INNOVATION & TECHNOLOGY ON SHOW AT HOSPIMedica ...

April 2008 • Policy Patter
PLUS...
• Anzac Day services around the country
• Information Technology
• 50th Anniversary for St Andrew’s War Memorial Hospital
• As I see it • On the ground
• Pharmacy Focus

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Private Hospital - April 2008

Private Hospital - April 2008
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John Amery .. Mater Misericordiae Hospital T’ville
Steve Atkins ............................. Healthe Care Australia
Dr Peter Catts ... Ind. Private Hospitals of Australia
Dr Leon Clark .................. Sydney Adventist Hospital
Andrew Currie ............ Vimy House Private Hospital
Christine Gee ................... Toowong Private Hospital
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Regulars
18 Michael Roff - As I see it
If you are really sick, go to a Private
Hospital…
26 Christine Gee’s Quality in Focus
Australian Commission on
Safety and Quality in Health Care
36 Paul Mackey’s Policy Patter
Private Hospitals providing good value
for Veterans
40 Moira Munro - Mental Health Forum
Veterans and Mental Health
58 Pharmacy Focus with Michael Ryan
Measuring the performance of the
Drug Committee
62 Membership Matters with Goran Josifovski
Delivering value to members
82 On the ground
Gail Rice - Social welfare worker and Veterans
Liaison Officer
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Features
Contents
12 Anzac Day Services
Anzac Day at Private Hospitals around Australia
14 Department of Veteran Affairs and
Private Hospitals
22 Information Technology in the
Health Sector
Interview with George Toemoe
32 Queensland Governor returns to hospital
she helped build
38 Revised Medical Technology Code
of Conduct
66 EMU at the San
75 One Life, a Second Chance
79 Book Review – Community Pharmacy
44
10 - Veterans
Feature
Private Hospitals have
a long tradition of
helping Veterans
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Private Hospital - April 2008 PH

Editors Letter
Welcome to the April edition of Private Hospital magazine!
This month, to coincide with Anzac Day and the 90th birthday of the
Repatriation Commission, we celebrate the excellent services so many
private hospitals around the country provide for veterans.
The Repatriation Commission was
established on 8 April 1918 to support the
thousands of veterans, many of them sick
and wounded, returning home from the
battlefields of the First World War.
Through the Second World War and
subsequent wars and conflicts, Australia’s
repatriation system has evolved to meet
the needs of servicemen and women and
their families.
Two APHA member hospitals, Greenslopes
and Hollywood, were initially repatriation
hospitals and have provided services
to Australia’s veterans for many years,
where other members have only become
Department of Veterans Affairs’ Tier 1or
Tier 2 hospitals in recent times.
Veterans are heavy users of the private
system and are becoming increasingly
older. DVA’s statistical unit have forecast
that their numbers will decline by almost
a half over the next decade. They are a
group with some of the more difficult
conditions and yet, private facilities do not
shirk from the responsibility of treating
these important citizens. APHA hospitals
that have a contract with DVA are treating
a wide variety of medical patients, not just
surgical ones.
DVA and APHA members are working
together on a number of projects
including: pay for performance initiatives,
supported discharge programs, data
analysis to make the system work better
and transition care.
No matter which facility veterans choose or
what their health needs are, our member
hospitals are committed to providing the
best possible service and honouring the
Private Hospital - April 2008
Editors Letter
sacrifices these men and women made for
our country.
This is my first issue as Private Hospital’s
editor and it represents a new approach
for the magazine. Just as this issue is
themed around veterans, our June edition
will be themed around an area that has
received much press lately, our healthcare
workforce. We will investigate the Rudd
Government’s plan to bring nurses back
into the workforce and get an idea of what
is happening in private hospitals around
the country.
If you would like to feature an innovative
workforce program at your hospital or
would like to provide feedback on anything
you read in this issue, please contact me
at APHA.
I’d also like to say thank you to everyone
who has made me so welcome at APHA.
I look forward to getting to know more of
you over the coming months and working
together to promote the private hospital
industry.
Lisa Ramshaw
Editor
Lisa.Ramshaw@apha.org.au
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10
Feature: Veteran Community
A Long Tradition of Helping our Nation’s Veterans
While Hollywood Private Hospital is now a modern, state-of-the-art private
health care facility, it has a proud history that dates back to the Second
World War.
Hollywood was originally built during World War II by the Commonwealth
Government and opened in 1942 as the 500-bed Australian General Hospital
(also known as 110 Military Hospital) and provided care for service men
and women.
Under an agreement with the Department of
Veterans’ Affairs, Hollywood has continued to
be the principal provider of inpatient hospital
services for veterans in Western Australia. Over
the past 12 months Hollywood has provided
over 10,000 inpatient services for veterans and
over 5,000 day case services for veterans.
Although there are no longer any veterans
of ‘the great war’ alive in Western Australia,
Hollywood still sees many of the thousands
of World War II veterans as well as veterans of
the Korea War, the Vietnam War, the Malayan
Emergency, Gulf War 1 and 2, the war on terror,
and the many peacekeeping missions, both
past and current.
The vast majority of Australia’s ex-service
personnel are World War II veterans, and most
of these are now in their 80s. As well as the
health problems normally associated with
ageing, many of the veterans carry health scars
from their service days. It is difficult to say
which of the ailments normally associated
with older age can be directly attributed to
war service.
There are a few obvious ones of course. Many
of Australia’s servicemen carry ‘shrapnel’
- pieces of metal resulting from fragmented
bullets or from other sources. Hearing is an
enormous problem for artillery men (and
indeed infantry who were in close proximity to
the firing of the heavy guns). Many of Australia’s
ex-service people are afflicted with joint
problems, resulting from traumas of battle.
Tobacco was issued as part of ‘ration packs’ to
all of our service personnel. Many young men
and women started smoking as a result of this,
and continued the habit for many years, often
for the rest of their lives. The adverse health
effects of tobacco were not as well known at
that time as they are now - the tobacco was
provided as a well-intentioned treat and a
little luxury.
The link between cardiovascular disease and
tobacco smoking is well known. Cardiovascular
disease can take the form of heart disease,
with an increased propensity for myocardial
infarction (heart attack) and cardiac failure. It
may also affect the blood supply in the brain,
causing stroke, or in the peripheral circulation
causing difficulty walking, or even leg
ulceration which ultimately may result
in amputation.
Smokers have a higher incidence of cancers of
all kinds, particularly lung, stomach and bowel.
Chronic lung disease is a common condition in
the ex-service community. This is partly related
to smoking, but also the effect of inhalation of
dust, gas, fumes and chemicals. People with
chronic obstructive pulmonary disease typically
have shortness of breath, and persistent cough
and phlegm.
They are prone to recurrent infections,
including bronchitis and pneumonia.
Many service men and women contracted
tuberculosis during their service years. This was
particularly rife in the prisoner of war camps.
Tuberculosis was notoriously difficult to treat,
Private Hospital - April 2008
though presently we have excellent drugs to
treat this condition.
As well as the health problems normally
associated with ageing, many of the veterans
carry health scars from their service days.
One specific material which has caused
damage to the lungs of service personnel
has been asbestos. Asbestos was used as a
cheap and easy to use building material for
many years prior to the health risks becoming
known. Asbestos was used for insulating and
protective lagging in much of the defence
force equipment, such as around pipes and in
the hulls of navy ships, aircraft and personnel
carriers and assault vehicles.
While asbestos is most notoriously associated
with an aggressive type of cancer called
mesothelioma, it can also cause chronic fibrosis
in lungs and plaques in the pleura (the lining of
the lungs). This can lead to gradually worsening
breathlessness and in some cases, ultimately,
respiratory failure.

While many service men and women were
exposed to atrocities which are beyond the
imagination of most people, the condition of
Post-traumatic Stress Disorder (or PTSD) was
not formally recognised by the Department of
Veterans’ Affairs until the early 1980s.
Many of the WWII veterans returned from war
zones or internment camps with significant
psychological conditions. These were variously
called ‘war fatigue’, ‘asthenia’, ‘shell shock’ or
‘battle fatigue’. At the time many people just
got on with their lives, but were never able to
access adequate treatment programs which
addressed their problem. Many of these men
and women carried the scars of their condition
for the remainder of their lives.
The Vietnam War was something different.
It was clear that many of the servicemen
and women returning home from Vietnam
had severe psychological issues. These took
the form of vivid nightmares, flashbacks to
traumatic events, severe and incapacitating
anxiety and difficulty returning to mainstream
living in the ‘lucky country’.
The Vietnam War also saw the introduction of
widespread environmental use of defoliants
and other poisonous chemicals, with
widespread, accidental exposure of the troops
and the introduction of the term ‘friendly fire’.
The PTSD program which is conducted in
The Hollywood Clinic, on-site at Hollywood
Private Hospital, is a program that endeavours
to provide PTSD sufferers with insight about
their condition, and offers strategies to manage
some of the worse features, including the
associated use of alcohol and other drugs.
While the program does not profess to be
curative, to date there have around 300
Vietnam Veterans who have gained significant
benefit from the program.
One of the most helpful aspects of Hollywood’s
PTSD program has been the insight the
participants have been able to gain into
the condition.
The program recognises that every individual’s
trauma and their reaction to it is unique. Many
sufferers of PTSD have never spoken about
their pain or the destructive nature of their
stress, and some have harboured a long held
belief that they are the only one with
a problem.
To be in a group of people who have shared
similar traumatic experiences and have suffered
from similar disabling symptoms for many
years has been very healing for many of these
men. There is also mounting evidence that the
children of Vietnam Veterans have a number of
health issues.
There are claims that they experience a higher
rate of congenital abnormalities, ranging from
the very trivial to the very severe. The program
recognises that every individual’s trauma and
their reaction to it is unique.
There would also appear to be a higher
overall death rate from suicide and accidents
in the children of Vietnam Veterans than in a
comparable general population whose parents
Private Hospital - April 2008
Feature: Veteran Community
were not involved in the war. The reasons for
this are unknown, however many theories have
been put forward. At this stage there are no
studies into the health of the grandchildren
of Vietnam Veterans.
With over 60 years of experience in treating
veteran and war widow patients, Hollywood
Private Hospital takes much pride in their
reputation as being the best equipped to
anticipate and meet the needs of these very
special Australians.
By Dr Margaret Sturdy, Director of Medical
Services, Hollywood Hospital
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The art therapy component of PTSD treatment at Hollywood

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Feature: Veteran Community
Anzac Day at Private Hospitals around Australia
Members of the Shortland sub branch will
officiate at Hunter Valley Private Hospital’s
annual Anzac Day service. The service usually
has 20 to 30 people in attendance with a
bugler who plays the last post and reveille and
they serve a morning tea with Anzac biscuits
afterwards.
The Sunshine Coast Private Hospital will
be marking Anzac Day with a service in the
Hospital Chapel at 10 am. The service will be for
patients, staff and visitors to the hospital.
Westmead Rehabilitation Centre will again
hold an Anzac Day Ceremony on 24th of April
at 11.00. This ceremony will be conducted by
Vietnam Veterans from St. Marys Outpost, and
is open to patients and visitors. A BBQ lunch
will follow.
Last year was the first year an Anzac Day
Ceremony was held at Westmead Rehabilitation
Centre and patients who had served in the
Armed Forces took part in the ceremony.
Feedback received from patients, visitors and
staff was very positive and the BBQ lunch that
followed was very well received.
Greenslopes Private Hospital will once again
host their annual Anzac Day dawn service.
The service begins at 5.30am in the ANZAC
memorial located adjacent to the Chapel and
is open to the general community, patients
and staff. The Dawn Service is followed by
the traditional gunfire breakfast. Attendance
continues to grow each year with more than
1500 people expected to attend.
Tamara Private Hospital (RHC) will have the
local RSL Branch hold their annual pilgrimage
for ANZAC service on Sunday 20th April in
the Remembrance garden within the hospital
courtyard at 2.00 pm.
Canossa Private Hospital in Brisbane will be
holding a ceremony in their garden near the
flag pole on Anzac Day. Before the ceremony
begins, a breakfast is held for veterans and their
families. Then the veterans do a short march to
the flag pole before the ceremony commences
with one of the local Catholic priests presiding
over the Anzac Day service. Canossa provides
Rehabilitation, Oncology, General Medicine,
Palliative Care and Interim Care for Veterans
and has a very strong focus on the needs of
Veterans and their families.
Private Hospital - April 2008
John Flynn Private Hospital on Queensland’s
Gold Coast will once again hold their Anzac
Day service conducted by the hospital’s
Chaplains.
Baringa Private Hospital has a Remembrance
Garden in the courtyard of their hospital and
holds a small service for patients on Anzac Day
at 9am every year.
Donvale Rehabilitation Hospital will have its
annual Anzac Day ceremony with the local
Doncaster RSL on Monday 21 April 2008 at
10.30am. This will be the 10th service with the
local RSL, since we had a flagpole and plaque
erected in the hospital grounds in 1999.

Greenslopes: Providing for the Veteran Community
Since taking over Greenslopes Hospital in 1995, Ramsay Health Care has
enjoyed providing the veteran community with great private health care.
There have been a great number of changes in that time including the
significant expansion and upgrade of the facilities and services. The hospital
has committed to ensuring it continues to provide excellent services to the
veteran community as well as grow to become Queensland’s finest and most
comprehensive private hospital.
In July 2006, Greenslopes Private Hospital’s
exclusive contract with the Department of
Veterans’ Affairs ended and the veteran market
was opened up to other private hospitals.
Greenslopes Private Hospital Chief Executive
Officer, Associate Professor Jill Watts said that
through this change, GPS has continued to
position itself as the number one choice for
veterans and war widows in Queensland.
“We have enjoyed providing the veteran
community with first class health care for more
than 60 years and we are committed to doing
so well into the future,” Assoc Prof Watts said.
“We continue to welcome feedback from our
patients on how we can improve our service.
This helps us to implement new initiatives and
work harder to ensure we are meeting the
needs of both veterans and private patients.”
The hospital has always invested in ensuring its
facilities and services are second to none and
that we have grown to be Australia’s largest
private hospital.
In 2005 The Gallipoli Research Foundation was
established at Greenslopes Private Hospital
and will endure as a tribute to the Australian
veteran community. The Foundation’s vision
Private Hospital - April 2008
Feature: Veteran Community
is to become an internationally renowned
centre of excellence in health and medical
research, improving future health standards
for the Australian community. In doing so, the
Foundation will provide a lasting legacy to
the veteran and war widow community, and
the wider Australian community. The Gallipoli
Research Foundation continues to receive
outstanding support from the veteran and war
widow community, and the wider community.
By Frances McChlery, Marketing Manager,
Greenslopes
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14
Feature: Veteran Community
Department of Veterans’ Affairs and Private Hospitals:
Working Together for the Benefit of Veterans
The Department of Veterans’ Affairs (DVA) work closely with most APHA
member hospitals and have developed good partnerships in order to provide
the level of care veterans’ need. There are a number of recent initiatives by
DVA that all contracted hospitals should be aware. DVA have provided Private
Hospital with information on these programs.
The Enhanced Discharge Planning
Initiative
The Department of Veterans’ Affairs (DVA) aims
to work with providers so that veterans receive
quality health care and support services that
will assist them to maintain their independence
and remain living at home. It is recognised
that an admission to hospital, particularly for
the aged and frail, can have an adverse effect
on overall health and wellbeing, from effects
such as delirium, de-conditioning, loss of
confidence, increased risk of falls and possible
premature entry into residential aged care.
A fundamental aspect of DVA’s contractual
arrangements for the provision of hospital
services is effective discharge planning in
accordance with best practice. DVA has
however recognised that some members of the
ageing veteran population require additional
support following discharge from hospital to
ensure that there is a seamless transfer of care
from the hospital to community setting.
The Enhanced Discharge Planning Initiative
is designed to facilitate this by providing for
services over and above the standard discharge
planning requirements contained in the Tier 1
Services Agreements. The service will involve
the hospital supporting the transfer of care
back to community based services in the two
week period post discharge, and in particular,
strengthening communication with General
Practitioners (GPs).
The initiative is targeted at those veterans
with complex health care needs, in particular
those with chronic medical conditions, who on
discharge from hospital are at risk of adverse
health outcomes which might result in an
unplanned or preventable re-admission. It is
expected that in addition to chronic medical
conditions, those at most risk would also have
a combination of the following:
• Previous pattern of unplanned re-admissions
to hospital;
• Loss of functionality, mobility problems, risk
of falls;
• Complex medications or a change in
medication regime;
• Live alone or with a carer unable to provide
the care needed post discharge;
• Advanced age together with multiple
co-morbidities;
• Risk of poor nutrition post discharge; and
• Other risk factors identified during the
episode of care.
The Enhanced Discharge Planning service is
only intended to be provided to those veterans
most at risk following identification of that risk
during their hospitalisation. Accordingly, there
are a number of categories of patients that
DVA would not expect to be targeted, such as
same day or short stay patients; those being
discharged to residential aged care; or where
the standard discharge plan can be effected
without additional intervention by the hospital.
Tier 1 Private Hospitals are encouraged to
establish Enhanced Discharge Planning services
for their high risk veteran patients. Services
commenced at some hospitals from 1 October
2007 and continue to be rolled out nationally.
Should your hospital wish to find out more
about this initiative please contact your DVA
Contract Manager for further information.
Transportation Issues in Discharge
Planning
One aspect of discharge planning that often
can be neglected is transport for the veteran
upon discharge. This is an important element
in ensuring that the discharge from hospital is
made as effective and painless as possible, and
is one that can seriously impact upon the DVA
patient’s wellbeing and overall impression of
the hospital.
There have been cases where patients have
been discharged without due recognition of
their clinical needs for travel, and also where
they have been discharged in inappropriate
clothing, for instance in their night attire.
This is clearly not an acceptable standard of
dress on discharge. In a recent instance a war
widow was discharged in her dressing gown
Private Hospital - April 2008
and, as well, was left by the driver at an airport
to fend for themselves, with no assistance,
thus compounding the problem. While these
incidents are the exception, they often generate
adverse exposure for the facility (by the patient
or their family) which must then be rectified.
Discharge planners and other staff at hospitals
are reminded of the need to ensure that all
aspects of discharge are managed well, not
just the clinical treatment. If hospital staff have
any questions regarding transport they should
contact Veterans’ Transport Services on
1300 550 455 or their DVA contract manager.
Discharge Planning Seminars
The DVA Provider Partnering (PP) team is
coordinating a series of seminars nationally
for Veteran Liaison Officers (VLOs) and private
and public hospital staff involved in discharge
planning for the veteran community. The first
seminar organised by PP was held in Sydney
in August 2007, and since then two other
successful days have been held.
Brisbane Seminar
The Brisbane seminar in this series which
featured information about the range of DVA
services available to veterans post-discharge
and how to access them, was held at the Sebel
and Citigate Hotel in Brisbane on 13 December
2007. As with previous seminars held it was
well supported, with participants coming from
29 private and 13 public, metropolitan and
regional hospitals.
Adelaide Seminar
The most recent discharge planning seminar
was held at the Mecure Grosvenor Hotel in
Adelaide on 6 March 2008. This seminar also
attracted an excellent number of participants,
including a large contingent from rural and
remote locations which was pleasing to see
given that many travelled long distances to
attend. In Adelaide, the majority of participants
(50) worked in public hospitals, while 30 came
from private hospitals.

Seminar Programs
Both seminars featured presentations on a
range of DVA primary and community health
care services including:
• Medical and Allied Health Services;
• Veterans’ Home Care;
• Community Nursing;
• Veterans’ Transport Services;
• Rehabilitation Appliances Program;
• Medication Management; and
• Veterans’ and Veterans’ Families Counselling
Service.
In Brisbane: DVA was pleased to welcome as a
presenter, Ms Valerie Howells from St Andrews
War Memorial Hospital, Brisbane who delivered
a presentation on the discharge planning
model used at St Andrews.
An addition to the Brisbane program was
an interactive session focussing on the roles
of general practitioners and community
nurses in the discharge planning process and
highlighting the importance of hospital staff
sending a discharge summary to the veteran’s
local medical officer and referring doctor. The
DVA Health Medical and Community Nursing
Advisers facilitated this session.
In Adelaide: Ms Stella Goodall from Noarlunga
Health Services delivered a presentation on
the discharge planning model and associated
services used at Noarlunga. As with previous
seminars, DVA is pleased that hospitals and
their staff are willing to be involved in these
seminars to share their discharge planning
models with their peers.
In addition, the Adelaide seminar featured
details on DVA mental health initiatives,
while the final session was also an interactive
session facilitated by a DVA staff member.
At this session, participants were presented
with a scenario and asked to provide their
ideas on the possible issues that needed to
be addressed before and during the discharge
process for a veteran patient.
“ A fundamental aspect of DVA’s contractual arrangements for the
provision of hospital services is effective discharge planning in
accordance with best practice.”
Take home information
A printed program booklet was given to all
participants at each seminar to keep as a
reference tool along with other useful resources
including a handy Discharge Planning Checklist.
Feedback
Forum participants from both Brisbane and
Adelaide provided positive feedback including
comments that they would use the program
booklet as an education tool at their facility
and that, prior to the seminar, they had been
unaware of some DVA services available to
veterans. Participants also made suggestions for
improvement and these are being incorporated
into future seminars.
Future Seminars
The next seminar is scheduled for Perth in
August and invitations will be sent to hospitals
in Western Australia closer to that date. From
the responses received to date to this seminar
again looks like being well attended. A further
seminar is planned for Hobart later this year
(tentatively scheduled for November) and the
PP team will be advising all hospitals in this
state of details as they are known. We look
forward to seeing you at one of these seminars.
If you have any questions about the discharge
planning seminars please contact the team at:
providerpartnering@dva.gov.au.
Quality Reports
Hospitals involved in veteran partnering
arrangements are required to submit sixmonthly
Quality Reports to the Department of
Veterans’ Affairs (DVA). These reports provide
the Department with valuable information
on hospital benchmarking, new activities and
initiatives, veteran concerns, and emerging
trends in the treatment of veteran patients.
Requirements for Quality Reporting are detailed
in the Hospital Services Agreements, under
Clause 11.5. Reports for each six monthly
period are to be submitted to the Department
Private Hospital - April 2008
Feature: Veteran Community
within 90 business days of the end of the
period. e.g. the January-June report is to be
submitted 90 business days after 30 June.
15
Hospitals should take particular note of Clause
11.5.2(b) concerning the inclusion of veteran
complaints in Quality Reports, and Clause
16.9.1, regarding the development of
a complaints handling mechanism for Entitled
Persons. The provision of this information is
vital in allowing DVA to assist in addressing
veteran concerns.
Quality Reporting templates are available
on the Hospital Resources page of the DVA
website. Where information is provided via
ACHS comparative reports, the template
may be customised to avoid duplicating
information.
www.dva.gov.au/health/hospital/resources.htm
Any queries in relation to Quality Reporting should
be directed to your DVA contract manager.
Medications for Veterans in
Private Hospitals
The Department of Veterans’ Affairs (DVA)
funds the majority of medication required for
veteran patients attending private hospitals
through the Repatriation Pharmaceutical
Benefits Scheme (RPBS). The only medication
not funded through the RPBS is that provided
on an ‘imprest’ or similar basis as detailed in the
contractual arrangements.
The RPBS is a flexible pharmaceutical benefits
scheme ensuring that optimal pharmaceutical
treatment is delivered to veterans particularly
those needing treatment in hospital.
It is recognised that hospital medication
treatment can be significantly different from
the usual treatment needed in the community
setting. The RPBS has the ability to approve
a range of non-PBS listed medications, when
clinically appropriate, through the prior
approval process.

16
Feature: Veteran Community
The Veterans’ Affairs Pharmaceutical Advisory
Centre (VAPAC) provides expert pharmacy
advice as well as a prior approval process on a
24/7 basis. Pharmacists answer all calls and can
quickly provide necessary funding approval to
prescribers who call. In addition information on
veteran’s eligibility and treatment card types
can also be provided.
Pharmacists who service private hospitals
are invited to call VAPAC to clarify any issues
regarding RPBS authority prescriptions,
patient entitlements and other pharmacy
related matters.
VAPAC’s phone number is 1800 552 580.
Introduction of a Item Number M153
A new item number, M153, has been
introduced to improve the claiming process
for surgically implanted prostheses items not
listed on the Department of Health and Ageing
(DoHA) Prostheses Schedule.
The use of prosthetic items that have not yet
been considered for listing by the Prostheses
and Devices Committee still requires prior
financial authorisation from the Department
of Veterans’ Affairs (DVA) and this process has
not changed.
Where case-by-case approval has been given
by DVA for a non-listed prosthesis, claims for
payment at invoice cost should now be made
using item number M153. A supply charge is
not payable for non-listed prostheses.
While copies of supplier invoices are not
required, DVA does reserve the right to view
relevant invoices as part of our post-payment
monitoring regime.
Online In Hospital Claiming (IHC)
for DVA
Online In Hospital Claiming (IHC) was
successfully implemented by the Department
of Veterans’ Affairs (DVA) on 1 May 2007.
IHC is an extension to Medicare Australia’s (MA)
online claiming solutions, and offers a secure
connection between private hospitals, MA, DVA
and Private Health Funds.
IHC is a result of a collaborative project
between DVA, MA and Private Health Funds
and enables paperless claiming for DVA private
hospital providers. Private hospitals now have
access to DVA, MA and health funds in one
product. At this time DVA can only accept IHC
claims from private hospitals.
The IHC function enables private hospitals to
submit electronic claims to DVA and health
funds. The claims can be submitted 24 hours
a day, seven days a week without the need
for accompanying documentation - saving
time and resulting in faster payments! (note:
paperwork must be retained by hospitals for
audit purposes).
Participating private hospitals are now able
to check the progress of their hospital claims
assessments and request processing reports
regarding these claims. A further feature of
IHC is the ability for hospitals to automate
account reconciliation through remittance
advice statements which detail the payment
of hospital claims. The submission of Hospital
Casemix Protocol (HCP data) to DVA and health
funds is also facilitated by IHC.
Private hospitals may verify veterans’ details
using the Online Veteran Verification function.
This function checks that the veteran’s details
are correct, and that the veteran is known
to DVA and can be used prior to submitting
claims for payment. If the veteran’s details are
incorrect providers should correct the details
before submitting claims. This process only
verifies that the veteran is known to DVA.
Hospitals will still be required to ensure the
veteran has appropriate eligibility and seek
prior financial approval where required.
Further information is available from the
Medicare Australia eBusiness Service Centre
on 1800 700 199 or visit Medicare Australia’s
website:
http://www.medicareaustralia.gov.au/
providers/online_initiatives/index.shtml
HCP Data Reminder
Submission of HCP Data to DVA
In accordance with Clause 10.6.1 of your
hospital’s arrangements with the Department
of Veterans’ Affairs (DVA), Hospital Casemix
Protocol (HCP) data must be submitted on
a monthly basis. Data should be submitted
via secure file transfer before the end of the
following month e.g.: March 2008 data by the
end of April 2008 etc.
Help for HCP data queries
Queries related to HCP data processes can
be sent to the following email addresses, but
keep in mind these are not to be used for
submission of data:
Victoria
Western Australia
Tasmania PDataSth@dva.gov.au
South Australia
Northern Territory
Private Hospital - April 2008
New South Wales
Queensland HCPDataNth@dva.gov.au
Australian Capital Territory
You can continue to contact DVA by phone on
1300 131 945.
New National Phone Number for
Providers
The Department of Veterans’ Affairs (DVA) has
introduced a new national 1300 telephone
number for health providers from 1 November
2007. A corresponding Freecall 1800 telephone
number was introduced for health providers in
regional areas.
The new number for provider enquiries is:
Metro callers: 1300 550 457
Non-metro callers: 1800 550 457
When dialling the provider-specific telephone
number, providers will be presented with a
number of automated voice prompts. Providers
will respond to the prompts by using the
numbers on their telephone keypad. Once
their enquiry type has been selected from
the available options, providers will then be
directed to the DVA staff member who has
the knowledge and skills to handle that
particular enquiry.
The general enquiries number of 133 254
should only be used by veterans calling DVA
- all health care providers should use the new
numbers 1300 550 457 or 1800 550 457.
PHacts
The Department of Veterans’ Affairs has recently
developed a newsletter, PHacts, to inform
private hospitals of topical information, and
address common issues that many hospitals
may encounter. The first edition came out in
October 2007, and is produced by the Provider
Partnering section within Primary Health in
DVA. The newsletter is a quarterly production,
with expected distribution dates being late
March, late July and late November each year.
The newsletter is sent electronically to all
private hospitals, either individually or to the
relevant corporate group for the attention
of the CEO or Contract Manager but is also
available on the DVA website at:
http://www.dva.gov.au/health/hospital/index.htm
Hard copies are also distributed to delegates
attending APHA conferences, and to interested
participants at discharge planning seminars
coordinated by DVA.

A Focus on Veterans – It’s All in the Family
When Anna Shepherd’s grandfather left Australian shores for World War I, it is
certain he never thought that his actions would have such a profound effect on
his granddaughter years later.
Anna leads Regal Health Services, a home
health service in Sydney that cares for many
whose lives have been altered by war. Anna’s
mother, Patricia R Shepherd established Regal
Health Services in 1966 after training and
practising as a RN at Concord Repatriation
Hospital for many years. She had two goals:
firstly a commitment to the highest standard
of care for patients who have the right to live
with dignity, quality of life and independence
in their own home and to provide a service
that supports Community Nurses by providing
a workplace that respects their need to be
recognised and supported to provide the
best care.
Regal Health continues today as a service
to veterans and others in the community.
“As the grand daughter of a soldier who
served in both World War I and World War II I
feel privileged to lead a home health service
that cares for so many whose lives have been
impacted by war,” says Anna. “I had three uncles
who served in World War II who have shared
with me their many experiences of war and
wisdoms passed down through generations.
I am grateful for the many sacrifices our war
veterans have made that allow us our freedom
today.”
Anna says, “Supported by a committed team,
I aim to ensure that Regal Health Services is
acknowledged as a service of excellence in
home healthcare throughout Australia for the
benefit of our clients. I believe that a team
that is comprised of like minded professionals
produces excellent results in terms of service
delivery and job satisfaction. My aim is to
do whatever it takes to acknowledge and
support my team empowering them to achieve
excellence for the benefit of our patients.”
To that end, Anna has established an award
in her mother’s name for community nursing.
The Patricia R. Shepherd award for community
nursing is an annual award granted to a
community nurse who is nominated by peers,
patients and the management staff.
As a leader Regal Health also provides two
scholarships that are open to all Community
Nurses across all sectors each year. The first is
for wound management in community nursing
and provides the winner a $2,000 scholarship
towards education, research and/or conference
participation for wound management. The
second award allows the winning community
nurse to attend and present an abstract at
the biennial Joanna Briggs Colloquium and
International Nursing Conference which in
2008 will be held in Cordoba, Spain.
The investment in her staff pays off, insists
Anna. “We were the first private nursing service
in Australia to achieve ACHS accreditation in
1994. And of course, we have excellent clinical
outcomes. We achieve higher than the DVA’s
benchmarks for wound healing.”
Veterans’ Health to be Examined
The Centre for Military and Veterans’ Health
(CMVH) has been contracted by the Australian
Defence Force to conduct a survey into the
health of ADF personnel who have deployed
on operations. They will compare the health
of those deployed to East Timor and/or
Bougainville with the health of those who
did not deploy to these locations. More than
12,000 Defence personnel are being invited to
take part.
The study will contribute to increasing the
knowledge about Service-related health
and ill health. It may also assist the ADF in
developing the most appropriate supportive
and protective measures against future
health threats.
Private Hospital - April 2008
Feature: Veteran Community
17
“ As the grand daughter of a
soldier who served in both
World War I and World War II
I feel privileged to lead a home
health service that cares for
so many whose lives have
been impacted by war,” says
Anna. “I had three uncles who
served in World War II who
have shared with me their
many experiences of war and
wisdoms passed down through
generations. I am grateful for
the many sacrifices our war
veterans have made that allow
us our freedom today.”
CMVH is a University of Queensland led
consortia, with University of Adelaide and the
Charles Darwin University, supported by the
Department of Defence and the Department
of Veterans’ Affairs, as an Australian
Government initiative.
More information about the study is available
at www.uq.edu.au/dhsp.

18
as it see it... with Michael Roff
If you are really sick, go to a Private Hospital…
This issue of Private Hospital is part of APHA’s contribution to the celebration
of the 90th year of the Australian repatriation system.
Private hospitals have for many years been
working in partnership with Department of
Veterans Affairs (DVA) providing high quality
hospital services for the veteran community.
There is no doubt that many of these are
the oldest and sickest patients, once again
deflating the myth that “if you are really sick,
you go to a public hospital.”
Of course, veterans are also treated in the
public hospital sector. However, the latest
figures available from the Australian Institute
for Health and Welfare indicate that 186,000
DVA patients are treated annually in private
hospitals, compared to just 135,000 in the
(much larger) public hospital system.
This poses two questions; firstly, why would the
private hospital contribution to the provision
of care to veterans be much higher than public
hospitals, and secondly, are there any lessons
from the DVA experience that could be applied
more broadly to the provision of hospital
services?
In answer to the first question, a large part of
the reason could be related to relative cost.
That is, DVA negotiates with State Governments
for veterans to be treated in public hospitals on
a cost-recovery basis with the Commonwealth
picking up 100% of the cost. In private
hospitals, DVA undertakes a national tender
for services. So how do the outcomes of these
processes compare?
According to evidence given by DVA to a
parliamentary committee in 2006;
“the work we have done basically suggests that
we pay significantly lower prices in the private
sector than we do in the public sector.”
And, when talking about the negotiated
arrangements with private hospitals;
“The premise when we first went into those
arrangements was that we had to be able to
demonstrate that they were lower than the cost
of the equivalent services in the public sector. We
can certainly do that.”
DVA subsequently confirmed the cost
differential between public and private
hospitals could be up to 20%.
So the demonstrated efficiency of the private
sector is a major reason the majority of
veterans are treated in private hospitals. But
what does this mean for the rest of the hospital
system beyond just treating veterans?
The Commonwealth Government has been
trumpeting its injection of funding to “blitz”
elective surgery waiting lists. Indeed, $150
million has been allocated across the states
in 2008 to treat additional patients. When this
policy was announced during the election
campaign, we were told that States would be
encouraged to use this funding to contract
with private hospitals because the ALP
believed the capacity of the private sector
should be harnessed.
Well there can’t have been too much
encouragement. Victoria recently announced
how it was dividing up an instalment of $27.11
million provided under that program. Of this
amount, only $1.58 million is being spent on a
“Private Patient Initiative” to treat 470 patients.
It is interesting to note that, on the figures
released, the average cost per additional
elective surgery patient to be treated in
Victorian public hospitals is $4783. This
compares with the Victorian cost per casemix
adjusted separation (including depreciation) of
$3785. The average cost per patient treated in
a private hospital under this scheme is $3361.
Looking at these numbers, I could make the
bold assertion that private hospitals in Victoria
are 30% more efficient than their public
counterparts and the Government could have
saved $7 million if it contracted all of this
elective surgery work to the private sector.
Of course, I can’t do this because we don’t
know what procedures are being performed
so we can’t make a valid comparison.
And although the States have agreed to a
performance reporting framework imposed by
the Commonwealth in return for the funding,
there will be no requirement to report on types
of procedures undertaken so cost comparisons
can be made across states or between sectors
– so much for transparency.
Which brings me to another point. We have
just seen the annual gnashing of teeth from
the usual suspects, including the States, in
relation to health fund premium increases
which averaged 4.99% this year. Once again,
Private Hospital - April 2008
“ The real question for private
hospitals, health funds, the
public system, governments
and patients, is how long can
we sustain the current system
before something cracks?”
this is cited as evidence that “the 30% rebate
is not working” and “costs are out of control” in
the private sector.
Let’s look at the facts which highlight a
breathtaking case of double standards. In the
2003-2008 Australian Health Care Agreement,
the States were guaranteed indexation over the
previous agreement of 17% in real terms. That
is, over the five-year period they would receive
funding increases to run public hospitals of
17% over and above the rate of inflation!
This means they have received increased
funding of 31.1% over the course of the
agreement. And we hear claims, becoming
more strident each day, that this amount is
simply not enough to cover the increased cost
of providing hospital services.
Over the same period, health fund premiums
have increased 30.6% - and this supposedly
means costs are out of control!
But of course the increases in health fund
premiums do not flow through in full to private
hospitals. Perhaps this is an indication that
neither state governments nor health insurers
are particularly good judges of the level of
cost increases being experienced by private
hospitals at the coalface of care delivery.
So for now, let’s forget about arguments over
which sector is more efficient or is better able
to control rapidly rising costs (and we can
because the facts speak for themselves). The
real question for private hospitals, health funds,
the public system, governments and patients,
is how long can we sustain the current system
before something cracks?

20
Sydney Convention & Exhibition Centre, 13 – 15 May 2008
INNOVATION & TECHNOLOGY ON SHOW AT
HOSPIMedica AUSTRALIA
With HOSPIMedica AUSTRALIA 2008
just around the corner, hospital and
healthcare professionals from all
over Australia and New Zealand are
planning their trips to Sydney!
HOSPIMedica AUSTRALIA will be the
ultimate destination for those wishing to
explore the most comprehensive showcase of
technology, equipment, products and services
for the hospital, diagnostic, pharmaceutical,
medical and rehabilitation industries ever
staged in Australia.
There’s no conference or workshop here - just
an unrivaled opportunity to take a look at the
1000’s of products and equipment on show
from over 190 exhibitors, representing some
16 countries - 60 of which have never
exhibited in Australia before!
The event, to be held over three days, offers
a long awaited chance for the trade visitors
to get close to the cutting edge of medical
innovation, from simple products to high-tech
systems, all under one roof.
Not to be missed exhibits include the NEW
Teletom range of power booms – part
of Berchtold’s new Supersuite Custom
Surgical Environments Solutions. Developed
via extensive consultation with surgeons,
operating theatre nurses, biomedical
engineers and many other parties involved
with the theatre preparation and set up,
you’ll be amazed at its ease of operation
in theatre.
Internationally successful EBOS Group will
be launching the NEW VORTEX Macerator
and as the newly appointed Australian agent
for Eschmann, they’ll have a range of their
world-renown operating tables on show.
Siemens will showcase the latest technology
in diagnostic imaging and medical laboratory
systems, whilst Gallay will present all their key
products and feature an endoscope drying
cabinet that’s fresh to the market.
Also look out for the new Patented Model
Nursing Bed from MAXI-CARE - this new
model lifts up and down in a straight
motion which means easier transfers. And
you shouldn’t miss the latest in Biomedical
Equipment from newcomer Nison either.
Visitors will also see exciting displays from the
likes of Gubbemed International, Invacare,
Lumenis, Meiko, Miele Professional, Philips
Medical Systems, Tuta Health, Unique Care,
Visiomed Group, Welch Allyn, AIS Healthcare,
Austco, Bioclone, Bremed, Caraleen, Stern,
C&A Scientific, DB Health and others.
From the big stuff such as the latest DHS
Emergency power-lift stretchers and
loading system to the small including the
all-new Clearview Laryngeal Mask from
Ultimate, HOSPIMedica AUSTRALIA will have
something for everyone.
And you’ll save money with over
18 specialised medical consumable
manufacturers and suppliers competing for
your business!
The website, www.hospimedica-australia.com
features a comprehensive preview of exhibit
content that is being updated daily.
A large number of international exhibitors
are also utilising their involvement in the
event to source local distributors and this too
is indicated in listings where applicable.
It just doesn’t get any better than this.
All under one roof, for three days, but only
every two years!
HOSPIMedica AUSTRALIA is part of the ‘med by series’ of medical
trade fairs organised throughout the world, including MEDICA,
the world’s largest medical trade fair held annually in Germany.
Private Hospital - April 2008
ORGANISE YOUR FREE TRADE
ENTRY NOW
You can organise trade ID badges in
advance! To gain free trade entry visit
www.hospimedica-australia.com and
complete the on-line trade application
form or simply do it on arrival.
WHERE?
Hall 3, Sydney Convention &
Exhibition Centre, Darling Harbour
WHEN?
Tuesday 13 May 2008
10.00am-6.00pm
Wednesday 14 May 2008
10.00am - 6.00pm
Thursday 15 May 2008
10.00am - 6.00pm
NEED TO KNOW MORE?
For full details including exhibitor
listing, exhibit previews, trade entry
applications, special discounted travel
and accommodation packages and
how to get to the event, visit
www.hospimedica-australia.com

Private Hospital - April 2008
21

22
Interview - George Toemoe
Information Technology in the health sector
In our first interview for 2008, Private Hospital magazine talks to George
Toemoe, CEO of St. Luke’s Care in Sydney and APHA National Board member
about Information Technology in the health sector.
Private Hospital magazine:
How do you think private hospitals generally
are placed in the industry regarding their
information technology systems?
George Toemoe:
First can I say, my focus in commenting on
IT and Health Sector will be from a hospital
clinical information perspective mainly as
general administration systems such as
admissions, billing, coding and financial
information systems have been in place for
over a decade and implemented in most
private hospitals.
Prior to joining the health care sector in 1997,
I had worked in a number of other industries
such as manufacturing, high technology,
finance, mining, waterfront and local
government.
IT systems in these industries in my view were
generally well in advance of systems in health
care sector and particularly in the non back
office applications. However this gap has
significantly narrowed with the progressive
implementation of clinical IT applications over
recent years.
PH magazine:
How are advances in IT impacting on the
health sector? What are the main benefits/
pitfalls/obstacles?
GT:
IT advances in the health care sector are
helping to deliver better health care and
outcomes and these will only improve as
implementation becomes more intensified.
That is, implementations to date have been
concentrated mainly in a few major health
care providers and not across the board.
The benefits of implementing clinical IT are:
• Web, Internet and e-commerce capabilities
including offsite access and clinical planning
by clinicians and other authorised personnel.
• Clinical pathway development and
management including resource and program
scheduling, orders for pharmacy, radiology,
pathology and allied health tests and
procedures.
• Highlighting of overdue tasks including orders
such as pathology and imaging.
• Electronic receipt of order results including
variances and adverse results.
• Warnings for pharmaceutical items ordered
such as drug to drug, drug to age, drug to
allergy and drug to tissue.
• On-line reports and graphs including those
for vital signs such as temperature, blood
pressure and heart beat.
• On-line dictation of clinical notes.
• Data entry and access at the bed side using
wireless application protocols for either
hand-held or trolley based computers.
Private Hospital - April 2008
• Applicability to nursing home and home
care clients.
• Interfaces to existing patient management,
billing and financial software applications.
• Faster coding and therefore transmission
of data to health funds for reimbursement
purposes and therefore improved cash flow.
• Automated discharge notes once again
shortening a perennial bottle neck of having
to wait until busy clinicians could address this
task which is a necessary prelude to coding.
• Multiple user access to records by approved
users rather than one user at a time which is
the case with paper records.

• Improved efficiency as opposed to the
perennial “in transit or lost paper record”.
• Further improved efficiency for clinical staff
in having information available at their finger
tips rather than having to go looking for
information eg pathology results, clinical
records. A survey sometime ago indicated
that a nurse on average walked 14 kms per
shift, a great deal of which was looking for
records and results.
• Further quality of care improvement and
increased clinician and nursing availability
and care with administrative and manual tasks
being computerised.
These benefits result not only in cost savings
but higher quality of care due to significantly
reduced risks of missing clinical pathways
items and also proving more time to that
scarce resource called nursing and
providing care.
The main pitfalls, which can be minimised by
good planning and resource allocation are:
• An under estimation of the time required for
training and implementation.
• An under estimation of the cost involved and
the resources required.
• The non identification of a champion to
deliver the systems.
• Fear by those that do not have good
computing skills and particularly
contemporary ‘point and click’ skills.
• Not supported by senior management.
• Insufficient review of the different solutions
available including user review and testing
and therefore the potential selection of the
wrong solution.
• Inflexibility of the selected solution to be
adapted to existing and preferred work
pattens.
• Insufficient resolution hardware (ie quality
of screen images)
• Insufficient hardware capacity and speed.
The obstacles tend to be:
• A complete misconstruing of the privacy
argument.
• Workforce experience and age.
• The need to allocate some existing
operational resources to project
implementation and the general aversion
of some operational managers to such
a concept.
• The considered non-necessity to use such
systems for simple and short term/day only
type procedures.
PH Magazine:
How is IT helping to streamline processes
in hospital administration?
GT:
This has generally been answered in the
previous point of which examples are discharge
note automation, procedure coding, health
fund data transmission, faster cash receipts
reduced nursing diversions on matters such
as looking for records and results, elimination
of lost and in transit records, multiple user
access and most importantly significantly
improved quality and risk management.
PH Magazine:
Are paper-based systems becoming obsolete?
GT:
Yes except for mainly medico legal reasons or
where hardware resolution insufficient.
The implementation of clinical IT is similar to
experiences in local government where paper
documents and records such as development
applications are now electronically and
simultaneously handled by a number of staff
eg town planners, health and building
surveyors, engineers.
PH Magazine:
How are advances in IT impacting on risk
management?
GT:
In summary, errors and omissions are
significantly reduced and/or eliminated by
the “poor human brain” which is essentially a
computer itself by not being overloaded with
trying to remember tasks carried out, tasks
required and results and prioritisation of these.
Implementation of clinical IT by improving
quality and risk management will also have
Private Hospital - April 2008
Interview - George Toemoe
a positive impact on relevant insurance
premiums such as medical malpractice
insurance.
But most importantly much better patient
care and outcomes.
PH Magazine:
Are advances it IT allowing for more
in-home care?
23
GT:
Yes to the extent that access to clinical
pathways, records, results and the on-line
updating of records and results can be carried
out remotely. Resource management can
also be improved and in St Luke’s case simple
care manager type software has provided
significantly improved community homecare.
PH Magazine:
Is there a resistance to change amongst health
care professionals?
GT:
Yes but only generally to a fairly minor extent.
The reasons in question are:
one being privacy and flexibility of these
selected systems to be adapted to existing
and two, preferred work practices and the
assumption that existing and preferred
practices are appropriate.
PH Magazine:
Has re-training been a problem?
GT:
Yes for those who have little or no experience
with computers, especially with point and click
type applications. The potential complexity of
such applications is much higher than with the
older character based systems. Many people
become quite concerned when exposed to
complexity with sub-optimal time to be trained
and fully understand.

24
Healthcare and medical workers demand
ethical workplaces
In a warning sign to the country’s healthcare and medical employers, staff
within their sector are the most likely to believe that good company ethics
would highly improve their current workplace (31%) according to a new survey.
The SEEK Satisfaction and Motivation survey
also revealed that across all industry sectors,
medical professionals were the most likely to
hold hours of work (51%), the people they work
with (45%) and the workplace environment
(48%) as extremely important when looking for
a new job.
Commenting on the findings, SEEK Sales
Director Joe Powell said:
“In an industry that often has to make tough
ethical decisions it’s not surprising to see that
employees within the healthcare and medical
sector want to work for companies that behave
in an ethical way and expect their staff to do
the same.”
In another interesting discovery, nearly half of
respondents (49%) only intend on staying with
their current employer for a year or less, while
18% plan to stay on for three months or less.
“Healthcare and medical employers need to
think about the demand for ethical workplaces
and take these requirements into consideration
if they hope to retain and attract staff,” he said.
“The added check or difficulty that the
healthcare and medical profession has is that
unethical behaviour in their field often creates
negative publicity that stays in the minds of
potential future employees for a long time to
come. It is far better to avoid these situations
by creating an ethically sound workplace and a
positive reputation, than try to overcome these
barriers in the future,” he said.
Other interesting findings for the healthcare
and medical sector include:
• 34% of respondents rated the ‘company
reputation’ as extremely important when
looking for a new job, exceeding the industry
average of 27%,
NPS RADAR reviews released
Two new drugs are reviewed in the April edition of NPS RADAR, an
independent drug bulletin from National Prescribing Service Limited (NPS).
The drugs are fentanyl lozenges (Actiq), an
oromucosal formulation for the control of
breakthrough cancer pain, and paliperidone
(Invega) for people with schizophrenia.
Both drugs became available on the PBS from
1 April 2008.
NPS RADAR notes that fentanyl lozenges are
only to be used by people who are stabilised
on regular opioid therapy for their underlying
persistent cancer pain. Fentanyl lozenges may
be prescribed on the PBS when escalating
doses of morphine for the control
of breakthrough pain causes intolerable
adverse effects.
NPS CEO Dr Lynn Weekes asked doctors and
pharmacists to be aware of three important
safety issues with the use of fentanyl lozenges.
• Do not use fentanyl lozenges in
opioid-naïve patients, as this increases the
risk of respiratory depression.
• Instruct patients and carers on the correct use,
storage and disposal of fentanyl lozenges to
help prevent accidental or deliberate misuse.
• Intact or partially used lozenges can be fatal
if consumed by a child, so it’s imperative to
keep them out of sight and reach of children.
Any lozenge that remains on the handle
needs to be dissolved under hot running
water and must not be discarded whole.
Paliperidone is the major active metabolite of
risperidone. In its review, NPS RADAR states
that the clinical response to paliperidone is
Private Hospital - April 2008
• The people they work with (24%), benefits
and conditions (12%) and training and
development opportunities (12%) are the top
three things employees love about their job,
• 42% of respondents are unhappy or very
unhappy in their current job,
• The top three hates in their current job are
their stress level (25%), the lack of feedback/
appreciation they receive (21%) and the
quality of overall management (20%),
• Openness and honesty (77%), the ability
to follow up words with actions (73%) and
support of their team (67%) are the most
respected leadership attributes for this group.
likely to be similar to risperidone, but there are
no comparative data.
The April print edition includes an update
on the extended PBS listing for pioglitazone
(Actos) in the treatment of type 2 diabetes
and the review of varenicline (Champix) for
smoking cessation which was published on the
website www.npsradar.org.au in January.
This edition also carries brief reviews of
methylphenidate (Ritalin LA), a second
long-acting formulation PBS listed for attention
deficit hyperactivity disorder; smaller syringe
volume influenza vaccine PBS listed for children
aged 6–35 months; and terbinafine cream and
tablets for fungal infections in Aboriginal and
Torres Strait Islander peoples.

Private Hospital - April 2008
25

26
quality in focus...
with Christine Gee
Australian Commission on
Safety and Quality in Health Care
Christine Gee reports on current activity underway within the national
safety and quality agenda that is being developed and implemented by
the Australian Commission on Safety and Quality in Health Care (ACSQHC).
National Measurement and Reporting
of Safety and Quality Indicators
At their meeting on 24 July 2007, Health
Ministers agreed to “ask the Australian
Commission on Safety and Quality in Health Care
to develop a reporting framework for private
hospitals that is comparable to the reporting
framework for public hospitals, and for general
practice.”
Leaving aside the fact that at present there is no
agreed national reporting framework for public
hospitals, the ACSQHC Private Hospital Sector
Committee (PHSC) has undertaken
the task of identifying an appropriate suite
of indicators for private hospitals to report that it
can recommend to the ACSQHC. In pursuing this
activity, the PHSC has sought input and advice
from the APHA Safety and Quality Committee.
In the box below, I have provided a visual
illustration of the two-way process of providing
private hospital input into the national safety
and quality agenda and the implementation
of this agenda nationally. At each point I have
noted the quantum of private hospital expertise
Australian Health Ministers’ Conference (no
direct private hospital expertise)
Australian Health Ministers Advisory Council
(no direct private hospital expertise)
Australian Commission on Safety and Quality
in Health Care (1 of 10 with Private
Hospital expertise)
ACSQHC Private Hospital Sector Committee
(5 of 9 with private hospital expertise)
APHA Safety and Quality Committee (9 of 9
with private hospital expertise)
Private hospitals
available to inform the development and
implementation of the national agenda.
At the invitation of the Minister for Health and
Ageing, APHA Executive Director Michael Roff
recently attended part of the first meeting
of the new Health and Hospitals Reform
Commission (H&HRC). This session related to
the development of indicators for a national
reporting framework. At the meeting, the H&HRC
confirmed that it would look to the ACSQHC to
develop the indicators for private hospitals.
The H&HRC is working to a very tight deadline
and therefore the development of indicators to
be reported by private hospitals has necessarily
been accelerated by the PHSC and the APHA
Safety and Quality Committee. I will report
on the development of these indicators in
a future column.
National Charter of Patient Rights
As I have outlined in an earlier column, the
work of the ACSQHC is guided by nine priority
programs, one of which is the National Charter
of Patient Rights. During February-March, the
ACSQHC circulated a draft version of the Charter
together with a Consultation paper. The APHA
Safety and Quality Committee provided a
submission to the ACSQHC on the Consultation
paper and the draft Charter (members interested
in a copy of the submission should contact Paul
Mackey at APHA).
One of the central concerns of the APHA Safety
and Quality Committee is that in their present
form, the draft Charter and Principles do not
strike an appropriate balance between the
roles, rights and responsibilities of patients
and providers.
In APHA’s view, the Charter currently omits an
important aspect of a consumer’s interaction
with the health system, their responsibilities,
which is a significant shortcoming. APHA has
recommended to the ACSQHC that the notion
of Responsibilities be added to the Charter
and that a separate set of Principles should be
developed that articulate the responsibilities
expected of health consumers. APHA believes
Private Hospital - April 2008
that this is an important issue as arguably health
care services can only be provided safely when
it is accepted by the Patient/Consumer that they
have responsibilities as well as rights.
While two patient responsibilities are identified
in the draft Principles, these are included, almost
as an afterthought, under the consumer’s right
to Information. The APHA Safety and Quality
Committee believes that greater clarity, for all
parties, would be provided by the inclusion
of a separate set of Principles around the
responsibilities of consumers. These could
include, for example:
• To provide to the best of their knowledge and
ability, accurate and complete information
about past and present illness, medication,
treatments, relevant family history and other
matters relating to their health
• To communicate whether or not they clearly
comprehend the care provided
• To follow the instructions about care provided
by the health care provider and to report any
changes in their condition in a timely manner
• To acknowledge the consequences of their
actions if they refuse treatment or do not follow
the recommended instructions
• To be considerate of the rights or other
patients/consumers and health care workers
• To accept and comply with a policy of zero
tolerance of aggression towards staff and
understand that unacceptable behaviour may
delay or negate receiving treatment
• To adhere to relevant legislative and facility
requirements regarding the safety and security
of those who use the facility
• Health service users should make complaints
in a respectful and honest manner and provide
truthful and accurate information when making
a complaint.
I welcome your feedback on this column and on
any matters relating to quality and safety and
the Australian Commission on Safety and Quality
in Health Care. I can be contacted via the APHA
Secretariat – paul.mackey@apha.org.au

Private Hospital - April 2008
27

Advertorial
Access the latest equipment with an operating lease
One of the greatest challenges to providing exceptional health care is giving health care professionals
access to the most up-to-date and advanced technologies. Diagnostic and treatment equipment is
continually being improved and refined, and medical staff are rightly demanding the very best tools
available so they can deliver more effective health outcomes for patients. However, new technologies
come at a cost, and keeping up to date is difficult even for the most rigorously run organisations.
Operating leases provide a mechanism for
private hospitals to always have the best and
very latest equipment. An operating lease
is particularly well suited to equipment that
becomes relatively obsolete quickly. Continuing
improvements in medical equipment means
there is nearly always something better coming
onto the market – devices that deliver a clearer
image, a faster process or greater accuracy.
So, what does a responsible hospital manager
or financial controller do? Buy now and
put current technology to use or wait for
the next generation of equipment due out
soon? An operating lease solves the dilemma
– your hospital or surgery can have the
latest equipment now, and when the next
improvement is available, simply upgrade.
Hospitals can constantly be at the leading
edge without having the bother and expense
of equipment ownership.
As Hal Leasing’s CEO Raylee Carruthers puts it
“patients benefit when hospitals use advanced
technology, not when they own technology.”
For most modern hospitals, there is little point
in owning and being stuck with equipment
that will be quickly superseded. Out of date
technology is not consistent with the high
standards of care and treatment that both
patients and doctors have come to expect from
the private hospital sector.
Private hospitals generally have greater
autonomy and flexibility in financial matters
than their public counterparts, and so can use
a greater variety of funding mechanisms to
achieve their goals. Operating leases are
a highly effective option for many classes
of equipment.
An operating lease is a rental agreement. In
simple terms it works like this: you source the
equipment you want, the finance company
buys it, you then rent the equipment from the
finance company. At the end of the term of
the lease you simply return the equipment to
the finance company.
The greatest advantage of an operating lease
is the ability to upgrade to newer equipment
at any time during the rental period. But there
are other significant benefits:
• Payments are agreed up front and are not
impacted by changing interest rates, aiding
predictable cash flow
• The overall cost is often less expensive
than owning and disposing of purchased
equipment
• The entire rental payment is usually 100%
tax deductible
• The equipment is generally off balance sheet
• An operating lease does not impact a bank
line of credit
• The residual risk is carried by the finance
company
• There is no need to arrange the sale or
disposal of obsolete equipment
“Not all operating leases are the same” warns
Raylee Carruthers. “Buried in the detail of
some agreements are special clauses designed
to lock you in for additional rental periods,
or clauses that penalise heavily if the original
packaging or peripherals are not returned with
the equipment at the end of the rental period.
Be careful to read the fine print thoroughly
so that you are not caught out.” Hal Leasing,
a leader in this type of funding arrangement,
has worked hard to develop lease agreements
that are commercially sensible and expressed in
plain language.
Raylee also recommends asking your finance
provider about a Master Rental Agreement
with a pre-approved spending limit. A
revolving facility like this allows you to rent
equipment worth a few hundred dollars along
with multi-million dollar equipment on a single
agreement. Simply add additional items to the
lease as the need arises without the need to
reapply for finance.
“An important factor to consider when
choosing a supplier of an operating lease is
the stability of the finance provider” suggests
Hal Leasing’s Chief Financial Officer, Matthew
Sykes. “You don’t want to be caught in
a situation where the owner of the rental
equipment, the finance company, is being
pursued by creditors looking to sell all assets”.
As in all transactions, some amount of due
diligence is wise before committing to
a contract.
Operating leases offer an effective alternate
source of finance to traditional sources, one
that is increasingly becoming popular within
many industries where technology is advancing
rapidly. Rental arrangements sit alongside
and complement other financing options; talk
with your finance provider or adviser about
designing the best funding solution for your
organisation.

30
Robotic surgery introduced at St John of God
Hospital, Subiaco
St John of God Hospital, Subiaco is the first hospital in Western Australia and
within the St John of God Health Care group to offer robotic surgery.
The minimally invasive da Vinci Robot is used
for radical prostatectomy and other delicate
surgery. The hospital’s Chief Executive Officer,
Dr Shane Kelly, spear-headed the campaign to
obtain a surgical robot for Western Australia.
“We are extremely excited about the
possibilities the da Vinci robot offers our
surgeons, patients and the health care industry
in general,” Dr Kelly said.
Patients benefit from less post operative
pain, less scarring, quicker recovery time, less
blood loss and therefore lower chance of cross
infection.
The hospital’s urologists and gynae-oncologists
will use the robot, which offers surgeons the
benefit of a 10x magnified 3D view of the
anatomy and removes the fine tremor of a
surgeon’s hand. Large hand movements can
be scaled down to miniature, fully ‘wristed’
instruments allowing superior dexterity.
Dr Kelly said currently one in every two radical
prostatectomies in the USA is performed
robotically and figures already show Australia
mirroring this growth, indicating that the
da Vinci prostatectomy will become the
standard of care in Australia in the not so
distant future.
“In addition to urological procedures,
the da Vinci Robot will also be available
APHA Speaking Opportunities
APHA has been represented at several
conferences in the past few months.
APHA President Christine Gee spoke at a
Health Focus Forum at Minter Ellison on 15
February 2008. The Forum brought together
Minter Ellison partners, special counsel and
senior associates from the firm’s Health and
Ageing Industry Group and experts in the
health industry. Christine profiled the Private
Hospital industry; the role played by APHA and
canvassed the key challenges facing the sector.
Public and private oncology hospital
representatives from China visited Canberra on
21 February and Paul Mackey, APHA Director of
Policy and Research participated in a briefing
for them on the Australian health system. Paul
explained the role of the private sector in the
provision of cancer services at the briefing at
the Department of Health and Ageing.
Dr Leon Clark, APHA Board member and CEO
of Sydney Adventist Hospital, spoke at the
Financial Review 10th Annual Health Congress
on 28 February. Dr Clark took part in a CEO
forum which looked at a needs audit for 2025
and also presented a paper on private hospitals’
viewpoints on restructuring private health
insurance in Australia.
The Tasmanian Association for Quality in
Health Care Seminar was held on 13 March and
APHA President Christine Gee’s presentation
focused on the work of the APHA and APHA
Quality and Safety Committee, particularly in
terms of coordinating and supporting both
the Australian Commission on Safety and
Private Hospital - April 2008
for gynaecological surgeries such as
hysterectomies, and for some thoracic
operations,” Dr Kelly said.
Already some 1,800 da Vinci procedures have
been carried out in Australia at four hospitals
in Melbourne, Sydney and Adelaide.
Quality in Health Care / Private Hospital Sector
Committee in progressing and translating the
national agenda. She also gave an overview of
the feedback to the Accreditation Alternative
Model Review and emphasised the need
for there to be transparent ‘rules’ (reporting,
assessment etc) across public and private and
the need for partnerships rather than after
thoughts. Christine also chaired a panel session
on Bringing Public and Private together for the
Health of Everyone at the seminar.
Christine Gee also took part in a panel discussion
at the Chronic Disease Management conference
in Sydney on 1 April 2008. The panel looked at
components required of the key stakeholders
to move forward on the government’s chronic
disease management mandate.

National Health and Hospitals Reform Commission:
A Blueprint for Reform
In August 2007, in the lead up to the 2007 Federal Election, the Labor party
announced that a Rudd Labor government would ‘undertake one of the most
significant reforms of Australia’s health and hospital system since Federation’.
As part of this announcement, Labor committed to the establishment of a
National Health and Hospitals Reform Commission within 100 days of the
election.
On 25 February 2008, Federal Cabinet approved
the establishment of the National Health and
Hospitals Reform Commission and the Prime
Minister and the Minister for Health announced
the membership of the Commission to the
public. The Commission, which has been
directed by Cabinet to develop a long-term
health reform plan for a modern Australia, has
been tasked to provide an interim report by the
end of 2008 and a final plan in mid-2009.
The Commission is chaired by Dr Christine
Bennett, chief medical officer for private health
insurer MBF, and includes nine other experts
from both sides of the political fence.
The Commission will provide a blueprint for
tackling future challenges in the Australian
health system including:
• The rapidly increasing burden of chronic
disease;
• The ageing of the population;
• Rising health costs; and
• Inefficiencies exacerbated by cost shifting and
the blame game.
The Commission will focus on health financing,
maximising a productive relationship between
public and private sectors, and improving
rural health. It will also advise the Government
on the key aspects of the framework for the
next health care agreements between the
Commonwealth and the States and Territories.
The other nine members of the commission
are:
• Rob Knowles, former Victorian Liberal Health
Minister and current chair of the Mental
Health Council of Australia;
• Geoff Gallop, former Premier of Western
Australia and current Professor and Director
of the Graduate School of Government at the
University of Sydney;
• Mukesh Haikerwal, Melbourne GP and
immediate past-President of the AMA;
• Stephen Duckett, health economist and
former Secretary of the Commonwealth
Department of Health. He is currently
Executive Director of the Reform and
Development Division of Queensland Health;
Private Hospital - April 2008
31
• Ron Penny, Emeritus Professor of Medicine,
University of NSW and is one of Australia’s
leading immunologists and a well known expert
in chronic disease management and care;
• Sabina Knight, a remote area nurse, is
currently Senior Lecturer at the Centre for
Remote Health. She has worked extensively
in remote health including in Indigenous
Communities;
• Sharon Willcox, Director of consulting firm
Health Policy Solutions. Prior to this Dr Wilcox
had 20 years experience in public health
policy in Victoria, New South Wales and in the
Commonwealth;
• Justin Beilby, Executive Dean of the University
of Adelaide’s Medical School and a GP for 20
years who has practiced in urban, rural and
remote practices; and
• Mary Ann O’Loughlin, Director, The Allen
Consulting Group. She was a senior Social
Policy Advisor to Prime Minister Keating,
and has held a number of Senior executive
positions in the Commonwealth
Public Service.
Medical Industry Association of Australia
changes name to Medical Technology Association
of Australia
The Medical Industry Association of Australia
(MIAA) has changed its name to Medical
Technology Association of Australia (MTAA) to
better reflect the association’s membership and
its role in the healthcare system.
“Our members supply approximately 90%
of the non-pharmaceutical products used in
the diagnosis and treatment of disease and
disability in Australia and our new name better
reflects this key function” said Anne Trimmer,
MTAA CEO.
The range of medical technology is diverse
with products ranging from familiar items such
as syringes and wound dressings, through
to high-technology implanted devices such
as pacemakers, defibrillators, hip and other
orthopaedic implants. Products also include
hospital/surgical equipment, diagnostic
imaging equipment such as ultrasounds
and magnetic resonance imaging machines,
as well as diagnostic (pathology) tests that
detect disease. Members also play a vital role
in providing healthcare professionals with
essential education and training to ensure safe
and effective use of medical technology.
“Medical technology has an essential role in
managing the health of Australians and is relied
upon to alleviate pain, injury and handicap.
Our new name will better assist us position
ourselves in the health environment to ensure
Australian patients have equity and access to
the most appropriate medical technology” Ms
Trimmer concluded.

32
Queensland Governor Returns to the Hospital
She Helped Build to Launch its 50th Anniversary
Celebrations
Governor of Queensland, Quentin Bryce, could hardly have imagined 50 years
ago, as she launched the first door knock appeal in Brisbane to raise money to
build a new hospital, that she would be invited to launch the venue’s jubilee
celebrations in 2008.
St Andrew’s War Memorial Hospital in Spring
Hill this year marks its 50th Anniversary and
launched its celebrations with a special service
on Tuesday, March 4, at St Andrew’s Uniting
Church in Brisbane.
The Governor opened the proceedings and
unveiled a plaque commemorating the
Hospital’s 50th anniversary. She reminisced
about marching the streets of Brisbane as a
University of Queensland student all those
years ago, raising funds for the original
hospital building.
Ms Bryce explained that she had attended
Moreton Bay College as a child, which was
at the time a Presbyterian school, the same
church (now known as the Uniting Church)
that was behind the founding of St Andrew’s.
In her first year studying social work at UQ, she
helped raise funds for what has now become
one of Brisbane’s most medically influential
private hospitals.
“I remember door knocking in Auchenflower,”
she muses, “as it was particularly hot that day
and those hills are very, very steep!”
However all that walking helped towards the
foundation of a great new hospital that is a
living memorial to the men and women of the
armed forces who fought in the world wars,
and subsequent wars after that.
The doors of St Andrew’s opened on May
17, 1958 as a small 84 bed hospital. It is
now undergoing a massive $73 million
redevelopment that will allow it to take 260
inpatients and will boast the most modern
and up to date facilities.
The hospital, which now comes under the
umbrella of UnitingCare Health, has played
an enormous part in the medical history of
Brisbane and indeed has featured heavily in
the life the Governor’s family too.
Her sister Diane was one of the first nurses to
train at the hospital and went on to become
the head theatre nurse. The Governor has also
used the hospital for herself and all her family
when hospital care has been required and
explains: “My daughter was at St Andrew’s for
treatment only last Christmas and received
wonderful care and attention.”
Ms Bryce says her involvement with St
Andrew’s was her first “grass roots experience”
of community activity and helped shape her
future. “The foundation of the hospital was a
remarkable endeavour,” she says. “It was driven
by marvellous doctors and supported by so
many in the church and the community.”
Private Hospital - April 2008

Private Hospital - April 2008
33

34
Private Hospital - April 2008

Private Hospital - April 2008
35

36
policy patter...
with Paul Mackey
Private hospitals providing good
value for Veterans
A recent report from the Australian Institute of Health and Welfare (AIHW)
highlights Veterans’ use of health services.
This report uses linked aged care and
Department of Veterans’ Affairs (DVA)
administrative data to examine patterns
of use of DVA-funded hospital, medical
and allied health services by DVA Gold
Cardholders aged 70 years and over living in
permanent residential aged care (RAC), and
compares these patterns with those of Gold
Cardholders of the same age and sex living in
Health service use of DVA Gold Card Holders, 2002-03 and 2003-04
Services received during
the year
GP Services
% using
$ per patient (mean)
Specialist services
% using
$ per patient (mean)
RPBS
% using
$ per patient
Hospitals
% using
$ per patient per year all
hospitals (mean)
$ per patient per year public
hospitals* (mean)
$ per patient per year private
hospitals (mean)
the community. DVA Gold Card holders living
permanently in residential aged care comprise
around 10% of all DVA Gold Card holders.
Analysis in the report concentrates on use of
health services during 2002-03 with additional
data on use in 2001-02 and 2002-03. Datasets
used in compiling the report are:
• Hospital use (private and public)
Living in RAC Living in the Community
94.4%
$605
46.2%
$435
91.3%
$1,281
37.6%
$8,753
$8,234
$7,005
97.3%
$492
77.5%
$463
94.8%
$1,316
45.6%
$8,538
$8,262
$6,694
Source: Australian Institute of Health and Welfare, Veterans’ Use of Health Services, 2008, p.xi
[Note that utilisation and cost data were not available for public hospitals in Western Australia and the Northern Territory].
Ramsay Health Care Extends UK Platform
Ramsay Health Care Limited has extended its
reach in the UK market, agreeing to acquire
the BMI Nottingham Hospital from General
Healthcare Group. The BMI Nottingham
Hospital is a private acute care hospital
offering a wide range of services notably in
orthopaedics, general surgery, urology and
plastic surgery. It has 41 registered beds, two
theatres and 13 consulting rooms. Ramsay
Managing Director Pat Grier said: “The BMI
Private Hospital - April 2008
• General practitioner (including local medical
officer) consultations
• Medical specialist consultations
• Pharmaceutical use under the Repatriation
Pharmaceutical Benefits Scheme
Key points of interest from the report include:
• The report indicates that private hospitals
provide services to DVA Gold Card Holders
at a lower average cost than public
hospitals. In the case of veterans living in
the community, private hospitals provided
services at an average cost per patient per
year that was 23% lower than public hospitals.
In the case of patients living permanently in
RAC, private hospitals provided services to
DVA Gold Card Holders at an average cost per
patient per year that was 18% lower than in
public hospitals;
• Across all age groups, 46% of DVA Gold Card
holders living in the community and 38% of
Gold Card holders living in RAC used hospital
services at some stage during 2002-03;
• More DVA Gold Card holders living in the
community used private hospitals (34%) than
public hospitals (19%) while a slightly higher
proportion of Gold Card holders living in
RAC used public hospitals (24%) than private
hospitals (20%).
The table below provides an overview of the
use and per patient cost of health services used
by DVA Gold Card holders in 2002-03 (hospital
services and RPBS) and 2003-04 (GP and
specialist services).
The full report is available from: http://www.
aihw.gov.au/publications/index.cfm/title/10390
Nottingham Hospital is a quality hospital and a
valuable addition to Ramsay UK’s portfolio.”

38
Department of Veterans’ Affairs and Private
Hospitals: Working Together for the Benefit
of Veterans
The Medical Technology Association of Australia (together with its New
Zealand sister association, MIANZ) has had a Code of Practice since September
2001. The Code was substantially revised in 2005, and with the Code now
nearing the end of its second year of operation it has again been reviewed
with the 3rd edition of the Code to be put to members for adoption in the
first part of 2008.
The launch of the 3rd edition of the Code this
year will be followed by an extensive education
program, both with industry and with the
healthcare sector with whom industry works
very closely to ensure all stakeholders have
a clear understanding of the Code and its
implications.
There is a high level of public scrutiny
of industry behaviour (which has been
highlighted more recently in articles in The Age
newspaper about company relationships with
the Royal Prince Alfred Hospital in Melbourne)
and MTAA takes the maintenance of integrity
seriously.
The elements of the Code that hospitals and
healthcare professionals need to be aware of
are focused on:
• Claims and endorsements in advertising
material
• Provision of product training and education
by industry
• Sponsorship of, and grants for, third party
educational conferences
• Hospitality for healthcare professionals
• Consultancy arrangements with healthcare
professionals.
Claims and endorsements in
advertising material
As very few products are marketed directly
to consumers, most advertising material
is directed to healthcare professionals. A
company must be able to substantiate a claim
that it makes in an advertisement. It may
only make claims that are consistent with the
intended purpose of the product as listed
with the regulator (the Therapeutic Goods
Administration). It is also not permitted to
use the name or photograph of a healthcare
professional without consent or in a way that
is contrary to the ethical guidelines of the
relevant professional association.
Provision of product training and
education by industry
One of the characteristics of medical
technologies is that further research and
development on a product is often as the result
of feedback from the clinicians who use the
products, thereby creating a very symbiotic
relationship between industry and clinicians.
Companies provide considerable training in
their products to ensure that clinicians are
able to make best use of them. The Code
acknowledges the need for this type of training
and sets out the guidelines within which it
may occur. In general, the training must be
conducted in appropriate training facilities
and any hospitality provided to the healthcare
professional must be modest in value and
subordinate in time and focus. A company may
pay for reasonable travel and accommodation
costs incurred in attending the training.
Sponsorship of, and grants for, third
party educational conferences
One of the most vexed areas is sponsorship
of attendance at professional conferences in
Australia and overseas. There is benefit to a
company in having a healthcare professional
present at a conference on his or her
experience with a procedure or product.
There is also a broader educative benefit
to the healthcare sector in attendance at
a conference by a healthcare professional
or trainee. However in order to ensure
transparency in the relationship between the
healthcare professional and a company, the
Code does not permit direct payment to a
healthcare professional of the costs of travel
and attendance.
Private Hospital - April 2008
The Code permits the payment of a grant or
sponsorship to the organiser of the conference
(usually a professional association or training
institution) to enable funding of attendance,
provided the conference organiser selects the
recipient. Alternatively a company may make a
grant to an educational institution for medical
education which may be applied by that
institution in meeting the cost of a healthcare
professional to attend an educational
conference.
Hospitality for healthcare
professionals
The Code permits companies to provide
hospitality to healthcare professionals in
limited circumstances - by sponsorship of
hospitality at a third party conference and by
provision of hospitality as a subsidiary part of
product training. The key requirements are that
the hospitality is subordinate in time and value
to the overall proceedings.
Consultancy arrangements with
healthcare professionals
For reasons mentioned earlier, there is a very

“ One of the most vexed areas is sponsorship of attendance at
professional conferences in Australia and overseas. There is
benefit to a company in having a healthcare professional
present at a conference on his or her experience with a
procedure or product.“
close and ongoing working relationship
between medical technology companies and
healthcare professionals. It is common for
companies to retain a healthcare professional
on contract as a consultant to provide advice,
research or consulting services, or to serve on
an advisory board. The Code permits such an
arrangement provided that any compensation
is consistent with fair market value for the
services provided, selection is based on the
qualifications and expertise of the consultant
and not on volume or value of business
generated, and the arrangements are
well-documented.
The Code is a voluntary Code and while
binding on members of MTAA and MIANZ
is advisory only for non-member medical
Private Hospital - April 2008
39
technology companies. MTAA would like to see
all companies working in the industry adhere
to its principles for the benefit of all. The Code
includes a comprehensive complaints process
- a complaint may be brought by a range of
interested persons, including a healthcare
professional.
MTAA will be writing to private hospitals
over the next few months to provide further
information about the Code and will also be
providing training on the code to industry. If
you would like more information on the Code
please feel free to contact MTAA.
by Anne Trimmer
Chief Executive Officer, Medical Technology
Association of Australia

40
mental health forum...
Veterans and Mental Health
with Moira Munro
In keeping with the theme of the April issue of Private Hospital, my column
focuses on veterans and mental health.
It is estimated by the Department of Veterans’
Affairs (DVA) that some 40,000 veterans receive
compensation for a mental health condition
and the Department recognises mental health
as “a significant component of the health care
requirements of the veteran community.”
Current estimates indicate that around 22%
of the DVA treatment population receive some
form of mental health treatment within any
given year, which is higher than the population
at large. This mental health treatment is
provided in a variety of settings, including
private hospitals.
A number of private hospitals have developed
treatment programs specifically to meet the
mental health needs of veterans, including:
• Post Traumatic Stress Disorder (PTSD)
• Anger Management
• Alcohol and Drug Treatment and
Rehabilitation
In private mental health facilities, treatment
programs for each of these conditions are
designed around the needs of the individual
veteran and are provided by multi-disciplinary
teams.
Post Traumatic Stress Disorder
Combat or war-related PTSD has a profound
effect on the health and quality of life of
Veterans, Peacekeepers and Defence personnel
and their families. This disorder can stem from
a wide variety of military experiences. While
feelings of stress in response to trauma may
be regarded as normal, PTSD is characterised
by the intensity of the feelings, how long they
last, how an individual behaves in response to
these feelings and the presence of particular
symptoms such as:
• intrusive thoughts recalling the traumatic
event;
• flashbacks and nightmares;
• depression and anxiety;
• being easily startled;
• irritability and being quick to anger.
PTSD can lead to relationship difficulties,
substance abuse and a decline in physical as
well as emotional health.
Programs developed by private mental health
facilities to treat combat-related PTSD are
tailored around the individual needs of the
veteran and a specialist multidisciplinary
program team is assembled to provide a
complete treatment program for individual
veterans and their partners, including:
• Comprehensive assessment
• Primary treatment sessions, including group
and individual therapy sessions
• Review and subsequent treatment sessions
are held following the completion of the
primary treatment sessions and may be held
at 6, 12 and 24 month intervals to reinforce
the skills and strategies learnt during the
program with the aim of enhancing recovery
and preventing relapse.
Importantly, this latter phase of treatment
will often include partner-specific sessions
which provide:
• Education around PTSD
• The development of coping skills
• A focus on personal needs
Programs developed by private mental health
facilities to treat PTSD are accredited by the
Australian Centre for Post-traumatic Mental
Health. (http://www.ncptsd.unimelb.edu.au/).
Anger Management programs
Programs are developed by private mental
health facilities to assist veterans to better
manage their feelings of anger and aggression
and to enable improved quality of life for
themselves and their families. Through these
programs, key issues are targeted to facilitate
recovery, including:
• Understanding anger and aggression
• Physical health
• Depression and anxiety
• Relationship difficulties
• Anger management
• Assertion skills
• Relapse prevention
Alcohol and Drug Treatment and
Rehabilitation programs
In recognition that substance abuse disorders
Private Hospital - April 2008
“ Current estimates indicate
that around 22% of the DVA
treatment population receive
some form of mental health
treatment within any given
year, which is higher than the
population at large.”
are increasingly common among veterans
and Defence personnel, private hospitals have
developed treatment programs specifically
tailored to meet the needs of Veterans and
their families. Left untreated, these conditions
can have a severe impact on the health and
quality of life of the individual veteran and
their family.
Following a comprehensive assessment which
identifies individual needs and suitability
to participate in the program, the veteran
undertakes the detoxification component of
the program, usually on an inpatient basis. The
veteran is generally discharged from hospital
prior to commencing the group and individual
therapy sessions, after which a follow up
session is provided at 3 months to reinforce the
skills and strategies learnt during the program
with the aim of enhancing recovery and
preventing relapse. Partner-specific sessions
are also incorporated into the program which
focuses on alcohol and drug education; and
relationship education.
I welcome your feedback on this column and
any matters relating to private mental health
services. I can be contacted at
moiram@perthclinic.com.au

42
Ramsay Managing Director Pat Grier Announces
Retirement, Chris Rex to Become New MD
The Board of Ramsay Health Care announced at the end of February that
Managing Director and CEO Pat Grier intends to retire at the end of the current
financial year and that Chris Rex, currently Chief Operating Officer, has been
appointed Managing Director and CEO, effective 1 July 2008.
Ramsay Chairman Paul Ramsay said Mr Grier’s
contract was due to be renewed at the end of
June and that Mr Grier had advised the Board
that he had made a decision to retire then,
after 13 years as Managing Director. Mr Grier
will remain on the Board as a non-executive
Director assisting the Company with its
aim to expand its offshore business in the
coming years.
“After 20 years with Ramsay, Pat has decided
it is the right time to retire and the Board
respects his decision,” Mr Ramsay said. “Under
Pat’s leadership, Ramsay Health Care has grown
profitably from a relatively small, privatelyowned
operation to the country’s largest
provider of private hospital services, with over
100 hospitals and 8,000 beds across Australia,
the UK and Indonesia and more than 20,000
employees.
“Pat has been the architect of the company’s
special culture known as “The Ramsay
Way” which is central to the success of our
organisation. Under his stewardship and
guidance, Ramsay Health Care has become a
well-respected leader in the private hospital
industry in Australia and I thank him for that. I
really believe Chris will make an excellent CEO
and I look forward to working with him in his
new role from the 1st July” Mr Ramsay said.
Mr Ramsay said Mr Rex – who will also be
appointed as a Director to the Ramsay Board
– was an excellent choice to succeed Mr
Grier. “In his 13 years with Ramsay, Chris
has played an important role in building
Ramsay’s management expertise and has
been instrumental in setting Ramsay’s growth
strategy including the company’s transforming
acquisition of Affinity Hospitals and, more
recently, our first major offshore acquisition
Capio UK.
“Working closely with Pat and the Ramsay
executive committee, Chris has played a key
Private Hospital - April 2008
role in developing the Company’s excellent
record in hospital management. His ability to
run hospitals efficiently and effectively is widely
acknowledged,” Mr Ramsay said.
Commenting on his decision to retire, Mr Grier
said: “This has been a tough decision but I
feel that it is the right time for me to retire.
Ramsay is in terrific shape. We have a wellplanned
growth strategy to create a world class
company and Chris is the right person to lead
the company through this exciting new growth
phase,” Mr Grier said.
Mr Rex said: “It has been a wonderful
opportunity and experience working with Pat.
He leaves the Company well positioned for
growth and I look forward to working with the
Board and the management team as we head
into our next phase of growth.”
Chris Rex, Paul Ramsay and Pat Grier of Ramsay Health Care

Private Hospital - April 2008
43

44
Catholic Health
Appoints New
CEO
Mr Martin Laverty will commence as the
new CEO of Catholic Health Australia from
May 2008. The appointment reaffirms CHA’s
commitment to working with the Australian
and state governments to improve the
capacity of the Australian health and aged
care systems to better meet the needs of
disadvantaged Australians.
Private Health
Insurance
Ombudsman
Ms Samantha Gavel was appointed to
the position of Private Health Insurance
Ombudsman in late March 2008. She
originally joined the staff of the Ombudsman
in 1997 and has held a number of positions
within the office. As Private Health
Insurance Ombudsman, she is responsible
for high level advice to government about
issues affecting consumers in relation to
private health insurance. Recent initiatives
completed by the Office include the
development of the consumer website
www.privatehealth.gov.au and significant
changes to the Office’s corporate
governance arrangements.
Ms Samantha Gavel
New Haemovigilance Report
The National Blood Authority (NBA) has released the Initial Haemovigilance
Report 2008. This report has been developed by the NBA in conjunction with
the NBA Haemovigilance Project Working Group and it provides a national
perspective on transfusion incidents and adverse events reported in a number
of States over the past 3-5 years.
The report indicates that the broad types
of transfusion risks in Australia are similar to
those of other countries that report transfusion
adverse events, such as the United Kingdom,
New Zealand, Sweden and Canada.
Specifically, the data in the report shows
that there is minimal risk of infection from
the provision of blood and blood products
in Australia, as there were no reports of HIV,
hepatitis B or hepatitis C in the data collected
for this project. However, consistent with
international experience, the data show
that patient harm resulting from reactions
and near misses is occurring in Australian
hospitals. Across the various reporting periods
from which the data were drawn, more than
600 transfusion-related incidents, errors and
reactions were reported.
Of these:
• There were 134 instances of patient
misidentification, mislabelling, wrong blood in
tube or near misses reported. If unrecognised
prior to transfusion, these errors can lead to
patients receiving the wrong blood, which
may result in severe morbidity or mortality.
• There were 172 prescription and dispensing
errors reported. Typically, they included
ordering or providing the wrong blood
component or delivering an out-ofspecification
component.
• There were 30 reports of incorrect blood
component transfused. This human error
is a major cause of patient morbidity and
mortality.
• There were 67 reports over five years of
ABO incompatibility. However, there are no
published, consolidated data on the aetiology,
morbidity or mortality associated with these
events.
• There were 26 reports of haemolytic
transfusion reactions, and eight reports of
transfusion-transmitted infections, none of
which were viral.
• There were 59 reports of allergic reactions and
eight reports of anaphylaxis.
• There were 106 reports of febrile
Private Hospital - April 2008
non-haemolytic transfusion reactions.
• There were five reports of transfusion-related
acute lung injury, which is known to be underrecognised
and under-reported, including
when compared to suspected cases reported
to the ARCBS for investigation.
• There were nine reports of circulatory
overload as a result of over-transfusion. A
number of deaths have occurred in Australia
and internationally as a result of overtransfusion.
• Twenty-seven percent (219/810) of events
extracted from AIMS involved labile
components transfused overnight between
the hours of 22:00 and 0:700.
• Two transfusion-related deaths were reported.
The report found that the majority of the
transfusion and adverse events resulted from
human error. The report proposes a number
of key issues for future system improvement,
including:
• The establishment of ongoing haemovigilance
framework to underpin improvements to the
quality and safety of transfusions in Australia;
• Improvements in the consistency of recording
and reporting of transfusion-related adverse
events;
• A focus on procedural training and process
improvement which should lead to
transfusion only when absolutely necessary.
The report is available from: http://www.nba.
gov.au/haemovigilance/index.html

Advertorial

48
Drowning – 1000 a year either die or
are hospitalised
An average of 370 people die and 618 were
hospitalised each year over a five-year
reporting period, according to a new report by
the Australian Institute of Health and Welfare
(AIHW). The report, Deaths and hospitalisations
due to drowning, Australia 1999-00 to 2003-04,
shows that around one-third of all drowning
deaths occurred in natural bodies of water
such as beaches, lakes, the open sea, rivers
and streams, while 10% of deaths occurred
in swimming pools and 10% were boat or
watercraft related.
‘The dangers of swimming pools for very
young children are readily apparent in the
data we have analysed for this report’, said
Renate Kreisfeld of the Institute’s National Injury
Surveillance Unit based at Flinders University in
Adelaide. “The highest death rates for swimming
pool drowning was in the 0-4 year age”.
Coroners’ data showed that by far the most
important factor identified for young children
and death by drowning in swimming pools
was the lack of adequate supervision. Various
aspects of pool fencing and gates were also
commonly identified as contributing factors.
Over the period covered by the report, around
20 deaths a year were the result of drowning
in bathtubs, with 47 hospitalisations for near
drownings.
Private Hospital - April 2008
In such cases, epilepsy, other seizure disorders,
and inadequate or non-existent supervision
were factors commonly identified by coroners.
Alcohol intoxication was also mentioned
frequently in case documents.
Approximately 37 drowning deaths and
65 hospitalisations per year were watercraft
related. These incidents often occurred while
the person was engaged in a leisure activity.
An annual average of 56 drowning deaths and
39 hospitalisations were due to intentional
self-harm.

Private Hospital - April 2008
Nearly two thirds of
Australians die from
heart disease or cancer
The leading underlying cause of death for all Australians
was Ischaemic heart diseases, contributing to 18% of
all male deaths and 17% of all female deaths registered
in 2006, according to figures released in March by the
Australian Bureau of Statistics (ABS).
Ischaemic heart diseases (includes angina, blocked arteries of the heart
and heart attacks) have been the leading cause of death in Australia
over the last 10 years, however the proportion of deaths attributed to
Ischaemic heart diseases has declined from 23% in 1997 to 17% in 2006.
Cardiovascular disease was responsible for the deaths of 45,670
Australians in 2006. It includes diseases such as ischaemic heart
diseases, heart failure aneurysms, heart valve disorders, hypertension,
haemorrhages and strokes and represents 34% of the 133, 739 deaths
registered in Australia in 2006 (down from 41% in 1997).
Cancer was the underlying cause of death for 39,753 registered deaths
in Australia. This is a 12% increase since 1997, when 35,363 people died
from cancer. In 2006, cancer accounted for 30% of all registered deaths
compared with 27% in 1997. Lung cancer is the most prevalent type of
cancer death, with 7,348 Australians dying of the disease in 2006.
Prostate cancer was the underlying cause of 4.3% of all male deaths, with
2,952 deaths registered in 2006. The median age at death for prostate
cancer is 80.4 years. Breast cancer was the underlying cause of all female
deaths with 2,643 (4%) women dying of this disease in 2006. The female
media age at death for breast cancer is 68.3 years, which is 14.9 years
lower than the median age for all female deaths (83.3 years).
Deaths due to Dementia and Alzheimer’s disease have risen by 99% since
1997. Dementia and Alzheimer’s disease is Australia’s 4th leading cause of
death (up from 8th in 1997) with 6,543 deaths registered in 2006
More details are available in Causes of Death, Australia which is available
free of charge when downloaded from the ABS website on
www.abs.gov.au
New Secretary General
for the AMA
The Executive Council of the Federal AMA appointed Mr Francis
Sullivan as Secretary General of the Federal AMA in February. Mr
Sullivan was CEO of Catholic Health Australia for the past 14 years.
51

Advertorial

54
Latest Data from PHIAC
The Private Health Insurance Administration
Council (PHIAC) has released data on private
health insurance membership and utilisation
and benefits paid for insured patients in private
hospitals and day hospitals in the December
quarter 2007. The key features are:
Membership
The proportion of the population covered
by private health insurance has increased to
44.4% of the population and 9,391,000 people
are now insured, an increase of 99,280 people
since the September quarter and an increase
of 392,000 people compared to the December
quarter 2006.
Private Hospitals
Compared to the December quarter 2006:
• Insured episodes increased by 4.5% to
481,247 episodes
• Insured days increased by 3.2% to
1,313,978 days
• Total Benefits increased by 10.2% to
$1.06 billion
• Average Benefit per episode increased by
5.4% to $2,214
• Average benefit per day increased by 7.0%
to $810.75
Day Hospitals
Compared to the December quarter 2006:
• Insured episodes increased by 12.3% to
94,295 episodes
• Total benefits increased by 16% to
$53,755 million
• Average benefit per day increased by
3.7% to $570
Hospital substitute treatment
Compared to the September Quarter 2007:
• Insured episodes fell by 26% to 2917 episodes
• Total benefits paid also fell, by 2.7% to $0.71
million
Private Hospital - April 2008
Chronic Disease Management Programs
(CDMP)
Compared to the September quarter 2007:
• 2,214 CDMP were provided in the December
quarter, an increase of 78% on the previous
quarter
• Total benefits paid increased by 68% to $0.9
million
Medical benefits
Compared to the December quarter 2006:
• Total benefits paid for medical services
increased by 13.8% to $291.16 million
Prostheses benefits
Compared to the December quarter 2006:
• Benefits paid for prostheses increased by
11% to $242.8 million
The full PHIAC reports are available from:
http://www.phiac.gov.au/statistics/
membershipcoverage/index.htm

Vote on proposed MBF merger to take place
on 12 May 2008
MBF Australia Limited (MBF) is just that little bit closer to merging with BUPA
Australia after the Federal Court of Australia approved the release of an
Information Memorandum about the proposal to merge the two companies.
The Information Memorandum will provide eligible contributors with full details
of the $2.41 billion offer from BUPA Australia to combine the businesses of the
MBF Group and the BUPA Australia Group and instructions on how to vote.
The MBF Board recommended the proposal to
combine the two businesses to MBF Council and
MBF Contributors back in December 2007.
The Information Memorandum will be
accompanied by an Allocation Form that will
set out an estimate of the cash entitlement
eligible contributors will receive if the proposal is
approved and implemented. The cash entitlement
will be based on tenure and type of policy.
MBF Chairman, Mr John Conde, said the
combined group will retain the iconic MBF brand.
“MBF is strong in Queensland, New South Wales
and Tasmania while BUPA Australia’s brands
HBA and Mutual Community – are strong in
Victoria and South Australia.
“Together, the two businesses will create a
competitive private health insurer with a national
footprint.”
Mr Conde said the Board of the combined group
would comprise six directors, three each from
MBF and BUPA. MBF Managing Director and
Chief Executive Officer, Eric Dodd, would become
managing director of the combined group to
guide the implementation of the merger before
Private Hospital - April 2008
making the transition to a non-executive
board role.
55
Mr Dodd said the merger was a significant step in
the consolidation of the private health insurance
industry at a time when rationalisation has never
been more essential. “Bringing together MBF and
BUPA Australia Health’s brands will create a strong
and competitive health insurance group with
national reach. This is something MBF has wanted
to achieve for a long time.”
The ACCC has said it will not oppose the merger.

56
Health Privacy – Everything You Wanted to Know
Five new information sheets and seven new Frequently Asked Questions
(FAQs) related to health privacy have been released by the Office of the
Privacy Commissioner.
The new information sheets are intended to
assist private sector health service providers
in fulfilling a range of obligations under the
Privacy Act 1988 relating to use, disclosure and
individual access to health information.
The information sheets address key health
privacy issues which stakeholders in the private
healthcare sector have raised as needing
further clarification or guidance.
The information sheets have a one-page
snapshot of ‘Key Messages’ on the front page to
assist busy providers on the relevant issues. This
is followed by a more detailed explanation for
providers, practice managers and peak bodies
who seek further information and practical
examples. Several of the examples provided
draw on real (de-identified) cases that have
been investigated by the Office of the Privacy
Commissioner.
The titles of the information sheets are:
• Denial of access to health information due
to serious threat to life or health
• Fees for access to health information under
the Privacy Act
• Use and disclosure of health information for
management, funding and monitoring of a
health service
• Disclosure of health information and impaired
capacity
• Sharing health information to provide a health
service
The seven new FAQs cover similar issues to
the five new information sheets. The new
FAQs are primarily designed to provide brief,
user-friendly guidance to health consumers.
It is hoped that the FAQs will promote greater
understanding of privacy rights and raise
awareness of information-handling practices
in the health sector.
Copies of both the information sheets and the
FAQs can be printed from the website,
www.privacy.gov.au. Additional copies can
be mailed on request by calling the Office of
the Privacy Commissioner’s Office Enquiries
Line on 1300 363 992.

58
pharmacy focus....
with Michael Ryan
Measuring the performance of the Drug Committee
The potential of the multi-disciplinary drug and therapeutics committee (DTC)
is too often not realised and as a consequence medicines are not used as safely,
efficaciously and cost-effectively as possible in hospitals.
A DTC potentially can have a significant impact
on medicine use outcomes – clinically and
financially 1 . Unfortunately the DTC for many
hospitals is underutilised or underperforms.
For many, it is a necessarily evil – a committee
created to meet perceived ACHS requirements,
or to deal with a ‘rag-bag’ of medicines or
pharmacy-related issues.
Individual DTCs have attempted to measure
their performance but there is little in the
literature documenting the processes or the
success of these activities.
The following is suggested as one approach
to providing a mechanism to prove the value
(or otherwise) of the DTC. The approach is
based on my experience in an acute care
private hospital.
Process for measuring DTC performance
This includes:
1. developing objectives for the DTC;
2. developing a strategy to achieve these
objectives;
3. developing an action plan to implement the
strategy;
4. developing a process to monitoring the
progress of the action plan; and
5. measuring the success of the DTC in
achieving its objectives.
Space restrictions limit the number of examples
of putting this approach into action which can
be given here. Additional examples can be
supplied on request. Examples include:
Examples of objectives to:
1. increase the safety,
2. maintain (or reduce) the cost, and
3. increase the quality of medicine use in the
private hospital
• safety as measured by the number and
severity of medicine-related incidents;
• costs as measured by total cost of all
medication per patient bed day or total
cost of care of key diagnosis related groups
(DRGs);
• quality as measured by compliance with
best practice guidelines for key medicines.
The DTC may set objectives such as:
1. reduce the number of medicine-related
incidents reported via the Incident Reporting
System by 25% over the next 12 months;
2. reduce the total cost of medicines per
patient bed day or as a percentage of
hospital revenue, to previous financial year’s
level; OR reduce the total cost of care of
patients for those diagnosis related group
(DRGs) which impact most heavily of total
medicine costs for the hospital;
3. compare the use of high risk or high cost
drugs with peer reviewed guidelines using a
drug use evaluation process.
Examples of strategies to achieve safety, cost
and quality objectives:
1. develop and / or regularly review the policies
and procedures to achieve safe, rational and
cost-effective medicine use;
2. review the medicines which are distributed
via imprest and those delivered by dispensed
prescription to ensure that the top 80% (by
total annual expenditure) in each category is
supplied at the least cost to the hospital;
3. identify the medicines which have the
greatest potential to cause adverse events or
to be inappropriately used (e.g. over-use of
antibiotics for which there is a history in the
hospital of the development of resistance).
Examples of actions to implement strategies
related to safety, cost and quality (organised
as a 12 month action plan):
1. review and update three medicine-related
policies and procedures at each DTC meeting
to ensure that all remain current and
appropriate to the Hospital’s needs;
2. review the imprest and dispensed
prescription charges reports twice yearly
to identify if medicines can be supplied at
less cost using an alternative distribution
method;
3. conduct a drug use evaluation of high risk
or high cost or targeted medicines and
compare usage with peer reviews and DTC
approved guidelines, and take action as
appropriate.
Private Hospital - April 2008
“ The following is suggested as
one approach to providing a
mechanism to prove the value
(or otherwise) of the DTC.
The approach is based on my
experience in an acute care
private hospital.”
Monitoring the effectiveness of the DTC
At the end of the 12 month period, the
secretary of the DTC should report on the level
of achievement (complete, partial, none) of the
objectives as each is quantifiable.
In summary
Adapting an approach such as this allows the
DTC to:
• set measurable objectives through a
multi-disciplinary committee related to
the medicine-related issues of greatest
importance to the hospital;
• measure the DTC’s progress in achieving these
on a 12 monthly basis; and
• assess the DTC’s performance in contributing
to safe, cost-effective and quality use of
medicines.
Reference:
1
An EL, Day RO, Brien J. Improving decision
outcomes of drug and therapeutics
committees. J Pharm Pract Research 2003; 33
(1): 65-7.
Michael Ryan, BPharm, FSHP, MBA
Director, PharmConsult
PharmConsult is Australia’s pre-eminent
hospital pharmacy consultancy advising
hospitals on the operational, financial,
professional, service, and legislative issues
associated with hospital pharmacy services.
Telephone: 03 9813 0580
Email: m.ryan@pharmconsult.com.au

MABEL – Improving the working life of Doctors
MABEL (Medicine in Australia: Balancing
Employment and Life) is a major new national
longitudinal survey of doctors, funded by the
NHMRC. Policies about the medical workforce
and how to alleviate shortages of doctors
need to be based on evidence about doctors’
own views, preferences, and work and family
circumstances. Without such evidence, policies
may be insensitive to the realities of medical
practice and less likely to be effective. MABEL is
More talk, more action required
in treatment of type 2 diabetes
The National Prescribing Service Limited (NPS) is advising health professionals
to be more aggressive in their management of patients with type 2 diabetes.
The latest education program for NPS – ‘Early
use of insulin and oral antidiabetic drugs’
– focuses on appropriate drug therapies, earlier
introduction of insulin, lifestyle interventions
and the close relationship between type 2
diabetes and cardiovascular events.
NPS spokeswoman Judith Mackson said a
plethora of recent information surrounding
the risks of thiazolidinedione (glitazone)
use, the need for more pro-active medical
management of diabetes and patient
resistance to introducing insulin had created
concern and uncertainty among some health
professionals about how to escalate treatment
once control is no longer achieved with one or
two oral agents.
“When dietary changes, adequate regular
exercise and oral agents are failing to control
blood glucose levels, it can be challenging
for health professionals to know which drug
therapy will be suitable for their patients,” Ms
Mackson said. NPS still recommends metformin
as first-line therapy in most cases – either alone
or in combination with other
oral drugs.
“When oral therapy is no longer working
effectively, early introduction of insulin is
optimal for reducing diabetes-related
micro-vascular complications and maximising
overall health. However, convincing patients
the first survey that will provide such rigorous
evidence in Australia. The longitudinal nature
of the survey will enable changes in doctors’
views and circumstances to be followed
up over time. The survey gives doctors the
opportunity to provide information about what
it is like working in medicine and how this
interacts with their personal life. Invite letters
for the first wave of the survey will be posted
to a stratified random sample of doctors in May
Private Hospital - April 2008
to start administering insulin is another matter
entirely,” Ms Mackson added. “A major thrust of
this NPS program is advising GPs, pharmacists,
nurses and other health professionals on how
to initiate insulin simply and safely, as well
as specific counselling points to overcome
common patient barriers. Our recommendation
is to introduce night-time basal insulin with
existing combination drug therapy – they
should not be mutually exclusive.”
The program also examines current evidence
and controversies around the benefits and
harms of glitazones, particularly as they relate
to patients with existing heart failure or
ischaemic heart disease and those at high risk.
NPS Facilitators, based in divisions of general
practice around Australia, will conduct
educational visits and group discussions with
a range of health professional groups over
coming months. Additionally, GPs, pharmacists,
nurses and diabetes educators can participate
in a clinical audit and case study, which will
contribute to their continuing professional
development (CPD) points.
To obtain a copy of NPS News or for more
information on the NPS education program,
‘Early use of insulin and oral antidiabetic drugs’,
visit the website www.nps.org.au.
2008. Doctors can also register to take part in
MABEL by going to www.mabel.org.au.
The survey is being led by Professor Anthony
Scott at the Melbourne Institute of Applied
Economic and Social Research (University of
Melbourne) in collaboration with the Faculty
of Medicine, Nursing and Health Sciences at
Monash University, and is supported by a Policy
Reference Group comprising professional
organisations and governments.

62
membership matters... with Goran Josifovski
Delivering Value to Members
With the recent changes in Government and health policy, future consolidation
of the health insurance landscape, and changes to APHA’s constitution and
structure, 2008 is shaping up to be an extremely busy year. The Association’s
commitment to understanding and delivering value to members is particularly
important, moving into the rest of this year and beyond.
APHA Potential New Services –
Web Survey
A survey of senior managers offered to all
APHA member hospitals was recently carried
out and completed via email. A 29% response
rate has provided the APHA with honest and
constructive feedback which will serve as a
guide to our new service undertakings in the
future. The challenge for APHA is to balance
these opportunities with the Association’s
ability to deliver the right services, in order to
ensure maximum benefit to all members.
A number of multiple choice and open
text questions were asked in relation to
APHA developing new services, particularly
focused on educative forums, workshops and
benchmarking activities.
When asked to list the three key issues that
APHA should cover in any educative forums
or workshops, a vast majority listed issues
related to Health funds, Workforce, Safety &
Quality and changes to the IR, legal and policy
environment.
It is perhaps a gauge of the current landscape
that 51% of respondents included contracting,
funding and negotiating with health funds in
their top three issues. This was closely followed
by recruitment and retention strategies and
staffing innovations, which was listed as a key
issue by 37% of respondents. Workshops on
implementing safety and quality initiatives
were also a popular topic highlighted by
respondents.
Members indicated that workshops or
educative forums should be run a maximum
of four times per year and that a fee for service
model would be acceptable depending on
the type of workshop or educative forum
being run.
APHA will look to implement at least one
stream of educative forums or workshops
regularly, on one of the above issues, over the
next 24 months. We will also look to run these
workshops in partnership with a recognised
training provider, where applicable.
At present, a large number of APHA member
hospitals carry out benchmarking actions
on various operations. According to the
survey results, 98% of respondents utilize
benchmarking tools, with 30% developing
their own internal benchmarks. The remainder
of respondents’ utilise external tools of which
Press Gainey (21% of respondents), NHCDC
(17% of respondents) and QPS (11%) are the
most popular.
Qualitative data collected pointed to a number
of barriers which may cause difficulties in
implementing these benchmarking tools.
They include:
- Complexity of the industry (Not for profit vs.
for profit)
- Being able to compare hospitals with similar
case mix and structure
- Getting buy in from a majority so that initial
data is not skewed and/or obvious as to
who has submitted it. Establishment of peer
groups may assist with this issue.
- Keeping cost below $1,000 per module/per
annum
- May require a seed funding investment by
APHA to develop and trial benchmarking
product.
I believe that APHA should continue to assess
the validity of offering benchmarking services
to members; however it is important that we
can confidently navigate around the above
challenges in the first instance.
Member Services Audit
Whilst looking to add new services,
APHA is also keen to ensure that current
members understand and utilise the various
communication services we already provide.
To this background, a review of member
entitlements is underway at present, with
a view to ensuring each hospital employee
on our database is communicated with via
our weekly news, information papers series
(quarterly), member only bulletins, Private
Hospital Magazine (bi-Monthly) and web access
to our member only portal. If you have any
Private Hospital - April 2008
“ I believe that APHA should
continue to assess the validity
of offering benchmarking
services to members; however
it is important that we can
confidently navigate around
the ... challenges in the first
instance.”
questions regarding current member services,
please contact me on 02 6273 9000 or
goranj@apha.org.au.
National Congress
With various changes in the Private Hospital
sector on the horizon the APHA National
Congress and APHA/Baxter Awards should
already be a fixture in your calendars for 2008.
The aptly themed congress “Private Hospitals:
2020” will look to shed light on what the
future holds for our industry. The congress will
run from 26th-28th October at the Adelaide
Convention Centre with topics covering
workforce issues, safety and quality, future of
private hospitals and leadership in healthcare.
The congress will conclude with a motivational
speaker, ensuring each delegate takes
something away from the congress. For more
information on the APHA National congress
please visit www.apha.org.au.
With so much on the cards, I am confident
that 2008 will be a challenging, and hopefully
rewarding year for APHA and our members.

Private Hospital - April 2008
63

Advertorial

66
An ‘EMU’ up and running at Sydney Adventist Hospital
Sick or injured people, particularly the aged, are united by one wish
– the quickest access to competent assessment, diagnosis, stabilisation
and treatment.
Now thanks to a new multi million dollar
dedicated Emergency Medical Unit (EMU),
part of the soon to be redesigned Emergency
Care Department at Sydney Adventist Hospital,
residents on Sydney’s Upper North Shore will
have it.
The Emergency Care Department currently
treats more than 20,000 patients a year, has
24 beds, and is staffed by over 20 emergency
doctors, and dozens of nurses, allied health
professionals and administrative staff.
Since it opened in 1996 the EC has seen a
dramatic rise in the number of aged patients.
Between 2003 - 2007 the proportion of patients
aged 55 and over admitted to the Hospital
via Emergency Care has risen from 63% of
all admissions to just under 70%. Similarly
the proportion of patients aged 75 years and
over has risen from 38% to almost 44% of
admissions.
Planning ahead to meet the challenges of
helping more patients with a complex range of
medical conditions, Sydney Adventist Hospital
(the San’s) new dedicated Emergency Medical
Unit is a key part of the expansion and redesign
of the busy Emergency Care Department.
The San’s Emergency Care Department is a
critical facility supporting the 160,000 yearly
admissions, the 500 visiting medical officers
and the 2000 staff of the largest single campus
not for profit private hospital in NSW.
Dr Greg McDonald, Emergency Care Director
says the additional 9 bed EMU, is the result of a
thorough assessment of how different patients
have different needs and different ‘journeys
of care’ when they arrive at emergency.
The redesign will speed up access to triage,
medical consultation, diagnosis, treatment and
discharge or admission.
“Experience here at the San, and Australiawide
and international research, has taught us
that a well designed space that allows us to
allocate patients to certain areas based on their
condition and their needs, maximises the care
we can give, and it maximises the number of
patients we can help in the fastest time” said
Dr McDonald.
“And when you’re unwell, that’s what
important.”
“An addition to our existing 24 emergency
care beds, the 9 bed Emergency Medical Unit
is a dedicated space where we will care for
patients who will be discharged or admitted
into the main hospital within a 23 hour period,
after initial assessment, tests and treatment.
These patients don’t need or want to be
where patients with more complex needs are
being cared for. Medical and nursing care and
efficiency will be maximised.”
“No matter why you attend Emergency Care
- chest pain, gastroenteritis, fractures, wounds
or infections - you want to know that we will
care for you as quickly and as effectively as
we can. Having separate dedicated triage,
Jill Watts to head Ramsay UK
Ramsay Health Care has announced the appointment
of Associate Professor Jill Watts to the position of
CEO of Ramsay Health Care UK. Jill is currently CEO
of Greenslopes Private Hospital in Brisbane and has
more than 30 years experience in healthcare both as a
practitioner and as a senior executive.
Jill grew up in London, where she started her
healthcare career, before relocating to Australia
in 1981. She has been at Greenslopes since 2001
and prior to this role held executive positions
at other private hospitals in Australia. As well as
Private Hospital - April 2008
emergency medical unit, resuscitation, trauma
area, fast track and aged care observation
areas is all about us recognising that we have
a diverse population and an increasingly busy
Emergency Care department, but that our
prime concern is to provide the best care we
can for every one of our patients”.
“It is two years ago since we started detailed
discussion and planning on this and other
initiatives, including a new computerised
patient medical record system and extra
emergency care physicians,” said Dr McDonald.
The San’s aim is to constantly make sure we
are at the pinnacle of best practice for our
patients….We want to see them, assess them,
treat them and send them either home or to an
inpatient ward, as quickly as we can.
The Unit is expected to open by Spring 2008.
holding a Masters in Business Administration and
postgraduate qualifications in Health Administration
and Information Systems, Jill also has professional
qualifications as a Registered Nurse and Midwife.
Jill replaces David Hillier, who has decided to move
back to France after accepting a role as Managing
Director of a hospital group based in Paris.
With 30 hospitals and day surgery facilities plus two
neuro rehabilitation homes Ramsay Health Care UK is
one of the largest providers of independent hospital
services in England.

The Baxters
The APHA seeks to stimulate, encourage and recognise the pursuit and
achievement of excellence among its members. Peer recognition provides
an impetus for further achievement; improves the image of the organisation
and its members, both within the health care sector and across the broader
community; increases morale and aids in the continuing endeavour towards
improving quality outcomes for patients.
The APHA/Baxter Awards have been running since 1988 and aim
to recognise private hospitals and individuals that have made an
outstanding contribution to patient treatment and care, as well as
the management of hospital facilities.
Baxter Healthcare has supported the awards since their inception and
continues to see the benefit of highlighting excellence in the private
hospital industry. Their commitment to the awards is synonymous, hence
the awards are known as the Baxters.
This year the Baxters will recognise achievement in three categories:
The Baxters
• Clinical Excellence – quality of care and patient outcomes
• Ambulatory Care Award – acute, day surgery, psychiatric or
rehabilitation
• Community Involvement Award – work with/in local broader
community
APHA encourages you to enter these awards. The awards information
brochure has been sent out to each member hospital via email, but if
you have not received yours, please contact Member Services Manager,
Goran Josifovski on 02 6273 9000 or by email goranj@apha.org.au
The closing date is 30 July 2008.
67

68
Annual licence renewal period for nurses begins
Queensland Nursing Council’s (QNC) annual licence
renewal period for 2008 has begun. Between 1 April
and 30 June 2008, almost 60,000 nurses and midwives
in Queensland must renew their licence to continue
practicing in Queensland.
QNC encourages any nurses who haven’t renewed online before to
give it a go. Online renewal is quick, easy and secure.
• With online renewal it typically take less than ten minutes
to complete—just have your credit card, nurse ID and web
password handy.
• With online renewal all that is involved is a few key strokes and mouse
clicks—no postage or travelling necessary.
• With online renewal all your details are secured with digital
encryption—and you don’t have to worry about your form being lost
in the mail.
Joseph Ransfield was the first to renew this year, when he completed
his renewal online at 12:15 am 1 April, shortly after an evening shift at
Bamaga Hospital, Cape York. Joseph was very surprised that he was the
first nurse in Queensland to renew his licence and said that usually he
is the type of person that leaves everything to the last minute.
Joseph said he found online renewal quick and easy, “Online renewal is
so straight forward. You can’t go wrong.” He said he would recommend
online renewal to other nurses, “You can renew your licence when you
want to, anytime at all. I was just winding down at home after work.”
To renew online, visit www.qnc.qld.gov.au and select “renew your
annual licence” towards the bottom of the screen. Complete the
easy-to-follow instructions and licences will be posted in the mail.
Alternatively licence renewal can be completed either by post or
in person.
To ensure your application for licence renewal is approved in time,
QNC asks that you apply for renewal before 1 June 2007, as this is the
peak time for processing.
To find out more, contact the renewal team today on 07 3223 5188
(for Qld callers outside Brisbane 1300 139 993)
QNC is the regulatory body for nursing and midwifery in Queensland.
Its mission is to ensure the people of Queensland receive safe and
competent nursing and midwifery care by setting the standards for
nursing and midwifery education, practice, licensing and conduct.
“ Online renewal is so straight
forward. You can’t go wrong.”
- Joseph Ransfield
Private Hospital - April 2008

Private Hospital - April 2008
69

70
Courses and
Conferences
The 5th Annual Future of the PBS Summit
will be held on the 6th and 7th of May 2008
at the Radisson Plaza Hotel in Sydney. This
national conference will bring together
senior industry leaders to discuss the future
and sustainability of the PBS in the dynamic
healthcare environment. More information
can be found at www.informa.com.au
Operating Theatre Protocols is one of
many courses organised by the Medical
Technology Association of Australia
(MTAA). This full day course will be held
on 3 June in Sydney and will provide
an assessed overview of the Australian
College of Operating Room Nurses (ACORN)
Standards for visitors to the peri-operative
environment. Past operating theatre
registered nurses (within the last two years)
may apply for recognised prior learning
pending a successful pre-assessment. For
more information see www.mtaa.org.au
The 8th Annual Adverse Events
Management Conference will encourage
an industry wide cooperative approach
to enhancing patient safety and quality,
23-24 June 2008 at the Rendezvous Hotel,
Melbourne. To register visit
www.iir.com.au/adverse
The Amora Hotel Jamison in Sydney will
host the 7th Annual Health Insurance
Summit on 28 & 29 July 2008. For more
information see
www.informa.com.au/HealthInsurance
Founding CEO leaves NEHTA
Dr Ian Reinecke, the founding Chief Executive Officer
of the National E-Health Transition Authority, left NEHTA on 4 April 2008.
Dr Reinecke was responsible for establishing
NEHTA as a company in 2005 and the
subsequent development of a work program
that now involves more than 150 staff working
on a range of complex e-health projects.
Chair of the NEHTA Board Dr Tony Sherbon
thanked Dr Reinecke for his leadership of
NEHTA. “Following funding support from
COAG, Dr Reinecke has negotiated the
contract to establish unique health identifiers
for all Australians as well as their health care
providers.
“This project is now well underway and Dr
Reinecke’s efforts will prove
to be of great benefit in the near future to
millions of Australians.
“Dr Reinecke has also overseen negotiations
for Australia to join the world’s most significant
Private Hospital - April 2008
alliance for the international coordination
of clinical terminology development. This
development has significantly accelerated
the development of information standards
throughout Australia.
“Under Dr Reinecke’s leadership NEHTA has
taken the evolution of e-health in Australia to
a new level where much of its work is ready
for implementation to improve the quality of
electronic health information for clinicians and
consumers,” Dr Sherbon said.
Andrew Howard will act as Interim CEO
of NEHTA while an international search
is conducted to recruit Dr Reinecke’s
replacement. Mr Howard is currently the Chief
Information Officer of the Victorian Department
of Human Services.
Upcoming Safety and Quality
Workshops
Following on from last year’s successful
series of workshops on the National Inpatient
Medication Chart (NIMC), APHA is planning to
conduct a series of workshops for our members
during 2008 focussing on key Safety and
Quality issues.
The next series of APHA member workshops
will cover Credentialling and Defining the
Scope of Clinical Practice. As was the case
with the NIMC workshops, the Credentialling
workshops will be facilitated by experts who
will cover a range of relevant issues, including:
• an overview of the Credentialling and
Defining the Scope of Practice Standard,
(which was developed by the former
Australian Council on Safety and Quality in
Health Care)
• how to implement the Standard with a
particular focus on defining the scope of
clinical practice
• highlighting problems and identifying
solutions, for example around:
- delineation of particular specialities
- performance management
- insurance
- appeals processes
• particular challenges/difficulties faced by
smaller facilities, especially those without an
employed Director of Medical Services and
how these issues may be addressed.
An important feature of the 2008 workshops
is the identification of issues around the
implementation of the Credentialling Standard
in private hospitals that can be fed back to the
Australian Commission on Safety and Quality in
Health Care to inform current and future work
being undertaken on the Standard.
Members will be advised of the dates and
places for the workshops in the near future.

Private Hospital - April 2008
71

Advertorial

One Life, A Second Chance
One Life, A Second Chance, a healthy lifestyle program, has recently been
launched to members from health organisations across Australia. This program
has been produced by Heart Support Australia in a user friendly, DVD format,
and is narrated by Mr. Peter Harvey of Channel Nine fame.
Tony Arvidsson developed this program as a
result of a heart event he experienced many
years ago. At the time there were few resources
available which led him to undertake his own
research into heart disease, risk factors and
lifestyle changes. The program is a result of this
endeavour and he is living proof it works.
For the past 10 years, Tony has presented this
program to patients at the HeartStart cardiac
rehabilitation and Disease Prevention program,
working closely with health professionals in the
region to ensure the program meets the needs
of patients.
As a director of Heart Support Australia,
Tony could see the need for this program to
be rolled out on a national level and gifted
the program to the organisation. This will
enable the program to be utilised in cardiac
rehabilitation units, hospitals and clinics across
the country as well as assist people in rural and
remote areas who have little or no access to
cardiac rehabilitation.
Speaking at the launch was Mr Alan Cooper,
CEO of the Friendly Society Private Hospital,
Bundaberg who said, “Patients who have
suffered an adverse cardiac event are often
bewildered as to what action to take. One Life,
A Second Chance is a helpful DVD to assist
them back on the road to recovery.
“This Self Management tool is not only
invaluable for the patient but is an essential
inclusion in the aids for professional staff who
guide these patients to better health,” Mr
Cooper added.
More information about the One Life, A Second
Chance program can be found at
www.heartnet.org.au.
Private Hospital - April 2008
“ Patients who have suffered
an adverse cardiac event are
often bewildered as to what
action to take. One Life, A
Second Chance is a helpful
DVD to assist them back on
the road to recovery.“
75

More brain research suggests “use it or lose it”
Queensland Brain Institute (QBI)
scientists have found another
important clue to why nerve cells die
in neurodegenerative diseases, based
on studies of the developing brain.
Neuroscientists at The University
of Queensland have just published
findings, which add more weight to
the “use it or lose it” model for
brain function.
QBI’s Dr Elizabeth Coulson said a baby’s brain
generates roughly double the number of
nerve cells it needs to function; with those
cells that receive both chemical and electrical
stimuli surviving, and the remaining cells
dying. In research published in the “Journal of
Neuroscience”, Dr Coulson and her colleagues
have identified a crucial step in the cell-death
process.
“It appears that if a cell is not appropriately
stimulated by other cells, it self-destructs,”
Dr Coulson said. This self-destruct process
is also known to be an important factor in
stroke, Alzheimer’s and motor neuron diseases,
leading to the loss of essential nerve cells
from the adult brain. “We know that a lack of
both chemical and electrical stimuli causes
the cells to self-destruct,” Dr Coulson said.
“But we believe that nerve cells will survive if
appropriate electrical stimuli are produced
to block the self-destruct process that we
have identified.”
The researchers’ next step is to test whether
dying cells receiving only electrical stimulation
can be rescued.
More than three years’ research has gone into
understanding these crucial factors regulating
nerve cell survival, but it is a major step in the
long process of discovery needed to combat
neurodegeneration.
QBI Director, Professor Perry Bartlett said
the research is an extremely exciting finding
because it also provides the missing piece of
information as to how the brain likely keeps
alive the new neurons it generates in some
brain areas as an adult.
“Combining this with our knowledge of how
to stimulate new neurons in the brain of adults
following to disease processes such as stroke,
it provides new mechanisms for the treatment
of a variety of diseases from depression to
dementia,” he said.
Commonwealth Chief Nursing
and Midwifery Officer
The Australian Government has announced
it will establish a new position of
Commonwealth Chief Nursing and Midwifery
Officer (CNMO) in recognition of the vital role
nurses play in our health system.
With more than 200,000 nurses across the
country, working in hospitals, clinics, aged
care facilities and schools, nurses are a vital
part of our health system. This new leadership
role comes in response to strong demand
from the nursing profession.
The CNMO will:
• work towards building and strengthening
the nursing profession as a career of choice;
• play a key role in developing a strategic and
collaborative approach to national nursing
policy across all jurisdictions;
• provide advice on key Government
commitments, including the plan to bring
10,000 nurses into the health and aged
care sectors through a combination of cash
incentives and new graduate places; and
• participate in the development of a primary
care strategy and midwifery review.
It is hoped that the new CNMO will be
appointed by April 2008
77

Book Review
- Community Pharmacy: symptoms, diagnosis and treatment
Authors: Rutter and Newby
Imprint: Churchill Livingstone
269 pages. Price $99.00 (inc GST)
Reviewed by: Ian DeBoos, community pharmacist and qualified practising market
researcher, Hawthorn East, Vic.
In recent years there has been an increased
demand on pharmacists and other non medical
practitioners for advice as a result of some
drug deregulation and the publics’ reluctance
to seek medical advice for seemingly simple
ailments. Therefore, for example, community
pharmacy is often the publics’ first step in
gaining advice on a range of complaints.
This book aims to provide the pharmacist (and
other non medical practitioners) with a greater
and deeper knowledge on a range of minor
complaints so a practitioner may be better able
to distinguish more minor complaints from
more grave scenarios.
The book includes chapters on: the
respiratory system, ophthalmology, otic
conditions, women’s health, gastroenterology,
dermatology, musculoskeletal conditions,
paediatrics, and information on a range of
situations. These situations include motion
sickness, emergency hormone contraception,
nicotine replacement therapy and weight loss.
The layout of each chapter covers basic
anatomy, an understanding of the anatomical
location of major structures, a discussion on
the various common conditions relevant to
the chapter, summary tables and algorithms
to assist the reader to arrive at a differential
diagnosis. It also suggests trigger points for
referral and a list of Australian OTC medications
suitable for treatment. At the end of each
chapter there are a set of self assessment
questions and case histories to test the reader’s
comprehension of the chapter. Throughout
the text, photographs assist the reader in
identifying common conditions and diagrams
summarise the relevant information.
Each book chapter has different coloured
tabs to enable the text to be used as a quick
reference guide but the book could equally be
used for study purposes.
Private Hospital - April 2008
Book Review
“ This book aims to provide
the pharmacist (and other
non medical practitioners)
with a greater and deeper
knowledge on a range
of minor complaints so a
practitioner may be better
able to distinguish more
minor complaints from
more grave scenarios. “
79
The text provides a very good summary of
the more common health conditions that
present in the community. It is easy to follow
and the tables and algorithms are very useful
in assisting a differential diagnosis. However
community pharmacists and other non medical
practitioners often conduct consultations
in circumstances which are not completely
private for the consumer. This limits the
practitioner to a quick and sometimes cursory
visual check of the patient. Common skin
conditions and infestations must account
for many OTC consultations. These are often
difficult to diagnose and the text could be
further enhanced with more photographs of
these type of conditions.
Overall this text as it stands is a valuable
addition to an OTC practitioner’s library of
reference texts and is highly recommended
for those who want to refresh or update their
knowledge.

80
Private Hospital - April 2008

Private Hospital - April 2008
81

82
on the ground...
... with Gail Rice
What is your current job and how long
have you been there?
I am social welfare worker and Veterans Liaison
Officer (VLO) at Canossa Private Hospital in
Oxley, QLD. I have worked at Canossa for
the past 4 ½ years. For most of that time,
I have been the VLO. I have always had a
particular interest in working with the veteran
community.
What is your background for your job?
My father was a WWII veteran and after his
death when I was 12, my mother became (and
still is) a DVA war widow. We were supported
by Legacy and DVA. My welfare studies 30
“ Introducing veterans to each
other is a great example of
how a simple gesture can
make the world of difference.
Canossa will maintain its
commitment to the veteran
community, and I intend to
enhance the standing of our
veterans with all local service
providers by way of advocacy
and respect.”
years ago were funded by DVA. I am now in
the privileged position of applying my welfare
skills and knowledge directly to the veteran
community.
What is Canossa’s commitment to
working with veterans?
Patients with DVA Gold Cards are admitted to
all of our wards – palliative care, rehabilitation,
general medical and oncology. We also hold a
contract with DVA to provide interim care for
veterans and war widows who need care while
waiting for residential aged care. Whilst some
interim care patients are offered placement
soon after admission, some are with us for
several months. This allows us to form a close
bond with the patient and their families.
What are your main responsibilities
at VLO?
I am advised of all DVA patients on admission,
and make myself known to them. Many have
no specific veteran-related needs, so my
involvement may simply be supportive visits.
Others benefit from substantial interventions.
Typical involvement could entail:
• Discharge planning. The best outcomes start
with discharge planning from the time of
admission. This involves a team approach of
assessing patient’s needs and linking them
with services in the community such as
Private Hospital - April 2008
community nursing, meal provision, domestic
assistance etc. A thorough knowledge of
services available and how to access them
is essential for discharge to be effective and
successful.
• Residential aged care. Not all of our veterans
and war widows are able to return home, so
assistance to our patients and their family
through the maze of information, paperwork
etc is provided. Networking with the aged
care facilities ensures optimal assistance to
the patient.
• DVA entitlements. This assessment can be
of benefit to the veteran, as many have
entitlements of which they are unaware. We
have excellent relationships with local RSL
sub-branches who will come to the hospital
to provide advocacy and assistance.
• Psychological support. Veterans (and their
families) often have issues that are best met
by veteran-specific services. Thus, referrals to
the Veterans’ & Veterans’ Families Counselling
Service, Veterans Home Care, Repatriation
Transport Scheme, Legacy, War Widows
Association are regularly made.
What is the best part of your job?
I find the most satisfying part of being a VLO
is the positive response from veterans, war
widows and their family. Without fail, veterans
appreciate that there is someone interested
in them. The veteran community is made up
of a cross section of the community who has
a common thread in their lives – ie service
to their country. Ex- P.O.W.s, those with war
related disabilities, recent widows, the socially
isolated, Vietnam vets with specific needs – all
appreciate the opportunity to interact with
someone who cares about their welfare.
Thoughts for the future?
Introducing veterans to each other is a great
example of how a simple gesture can make
the world of difference. Canossa will maintain
its commitment to the veteran community,
and I intend to enhance the standing of our
veterans with all local service providers by way
of advocacy and respect.

PH Private Hospital - April 2008
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Private Hospital - April 2008