C A T H O L I C H E A L T H A U S T R A L I A

i s s ue 55Sp r ing 2010

www.cha.org.au

matters

NursiNg &midwifery

projeCt findings

released

C H A 2 0 1 0 N At i o N A l C o N f e r e N C e

from the ceo martin laverty

where will we be 10 years from now?

CatholiC healthaustralia

Five-hundred people gathered in Adelaide for the CHA Conference. It was the largest Catholic Health Australia conference ever. Perhaps a reason for the large gathering was its topic—“where will we be ten years from now”.

To look to the future, we can look to the past. Ten years ago, there were 55 Catholic hospitals in Australia. Today, there are 75. This is growth to be proud of. Yet market share of Catholic hospitals in that period has gone backwards, despite growth in actual bed numbers. Similarly, market share of aged care services has gone backwards, despite an increase in actual bed numbers.

If we want our ministries in health, residential aged care, and community care to grow, there is hard and challenging work to be done. Indeed, just to sustain health, residential aged care, and community care ministries as they are today will require work.

At the beginning of 2010, the CHA Stewardship Board, in fulfilment of its strategic plan, asked the CHA staff to commission PricewaterhouseCoopers (PwC) to assess methods by which the 74 members of Catholic Health Australia could sustain and grow their ministries.

During the course of 2010, there were consultations, surveys, and briefings. Every single CHA member was asked to contribute. Most did. PwC wrote up its report, and this was launched on 23 August in Adelaide. The report’s title, inFORMATION, was chosen deliberately. It provides information to all CHA members about why they need to act to sustain and grow, and how action can be taken collaboratively.

It also seeks to address the formation of how each of the 74 members of CHA go about sharing responsibility for the future of all health and aged care ministries of the Church together. The report sets out this challenge by asking us to think collectively and collaboratively about the Church’s future in health and aged care.

The findings of inFORMATION will surprise few.

We are told many smaller Catholic residential aged care services face viability challenges into the future, and that there is a role for a new business advisory service to help them either to grow to become sustainable, to form alliances with other smaller providers, or to find partners able to continue their ministries into the future.

We are told extraordinary growth is expected in community aged care. To position all Catholic providers to be best able to respond to this growth, we are encouraged to profile Catholic credentials better by building brand awareness. We’re also encouraged to negotiate with funders collectively.

For hospitals, we’re told there is no burning urgency for radical change. However, PwC make the point that both public and private funding for hospital services will continue to demand greater cost efficiencies. This begs the question as to if our hospitals are best positioned to meet this efficiency drive into the future. To become more efficient, inFORMATION outlines options for expanded collective negotiation with funders, collective procurement, new collective recruitment strategies, and the establishment of communities of practice or excellence hubs.

policy & advocacygreen healthcare ... the place to be 2aged care who pays 4nursing and midwifery project findings released 8inFORMATION 10

innovationenvironmental stewardship in health care 12mercy sets new standards for aboriginal child health 14australian first for mater private hospital brisbane 15SJOG’s commitment to cutting edge technology 15

national conference 2010conference photos 16conference awards 22

the sector speaksexperienced nurses - the ‘new breed’ in sustainable aged care 24fitzroy crossing—evaluating the impact of alcohol restrictions 26sustainability of the medical workforce 28nurses call for a national nursing and midwifery workforce strategy 29

These are the business considerations, but as Archbishop Philip Wilson told the CHA Conference, as we assess these options we must also give priority as to how our services evolve to fulfil the message of the scriptures.

In considering our ability to continue to fulfil the call of the scriptures, we’re invited through inFORAMTION’s recommendations to assess how health and aged care ministries are responding to the needs of the marginalised or under-served, and how we express the way in which we go about the healing ministry of Jesus.

A gap analysis of the needs of those in socioeconomic disadvantage is proposed to be carried out to assess where health or aged care needs are not being adequately met across Australia. Armed with this knowledge, Catholic services can then plan their service response over the coming years, in the tradition of how many religious congregations once set their services up in response to identified need.

Where it is not possible for a Catholic service to be provided, CHA would take up the case with government to ensure service needs do not go unmet. The service gaps to be assessed would in the first instance be those in which Catholic providers have current expertise. But if the Church is to fulfil its mission of improving the health of those in socioeconomic disadvantage, it should not restrict itself to hospital and aged care.

The CHA/St Vincent de Paul/Catholic Social Services Australia Advocate in Residence, Fr Frank Brennan, told

the Adelaide conference that it is the social determinants of health that have the greatest impact on the likelihood of a person facing a premature death. The social determinants are those factors such as early childhood experiences, quality of schooling, the transition to work, income, housing, and social connectedness. As evidence emerges on how crucial these factors are to a person’s health, Catholic health providers will need to consider what role they should play in working with others to ameliorate the adverse impacts of the determinants of health.

inFORMATION addresses these and other challenges for our future. It sets out a ten year road map for how we can collectively ensure we sustain and grow Church ministries into the future.

The road map is only that suggested by PwC. It is has not been adopted. It is not CHA policy. Rather, the road map is now over to you. Having provided inFORMATION as a platform for the CHA membership to discuss its future over the next decade, you are now invited to speak up in response to the report to help chart the next phase of our shared future.

The report and associated materials can be accessed at www.cha.org.au . In the coming weeks, each CHA organisation will be invited to a general meeting of the association in December to formally respond to the report recommendations.

In the interim, feel free to let me know what you think. All feedback will form part of the response of how we set about the next 10 years of our shared future.

ethicsremember RU486? 30

people and places100 years on mater hill 32award for indigenous health project 32mercy place warrnambool blessed 32opening of southern cross apartments 33cabrini expands its rehabilitation services 33murdoch couch gets front row seat at parliament 33st vincent’s brisbane—a different approach 34CHA members recognised 34a ‘life-changing’ milestone 34

comings & goingsSJOG subiaco farewells long serving director 35a new era in care 35

newsnew publication informs holistic pastoral care 36

Health Matters is published quarterly by Catholic Health AustraliaEditor – Kylie Walker

Copy Editor - Adrienne DayNational Office, Level 1, Rowland House,

10 Thesiger Court DEAKIN ACT 2600 | PO Box 330, Deakin West ACT 2600P 02 6260 5980 F 02 6260 5486 e secretariat@cha.org.au

www.cha.org.auABN 30 351 500 103 ISSN 1443-3532

CHA 2010 National Conference pictures (front cover and pages 16,17, 22 and 23)courtesy Layne Hardcastle Photography.

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policy & advocacy

At the time of writing this article, the US government’s National Oceanic and Atmospheric Administration has just issued its August report on global temperatures for the year to July 20101. This report stated that global temperatures so far this year (to the end of July) are at their highest levels since records were commenced in 1880. For planet Earth as a whole, July 2010 (average temperature 16.5 C) was the second warmest July on record behind 1998.

Going beyond numbers—how and where has this outcome manifested itself?

One of these areas was western Russia where large forest fires and extensive drought have occurred. Moscow, better known for the bitter cold that ended up contributing to the undoing of both the French and German invading armies in each of the last two centuries, set a new all-time maximum temperature record of 39C on 30 July. Before this the previous highest temperature recorded in Moscow was 36.8C over 90 years ago.

More significantly, the Russian drought has resulted in 25 per cent of the Russian grain harvest being wiped out and caused world wheat prices to jump around 50 per cent over the last couple of months.

While Australian wheat farmers will no doubt rejoice at increased prices, for many people in developing countries the result will be food shortages, riots and in some places starvation—just as occurred in 2008 after the World Bank reported an 83 per cent increase in food prices between February 2005 and February 2008. Apart from food riots, most of these consequences will occur quietly and out of sight of the western media.

More visible has been flooding in Pakistan which has impacted on the housing and livelihoods of 20 million people (some five times the scale of the impact of the Indian Ocean tsunami in 2004), as well as widespread flooding in China. As global warming continues, such events are predicted to increase in frequency.

As has been the case with the Global Financial Crisis, most of Australia’s population has been fortunate in avoiding—at least up to now—some of the most serious consequences from climatic fluctuations. We have become used to regarding disasters, whether economic or environmental, “over there” as the norm.

While Australians have long been used to dealing with a widely fluctuating climate—the recent 12 year-long drought over the Murray Darling basin and the impact of the recent Victorian bushfires in 2009 suggest that all is not right here as well.

Indeed while the impact of the Victorian bushfires has been imposed on our national psyche, it is much less well known that nearly twice as many people (374) died in Victoria in the week before the bushfires as a result of the heatwaves that brought record temperatures to Victoria2, according to data assembled by the Victorian Department of Human Services in a report titled: January 2009 Heatwave in Victoria: An Assessment Of Health Impacts.

Figure 10 from the above report is included opposite showing deaths between 26 of January and 1 February 2009 together with Melbourne’s maximum temperature during that period.While there is wide agreement among climate scientists that the world has and is continuing to warm and

that most, if not all of this warming is due to human activity, our political systems, whether at a global or national level, are having trouble developing effective responses that both seek to reduce our emissions of greenhouse gases as well as preparing our societies to adapt to the changes that are already inevitable given past emissions.

If national level governments are having difficulty crafting a credible response to human induced climate change, this is even more problematic within countries at an individual industry level.

The health industry in particular has been slow to respond to the challenges posed by climate change. Given the fragmented nature of the delivery of health services, which range from one or two person GP or allied health practices in the community through to very large hospitals that consume large amounts of energy water and other materials, this should not come as a surprise.

As with national and international efforts, the health sector will need to respond in two broad dimensions—reducing its own emissions of greenhouse gasses, and gearing up to adapt to increasing demand for health services resulting from the impact of warming. The health sector and hospitals in particular are high users of energy and consequently significant contributors of greenhouse gases to the

“If we are clever, the development of a carefully crafted climate change strategy may well result in better overall health outcomes.”

green healthcare … the place to be

atmosphere. Energy is required to drive many of the high technology diagnostic equipment such as MRI scanners as well as operating theatres. Providing ventilation to large buildings also consumes large amounts of energy.

None of us want to compromise the therapeutic effectiveness of hospitals and health services. Smarter design—especially of buildings which can enhance the use of natural light and ventilation—can however result in significant improvements in energy efficiency.

Hospital campuses and buildings can also incorporate alternative energy generating technology such as wind and solar power within their built fabric. Some hospitals in the US have gone further by using the waste water from the wider community as both a power source and to enhance ambience by creating ponds that can also act as heat storage mechanisms.

The health sector will face increasing demand for health services as a result of the impact of warming. This includes those, especially the elderly, who may increasingly suffer directly from increased frequency and intensity of

heatwaves or are indirectly affected through the impact of the spread of diseases such as dengue fever.

It is therefore welcome to see the increase in spontaneous initiatives being taken by individual Catholic health providers to increase their environmental sustainability and to reduce greenhouse gas emissions. It will be important for us to increasingly share and network our achievements across both the Catholic and wider health sectors.

It is interesting that many of the measures that will be effective in reducing the gas emissions are also likely to be effective in promoting improved health. For example encouraging greater use of public transport will also add to an increase in physical activity. Less atmospheric pollutants will also result in reduced respiratory illness and reduce demand of health services.

There are times when good policy in one area can have positive impacts in other areas. If we are clever, the development of a carefully crafted climate change strategy may well result in better overall health outcomes and in reducing demand for overstretched health services.

Footnotes:

1. www.noaanews.noaa.gov/stories2010/20100813_globalstats.html 2. January 2009 Heatwave in Victoria: an Assessment of Health Impacts accessed at http://www.health.vic.gov.au/chiefhealthofficer/downloads/heat_impact_rpt.pdf

deaths between 26th jan and 1st feb: mean deaths in 2004-08 vs 2009

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patrick tobin

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policy & advocacy

The purpose of the Productivity Commission’s public inquiry into aged care, Care for Older Australians, is to develop options for the redesign of the current aged care system in response to:

• increaseddemand• shiftsinthetypesofcaredemanded,and• theneedforworkforceexpansionatatimeoftightening

labour markets and widening wage differentials with other sectors.

Embedded in the inquiry’s terms of reference is a requirement that the options are financially sustainable for government and, with appropriate private contributions, for individuals. Further, the Productivity Commission is required to assess the medium and long term implications of any changes it proposes for the Commonwealth Budget.

projected spending This focus on cost and sustainability is understandable. The 2010 Inter Generational Report projected that spending on aged care as a proportion of GDP would rise from 0.8 per cent to 1.8 per cent by 2050, with expenditure on residential care rising to 1.4 per cent of GDP.

The projection is based on the continuation of current government policies, the most significant of which being the provision ratio (113 places per 1,000 people aged 70 and over) and a balance of care ratio which favours residential care.1 The primary driver of the projected cost increase is the growth in the number of people aged 85 and over, which is expected to quadruple to 1.8 million by 2050.

The projection also factors in an annual 1.6 per cent real increase in per capita expenditure (equivalent to the projected annual rate of productivity growth). But it is a moot point to what extent this index can take into account the rising incidence of dementia and chronic conditions, wage pressures from a tightening labour market and the reduced availability of informal carers due to structural ageing and other social factors, and rising community expectations.

While a 1.0 per cent increase over 40 years (from 0.8 per cent to 1.8 per cent) may not sound much, it represents a 125 per cent increase which would put expenditure on aged care on a par with education and defence (but still half that for the age pension and about a quarter of expenditure on health).

who pays nowThe Commonwealth currently meets about 70 per cent of the costs of aged care from consolidated revenue (ie current taxpayers). The balance is contributed by care recipients, including payments made from age pension entitlements. The Commonwealth’s contribution varies with care types, ranging from 95 per cent for an EACH package, 75 per cent for residential high care, through to about 50 per cent for residential low care.

In broad terms, the funding issues to be weighed up include:

• What is the appropriate split between privateresponsibility and community (taxpayer) responsibility?

• Whatistheroleforpre-paymentarrangementswherefuture beneficiaries accumulate funds needed to cover their long term care costs?

• Ifthereistobeacommunitycontribution,howisitbestfunded—from consolidated revenue, or by a special levy or compulsory insurance premium on tax payers?

who should pay?Community norms would suggest that individuals should be responsible for their own life time needs, with government providing a safety net for those who cannot support themselves or becoming involved when a public good case can be made. Applied to aged care, this would point us in the first instance in the direction of pre-payment arrangements such as private insurance and savings accounts dedicated to aged care.

Voluntary savings accounts are unlikely to be effective or efficient. The considerable unevenness in the likelihood, duration and intensity of need for formal aged care and the unevenness in people’s financial capacity to contribute towards their care needs are likely to result in over or under saving. Inevitably, this would mean the continued need for a government funded scheme which, in turn, would be another disincentive for saving.

voluntary private insurance options The experience with voluntary private insurance options is also not encouraging, as evidenced by poor take up in other countries. Several practical issues present themselves.

“(Inertia) must not be allowed to hold up essential reform of the aged care system.”

aged care - who pays?

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First, there are complexities in pricing long term insurance products eg factoring in the possibility of advances in medical technology affecting entire cohorts and the extent to which informal care may or may not be available. Second, there are also demand constraints arising from the likely unaffordability of premiums for older cohorts who have never held long term insurance and the availability of a government funded system.

Finally, transitional intergenerational equity issues arise as the younger insured start accumulating while at the same time supporting the government scheme for the older uninsurable. The intergenerational equity issue is amplified in the Australian context by size of the ageing, and currently uninsured, baby boomer generation.

pay-as-you-go This brings us full circle to the current system of pay-as-you-go from consolidated revenue or some variation of compulsory social insurance by way of a dedicated aged care levy on taxpayers or premium linked to an accumulation fund or funds from which benefits would be paid.

The experience with overseas social insurance arrangements as they mature is that they struggle with the affordability of levies and contributions and the adequacy of fund accumulations, with many having to look for ways to top up funds from consolidated revenue and constrain eligibility and benefit levels, ie sustainability remains an ongoing issue.

intergenerational equity These options also raise intergenerational equity considerations as they would all involve younger tax payers contributing to the aged care cost of current older cohorts, as well as their own. The extent could be cushioned by, for example, only applying the levy to tax payers above a certain age, but the levy would only be affordable if there was also a significant contribution from consolidated revenue (as in the case in Japan).

The intergenerational equity issue in a pay-as-you-go system can however be overstated because a consequence of the costs of aged care being met by current taxpayers is a preservation of inheritances, though the extent of inheritance preservation would not fall equally for all taxpayers.

In CHA’s submission to the Productivity Commission Inquiry, we argued that the costs of accommodation and living expenses should be met by the individual, using the

rationale that older people who are cared for in an aged care home should continue to contribute towards the cost of their accommodation and living expenses as they would if they continued to live in the community. Safety nets should apply for people without means, in the same way as they apply for the population at large, to ensure equity of access to quality aged care services irrespective of personal circumstances.

The costs of personal and nursing care can and do fall unevenly in later life. Consistent with the Medicare principles, the financial risks involved should be shared across the community.

copayment arrangements People who can afford to should also make a reasonable contribution towards the cost of their care, as is currently the case. The tightening of means testing arrangements in 2005, which were first introduced in 1997, has seen aggregate resident contributions towards care costs increase by 13.5 per cent per annum.

Copayment arrangements such as these are essential if funding arrangements are to be sustainable, irrespective of the aged care funding system used. Equally, compulsory superannuation schemes, such as Australia’s Superannuation Guarantee Scheme, have a role to play.

nick mersiades

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Although primarily intended to support people in their retirement, superannuation savings may be available to contribute to aged care costs (depending on an individual’s accumulations, longevity and the financial performance of allocated pensions).

More importantly, compulsory superannuation can significantly increase Commonwealth Budget flexibility by reducing the amount required to fund age pensions, especially if the contribution rate were to be increased beyond the current 9.0 per cent.

future funding Identifying sources of funding for aged care services is, however, only one side of the equation. Irrespective of the funding system, funders and governments will also be concerned to ensure that care of an appropriate quality is delivered as efficiently as possible.

Hence, the future funding system will need to be complemented by aged care arrangements which allow greater scope for competition and innovation, and for

service choice in response to consumer needs and preferences. Long term care costs can also be reduced by an appropriate focus on preventative strategies designed to maximise independence for as long as possible.

Experience would suggest that the final shape of aged care funding arrangements will revolve around pay-as-you-go from consolidated revenue or social insurance, or a combination of both. Either way, the complexity of the issues involved in the design of a system acceptable to the community suggests that changes to current arrangements for funding community contributions will not be arrived at easily or quickly.

Consideration of these matters will be competing with other priorities, including a social insurance scheme for people with a congenital or acquired disability, the appropriate contribution level for the Superannuation Guarantee Scheme and perhaps even pricing arrangements for carbon pollution. It is also the case that there may be merit in not considering aged care funding arrangements in isolation from future funding arrangements for health care.

aged care—who pays?

1. Create a more open market for aged care services by introducing ‘entitlement based on assessed needs’ and greater choice of service provider and services, supported by fair and robust assessment arrangements to ensure that subsidy payments go to all who are assessed as in need of care and support.

• Would create a more efficient and innovative systemthrough enhanced competition which would reduce the cost of the system and financial risk for whoever is paying for it (private or public).

• Would provide a market informed basis for settingprices and subsidy levels to cover the real cost of care and accommodation. Price controls could be maintained until the market deepens or where markets do not operate efficiently.

• Would allow for consumer choice and greaterresponsiveness in service delivery and service types, consistent with rising community expectations.

• Theavailabilityofgreaterconsumerchoiceofserviceswould make user contributions more acceptable to the community, and provide an incentive for more people to plan and save for their aged care.

• Comprehensive safety net arrangements wouldcontinue to be needed for those with special needs.

2. Create a rational basis for public policy making around user contributions by ‘unbundling’ aged care costs

• Consistent with Medicare principles and the sharing of financial risk, a means tested subsidy would be available for all to support personal care and nursing costs. Means tested contributions would be expected to increase as the Superannuation Guarantee Scheme matures and the contribution rate is increased (going to 12 per cent is supported) and community wealth increases.

• Consistent with lifelong arrangements, living costswould be a private responsibility (supported by the age pension for those with fewer means).

• Also consistent with lifelong arrangements,accommodation costs would be a private responsibility, supported by a safety net for those without means.

3. Introduce flexible payment arrangements for private contributions to accommodation costs for all residential aged care, including a deferred payment scheme.

• Would allow people to tailor payments to meet their

individual circumstances.

• Wouldcreatefairerarrangementsacrossallresidentialcare by abandoning the high/low distinction.

• WouldrecognisethatwealthformostAustraliansisinthe illiquid form of home ownership.

• Would provide a source of capital for the expansion and renewal of residential high care, which is urgently needed.

• Theimplicationsforintergenerationalequityshouldbekept in perspective; while increased user contributions would impact on inheritances, the alternative is that current tax payers would meet the costs involved at the expense of current consumption.

4. Support the development of ‘independence’ and ‘active service’ models of care and support for the less frail aged.

• Timelyinterventionandeducationanduseofassistivetechnologies can enable older people to maintain a higher degree of independence for longer, thereby reducing the level of ongoing support required.

CHA’s submissions to the Productivity Commission Inquiry (the Initial Submission in April 2010 and the Supplementary Submission in July 2010) may be accessed at www.cha.org.au/site.php?id=18.

CHA’s reform proposals

Confronted with these and other Budget and political pressures, inertia may hold sway for some time regarding the bigger funding picture for aged care. However this must not be allowed to hold up essential reform of the aged care system, as proposed in CHA’s submissions to the Productivity Commission Inquiry.

Their implementation would not compromise opportunities for future funding system reform. More importantly, their implementation would result in an aged care system with attributes that would be desirable to support any future funding system.

CHA’s reform proposals are wide ranging and comprehensive, but for the purposes of this article the key elements with sustainability implications may be presented as follows:

Footnotes:

1. Rebalancing the care ratios more in favour of community care would reduce costs to the Budget, but this effect should not be overstated because accommodation related expenditure is currently only about 11 per cent of total residential aged care subsidies (though arguably the proportion would be higher if Commonwealth subsidies were to reflect the real cost of renewal and expansion of high care homes).

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nursing and midwifery project findings released

In March 2010 Catholic Health Australia (CHA), under the leadership of the CHA Directors of Nursing and Midwifery (DONM) Committee and with the generous support of project sponsor Health Super, invited Nurse/Midwifery Unit Managers (N/MUMs) employed across CHA membership to participate in a project that would identify the barriers and enablers in their N/MUM role.

The project also aimed to identify strategies to support N/MUMs in carrying out this role, recognising the pivotal part they play in coordinating patient care.

The project design, in part, replicates the NSW Health-led ‘take the lead’ project undertaken in 2008. The ’take the lead’ project aimed to determine the essential framework within which N/MUMs should work, and the skills they require to carry out the role.

Like the NSW health ‘take the lead’ project, CHA developed a survey which was distributed to N/MUMs in April 2010 to collect data on their roles and the challenges and benefits of working in a Catholic health service. The survey questions were broadened, however, to obtain better demographical data. Focus groups were then conducted in May 2010 in every Australian capital city from which N/MUMs had responded to the survey.

Preliminary analysis of the survey data collected was reported back to survey participants to validate the findings and their interpretation. N/MUMs were also asked to identify any barriers and enablers that they perceived either hindered or assisted them in fulfilling their roles. The skills and attributes necessary for the role of N/MUM, and the ‘ideal’ N/MUM role were also discussed.

The findings presented in the report describe the N/MUM key functions and responsibilities and identify the supports required for N/MUMs to fulfil their roles. These findings lead to a number of recommendations for action to support N/MUMs.

As a result of the consultation processes and analysis of survey results, seven key issues have emerged:

1. Core responsibilities2. Management capacity3. Workforce planning4. Professional development5. Leadership6. Broadening of management scope7. Research and development

These areas cover the key issues identified and have been progressed into a number of recommendations to help inform future discussions with the CHA DONM Committee.

policy & advocacy

Key findings identified include the following:

• There are a variety of educational levels among N/MUMs. CHA N/MUMs appear to hold higher numbers of graduate and post graduate qualifications than the respondents to the NSW Health ‘take the lead’ survey.

• LiketheNSWHealth‘takethelead’surveyresultsCHAN/MUMs report a large percentage of time spent on general management tasks.

• N/MUMs employed across CHA undertake a broadrange of functions within the clinical areas that they manage; their roles vary significantly, are described differently, carry different titles, and have variable support structures.

• There are vast differences in N/MUM roles across the country. Significant variability commonly exists in the role between clinical units within a given health service as well as across services within CHA. There is minimal standardisation of the role and as a consequence the role is not clearly defined and understood fully by many N/MUMs themselves, executive management of health services and other personnel working in health services.

• The lack of clarity around the N/MUM role in somehealth services has lead to N/MUMs taking on a range of responsibilities that are not generally considered key responsibilities.

• Key responsibilities of the role of N/MUM aregenerally understood to be staff management, general management, quality and safety, and leadership. However, N/MUMs in CHA describe a very broad range of responsibilities that commonly extend beyond the identified key responsibilities.

• N/MUM roles often include a range of operationalresponsibilities extending into other areas of the health service and may include overseeing or playing an active role in maintenance activities, infrastructure management, equipment and supplies, and human resource responsibilities.

• Engagement in theseactivitiesandthe timeallocatedto these activities diverts managers from what are considered to be the key responsibilities of their role. Many N/MUMs report significant involvement in human resource services, occupational health and safety, and payroll clerical practices. Devolvement of these practices to other departments is supported by the majority of N/MUMs.

• Significant variability exists in the amount of clinicalresponsibility built into the N/MUM role. Many N/MUMs report that a clinical leadership role should be distinct from a management leadership role, and that the removal of clinical responsibilities would support them in their management role.

• N/MUMs report that the values and mission of theservices in which they work are generally known, understood and applied by staff of the services. The values and mission are considered to be valuable in guiding N/MUMs in managing performance and human resources issues and to have a positive impact on the environment of the health service. They are considered to be explicit in the services and practised widely.

• N/MUMsmeasuresuccessintheirrolebystaffretentionrates, number of staff performance issues, team development, and level of professional development of support available for themselves and staff. Therefore support to achieve positive results in these areas is sought by N/MUMs.

• N/MUMshaveexpressedtheneedforgreaterautonomyin their role, position descriptions signed off by line managers, and the development of clear key performance indicators against which their performance can be targeted and managed. Many also seek a framework comprised of a performance development pathway with necessary professional development support and key performance indicators arising from the position description.

CHA has developed a range of recommendations that will be considered by individual Directors of Nursing and the CHA DONM Committee. CHA is also grateful to Health Super for its sponsorship that enable this project to be undertaken.

The full report can be found on the CHA website. If you would like a hard copy of the report (minimal numbers available) please email Liz Callaghan at lizc@cha.org.au.

nursing and midwifery project findings releasedliz callaghan

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policy & advocacy

what is inFORMATION?As your member association, you told us in 2008’s consultations in developing the CHA Strategic Plan to give priority to “... identifying what is required for the long term effectiveness of the Catholic health and aged care sector”.

inFORMATION has been aimed at informing the future of Catholic health and aged care services and improving the way in which Catholic care is provided for individuals and communities.

Why did CHA follow up on this recommendation?The Rules of the Catholic Health Australia Association state part of CHA’s role is to:

a) take a leadership role in supporting and strengthening its membership to develop individually and collaboratively to ensure the healing ministry flourishes as an integral part of the mission of the Catholic Church

b) renew and inform through research as the basis of advocacy and communication both within and outside the sector, and

c) communicate to the members relevant matters of significance.

inFORMATION seeks to do just that. PricewaterhouseCoopers (PwC) was commissioned to consult and research and outline ideas for CHA members to develop individually and collaboratively to sustain and grow Catholic ministries for the future.

inFORMATION reveals that:• Thereisnourgencyforradicalchangethatshould

encourage members to change their current activities. There is urgency to address viability challenges for some aged care providers.

• There are opportunities open to Catholic health,aged and community care services to grow through collaborative planning options.

• Organisations are independent; services oftencompete with each other for resources.

• PeopleinmanydisadvantagedcommunitiesacrossAustralia do not currently have access to those services that are uniquely Catholic.

• Thehealth,agedandcommunitycareworkforceisdifficult to attract and retain.

• In some geographical areas there has beenlittle collaborative strategy between Catholic organisations, including limited information sharing and few partnerships. In other geographical areas collaboration is strong.

headlines• CatholicHealthAustraliamembersprovide33per

cent of all community care packages (excluding Home and Community Care services).

• There are 23 aged care services under 100 beds,of which 17 have less than 60 beds and are usually operated by a single Catholic owner. Research suggests that services of less than 40 beds are well below the minimum efficient size for most locations.

• There are many areas of need that the Catholicsector could invest future services in.

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liz callaghan

What specifically does PricewaterhouseCoopers recommend the CHA membership thinks about and responds to over the next decade?

PwC has presented a ten year options plan. Slowly and cautiously over the next decade, PwC proposes that the CHA membership considers options to:

PwC has also advised that into the future a federation of Catholic organisations might be best suited to sustaining and growing our ministries. This model would allow organisations to remain responsive and innovative in service delivery, and to retain independent governance and decision making. It would foster a new Catholic ‘sub-brand’ to acknowledge a broader, united Catholic health, aged and community care sector.

Initial survey results following consultations in July / August generally show significant support for most recommendations presented.

next stepsTrustees of Catholic organisations are invited to meet in December 2010 to discuss and agree what the future looks like for the Catholic sector(refer back cover of this edition of Health Matters). That meeting will be asked to agree a set of options for implementation drawn from the inFORMATION report.

the full reportThe full PwC inFORMATION report will be sent to all CHA members. A copy of the report can be downloaded from the CHA website at www.cha.org.au.

• Createanindependentagedcarenegotiationservicetoprovide small Catholic aged care services with access to a panel of vetted commercial advisors, aiding the necessary support to undertake informed negotiations towards partnership and amalgamation.

• Encourage partnerships between the smallest, morevulnerable, Catholic aged care services with larger, sustainable Catholic aged care service providers, leading to progressive amalgamation of approximately 17 organisations by the end of 2017.

• Develop a large, common and identifiable ‘Catholic Care’ brand for all Catholic managed community care services.

• Conduct a gap analysis to identify unmet communityneed with a focus on the poor and underserviced resulting in a sector (refer back cover ... ) wide strategy to address gaps over the coming decade.

• Develop a common Catholic Mission statement tofurther enhance trust, collaboration and formation in the sector.

• Share information transparently within the sectorthrough the creation of a knowledge management model that would enable hospital and aged care benchmarking, and developing communities of practice.

• Adopt a proactive approach to increase collaborativeagreements for goods and services.

• Provide accessible and affordable Mission training tocurrent and future governance personnel.

• Promote a series of current best-practice modelsof governance in the sector, with a focus on skills to interpret and guide the Catholic Mission, commercial skills and operational skills relevant to the sector.

environmental stewardship in health care

The health of the environment and the health of people on planet Earth is intrinsically linked. We as human beings depend on the quality of our water, air, land and ecosystems to survive and ensure a good quality of life. At St Vincents & Mater Health Sydney (SV&MHS) environmental sustainability is high on the agenda.

“In the health and aged care sector, where looking after people and the community is what we are passionate about, we are well placed to ensure our own house is in order and seek to minimise harm to the environment,” SV&MHS CEO, Steven Rubic said. “This can be achieved by reducing energy, water, waste and pollution with the added benefit of significantly reducing costs, improving patient and client outcomes, better staff health and recruitment and positive flow on benefits to the community.”

Hospitals are among Australia’s most energy and water intensive facilities using twice as much energy per square metre as a commercial office building and six times as much water2. Statistics from the United States show that health care uses four per cent of all energy consumed and an average sized hospital emits approximately 18,000 tonnes of carbon dioxide annually (the equivalent to 3000 cars on the road). This in turn makes health care a significant contributor to global greenhouse gas emissions and climate change.

A mission imperative for Catholic health organisations is to care for the environment and be good stewards of the earth’s resources. A degraded environment has a negative impact on communities, especially the poor and disadvantaged. To be good stewards of financial resources it is also essential to be responsible in our use of and impact on the natural environment.

Recently in the encyclical ‘Caritas In Veritate’3, Pope Benedict XVI said that “The environment is God’s gift to everyone, and in our use of it we have a responsibility toward the poor, toward future generations, and toward humanity as a whole”. Catholic health care organisations working within a mission framework are in a unique position to drive change and optimism by aiming to lessen their environmental impact.

From a legislative standpoint there can be thirty or more pieces of environmental legislation potentially applicable to any one health or aged care facility. Many large health and aged care organisations in Australia now have mandatory reporting obligations under the National Greenhouse and Energy Reporting Act and Energy Efficiency Opportunities Act. To ensure compliance with this legislation robust energy and greenhouse gas emissions reporting systems must be put in place. There are penalties for non-compliance and reports may be audited by an external third party.

There are resources available to those beginning on the environmental sustainability journey. The Green Building Council of Australia’s Green Star Health Care tool provides a framework for the sustainable planning, design and construction of high performing and efficient health care facilities. Catholic Earthcare has been working to educate and empower schools, parishes and health care organisations. Internationally, organisations such as Healthcare without Harm and the Green Guide for Health Care provide tools for ‘greening’ up health care buildings and service delivery. From an advocacy perspective recently a national Climate and Health Alliance was formed in Australia by stakeholders in the health care sector who wish to see the threat of climate change addressed.

References

1 Healthcare without Harm, www.noharm.org/ 2 Davis Langdon Research Report, Health Sector Joins Green Ratings Era,

www.gbca.org.au/resources/publications/davis-langdon-report-health-sector-joins-green-ratings-era/2413.htm

3 The Vatican, The Supreme Pontiff Benedict XVI, 2009, www.vatican.va/holy_father/benedict_xvi/encyclicals/documents/hf_ben-xvi_enc_20090629_caritas-in-veritate_en.html

innovation

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“By using excess energy, polluting the environment with phthalates, mercury and other toxic chemicals, and producing waste which is burned instead of recycled, healthcare is ultimately compromising public health and damaging the ability of future generations to meet their needs.”

Health Care Without Harm1

(left) Kylee Carpenter with Amanda Barnes (on bike) the winner of a bicycle competition to design the SV&MHS environmental logo

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St Vincents & Mater Health Sydney (SV&MHS) is taking seriously the ‘do no harm’ philosophy and its organisational mission and values by having recently developed an Environmental Sustainability Strategy (ESS). The focus areas of the strategy are:

case study: SV&MHS environmental sustainability strategy

• Utilities and Greenhouse Gas Emissions – reducingthe energy, water and greenhouse gas emissions associated with SV&MHS activities.

• Buildings and Physical Environment – maximisingthe environmental sustainability of new and existing infrastructure through best practice sustainable design.

• Waste Avoidance and Resource Recovery – using thewaste hierarchy philosophy of ‘avoid, reduce, reuse, recycle’ to minimise waste to landfill and clinical waste and increase recycling rates.

• SupplyChainandProcurement–alldecisionsinvolvingthe procurement of goods and services will take into account the environmental impact of the product.

• Transport and Travel – implementing programs andcreating infrastructure that facilitates and encourages alternative transport options to the single occupant motor vehicle.

Some examples of current SV&MHS initiatives include energy efficient lighting installation in the car park (where lighting must be on 24/7), recycling of sterile wrap, defaulting printers to double side print and energy and water saving design for new buildings and redevelopments. Promotional activities to build a culture of environmental stewardship such as participation in World Environment Day and Ride to Work Day are regular annual activities.

There are plans to have a series of Eco-Workshops for staff and the formation of a Bicycle User Group for those that cycle to work. Comprehensive energy, water and waste audits are planned for each site to identify areas for investment in energy and water efficiency and for targeting behaviour change programs.

The key to the success of the sustainability strategy is the ‘enabling mechanisms’:

• Governance – putting strategies in place to removebarriers and provide the necessary direction and drive to implement the ESS effectively.

• Measurement and Accountability – development ofdata and systems needed to measure and improve environmental performance.

• Engagement and Knowledge Building – providing thenecessary education and support, at all levels, to allow people to contribute fully to environmental stewardship.

In the learning from this process, SV&MHS has identified some key critical success factors for health and aged care facilities who are beginning down the sustainability path:

• Creatingacultureofsustainability– itshouldbepartof everything you do as an organisation. Educate staff about what it is you are trying to do and develop clear messages. Involve staff and garner leadership support.

• Data–weallknowthatyoucannotmanagewhatyoudo not measure. By making energy, water and waste statistics highly visible to management and other staff this will drive change and build your business cases.

• Having agreed upon goals – this will help focus and

coordinate the efforts of different groups across the organisation so you do not get lost trying to achieve everything at once. Have a yearly action plan for each focus area.

• Addressing the “low-hanging fruit”– as you begin,undertake easy to implement, low-cost initiatives that help build momentum and support. Make sure you celebrate and communicate these achievements.

kylee carpenterenvironmental

stewardship managerst vincents and

mater health sydneyCEO Steven Rubic planting a tree on World Environment Day to launch the SV&MHS Environmental Stewardship Strategy

innovationmercy sets new standards for aboriginal child health

A new maternal and child health program for Aboriginal and Torres Strait Islander families at Mercy hospital for Women in Victoria promises to deliver a better health service to Indigenous communities which, if successful, could serve as a model of care for other Australian hospitals.

“We’re going to look after the health and wellbeing needs of Aboriginal and Torres Strait Islander children from their conception through to early primary school age,” says New Direction Program Manager, Joanne Borg.

“The program is called Nangnak Wan Myeek, which in the Wurundjeri language means ‘nurture, care and look after me and mine’.”

The project received funding from the Office for Aboriginal and Torres Strait Islander Health for four years under the Australian Government’s New Directions program, which is part of its ‘Closing the Gap’ strategy and policy framework for Aboriginal and Torres Strait Islander maternal and child health. The hospital is one of only three New Directions programs to commence in Victoria.

The CRC for Aboriginal and Torres Strait Islander Health (CRCATSIH) is also working with Joanne Borg and her team on the research and evaluation component of their work, and a formal agreement between the CRCATSIH and the hospital is expected soon.

Mercy Hospital for Women has had a long history of commitment to Aboriginal and Torres Strait Islander women’s and children’s health, but like most hospitals was mainstream in its approach to the health needs of Aboriginal and Torres Strait Islander infants and their mothers.

The hospital and its partners, Banyule Community Health Service and the Children’s Protection Society, are now developing a more effective, culturally respectful model of care, with tailored choices in care for Indigenous families depending on each child’s situation.

‘This new program is very much about getting the child ready for school by ensuring their health and wellbeing is as good as that of other children to give them the best chance of doing well at school and a better start in life,’ Ms Borg said.

The hospital intends to focus on:• access toantenatal care forwomenpregnantwithan

Aboriginal child• standard information about baby care for mothers of

Aboriginal children• practical advice and assistance with breastfeeding,

nutrition and parenting skills for mothers of Aboriginal children

• monitoring of Aboriginal children’s weight gain,immunisation status, infections and early developmental milestones, and

• testing, early detection and timely treatment ofAboriginal children’s hearing, sight, speech and other development issues before starting school.

For further information about the program, please contact Joanne Borg, Program Manager,T: 03 8458 4392, E: jborg@mercy.com.au.

Article reproduced with the kind permission of The Lowitja Institute

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peter russ

The motto of the New Directions program is Nangnak Wan Myeek or ‘nurture, care and look after me and mine’. (Images courtesy Mercy Private Hospital and artist Lyn Brigg)

The recent unveiling of two state of the art cardiac and vascular laboratories, reflects St John of God Hospital Subiaco’s (SJOG) continuing commitment to providing the latest technology.

The cutting edge technology found in the laboratories allows cardiologists and vascular surgeons to perform what were once complex procedures, with greater ease and accuracy.

The laboratories are the first in WA to have the Philips “Allura Xper FD20” version 7—an x-ray imaging system for diagnostic and interventional procedures—offering large image area, high flexibility, intuitive user interfaces and a full range of advanced interventional tools.

Another recent addition to the laboratories, and the first of its kind installed in Australia, is the CARTO 3—a new 3D GPS mapping system used to accurately locate cardiac arrhythmias.

Using GPS technology, the Carto 3 allows cardiologists to accurately navigate their way inside the human heart to treat arrhythmias. The procedure delivers many benefits, including the prevention of strokes, a possible reduction in medication and improved quality of life.

Approximately 200 diagnostic, interventional cardiac and vascular procedures are performed in the laboratories per month and, with the availability of this new technology, this number is expected to increase.

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Mater Private Hospital Brisbane (MPHB) has become the first private hospital in Queensland to launch an automatic notification system for tissue donation.

Its implementation at Mater Private follows a highly successful launch of the same system at Mater Adult Hospital—since its introduction three months ago, Mater Adult Hospital has recorded a 100 per cent report rate and exceeded the number of donations made in 2009 within the first two months of operation.

The real-time system works via Mater’s electronic inpatient system ‘iPM’ and allows for automatic notification to the Tissue Banks upon the death of a potential donor inpatient. Donor corneas and heart tissue is only viable for retrieval within 12 hours.

MPHB Executive Director Don Murray said the new system would optimise the number of possible donors.

“Through this technology, we will ensure that the family of every medically suitable patient is given the opportunity to decide to donate should that be their wish or the desire of their loved one.”

For more information go to www.donatelife.gov.au or to sign on to the Australian Organ Donor Register go to www.donorregister.gov.au or call 1800 777 203.

australian first for mater private hospital brisbane

SJOG’S commitment to cutting edge technology

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1 0 Y e a r s f r o m n ow

2 3 - 2 5 A u G u S T

CHA national conference 2010

A d e l A I d e C O N V e N T I O N C e N T R e

your super…10 years from now

Contribute and have it matched

Finding extra money to contribute to your super can be difficult. So, imagine getting a dollar-for-dollar match for your after-tax super contributions, of up to $1,000! Well, that’s what the government is doing to help boost your super—if your total assessable income is under $61,920. Thousands of HESTA members received a government co-contribution last year, so if you’re eligible why not make sure you’re one of them?

Terms and conditions apply, so for more information and eligibility criteria go to hesta.com.au/contribute

Put away a little bit now for later on

A small additional super contribution made each pay period, above what your employer puts in, could mean a much bigger super balance than you expected when you retire.

Making those contributions before-tax (often referred to as ‘salary sacrifice’) could make a significant difference to your retirement. That’s because the money you salary sacrifice into your super is taxed at 15%, which may be lower than your income tax rate.

To see if this form of contribution works for you visit hesta.com.au/contribute

Don’t give your money away, roll it over!

If you have multiple super accounts, you’re probably paying multiple account fees. Roll all your accounts into one, with your preferred super fund, and you could benefit in the long term.

Roll on over to hesta.com.au/consolidate to find out how.

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In 10 years time it will be 2020. What will our environmental, political, financial and spiritual landscape be like nationally and globally? And more importantly, what will your lifestyle be like?

HESTA is proud to support the Catholic Health Australia National Conference 2010—especially since this year’s conference theme ‘10 years from now’ is close to our hearts. That’s because, at HESTA our vision is always focused decades ahead, to ensure you’ll have the best super balance when you retire.

If you’re in your 20s or 30s accessing your super benefit might seem such a long way off. And if you’re nearing retirement it could seem like you don’t have enough time!

However, it’s the steps you take now that could make a big difference to your super in the long term. And since many members are choosing to keep their superannuation invested in funds even after they retire, the long-term nature of superannuation affects us all.

So, organise your super today and make sure you’re set up for

the years ahead -whatever they may hold …

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About HESTA

At HESTA, we’re committed to supporting you reach your retirement goals. With more than 690,000 members, 89,000 employers and $15 billion in assets, we offer many benefits to members and employers—low fees, an account you can take from job to job, easy administration, access to low-cost death & disablement insurance, transition to retirement options, super education sessions & limited financial advice at no extra cost.

Since our inception in1987, we’ve been committed to the health and community services sector. And our two decades of experience help us to deliver our finance education and advice services, in straightforward language, using relevant examples.

Led by CEO Anne-Marie Corboy, the role of our administration, client relationship, communications, investments, member advice and education teams is to inform you about your options—so that you can build a better retirement savings balance, whether you’re 25 or 65. In addition, we provide access to a range of great value products and services such as health insurance, financial planning and banking.

For more information go to hesta.com.au or free call 1800 813 327

1The Lifewise / NATSEM underinsurance report, February 2010. Issued by H.E.S.T. Australia Limited ABN 66 006 818 695 AFSL 235249 regarding HESTA Super Fund ABN 64 971 749 321. The information is of a general nature and does not take into account your objectives, financial situation or specific needs. You should look at your own financial position and requirements, and consider our Product Disclosure Statement before making a decision about HESTA – free call 1800 813 327 or visit hesta.com.au for a copy.

Make time for learning

HESTA has Member Education Managers covering each Australian state and territory—presenting sessions on a number of practical super and money management topics at the invitation of employers. There’s no fee to attend, so when you hear HESTA is visiting your workplace, why not come along?

Seek help

If you’re not sure how to make the most of your super then a session with one of our Superannuation Advisers could help. This service, available exclusively to HESTA members, guides you through consolidating your super accounts, your investment options, your insurance options and a contribution strategy that works for you.

Free call 1800 813 327 to make an appointment.

Ensure you’re insured

While most Australians insure their car, many of us don’t insure ourselves. Did you know that 1 in 5 Australian families will experience a parent being unable to work because of serious accident, illness or death1? As a HESTA member you have access to Income Protection, Lump-Sum Total and Permanent Disability Cover and Death Cover. HESTA’s default insurance for eligible members is two units of Income Protection and two units of Death Cover. For added peace of mind, extra cover is available—apply online at hesta.com.au/insure

Choose your investment

At HESTA we have a team who work hard to bring you a range of investment options to suit your investor risk profile and long term goals. You simply decide what’s best for your situation—and select accordingly.

Remember, our Superannuation Advisers can help you (free call 1800 813 327), or you can download a copy of Your investment choice guide at hesta.com.au/yourchoice

CATHOLIC DEVELOPMENT FUNDARCHDIOCESE OF MELBOURNE John HurrenCatholic Development FundP O Box 174EAST MELBOURNE VIC 8002

P: 03 9411 4200E: to hurren@melbcdf.org.au

ARCHDIOCESAN DEVELOPMENT FUND BRISBANE Andrew MusialArchdiocesan Development FundP O Box 282BRISBANE QLD 4001P: 07 3336 9289E: musiala@bne.catholic.net.au

CATHOLIC DEVELOPMENT FUND SYDNEY

Henry PruynCatholic Development FundLevel 15, Polding Centre, 133 Liverpool StreetSYDNEY NSW 2000P: 02 9390 5201E: henry.pruyn@cdf.sydney.catholic.org.au

CATHOLIC DEVELOPMENT FUNDARCHDIOCESE OF CANBERRA Victor DunnCatholic Development FundGPO Box 1887BRADDON ACT 2601P: 02 6201 9870E: victor.dunn@cg.catholic.org.au

APHS—your pharmacy partner—is a leading provider of specialised hospital, aged care and oncology pharmacy services. With over 23 years experience in the pharmacy industry and 500 staff, APHS provides efficient, accurate and reliable medication management solutions for Catholic health care facilities and patients nationwide.

As an industry leader APHS works with government and stakeholders on medication related issues that affect the private health sector, such as advocating a more sustainable chemotherapy funding model within the recently released Fifth Community Pharmacy Agreement.

In addition to this, APHS is committed to working with our hospital partners on sustaining a quality, viable private hospital pharmacy service. This is especially pertinent as the industry faces proposed changes to remuneration arrangements for hospital operators who have approval to provide government subsidised pharmaceuticals under Section 94 of the National Health Act.

As part of our proud association with Catholic Health Australia (CHA), APHS is delighted to once again be supporting CHA’s National Conference. APHS is dedicated to a strong partnership that continues to support your valuable work today as well as ’10 years from now’.

For more information on becoming an APHS Pharmacy Partner, please contact our

Business Development division on 07 3347 9500 or aphs@aphs.com.au

www.aphs.com.au

Supporting the Church’s Mission in Australia, the Catholic Development Funds and the Archdiocesan Development Fund provide a full range of financial services and a means by which these financial

resources are utilised for the benefit of the Church. Representatives of the Melbourne, Brisbane, Canberra and Sydney Funds are happy to discuss your needs.

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With billions of dollars tied up in superannuation it pays to do your homework before you commit your hard-earned money. Catholic Super is one fund that is consistently doing well for both members and their employers.

Originally established in 1971 as an industry fund with a membership drawn from Catholic school teaching ranks, it has been open to everyone to join for the last decade of its 40-year history. Catholic Super has an Australia-wide membership of 70,000 following a merger with National Catholic Superannuation Fund earlier this year. Although regarded as a medium-sized fund, this is not reflected in the size of the funds it manages or by the services it provides.

It currently has $3.7 billion under management and has been consistently ranked among the top 10 performing superannuation funds by independent ratings and research firm SuperRatings.

SuperRatings has also awarded Catholic Super the prestigious Platinum rating for its sustained returns and high service standards in both super and pensions. For the third year in a row, Catholic Super has been a finalist for Australia’s “Fund-of-the-Year”—a rare honour for a quiet achiever in the highly competitive superannuation market.

Catholic Super prides itself on not only sustained good performance but the values-driven investment decisions it makes. It was the first Australian financial institution to sign-up to the United Nations Principals of Responsible Investment and all investments are carefully and consistently scrutinised for their adherence to strict environmental, social and governance principles.

Catholic Super members pay amongst the lowest fees yet receive the added benefit of access to financial advice through Catholic Financial Services. Neither Catholic

Super or Catholic Financial Services staff pay or receive commissions which leaves them able to offer advice that isn’t tainted by commissions or bonuses. It’s a standard that should be applied to the entire financial services industry. At Catholic Super, members’ interest come first, not profits.

Catholic Super also offers transition to retirement and full-time pensions with a dedicated service team who can steer their way through the maze of regulation and Centrelink rules.

Catholic Super has some of the most sophisticated but easy to use online calculators and as well as making sure members and employers have all-hour-every-day access to their accounts online. Membership of Catholic Super also brings with it discounted health insurance from Medibank Private VIP, reduced banking fees from ME Bank and exceptional life and income protection insurance cover.

Catholic Super has negotiated its generous insurance packages at very low cost because there are no commissions trailing back to agents and the entire membership benefits as a group purchaser. Add to this the discounts on personal insurance from Catholic Church Insurances, Catholic Super offers much more than just great super.

As part of its service to members and employers, Catholic Super visits workplaces and offers, free-of-charge, to members and non-members alike, seminars and licensed financial advisers to help them plan their superannuation needs. Catholic Super will even cover staff replacement costs in many cases.

This low-fee, strong-performing, not-for-profit fund is easy to join too. Catholic Super’s Join-on-Line facility is painless, fast and free with the bonus that it will consolidate other super accounts into one at the same time.

Find out how Catholic Super can help you and your organisation—visit

www.csf.com.au or call 1300 655 002

Catholic Super—a quiet (high) achiever

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CHA 2010 award winners announced

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CHA’s Annual Awards, honouring and highlighting the excellent work of members and their staff, were presented at a formal dinner during the CHA National Conference in Adelaide in August.

The awards cover four key areas—leadership, nursing, outreach healthcare and positive ageing—and, for the winners of the Nurse of the Year and Emerging Leader of the Year, include a $5,000 prize generously donated by HESTA Super Fund for professional development opportunities.

nurse of the year -helen walkerAs Clinical Manager of Mary Potter Hospice in Adelaide, Helen Walker is known for her great care, compassion and strength. Helen is a strong community advocate for improved access to palliative care, and has made a special effort to ease the journey for custodial patients.

The conditions in which prisoners are nursed at the end of their life are very difficult. Helen recognised that to be able to leave prison and come to the hospice is very important for them and worked hard to overcome legal hurdles to

enable this to happen. She has recently also begun a new project to help improve access to services for the local Aboriginal population.

As a result of a recent experience helping an Australian Lebanese lady fulfil a wish to spend her final days with family in Beirut, Helen is looking at using her prize money to support the establishment of a palliative care service in Beirut. While still in the developmental stage, her aim is to work with medical and nursing staff in Beirut to set up a sister hospice to Mary Potter Hospice.

(L-R) Lynn Hart, HESTA’s Executive Manager Client Relations with Nurse of the Year Helen Walker

outreach healthcare -youth engagement programOperated in partnership with St John of God Hospital Geelong and Barwon Youth, the Youth Engagement Program helps to lessen alcohol and drug related harm by supporting young people experiencing problems with substance abuse.

Under this outreach program, youth workers engage with vulnerable young people in the young person’s own environment to establish a trusting relationship before linking their clients with agencies that can provide additional treatment.

To learn more about the awards, visit CHA’s Awards webpage www.cha.org.au/site.php?id=34

(L-R) Josie Taylor, Youth Drug and Alcohol Coordinator, Barwon Youth, with St John of God Hospital’s CEO Stephen Roberts and Director Community Development Taanya Widdicombe

(L-R) Tina Melrose from Prague House with Emerging Leader of the Year Belinda Gibso

emerging leader of the year -belinda gibsonBelinda Gibson is Elective Surgery Manager at St Vincent’s Hospital Melbourne, a complex, challenging area which is a major component of St Vincent’s day-to-day business and its accountability to government and the community.

She is described by colleagues as an exceptional and rare leader with outstanding management skills and a strong track record of achieving positive outcomes, and personal qualities which have made her a highly respected manager of people and a compassionate caregiver and patient advocate.

Belinda is planning on putting her the prize money towards further education, and is currently assessing the feasibility of two options—undertaking a degree in management or attending an international medical conference to further her knowledge in best practice in surgery.

leadership in positive ageing – prague houseRun by St Vincent’s Hospital Melbourne, Prague House is a 45-bed low care residential facility caring for people who have been homeless or at serious risk of homelessness.

The residents at Prague House often have a mental illness such as schizophrenia or bipolar disorder or an alcohol-related brain injury. Prague House provides an environment where its residents can live in safety and comfort, freedom and security, privacy and community in a hostel-type environment.

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the sector speaks

background According to Access Economics (2009)1 the aged care industry in 2008 provided residential services to 160,250 people, 70 per cent of whom were classified as ‘high care’ and 55 per cent aged 85+ years. Those employed to provide care to these residents accounted for 78,849 FTE or 133,314 direct care employees. Registered nurse participation fell from 21 per cent to 17 per cent of the care workforce between 2003 to 2007 and enrolled nurses decreased from 14 per cent to 12.5 per cent in that same period. At the same time there was a 12 per cent increase in supply of nurses across Australia (NILS, 2008)2 highlighted the particular problems faced by the aged care industry.

Some providers, despite the risks involved, responded to nurse vacancies by substituting care staff to work in high capacity utilisation environments of around 95 per cent occupancy (Productivity Commission 2008)3. The risk is actually borne by high care residents with complex and multiple degenerative conditions where a decline occurs in staff skill mix and access to professional nursing services is limited. Substitution for professional nursing can also deter experienced nurses from remaining or seeking employment in such risky care environments-making recruitment more difficult.

are older nurses the key to future aged care sustainability?The average age of aged care nurses is around 50 years with 12.2 per cent aged 60+ years while the majority (93.4 per cent) are women (NILS, 2008). The average age of all employed nurses in 2005 was 45.1 years. However those aged 50+ years were rapidly increasing accounting for 35.8 per cent of employed nurses (AIHW 2009)4. Projections by NILS (2008) and Access Economics (2009) are thatnursesaged55–65yearswillincreaseby3,225FTE(18percent)by2020representing the fastest growing group of nurses employed in aged care.

Traditionally, aged care has attracted mature nurses who thrive on professionally complex nursing with diverse clients, conditions and situations. Experienced nurses are attracted by the opportunity aged care practise provides for long term nurse-client relationships that support a professional commitment to individualised care.

The roles of nurses in aged care differ substantially from acute hospital work which is aligned with medical procedures, protocols and prescriptions for patients who are in health crisis. Rapid turnover of patients and high pressure work completing medical procedures within short hospitalisation times may attract some nurses however, some discontent can occur through not getting to know patients or seeing the longer-term outcomes of nursing care. Aged care nurses have the time and assistance from care staff to support people who have successfully achieved a long life and need to adapt to the normal effects of ageing and respond well to any illness and disability that occurs5.

Their pivotal intellectual and professional input to quality and safety as well as implementing and testing service delivery and regulatory compliance risk management strategies, is often underrated. Consequently, they are paid around 10 per cent less than nurses in the acute care sector.

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experienced nurses - the ‘new breed’ in sustainable aged care

professor tracey mcdonald RN, Phd, FRCNARSl lifeCare chair of ageing, australian catholic university

attracting and retaining experienced nurses in aged care The 2010 Intergenerational Report5 highlighted workforce participation as the key to future economic prosperity. To achieve this outcome, incentives around income tax, employment culture, work flexibility, superannuation and insurance cover were introduced. For many in this generation of workers, the prospect of leaving work at 60 and spending the next 30 years socially disconnected and impoverished is less enticing than remaining in the paid workforce where their skills and experience are valued.

Nurses are especially equipped to continue working effectively well beyond the age of 65 if professional support and employment arrangements are favourable. While remuneration is not a major factor in decisions by aged care nurses to continue practicing in this field, it is increasingly difficult for nurses to afford to work for employers who offer baseline salaries and minimum conditions. Nurses in their 50s and 60s often have responsibilities for their parents and many also support adult children for whom they undertake a continuing financial impost. The cost of living in Australia, and especially larger cities, is increasing and socioeconomic supports that were available in the past are being wound back by governments, leaving older workers uncertain of future support.

Professional nurses in aged care are among the less-affluent in society. Quite apart from the financial realities of this situation, the message given to nurses through low remuneration is that their contribution to public health and the sustainability of their organisation is not valued and possibly less relevant than line management.

Experienced nurses who have developed a sense of identity and purpose in their profession may continue to ‘subsidize’ ineptly designed policy and funding systems because withdrawing their services in pursuit of higher salaries would leave residents and clients in a parlous situation. The long-term sustainability of such a presumption on the good-will of nurses with alternate employment options is doubtful.

how different are they from previous generations of mature nurses? Any assumption that people, as they move through life stages, will alter their priorities in similar ways to previous generations, is fundamentally flawed. While it is possible that the current group of experienced workers may manage themselves differently as they get older7, we cannot predict that the onset of normal ageing in a cohort of self-sufficient, highly qualified and healthy Australians will reduce their availability, or desire, for paid work as did their parents’ generation.

It is not surprising that the ‘boomers’ are again reinventing social and work lives as they embrace the adventure of incorporating the challenges of normal ageing in their plans. In our post-modern lifestyles where multiple and shifting identities are part of adaptation to the world and to rapid social change8 this generation leads the way in innovation and influence.

As people live longer, a strong self-concept can be built to support an integrated appreciation of who one is in the world (Eriksen, 2006)9. In Australia older nurses have done this and also have the benefit of wide exposure to many cultures and social influences which have enriched their lives and provided cultural opportunities that were not

available to previous generations. If expectations of capacity arising from ageist stereotyping such as ‘age-structured dependency’10 are to be imposed on mature aged care nurses, their opportunities to practise will be constrained and they will leave, threatening industry sustainability.

conclusionAged Care employers need to retain and attract experienced nurses to achieve ongoing sustainability. These nurses have a different outlook on what it means to be older in today’s world compared with veteran nurses—and successful employers who understand this difference will factor into employment arrangements, changes that support the needs of this ‘new’ breed of nurse.

“Nurses are especially equipped to continue working effectively well beyond the age of 65 if professional support and employment arrangements are favourable.”

Footnotes

1. Access Economics (2009) Nurses in residential Care, Report commissioned by Australian Nursing Federation, November.

2. Martin, B. & King, D. (2008) Who cares for older Australians: a picture of the residential and community based aged care workforce 2007. National Institute of Labour Studies (NILS) Flinders University Adelaide SA.

3. Australian Government Productivity Commission (2008) Trends in Aged Car Services: some implications. September. ISBN 978-1-74037-264-0

4. Australian Institute of Health and Welfare (AIHW) (2009) Residential aged care in Australia 2007-08 Report No.28.

5. McDonald, T. (2006) A Model of Nursing for Contemporary Aged Care Environments. Presented at the RCNA National Conference “Leaders, Pioneers and Innovators” Cairns, July.

6. Australian government (2010) Australia to 2050: Future Challenges. Intergenerational Report (p. 26-30) ISBN 978-0-642-74576-7

7. Biggs, S. Beyond appearances: Perspectives on Identity in Later Life and Some Implications for Method. (2005) Journals of Gerontology: Series B: Psychological Sciences and Social Sciences.

8. Polivka, L. (2004) Postmodern Ageing and the Loss of Meaning. Journal of Ageing and Identity. (5)4, pp.225-235.

9. Eriksen, N. Ageing and Diversity. (2006) in Daatland, S.O., and Biggs, S. (Eds) “Multiple Pathways and Cultural Migrations” Policy Press, Bristol, UK.

10. Powell, J.L., Longino, C.F. (2004) Postmodernism versus Modernism: Rethinking theoretical Tensions in Social gerontology. Journal of Aging and Identity. (7)4, 219-226.

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26

the sector speaks

introductionThe health and social wellbeing of the people of Fitzroy Crossing has been the focus of government initiated programs, government and independent research projects and community based initiatives for over four decades.

In these same four decades many people in Fitzroy Crossing became dependent on alcohol and suffered increasing alcohol related harm and ill-health. Fitzroy Crossing was also subject to media scrutiny and was often portrayed in purely negatives terms.

the valleyLocated 400 kms north east of Broome on the banks of the Fitzroy River, the town of Fitzroy Crossing is based within Bunuba Country. Fitzroy Crossing’s exponential development as a service town was forged in the early 1970s when the provision of equal wages saw hundreds of Indigenous people forced off cattle stations they had worked on their lands for almost a century.

Since that time Fitzroy has become home to many Walmajarri, Wangkatjunka and Gooniyandi people. The town suffered great hardship due to the layered effects of poverty, lack of investment in the people of the region and internalised community violence fueled by substance abuse. Despite these circumstances, Fitzroy communities have created their own representative organisations dealing with culture, law, women’s issues, community and cultural health and employment and training. So too have Fitzroy residents created businesses providing food, fuel and transportation for their people. Beyond the wider media reputation as a place of despair, regionally, Fitzroy is recognised as a town with strong Indigenous leadership.

restrictions as a turning point, not a solutionAt the Women’s Bush Meeting of 2007 held in the Fitzroy Valley, local Aboriginal women decided to approach the Director of Liquor Licensing to apply a restriction on the sale and purchase of alcohol in Fitzroy Crossing.

Building on the findings of Coroner Alistair Hope’s February 2008 report into the suicide of 22 youths in Kimberley, Fitzroy Valley woman mobilised other Indigenous leaders, both men and women, to restrict the impact of alcohol upon their communities through restricting this sale of take-away alcohol.

On 27 September 2007, the Director of Liquor Licensing emplaced the following restriction for six months:

The sale of packaged liquor, exceeding a concentration of ethanol in liquor of 2.7 per cent at 20 degrees Celsius, is prohibited to any person, other than a lodger (as defined in Section 3 of the Act).

Once implemented, Indigenous leaders worked in collaboration with the Drug and Alcohol Office (DAO) WA to ensure appropriate monitoring and evaluation of the restriction was undertaken. Thus far four evaluation reports have been completed by Nulungu Centre for Indigenous Studies at three months, six months, twelve months and two years. At the release of the six month evaluation in May 2008, the Director of Liquor Licensing decided to continue the restriction indefinitely based on the initial findings of the evaluation.

fitzroy crossing-evaluating the impact of alcohol restrictions

community based approachIn 2010 the picture for the future of Fitzroy Crossing is the brightest it has been in decades. Alcohol related harm has reduced. Youth Suicides are drastically reduced. And practically all health indicators are moving positively, from acute responses to trauma, to long-term solutions for chronic health and social problems.

Restrictions are not the sole reason for this turn around. The community of Fitzroy Crossing is finally experiencing the benefits of many years of hard work by key community leaders and community based organisations.

impacts of the restrictions two years onThe twelve month mark of the restrictions revealed a high-point of positive impacts on health and social well-being. At the two year mark an increase in take-away alcohol being brought in legally from nearby towns of Derby (258 kms) and Broome (396 kms) has impacted negatively on health and well-being.

However, the increase in positive outcomes remains significantly greater than before the restriction was put in place.

The two year review revealed:• continuingreducedseverityofdomesticviolence• continuingreducedseverityofwoundingfromgeneral

public violence• familiesbeingmoreawareoftheirhealthandbeing

proactive in regard to their children’s health• reducedhumbugandanti-socialbehaviour• increasedeffectivenessofservicesalreadyactivein

the valley, and• generallybettercareofchildrenandincreased

recreational activities.

The two year evaluation also found that the window of opportunity created by the restriction had not resulted in significant targeted investment in a coordinated manner by government and other service providers, as expected by many community members. However, two years on, the hard work undertaken by community organsations is beginning to attract interest and increased investment in services.

There was, and still is a sizeable amount of suffering evident in Fitzroy Crossing. Forty years of alcohol related trauma will not be solved by a restriction alone, and certainly not overnight. However, the Fitzroy Valley Alcohol Restriction Report (August 2010) has found that restrictions have had significant positive impacts that are being utilised as a foundation for generational change for the better of the community. The narrative of hopelessness that has tagged Fitzroy Crossing far too easily in the past can no longer be so easily applied.

steve kinnane, senior researcher

nulungu centre for indigenous studiesuniversity of notre dame australia

27

28

the sector speaks

Health reform has been a lively topic over the last couple of years. There has been a lot of talk, numerous commissions and taskforces and reports, and more recently a little bit of action. The COAG Agreement on health reform saw the start of some new policy and ideas, but not at great pace.

The federal election was a catalyst for more talk and promises. Sadly, the election health policy debate was more about the small picture than big picture. The bidding was all about beds and boards and boats and broadband. We can only hope that the new government gets busy on the health reform vision thing early on in the term.

The health reform headlines are traditionally dominated by public hospitals and primary health care—but neither can be reformed or improved without a quality highly-trained medical workforce in the appropriate numbers to meet community needs into the future.

Do we have enough doctors to care for a growing and ageing population? The government’s current estimate of the medical workforce is that we have a shortage of around 4,500 doctors across the country. That’s a lot of doctors. The shortages are more acute in outer urban and rural and remote areas. Since 2004, there has been a strategy to increase medical student numbers dramatically. By 2012, there will be around 3,500 medical school graduates each year, which compares to around 2,100 in 2004. This will go a long way towards addressing workforce shortages, but only if we can train them all.

With such a dramatic increase in student numbers, the AMA has been campaigning since 2004 for more support to teach and train these students and graduates. We need to invest in infrastructure, fund more supervisors, utilise settings beyond public hospitals, and make sure that students and graduates can get hands-on clinical experience with patients. This is often difficult due to decisions to close wards or cut theatre time to meet budget requirements.

The Commonwealth and the states have established Health Workforce Australia following a 2008 COAG decision to provide extra funding for clinical training across the health workforce. Health Workforce Australia is now in place and this year started to roll out this extra funding. However, medical training does not stop at the university gate. Graduates need training in hospitals in order to progress to being fully-fledged doctors who have the qualifications needed for independent practice as a GP or other specialist.

This means that we need more prevocational and vocational training positions in hospitals, general practice, and other community and private settings. To illustrate the challenge, in 2009 there were 2243 intern positions across

the country, which falls well short of the 3500 positions that are needed in 2013.

This year’s Budget saw welcome progress with the announcement of a plan to double the number of prevocational general practice training places to 975 a year by 2014, increase the number of GP training places to 1,200 a year by 2014, and increase the number of specialist training places in private settings from 360 a year to 900 a year by 2014. This still won’t be enough. The Commonwealth needs to work with the states and territories to expand the number of training places in public hospitals.

The AMA has proposed that the government’s plan for the Commonwealth to fund 60 per cent of the training costs in public hospitals should see the funding linked to key performance indicators that require the states and territories to deliver the increased number of training places that are needed. We have also called for the government to establish a biennial review of clinical training places to be undertaken by the Medical Training Review Panel.

This review would utilise the support and resources of Health Workforce Australia to ensure that shortfalls in the number of pre-vocational and vocational training places are quickly identified and addressed. We have also called for Health Workforce Australia to supplement the effort of the states and territories by funding specific programs that will boost training capacity and help maintain standards, including programs that fund protected teaching time, support for innovative training models, and professional support programs for junior doctors.

We also need to ensure that this growth in doctor numbers flows to where it is needed. In this regard, the AMA has proposed the expansion of scholarship-based programs for medical students to encourage them to take up a career in rural areas We have also proposed the implementation of a comprehensive incentives program worth around $350 million a year to attract locally trained doctors to work in rural and remote Australia.

Everything looks good in theory, but it continues to fall down in practice. Due to poor planning or bad budgeting (or both) by state governments, our public hospitals are still unable to meet the demands of training the next generation of medical specialists. So far this year, the New South Wales, Queensland and Tasmanian health systems have been unable to offer internships to all the medical students who need them.

The sharp rise in student numbers has contributed to the problem. Health experts are now calling for a national approach to recruitment. There are 18 Australian

sustainability of the medical workforce

universities with accredited medical schools. According to the Medical Training Review Panel, the number of first year medical students has more than doubled over the past decade, and the number of international medical graduates has increased by almost 200 per cent.

However, hospitals are not yet equipped to meet the increased demand for internships. This is one reason why we need genuine health reform. Let’s start with single funder for the health system.

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dr andrew pesce, AMA president

The Royal College of Nursing, Australia (RCNA) says nurses have recognised workforce priorities as being key to reforming Australia’s health care system.

According to RCNA CEO, Ms Debra Cerasa, these priorities have been confirmed by the Nursing Accord 2010 declared at the RCNA Nursing Summit held in Canberra last May, and by recent surveying of more than 370 attendees at RCNA’s ACT Nursing and Health Expo.

“At both forums the development of a National Nursing and Midwifery Workforce Strategy was overwhelmingly recognised as the number one priority to enable future reform,” Ms Cerasa said.

“A National Nursing and Midwifery Workforce Strategy must be a top priority to be addressed by the incoming government,” she said. “Future health service planning cannot be undertaken without consideration of the nursing and midwifery workforce planning that is required to support the delivery of health services in Australia.

“We know the nursing and midwifery workforces are ageing. We know that there are significant skills shortages in nearly all jurisdictions. And we know the serious challenges this presents as demands on the health system expand,” she

added. “There is great variation in how the knowledge and expertise of nurses and midwives are applied across the health system, and it will take new models of care that make better use of their skills to meet the community’s future health care needs.

“We must ensure that we have the right nursing and midwifery workforce into the future as we face the realities of an ageing population and increasing rates of chronic disease. But preparation is hindered by the fact that nursing and midwifery workforce planning in Australia currently lacks national coordination.”

The RCNA supports calls for the development of a National Nursing and Midwifery Workforce Strategy that tests current thinking and assumptions to ensure the professions are well prepared to meet future challenges.

“Australia needs a National Nursing and Midwifery Workforce Strategy that extends beyond workforce numbers,” Ms Cerasa said. “Apart from ensuring a sufficient supply of nurses and midwives, the strategy should address the need for the workforces to be educationally prepared, well supported into the workplace, mentored and retained to meet future workforce demands.”

nurses call for a national nursing and midwifery workforce strategy

ethics

In February 2006 the Commonwealth Parliament voted to remove the health minister’s oversight of applications to use the abortion drug mifepristone, (formerly RU486), handing full responsibility over to the Therapeutic Goods Authority (TGA).

The popular view was that a prominent ‘Catholic’ health minister in a conservative government had used his ministerial powers to deny women access to a safe and effective alternative to surgical abortion. The reality was that no pharmaceutical company had ever actually lodged an application to market the drug in Australia.

Four years on, and the drug that caused such a political stir is no closer to being widely available to Australian women. Notwithstanding the political move to exclude the minister from the process, the cost of applying to import an off-patent drug like mifepristone means that pharmaceutical companies are not pursuing the license to market this drug. There is no profit in registering a controversial generic drug, only to see a rival company market it? As

a result, mifepristone is still classified by the TGA as an unapproved drug with only 80 doctors currently licensed to import and use it for the purpose of abortion in their own practices under Authorised Prescriber legislation.

Used mainly for ‘early medical abortion’ during the first nine weeks of pregnancy, and most commonly to end pregnancies up to 49 days, mifepristone works by blocking the pregnancy hormone, progesterone. A prostaglandin drug, most commonly misoprostol, is taken 48 hours later to cause the uterus to contract and expel the dead embryo or foetus, usually within a few hours. The abortion process can occur at home, but the woman must have access to appropriate and skilled 24-hour emergency help, and follow-up to confirm that all products of conception have been removed is essential.

Mifepristone advocates claim that the drug is safe, effective, cheap to produce, and highly acceptable to women because of the possibility for privacy and the minimally invasive nature of the treatment. They also emphasise that it

addresses the disparity of access to surgical abortion by women in rural and regional areas and those for whom privacy is an issue for religious, ethnic or other reasons.

Nevertheless, for up to 10 per cent of women, mifepristone will result in an incomplete abortion and they will in any event be required to undergo a surgical abortion as well. Another five per cent of women will have blood loss so severe that it will necessitate surgical intervention. Casting doubts on its true ‘acceptability,’ these figures further suggest that medical abortion may actually introduce a new level of risk for the geographically or socially isolated woman. The US experience has highlighted that the ‘convenience’ and ‘privacy of a ‘home abortion’ has proven fatal to a teenage girl who took mifepristone without her parent’s knowledge.

Presently there is no substantial evidence that the availability of medical abortion increases, or decreases, a nation’s overall abortion rates. However, it is hard to see how access to medical abortion will do anything to address

public concern about the high incidence of abortion in Australia. Prima facie, the more methods of abortion and the greater the access, the more ‘mainstream’ abortion may seem and the more likely the abortion rate is to increase. Social arguments in favour of medical abortion, on grounds that women should have a “choice of abortion methods”, would seem to support the current culture of high abortion rates.

A recent bizarre case of medical abortion in Queensland may affect abortion rates by another means. During a police search of a couple’s Cairns property, empty blister packets alleged to have contained abortion drugs were found alongside doctors’ instructions written in Russian. A 19 year-old woman, and her 21-year-old partner, were subsequently charged for importing the drugs from the Ukraine and using them to procure an abortion. This is the first reported case of a woman having been charged with the offence of intent to procure her own miscarriage. The offence if proven carries a maximum penalty of seven years’ jail. The couple will face trial in October.

remember Ru486?

30

“The advocacy for mifepristone’s use in Australia has traditionally been on ideological, not medical grounds.”

remember Ru486? dr brigid mckenna

policy officer of the life office of the catholic archdiocese of sydney

Pro-life and pro-choice campaigners have condemned the prosecution action which is more likely to trigger a relaxation of abortion law in that state than the enforcement of existing laws. Despite the case mainly being concerned not with abortion per se but with the illegal importation and use of drugs without medical supervision, Queensland doctors suddenly suspended all medical abortions for fear of prosecution. New legislation was hastily passed into law to clarify the doctor’s role in both surgical and medical abortions “for the patient’s benefit”.

Seemingly encouraged by the expansion of the law, pro-choice organisations are now bringing pressure upon the Bligh Government to completely decriminalise abortion. Going a step further, Kerry Peterson recently argued in the Medical Journal of Australia that the ongoing inaccessibility of early medical abortion is a reason for the decriminalisation of abortion laws in all states and territories throughout Australia.

Repealing these laws would protect medical practitioners from criminal liability, promote the health interests of Australian women and discourage the illegal importation of abortifacients that are being used without quality controls or medical supervision — reminiscent of the “backyard” abortions of yesteryear. [MJA 2010; 193: p.29]

The advocacy for mifepristone’s use in Australia has traditionally been on ideological, not medical grounds, as a matter of diversifying choice. But are Australian women better served by yet another method of abortion or rather, by positive strategies which address the social circumstances that leave them feeling compelled to choose abortion over childbirth in the first place?

Abortion drugs are an inadequate response to the complex needs of women facing a difficult pregnancy. The answer lies with building a culture where the pillars of society— law, social policy, institutions, communities and the rights of the individual—respect and serve the dignity of every human person by providing women with the emotional and practical support necessary to continue a pregnancy in difficult circumstances. The challenge is to provide real choices, rather than simply providing more options.

“The challenge is to provide real choices, rather than simply providing more options.”

31

people & places100 years on mater hillOne hundred years ago, on 14 August 1910, the Sisters of Mercy opened a 130-bed private hospital (now known as Aubigny Place) on Mater Hill in South Brisbane.

The 1910 grand ceremony was a much celebrated occasion attended by 8,000 people who crammed onto the site to witness Cardinal Moran and Governor Sir William MacGregor officially bless and open the new facility.

The hospital was the vision of Mother Mary Patrick Potter who was determined to build a private fee-paying hospital and a public hospital for the less affluent. She did this by rallying the community and the press at the time to raise the £25,000 needed to build the hospitals.

Since then the site has seen continuous growth and change—the Sisters of Mercy opened the Mater Public Hospital in 1911, Mater Children’s Hospital in 1931 and Mater Mothers’ Hospital in 1960.

Today, Mater is a world-class group of three public and four private hospitals plus the Mater Medical Research Institute.

A gala ball and special chapel service were held to launch the 100th anniversary celebrations. More information about ‘100 years on Mater Hill’ can be found at www.materhill.org.au.

Chairman, Mater Health Services Board Professor John McAuliffe, Former Mater Hospital Administrator Sr Angela Mary Doyle RSM and

Mater CEO Dr John O’Donnell at the celebratory ball.

The Hawkesbury District Health Service (HDHS), which provides hospital and community health services under the auspices of Catholic Healthcare, has received the 2010 Australian Business Award for Community for its ‘Bridging Cultural Divides’ project.

The Australian Business Awards recognise organisations which implement policies or projects that positively impact on the community and generate outcomes that have a long term benefit. The winning project aims to bridge the cultural divide between western style health services and Aboriginal people by ensuring health services and Aboriginal people have a greater understanding of each other.

‘Bridging Cultural Divides’ combines insight, artistic talent and dedication to create a new indigenous ‘story’ to improve Aboriginal health. The story welcomes indigenous Australians to value their health, (ie themselves) by utilising their local health service. Artwork describing the HDHS’ spirit and place in the community has been beautifully portrayed with the development of new language and unique Aboriginal symbols.

This artistic ‘story’ increases understanding of health and the evolution of indigenous culture—a bridge that ensures health services and Aboriginal people have a greater understanding of each other. It is hoped that, in turn, this new understanding will result in Aboriginal people utilising the health care available to them when required.

australian business award for indigenous health project

Warrnambool’s newest aged care precinct, Mercy Place Warrnambool has been officially blessed by the Bishop of Ballarat, Most Reverend Peter Connors DD DCL.

The new facility includes high, low and transitional care and 25 dementia specific rooms. Mercy Place delivers a much-

needed boost to aged care services in the region, while also supporting the creation of 60 new jobs in nursing, administration, hospitality and cleaning. Mercy Place adds to Mercy Health’s existing portfolio of more than 1,200 residential aged care beds and an expanding array of home and community-based care services.

mercy place warrnambool blessed

32

cabrini expands its rehabilitation servicesCabrini Health has integrated its newly acquired 41-bed Elsternwick Private Hospital with Cabrini Hopetoun Rehabilitation Hospital to create the Cabrini Elsternwick Rehabilitation Service—a comprehensive 71-bed amenity offering expanded and improved rehabilitation services.

The Elsternwick Private Hospital site will deliver slow stream rehabilitation services for older people needing general, orthopaedic or neurological rehabilitation and for those living with Parkinson’s disease. This slower stream of rehabilitation will complement the fast stream rehabilitation service currently delivered at the nearby Cabrini Hopetoun site.

The new service enables Cabrini Health to provide comprehensive rehabilitation and expand community services by increasing out-patient and home-based care.

murdoch couch gets front row seat at parliamentA ‘Talking Couch’ rebuilt and decorated by a group of young women as part of a joint St John of God Hospital Murdoch/City of Cockburn program took pride of place at the WA Parliament House for the month of August. Talking Couches are the most visible project of the ‘You Name It’ program, which is run by St John of God Hospital Murdoch and the City of Cockburn out of the City of Cockburn’s Youth Centre at Success.

The‘YourNameIt’programtargetsyoungwomenwhoareaged12–16 years, of Aboriginal descent and either not attending school on a regular basis, or engaged in the Juvenile Justice system. It aims to engage participants in fun and educational activities and in turn link them back into the education system or progression program.

‘Talking Couches’ involves the young women rebuilding and decorating old couches and incorporating their stories and experiences from their own couches at home. The couches feature built-in MP3 players which play back recordings made by the young women about their personal journeys.

The ‘You Name It Program’ was a finalist in the recent Australian Medical Association (WA) Healthway Award, which recognises programs that demonstrate significant benefits to the health and wellbeing of the WA community.

Back (L-R) St John of God Hospital Murdoch Social and Emotional Wellbeing Family Support Officer Lee-Anne Mason; Hon. Eric Ripper MLA, Leader of the Opposition; Mr Peter Tinley AM, MLA. Front (L-R). Program participants Brittany Indich, Lindsay Mourish and Cleonie Dinah; and St John of God Hospital Murdoch Social and Emotional Wellbeing Family Support Officer Kristy Lopes.

opening of southern cross apartmentsAround 300 people attended the August opening and blessing of the Southern Cross Apartments in Young. 2010 NSW Senior Australian of the Year, Lyn Thorpe, unveiled the plaque to officially open the apartments and Archbishop Mark Coleridge, Father Loorthusamy Irudeyasamy, Reverend John Thomas and Pastor Adrian Single led the Blessing.

The Southern Cross Apartments comprise 80 Supported Living Apartments—large bed-sitters with tea making facilities, private ensuite and verandah access—and replace

the Young Retirement Village which was opened in 1977.

The opening of the apartments represented the end of the first stage of a two-stage re-development of the Young Retirement Village. The elements proposed for stage two include the building of 43 two and three bedroom villas and the redevelopment of the previous hostel’s bedroom facilities into one and two bedroom affordable housing options, including accommodation for pensioners.

people & places

a ‘life-changing’ milestoneAustin Street, Victoria’s first purpose-specific residence for young people with high level complex care needs who are at risk of or are currently living in nursing homes, was officially opened in August.

The opening marks a life-changing milestone—the start of a brighter future for ten young people with Acquired Brain Injury and their families.

Developed under the ‘My future my choice’ initiative (a joint initiative of the Commonwealth and Victorian governments), Austin Street will be run by not-for-profit aged and disability services provider Villa Maria, which also contributed $3.65 million of its own funds towards construction. Villa Maria’s years of experience and expertise in aged care and disability services will see a unique model of care at Austin Street—one that blends nursing care with rehabilitation and community inclusion.

The home features state of the art technology to increase the amount of control and choice each resident has over their environment. Importantly, the home reflects each individual’s needs, aspirations and life goals with private, personalised living spaces and kitchenettes—a place where family and friends also feel welcome and at home.

James Macready-Bryan celebrates with his son James, 23, who is a new resident of Austin St.

The opening of St Vincent’s Brisbane represents a significant commitment by the Trustees of The Mary Aikenhead Ministries and St Vincent’s Health Australia.

The hospital’s services seek to offer a ‘different approach to healthcare’—a ‘niche medical hospital’ offering programs reflective of healthcare trends and the needs of an aging population rather than programs ‘based on commercial value’.As such it offers services around care for chronic disease, persistent pain, comprehensive geriatric restorative care

and palliative medicine. This approach is underpinned by the belief that care providers who innovate and develop and deliver comprehensive medical solutions for the complex chronic illness that surrounds geriatric care are well placed to deliver better patient outcomes.

The contemporary redevelopment of the hospital and its commitment to compassionate care of the chronically ill and aging ensures the Sisters of Charity’s pioneering spirit of service endures well into the future.

st vincent’s brisbane—a ‘different approach to healthcare’

Mercy Health and Villa Maria have received Victorian Government Fair and Flexible Employer Awards. The awards recognise both organisation’s efforts to improve the work and family balance for their people.

Fifty-one per cent of Mercy Health’s 5,000 people access flexible working arrangements; these include part-time, job share, variable shifts, working from home, children at work programs, phased return to work from parental leave and phased retirement options.

At Villa Maria, of their more than 950 staff, 504 are employed part-time while a further 285 work on a casual basis. As well, five per cent of staff have taken up the option of 48/52 employment, increasing flexibility for many people.

Mercy Health CEO, Dr John Ballard, said any organisation that worked to provide opportunities for staff to better balance careers with other life demands would see measurable benefits.

CHA members recognised as fair and flexible employers

34

a new era in careAs St Vincent’s Health Australia (SVHA) moves to adopt a new governance structure on 1 October 2010, the organisation is pleased to share news of some important appointments to senior governance and leadership roles.

On 10 August, the Trustees of Mary Aikenhead Ministries announced the membership of the incoming St Vincent’s Health Australia Board (effective 1 October 2010):

Assoc Prof John Gurry (Chair)Fr Frank Brennan sj AOSr Helen Clarke rscMr Brendan Earle Ms Patricia Faulkner AO Mr Gary Humphrys Ms Belinda Hutchinson AMMr Paul Robertson AMProf Peter Smith Mr Greg Sword AM

SVHA is also pleased to welcome two new appointments to its Group Office— Mr Peter Forsberg and Mr Rob Beetson.

Peter commenced as SVHA Group Chief Financial Officer (CFO) in July. He brings considerable expertise to the role having held senior executive and director positions in health and aged care, legal services,

and industrial companies including the position of CFO for DCA Group, a diversified healthcare business operating the largest aged care and diagnostic imaging service in Australia. Peter has also held roles as CFO for Blake Dawson solicitors and at Goodman Fielder and Burns Philp. Peter is an experienced finance professional whose broad professional background makes him an ideal addition to the St Vincent’s Health Australia executive team.

Mr Rob Beetson has been appointed to the role of Group Manager Legal and Governance for SVHA. Rob was previously Acting Company Secretary for SVHA while Ms Leah Coogans was on maternity leave. Rob is admitted as a Solicitor to the Supreme Court of NSW, a member of the Law Society of NSW and a member of the Institute of Chartered Secretaries. Rob has an extensive background in health having worked in the sector for over 25 years in clinical, executive, risk management, legal and governance areas.

He has previously worked with the NSW Police Service in the External Agencies Response Unit where he was responsible for overseeing the review of their legal and governance arrangements, and prior to joining SVHA Rob was the Manager of Investigations for the Health Care Complaints Commission (NSW).

comings & goings

After more than 30 years at St John of God (SJOG) Hospital Subiaco, Jean Wibrow, Director of Obstetrics, Gynaecology and Newborn Services, retired in August.

Jean began her career at the Hospital in 1970 as an 18 year old student nurse. She gained further experience at a number of different hospitals before returning in 1981 as the nursing supervisor. She went on to hold positions as charge nurse, central office manager, nurse co-ordinator, and over the last 10 years served in her current role.

Her career highlights include achieving her senior positions, commissioning a new paediatric ward and opening the Hospital’s Raphael Centre to assist families experiencing stress and anxiety associated with childbirth.

Leaving the Hospital is a bittersweet experience for Jean. But she is looking forward to exploring new opportunities, including learning to speak Italian and play the piano, travelling the world and spending time with family and friends. Jean with grandchild

SJOG subiaco farewells long serving director

Mr Peter Forsberg (top)Mr Rob Beetson

35

news

Catholic Health Australia recently launched a new publication to assist pastoral carers working across the spectrum of health and aged care, Pastoral Services in Catholic Health, Community & Aged care—Contemporary Practice.

Launched at the CHA National Conference in Adelaide, the new book is designed as a practical guide for those working in a range of health and aged care services.

It highlights the value the ministry and practitioners of pastoral care bring—not just to the patients, residents and clients but to their families, carers, staff and the spirit of the facility itself. Content has been contributed by experienced pastoral practitioners working in fields as diverse as intensive, psycho-geriatric and acute care, women’s health, mental health, rehabilitation and detoxification, palliative, community, dementia and aged care.

With an easy-to-read definition of pastoral services, illustrated by real examples of caring for people within Catholic facilities around Australia, Pastoral Services in Catholic Health, Community & Aged Care—Contemporary Practice sets the scene for different models of pastoral care and offers practical tailor-made tools for handling different scenarios.

Pastoral Services in Catholic Health, Community & Aged Care—Contemporary Practice is available for purchase online via the CHA bookshop.

new publication informs holistic pastoral care

Palliative CareForum

12 OctoberRheinberger Centre

Yarralumla, Canberra.CHA will host a Palliative Care Forum on

Tuesday 12 October in Canberra. The day will attract speakers from the Department of Health and Ageing—

Private Health Branch & Palliative Care Branch—Palliative Care Australia and academia.

It will also provide an opportunity to discuss the policy implications of supportive care as well as

palliative care in residential aged care. It will provide participants with the opportunity to discuss how Catholic palliative care providers can network

together more successfully.

Further information, including registration details will appear on the CHA website once

all speakers are confirmed.

Joint Senior Executive Forum—Health and Aged Care

1 7 N o v e m b e r , C a n b e r r aDirectors, executives and managers working in

health and aged care CHA member organisations are invited to attend a Senior Executive Forum at

the Hellenic Club in Woden, Canberra, on Wednesday, 17 November.

Senior officials from the Federal Department of Health and Ageing, Department of Treasury and the Australian Council on Quality and Safety in Health

Care have been invited to address the forum on health and aged care.

Further information, including registration details, will appear on the CHA website once all

speakers are confirmed.CatholiC health australia

cha booksNeW! Pastoral Services in Catholic health, Community & aged Care—Contemporary Practice

This publication seeks to highlight to all who work in Catho-lic health, community and aged care the value this ministry and these practitioners bring—not just to the patients, resi-dents and clients but to their families, carers, staff and, in-deed, the spirit of the facility itself. This publication provides a greater insight into and understanding of the unique value pastoral services brings to our ministry of healing.

Provision of Palliative Care in Catholic health and aged Care Services

This essential book guides staff through the complex world of delivering effective and holistic patient-centered interdisciplinary palliative care.

the Care of Persons with Dementia in Catholic aged Care

CHA has developed this book as a resource for providers committed to the continuous improvement of the care and support for people with dementia.

C h r i s t i a n Conscience

This CHA publication is designed to guide health care practitioners through moral situations in an increasingly complex world.

Written by Father Norman Ford, one of Australia’s leading theologians and ethicists, the book explores the challenges presented to practitioners of Catholic health and aged care by emerging moral and ethical dilemmas posed by the rapid introduction of new medical technologies.

Being a Catholic hospital

A book written for all who work in Catholic hospitals today, this publication explores the origins, ethos, values and challenges of the modern Catholic hospital. It invites reflection and conversation about the meaning of our work together as we enter a new era in the life of the Catholic hospital.

Pastoral Services in Catholic Health, Community & Aged Care—Contemporary PracticeCHA Members – AU$27.00 ex GSTCHA Members – AU$30.00 incl GSTNon-members – AU$40.00 incl GST

Provision of Palliative Care in Catholic Health and Aged Care ServicesCHA Members – AU$20.00 ex GSTCHA Members – AU$22.00 incl GSTNon-members – AU$32.00 incl GST

Christian ConscienceCHA Members – AU$30.00 ex GSTCHA Members – AU$33.00 incl GSTNon-members – AU$43.00 incl GST

The Care of Persons with Dementia in Catholic Aged CareCHA Members – AU$30.00 ex GSTCHA Members – AU$33.00 incl GSTNon-members – AU$43.00 incl GST

Being a Catholic HospitalCHA Members – AU$15.00 ex GSTCHA Members – AU$16.50 incl GSTNon-members – AU$26.50 incl GST

Books are available for online purchase or order forms can be downloaded at www.cha.org.au, or call 02 6203 2777.

Prices include postage (surface mail) and handling in Australia. Prices subject to change without notice.

to order:

C H A 2 0 1 0 N At i o N A l C o N f e r e N C e

help chart the next phase of our shared future …

the 74 voting members of cha are invited to nominate a representative to attend a special session to explore the inforMatIon report and draw up a plan to move forward on its recommendations.

the meeting will provide an opportunity for members to engage in in-depth, interactive discussions and prioritise recommendations.

cha will work to serve its members’ needs, as movement towards a sustainable and growing catholic sector is achieved.

this meeting marks the start of this journey.

more information:

• CHAwillsoonwritetomemberstoseektheirattendance• MoredetailswillbepostedontheCHAwebsiteclosertotheevent• Accessthereportandassociatedmaterialsatwww.cha.org.au

inforMatIon General Meeting2 deceMber 2010, Melbourne