Preoperative iron management has improved on the North Coast in the last 18 months. However there is still room for further improvement, particularly in major bowel surgery. The local co-ordinator of the project, Beverley Hiles, reports on progress to date. 

The Australian Commission on Safety and Quality in Health Care has been conducting the National Patient Blood Management Collaborative (NPBMC) since July 2015. Lismore Base Hospital and Lismore St Vincent’s Private Hospital along with the North Coast Primary Health Network have been a part of this national collaborative.

The aim of the collaborative is to identify and manage preoperative anaemia and/or iron deficiency in patients scheduled for elective surgery where significant blood loss could occur, namely in gynaecological, gastrointestinal and orthopaedic surgical streams. It is a key patient blood management strategy for optimising red blood cell mass before surgery while aiming to reduce blood transfusion which may be an independent risk factor for increased morbidity and hospital length of stay.

First Fleet in Botany Bay, 21 Jan 1788
General practitioners are small business owners working independently and unfamiliar with the process of tendering. The awarding of contracts is a discipline that has matured over the last 230 years. History has much to teach us. 
The loss of the American colonies in 1783 marked the end of transportation of British convicts to the New World. It is estimated that over 50,000 made the trans Atlantic journey in the century prior. The industrial revolution was changing British society and increasing numbers of workers were replaced by machines. The unemployed flocked to work in the cities but industrial growth was not strong enough to accommodate their number. Idle hands are the devil's workshop. 

Sophie Wagner (centre, orange top) with fellow medicine students at the Indigenous orientation program organised by the University Centre for Rural Health. Here, they are learning to make fish traps with Bundjalung woman Monica Kapeen.

She’s already a qualified pharmacist and now Northern Rivers-born Sophie Wagner is studying to become a doctor as well. Sophie, whose mother Fiona is a well-known doctor working at St Vincent’s in Lismore, grew up in Woodburn and completed high school at Summerland Christian College and later Trinity Catholic College. Her father Stephen is a local mechanical engineer and farms sugar cane and cattle. She finished a four-year pharmacy degree at The University of Queensland before undertaking her full registration at Dubbo Base Hospital where she got a close-up look at the medical world. Later, she worked in a local pharmacy in Sydney. Now Sophie is in her third year of medicine at The University of Sydney, a milestone marked by supervised practicum placements in clinical settings that include hospitals and primary care.

frozen Medicare

The new federal Health Minister Greg Hunt has been left in no doubt about Australia’s doctors’ views on the need to lift the government’s freeze on Medicare rebates.

While welcomed to the job by the Royal Australian College of General Practitioners and the AMA, Mr Hunt, who replaced Sussan Ley, heard the heads of both bodies say the freeze, which limits the amount reimbursed to GPs from the government at $37 per consultation, should be ended.

RACGP president Bastian Seidel described the appointment of a new minister as “a timely opportunity for the government to regroup and bolster its focus on general practice.”

Dr Seidel continued, “The provision of essential medical care for Australians has reached a crossroads and the nation’s general practice profession is at breaking point… Here is a fresh opportunity for the Federal Government to demonstrate once and for all it is committed to equity in health care and a general practice system accessible to all Australians.”

He said “the first and most effective move Minister Hunt should make is to heed the RACGP’s call to lift the Medicare freeze.”

Lilli Pilli fruit

After a wait since the opening of the new Byron Central Hospital in mid-2016, the impressive sub-acute mental unit at BCH will open on Monday 16 January. In keeping with a re-naming of mental health facilities across the Northern NSW LHD, it will have an aboreal moniker, in its case ‘Tuckeroo’.

“By mid-2017, we will see an increase of 20 additional mental health beds across the LHD, bringing the total number to 93,” Chief Executive Wayne Jones said.

Included in this number will be ‘Lilli-Pilli’, a new 16-bed dedicated older persons’ mental health treatment space within Lismore Base Hospital.

The Child and Adolescent Mental Health Unit at LBH will be called “Kamala”, while the Lismore Adult Mental Health Unit will be known as “Tallowwood”.

The Tweed Valley Clinic is now “Kurrajong – Tweed Mental Health Unit”.