Slugs and snails and researchers' tales - Autumn 2021 - The LARCS aren't singing Virtual Reality helps healing - Nordocs
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Autumn 2021
Slugs and snails and researchers’ tales
The LARCS aren’t singing Virtual Reality helps healing
info@nordocs.org.au nordocs.org.au
NorDocs | 1
in this issue
Editorial3
Dr David Scott awarded OAM 5
Connecting dads and their babies, a great start for life 5
NorDocs Board 2021 6
NorDocs Webinar Series 7 Photo by Tmaximumge form PxHere
New board members for Healthy North Coast 8 Cover photo: Our cover does not depict
the coronavirus 2 (SARS-CoV-2), a.k.a.
The importance of diversity on boards 9 COVID-19, pictured above, but an uncanny
Vale Mungo MacCallum 10 look-alike, the Janolus nudibranch,
photographed by marine scientist
Slugs and snails and researchers’ tales 11 Prof Steve Smith from Southern Cross
University.
The LARCS aren’t singing in Australia 12
To borrow the words of Sir David
WellMob – your ‘one-stop shop’ website for Indigenous wellbeing 13 Attenborough, Prof Smith must have “one
Who’s where? 15 of the best jobs in the world”, and in this
instance he was working in sheltered
Phones swat virus-bearing mozzies 16 rockpools along the Coffs coastline, around
the Solitary Islands.
Mental health inquiry calls for a sectoral ‘refocus’ 17
Less attractively known as a ‘sea
Massive health spend delivers mixed results 18 slug’, this creature is part of a large and
distinctive family found along much of the
North Coast Cancer Institute turns ten 19 Australian east coast.
Radiotherapy for skin cancer – an overview 20 Working further afield is another SCU
researcher, Dr Steven Purcell, whose
Of circuses, sideshows and high-wire feats 23 focus is the ‘sea snail’, more accurately
Virtual Reality moves from gaming to healing 24 the trochus, which he found to be having a
positive ecological impact on coral reefs in
Timing is right for SCU’s new health head 27 Samoa.
Book Review 29 A healthy environment is essential for
the physical and mental wellbeing of us all,
Tapa designs take a lot of beating 31 and NorDocs is pleased to be introducing
Allied Health on the North Coast 32 a regular ‘Environment’ section to our
magazine.
Rising vaccine hesitancy needs urgent addressing 34 We are not ignoring the ongoing
The jumble of recovery 35 impacts of COVID-19 – if only! – and the
impending vaccine rollout. Unfortunately,
Benefits of eReferrals becoming clear 36 the pandemic story seems set to continue
all year, and probably beyond. If anything
People with disabilities and the Covid-19 pandemic 39 can be predicted it would be to forget
international travel and to enjoy life within
our own safer borders - and our magical
waters.
nordocs on the web: www.nordocs.org.au Cover photo: Professor Steve Smith,
search - NorDocs is available in pdf and Issuu format from our website. Article references are Southern Cross University
available via the online hot links.
subscribe - Get the latest from NorDocs by subscribing to the newsletter editorial team
Dr David Guest Clinical Editor
write - Unless otherwise stated all articles in NorDocs can be reshared under CC BY-SA 3.0 AU editors@nordocs.org.au
NorDocs welcomes contributions from members and the general public.
Dr Andrew Binns GP Contributor
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facebook - join the private group Northern Rivers Doctors Group on Facebook Robin Osborne Editor
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2 | NorDocs
Editorial
Vaccine monitoring is up with the AIR
As summer ended we read the news that and given the pressure to get the vaccine
COVID-19 related deaths in the USA out with minimal delay, the task was never
exceeded 500,000 - that’s deaths, not cases going to be easy. Some suggestions for
- while in Australia the case tally stood at the program that made their way into the
under 10, with no new cases in NSW at the initial plans may have been visionary but
time. were clearly never going to work. They had
survived the first round of brainstorming
Phase 1a of the Australian Covid-19
in Canberra and were “pencilled in” before David Guest, Clinical Editor
vaccination national roll-out strategy has
more experienced administrators took
just commenced. It will take the rest of the huge scale of the nationwide vaccination
control.
year to vaccinate the majority of the over- program, the government recently
fifty years population but once 70,000 While it is easy to be critical, success enacted the Australian Immunisation
quarantine border workers and 100,000 will be defined as getting the majority of Register Amendment (Reporting) Bill
high risk health workers are vaccinated the Australian population vaccinated by 2020 mandating compulsory upload of
by early April the rest of the country can the end of the year. Keeping things simple COVID-19 vaccination data records.
exhale with a big sigh of relief. may be the key. A loose translation of 19th
While most GPs would regard this as
century German Field Marshal Helmuth
It is a tribute to Australia’s health system reasonable, given the nationwide crisis we
von Moltke’s remark, “No battle plan ever
and our public health workers that we have are facing, many have been surprised at
survives contact with the enemy” is apt.
weathered this storm better than nearly the harshness of the penalties for failing to
every other country. There is the feeling Even as we start the program it is lodge the data within a two-week period.
that life is getting back to normal, although confusing to have two different vaccine In theory the penalties could amount to
the ‘new normal’ is still spoken about. treatments. The ‘brand name’ debate several hundreds of thousands of dollars. It
Australia’s unemployment peaked at 7.5%, is hotting up in Europe as I write. This does look pretty heavy handed.
which was less than predicted, with the however merely reflects the difficulties
The only way GPs could cope with
recovery in job numbers in the last four of trying to manage a new and unknown
the requirements to upload such a large
months being strong and much faster than disease. In early 2020 the Federal
number of vaccine record submissions
in previous recessions. government was competing with other
is by using an automated system linked
governments around the world for vaccines
The Federal and State governments of to the practice’s usual electronic record
of unknown efficacy. Backing at least a
all persuasions, and their Oppositions, system. These systems are now largely in
couple of horses was only sensible.
have united behind the efforts to contain place, which is quite an achievement but it
and manage the virus and the downturn in Some vaccine efforts such as the does put the final nail in the coffin for non-
the economy. They have mostly succeeded, University of Queensland’s failed, not computerised general practice.
with only occasional bickering when under because they were ineffective, but because
GPs are also concerned about the logistics
the most extreme public (and media) of other unforeseen effects. UQ’s vaccine
of roll-out of the vaccines nationwide. In
pressure. would have rendered many Australians
recent years the Department has taken
positive for AIDS; falsely positive, but what
Australia as an island surrounded by a an increasing command and control
alarm that would have caused.
large maritime border, distant from other approach to the delivery of influenza
populous areas, has been in a fortunate It is therefore unlikely that the current vaccines. Delaying the commencement of
position. Look at the situation in Indonesia Pfizer and AstraZeneca vaccines that vaccination until mid-April and tightening
or PNG. It has been easier for us, to Australia has purchased will be the best the window for delivering the vaccine has
bowdlerise former Prime Minister Tony choices in the future. put increasing pressure on general practice
Abbott, to “stop the viruses”. logistics. The difficulties have been further
Monitoring the vaccination status of the
compounded by problems with the supply
The Federal Health Department has nation has been entrusted to the Australian
chain resulting in hundreds of hours of
stated that, “Rolling out the COVID-19 Immunisation Register (AIR). The
wasted practice time cancelling scheduled
vaccine is one of the greatest logistical Register has been tracking all vaccinations
clinics and then scrambling to reinstate
challenges in the nation’s history.” It will since 2016 and all childhood vaccinations
them when the supplies finally came
fall to general practice to deliver the vast since 1996. The COVID-19 vaccines have
through.
majority of these vaccinations. The tasks been added to the register.
are challenging at all levels of the program, Adding two COVID-19 vaccines to this
Previous uploads of data from GPs
from national to state and regional levels mix, each given at least a few weeks apart
to the AIR were voluntary and in some
and even down to the pointy end at the GP and separate again to the influenza vaccine,
cases were incentivised by payments for
clinic itself. has the making of a logistical nightmare for
lodging updates. Given the seriousness
thousands of practice managers around the
With so many unknowns and variables, of the COVID-19 pandemic and the
country.
NorDocs | 3
Editorial
continued from P3
the LHD and State. able to address the identified skills gap
While few GPs believe the rollout will in the current Board structure. Their
The North Coast Allied Health
be trouble free, coping with uncertainty appointment is expected to be announced
Association (NCAHA) is one of the five
and imperfections in the system is in the near future.
member organisations of the North Coast
something with which most of us have had Primary Health Network. On page 32 they Leaving the Board in 2020 after nine
long experience. We’ll probably muddle outline their vision for the North Coast. years were previous Chairman, Tim
through. Their vision for patient centred, multi- Francis, a GP/anaesthetist from Urunga,
On a brighter note - congratulations to disciplinary, team based, collaborative care Dr Chris Jambour, founder of the Grant
Dr David Scott on receiving the Order of echoes the same values as the Australian Street Medical Centre in Ballina and former
Australia Medal in the recent Australia Medical Home model of care. Alas this Director of Medical Services LBH, Naree
Day honours. On page 5 Dr Brian Pezzutti concept seems to have gone out of fashion Hancock, a North Coast administrator in
marks David’s many achievements leading in government health circles. health and education and Scott Monaghan,
to this award. CEO of Bulgarr Ngaru Medical Aboriginal
NCAHA laments that the current
Corporation.
Technical solutions and technical approach is failing on the North Coast and
problems abound in medicine just as they they call for stronger inter-disciplinary The new-look Board is better positioned
do in general life and some long for the integration and training, particularly for to take the NCPHN from its former role
“good old days”. However, as Franklin those dealing with chronic and complex of a support organisation for primary
Pierce Adams had noted, “nothing is more care patients. Current health care funding health practitioners to that of a lean,
responsible for the good old days than a models perpetuate the ineffective status innovative, technically advanced and
bad memory”. quo and they challenge the government to efficient commissioner of Commonwealth
once again innovate in this area. health services focussed on high value
In this issue we report on a few of deliverables to the government. This new
the many IT related innovations whose GOBSAT guidelines (Good old boys
focus is succinctly elaborated in NCPHN’s
progress has been accelerated by the sitting around a table) defined the
2020-2021 strategic plan.
COVID-19 virus. On page 13 Well Mob traditional care pathways in a bygone era.
outlines the resources they have developed They failed on multiple levels, not the least We wish them luck.
to reach the indigenous community with being the lack of an evidence base and nor
Other recent changes at NCPHN
assistance for the social and emotional were they patient centred.
also reflect a lesser role for local health
wellbeing of their clients. The modern focus for organisations organisations in determining the NCPHN
Last year’s rains resulted in worsening involved in health care is to build structures Board’s makeup. While some see this as
allergies in the spring and also more that reflect the local population and which detrimental it does obviate any potential
mosquito borne infections such as Barmah truly represent their communities. Gone conflicts of interest where Board members
Forest and Ross River viruses. Local are the days of decree by the white male were also associated with contractors to
councils in conjunction with the North patriarchy. the NCPHN. This had been an area of
Coast Public Health Unit are trialing an particular concern to the Executive and the
On page 9 North Coast Primary Health
SMS notification program on the risks and Department.
Network CEO, Julie Sturgess, highlights
preventative measures for these diseases the importance of diversity for local health On page 7 we outline our vision for the
(page 16). organisations mirroring a similar thrust in Nordocs monthly webinar series and
On page 24 North Coast Australia’s top 300 ASX companies which appreciate any feedback, recommendations
neuropsychologist, Lynne Ridgeway, writes has the interim goal of at least 30% of or assistance with our education program.
about the ways in which virtual reality Board members being female. The Board hopes to reinstate face to face
is being used in various conditions such meetings once the vaccination program has
Reflecting this new push to diversity at
as pain management, psychological and reached relevant targets later in the year.
the NCPHN, Ms Sturgess welcomes two
neurological disease. VR is not just for eminent Australians to their Board. Among Closer to home, NorDocs also has a
games, apparently. many other roles Graeme Innes is a former new Board, as we report on page 6. Local
Getting the right information to the right Human Rights commissioner and Kerry haematologist and new mum, Louise
person at the right time is a goal of modern Stubbs is Deputy Chancellor of Western Imlay-Gillespie is the new Chair, with
IT. In Who’s Where (page 15) we look at Sydney University. In addition to their Nathan Kesteven staying on as Vice Chair.
measures to also getting it to the right wide experience the CEO notes they bring We also welcome GP, David Glendinning,
place. Keeping track of where doctors are “expertise in the fields of law, social justice, to the Board where he will also take on the
currently practising is an ongoing task that advocacy, and high-level government and role of Treasurer.
still requires manual updating by practice administration and add value and diversity
NorDocs, like the rest of the nation, will
managers. to the organisation’s strategic direction”.
remember 2020 as a year of turmoil and
On page 36 Tim Marsh updates us on the Two more vacancies on the Board disruption. Few of us will miss it. However
Lismore Base Hospital eReferral system for are yet to be filled. The NCPHN with new challenges, new directions and
outpatient clinics. The trial to date has been Nominations Committee has identified new blood we are eager to see what 2021
positive and its success makes it a possible two highly credentialed candidates from will bring us. - David Guest
model for wider dissemination throughout the corporate/charity sectors who are
4 | NorDocs
Dr David Scott awarded OAM
by Dr Brian Pezzutti a number of senior positions with the
Society, including being an executive
counselor, Vice President 2014 – 2016 and
Dr David Scott is the recipient of well-
President 2016-2018, and he is currently
deserved community recognition for his
the Immediate Past President.
service to Australia, particularly in the area
of anaesthetic services. During the time of his Presidency,
David was deeply involved on the
David arrived in Lismore 26 years
Medical Benefits Schedule Review, and
ago and has served our community with
his direct liaison with the Federal Health
diligence and distinction, both in the public
Minister Greg Hunt ensured that the
and the private sectors, at a national and
inappropriate recommendations of the
international level.
Review Committee were not adopted by the
Along the way David has provided clinical Government. Had the Government adopted
leadership, training to young trainees, these recommendations patient care would conferences, and published a well-
anaesthesia and pain management and have been significantly affected, and out of acknowledged book with Alwyn Chan
consultancy, particularly in the area of pocket cost would have risen sharply. at Liverpool Hospital on Regional
Regional Anaesthesia.
David led a dispute between the Anaesthesia with Ultrasound Guidance.
His work with the College includes Anaesthetic Department and the Northern David has served in the Royal Australian
being the Founding Chair of the Special NSW Local Health District Chief Executive Air Force Reserves since 1990, currently
Interest Group for Regional Anaesthesia, to gain changes to the sessional contracts holding the rank of Group Captain. He is
and convening the Regional Anaesthesia for Anaesthesia services so that Lismore now Clinical Director of Anaesthesia and
Workshop of Queensland since 2005. was positioned well to attract Anaesthetists Intensive Care for the RAAF. David has
to work in Lismore. deployed overseas with the Australian
His efforts in education were recognized
with his appointment as an Associate Combined with supporting the dynamic Defence Force to Afghanistan and
Professor at the Lismore Clinical School leadership of the Department and the East Timor at great personal risk and
of the University of Western Sydney, and focus on “training and retaining”, Lismore considerable cost.
his holding a Visiting Professorship at the now has in excess of 30 Specialists in His deployment following the earthquake
University of California, Sacramento and Anaesthesia Pain Management and and tsunami in Bandar, Aceh (Indonesia)
at the Uniformed University in Bethesda in Perioperative Care, far more than any in 2006 saw him do outstanding work
Washington DC, USA. Country Region in Australia. His strong under the most demanding conditions.
advocacy for evidence-based practice
At a local level, David was at one time the
and innovation has been important I am sure David’s colleagues would
Director of the Department of Anaesthesia
for the continuing development of an join me in applauding this well-earned
and Acute Pain Medicine at St Vincent’s
excellent anaesthetic service for the people recognition for his services to our
Private Hospital, Lismore.
Richmond Valley. community, contributions to the profession
Joining the Australian Society of and advocacy at the highest levels of
At an International level, David has Government.
Anaesthetists in 1988 David has held
taught and lectured at many overseas
Connecting dads and their babies, a great start for life
The summer 2020-21 edition of NorDocs the birth of the baby, provided they are to play. General Practitioners and primary
introduced the Focus on New Fathers at least 14 years of age. The messages will healthcare providers are in a fantastic
(FoNF) pilot, a partnership between NSW continue until the baby is one. position to be able to refer new parents to
Health and the University of Newcastle this free and easily accessible service.
From the program launch on 6
to deliver a free service to non-birthing
September 2020, there have been more If you would like to experience the
partners of all cultures and genders.
than 125 fathers enrol from the Northern service firsthand, there is a professional
Once a ‘father’ has enrolled through NSW Local Health District, nine of which taster available to provide insight into the
www.health.nsw.gov.au/focus-on-new- identify as Aboriginal, and 1314 enrol messages that fathers will receive. To sign
fathers, the father will receive regular across the state. Along with Northern up for this, head to www.sms4dads.com,
text messages with tips, information and NSW Local Health District, there are scroll to the bottom left and click on ‘click
links designed to help them connect with three other pilot areas; Northern Sydney, here for professional taster’.
and support their baby and partner, while Western Sydney and Murrumbidgee
Further information about the program
looking after themselves as a parent. Local Health Districts. At this stage, the
can be found on the webpage, or by
pilot is continuing until 30 June 2021.
Fathers and co-parents can now sign contacting the Northern NSW Local Project
up from as early as 12 weeks into the Healthy child development starts Coordinator, Emma Murray on 6621 1245
pregnancy or up until 24 weeks following early and dads have an important part or emma.murray1@health.nsw.gov.au.
NorDocs | 5
NorDocs Board 2021
Dr Louise Imlay-Gillespie is the new Chair doctors. Louise and Nathan aim to program was devised as a way of increasing
of the Northern Rivers Medical Network foster improved communication and medical manpower in the hospital system
(NorDocs) for 2021. build stronger professional relationships during the early stages of the pandemic
between primary and secondary health in preparation for the anticipated large
Louise came to the North Coast in
care. numbers of patients who might have
2016 and has worked as a haematologist
required hospital treatment for COVID-19.
at LIsmore Base and Grafton District Also joining the Board is Dr David
Hospitals since then. She has recently Glendinning. David is a former engineer David was also an unsuccessful candidate
returned from maternity leave on a part- and project manager who retrained as a for 2021 Board membership of the North
time basis following the birth of her son, medical practitioner here on the North Coast Primary Health Network.
Fox. We congratulate Louise and her Coast, first through the University of
Continuing on the Board is surgeon
husband, oncologist Joe Gormally, on this Wollongong training program and then
Trafford Fehlberg. Trafford has worked
happy event. Joe has also been a member in the North Coast hospital system. On
as a general surgeon in a local private
of the NorDocs Board the past two years. page 38 David describes his journey into
practice since April 2019, and before that
medicine and expands on this in a recent
Louise was instrumental in organising in Timor-Leste. In November 2020 he was
episode of Destination’s podcast, where
various education events at Lismore Base appointed as the inaugural staff specialist
rural graduates talk of their decisions to
Hospital, including the physicians’ week- general surgeon at Lismore Base Hospital,
become rural doctors. (See link on page
end and the NorDocs Unconferences and now consults from the outpatients
38).
in 2018 and 2019. Under her guidance clinic at Lismore Base Hospital. Trafford
NorDocs hopes to build further on the David has also worked extensively and his wife Zoe have also recently had a
hospital based education program. with Lismore Base Hospital on various son, Tasman. We trust the demands of
eHealth and JMO education initiatives. patients and children do not cause too
Dr Nathan Kesteven, the former Chair,
He was the Director of the Assistants in many sleepless nights for them both.
stays on as Vice-Chair. Nathan has
Medicine program last year that allowed
championed improvement in education Trafford’s 2019 presentation on his
final year medical students to act as
and communication for all North Coast surgical experiences in Timor-Leste is
interns with limited responsibilities. The
6 | NorDocs
in our 2019 webinar archive at Vimeo.
Trafford has a particular interest in
upper gastro-intestinal surgery and he
will present on that topic in our 14 April
Webinar.
Dr Helen Lloyd joined the Board last year
and will continue on in 2021. Helen is a GP
NorDocs Webinar Series
in Mullumbimby and is pursuing research
on mammalian meat allergy which is one The NorDocs webinar series commenced they refer regularly. We believe this
of the subjects in our next podcast on 17 in August 2020 and is continuing in makes for a better understanding of
March 2021. 2021. Meetings are now scheduled on a the issues that both GPs and specialists
regular basis for 7.30 pm on the second face in providing a sound, efficient and
We are sad to see Dr Bronwyn Hudson Wednesday of the month. affordable service.
leave the Board. Bronwyn has organised our
most recent webinar along with colleagues NorDocs is an independently run Our preferred structure is for case
David Helliwell and Anthony Solomon on organisation and receives no funding based learning that spans all sectors
opiate dependence treatments. Bronwyn’s from the government or government of the health system from primary and
article from 2018 on opioid treatment in related entities. As such it relies on its secondary to tertiary care, involving
general practice along with the associated own activities, and sponsorship and doctors, nurses and allied health
webinar is found on our website. Bronwyn advertising from its supporters. It is a professionals. The sessions are live and
presented to the National Ice Taskforce in model used by most publications around interactive, allowing practitioners to pose
2019 as we reported in GPSpeak magazine. the world and by podcasts on the web. questions to the presenters in ‘real time’
We appreciate the work she has done for as well as being recorded if members are
Our webinars policy is to acknowledge
NorDocs and the general community over not able to make it at the allotted time.
our sponsors at the beginning and end
the last three years. However, we feel that the greatest value
of each podcast and grant them the
derives from being a participant.
Dr David Guest remains as secretary, opportunity to address the audience for
a position he has held for 10 years. one to two minutes. This occurs at the The first meeting for 2021 held on 10
However, he is now ably assisted by our beginning of the meeting. To date only February 2021 was on opiate dependency
administrative officer, Linda Ward. Linda one of our sponsors has taken up this treatment and was given by the North
has a background in nursing and practice option. Coast D&A team of Bronwyn Hudson,
management. She runs her own practice David Helliwell, Anthony Solomon, Petra
It is understood by our sponsors and
management consultation business and in Liedel and Michael Burgess.
advertisers that they exert no control
the past has worked for the Improvement over the content or format of the The schedule for the first half of 2021
Foundation and the North Coast Primary presentations, which are determined is ‘pencilled’ in below but is subject to
Health Network. solely by the presenters and the NorDocs change.
NorDocs runs a number of open email webinar committee.
GPs wishing to stay up to date
lists. The pracman list goes to all Practice There are many webinars and podcasts with the webinar series or who have
Managers in the Network’s footprint. available on the web today, some of recommendations for future topics
NorDocs-members is an announcement excellent quality. However, the particular should join the gp-talk email list at
list for North Coast doctors, particularly advantage of the NorDocs webinars is https://lists.nordocs.org.au/postorius/
those who are not on Facebook, and gp- that they give local GPs the opportunity lists/gp-talk.lists.nordocs.org.au/ or
talk goes to North Coast GPs. It mainly to hear and see the specialists to whom write to “Nordocs Webinars” .
discussions from the webinars and other
general practice/NorDocs matters. Practice
Date Topic Presenters
managers and members can subscribe
from the list page at https://lists.nordocs.
org.au/postorius/lists/. 10 Feb Opioid Dependence Riverlands Drug and
Alcohol unit
The Board is keen to hear from
members on ideas for activities, education
Susan Tyler-Freer,
17 March “Too much meat” Helen Lloyd and Louise
events or any other matters of concern. Imlay-Gillespie
The Board can be reached at “Nordocs
Board” and for general inquiries and
administrative matters contact “Info @
Nordocs” which is monitored by Linda
Ward, our administrative officer. 16 June Shoulder Disorders TBA
NorDocs | 7
New board members for Healthy North Coast
Healthy North Coast, the successful value in understanding those issues from
contractor for the federally funded North both the provider’s and consumer’s side.”
Coast Primary Health Network, has
Graeme Innes said, “I hope that I can
announced two high-profile appointments
bring a deep knowledge of the community
to its board of directors, Kerry Stubbs,
sector, experience in governance, and a
the Deputy Chancellor of Western Sydney
wide network of connections at all levels
University, and Graeme Innes, former
of state and federal government to the
commissioner at the Australian Human
organisation.”
Rights Commission for almost a decade.
Healthy North Coast CEO Julie Sturgess
Both share a deep passion for the health
said she was delighted to be welcoming
sector and are keen to contribute to their
the new directors whose expertise in the
local communities, according to the
fields of law, social justice, advocacy, and
Healthy North Coast announcement in ‘meeting’ but ‘exceeding’ our goal of
high-level government and administration
early February. delivering the Primary Health Network
would add value and diversity to the
program in our regional footprint, from
“I have had a lot of experience in organisation’s strategic direction.
Port Macquarie to Tweed Heads, and the
community health services, disability and
“Together, they will help Healthy North New England Tableland.
mental health services, and in palliative
Coast continue its drive to take a leading
care. I’m also particularly interested in “We believe our communities are the
role in the ongoing health reform and
Aboriginal health issues and initiatives,” ultimate beneficiaries of Healthy North
improvement that is clearly needed in our
Kerry Stubbs said. Coast’s successes and we are immensely
region and nation.
proud to be delivering the PHN program.”
“I believe I can contribute something of
“We will strive to succeed in not just
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8 | NorDocs
The importance of diversity on boards
by Julie Sturgess, She is a member of the Community
Advisory Committee for the Australian
CEO, Healthy North Coast Digital Health Agency; Advisory Council to
the Australian Health Protection Principal
As the new year gets into full swing for Committee on Disability Pandemic
Healthy North Coast, it is fitting to look Planning; and the NSW Government
at the role our board plays in shaping our Domestic and Family Violence and Sexual
future, and to celebrate the breadth of Assault Council.
talent and diversity they bring.
A former NSW Telstra Businesswoman
With our recent appointment of two truly of the Year in the Community and
remarkable board members, Graeme Innes Government sector, Kerry is particularly
and Kerry Stubbs, I have been reflecting interested in using design thinking to
on the words of KPMG Australia’s Chair, foster innovation and better co-design of
Alison Kitchen, in her introduction to services and systems for the people who
Building Gender Diversity on ASX 300 use them, and in particular disadvantaged
Boards, published last June. and minority communities.
Alison wrote: “… When you’re operating Our choice of two new members
in an environment where there’s a huge with exemplary legal, social justice,
number of unknowns – having a lot of New Healthy North Coast (HCN) Board members Kerry advocacy, and high-level government and
different experience around the table is Stubbs (front), Graeme Innes and CEO, Julie Sturgess. administration experience, reflects our
a very good thing. And that diversity of commitment to creating a diverse board
experience can help boards navigate the He was Australia’s Race Discrimination
with wide-ranging skills.
enormous challenges we are facing. Commissioner for three years and
served for almost a decade as a former Graeme and Kerry join our other highly
“…having different voices, different valued board members, who together
Commissioner with the Australian Human
perspectives, different life experience and provide Healthy North Coast with an
Rights Commission, developing significant
different business experience at the table extensive range of knowledge, skills and
networks with both federal and state
– all asking open questions, being curious expertise in local health care provision,
governments, including in the areas of
and sharing experiences, is the key to clinical expertise, Aboriginal health,
health and with First Nations People.
surviving and thriving. The advantage academia, community development,
a diverse board offers is the ability for Graeme has been a registered mediator
business and corporate management,
companies to be agile, flexible, and to for many years, and has negotiated at
accounting and finance, law and local
think, quickly and differently.” all levels of society, from community
government, and advocacy and social
mediation to the development of a UN
2021 heralds an exciting new chapter justice.
treaty.
for Healthy North Coast as we continue Having such a stable and diverse
to serve the Mid and North Coast regions He has a strong diversity and inclusion
board to steer Healthy North Coast has
with an ambitious and locally focused mindset and leads this area of change as
resulted in clear direction and strategy,
PHN program, and the guidance of an a non-executive director of Life Without
solid accountability and controls, and
experienced and diverse Healthy North Barriers, one of Australia’s largest service
transparency. Our diverse board will
Coast Board of Directors. providers in the areas of Aboriginal and
continue to help us better serve and
Torres Strait Islander people, people with
As we rise to meet the unprecedented represent the needs of our community
disability, asylum seekers and children in
challenges of the coming decade in as we navigate the move to regional
out-of-home care.
health care, we will continue to focus on commissioning and new partnership
connecting with, and serving the needs Kerry is Deputy Chancellor of Western structures with other organisations inside
of general practice, allied health, and our Sydney University and has worked as an and outside of the healthcare system.
communities, through our four strategic academic at both Sydney University and
As with all Primary Health Networks,
pillars. This is a mission about which we the University of Technology.
our contract with the Commonwealth
are incredibly passionate and proud. She has extensive human resources, Government dictates that we must have
It is a real honour to introduce Graeme research and teaching expertise in the areas a diverse, skills-based board as well as
and Kerry – both local residents – as new of anti-discrimination, equal employment clinical councils, to help us function and
board members. opportunity and social justice, as well as navigate the landscape that we are in.
significant expertise in the human capital Our current board members include a
Graeme is a lawyer and company director
field, including previous roles as CEO of specialist anaesthetist, a dentist, two
with more than 40 years of board, finance
Northcott and Executive Director of St GPs, and a senior public administration
and business management experience.
Vincent’s Hospital Sydney. executive.
NorDocs | 9
Vale Mungo MacCallum
by Robin Osborne era.
I dipped in and out of Mungo For many years a tradition in the Mungo-
MacCallum’s life for decades, starting Jenny Garrett household was a party
with an introduction in the office in (old) marking the Feast Day of St Mungo (13 or
Parliament House, Canberra that he shared 14 January, according to the calendar you
with my childhood friend, the late Helen choose), honouring a sixth century saint
Ester (nee Cunningham), an accomplished celebrated on Glasgow’s coat of arms.
journalist who held similar views of the
Arriving at one such event I noticed
Australian political class.
Mungo in his office, clattering away on his
Helen worked for the Inside Canberra manual typewriter, ignoring the mounting
newsletter, later launching her own revelry upstairs. I asked Jenny what he
publication, Monitor. Mungo was was writing and learned it was an obituary
writing for outlets far and wide. I was for a recently deceased, high-profile Labor
astounded that these bright sparks could politician. It was due to be filed that
turn out wonderful stories from such a afternoon for the next days’s paper.
claustrophobic office. Mungo (Felt pen on Echo newspaper
Soon Mungo joined the feast honouring
his namesake, and partied on. clippings) by Jeni Binns
Mungo and I shared space and time
in two media outlets, the quirky Nation A few days later Mungo’s obituary for
I read the obit next morning – it was
Review and ABC radio’s Double J where Helen appeared in The Sydney Morning
word perfect and insightful, amusing,
I interviewed him each afternoon for the Herald. As might be expected it was again
irreverent… all the qualities that marked
Frontline news program: “So, Mungo, word perfect: “In matters of belief and
his columns and other writings over the
what’s been happening in Australian conviction she was unswerving to the end,”
years. Moreover, it had been written as a
politics today…?”, and off he’d go. he wrote.
single draft on a typewriter, and faxed to
Later, as editor of the Lismore Echo, Sydney. Words that apply equally to Mungo
I engaged him to write a weekly column himself.
The last time I saw Mungo was on the sad
that we titled, with his amused approval, Legend has it that St Mungo performed
occasion of the funeral of our mutual friend
‘Political Corrections’. four miracles in Glasgow, which are also
Helen Ester on the Gold Coast in November
Along with the journalist gene I share 2015. Mungo wasn’t up to driving by then, depicted on the city’s coat of arms. One
Mungo’s Wentworth family background, so I gave him a lift up and back, and we of them, I’m pleased to note, is that he
mentioned in David Lovejoy’s tribute as conversed as much as we could, given his restored life to a robin that had been killed
being “hard to overcome, even when you dependence on a ‘speech box’ due to his by some of his classmates. This is some
choose left-wing politics”. My grannie was laryngectomy. relief, although next time the bell tolls it
a Wentworth, every bit as eccentric, and as may well be for me.
We didn’t stay for drinks and the drive
intelligent, as Mungo, albeit from an earlier Link to the Echo’s farewell to Mungo
south was a largely silent and sombre one.
The importance of diversity on boards
continued from P9 ● Warren Grimshaw AM has extensive University; and Sub Dean of Medicine at
senior experience in public administration the University Centre for Rural Health
The board, including our new members,
and the health sector. Warren is Chair of (Sydney University). He has been a GP in
will help Healthy North Coast continue its
the Mid North Coast Local Health District Murwillumbah for more than 35 years as
drive to take a leading role in the ongoing
Board, a position he has held since 2011. both senior partner and managing partner
health reform and improvement that is
clearly needed in our region and nation. ● Dr Caroline Hong has a Bachelor of King Street Medical Centre.
of Dental Surgery, Graduate Diploma ● Dr Joanna Sutherland is a specialist
We will strive not just to ‘meet’ but to
of Health Administration, and a Master anaesthetist in Coffs Harbour, with a
‘exceed’ all the goals of delivering the PHN
of Health Administration. She is a Master of Health Policy, and a Master
program in our regional footprint from
Board Trustee of the St Vincent’s Clinic of Clinical Sciences (Research). She is
Port Macquarie to Tweed Heads and the
Foundation and has been in that role actively involved in teaching and training
New England Tableland.
supporting healthcare and medical medical students (as a conjoint academic
Other Healthy North Coast board research since 2012. with UNSW Rural Clinical School), and
members: training and supporting specialist and GP
● Dr John Moran AM is Associate
● Dr Adrian Gilliland is a GP and co- Professor of Medicine at the University of anaesthetists.
owner of Coffs Medical Centre, a large, Wollongong; Assistant Professor at Bond
long-established general practice.
10 | NorDocsSlugs and snails and researchers’ tales
by Robin Osborne at Sydney Fish Market and is regarded as
highly nutritious.
Slugs and snails may be unwelcome
Now, as Dr Steven Purcell has confirmed
residents of terrestrial gardens but in the
in the journal Restoration Ecology, the
ocean they are being hailed for making
trochus is having a positive ecological
positive contributions to the aquatic
impact on coral reefs in Samoa where it
environment as well as delighting those
was first introduced 15 years ago, long
fortunate to sight them.
after it was well established in other Pacific
In the forefront of ‘sea slug’ and ‘sea countries as a valuable shellfish resource.
snail’ research are two Southern Cross
Noting that he had found no negative
University marine scientists, Steven Purcell Professor Steve Smith ecological effects of the trochus in colonised
and Steve Smith, the latter being fortunate
Samoan coral reefs, Dr Purcell wrote: “It’s
enough to share his initials with these
a story of the amazing colonisation of snails
extraordinary creatures. He may even be
that appears to benefit both the marine
able to say the words ‘Sea Slug Census’
environment and the livelihoods of the
three times quickly, although perhaps not
Samoan people.
under water.
“Unlike examples in Australia – the cane
At the end of January Professor Smith
toad, the fox, rabbit and European carp, to
coordinated the third annual Coffs Coast
name a few, which have been detrimental
Sea Slug Census, an event where “divers
to native species and habitats – the trochus
and rockpool ramblers” – another nice
has shown itself to be a welcome species
piece of alliteration – join forces to discover
that can control reef algae while offering a
a significant number of nudibranch
Dr Steven Purcell measuring trochus shell. valuable new seafood to coastal people.”
species. The flamboyant nudibranchs,
less attractively known as ‘sea slugs’, are Several years ago the Australian Centre
molluscs with reduced or absent shells, for International Agricultural Research
and they flourish in the waters of the NSW (ACIAR) commissioned SCU to partner
North Coast. with Samoa’s Ministry of Fisheries in the
study.
Professor Smith said, “The abundance
of sheltered rock pools along the Coffs “From a few initial release sites, trochus
coastline, combined with the underwater now can be found around both main
habitat diversity around the Solitary islands in Samoa. At many reef sites,
Islands, provide a fantastic combination populations are abundant, with several
of suitable conditions for a large range of Gold spotted nudibranch hundred animals or more per hectare,” Dr
species.” Purcell said.
With the support of the local diving “A vibrant fishery has been established
group, Professor Smith created the first Sea in Samoa, where artisanal village fishers
Slug Census in 2013 at Nelson Bay, north collect them for local consumption and sale
of Newcastle. Since then, in conjunction by the roadside.”
with local naturalist and diving groups, the In recent years, reefs in Samoa and
event has expanded to sites from the Gold elsewhere in the Pacific have been impacted
Coast to Melbourne and offshore at Lord by coral bleaching and subsequent algal
Howe Island. overgrowth. Other studies show that
“Participants simply find and trochus can benefit reef systems. Through
photograph as many species of sea slug its feeding, the herbivorous snails graze
as possible and note the location. It’s a A polished trochus shell Credit: Steven Purcell down this algal overgrowth that can
citizen science program that offers fun, smother young corals or prevent them
properly known as the trochus. from attaching on the reef.
adventure and opportunities to learn about
our remarkable marine biodiversity,” Prof If Australians know anything about “Our data found the introduced trochus
Smith added. trochus it is because of the spectacular in Samoa do not appear to be out-
lustre of the shell, which, when polished, competing the native marine snail species,”
Meanwhile, in Pacific waters far to the
makes it the most popular source of Dr Purcell said.
east, SCU’s other marine-researching
mother-of-pearl buttons. The meat, which
Steven has been on the trail of an equally
can be cooked in a variety of ways, is sold
fascinating creature, the ‘sea snail’, more
NorDocs | 11The LARCS aren’t singing in Australia
by Andrew Binns such as Lippes Loops and Copper
7s had a much higher infection
Noteworthy stories in the medical rate than the modern devices,
media have highlighted a general whether hormonal or copper.
lack of education and procedural
IUCDs have had their ups and
training for GPs around the
downs in reputation over the
topic of long-acting reversible
years, but the newer devices are
contraceptives (LARCS), used
safe, with minimal side effects
by 12% of women in Australia
and are generally well accepted by
compared with 15% in comparable
those women who use them.
countries.
More training for GPs at all
Although usage has increased
levels is a high need. For those
in recent times, we still lag behind
who would prefer not to be
other countries, and the uptake
regional areas. trained in these procedures,
rate has plateaued rather than
encouraging the use of LARCS rather than
increasing. So, what could be done at the primary just the OC pill for contraception would
Compounding the dilemma are our sky- care level to address these concerns? be beneficial for both contraception and
high hysterectomy rates, which according More training in LARCS procedures, reducing menstrual bleeding. Added to this
to a recent OECD report are much higher particularly insertion of etonogestrel are the benefits of minimising unplanned
than they should be. For example, Australia implants (Implanon) devices and the pregnancies that can occur through poor
does about 250 hysterectomies/1000 levonorgestrel intrauterine system (Mirena compliance, including remembering daily
women compared with, say, Denmark and Kyleena IUCDs), would help as these oral contraceptive pill taking.
at 20/1000. New Zealand has half our reduce menstrual bleeding. One new(ish) device on to the market
rates, while Finland has decreased its
There is some talk of this role partially to help encourage the use of LARCS is the
hysterectomy rate by 60% in the last 20
being taken over by trained RNs, which Kyleena, released in March 2020. This
years.
may fragment care if not performed in device not only provides safe contraception
Professor Jason Abbott, UNSW Faculty the GP setting. That said, specialised for five years but reduces menstrual loss. It
of Medicine, commented in AusDoc 2020 family planning clinics fulfill an important is also suitable for use in nulliparous and
(12 October, 2020) that we have one of the complementary role for many women and younger women. Women with menorrhagia
highest hysterectomy rates in the OECD offer valuable training opportunities for would be best suited to a Mirena, which
and that although the rates have fallen the GPs. contains a higher dose of levonorgestrel.
reduction has not been fast enough.
I was involved in the first family planning The Kyleena is a smaller device than
Prof Abbott says this is due to low clinic in Lismore. It started about 40 years the Mirena, and is indicated specifically
awareness in primary care alternatives to ago and was a controversial topic amongst for contraception. The comparison of
treat menorrhagia and a lack of training in GPs. We did IUCD clinics at that time these devices for patients is shown in the
minimally invasive endometrial ablation and I am pleased to say the devices have following table.
procedures, particularly in rural and improved vastly since then. The old devices
Consideration Kyleena Mirena
Risk of pregnancy over 3 years 2,7
Slightly higher (2%) Lower (0%)
Difference is not statistically significant but may be clinically significant for
women.
Risk of ovarian cysts over 3 years7 Less likely (8.6%) More likely (22%)
Difference is statistically significant.
Bleeding and spotting days over 3 years7 More likely due to lower Less likely due to higher
progestogen progestogen
Dimensions / ease of insertion and 28 mm width, 30 mm height: 32 mm width, 32 mm height:
may be easier to insert/remove may be more difficult to insert/
removal 4,5,7
due to smaller size remove due to larger size
Partial or complete expulsion over 3 years2,7 Low risk (2%) Low risk (1.6%)
12 | NorDocsWellMob – your ‘one-stop shop’ website for Indigenous wellbeing
Finding online resources and allied health community to use both
that support the mental in and out of session. Some case studies
health and wellbeing needs to give examples are shown below:
of Aboriginal and Torres Case Study 1 – ‘The Grog Brain
Strait Islander people has Story’ (Menzies School of Health
been made easier with Research)
the development of a new
website called WellMob. Showing a young person a short video
on a health topic can be a great way to
“It was like looking for discuss a sensitive issue such as alcohol
needles in haystacks to find misuse.
culturally safe, Indigenous-
specific wellbeing resources,” See The Grog Brain Story link here.
says Worimi man and project WellMob website team: Dr Judy Singer, Talah Laurie, Sharnie Roberts and David Edwards Case Study 2 – Coping with the
Co-Director, David Edwards. impacts of Trauma (The Healing
“Most people just used The WellMob team acknowledge the
Foundation)
Google, but it was hard to narrow down guidance of our website development
to Australian Indigenous online resources reference groups in Larrakia (Darwin, NT),
that were evidence-based or had been Kaurna (Adelaide, SA) and Bundjalung
vetted to ensure cultural-safety for our (Lismore, NSW) country. Through the
community.” dedication of these people, WellMob was
developed so it could meet the needs of
David and the WellMob team work part the many different Aboriginal and Torres
time at the University Centre for Rural Strait Islander communities as part of their
Health (Lismore) and helped develop wellbeing practice.
the website under the national eMHPrac
(e-mental health in practice) project How can we use the WellMob
in collaboration with the Australian website? Printing a brochure to explain to a patient
Indigenous HealthInfoNet. how experiencing
What is WellMob? a trauma such
as abuse can be
The WellMob website has over 200 triggered and
practical and effective videos, apps, some coping
podcasts and other websites together in mechanisms that
one place. It’s been designed to help our may support them.
diverse health and wellbeing workforce
to find and recommend online social and See Coping with the
emotional wellbeing resources for their Impacts of Trauma
Indigenous patients/ clients. brochure link here.
Click here for the website promotional video
Why develop WellMob? Health promotion videos – the
digital talking stick
The inspiration came from frontline
Aboriginal health and wellbeing workers The website landing page has 6 main Health workers wanted the website
here in Bundjalung country, northern topics you can search under for your to contain lots of video content using
NSW. They saw the need for a ‘one-stop Indigenous clients or for your professional storytelling techniques to supply
shop’ of culturally relevant resources to use development. These wellbeing topics information, rather than just giving a set of
with their Indigenous clients. The WellMob include: Mind; Body; Our Mob; Culture, facts. “Our mob often learns and connects
website was developed to fill a cultural gap Keeping Safe; and Healing. with information through story,” says
within the digital mental health space. One David.
Under each of these main health topics
of the local health workers stated: “It doesn’t have to be an evidence-based,
there are numerous sub-topics you can also
‘We need digital resources across a wide search under. There is also a search and online counseling program every time. It
range of topics, such as healthy living, advanced search function that allows you can be something as simple as a video that
connecting with country, dealing with grief, talks about someone’s challenges dealing
identity etc. that fit within a social and to refine what type of resource and what
emotional model of care’ subject matter you are looking for. with stress, anxiety or depression, and how
they overcame them through connecting to
Anonymous Health Worker, 2016 The website is a useful tool for our GP support.”
NorDocs | 13WellMob – your ‘one-stop shop’ website for Indigenous wellbeing
“It can be a really great way for a non- the Black Dog Institute to develop some at the University Centre for Rural Health
Indigenous clinician to build rapport webinars about the website and using in Lismore. If you would like the team to
with an Indigenous client too. They’re online resources with your Indigenous send out some free ‘calling cards’ for you to
able to say, ‘Look at this fella, he’s really clients. You can register for a free webinar write online resources down and leave with
inspiring.’” titled Supporting Indigenous wellbeing your client, contact David at E: d.edwards@
through digital resources: an introduction for sydney.edu.au.
This idea of focusing on positive,
clinicians here.
strengths-based tools is an important part Also follow the WellMob project via its
of the philosophy behind WellMob. “I Want more information? FaceBook page here.
think it’s nice to have those more positive
We are fortunate to have the website
stories – to sell the strengths of our culture
development team based in our region
and how we can reconnect in times when
we’re feeling sad, worried, or stressed.”
And though the idea of bringing these
resources together in one place was
developed long before the pandemic
began, David and the team see the site as
even more crucial during the restrictions
and uncertainty of COVID-19.
Recorded webinars & CPD
The WellMob team have collaborated with
Tackling obesity
with lasting weight
loss solutions
As part of an integrated treatment plan, weight loss
surgery is now widely recognised as one of the most
successful methods of treating obesity. Bariatric Surgeon
at John Flynn Private Hospital, Dr Candice Silverman,
has developed The Peak Program. This multidisciplinary
program focuses on both the physical and emotional
wellbeing of the patient and considers their various
lifestyle, psychological and sociological factors to help
patients achieve and maintain long-lasting results.
To find out more visit our website or call 07 5598 9000
johnflynnprivate.com.au
14 | NorDocsYou can also read
