×

More subsidised MRI scans made available

New Medicare-subsidised MRI licences have been granted in an additional 30 locations around Australia.

More than 400,000 Australians will now be able to access lifesaving scans for cancer, stroke, heart and other medical conditions.

The Government has allocated $175 million for the rollout, with the first 10 hospitals to receive the new Medicare support being: 

  • Mount Druitt Hospital, New South Wales
  • Sale Hospital, Victoria
  • Royal Darwin Hospital, Northern Territory 
  • Mount Barker, South Australia
  • Pindara Private Hospital, Gold Coast, Queensland
  • Northern Beaches Hospital, New South Wales
  • Toowoomba Hospital, Queensland
  • Monash Children’s Hospital, Clayton Victoria
  • St John of God Midland Public and Private Hospital, Western Australia
  • Kalgoorlie Health Campus, Western Australia 

Health Minister Greg Hunt said each of the sites had been identified as a location of critical patient need. In many cases hospitals already have this technology, ready to provide services from November 1 this year. 

“Not only will our new Medicare support ensure patients get the most appropriate treatment and save money, it will also cut down the amount of time patients have to spend travelling to get a scan,” the Minister said.

“Medicare subsidised MRIs will be accessible in these locations from 1 November 2018, subject to the sites meeting the required approvals and administrative requirements.”

A competitive public application process for the location of a further 20 Medicare eligible MRIs has also been opened.

Shadow Health Minister Catherine King welcomed the new licences, but said the Government was only following Labor’s move on the issue.

“After five years of abject failure when it comes to the cost of medical scans, the Liberals have finally decided to follow Labor’s lead and award more Medicare-subsidised MRI licences,” Ms King said.

“When Labor was last in Government, we awarded 238 MRI licences – delivering more affordable scans to hundreds of communities across the country.

“In May this year, we promised a Bill Shorten Labor government would invest an extra $80 million to deliver a further 20 licences in locations of pressing need.”

Mr Hunt pointed out that earlier this year, the Government boosted Medicare support for a new MRI scan for prostate cancer checks helping 26,000 men each year. It also provided a new Medicare listing for 3D breast cancer checks, helping around 240,000 women each year.

“The Liberal National Government has also announced an additional $2 billion investment in diagnostic imaging over the next decade,” he said.

“We are retaining the bulk-billing incentive and indexing targeted diagnostic imaging services including mammography, fluoroscopy, CT scans and interventional procedures.

“By contrast, Labor has only committed $80 million and not made any commitment to the re-indexation of diagnostic imaging rebates.”

An MRI is a commonly used medical scan which gives a detailed view of the soft tissues of the body such as muscles, ligaments, brain tissue, discs and blood vessels, and helps with the diagnosis of (among other things) cancer, cardiac conditions, trauma and sporting injuries.

 

Cutting-edge cancer map for Australia

A new interactive online tool reveals in a few clicks cancer patterns nationally and at the local level.

The recently launched Australian Cancer Atlas, allows Australians to discover the impact of cancer in their suburb or town.

It is an interactive, colour-coded, digital cancer atlas showing national patterns in cancer incidence and survival rates based on where people live.

It holds data for 20 of the most common cancers in Australia, such as lung, breast and bowel cancer, and the likely reflecting the characteristics, lifestyles and access to health services in each area.

The project, led by researchers from Cancer Council Queensland, Queensland University of Technology (QUT) and FrontierSI, gives health agencies and policy makers a better understanding of geographic disparities and health requirements across the country.

Cancer Council Queensland Head of Research, Professor Joanne Aitken, said the digital atlas highlighted which geographical areas had cancer rates below or above the national average.

“Australians can filter down to look at the impact of various types of cancer in the region where they live, to understand cancer patterns across the country. However, it’s important to remember that local cancer trends won’t necessarily reflect your own cancer risk,” Prof Aitken said.

“Cancer rates vary across geographic regions depending on things like the age of local residents, participation in screening programs and trends in terms of cancer risk behaviours.

“One of the most revealing patterns in the atlas was the severe disparities in Australia with liver cancer, with incidence rates significantly higher than the national average in many areas in Northern Australia and many metropolitan areas of Sydney and Melbourne, due to differences in the distribution of known risk factors such as hepatitis, intravenous drugs use and excess alcohol consumption.

“In addition, other findings confirm that melanoma incidence rates are higher than the Australian average in many areas of Queensland and northern New South Wales.”

The online atlas is powered by myGlobe, a state-of-the-art digital system that has been developed and enhanced specifically for the atlas by the Visualisation and eResearch team at QUT.

Professor of Statistics at QUT, Kerrie Mengersen, said the atlas was designed to be user-friendly, with robust information and innovative visual presentations to help people interpret and understand the statistics.

“It can be added to and updated regularly so that all Australians can have access to the latest available information,” Prof Mengersen said.

“This project has been an exciting and rewarding one to work on, to build statistical models from the registry data gathered and to present this information in an easy-to-navigate, interactive tool.

“We believe the atlas will be an important resource, of benefit to all Australians, and hope it will drive policy and research so that we eliminate disparities across Australia in levels of cancer care, resourcing and survival.”

The Australian Cancer Atlas can be found at https://atlas.cancer.org.au and is ready to be used from the site.

 

Telehealth revolutionising diabetes management and costs

Telemedicine is providing better care at lower cost for diabetes patients in rural and remote areas.

This is according to a James Cook University (JCU) study that shows telelmedicine to be boosting the health of diabetes patients, saving them money and taking pressure off the health budget.

Nisha Nangrani, a sixth-year medical student at JCU, found the Diabetes Telehealth network operating from Townsville Hospital is making significant gains in helping diabetics to manage their symptoms.

The service enables remote patients to have regular consultations with a Townsville Hospital endocrinologist via satellite link.

The study found that patients with lifestyle-related Type 2 diabetes, as well those with uncontrolled diabetes (wildly fluctuating blood sugar levels) and hyperglycaemia (consistently high blood sugar levels) scored the biggest improvements.

The research reveals that patients, who previously travelled to Townsville for face-to-face consultations, showed a 20 per cent improvement in their hyperglycaemic levels after they switched to telehealth care.

The economic benefits to the Queensland healthcare system are yet to be further explored but the Diabetes Telehealth project has shown it is generating substantial cost savings, as well as better health outcomes.

“We are doing something that seems to benefit almost everyone involved. It’s better for the patient. It’s easier and more convenient for endocrinologists. We’re saving the healthcare system money,” Ms Nangrani said.

Over the past eight years, the Baker Heart and Diabetes Institute has been involved in remote diabetes services and have highlighted the extreme levels of ill health associated with poorly controlled diabetes in these communities.

The remote clinical services they visit are generally ill-equipped to manage complex chronic disease and the type of diabetes we see is aggressive and unusually resistant to treatment.

While the study did not investigate patient satisfaction levels, the researcher believes that access to the telehealth service boosted patient motivation.

“Because we are trying not to inconvenience them by making them travel all the way to Townsville just to see a doctor, they’re happy with the way they are receiving health care and more motivated to look after their diabetes,” she said.

 

Health leaders challenge global policy makers on cancer

 

Global health leaders have put out an urgent call to countries to improve action on cancer services.

At the World Cancer Leaders’ Summit (WCLS) in Kuala Lumpur, Malaysia, on October 1, health leaders from United Nations agencies, the non-profit and private sectors, and academia came together to issue the call.

They asked countries to increase access to, and investment in, cancer services to improve vital early detection, treatment, care, and public health data.

Insisting that the need for global action on cancer was more urgent than ever, the group presented new data from the International Agency for Research on Cancer (IARC) estimating that there will be 18.1 million new cancer cases diagnosed and 9.6 million cancer deaths in 2018.

This means that countries are way off-course to meet the ambitious global target of reducing premature deaths from non-communicable diseases (NCDs), like cancer, 25 per cent by 2025 as agreed by the World Health Organisation in 2013, they said.

Union for International Cancer Control President, Professor Sanchia Aranda, said: “Cancer is not just a health concern, but also a serious threat to development. The growing burden has clear implications for patients, their families, and health systems, but also for the economic growth of a country as a whole.”

UICC President-elect, HRH Princess Dina Mired said: “We know Treatment for All is possible in every country. What we need is strategic national plans and national champions for cancer control to implement these measures.”

CHRIS JOHNSON

 

New laws to help protect against critical medicine shortages

Medicine companies will have to report shortages of important medicines as soon as they occur, following the successful passage of new laws through Parliament.

The Government is hailing it as ‘landmark legislation’ aimed at protecting supply of critical and life-saving medicine to Australian patients.

The new law also insists that if a critical drug is being removed from the market, the Health Department must be notified by the manufacturer at least 12 months in advance, or as soon as possible.

Health Minister Greg Hunt said the new law protects patients who rely on vital medicines, and also gives the community, medicine companies and patients the opportunity to take action to mitigate against a medicine shortage.

Mandatory reporting will apply to all prescription medicines as well as other medicines that are vital for public health, such as EpiPens and inhalers.

Tough penalties will apply to companies that do not comply with these new laws, including fines of up to $210,000 for each infringement and the possibility of further court action.

“I make no apologies for taking a hard-line approach to ensuring patients aren’t kept in the dark about a potential medicine shortage,” Mr Hunt said.

“A shortage that will severely impact on patients must be notified to the Therapeutic Goods Administration (TGA) as soon as possible, and no later than two working days after the medicine company knows or should know of the shortage.

“Medicine shortages have become an increasing problem in recent years, as medicine companies (manufacturers or importers) have failed to comply with the current voluntary reporting scheme.

“Earlier this year, Australia was one of several countries hit by a shortage of EpiPens, which provide lifesaving adrenalin for people who have had an acute allergic response.

“In this and a number of other cases, the shortages were not reported in advance to the TGA within the Department of Health. As a result, patients and doctors were not alerted in time for them to make alternative arrangements.”

Under the new law, a critical medicine is deemed to be in shortage if there is not enough, or likely will not be enough, for all patients in Australia who take it or may need to take it, at any time in the next six months.

Responses to a shortage could include re-directing the available supplies to patients who need them most, nominating alternative treatments and providing Pharmaceutical Benefits Scheme coverage for the alternatives.

Medicine companies must also notify the department of shortages that will not have a severe impact on patients. They will have up to 10 working days to do so.

“Shortages cannot always be avoided but, when they do occur, this mandatory reporting scheme will help Australian patients and health professionals to be more prepared,” the Minister said.

“I want to thank the medical sector who have worked closely with my Department and the TGA on improving the process for reporting medicines shortages and their willingness to improve the system through legislative change.

“In particular I want to thank Medicines Australia, the Australian Medical Association, the Society of Hospital Pharmacists of Australia, the Pharmacy Guild of Australia, the Australian Self Medication Industry, the National Pharmaceutical Services Association, the Pharmaceutical Society of Australia and the Generic and Biosimilar Medicines Association.

“These groups have worked collaboratively together and with Government to design a new approach that will support and protect Australian patients.” 

The new mandatory reporting scheme for medicines shortages is included in the Therapeutic Goods Amendment (2018 Measures No. 1) Bill 2018, passed by the Senate in September.

The new law will come into effect on 1 January 2019.

 

Australia helps more PNG mums and babies

Thousands more newborn babies and their mothers will be helped in Papua New Guinea, with the expansion of a successfully piloted project across the country.

Australia’s aid program has injected more funds into the project.

The innovative program, known as the maternal and newborn care project, focuses on preventing neonatal hypothermia in newborns and managing bleeding after delivery, which is a common cause of death in mothers.

The United Nations Children’s Fund (UNICEF), in partnership with the Papua New Guinea National Department of Health, will expand the program now the funds have been committed.

“Once implemented, this initiative will save the lives of thousands of newborns and their mothers, as well as provide training to parents, carers and health workers about caring for babies over the first month of life,” said UNICEF Australia’s Felicity Wever.

“A key element of this initiative is an anti-hyperthermia bracelet, known locally as Bebi Kol Kilok, which will help prevent annual deaths from hyperthermia among approximately five thousand premature and newborn children.”

Papua New Guinea has the highest rate of newborn deaths in the region, with about 6000 babies dying every year before they reach four weeks of age.

Aside from addressing critical child survival issues, the project involves care of mothers through active management of the third stage of labour, prevention and management of post-partum haemorrhage and maternal anaemia, as well as early detection and referral of sick mothers by community health workers.

PNG Health Minister Sir Puka Temu said: “Our Government is focused on reducing the high maternal and neonatal mortality rates. This is a highly cost-effective intervention. I’m also very excited that fathers are recognizing the important role they can play in baby care by holding the baby close to their body for warmth.”

The Australian Government’s funding support will enable UNICEF to work with the PNG Government to strengthen capacity in the hospitals and health facilities that will deliver the care of newborns and mothers, to assess and remove bottlenecks in the delivery of these care services and to empower communities with skills to continue care at home.

In collaboration with the PNG Health Department, UNICEF will work directly with provincial health offices, district authorities, church health services and local non-government organisations.

Together, they will roll out the first round of the program in all provincial hospitals and district facilities. Seven additional districts will roll out community based maternal and newborn care in facilities that deliver more than 50 babies per year.

Learn about the 1 July 2018 MBS changes

INFORMATION FOR MEMBERS

The AMA has added the July 1 Medicare Benefits Schedule (MBS) changes to its health professional education resources.

We have updated our Indigenous and MBS eLearning and education guides with the July 1 MBS changes. These education resources help you work out claiming and billing MBS item numbers.

We also have education resources about:

  • the Australian Immunisation Register
  • the Child Dental Benefits Schedule
  • the Department of Veterans’ Affairs
  • incentives programs
  • digital claiming
  • PRODA (Provider Digital Access)
  • HPOS (Health Professional Online Services)
  • Pharmaceutical Benefits Scheme (PBS)

Our eLearning programs are comprehensive, using case studies to show you how to apply the information. Check out the changes and updated education resources (humanservices.gov.au/organisations/health-professionals/subjects/education-services-health-professionals) today.

Next steps

  • Explore the education services for health professionals (humanservices.gov.au/organisations/health-professionals/subjects/education-services-health-professionals)
  • Read more News for health professionals (humanservices.gov.au/organisations/health-professionals/news/all)
  • Subscribe to News for health professionals (humanservices.gov.au/organisations/health-professionals/news/all) and get regular updates directly to your inbox.

 

More money to fight STDs, please Mr President

The United States of America has the highest sexually transmitted disease rate in the industrialised world, and health experts say it is only a lack of resources that prevents them getting on top of the problem.

Public health experts in America recently called on US President Donald Trump to declare a public health emergency over the rapid spike in STDs across the nation.

The rate of STDs has increased in the US four years in a row, with cases of gonorrhoea, syphilis, and chlamydia rising by 200,000 between 2016 and 2017, to a total of 2.3 million.

The National Coalition of STD Directors has said the results mean the US has the highest STD rates in the industrialised world.

It also said a fall in public health funding and resources is to blame.

The organisation has called on President Trump and Health and Human Services Secretary Alex Azar to intervene and to declare STDs in America a public health crisis.

“What goes along with that is emergency access to public health funding to make a dent in STD rates and to bring these rates down and make sure all American get access to the health care they need,” said the Coalition’s executive director David Harvey.

He added that $70 million in government funding was needed immediately, and $270 million needed for the 2019 financial year.

Michael Fraser, executive director of the Association of State and Territorial Health Officials, put it even more bluntly when calling for more government funding.

“We know what works for STD prevention,” he said. “We just don’t necessarily want to pay for it.”

 

[Perspectives] Natasha Azzopardi-Muscat: promoting public health in Malta

Promoting public health in a small island nation such as Malta can be extremely challenging, but it is the career that Natasha Azzopardi-Muscat, President of the European Public Health Association and a senior lecturer on health services management at the University of Malta, has negotiated in the past 20 years, working to transform the country’s health system to be fit for the 21st century.

Care setting and 30-day hospital readmissions among older adults: a population-based cohort study [Research]

BACKGROUND:

Despite the fact that many older adults receive home or long-term care services, the effect of these care settings on hospital readmission is often overlooked. Efforts to reduce hospital readmissions, including capacity planning and targeting of interventions, require clear data on the frequency of and risk factors for readmission among different populations of older adults.

METHODS:

We identified all adults older than 65 years discharged from an unplanned medical hospital stay in Ontario between April 2008 and December 2015. We defined 2 preadmission care settings (community, long-term care) and 3 discharge care settings (community, home care, long-term care) and used multinomial regression to estimate associations with 30-day readmission (and death as a competing risk).

RESULTS:

We identified 701 527 individuals (mean age 78.4 yr), of whom 414 302 (59.1%) started in and returned to the community. Overall, 88 305 in dividuals (12.6%) were re admitted within 30 days, but this proportion varied by care setting combination. Relative to individuals returning to the community, those discharged to the community with home care (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.39–1.46) and those returning to long-term care (adjusted OR 1.35, 95% CI 1.27–1.43) had a greater risk of readmission, whereas those newly admitted to long-term care had a lower risk of readmission (adjusted OR 0.68, 95% CI 0.63–0.72).

INTERPRETATION:

In Ontario, about 40% of older people were discharged from hospital to either home care or long-term care. These discharge settings, as well as whether an individual was admitted to hospital from long-term care, have important implications for understanding 30-day readmission rates. System planning and efforts to reduce readmission among older adults should take into account care settings at both admission and discharge.