Welcome to the September 2009 issue of i2P E-Magazine - Information to Pharmacists.
In this edition I would point you to the Pharmedia link where trends in US pharmacy consumers are noted and matched to the Australian counterpart.
There is a strong similarity between the two countries.
In this commentary a direction and a strategy is suggested.
Please feel free to add your comment in the panel provided at the foot of this commentary, as it is a very important issue for Australian pharmacists.
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Volume 4 Number 1
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Volume 5 Number 1
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Volume 6 Number 1
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Volume 6 Number 6
Anyone who has followed the story of convenience clinics in the US would have come to a simple conclusion very early in their investigations.
That conclusion would have been that with a few exceptions, the market being serviced in primary care was identical to that serviced by Australian pharmacists.
What was commonly known as “counter prescribing” in Australia became known as the “Minute Clinic” or Rediclinic in the US.
Now we have a development here in Australia where nurse-led clinics are being hosted by pharmacies, with the initial players being the Revive Clinic and the Pharmacy Alliance Group, consisting of 186 franchisees, all based in Perth, Western Australia.
The divide between who writes prescriptions in Australia and who dispenses them has traditionally been seen as an important construct in minimising any conflict of interest.
Will the evolution of nurse practitioners working in pharmacies mean that this protection mechanism for the average Australian (and their taxes) is dissolved?
The National Competition Policy Review of Pharmacy has surely failed to protect the industry from itself.
The objectives of the restrictions include; “ Keeping pharmacy business small enough to facilitate the close personal supervision of their professional operation by the proprietor pharmacists.”
Oh, yeah, just how does that work?
And… “Protecting pharmacy businesses from perceived “unfair competition” and market dominance from large pharmacy-owning corporations and chains and, in some jurisdictions, Friendly Societies”.
Come on, let’s be serious!
I am going to preach to you dear reader.
So what is new with that you will say?
Plenty, because I truly do believe in this creed, which is the belief that without rigorous control of core data integrity the whole e-health plot is flawed.
This boring subject has been raised in these pages several times and there is no doubt the message has sort of got through, but ‘sort of’ is way, way too far from being acceptable. You see this mishmash problem in the pharmacy daily as you use different PDE numbers for the same product when you buy from more than one wholesaler.
You cope with different proprietary product identification and then use the GS1 barcode, on the product pack, to close the sale at the POS (you do, you do use that barcode don’t you!).
All of this means you have to use the wetware technology tool to interpret and map information from one system to another; and the minute you introduce wetware you introduce errors.
All of us have that neat stack of literature either beside our bed, under the desk or overflowing off the kitchen bench. If you are like me some are half read, bookmarked for later more in depth reads or stripped of relevant articles for pharmacy assistant training modules.
I also have a system with my emails and RSS feeds that categorises them to the ‘to be read when I have time file’. On a morning not so long back when I could lay in bed and clear this email in tray I completed a competition on the Pharmacy Daily website for the Pharmacy women’s Congress 2009. To my ultimate surprise I won!!
Comment about the future of pharmacy has been a daily occurrence for seemingly as long as Cook plotted a course up the eastern seaboard.
He hit the rocks, as will many of the so-called “players” attempting to seek proprietorship over parts of the pharmacy puzzle will.
Whether it be fact or Chinese whispers, a number of “core”(sorry Kev) “assets” have the attention of many.
Paracetamol overdosing is emerging as a problem in New Zealand similar to other western economies around the world.
In Australia we have seen some of larger chain pharmacies encouraging the sale of high volumes of paracetamol by deep discount,
Despite protests from a range of pharmacists, little has been done to prevent the spread of irresponsible paracetamol sales.
Pharmacy Boards state they need an official complaint backed up with evidence of adverse events resulting from inappropriate selling.
Liver damage is one adverse event, sometimes requiring a liver transplant to rectify the damage.
There is no easy solution for paracetamol is such a useful drug.
However, there is a strong argument for confining all paracetamol sales to pharmacies irrespective of the potential inconvenience.
In fact, if the general principle applied that all medicines should be sold from a pharmacy, the need to sell other types of merchandise would dissipate.
It's worth a thought
People overdosing on paracetamol
Source Otago Times
The consistent mismatch of approaches to Health IT continue to occur, even with the best efforts of Minister for Health and Ageing (Nicola Roxon) trying to uncover the best way forward.
Costs, both in the government and private sectors, have continually expanded to now stellar $ numbers.
Nicola Roxon's focus on the patient and building out from that point, will see her win the day.
Vendors (such as the Pharmacy Guild) who are canny enough to mould their systems to her view of the world, may eventually get a "nod" of some sort, provided the systems developed genuinely provide a scale of economy, saving development costs as well as delivering the specified benefits to health generally.
Commitment has been made to a National Broadband Network (NBN) and a 16-digit patient identifier so movement to shared health records is nearly possible, with the AMA making some "noises" towards a form of electronic health record (but not a full record).
Source: Australian IT
Proposals that would allow the pharmaceutical industry to provide drug information directly to consumers has been opposed by the Royal Pharmaceutical Society.
This against a EU background to develop an informational infrastructure that could be delivered to all of the European community.
A conflict of interest clearly exists between the public's interest to receive accurate and objective information and the pharmaceutical industry's objective of building revenue and market share.
The New Zealand Pharmacy Guild has commented on the efficiency of Project Stop in Australia and wants to introduce it to NZ pharmacists.
They would also like to extend its use for other medication tracking.
NZ interest may further stimulate a faster uptake of the system in Australia, and by comparing notes in developing the use of the software, governments may be encouraged to fund a range of extensions.
Pharmacies Fight to Stop P-Runners
At last there is a move to sort out the high costs and inefficiencies inherent in Australia's private health insurance system.
Not that the private funds are totally to blame.
Government policies built around the Medicare levy (an extra tax, unless you take out private insurance), the limited range of benefits payable by private funds (because of government controls) has led to a high level of dissatisfaction by people privately insured.
It appears that an entity titled Medicare Select, may be utilised to negotiate and "bulk buy" health services, including those of the state-owned hospitals.
Private health funds, including Medibank Private, would be involved in managing the services on behalf of their members.
This new system has a real potential to reduce major health costs.
Medibank backs system shake-up
In April 2010 the current program for QUMAX (Quality use of medicine in aboriginal community controlled centres) will come to an end.
This was a pilot program and work is being done to look at where to from here?
Like all pilots the program took some time to achieve its goals but achieve them it did.
The evaluation process has been ongoing and the feedback from pharmacists and patients has been excellent.
Will the issues revolving around complementary and alternate medicine (CAM) use ever be resolved?
Outcries from some respected science authorities deride all CAM as "witchcraft", yet most pharmacists would know of at least one good outcome from CAM.
For example, recent research into Traditional Chinese Medicine has uncovered the fact that some herbal remedies for the treatment of heart conditions, help to restore the nitrous oxide (NO) balance in the body, in part by converting nitrites and nitrates absorbed from foods, to beneficial NO (allowing proper dilation of blood vessels, subsequent reduction in blood pressure and gradual depletion of arterial plaque).
This information is now evidence-based, but will you see it appearing in mainstream medical publications?
It is my belief that while many critics of CAM definitely have a valid case for some complaint (particularly when patients are financially exploited), there are many "experts" that have been blind to information that could prove useful (and cheaper) for their patients, simply because they were unaware of the evidence available.
It is simply hidden from view under the sheer volume of total information that is being published and disseminated to health profesionals.
In February 2008 the respected BBC came under fire for providing information on CAM's and withdrew this popular service. I was unaware of this happening and have provided one of the media stories reporting the incident, for others who may have been unaware.
The BBC is a public broadcaster (like Australia's ABC) and serves the interests of the general population free from commercial pressure.
As 41% of people in the UK use CAM the decision to close down the service was certainly a controversial one.
A recent visit to the BBC site demonstrated some CAM news stories, mostly geared towards the potential problems that may be associated with its use.
This is a shame because the BBC are well placed to research evidence surrounding CAM's and provide a much needed and unbiased site for solid information.
The BBC Abandons Its Complementary Medicine Website Due to Pressure
Many firms that licence key software programs are tightening up licencing conditions such as who is entitled to received free licences and what scale of charges apply.
Clients are reluctant to pay fee increases for basically the same software each year, but charitable and aged care organisations will be hit hard for licences that formerly were available to them free of charge.
Obviously there will be some hard negotiating coupled with a review of the actual software required.
One alternative may be to replace Microsoft with the Sun Open Office suite of programs that virtually duplicates the entire range of programs contained in Microsoft Office and comes entirely free of any cost. Open Office can also convert to any of the Microsoft formats.
Pharmacists may like to consider the change as well.
Source: Aged Care Guide
Aged Care IT Investment Put on Hold
With the Baby Boomer retirement revolution due to start in 2010, one of the key needs will be an army of carers to provide home support needs.
Traditionally, this has fallen to family members, usually female.
And with a considerable number of carers being elderly themselves, there will be a human resource shortfall in this area.
One obvious solution is to elevate this activity to that of a career and the necessity to put training processes in place coupled with appropriate remuneration.
Government has made some moves in this regard, but not nearly enough nor in a timely fashion.
There is an opportunity for pharmacy to provide a support service in the form of "Pharmacy in the Home" services.
Creating the outreach is the difficult part, but pharmacies that do not try and participate will lose market share to those who do provide the service.
Carer at home issues raised by NHHRC reform proposals
Source: Aged Care Guide
A walk in the sun to generate a reasonable level of vitamin D3 is said to delay the need for a knee replacement.
But this vitamin is also implicated in heart health, cancer prevention, osteoporosis, arthritis and immune modulation, as in multiple sclerosis.
In fact, it is said that vitamin D3 is involved with over 1100 individual genes in an average person.
Even if you get sun exposure, if you utilise sunscreen preparations the conversion reaction in the skin is virtually negated, or if you have a shower 15 minutes after exposure, the vitamin washes away before being absorbed through the skin.
Old skin is also inefficient as a medium for generating and absorbing the vitamin.
While sun exposure is the cheapest and most optimal way of getting a daily dose of vitamin D3, a back up through oral supplementation is also recommended.
Knee replacements delayed by sun
Source: Aged Care Guide
The following story published by Drug Topics mirrors a trend that has already commenced in Australia.
A more conservative customer/patient is emerging, in part driven by government attempts to convert branded drugs on the PBS to a cheaper generic version.
Harsher economic conditions have also played a major part.
As we all know, not all customer/patients are convinced of the value involved in changing from long established brands, no matter what arguments are offered.
That means two distinct classes of health consumers are forming up within Australian pharmacies.
Note also that the value-conscious health consumer illustrated in the article is less impulse driven and creates a shopping list before leaving home.
And in the background, high levels of government stimulus spending means that the ability for government to fund existing and future services is at risk, and resources will have to be rationed even more than they are currently.
But this trend opens up a range of opportunities for pharmacists to develop a range of services targeted for customers/patients within their homes.
Mark Coleman discusses a "Pharmacy in the Home" concept further along this article.
Keeping you up to date with PSA activities.
Information made available from the Pharmaceutical Society of Australia by Peter Waterman. Peter Waterman is the Public Affairs Manager for the Pharmaceutical Society of Australia. He may be contacted by telephone (02)62834782, or on mobile phone 0419 260 827
STUDY HIGHLIGHTS EFFECTIVENESS OF HOME MEDICINES REVIEWS
A new study has shown Home Medicines Reviews (HMRs) undertaken by accredited pharmacists and GPs have a significant impact in reducing the rate of hospital admissions from heart failure.
HMRs are Government-funded collaborative medicines reviews designed to prevent, detect and resolve medication-related problems.
The study titled The Effectiveness Of Collaborative Medicine Reviews In Delaying Time To Next Hospitalisation For Heart Failure Patients In The Practice Setting: Results Of A Cohort Study, published in Circulation: Heart Failure, a journal of the American Heart Association, found HMRs appeared to be effective in reducing hospitalisations among those at high risk, including the elderly.
“Unadjusted results showed a 37% reduction in rate of hospitalization for heart failure at any time. Adjusted results showed a 45% reduction amongst those that had received a home medicines review compared to the unexposed patients,” the report says.
“Conclusion: Medicines review in the practice setting is effective in delaying time to next hospitalisation for heart failure in those treated with heart failure medicines.”
President of the PSA Warwick Plunkett said the risk of misadventure from medication misadventure had risen significantly in the past 20 years.
“Adverse-medication events are conservatively estimated to account for more than 400,000 visits to general practitioners each year and about 140,000 hospital admissions across Australia a year, adding a huge cost burden to the health-care system,” Mr Plunkett said.
“In the United States, the Bootman study found a health-care cost of $1.50 for every $1 spent on medicines as a result of medication misadventure, of which at least half are avoidable. Given the similarities between the US and Australian systems, I don’t think those figures would be much different in Australia.”
Mr Plunkett said the study clearly demonstrated that HMRs were an effective and accessible way of reducing hospitalisations through medication misadventure.
“Patients, particularly the elderly or those in high-risk groups — patients taking five prescriptions or more — are encouraged to speak to their GP and pharmacist about an HMR. It is a critical investment in their own wellbeing.”
26 August 2009
PAC SESSION ON PATIENT SELF-MONITORING WITH WARFARIN THERAPY
Antithrombotic agents (anticoagulant and antiplatelet drugs) are some of the most frequently prescribed medications in Australia and yet they are also often associated with adverse drug reactions.
It is common to see antithrombotics used in various combinations, and in the elderly, which further increases the risk of adverse events, a situation made even more pertinent to pharmacists with a number of new antithrombotic medications available in Australia.
As part of the AACP program at this year’s Pharmacy Australia Congress, a session presented by Dr Luke Bereznicki will provide some context to the appropriate use of antithrombotic agents available including some background into thrombosis and its consequences, the rationale for pharmacotherapy, appropriate drug choice and the importance of clinical monitoring.
PAC’s theme this year is Securing Your Practice Advantage, and the Congress is being held at the Sydney Hilton from 15-18 October.
Dr Bereznicki’s presentation will look at the subject of patient self-monitoring (PSM) of warfarin therapy which has emerged as the gold standard of care for those willing and able to perform it.
Dr Bereznicki says the benefits of PSM have now been well established in several countries and include a greater proportion of time spent in the INR therapeutic range, a reduction in the number of haemorrhagic and thromboembolic events, reduced mortality, improved warfarin knowledge and improved quality of life.
He explains that portable INR monitors are readily available and are becoming less expensive and easier to use. Community pharmacists are well placed to promote and facilitate PSM for interested consumers, and provide support for those who are self-monitoring.
Dr Bereznicki is currently a lecturer at the Tasmanian School of Pharmacy.
He is part of a pharmacy-practice research group, UMORE, and writes regularly for a range of pharmacy industry publications. He is also a practicing pharmacist and regularly works in retail pharmacy and performs medication reviews. Dr Bereznicki was the PSA Young Pharmacist of the Year in 2008.
PAC organisers advise that registrations for the Congress should be made as soon as possible as places at some sessions are limited.
21 August 2009
ROXON E-HEALTH COMMENTS WELCOMED BY PSA
Comments by the Minister for Health and Ageing, Nicola Roxon, committing to e-health reforms and electronic patient records have been welcomed by the Pharmaceutical Society of Australia.
Addressing the ‘Health e Nation Conference’ in Canberra during the week, Ms Roxon said she wanted Australia’s future health system to be connected, secure and efficient.
“It is frustrating that in a sector where technology and research drive continual innovation in patient care, paper is still king. After a decade of doing our banking – and almost everything else – online, we’re still carrying our x-rays under our arm, a script to the pharmacy, and the hospital can’t send a discharge summary to the family GP,” Ms Roxon said.
The President of the PSA, Warwick Plunkett, said pharmacists endorsed Ms Roxon’s comments and called on the Government to fast-track the implementation of e-health.
“The National E-Health Strategy has pointed to a 10-year implementation phase for the introduction of e-health in Australia which the PSA believes is just far too long and has the potential to endanger patient care,” Mr Plunkett said.
“We have to speed the process up so that reforms such as electronic prescriptions and electronic health records are available as soon as possible for the wellbeing of Australian consumers. There is little doubt that e-health initiatives will make our health-care system safer and more efficient and there is demonstrable proof that the technology is efficient and secure.
“The recommendation in the final report of the National Health and Hospitals Reform Commission for the introduction of personal electronic health records by 2012 is a timetable than can and should be met. There is no reason for Australia to be holding back.”
Mr Plunkett said the implementation of projects such as Medicare and the GST, which included privacy provisions and major IT capability, showed that with Government commitment major undertakings could be introduced in as little as two years.
“There is no reason that e-health should be any different.”
The PSA also calls on the Government to introduce robust standards for e-health capability and processes which includes the inter-operability of commercial solutions in the market place.
“The development of these commercial solutions is getting ahead of Government. It is important that the health professionals who will drive the system and the public who use the system have confidence and choice in it from the outset,” Mr Plunkett said.
Mr Plunkett said the PSA and its members would do everything possible to assist the Government in speeding up the process of implementation of e-health and its various components.
21 August 2009
PHARMACISTS’ ROLE IN MENTAL HEALTH HIGHLIGHTED
The Pharmacy Australia Congress this year will present a wide range of concurrent sessions covering subjects of clinical and professional interest for all pharmacists.
The four concurrent session themes this year are Advanced Clinical Practice, Professional Practice, Therapeutic Updates and Credentialed Programs.
PAC, the pre-eminent pharmacy event of the year, will be held at the Sydney Hilton from 15-18 October and will have as its primary theme Securing Your Practice Advantage.
In the Therapeutic Updates stream one particularly relevant session is Early Intervention in Mental Illness and the Role of the Pharmacist to be presented by Professor Ian Hickie.
Professor Hickie said that in the context of the recent development of collaborative care models of mental health treatment it was proposed that community-based pharmacists require specific training to intensify their capacity for work with customers to whom they are dispensing psychiatric medication and he would examine this issue in his presentation
Professor Hickie, the Executive Director of the Brain & Mind Research Institute (BMRI) at the University of Sydney has been described by The Australian Financial Review as one of the top 10 cultural influences.
His appointments include CEO of beyond blue: the national depression initiative as well as serving as its Clinical Advisor. In 2003, he was appointed as the inaugural executive director of the flagship Brain and Mind Research Institute at the University of Sydney. In 2006, Professor Hickie received the Australian Honours Award of Member (AM) in the General Division; for services to medicine in the development of key mental health initiatives and general practice services in the public and non-government sectors. In 2007, he was appointed to the Prime Minister’s Australian National Council on Drugs and has led the BMRI as a founding member of the new National Youth Mental Health Foundation (‘headspace’). In 2007, Professor Hickie was elected as a Fellow of the Academy of the Social Sciences in Australia. His research, clinical and health services development work focuses on expansion of population-based mental health research and development of international mental health strategies. In July 2008 he was appointed to the Federal Health’s Minister’s new National Advisory Council on Mental Health. In May 2009 he became a member of the Common Approach to Assessment Referral and System Taskforce
His session promises to be one of the many highlights for delegates at this year’s PAC.
Full details of PAC can be found at www.pac2009.com.au
19 August 2009
WARWICK PLUNKETT RE-ELECTED AS PSA PRESIDENT
Warwick Plunkett was re-elected as the President of the Pharmaceutical Society of Australia at a Board meeting held in Melbourne today.
The election sees Mr Plunkett, a former community pharmacist, serve a second term as the PSA President.
South Australian community pharmacist Grant Kardachi and Queensland academic pharmacist Lisa Nissen were elected Vice Presidents at the meeting.
Mr Plunkett said one of the major tasks for him in his new term was to lead the PSA as it entered into negotiations for the Fifth Community Pharmacy Agreement.
“This agreement is of vital importance to the whole profession and this time the PSA has a seat at the negotiating table,” Mr Plunkett said.
“This gives the PSA the ability to press for a much greater focus on the provision of professional services and the development of services to help enhance the health-care system in this country.
“It also gives us the opportunity to secure for pharmacy a greater role in the multi-disciplinary model of health-care which is evolving in Australia.
“Clearly one focus will be to expand the role of pharmacists to include additional services such as prescribing.”
Mr Plunkett said another focus for his Presidency would be to continue the consolidation of the PSA following its unification process last year.
“The unification has resulted in a stronger, more cohesive PSA which is better able to represent its members across all spectrums of the pharmacy profession,” Mr Plunkett said.
“I look forward in the coming year to help position pharmacy for the future and to ensure the profession and the professionals within it are recognised as pivotal members of the primary health-care system.”
7 August 2009
PSA CALLS FOR ACCELERATED IMPLEMENTATION OF E-HEALTH
A suggestion that the implementation of e-health infrastructure across Australia be funded from the Health and Hospitals Fund has been supported by the Pharmaceutical Society of Australia.
Chairman of the Health and Hospitals Fund’s advisory board, Bill Ferris, was reported today as saying the country’s e-health ambitions could be funded form the remaining $1.8 billion in the Health and Hospitals Fund.
President of the PSA, Warwick Plunkett, said it was essential that the introduction of an e-health system in Australia be fast-tracked.
“The PSA strongly supports an accelerated timetable for the implementation of e-health initiatives such as electronic prescribing and electronic health records and believes that the 10-year horizon envisaged by the National E-Health Strategy is far too long,” Mr Plunkett said.
“We know that e-health initiatives have the potential to make our health system safer and more efficient, we know that the technology works, we know that privacy can be protected, so what is holding Australia back?”
Mr Plunkett said the Council of Australian Governments (COAG) agreed more than three years ago to a national approach to developing, implementing and operating systems for individual and health-care provider identifiers as part of accelerating work on electronic health records to improve the safety of patients and improve efficiency for health-care providers.
“However, while work on the individual identifiers is finally underway, we are yet to see any agreement from Health Ministers or COAG on the adoption of electronic health records,” Mr Plunkett said.
“Indeed, even if the recommendation in the final report of the National Health and Hospitals Reform Commission for the introduction of personal electronic health records by 2012 is actually adopted, this would still be a full six years after COAG’s 2006 agreement.
“Discussions on national uniformity around health privacy have been underway between governments since at least 2000 and we still appear to be no closer to resolving jurisdictional differences.
“It is time to stop delaying and start acting.”
5 August 2009
PSA DISAPPOINTED AT CODEINE DECISION
The announcement by the National Drugs and Poisons Schedule Committee today to implement major changes to the scheduling of medications containing codeine is disappointing and could place barriers in the way of legitimate consumers, the Pharmaceutical Society of Australia says.
President of the PSA, Warwick Plunkett, said the rescheduling of many products containing codeine and reducing pack sizes could present more problems than it sought to address.
“The PSA fears that reducing the pack size will only result in those people who are determined to secure a supply of these products engaging in ‘pharmacy shopping’, that is buying packs at as many pharmacies as they can,” Mr Plunkett said.
“This defeats what the NDPSC hopes to achieve by limiting the pack size, and that is to stop these products being used for illicit purposes.
“The PSA fully supports the intent of stopping the illicit use and over use, but believes the NDPSC has opted for an approach which could be counter-productive and put pressure on pharmacists with inappropriate consumer demand for multiple sales of smaller packets by those abusing the product.”
Mr Plunkett said the PSA had presented a submission to the NDPSC in which it advocated the uniform scheduling of medications containing codeine.
“We submitted that standardising arrangements across all jurisdictions for all combination analgesics containing codeine including, but not limited to scheduling, pack sizes, storage requirements, supply and recording would be a major and productive step in containing the illicit use of these medications.
“Simply restricting pack sizes and access doesn’t seriously address the issue of abuse to any real degree.
“Making these delete large numbers of products S3 will also put significant pressure on pharmacists’ precious time and may well require a rethink of how they allocate their staff and other resources.
“The lesson for pharmacy and the pharmaceutical industry is that when substance abuse or potential therapeutic misadventure is known to be likely, it is essential that such products are handled by appropriately trained support staff or pharmacists.
“The delivery of education and training on the therapeutic issues surrounding these codeine-containing products may have been a far more effective answer than the blunt restrictive response to the problem by the NDPSC.”
3 August 2009
LEADING AUSTRALIAN HEALTH EXPERT TO SPEAK AT PAC
One of Australia’s leading experts on the health-care system in this country will present what promises to be a thought-provoking session at the Pharmacy Australia Congress in Sydney.
John Menadue AO, currently a Board Director of the influential Centre for Policy Development, will address PAC delegates on the subject of “An Extended Role For Pharmacists In Prevention And Healthcare”.
This year’s PAC, to be held at the Sydney Hilton from 15-18 October, will focus on the theme of Securing Your Practice Advantage and Mr Menadue’s topic is especially timely given the range of studies and reports being undertaken and presented with a view to improving the health-care system in Australia.
Mr Menadue has had a distinguished career in the private sector and in the Public Service.
He was made an Officer of the Order of Australia (AO) in 1985 for public service.
In 2003 he was awarded the Centenary Medal ‘for service to Australian society through public service leadership’. In 1997, he received the Japanese Imperial Award, The Grand Cordon of the Order of the Sacred Treasure (Kun-itto Zuiho-sho).
Mr Menadue was Private Secretary to Gough Whitlam, Leader of the Opposition, from 1960-67, before moving into the private sector for seven years as General Manager, News Limited.
He was head of the Department of Prime Minister and Cabinet from 1974 to 1976 and worked for Prime Ministers Gough Whitlam and Malcolm Fraser. He was Australian Ambassador to Japan from 1976 to 1980. In 1980 he took up the position of Head, Department of Immigration and Ethnic Affairs. In March 1983, he became Head of the Department of the Special Minister of State. He was appointed Head of the Department of Trade in December 1983.
He has chaired the NSW Health Council which reported to the NSW Minister for Health in March 2000 on changes to health services in NSW. He also chaired the SA Generational Health Review which reported to the SA Minister for Human Services in May 2003.
In October 1999, John Menadue published his autobiography Things You Learn Along the Way and there is no doubt his PAC presentation will show delegates a great deal they can learn along the way.
Full details of PAC can be found at www.pac2009.com.au
Warwick Plunkett 0412 304 45
Peter Waterman 0419 260 827