Category: Blog

Your Say on Cancer WA

Posted on February 15, 2016

A recent state-wide survey shows that many people don’t know that 30 – 40% of cancer cases in WA are preventable. With almost 12, 000 Western Australians diagnosed with cancer every year, this is both shocking and heartbreaking.

 

This information comes from a report recently released by the Department of Health entitled Priorities and Preferences for Cancer Control in Western Australia

 

This report summarises responses to an online public consultation conducted last year on the seven cancers which have the greatest impact on the WA community and greatest opportunity for prevention: bowel, breast, cervical, lung, melanoma, prostate and oesophageal/stomach cancer. The report has revealed that a third of participants were unaware that much could be done to prevent cancer.  In particular, many people were not aware of the dietary risk factors for bowel cancer and that cervical cancer is almost entirely preventable.

 

A poor understanding of the preventability of cancer is not necessarily surprising as historically, much of the discussion about cancer in the community has focused on treatment, sometimes to the detriment of prevention messages.  However, it does highlight the potential for reducing the pain, anguish and cost associated with treating cancer.

 

The value of this new report is that, in seeking out community views on priorities and preferences for cancer control it has identified some clear areas for increased action in the immediate future, including: Increasing the number of Western Australians participating in the National Bowel Cancer Screening Program; Strengthening health promotion messages around recommended red meat intake; reducing processed meat consumption; reducing alcohol consumption; and reducing salt intake, as well as links between obesity and cancer risk; Working to raise the profile of cancer prevention and early detection; and Building on gains made in tackling harm caused by smoking, exposure to ultra violet radiation and asbestos, as well as exploring new and innovative programs to reach vulnerable groups and address emerging issues.

 

This is the first time the Chief Health Officer of WA has asked the community for feedback in a report and the first time (to my knowledge) an online forum has been used to gather community opinion on cancer prevention in WA. As a co-author on the report it was a privilege to bear witness to the frank, open and creative ideas for cancer prevention from our consultation participants.  We are very grateful for their input and the time they devoted to answering our questions.

 

The report was prepared in collaboration with a number of agencies including the Health Consumers’ Council WA, Cancer Council WA, Public Health Advocacy Institute of WA, Curtin University and WA Clinical Oncology Group.

 

To read more about the findings of the consultation and how the Department of Health is responding, you can access the full report here:

 

www.healthywa.wa.gov.au/~/media/Files/HealthyWA/Original/Your-say-on-cancer-wa/13009-chief-health-officer-report.ashx

 

As a project team we also had a lot of fun planning and putting together a consumer website with a range of supporting material including a summary of the report findings, some innovative infographics of cancer data, and expert videos.

 

Check out the website for yourselves here:

www.healthywa.wa.gov.au/yoursayoncancerwa

Guest Blogger: Dr Jennifer Girschik

Pap smear costs- a storm in a teacup?

Posted on January 7, 2016

The announcement slipped in easily enough just before Christmas. On December 15, in its mid-year budget update, the Federal Government announced that they would scrap the incentive payments for pathologists for bulk billing of tests, because the rate of bulk billing had not increased. In other words, the measure appeared to have failed.

This announcement reflects the work being undertaken in the Medicare Benefit Schedule (MBS) reform process which was established in April 2015. The MBS is a list of more than 5,500 item numbers against which medical practitioners can bill the federal government for payment. It is the basis of business models for public, private and not for profit health services. It includes clinical items as well as this type of incentive payment.

Queue then the entrance of the Royal College of Pathologists, and the Australian Medical Association. In other words, organisations whose bottom line is affected by this change. In some online and newspaper reports, figures were put on the cost to consumers of a pap smear  at around $30. On 6th January an article appeared on Mamma Mia’s website, and a petition about the cost of Pap Smears and pathology tests was launched by Change.org. Signatures are nudging very close to 150,000, and rising as this blog is being written. Yet the incentive payment being scrapped was in the region of $1.30-$1.40 according to the Federal Government. In the short discussion I just had with the media spokesperson for the College of Pathologists, the position of the College seems to be a reluctance to nominate an actual figure to be passed onto consumers. So is this an issue, or isn’t it?

I would venture to suggest that it is not. Change is always a difficult phenomenon to manage, and communication seems to have contributed to the backlash the Federal Government is experiencing. The real story is the reason behind the MBS Review and why it is so important for Australians that this happens. Here are some terrifying facts and figures about the MBS provided by our national body The Consumers Health Forum:

  • Until 1 January 2010, there was no clear process for adding new items to the MBS.
  • There was also no clear, consistent system for identifying and removing items from the MBS when they were no longer considered best practice or effective.
  • There was no consistent and formal process in place to test or review items already on the MBS, or new items coming onto it, to ensure they were doing what they were intended to do and were safe and cost effective.
  • Only three percent of items have been assessed for safety, effectiveness and cost-effectiveness. 

You read that right. Only three percent.

So the MBS Review team are carrying on their work, amidst the media cacophony. They are still very keen to hear from the community, but many people find the topic inaccessible and can fail to see how this may affect them. Perhaps this controversy will raise awareness of this enormous and much-needed reform currently unfolding. It is unfortunate that this Review is always going to get caught up in economic rationalist arguments and the undeniable need for our country to reduce its health costs. Public scrutiny will be important to ensure that the focus is on eradicating inefficiencies, duplication and waste rather than diminishing access to quality health services. But let’s ensure that this is a patient centred discussion, not a vested interest centred discussion.

Just before Christmas the MBS Review Taskforce released a new consultation has to look at obsolete MBS items, with feedback invited until 8th February 2016. If you are brave to work your way through the consultation documents, feel free to have your say.

Written by Pip Brennan, Executive Director of the Health Consumers’ Council of WA.

 

The cigarette packet that stops you smoking

Posted on October 12, 2015

All cigarette packets now carry warnings and graphic images to remind you of the dangers of smoking. Now Edith Cowan University and Curtin University researchers have gone a step further. They have built a cigarette packet that talks to you.

The cigarette packet is a plastic case for smokers to keep their cigarettes or nicotine-replacement products. The box is equipped with a speaker and microphone.

Smokers can record their own voice (or that of their loved ones) reminding them of the reason they want to quit. This plays every time the packet is opened.

Associate Professor Paul Chang from ECU’s School of Psychology and Social Science said the idea was to tap into the smoker’s own motivations for quitting.

“So far we have no widespread data, but we have tried the box out on clients of one pharmacy with good results. If you are a confirmed smoker with no intention of quitting you will have no interest in the device. But people who have already tried and failed to quit find it is a really good add on to change behaviour. It is very important for people to have their own personal motivation to do so,” he said.

Every time they open the packet it will give them a powerful motivation to quit once and for all.

“The message should give personalised reasons to quit that are important to the smoker, such as promises they made to themselves, their spouse or their children.”

“One thing I think that could be particularly effective for parents who smoke would be to get their children to record the message, encouraging them to kick the habit.”

Study participant Cathy Skalski said she had reduced the number of cigarettes she was smoking since she started using the packet.

“I have a recording of my two-week old grandson crying on my packet,” she said.

“It’s a great reminder for me of why I want to quit, so I can watch him grow up.”

Ms Skalski said having the sound play every time she opened her cigarette packet was embarrassing. That is a further incentive to reduce her smoking.

“I don’t like people looking at me when they hear the sound of a baby crying when I open the pack, which is good because it means I’m less likely to reach for a cigarette,” she said.

Professor Chang said the next step for the research was to use the data from the study to design a larger randomised control trial.

Professor Chang is currently looking for volunteers.If you are a smoker and want to stop but are finding it difficult to quit, leave a message on 6304 5745 or send an email to: p.chang@ecu.edu.au

By Frank Smith – HCC Blog Contributor

Wasted – did you watch this?

Posted on September 29, 2015

Wasted

Did you watch the Four Corners episode Wasted on waste in health care last night? It is highly recommended viewing and made a number of interesting points:

  1. That our Medicare Benefits Schedule (MBS) pays an amount to a health care provider every time they provide a test or treatment. This provides a perverse incentive for medical practitioners to offer more tests and treatments. And more does not always equal better.
  2. That up until the last five years, procedures were not subjected to an evidence base test before being added to the MBS. Which means there are several decades worth of procedures on the MBS that do not pass the evidence base test.
  3. That there is no connection easily made between the number of treatments done and the health outcomes they are achieving for us. So while data is collected from MBS, from our hospitals and health services, from our diagnostic services, this data is collected in silos and cannot easily be translated into a coherent picture of what works, and what doesn’t
  4. That health consumers are sometimes asking for diagnostic procedures and treatments on the understanding that this will ensure they a) reduce their worries and concerns and b) they will get better.
  5. That it takes time in a clinical consultation to explain why tests and treatments may not actually achieve the outcome the consumer is seeking, and spending more time discussing and explaining treatments and options with consumers is not financially rewarded.

At one point consumers are encouraged to ask questions in order to feel sure that the treatment they are having will a) be useful and b) won’t potentially harm them and c) won’t waste our precious resources. A key question is “what’s the evidence for that?”

The imagery throughout the episode of the journey we all face through the different systems once a test is ordered highlights how important it is for us to get on the train knowing exactly where we may end up.

If you have a body and have ever been to a GP, then this story affects you, and you can be part of the change. The current MBS reform has a consumer survey open until 9th November 2015 which aims to help update the MBS to reduce waste and unnecessary treatments. Jump on board now to have your say – you have until 9th November 2015.

This blog was written by Pip Brennan, Executive Director of the Health Consumers’ Council.