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The Health Wrap: Getting serious about suicide, a private health ‘game of thrones’ drama, ward rounds, food for thought and research rows

This week’s monster Health Wrap, covering three weeks of  health news, is compiled by Megan Howe, the Sax Institute’s Publications Manager. Enjoy the Wrap and tweet us via @medicalmedia or @meghowe68 if you have any ideas for future issues.

Getting serious about suicide

The need to take action to reduce suicide rates has been put on the national media agenda, after NSW Premier John Brogden spoke out about his 2005 suicide attempt.

“Experiences like mine show there is a way back”, Mr Brogden told The Sydney Morning Herald, in an article accompanied by a story urging a national education campaign to address misconceptions about suicide, as recommended in the Lessons for Life report. The joint research project between SANE Australia and the University of New England found that judgement from both health professionals and friends or family hindered the recovery of people who had attempted suicide.

A separate study also revealed that people who had attempted suicide described the treatment they received from medical staff as “negative, angry and irritated”, ABC News reported.  The ABC AM program revealed that the families of several suicide victims believe there are gross inadequacies within the mental health sector in Western Australia, after five patients from the same public psychiatric clinic killed themselves between 2011 and 2012.

And BBC News covered new research which gives insights into ‘pre-suicide’ behaviour, showing that depressed people who display “risky behaviour”, agitation and impulsivity are at least 50% more likely to attempt suicide, a study has found.

The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP), in a statement published on Croakey, called for a national inquiry or Royal Commission into Aboriginal and Torres Strait Islander suicide rates, which are among the highest in the world. Project head Professor Tom Calma said the current tragedy of Indigenous suicide should prompt similar attention to Aboriginal deaths in custody in the mid-1980s.

The need to address “obscenely high” rate of suicides among Australia’s oldest men ‒ those aged over 85 years who are three times more likely to kill themselves than the national average ‒ was the focus of an article (paywall) in The Australian. Writing on The Conversation, Brian Draper of The University of NSW said with our rapidly increasing ageing population, there was an imperative to address the issue, and urged the implementation of well-researched programs for preventing late-life suicide.

The calls came after leading economists including Allan Fels and Ross Garnaut called on the federal government to embrace mental health as its next big reform agenda, warning it is costing the economy more than $60 billion each year, as reported by the Australian Financial Review (paywall).  Fels, the chairman of the National Mental Health Commission, said that much of the federal government’s $10 billion spending on mental health and suicide prevention was being wasted on “downstream programs” that were “neither effective nor efficient”.

For help or more information

For people who may be experiencing sadness or trauma, please visit these links to services and support

• If you are depressed or contemplating suicide, help is available at Lifeline on 131 114 or online. Alternatively you can call the Suicide Call Back Service on 1300 659 467.

• For young people 5-25 years, call kids help line 1800 55 1800

• For resources on social and emotional wellbeing and mental health services in Aboriginal Australia, see here.

********

Private health ‘game of thrones’ drama

The question of who should pay for hospital mistakes ‒ or adverse events ‒ is at the centre of a public stoush between health insurer Medibank Private and the Calvary hospital group that has continued to play out in the media over the past few weeks.

The insurer had revealed it would not pay for events it deemed preventable, sparking headlines such as “Medibank won’t pay for suicides, death in childbirth or falls in hospitals”.

The AMA urged the Federal Health Minister Sussan Ley to step in to resolve the dispute. Ms Ley did step in, firing a warning shot to both parties and announcing that the Government would fast-track a list of avoidable medical mistakes in attempt to settle the row, The Australian reported (paywall).

[quote font_style=”italic”]”Patient safety and welfare should be the priority in any negotiations between private hospitals and health insurers, not used as ransom in a cynical Game of Thrones”, the Minister said.[/quote]

Medibank responded by releasing the full list of the 165 adverse events it deemed preventable and would not cover, winning the support of rival health insurer, nib, but criticism from the Australian Commission on Safety and Quality, which said the list was inappropriate, according to The Sydney Morning Herald .

Just a day before the contract between the health insurer and hospital group was to expire, a deal was struck  that will see the introduction of an independent umpire to determine fault in the case of disputed adverse events, The Australian (paywall) reported.

But the repercussions continue, with the Australian Medical Association criticising the secrecy shrouding the contract deal, as reported by news.com.au, and Michael Vagg writing on The Conversation that Medibank Private had used its market power to crucify private hospitals.  Leanne Wells, CEO of the Consumers Health Forum of Australia, writing on Croakey, said that the episode highlighted the need to “examine and rethink the role and place private health insurance should play in the overall health system”.

Meanwhile, The Sydney Morning Herald revealed that consumer complaints to the Private Health Insurance Ombudsman had hit a 12-year high, with the industry being rebuked for confusing people with vague or conflicting information on benefits, especially public hospital cover.

*******

Dementia and other disease states

The number of people living with dementia is levelling off in parts of western Europe, according to a study reported on by BBC News, which found the proportion of elderly people with the condition in the UK has fallen, contrary to predictions that cases would soar. But globally the news isn’t that good, with a report by Alzheimer’s Disease International finding there are now nearly 47 million people living with dementia, up from 35 million in 2009, and that numbers are set to double every 20 years, with developing countries likely to be hit hardest, Fox News reported.

Meanwhile, a new study showed that people with dementia tended to lose awareness of memory problems two to three years before the condition developed, according to The Guardian, while Australian Ageing Agenda revealed that the team behind Alzheimer’s Australia Vic’s high-tech dementia learning centre picked up first prize and $50,000 at a technology world cup for students in recognition of its ground-breaking virtual reality training program.

If you’ve worked extra long hours this week, you might want to cut back, with a study finding that those working 55 hours or more have a 33% increased risk of stroke compared with 35-40 hours a week, Fairfax’s Daily Life reported.

The Guardian reported that a lack of vitamin D may be a direct cause of multiple sclerosis, according to a study that could have important public health implications since so many people have insufficient levels of the essential vitamin.

And the Daily Mail Australia busted the 10 of the most common myths associated with cancer as outlined by the Cancer Council Australia, including the misconception that drinking water from plastic bottles can cause cancer and that eating apricot kernels can cure it.  The Sydney Morning Herald also revealed a unique collaboration between the Children’s Cancer Institute and Sydney Children’s Hospital called The Zero Childhood Cancer project, which will analyse the unique cancer cells of every child diagnosed with the most aggressive forms of cancer, with the ultimate aim of eliminating child cancer deaths.

*******

Research rows

Medical website Medscape reported on an editorial in the BMJ this week which raised concerns over claims that technology could harm young brains, as put forward in a book by researcher Susan Greenfield. “As scientists working in mental health, developmental neuropsychology, and the psychological impact of digital technology, we are concerned that Greenfield’s claims are not based on a fair scientific appraisal of the evidence, often confuse correlation for causation, give undue weight to anecdote and poor quality studies, and are misleading to parents and the public at large,” the authors wrote.

The question of whether playing violent video games makes young people violent is also in dispute, with BBC News reporting that more than 200 academics have signed an open letter criticising controversial new research that suggests a link between violent video games and aggression.  The report by the American Psychological Association reviewed hundreds of studies and papers published between 2005 and 2013.

In findings described as “bad news for science” by the Science Reporter, a team of international experts who attempted to replicate the findings of 100 studies that had been published in three prestigious psychology journals found that they could do so in less than half the cases.

*******

Vaccine ins and outs

Queensland is in the grip of an influenza outbreak, with nearly half of the state’s 18,000 flu cases this year occurring in the past three weeks.  ABC News reported that one of the two strains of influenza B that is circulating, known as “Brisbane virus”, is not covered by this year’s flu vaccine.

That problem could be overcome in the future, with The Guardian revealing that a universal flu vaccine that protects against multiple strains of the virus is a step closer, after scientists created experimental jabs that work in animals.

The news comes as researchers urged free flu vaccines to be made available to everyone aged over 50, after finding that people who have been vaccinated are 29 per cent less likely to have a heart attack ‒representing a greater protective effect than ceasing smoking and nearly as much as taking anti-cholesterol drugs statins, The Sydney Morning Herald reported.

Meanwhile, warnings that the Fluvax vaccine should not be given to children aged under five due to concerns about febrile reactions are being ignored by some GPs, according to medical news website 6minutes (registration required) with the Department of Health documenting 33 cases of the vaccine being given to a child under five this winter.

ABC News revealed that public health advocates have warned that plans for a “no-vaccination” child care centre in northern NSW are irresponsible and dangerous. The ABC reports that it has seen an expression of interest on Facebook, asking parents if they would be interested in sending their children to such a centre.

Also in vaccine news, a prototype vaccine against the lung infection MERS (Middle Eastern Respiratory Syndrome) has shown promising results, according to BBC News, with a study published in the journal Science Translational Medicine, suggesting the vaccine guards against the disease in monkeys and camels.

*******

Indigenous health reality check

Institutionalised discrimination against Aboriginal and Torres Strait Islander Australians may be behind a widening gap between Indigenous and non-Indigenous patients receiving kidney transplants, a kidney specialist and researcher told Guardian Australia.  Indigenous patients are much less likely to be put on the waiting list for a kidney than non-Indigenous patients, Dr Paul Lawton said, because doctors misunderstood the challenges faced by Indigenous patients and made an assessment of “non-compliance” with current or future treatment.

[quote font_style=”italic”]“What that means is people who are similar to kidney specialists – older, middle-aged, white men – are more likely to get a kidney transplant than middle-aged white women, and white people are much more likely to get a kidney transplant than an Indigenous Australian,” he said.[/quote]

Meanwhile, a report suggested that the eyesight of 32,000 Indigenous Australians could be saved if the Federal Government committed more than $20 million, as reported in The Sydney Morning Herald.

The findings came after Prime Minister Tony Abbott completed a week-long tour of Indigenous communities, where he was given a blunt reality check on the tip of Cape York where primary school attendance is improving but the gap in other areas between mainstream and Indigenous Australians is widening.

ABC News reported on a new initiative which aims to close the chronic disease gap between Aboriginal and non-Aboriginal people called “Healthy Black and Deadly”. The program being launched by Hunter New England Health includes a 10-week school-based program teaching students the benefits of physical education and personal development.

In Western Sydney, an interim health service has been set up in to meet local Aboriginal health needs following the closure of the Aboriginal Medical Service Western Sydney, PS News reported. And in south east NSW, a newly announced funding grant of $1.1 million was the climax of a story of rebirth for the Katungal Aboriginal medical service, according CEO Jon Rogers.

*******

Ward rounds

NSW doctors are calling for more hospital beds after a report showed a 25% increase in patient numbers going to emergency departments over the past five years, according to The Guardian. The latest Bureau of Health Information Hospital Quarterly report showed that compared to the same time in 2014, there were on average about 900 more patients visiting emergency departments every week. The proportion of patients who left emergency departments within four hours was 73% in the April to June quarter, which was one percentage point lower than the same quarter last year, but six percentage points higher than the same quarter in 2013.

The report came after The Sydney Morning Herald  reported on calls for an inquiry into a string of ambulance delays in the state, despite NSW Health Minister Jillian Skinner saying there was no problem with a shortage of resources for ambulances or hospital beds. The newspaper reported that people haemorrhaging blood after a sexual assault or suicide attempt were no longer receiving the most serious “emergency” ambulance response after classification changes that could see them face long waits.

In Victoria, patients waiting too long for treatment will be sent to less busy hospitals to try to resolve a “hidden crisis” in the state’s health system. The Herald Sun reported that the patient-swap plan was unveiled by Victorian Health Minister Jill Hennessy, as a review revealed some patients were waiting up to a year to see a specialist, just to be considered for further treatment.

Meanwhile, a blog on Kevin MD argues that the route to satisfied patients is through satisfied nursing staff, with studies showing that patients’ interactions with nurses are the number-one strongest predictor of patient satisfaction scores.

*******

From the capital

The successful passing of legislation to establish one of the Government’s flagship projects, the Medical Research Future Fund,  had been “buried” by the Government, according to an opinion piece by Niki Savva in The Australian (paywall), who said the marathon Coalition party room debate over same-sex marriage had swamped the good news story.

Meanwhile, The Federal Opposition called on Treasurer Joe Hockey to rule out broadening the base of the GST to include healthcare to raise funds, after Mr Hockey promised to unveil personal income tax cuts before the next election.

And Health Minister Sussan Ley and the head of her Medicare review taskforce, Bruce Robinson, warned stakeholders that Australians would ultimately suffer if the Government could not overhaul primary care funding, in a speech to a Consumers Health Forum function, the Guardian reported. The burden of chronic illness ­required structural changes and a cost-effective and clinically effective Medicare Benefits Schedule, she said.

Her comments were followed by the news that Australians are now making one million Medicare claims a day, as 21 million patients accessed 368 million services on the Medicare Benefit Schedule last financial year, The Sydney Morning Herald reported.

The Government was offered some tips on how to reform the fee-for-service system in a report released by the George Institute for Global  Health stemming from a roundtable of 30 health-related experts. The report puts forward seven recommendations for change, as outlined on Croakey.

*******

Food (and drink) for thought

Food and its impact on health have been making news, with the Aboriginal Medical Services Alliance in the Northern Territory calling for more action from governments to make sure out-of-date food is not on the shelves of remote area stores.  ABC’s The World Today program reported that the alliance says expensive and poor quality fruit and vegetables in many community stores is affecting people’s health.

While the Prime Minister told the ABC AM program that the Government was unlikely subsidise fresh food in remote areas, public health experts writing on The Conversation argued there was mounting evidence that price subsidies can encourage healthier food purchases and are more cost effective than nutrition education.

The debate came as The Sydney Morning Herald revealed that fast-food chain Hungry Jack’s  had breached a children’s food advertising code nearly three times more than the previous year, prompting public health advocates to slam the code as ineffective.  One message about healthier eating appears to have got through to consumers in the UK, with two in three Britons actively cutting back on sugar following warnings from health experts that it is ‘the new tobacco’, The Daily Mail reported. Those reducing their purchases of soft drinks might be reducing their risk of a heart attack, according to a story in UK newspaper The Mirror, which said a major new study of 800,000 Japanese people had found that the more people spend on fizzy drinks, the more likely they are to suffer a cardiac arrest outside hospital.

In the US, the soft drink industry spent at least $US106 million on lobbying and advertisements in the past six years to kill local, state and federal public health initiatives, according to an analysis by the Center for Science in the Public Interest, International Business Times reported.

The report came as an Australian professor defended her involvement in an obesity research group accused of failing to properly disclose funding from Coca-Cola and downplaying the role of diet in obesity. Medical newspaper Medical Observer (registration required) reported that Professor Wendy Brown, a physical activity researcher based at the University of Queensland, is the Oceania representative for the Global Energy Balance Network (GEBN), which aims to tackle obesity based on the science of energy balance. As Croakey reported, the network has been embroiled in controversy over its failure to disclose a $US1.5 million ($2.03 million) donation from the soft drink giant.

*******

The vaping debate

New laws have come into force in NSW banning the sale of electronic cigarettes to anyone under the age of 18, ABC News reported, in the wake of heated debate over a UK public health body’s move to support e-cigarettes. Public Health England came under fire after announcing that e-cigarettes were 95% less harmful than conventional cigarettes and suggesting they could one day be offered by the National Health Service (NHS) alongside nicotine patches as a smoking cessation aid. The Daily Mail reported that it had emerged that the body’s assertion relied on a 2014 study conducted by scientists in the pay of the e-cigarette industry, prompting experts to warn the conflict of interest raised serious questions about the report’s conclusions.

*******

Births… and marriages

The question of whether Australian parents should be able to choose the sex of babies conceived from in vitro fertilisation is being debated, ABC’s PM program reported, with current rules banning sex-selection under review in a new set of draft guidelines which govern Australian IVF clinics.

Meanwhile, the debate over gay marriage shifted into the health arena, with The Guardian reporting that leading public health organisations had written to every federal MP arguing that there is a “strong public health case for marriage equality” and urging all public figures to consider the health impacts of the language used in the marriage equality debate.

[quote font_style=”italic”]“A definition of marriage that promotes social exclusion … compounds health inequities, worsening health outcomes,” the letter states.[/quote]

Other Croakey reading you may have missed:

Comments 1

  1. “…the route to satisfied patients is through satisfied nursing staff, with studies showing that patients’ interactions with nurses are the number-one strongest predictor of patient satisfaction scores”. This is an area ripe for exploration and remediation. I left clinical ICU nursing 2 years ago and had seen a real decline in morale amongst nurses in the 5 years prior to that. “Satisfaction” doesn’t equate with “nice” or “empathetic”, it means that the nurse:patient interaction has positive outcomes. Satisfactory interactions are not congenial chats. They are healthcare events that are vital for patient well being.
    Patients need their needs met and their healthcare outcomes prioritised. Too often, nurses are unable to achieve those outcomes, for multiple reasons. Frequently they do not have time. They do not have autonomy to make decisions and initiate strategies. They do not have management support. There is a real sense of despair and futility for many nurses. Many young graduates leave and pursue more rewarding careers and the older nurses (average age 44 years!!!) are increasingly becoming demoralised.

    There has been a total absence if leadership in nursing at a policy level. Where are the nursing statesmen? When did I last open a major newspaper and read an interesting, insightful opinion piece about the state of the nursing profession in NSW?

    Dorothy Kamaker MN RN
    http://www.patientadvocates.com.au
    http://www.alzheimersassistsydney.com

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