expect when they are sick or injured.”

Dr Gannon welcomed the decision to introduce Gold, Silver, and Bronze categories for PHI policies and that standard clinical definitions will be applied.

“Importantly, the changes will provide better coverage for mental health services and for people in rural and regional Australia,” he said.

“The AMA advocated strongly for standard clinical definitions on behalf of our patients. What we need to see now is meaningful and consistent levels of cover in each category.

“While we had called for the banning of so-called junk policies, we will watch closely to ensure that any junk policies that remain on the market are clearly described so that people know exactly what they are buying and are not subject to unexpected shocks of non-coverage for certain events or conditions.

“Basic cannot mean worthless.

“We will continue to call out any misleading products in our yearly report card.

“Other areas that will need further investigation include the fine detail of the new prostheses arrangements, how and at what level pregnancy will be covered, and the review of low value care for things like mental health and rehabilitation.

“We welcome the removal of coverage for a range of natural therapies such as homeopathy, iridology, kinesiology, naturopathy, and reflexology, which the Chief Medical Officer has rightly declared as lacking evidence or efficacy.”

Dr Gannon said the AMA has concerns about the possible direction of ongoing work on out-of-pocket costs and the review of privately insured patients being treated in public hospitals.

“We will be pushing for the expert committee considering out-of-pocket costs to broaden its review beyond doctors’ fees.

“Doctors’ fees are not the problem – 95 per cent of services in Australia are currently provided at a no-gap or a known gap of less than $500,” he said.

“The out-of-pockets committee must instead focus on the issues that leave patients with less support such as the caveats, carve-outs, and exclusions; hospital costs; and inconsistent and tricky product definitions.

“We will of course support efforts to rein in unacceptably high fees in the small number of cases where they occur.

“And we will be vigilant on any moves to deny private patients access to care in a public hospital. This is a critical and complex area that needs careful consideration. It is especially critical if the Government is going to promote basic and public hospital only cover.”

Dr Gannon told ABC Radio that the changes were “perhaps” a start in the right direction, but that ongoing work was required.

“The one thing the Minister is up against, one thing that future Governments will be up against is the inevitable increase in the cost of health care,” he said.

“Health CPI runs at four, five, six per cent per year. We’re interested in some of the one-off savings that the Minister is going to be able to achieve, but it’s going to require ongoing work.

“The different players in the industry, the hospitals, the doctors, the insurers, need to continue to try and work with Minister Hunt on savings in the system. He’s come up with some good ideas here.

“So, for example, he has managed to negotiate some savings with the people who manufacture prostheses. That’s how he intends to deliver on cheaper hip replacements.

“But he’s got cost control when it comes to doctors’ fees. They’ve been in many ways frozen for nearly five years now. That’s not the problem in the system. The biggest problem in the affordability of private health insurance is the amount that’s going into the pockets of the for-profit insurers.

“Now I’ve spoken to the Minister about this. The genie is not going back in the bottle…

“There are too many tricks in the current system, too many carve-outs, and too many caveats. Too many people who find out they’re not covered for the first time when they’re actually sick.

“We went to the Minister and said we want to get rid of junk policies. We’re not overly excited about the idea of maintaining Basic, but he came back to us and other stakeholders and said ‘look we need to do something about affordability’. So I think, at least for now, we’re stuck with Basic.

“But as long as people know what they’re getting, as long as there’s no tricks on clinical definitions. People shouldn’t need to be six months into a medical degree to know what they’re actually covered for.”

CHRIS JOHNSON

New guide for communication between health services and GPs

The AMA has released a new Guide, which sets out 10 minimum standards that should apply for communication between health services and general practitioners and other treating doctors to ensure the best possible health outcomes for patients.

The Guide, 10 Minimum Standards for Communicating between Health Services and General Practitioners and other Treating Doctors, which has been adapted from an AMA Victoria document, provides key criteria for communication that can improve quality of care for patients, and also reduce duplication and waste in the health system.

The AMA has written to all State and Territory Health Departments, and the major operators of private hospitals, urging them to use the new standards to inform the development of policy and to improve the standards of care being provided to patients.

AMA Vice President Dr Tony Bartone, a Melbourne GP, said the AMA Guide encourages all health care providers and institutions to share the responsibility for improved communication across the whole patient journey.

“The Guide covers the patient journey from the community setting to treatment in a hospital or healthcare facility and return to the community – including clinical handover back to the patient’s general practitioner,” Dr Bartone said.

“Improving the communication between all the different providers in the health system can help to reduce re-admissions and minimise adverse events.

“More effective communication delivers improvements in satisfaction and experience for patients, carers, families, doctors, and other health practitioners.”

Dr Bartone said the development of the AMA Guide was led by GPs, who are often frustrated by the lack of timely information or inadequate information about their patient’s progress in the health system.

“GPs are the key coordinators of patient care, monitoring and managing their care and treatment. Any disruption to clear communication channels can have an adverse effect on patients,” Dr Bartone said.

“We are delivering very good outcomes for patients in the Australian health system, but we can and should do better. We are confident that the AMA Guide will contribute to improved communication and, in turn, better overall care.”

The AMA Guide covers vital criteria such as the timeliness of communication and its content; communication processes; the interface with practice software systems; good quality referrals, better discharge processes, and secure electronic communication systems.

The work undertaken by AMA Victoria has been well received in that State. The AMA believes the Guide can now play a similar role in driving quality improvement nationally.

The Guide is at article/10-minimum-standards-communication

First ever National Rural Health Commissioner appointed

The AMA has congratulated Professor Paul Worley on his appointment to the new position of National Rural Health Commissioner.

Welcoming the appointment, AMA President Dr Michael Gannon said Professor Worley was a highly respected member of the profession who has made a substantial contribution to rural health over many years.

“Professor Worley has a big job ahead of him, and he will have the full support of the AMA and other groups with a commitment to improving access to quality health services in rural, regional, and remote Australia,” Dr Gannon said.

“The long-awaited appointment of a National Rural Health Commissioner had the potential to boost the profile of rural health issues in Government decision-making and health policy development.

“The Rural Health Commissioner will also lead the establishment of a Rural Generalist Pathway, which could boost the much-needed recruitment and retention of skilled practitioners in rural areas.

“The AMA is uniquely positioned to provide Professor Worley with advice on rural health policy.

“We have an extensive rural membership, including medical students, doctors-in-training, career medical officers, GPs, and other specialists.

“The AMA has also established the AMA Council of Rural Doctors (AMACRD) to ensure our rural members have a strong say in our policy and advocacy.

“We are excited at the prospect of working with Professor Worley, and look forward to meeting with him as soon as he settles into the new role.”

Professor Worley was formerly Dean of Medicine at Flinders University. He is a past President of the Rural Doctors Association of SA, a previous national Vice President of the Australian College of Rural and Remote Medicine (ACRRM), and he is a current Council Member of AMA (SA).

In announcing the new role, Assistant Health Minister David Gillespie said he was looking forward to working collaboratively with Professor Worley to progress regional and rural health reform.

“Professor Worley will be a determined, effective and passionate advocate for strengthening rural health outcomes across Australia,” Dr Gillespie said.

CHRIS JOHNSON

Invitation from AMA President to participate in aged care survey

The Australian Medical Association invites you to participate in a brief online survey to help inform AMA policy and lobbying in the area of medical services for older Australians.

Australia is experiencing an ageing population with more complex medical conditions than before. In 2016, there were 3.7 million people aged over 65 in Australia, and this is expected to rise to 8.7 million by 2056. The prevalence of Dementia, a leading cause of death in Australia, is predicted to increase to 900,000 by 2050 (298,000 in 2011).

Currently, Australia’s aged care system is failing this older population. This has become increasingly evident over the past year, with multiple stories of negligence highlighted in the media. In particular, the serious neglect in patient care at the Oakden Older Person’s Mental Health Service has sparked both an independent review and a Senate inquiry into the quality of the whole aged care system.

If nothing changes, Australia’s ageing population will see a system diving further into inadequacy, putting the lives of our patients, and families, at risk.

This is why the AMA will continue, and increase, our advocacy in aged care. Part of this advocacy will also involve updating our position statements to reflect the current climate.

This is where we need your help. As members, this aged care survey gives you an opportunity to comment on your experiences with aged care, and better inform our advocacy strategy, our position statements and our submissions. In developing our future advocacy resources, we want to focus our efforts on ensuring that medical practitioners who provide medical care to older Australians are supported, and their needs are highlighted to government.

Similar surveys were undertaken by the AMA in 2008, 2012, and 2015.

In 2015, the AMA Aged Care Survey revealed the major reasons affecting the provision of medical care in the aged care sector were the lack of availability of suitably trained and experienced nurses, and MBS rebates not properly compensating for the time spent away from surgery.

The results from this 2017 survey will be compared to these earlier surveys to identify trends and measure some of the changes over the past nine years.

The survey takes approximately 15 minutes to complete. Your individual response will not be identifiable, however overall survey results will be published. I urge you to please take the time to complete this very important survey.

Click the following link to begin. Please complete the survey only once.

https://www.surveymonkey.com/r/amaagedcaresurvey2017

The survey closes on Monday 27 November 2017.

Dr Michael Gannon
AMA President

Compliance with the advertising provisions under the National Law

As part of the Australian Health Practitioner Regulation Agency’s (AHPRA) ongoing work to ensure compliance with the National Law’s advertising requirements, it has commenced contacting medical practitioners who AHPRA has assessed as having non-compliant website, social media and/or print advertising by letter.

While only a small number of medical practitioners will receive correspondence about non‑compliant advertising, it is important that practitioners ensure that they meet the requirement under the National Law and that the profession maintains and upholds the best standards as an exemplar amongst the regulated professions.

Medical practitioners who are contacted have 60 days to check and correct their advertising to ensure they comply with the National Law. AHPRA will check that the advertising content has been amended. If AHPRA remains concerned, it may take further action. Further non-compliance may result in a condition being placed upon a practitioner’s registration or the relevant National Board taking disciplinary action.

If you are advertising a regulated health service, your advertising must not:

be false, misleading or deceptive, or likely to be misleading or deceptive;
offer a gift, discount or other inducement, unless the terms and conditions of the offer are also stated;
use testimonials or purported testimonials about the service or business;
create an unreasonable expectation of beneficial treatment; or
directly or indirectly encourage the indiscriminate or unnecessary use of a regulated health service.

Examples of unacceptable advertising include:

“When I was first diagnosed, I felt there was no hope for me to survive. I had constant pain and was unable to care for myself. But then I saw Dr Smith at Wonders Day Surgery. Dr Smith agreed with my diagnosis and was able to provide treatment which saved my life. Dr Smith cured me and I have no more pain.”

“As an incentive to my existing patients to introduce their friends and family to our work, I am offering a $20 discount on their first visit! Just fill in the forms on our new website, present them to reception and get a $20 discount.”

“At the Rose Street Clinic, cosmetic and reconstructive procedures are an area of care we can provide. These simple procedures are completely safe and can be done on site. Our cosmetic surgery procedures are guaranteed to provide consumers with the desired result. Improve your happiness through the wonderful work at the Rose Street Clinic.”

AHPRA has published resources on its website to support practitioners to comply with the advertising requirements. The correspondence sent to identified practitioners includes a direct link to a check, correct and comply webpage (www.ahpra.gov.au/Publications/Advertising-resources/Check-and-correct.aspx), which provides links to several resources for practitioners including common examples of non-compliant advertising and how they can be fixed. This site also provides more details about the process for managing advertising complaints.

Complaints about advertising rose by 237.7 per cent and accounted for 75.2 per cent of all offence complaints[1] between 2014/15 and 2015/16. Almost 57.3 per cent of these complaints related to chiropractic services. However, while most of the complaints relate to chiropractic advertising, medical practitioners also attracted some complaints. As such, the AMA advises that practitioners should make themselves aware of the guidelines.

The Medical Board of Australia has guidelines for advertising regulated health services, which can be found here http://www.medicalboard.gov.au/Codes-Guidelines-Policies.aspx

There are also specific guidelines for medical practitioners who perform cosmetic medical and surgical procedures, which can be found here http://www.medicalboard.gov.au/News/2016-09-29-revised-registration-standards.aspx

The AMA will monitor this compliance program as it develops.

Jodette Kotz
AMA Senior Policy Advisor

New Medicare items announced

The cost of some treatments for heart disease, epilepsy, stroke, breast cancer, lymphoma and liver tumours are set to become much cheaper for thousands of Australians.

Health Minister Greg Hunt (pictured) has announced 33 treatments will be subsidised by Medicare from today, helping thousands of Australians reduce their medical bills.

The move by the government is based on recommendations from the independent Medical Services Advisory Committee (MSAC).

More than 2000 people a year with slow growing non-Hodgkin lymphoma, or lymphatic cancer, will have the costs of positron emission tomography (PET) imaging subsidised so doctors can monitor the progress of the disease.

Another 800 patients who are not eligible for open heart surgery will instead be able to receive a subsidised transcatheter aortic valve implant to replace damaged aortic valves.

Hundreds of other patients with irregular heart rhythms but who are unable to take blood-thinning medication, will have access to a device which can lower their risk of stroke.

Stroke patients will also be given access to a new treatment to mechanically remove blood clots from the brain.

Other treatments added to the Medicare subsidy list include vagus nerve stimulation therapy for management of treatment resistant epilepsy, and microwave tissue ablation for patients with primary liver tumours that can’t be treated by conventional surgery.

Under plans announced in October, women with a family history of breast and ovarian cancer will also be able to undergo free genetic tests to see if they are at risk of developing the potentially deadly diseases.

You can access the list of new items here.

[Editorial] Xi Jinping’s roadmap for China prioritises health

During the week of Oct 18, General Secretary Xi Jinping presided over the 19th Party Congress of the Communist Party of China. This twice-in-a-decade meeting an-nounces the leadership’s ideology and elects the party’s top positions. Xi has consolidated power and political will for deeper reform, including establishing the Healthy China initiative for primary health-care services, medical insurance, and modernising hospital management.