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ePulse, Vol 6 #21

28 Sep 2004

ePulse, Vol 6 #21

This latest email version of GP Pulse, Vol 6 No 21 will not be available on the RNZCGP website until Friday at > The web version provides full indexed functionality with hyperlinks, and may be downloaded, then read when offline.



The work of the College continues unabated, with the Policy Unit currently addressing issues such as After Hours, multi-disciplinary teams, Stress certification, PHO indicators, Sexual Health, ACC's Medical Misadventure, Repeat Prescribing resource, Electronic special authorities, Influenza vaccine consultation, Older Driver licensing, workplace safety. Then there's Maori faculty development, in the Pacific peoples area as well, with our education teams working on the educational needs of Overseas Trained Doctors. Primex is rolling on, with candidates sitting the written papers in five centres on 9 October and the clinical exams in four centres on 6 November. In the AVE programme we have recently employed five assessors to conduct the assessments at the end of the AVE programme. The assessors will be involved in regular training and review. Moving to a smaller more experienced group of assessors we believe will bring greater consistency and robustness to the process. We're reviewing the structure of our website, and setting out the protocols around your crisis line, 0800 769 247



Pharmac is consulting on a number of issues that may affect you in everyday practice. Comments to the Unit by Wednesday 6 October 2004 please:

Electronic special authority applications

What do you think of Pharmac's latest proposal on electronic special authority applications, audit, and requirements for GPs to inform their patients of how their health information may be shared?

Pharmac proposes to roll out the special authority process that requires a digital certificate, Health Intranet access that links with your PMS through broadband. It also intends to introduce an audit of clinicians that use such a system and will require them to sign an agreement stating they understand they could be audited and that they have a duty to remind their patients that their identifiable health information may be used for such a purpose.

The College considers quality outcomes require meaningful input from clinician-based organisations such as the RNZCGP. Essential to this is work on the criteria required for the audit and the evaluation of the process. Of critical importance is the definition of compliance with the criteria (which must be evidence based), and the consequences for non- compliance. These are issues of great interest and concern to the RNZCGP, and we will request that we are involved with any further development in this area.

As a related but side issue do you belong to a PHO and if so how do you ensure your patients are aware of what happens with their health information in this organisation now they are enrolled with the PHO and not just registered with your practice?

Rural practitioners - Remote practitioner supply order review

Would any rural GPs be affected by Pharmac's proposal to change their criteria for being able to apply for Remote PSO's? Do any of you at the moment meet Pharmac's criteria but do not have a RRS of 35 or more?

Pharmac proposes to review the remote PSO list of rural areas so it reflects the Ministry's list of rural areas based on the rural ranking scale. The Pharmac list can be found in Section E Part II of the Pharmaceutical Schedule. They also want to change the word remote to rural.

Influenza vaccination

Do you have any comments to make on this suggested sole supply?

Pharmac proposes to subsidise the Vaxigrip vaccine from 1 March 2005, with a minimum order requirement depending on the time in the influenza season that it is ordered (a minimum of 50 units in March to 10 units in June). The eligibility criteria remain the same, but there may be the opportunity for the DHBs to arrange for their own variation of these criteria. Should a pandemic occur this sole supply status would not hold for the duration of the pandemic.

Bulk Supply Order Review

Would the removal of BSO affect you as a GP? Pharmac is proposing to remove the BSO provision. However the PSO provision would remain available and would be unaffected by this proposal


The Ministers of Transport, Transport Safety, and Senior Citizens have directed the MOT to review, with key stakeholder groups, the policy framework and operational aspects relating to older driver licensing. The report back date, with options and recommendations to Ministers, is 30 June 2005. GPs interested and qualified to represent the College should contact Jim Turner, ph 04 496 5968, email:


The Hepatitis Foundation in Whakatane has asked the College to nominate a representative to a committee to review the protocol for the follow-up and treatment of Hepatitis B carriers. The revised guidelines will be published and distributed to general practitioners and other health professionals. It is envisaged that the committee will also include a hepatologist, an infectious disease physician, a hepatobiliary and transplant surgeon, a gastroenterologist, a virologist, and the Hepatitis Foundation CEO. Communication will normally be by e-mail and teleconference. College members interested should contact Jim Turner at the College,nz.


Waitemata DHB CEO Dwayne Crombie chairs the Safe Use of Medicines group for DHBNZ, and seeks GP input for the group. Any GP with a particular interest in improving medication safety across DHBs should contact him directly, Private Bag 93 503, Takapuna or Ph 09 486 8953.


Date: 15 & 16 October 2004 Friday - 15 October: 2pm to 6.30pm Dinner - 7pm @ Downtown or College?? Saturday - 16 October: 8.30am to 3pm Where: The College, 3rd floor, 88 The Terrace, Wellington Cost for attendance: $100 per person

Workshop theme: Practice Accreditation - Getting started? The CORNERSTONE Accreditation Programme is now underway. - This workshop will help you to apply Aiming for Excellence effectively and prepare for a successful outcome to an assessment visit. Success depends on: - Working together as a team - Having good systems in place - Being organised

This means - 'Buy in' from the whole team - Effective clinical practice - Effective management - Demonstrating to others that you are providing good care The College Quality team will use indicators from Aiming for Excellence to help you: - Learn about - effective processes to prepare for practice accreditation - Learn from those who have been through the assessment and those who carry out the assessments. We want to continue to build a network of people who are passionate about quality in general practice & primary care. This workshop is aimed at GPs, practice nurses, practice managers/administrators, GP liaison group, and others working in PHOs or DHBs.

Do you have a burning issue, new idea or concern? The College is keen to respond and support where possible. Write down your thoughts and bring them to the Issues Forum on Saturday afternoon.

RSVP - 1 October, 2004 - Liz Walters, - phone (04) 496 5993

MOPS Reporting

For the people reporting 1 September 2003 ~ 31 August 2004 the credit summary request was sent out last week. The delay will give registered providers time to get their participation documentation up to date either by paper or by using the MOPS Online process. We will also send to this group the MOPS Programme for the 3rd triennium which began 1 June 2004.


NZRC Core Certification Level 4 -7 Courses at Wakefield Hospital. (8 hours = 16 endorsed credits for MOPS and AVE purposes) Course dates for 2004: Oct 16, Nov 13. You will require the text six weeks prior to the course date to allow for pre-reading. For information or to book please contact: Ginny Abernethy Wakefield Hospital Private Bag 7909 Newtown, Wellington. Ph (04)3818100 Ext 5316 or Email:


The Winds of Change, New Zealand Private Hospitals Association conference, 18-19 October, Westpac Stadium, Wellington. Email:, tel (03)372 9116

Regional Conference on Cost Effective Healthcare 21-23 October 2004, Grand Copthorne Waterfront Hotel, Singapore. Further information:

Integrated Women's Health Care, The Royal Hospital for Women - Centenary Scientific Conference, 20-22 October 2004, Masonic Centre, Castlereagh Street, Sydney Enquiries: Ph (61) 1300 797 794; email:

Three conferences, Wellington,1-6 November 2004 Wellington Convention Centre, 6 November 2004.

Evidence in Action ( Guidelines international network 1 November - 3pm 3 November 5th International Conference on Priorities in Health Care - Internatinal Society on Priorities in Health Care. 4pm 3 November to 5 November. Queries: Wendy Edgar (MOH), (04) 496 2299,

Economics, Priority setting and Health Care Funding, One-day workshop for decision-makers, practitioners and researchers interested in priority setting in health care organisations. To register online:

NEWS DIGEST (from the NZPA wires)


Brussels, Sept 24 Reuters - A Belgian woman has given birth to the first baby born after an ovarian tissue transplant, a medical breakthrough that brings hope to young cancer patients whose fertility may be damaged by treatment. The baby, a healthy girl named Tamara, weighed 3.72kg. Her mother is Ouarda Touirat, 32. "The mother and baby are in excellent health," the spokeswoman told Reuters. "This astonishing feat gives tremendous hope to all women rendered infertile by cancer treatments," the hospital added in a statement. Doctors led by Professor Jacques Donnez, head of the Department of Gynaecology and Andrology at the Cliniques Universitaires Saint-Luc, removed and froze ovarian tissue from Touirat in 1997, when she was 25. Touirat had Stage IV Hodgkin's lymphoma and needed both chemo- and radiotherapy. Such treatments can save patients' lives but can also damage or destroy their fertility. The ovarian transplant was carried out six years after her treatment, when doctors declared she was free of cancer. Four months after the ovarian tissue was transplanted Touirat's ovarian function was restored. Tamara was conceived naturally after the transplant.


Auckland, Sept 26 - Auckland children are five times more likely to be hospitalised with pneumonia than children in other developed countries and researchers are trying to find out why. Childhood pneumonia costs the country about $7 million a year in direct medical costs but much of it is thought to be preventable. Dr Cameron Grant, associate professor of paediatrics in Auckland University's Faculty of Medical and Health Sciences is the principal investigator of a study to look at the reasons for New Zealand's high hospitalisation rates. A paediatrician at Starship Children's Hospital, he said between 1993 and 1996, the admission rate for children aged 0-14 with pneumonia was 5 per 1000. In the United States the figure was five to 10 times lower.


Geneva, Sept 23 Reuters - Russia and Ukraine must iodise all salt to protect their children from the risk of mental retardation, former world chess champion and Unicef ambassador Anatoly Karpov said on Thursday. Russia and the Ukraine account for half of the 2.5 million babies born each year in the former Soviet Union and eastern Europe who are exposed to iodine deficiency, the leading cause of retardation, according to the UN Children's Fund (Unicef). "This is one of the few problems we know how to solve -- we must act strongly and quickly. It only costs five US cents per person per year," Karpov told a news briefing in Geneva. Only 48 percent of homes in Central and Eastern Europe, the Commonwealth of Independent States (CIS) and the Baltic States use iodised salt, according to Unicef.

HUMAN STEM CELLS SHOW POTENTIAL FOR EYE REPAIR Washington, Sept 23 Reuters - Corporate researchers working outside controversial federal restraints said on Thursday they had engineered human stem cells that they believe could be used to repair eyes. The team at Advanced Cell Technology in Massachusetts worked with stem cells taken from human embryos made by a team at Harvard University, and coaxed them to form retinal cells. "This is the first derivation of retinal cells from human embryonic stem cells," said Dr. Robert Lanza, Advanced Cell Technology's scientific director. "We believe these new retinal cells could be used to treat blindness and may, in fact, be the one of the very first applications of embryonic stem- cell technology.''


The contents of ePULSE are sourced from a wide range of organisations and other publications and are presented for the information of recipients. Nothing herein should be construed as reflecting the views, or carrying The endorsement, of the Royal New Zealand College of General Practitioners unless this is specifically indicated.

We also welcome your feedback on what should be included in this update. Use reply email to let Bob Fox know your views, >

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(c) 2004 Royal New Zealand College of General Practitioners. All rights reserved.


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