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Dr Blayney's Practice Newsletter July 2004 -page 1

Surgery 100 years old!!
The present surgery building was built in 1904 by A B Burrell for an American, Dr G Herbert Brown. Subsequent doctors included, Dr James Breadalbane MacDiarmid (Scotland) about 1907, Dr William Frederick Buist (Argintina) in 1919, Dr Alastair Gordon Buist (NZ) from 1946 to 1983, Drs D R (Bob) Armstrong and Phil Stockdill 1951-79, a short with Dr Louis Trichard (SA), Dr Keith Thomas Blayney (Auckland) from 1980 till present and Dr Erwin Eloff (SA) 1983-1986.
More Staff changes
Our part-time practice nurse Jill Dunlop had to leave to support her own business, but will provide occasional relief work. Kathryn Abraham is also providing some relief work. Dianne Bezuidenhout now works every day until mid afternoon. Note there will usually be no nurse available in the late afternoon.

(Practice Nurse)

(relief Nurse)

(relief Nurse)
Gail Werder remains our receptionist Monday - Thursday with Kerry Coxhead working Fridays.

Consultation Times
The surgery starting time of 8.30am has been reasonably successful and will be continued. Friday afternoons have been freed up as well for normal consultations. Because some patients only need a brief consultation (eg a repeat prescription), while others have problems needing a full or extended consultation, we have been asking you to make it very clear to the receptionist what you need, so an appropriate time can be allocated to avoid long waits.
Fees relate to the cost of providing the service, less ACC and GMS subsidies. Longer, multiple problem and involved consultations do attract a significantly higher fee. Stable conditions such as hypertension can often be seen three times a year as a brief (and cheaper) consultation, with a more involved review annually. However, because neither ACC nor the Health Funding Authority wish to pay a resonable GP fee, a "shortfall" payment is necessasry to cover what was promised as free. For accidents this is $25, for under sixes it is $12 and over 65s have no reduction because your subsidy money is only paid to PHO patients (see article on the right).
No Repeat Prescriptions!!
This was the most controversial change last year, but also the most successful, as patients often needed significant changes in medication and many new conditions were identified and managed. It has reduced practice stress, as patients now rarely attend with multiple unrelated (and often late stage) problems.
Leg lacerations & tears
Please attend the surgery (or the after-hours service at the Hospital ED) straight away, if you injure a leg and damage the skin. Early appropriate management of these prevents the inevitable ulcer that we still see too often. What could take days to heal then takes months!
Pregnancy & Folic Acid
Any sexually active fertile woman who plans or even suspects a pregnancy is advised to start supplementation with the vitamin Folic Acid. The 0.8mg over the counter size is the MINIMUM dose, while I recommend 5mg as the evidence suggests this dose is better at preventing Spina Bifida, HareLip and Cleft Palate. I suggest going from the contraceptive pill directly onto a Folate tablet daily (and stop smoking, drinking & stressing)!
What is a PHO?
Primary Health Organisations have been set up, according to the Minister of Health, to "improve health and reduce health inequalities by moving to a system where services are co-ordinated around the needs of a defined group of people". The governance of these organisations is theoretically "the community" but in reality it is those who control the funding. "Minimum requirements" include "management of referred services within a budget", a "national enrolment system" with "requirements of information collection", which is largely ethnicity. This is Managed Care at its worst.

Other loss of freedom to practice in the best interest of an individual for the supposed advantage of a larger group defined by politicians (eg place of residence) are featured.

The carrot is not the (unproven) improvement in individual health, but extra funding. Unfortunately, this funding is tightly controlled and ONLY available to patients of doctors who join PHOs. This creates a new inequality, namely patients who attend non-PHO GPs.

Membership is "voluntary" for the GP ......

Continued on page 2

Have you checked our Web Page at www.drblayney.com yet?

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