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The soon-to-open Clarence Correctional Centre near Grafton is slated to be ready to accept prisoners by July 2020, however the preparedness of the system to accommodate inmates needs to be matched by the provision of essential community resources such as housing, and a proper assessment of the impact on local (and regional) health services beyond the prison walls.

As has been discovered elsewhere, this is a very complex social and public health issue. When it comes to health if there is one stand out issue of concern it is the interface between NSW Health, the funder of hospitals and justice and community health, and the federally funded Medicare system.

Adding to the complexity is that in NSW there are both State and privately run prisons. However the NSW Justice Health and Forensic Mental Health Network that manage prisoner health also have a monitoring role within private jails, including medical records being handled by their software and stored on their data base.

Dr Hilton Koppe


Australia’s ageing population - largely due, of course, to modern medicine keeping us alive longer - is resulting in an increase in the prevalence of dementia,1 this increasing with age, from about 3.4% at 70-74 years to 20% at 85-89 years, and 40% at 95 years or over. 

As the population ages, the number of people with dementia is estimated to rise from 200,000 (1% of current Australians) in 2005, to 730 000 (2.8% of the projected population) by 2050. Aboriginal and Torres Strait Islander people experience dementia at an earlier age, and at a rate 3 to 5 times higher than the general Australian population.2 

Most people with dementia (84%) first report symptoms to their GP, but a delay between the appearance of dementia symptoms and a confirmed diagnosis  is common, with one-half of those having  early dementia not being diagnosed when presenting to primary care. 3

While the morbidity rates are concerning the incidence of mortality is especially so,  with dementia currently being the leading cause of death for Australian women  and the second leading cause of death overall. 5

Muḥammad ibn Mūsā al-Khwārizm (محمد بن موسی خوارزمی) was a mathematician and head of the library of the House of Wisdom in Baghdad in 820 CE. His book on calculations gave us the word algebra and his name lives on in the term algorithm.

An algorithm, as defined in Wikipedia, is  a “finite sequence of well-defined, computer-implementable instructions, typically to solve a class of problems or to perform a computation. Algorithms are always unambiguous and are used as specifications for performing calculations, data processing, automated reasoning, and other tasks”.

The RSA (Rivest–Shamir–Adleman) algorithm is used for encrypting and decrypting messages. A user creates two paired keys, a public key that is widely disseminated to those with whom you may want to communicate securely and a private key, which unsurprisingly you keep to yourself. In simple terms the way it works is that one of the keys locks the message and only the other can unlock it. Its practical use is to allow the sending and receiving of secure, authenticated messages.

Dr Louise Imlay-Gillespie

On 3 February 2020, the Clinical Year commenced! New interns arrived and we said farewell to many of our previous cohort. This year we have 12 new intern Rural Preferential Recruits (RPR) commencing at the Base to join the current 12 resident RPRs.

There will still be two rotating junior doctors from Prince of Wales as interns and residents (four in total) but our homegrown talent is certainly increasing. This year four of the interns had been students with us and liked us enough to return: generally our reputation as a centre is strong, attracting the other new RPRs. Lastly our retention from residency to PGY (postgraduate year) 3 was also very strong, with our managing to retain the majority of our previous RPRs compared to the state average of less than 20%

The year will see the second tower at Lismore Base Hospital opening, with many wards planned for decanting across in the next few months including the ICU. Exciting days ahead.

Bundjalung artist Digby Moran with Lismore Flood, one of the highlights of his recent ‘Growing up on the Island’ exhibition at Lismore Regional Gallery.

The most public, hence most viewed, work by the late Albert (Digby) Moran spans the facade of Woolworths River Street, Ballina store. The work, or more accurately works plural, as the materials used are quite different, is made up of a painting, Floating Through My Spirit Home, affixed to a large, eye-level glass window, and panels of drilled corten steel*, Someone’s Always Watching You, translated from Digby’s cloth paintings.

Inspired by the Bundjalung side of his heritage and nearby Cabbage Tree Island where he grew up, the works were an innovative commission by the supermarket in 2014. They will remain here in perpetuity, a short walk from the Richmond River that figured so prominently in the artist’s life. (Another large work adorns the Goonellabah Sports & Aquatic Centre).