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AUTUMN NEWSLETTER

NEW ENGLAND

eHEALTHConnecting Australianhealth care

BOOK REVIEW- Janet Robilliard

SpEcIAL REpORTIntroducing the National Relay Service

TELEHEALTHpAgE 7

Aboriginal Health Page16

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Photo courtesy of GP Synergy

FEATURE“Record numbers of doctors in training”

While 2013 seems to be getting away from us I would like to briefly revisit what I considered to be our very successful strategic planning days held in 2013. Firstly there was a lot of similarity and synergies between the thinking at our Board level with the outcomes of the efforts by our staff, particularly in respect to the values we aspire to as an organisation.

These can be neatly summarised as being about people, relationships and collaborations based on respect and trust, adopting evidence based approaches in management and service delivery as the basis for our practice, with a focus on; innovation, integrity and quality. These are very well described in the cloud image that was put together following the staff planning day. These same values are implicit in published health research about quality and safety, where leadership and teamwork are often stated as missing when health systems are said to fail.

Secondly our strategic intent that came from that planning can be summarised as giving priority to prevention and the preventative aspect in all services we deliver, a renewed emphasis on engagement with general practice and other health professionals practising in primary health care settings, and addressing the critical health workforce shortages across the region.

This latter issue was recently highlighted by the release of the first ‘Healthy Communities’ report from the National Health Performance Agency. While based on data that predated the commencement of the NEML, it did highlight the difficulty experienced in this region in accessing general practitioners. This national performance reporting will fast become a feature of our lives and we need to respond proactively by using data, planning, prioritising, innovation and common sense to address areas where we might not be performing as well as we would like.

Talking about innovation, the Board has agreed to provide some support and resources as an incentive to staff that might come up with an innovative new idea or a better idea to improve an existing service or how we do business. These ideas might take many forms; research, projects, quality improvement, strengthen our capacity in some way etc. Ideally, they will address or respond to some of our stated values and our strategic intent described above. The Chief Executive and I are currently finalising arrangements to announce this initiative in more detail. It is also based on the premise that staff at the front line, often have a deeper understanding of needs and priorities, ahead of those that are often preoccupied with the management and governance of NEML.

Finally, at the last Board meeting there was strong agreement for a focussed approach to marketing and communications for NEML. No doubt this strategy will also be given some priority to address how we might market NEML and

chair of NEML Board DR DAVID BRIggS

communicate our messages to communities, health professionals and stakeholders. In the interim we have agreed to issue a one page ‘year in review’ document that describes our services, our locations and our staff numbers in those locations. We believe this will assist us all to better describe who we are and what we do in an effective manner.

Dr. DS Briggs, Chair

Word cloud outling our organisational values that was put together following the staff

planning day, earlier this year.

If you work in the Medicare Local you know the conversation. At a party or a BBQ or any social gathering with new people, “So, what do you do for a living?” To which you reply, “I work for the New England Medicare Local.” This is usually followed by a blank look or an explanation about the last time they had difficulty with a Medicare claim.

Now you can come back with a one liner that will open up a conversation that will inform them about how important your job is. To the question about your occupation, you can reply “I keep people well and out of hospital”. Because believe me, if you work in this organisation you are a critical part of Australia’s primary health care system. The work that our staff does strengthens that system and the evidence is clear that all countries with well resourced and connected primary health care systems have less people admitted to hospital and better health overall than those who don’t. So if you work for NEML, you can tell them what your part in that is. You may be a clinician seeing clients, an admin person supporting the organisation and its programs or someone who is supporting general practice or other health practitioners. Whatever you do, you are vitally important to the health of this region.I’ve been looking closely at what we do as part of what the Chair described in his report as compiling a ‘year in review’ message.

Here is some of that I’d like to share and more you will read later in this newsletter:

• Our region covers the New England North West, an area of 93,000 sq. kms. • Our total population is 174,194 of which 9% are Aboriginal or Torres Strait Islander people.• We directly employ 130 people in 11 different communities and we have contracts with another 70.• About 50 NEML staff provide services to Aboriginal communities across the region. The team works with GPs and other agencies including Aboriginal Medical Services, schools, universities and other non-government organisations. • Over 2500 individual patients across 22 communities each year benefit from no-cost clinical care through our mental health programs provided by 15 employed mental health practitioners and 19 private practitioners. • Almost 9,000 allied health services are provided each year for patients referred by their GP, at no cost to the patient. Access to this type of health care will dramatically increase in 2013-14 when the Medicare Local takes on an additional $1.2M of funding.• NEML staff work alongside other organisations to bring additional medical practitioners, nurses and allied health practitioners to the region.

chief Executive Officer gRAEME KERSHAW

Recent examples include: o recruitment of a Paediatrician, Urologist and Anaesthetist o all of the specialist and technical positions at the North West Cancer Centre o GPs in Narrabri, Guyra, Quirindi and Inverell

• eHealth – NEML Information Technology and Provider Support staff assist GPs, Medical Specialists and Allied Health Practitioners with eHealth needs including secure messaging of health information, telehealth services through videoconferencing and adoption of the national electronic health record. Over 230 health practitioners have secure messaging capability and over 50% of GPs have used telehealth to connect with specialists. One GP with their patient in Inverell conducting a telehealth consultation with a Newcastle specialist saves 868 kilometres in travel and an overnight stay for the patient.

• Visiting Specialist Services – NEML manages the logistics of over 200 visiting specialist clinics by 11 different health disciplines within the region, from consultant Neurosurgery in Tamworth to Podiatry in Guyra; from Endocrinology in Armidale to a Diabetes Educator in Moree.

Apart from these key programs, the Medicare Local provides incentive payments for GPs to provide after hours care to their patients, funds allied health services into nursing homes, supports General Practice Nurses with education and information, provides specialist perinatal depression services, supports dementia assessment and connects care for people with chronic and complex conditions. So, in the conversation about keeping people well and out of hospital – this (and so much more) is what you do!

Graeme Kershaw, CEO

#keepingpplwell

New England Medicare Local | Page

Registration Booklet | 13

Visit www.ehealth.gov.au

Or call: 1800 723 471 for more information

• Information that we need to verify that you have for parental responsibility:

- If you are listed on the same Medicare card as the child and have previously established to Medicare that you are the child’s parent, you can use your Medicare card to support your declaration that you have parental responsibility for the child.

- In all other circumstances, you will need to supply evidence of parental responsibility. The type of evidence will depend on your particular situation, but will usually include documents such as a birth certificate, your parenting order or guardianship order, or your adoption papers. Please see the Submitting your evidence section on page 18 of this booklet for your options when submitting evidence as part of your application.

What happens next?You will be notified of the progress of your application.

Unless your application is made online, it will be processed by the Department of Human Services, who will generally notify you by phone whether your application has been successful. If you can’t be contacted on the daytime phone number you’ve provided in your application, we will write to you. When we notify you of the success of your application we will provide you with an Identity Verification Code (IVC), which you can use to access your dependant’s eHealth record online.

You will be able to start controlling your dependant’s record.

Once registered, you can set access controls for the child’s eHealth record. These controls will allow you to choose which healthcare provider organisations can view the child’s eHealth record. You will also be able to control access to the information that is included in the child’s eHealth record. This includes being able to change your preferences for the inclusion of information held by Chief Executive

Medicare (see the Department of Human Services – Medicare Information Fact Sheet on www.ehealth.gov.au for further details).

Another eligible person (for example, your spouse) can also apply to access and manage the child’s eHealth record as the child’s authorised representative. They can apply online or in writing using the Application to add Authorised Representative form.

An authorised representative must act in the best interests of their dependant.

5

eHealth

A National system of eHealth records will help deliver better care for patients and make the health system more efficient. People seeking health care in Australia can now register for an eHealth record. Once registered, they can choose to grant healthcare professionals permission to access their record. Healthcare organisations can also register for the eHealth record system and authorised healthcare professionals can use the provider portal to view their patients’ eHealth records online.

The Australian Government is rolling out the eHealth record system in carefully managed stages. Over time, the eHealth record system will give Healthcare Providers better access to patient information- Patient medications, test results and allergies or treatments- Meaning better, more efficient care for patients.

Why participate in the eHealth record system?

• Better access to accurate information about a patient, their medical history and treatment.

• More time treating patients, less time spent tracking down records and test results.

• Faster access to relevant information thus helping GPs make better clinical decisions and save time.

• Access to potentially life-saving patient information in an emergency.

• To help patients, including those with chronic and complex conditions, better manage their health.

• The more healthcare organisations that participate, the better connected the network will become, and the better it will serve the GP and the patients.

personallycontrolled electronichealth record system

Connecting Australian health care


Registration Booklet | 13

Visit www.ehealth.gov.au

Or call: 1800 723 471 for more information

• Information that we need to verify that you have for parental responsibility:

- If you are listed on the same Medicare card as the child and have previously established to Medicare that you are the child’s parent, you can use your Medicare card to support your declaration that you have parental responsibility for the child.

- In all other circumstances, you will need to supply evidence of parental responsibility. The type of evidence will depend on your particular situation, but will usually include documents such as a birth certificate, your parenting order or guardianship order, or your adoption papers. Please see the Submitting your evidence section on page 18 of this booklet for your options when submitting evidence as part of your application.

What happens next?You will be notified of the progress of your application.

Unless your application is made online, it will be processed by the Department of Human Services, who will generally notify you by phone whether your application has been successful. If you can’t be contacted on the daytime phone number you’ve provided in your application, we will write to you. When we notify you of the success of your application we will provide you with an Identity Verification Code (IVC), which you can use to access your dependant’s eHealth record online.

You will be able to start controlling your dependant’s record.

Once registered, you can set access controls for the child’s eHealth record. These controls will allow you to choose which healthcare provider organisations can view the child’s eHealth record. You will also be able to control access to the information that is included in the child’s eHealth record. This includes being able to change your preferences for the inclusion of information held by Chief Executive

Medicare (see the Department of Human Services – Medicare Information Fact Sheet on www.ehealth.gov.au for further details).

Another eligible person (for example, your spouse) can also apply to access and manage the child’s eHealth record as the child’s authorised representative. They can apply online or in writing using the Application to add Authorised Representative form.

An authorised representative must act in the best interests of their dependant.

6

For more information go to www.ehealth.gov.au

or contact Nicolle Kelly Regional eHealth program Manager at New England Medicare Local on 6771 1146

How does the eHealth record system work?The eHealth record system provides access to key health information drawn from the patients’ health records. With the patients consent, this information can be quickly accessed and securely shared with other authorised healthcare professionals involved in the patients care.

An eHealth record will grow over time to contain a summary of the patients’ key healthcare events and activities, including medical history, allergies and current medications. The system is designed to be integrated into local clinical information systems.

Who can enter health information into an eHealth record?Only authorised healthcare professionals can enter information in the clinical section of a patient’s eHealth record, ensuring it is clinically relevant and accurate.

Patients have their own section in the eHealth record, separate from the clinical section, where they can enter basic health information and keep notes for their own use- allowing consumers to be more actively involved in monitoring and managing their own health.

At present The New England Medicare Local is assisting healthcare professionals to set up and register for the personally Controlled Electronic Health Records along with assisting the General Practice register for the Medicare eHealth Practice Incentive Payments.

Healthcare organisationscan now register for the eHealth record system at:

www.ehealth.gov.au

New England Medicare Local | Page 7

TELEHEALTH

Joy Bowles the New England Medicare Local Telehealth Program Manager explains her role of helping to further implement the use of telehealth throughout our region.

Telehealth encompasses any use of e-technologies to facilitate health of the community by improving access to remotely located health providers. In the New England Medicare Local region we currently have four Telehealth projects that I am aware of:

• The AMLA/ACRRM funded project I work on o Mapping video-conferencing use by General Practitioners, Residential Aged Care Facilities and specialists. o Encouraging increased uptake of video- conferencing use.

• NEML’s Memory Assessment Program and Support Services connection to a remote Geriatrician.

• Planning is in place to use video-conferencing, and also in-home monitoring in the Connected Care Telehealth project and to partner with the After Hours GP project.

• The planned extension for the current post- natal depression project “Early Years Outreach Clinic” with St John of God Hospital with Telehealth clinics in other destinations in the region has been prioritised after the preliminary general practice roll out.

In addition there are two other projects in the community in which NEML is seeking to collaborate on in the near future.

Although I started work as the Telehealth Support Officer 3 months after the official start of the project, I have found the role immensely rewarding. I have lived in the New England and Northern Rivers region since 2003, and am passionate about the promotion of equity of access to health services for all people in rural and remote areas of Australia. In my opinion, use of video-conferencing for accessing remote health providers can only be of

telehealthImplementation & current use of

JOY BOWLESTelehealth program Manager


telehealthImplementation & current use of

benefit to the people and communities who have previously been disadvantaged by their distance from Australia’s urban centres. Here’s one story I collected during my RACF visits that highlights the benefits of video-conferencing in aged care facilities:

“A resident of an aged care facility in Glen Innes, an elderly frail gentleman, had something wrong with his eye. His GP thought that he might need to have his eye removed, so referred him to the ophthalmologist in Armidale, a larger town one hours drive away. Because he had no friends or relatives living nearby and the ambulance services in our area are often already stretched beyond capacity, the man took a taxi. Of course, the taxi had to wait for him during the appointment so the man could return to his aged care facility afterwards. The man’s eye did not need to be removed, but the ophthalmologist required three follow-up appointments in the next week, just to check the external area was healing correctly. Unfortunately, the aged care facility and the specialist did not at the time have access to video-conferencing. If they had, they could have saved their patient $1,200 in taxi fares – it was a $400 return trip from Glen Innes to Armidale.”

The key issue facing health providers as we move into the electronic health era will be interoperability of systems. To provide seamless, integrated, multidisciplinary care pathways that allow maximum flexibility, choice, and timely access to appropriate services, all health providers are going to need to be able to communicate freely with one another

and their patients. Historically in NSW, public and private health care have been separate entities. It seem to me that the time has come for patients to be at the centre of their own health-care, and it benefits all of us in health care to work together to help make the patient journey as smooth as possible. This must include modalities such as professional accredited allied health and perhaps even alternative and complementary medicine practitioners.

The technology exists, or is very close to being operational. In my opinion, what is required is the adoption of interoperability and inter-connected care pathways as a key priority by the upper levels of management in both the public and private health sectors.

By 2018, I would like to see a seamless interoperable video-conferencing and “Telehealth in the Home” capability across the whole Hunter New England region, with all GPs, Specialists, Allied Health Providers and Aged Care Facilities able to provide the best care for their clients, regardless of their place of residence.


Imagine the challenge of not being to do an ordinary task like making a doctor’s appointment or ringing a family member.

Since 1995, the National Relay Service (NRS) has provided an Australia-wide phone relay service that helps people with hearing or speech impairments to make successful phone calls. Using specially trained relay officers who act as a bridge between callers, the service results in users having phone conversations with less misunderstanding and repetition, allowing them to make appointments and business calls, and keep in touch with friends and family.

More than 1.3 million Australians report hearing impairment as a

long-term health condition and numerous others have a speech impairment. As Australia’s population gets older, the proportion of those with hearing impairments will grow. In fact, this group is expected to double in size over the next 40 years.

In the New England Medicare Local catchment, there are an estimated 8,500 people with a communication impairment, 2,700 with a speech impairment and 11,000 with a hearing impairment. It is estimated that 16,000 people, or 8.6% of the catchment population, report deafness and hearing loss as a long-term health condition.

People with hearing and speech impairments who use the National Relay Service account for more than half a million calls

a year.However, many health professionals have low or no awareness of the service, especially if they have not had personal experience with it themselves. We’re glad of the support the New England Medicare Local to help spread the word. For those who are deaf or have a hearing or speech impairment, and for those who are losing their hearing, the NRS can be an essential part of their lives. Informed health professionals are well placed to let them know about this service and support them to use it.

How the relay service works

The NRS helps its customers to communicate with anyone with a

Introducing the National Relay Service

9


telephone and is also available to hearing people to ring those who are deaf, or who have a hearing or speech impairment. NRS customers generally make their calls on a special phone called a teletypewriter (TTY) which has a display screen and a keyboard. With their TTY, they access different options to accommodate their specific needs. Conversations are relayed between speech and text by relay officers available 24 hours a day, 7 days a week.

Text-based relay calls may also be made through the internet. The calls go to the same relay officers in the call centre, but the user has the extra flexibility of being able to log onto a PC or laptop (with the benefits of a larger screen and keyboard), or even certain models of mobile phones.

Learning to use the NRS is straightforward. Training is free and can be done at customers’ homes. The NRS can also provide one of our Education and Information Officers to run a free information session for anyone who works with clients with hearing and speech difficulties. Just contact us to arrange direct training.

Relay officers are trained to maintain strict confidentiality and the privacy of every call is protected by law. No records are kept of any conversation except for possible training purposes, or where legally required, such as calls to emergency services.

E-learning module and cpD points

The NRS has recently launched a new e-learning module

– ‘Understanding the NRS’ – for health and aged care professionals. If you’re a health professional who would like to know more about the service, it’s a great solution, and includes true stories of NRS users and video animations showing how the different relay call options work. The module also includes interactive video activities with ‘virtual clients’ and may help you earn CPD recognition. It will support health professionals in spreading the word about the important services that the NRS provides.

Go to www.relayservice.com.au/support/introduction-to-the-nrs-e-learning-module/

Find out more

If you want to find out more about how the NRS can help your clients, give us a ring on 1800 555 660 or send an email to [email protected].

The NRS can send you:

• General brochures about what the service does that you can provide to clients• Various factsheets about the different call options• A copy of a DVD which explains how to make and receive phone calls using the NRS, information on all the call options, equipment and emergency calls • Posters to put up in your offices and waiting area

For more information about the NRS, please visit www.relayservice.com.au.

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More and more doctors are applying to train to become a GP in New England/Northwest NSW. One of these doctors, GP Synergy GP Registrar Dr Elizabeth Leprince, explains why she chose north-western NSW as her training ground.

Elizabeth (or Liz as she is better known) is one of 60 GP registrars currently enrolled in the Australian General Practice Training (AGPT) program in the New England/Northwest NSW region through the local GP training provider, GP Synergy.

Training in the AGPT program is the most common way for a doctor to become a GP. In the program doctors are required to undertake three to four years of training in hospital and general practice environments, and pass rigorous exams.

Liz first became interested in general practice after completing a degree in agriculture and working in small rural communities. Whilst she loved her job, as she moved around the different towns she saw first-hand the lack of primary healthcare available in these small towns. It was this experience that sparked her decision to undertake medical training to become a rural GP.

After completing a postgraduate medical degree at the Australian National University in Canberra, Liz began her GP training journey as an intern at Tamworth Rural Referral Hospital.

Record numbers of doctors training in New England/Northwest

Come onecome all!

Originally from Pokolbin near Newcastle, Liz was attracted to region largely by the reputation Tamworth Rural Referral Hospital had for teaching junior doctors.

“Tamworth has always had a really good reputation as a teaching hospital and supporting junior staff, as well as a strong reputation for training rural doctors”, Liz explained.

Although somewhat anxious at leaving her close personal and professional networks, Liz said the wide variety of towns and facilities available in the region also influenced her decision to move to the area.

“Location wise, the area is close to Newcastle and the beach, and easily accessible to Sydney”, said Liz.

“In addition to being a beautiful area, the large regional centres such as Armidale and Tamworth offer a range of things to do, shops, cinemas, theatres and restaurants. The area also has lots of lovely little towns, offering a fit for everyone.”

As part of her GP training experience, Liz spent 12 months specialising in emergency medicine at Tamworth Hospital and 12 months in a general practice in Tamworth. She is now training in the local general practice in the small town of Warialda. In addition to the support and guidance provided by

11


Come onecome all!

her GP supervisors, Liz said the support of the local specialists and other staff in the regional hospitals has been invaluable.

It seems Liz is not alone in her reasons for choosing the New England/Northwest region as her training location of choice. Many other doctors are starting to recognise the same benefits as Liz and are seeking to undertake their GP training in the region.Since 2009, the annual intake of Registrars into the region has more than doubled, from an intake of 10 in 2009 to 26 in 2013.

For more information about GP training, please contact GP Synergy – 02 6776 6225 or visit www.gpsynergy.com.au

Images courtesy of GP Synergy: Dr Liz Leprince (photo taken at Tamworth Hospital during her emergency medicine training).

“Since 2009, the annual intake of Registrars into the region has

more than doubled”

11 12

Moree 55Tamworth 257Armidale 358

ABORIgINALHEALTH Snap Shot

MoreeThe Aboriginal Drug and Alcohol service plays a key role in improving access to drug and alcohol interventions for Aboriginal people within the region.

The Moree Drug and Alcohol team are currently developing a preventative advertising campaign starring local Olympic boxer Cameron Hammond and members of the local community. The campaign message aims to teach youths that they have their whole lives in front of them to achieve great things so, “Get High on Life not drugs!” Filming started this month in Moree so stay tuned to see the final product which will be on television soon.

Tamworth

ArmidaleFebruary 13th 2013 marked the 5th Anniversary of the National Apology to Australia’s Stolen Generation. The Tamworth Aboriginal Health Team, with the assistance of funding from the ‘Aboriginal and Torres Strait Islander Healing Foundation, organised a day of healing to commemorate and celebrate this event. Both the Aboriginal and Torres Strait Islander and Non-Aboriginal and Torres Strait Islander community were encouraged to attend to reconcile and build stronger support networks, highlighting this year’s theme, ‘Healing our Past, Building our Future’.The day comprised of talks from community member and Stolen Generation member, Donna Meehan and the McCarthy Catholic College Dance Group, ‘Deadly X-pression’ also performed their ‘healing dance’ in sync with a story which time-lined events in Australian history.

A highlight was the release of balloons, followed by a minute silence to remember the people and families affected by the issues surrounding the Stolen Generations.

New England Medicare Local’s aim for the day was to encourage and support healing as a community, re-enforce positivity and celebrate this hallmark occasion in Australian history. A turnout of around 300 people and the amount of positive feedback from the community has proven the day was a huge success. New England Medicare Local would like to thank all organisations and individuals who had been involved in assisting with this significant event.

The Tamworth Aboriginal health team has been running a hydrotherapy

exercise program for just under 10 months. Clients have the option

of being picked up on a Thursday to attend the class or alternatively

attending on another day convenient to them. The team have seen

great improvements with their regular clients, Some attend to help with

their diabetes management, others to relieve arthritic pain or to assist

with weight loss goals and some to just improve their overall health and

wellbeing. The classes have received some very positive feedback. The

Aboriginal Health team has challenged participants to shed a few extra

kilos by encouraging them to exercise regularly and enter a three month

weight loss challenge. Staff will help monitor participants progress with

monthly health checks and are offering some fantastic prizes as an

incentive to help shed the extra weight.

The chronic disease Aboriginal health team in Armidale operates a monthly diabetes support group, called “Kick a Goal for Better Health”. The programs key strategies this year are; manage better, feel better, eat better and move better, which incorporates diabetes education, social and emotional wellbeing, nutrition and exercise. NEML staffs as well as outside health professionals are used to deliver fun and appropriate education to the clients. The program also encourages self management with individual goal setting and evaluation of results each month. Observations of clients HbA1c, blood pressure, weight and waist measurement are taken before the program starts and then again after 6 months, with an aim to hopefully measure individual improvements in each client. Staff are excited to begin working with a great new resource called “Feltman” which is an educational tool developed specifically for Aboriginal clients.


EVENTSBOOK

REVIEW

Title: MY GRANDMOTHERS AND I

Author: Diana Holman-Hunt

Diana Holman Hunt was the granddaughter of the pre-Raphaelite painter William Holman-Hunt, whose painting of Christ as light of the world graced the front of many a Book of Common Prayer. While his son was away working in the Far East, his granddaughter Diana, who was born three years after the artist’s death, was shuffled like a parcel between her two grandmothers. Both grandmothers were selfish and self-centred although not in similar ways however both were indifferent to their grand daughter’s welfare.

Diana’s paternal grandmother, whom she called Grand, was the widow of the famous painter and her every word and every action was tilted towards evoking his memory. She was obsessed by her late husband’s genius and lived in a tall, poorly lit house kept as a museum to his memory and filled with jewels, antiques and an astonishing collection of paintings. Grand was also extraordinarily mean, and when Diana went to stay she was expected to sleep on a Chesterfield in her grandmother’s bedroom under a scratchy grey blanket to try and save on heating expenses, and to survive on meagre rations insufficient for a growing girl. Grand was also too mean to take a taxi and preferred to flag down an omnibus by barging into traffic and brandishing her umbrella, which would prove to have disastrous consequences. Going out for tea meant asking the waitress for two empty cups and a jug of boiling water and having Grand produce from her ‘reticule’ a box of saccharin, a muslin bag of tea-leaves and a creased manila envelope of powdered milk. After retiring for the evening, it was impossible to get up in the middle of the night due to the conglomeration of trip wires festooned with bells and assorted pots and pans “for trapping the thieves

what come in the night” and to which her father fell victim when he arrived unexpectedly one evening.

In contrast, her maternal grandmother, with whom she spent most of her time, lived in Sussex in a house by the sea with her husband who had once been a successful barrister but who had gone blind. This grandmother, Grandmother Freeman, was fashionable and self obsessed, always bored and in search of amusement with strong opinions as to whether something was ‘suitable’ or ‘unsuitable’. Diana’s childhood here was strict, old fashioned and whimsical. In between completing her daily list of tasks, she talked to the cupid on the fountain as she considered him one of her few friends, although the numerous maids and servants were allies as well as her grandfather who was possibly the only person who truly loved her. Changes came when he had a fall and Diana was sent off to live with Grand on a more permanent basis until an unpleasant stint at a hateful boarding school, from which she was rescued by her long lost father.

This is a tale of a different life and time, where a miserable childhood has been described in a story without self pity but with a great deal of humour written in beautiful and descriptive prose.

By

JANET ROBILLIARD

New England Medicare Local | Page 15 16

EVENTSFOOD

Warm Autumn Vegetable Soup

There is nothing better than a warm hearty vegetable soup to get rid of an Autumn chill this season.

Ingredients

1 tablespoon olive oil1 medium brown onion, chopped2 garlic cloves, crushed1 celery stalk, chopped1 large zucchini, sliced1 large red capsicum, chopped1 litre salt-reduced chicken stock575g jar napoletana pasta sauce1 cup dried small shell pasta1/2 cup frozen peas80g baby spinachShaved parmesan cheese, to serve

Method

Step 1Heat oil in a large saucepan over medium-high heat. Add onion, garlic and celery. Cook, stirring, for 3 to 5 minutes or until onion has softened. Add zucchini and capsicum. Cook, stirring occasionally, for 4 to 5 minutes or until vegetables start to soften.

Step 2Add stock, sauce and 2 cups cold water. Cover. Bring to the boil. Reduce heat to low. Simmer for 10 minutes or until vegetables are just tender. Add pasta and peas. Simmer, uncovered, for 10 minutes or until pasta is just tender. Stir in spinach. Serve topped with parmesan

Serves

4Cook

35Mins

Easy

Energy1455kJ

Fat Saturated1.70g

Fat Total9.90g

Carbohydrate sugars-

Carbohydrate Total45.60g

Dietary Fibre6.60g

Protein14.70g

Cholesterol7.00mg

Sodium1349mgAll nutrition values are per serve

Nutrition

For healthy tips, hints & ideas from our NEML Dietitians & much more.www.facebook.com/newenglandmedicarelocalwww.twitter.com/NEMedicarelocal

NEW ENGLAND

NEW ENGLAND

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It’s ComingStart your engines People.

TamworthSuite 3, 180 Peel St

PO Box 1916Tamworth 2340

t: 02 6766 1394f: 02 6766 1372

Inverell7 Glen Innes Rd

Inverell 2360

t: 02 6721 4117f: 02 6721 4118

MoreeShop 5, 96 Balo St

PO Box 804Moree 2400

t: 02 6752 7196f: 02 6752 7397

Gunnedah99a Barber StPO Box 687

Gunnedah 2380

t: 02 6742 3633f: 02 6742 3699

Armidale213 Rusden StPO Box 1321Armidale 2350

t: 02 6771 1146f: 02 6771 1170

Glen Innes188 Bourke StPO Box 750

Glen Innes 2370

t: 02 6732 4189f: 02 6732 4181

Tenterfield119 Douglas St

PO Box 630Tenterfield 2372

t: 02 6736 5352f: 02 6736 5353

Narrabri93-95 Barwan St

PO Box 430Narrabri 2390

t: 02 6792 5514f: 02 6792 5518

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