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Drs Anthony Djurkov, David Bratt & Peter Jansen ACC, WINZ & Mental Health Drs

#1 User is offline   hukildaspida 

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Posted 20 November 2008 - 10:03 AM

Do a google on these Drs & discover what is really going on behind the scenes in these Depts in the last year.

MOH WEBSITE HAS SOME INTERESTING ARTICLES.
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#2 User is offline   hukildaspida 

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Posted 21 November 2008 - 03:31 PM

May we suggest those whom end up on a WINZ benefit & suffer "Depression" as a result of ongoing distress as a result of not getting your ACC entitlements that you ask your Dr to specify that the "Depression is as a direct result of ACC & your Injuries."

Dr Djurkov stated in a recent conference which was reported in the Herald that those whom suffer from "Depression should return to work within a month or 2 & not be on a Benefit for longer."

Food for thought & of concern for those who end up on WINZ benefits whilst sorting out ACC botch-ups.
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#3 User is offline   hukildaspida 

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Posted 11 December 2008 - 12:31 PM

http://www.ranzcp.tcc.co.nz

Dr Peter Jansen Mauri Ora Associates ' Towards NZ Medicines Strategy Submissions

http://www.moh.govt.nz/moh

http://www.moh.govt....egy-consult.pdf

http://www.rnzcgp.or...cord-review.pdf
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#4 User is offline   Maraqita 

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Posted 13 August 2009 - 09:11 AM

View Posthukildaspida, on Dec 11 2008, 02:31 PM, said:

http://www.ranzcp.tcc.co.nz

Dr Peter Jansen Mauri Ora Associates ' Towards NZ Medicines Strategy Submissions

http://www.moh.govt.nz/moh


You're right about doing a Google search. Seems Mr ACC is speaking in Rotorua at the Maori cancer hui.

Quote

Dr Peter Jansen
MB ChB, FRNHZCGP (Dist), Grad Cert Clin Tchg
Peter, (Ngāti Raukawa) was a founding director of Mauri Ora Associates Ltd. Peter now works fulltime for ACC as Senior Medical Advisor.
Peter has been the lead investigator for the HRC/MoH/ACC funded research project on Maori Consumer Use & Experience of Health & Disability and ACC Services (he ritenga whakaaro). This project will be published in 2009. Peter was awarded a Distinguished Fellowship from the Royal New Zealand College of General Practitioners in 2008. He has contributed to many Mauri Ora projects and to publications on cultural competence in health care. For example, see the ACC and Medical Council publications on cultural competence and the papers:
Jansen P. and Sorenson D. Culturally Competent Health Care, NZFamPhys 2002 October; 27(3)
Jansen, P, Bacal, K., and Smith, K. Developing Cultural Competence in accordance with the Health Practitioner Assurance Act, NZFamPhys 2006 October 33(5)
Mobile: 027 280 1445
Email: [email protected]
http://www.mauriora....uriora_9.php#pj
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#5 User is offline   hukildaspida 

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Posted 10 September 2009 - 02:09 PM

ACC Dr Peter Jansen

http://www.nzherald.co.nz/nz/news/article....jectid=10596123


http://www.psycholog...load.php?id=125

Dr Raymond Nairn

http://www.mentalhea...-Grants+History

http://www.gudrunfrerichs.com

Open letter to Nick Smith (Minister for ACC& also to ACC'S Dr Peter Jensen
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#6 User is offline   jocko 

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Posted 12 September 2009 - 05:34 AM

Online Access to DSM-IV
www.PsychiatryOnline.com Access DSM codes, diagnosis, criteria lists, decision trees.
Hi are these are the American Guidelines mentioned?
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#7 User is offline   hukildaspida 

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Posted 24 December 2009 - 03:50 PM

View Posthukildaspida, on Nov 20 2008, 12:03 PM, said:

Do a google on these Drs & discover what is really going on behind the scenes in these Depts in the last year.

MOH WEBSITE HAS SOME INTERESTING ARTICLES.



Bump for those whom are unaware who these "clinicians" are.
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#8 User is offline   Moeroa 

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Posted 24 December 2009 - 05:09 PM

View Posthukildaspida, on Dec 24 2009, 05:50 PM, said:

Bump for those whom are unaware who these "clinicians" are.


THANK YOU!


Merry Christmas!
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#9 User is offline   hukildaspida 

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Posted 25 March 2010 - 03:32 PM

BIG BUMPS
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#10 User is offline   jaffa 

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Posted 25 September 2011 - 10:37 PM

http://www.george-eb...on-anxiety.html


It's ACC's behaviours towards us that cause depression. Denials of entitlements, threats of disentitlement, lies, dodgy assessors whom discriminate against us, abuse us and assault us (then deny it and call YOU the liar), so-called rehab appointments as well as the usual therapy and doctor treatments - all under constant threat of suspension of entitlements even when claimants are denied wheelchairs yet cannot walk to attend all the assessments. Being exited under illegal excuses conjured up by well-paid toady pocket pisser doctors, reinstated and placed immediately onto the Vocational Exit process, under coercion for threat of disentitlement. Being taxed on the higher rate so that the ERC is less than even WINZ benefits and also being pursued by MSD because ACC failed to reimburse WINZ (while telling you they’ve paid, yet keeping your money instead of repaying WINZ etc. etc. etc.) all of which is designed to wear down the claimant so that the individual eventually trips up and fails to attend the overwhelming myriad of appointments and prescribed assessments - And then the poverty and debt, ill health, poor dental health (for lack of funds) poor nutrition (for spending your ERC on your own rehab, only to be threatened for that rehab by ACC) And in that poverty being refused debt consolidation finance by banks who KNOW once reinstated onto ACC, the ERC is only for 12 months before the claimant is back on WINZ. AND you wonder why people are depressed?

VISIT HOME PAGE OF GEORGE EBY RESEARCH
- MANY NEW NATURAL DISEASE CURES


NOTE: This comprehensive mental health
page is 180 pages long and has many graphics.
It may load very slowly.







MENU

-12,000 word article magnesium for mental health (222 references)

-DISCUSS MAGNESIUM FOR DEPRESSION
-Discuss Magnesium
-Discuss Depression
-Internet Resources
-Depression Defined
-MY STORY
-Cured with Lithium or Magnesium
-NIH Table of Food Sources of Magnesium
-Well by June 7, 2000
-Stress as Ultimate Cause of Depression
-January 19, 2001 Update and Miscellaneous Musings
-FURTHER RESEARCH
-Government Censorship of this Page
-Homeopathic Uses for Magnesium
-Collected Thoughts on Dosage
-Could George be Wrong about Magnesium Oxide?
-Leaky gut Syndrome
-Inulin - the Vital Prebiotic
-Magical Taurine - The Perfect-Poop Maker!
-Anti-Candida Albicans Agents
-Coconut Oil: Cure for Everything?
-Garlic: The Cure for Everything Else!
-Kefir: The Candida Crusher!
-Iodine: The Candida Killer
-Spanish Black Radish
-Bacillus Coagulans probiotics plus Biotin
-Killer Sugars
-Milk & Calcium Toxicity
-High Fat Dairy and Whole Grains Cause Brain Lesions
-What's Left to Eat?
-Monosodium Glutamate Causes Obesity and Short Children
-The Lethal Hypothyroid Low Magnesium Axis
-Exercise
-Diagnosing Magnesium Deficiency
-The Essentiality of Boron
-Foods that Contain 100 mg or more of either Calcium or Magnesium per 100 Grams
-Non Dietary and Non Stress Causes of Hypomagnesemia
-Magnesium and Calcium Ions in Synaptic Function in Brain
-Calcium Channel Blockers
-Glutamate Toxicity
-High Quality Sleep
-Fibromyalgia, CFS & Magnesium
-Transdermal magnesium chloride treatment of ciprofloxacin side effects
-Red Eyes, Dry Mouth, Dry Eyes
-Stress Relief Techniques
-Good & Bad Stress
-The Hypothyroid - Low Magnesium Axis
-Driving and Depression
-An Aspirin for the Emotions
-Headaches
-Epsom Salts Baths
-The Mind
-Suicide
-Meditation vs. Thought-Stopping
-Losing Your IQ? (Or Your Children's IQ?)
-Traumatic Brain Injury and Magnesium
-Other Types of Depression
-Magnesium and premature ejaculation
-Attention Deficit Hyperactivity Disorder
-Age Activated Attention Deficit Disorder
-Falling In Love
-Corporate Murder and our Food
-Wheat ,Asthma and Cardiac Arrhythmias
-Magnesium throat lozenges might kill pediatric asthmatics
-Constipation Means...
-Violence & Mayhem
-Good Fats and Deadly Fats
-Lithium / Magnesium Interactions
-Biochemistry
-Age of Onset is Getting Lower
-Magnesium in Water
-Cocaine / Magnesium
-Mitral Valve prolapse
-Other Nutrients Important in Depression
-Tryptophan, 5-HTP and Serotonin
-Alzheimer's Disease Caused by Niacin Deficiency
-DHEA
-Veterinary Uses and Animal Research
-Our Prognosis and Caveats; My View as of July 31, 2001
-Codex Alimentarius: Will It Kill Us or Save Us?
-Tips for Diarrhea
-Magnesium Topically, by Injection or Rectum - no diarrhea
-What About You
-Dead Doctors Don't Lie!
-Drug and Magnesium Interactions
-Magnesium Compounds that Work, That Are Ineffective, or That Injure
-Toxicology
-Economic Sources of Magnesium
-Concluding Remarks - Drugs Substituting for Magnesium
-Death by Modern Medicine
-Chinese Medicine: Doing It Right!
-Naturopathic Medicine
-What Does Dr. Atkins Say About Magnesium?
-Internet Resources
-Sum it up in a nutshell George Eby!
-White paper on magnesium and depression
-Glycemic Index of 1200 Foods (and how to live to 100)



<br clear="ALL">Posted Image


Depression Treatment: A Cure for Depression using Magnesium?

by George Eby
[email protected]
George Eby Research Institute, Austin, Texas
Copyright
Revised: October 18, 2010Welcome! This is the first (and best) of 2.5 million web pages listed in Google.com for "magnesium and depression" (compared with 3 million pages for "Prozac and depression").




NEW and INTERESTING!
    Divorce: George Eby style
    How your cat can cause you to catch schizophrenia
    Is gallium nitrate a cure for HIV and AIDS?
    World's first formal clinical trial of magnesium for depression - 2008
    YouTube presentation: Depression Treatment with Magnesium
    White paper
    Eby's ColdCure
    Driving and Depression
    Inulin - the Vital Prebiotic
    Some of my favorite music
    The worst mistake you can make
    Let the Sunshine In! - A 5 frame Opus cartoon
    Magnesium for depression article - 2000 words
    Bacillus coagulans + biotin = anti Candida albicans
    My movie on foods that contain 400 mg of magnesium
    Omega-3 EFAs and cardiovascular disease prevention
    Treatment of Depression with 222 medical journal references
    Eby's new medical journal article: Gallium treatment for arthritis
    Transdermal magnesium chloride treatment of ciprofloxacin side effects
    Beautiful views of this big blue earth - guaranteed to brighten your day! (1.7 MB)
    My slide show - Depression treatment with magnesium - quick overview of entire site
    Eby and Eby: Rapid recovery from major depression using magnesium (2006 medical Journal article)
    Treatment & prevention of side effects induced by oral high dose magnesium therapy mental illnesses.ppt This is poster presentation of mine presented at the XII International Magnesium Symposium in Iasi, Romania, 22-25 September 2009.
    Eby and Eby: Magnesium for treatment-resistant depression: A review and hypothesis (2010 medical journal article)




Forward: Although this depression treatment by magnesium essay was written originally to address the role of magnesium as a depression treatment, the role of magnesium deficiency as cause of vast other morbidity and mortality is also addressed. This essay is my "notes to myself", and you are welcome to visit and explore what I am finding and to discuss it with me by phone or e-mail. As much as possible, all depression treatment research presented is from primary medical research by others and personal observation. I am just a reporter who was very ill from depression and was interested in seeing why things are going wrong in American medicine. I am not a physician and, obviously, I do not practice medicine or give medical advice. I have researched nutrients as medicine since 1979 on a daily basis, and I have come to think that much is wrong with American medicine, but not American medical science. We need to look into the vast library of medical research to see our paths better, and not wait until organized medicine catches up. From this research, I am forced to believe that much of what is wrong stems from our practice of eating refined grain products and reliance on drugs for health, not nutrition. In centuries prior to the twentieth, bread was the "staff of life" primarily due to its mineral, protein and caloric content. Today, perhaps we need to think of bread and other refined grain products as the "staff of death" due to the absence or near absence of life-sustaining minerals and vitmins. As you read this essay, please ask yourself if it is actually possible that the entire foundation of modern medicine is built upon a foundation of quicksand (low magnesium and high calcium)? You may find some answers here.Concerning the above figure, magnesium deficiency causes a large number of mental and other illnesses, and the following article discusses nearly all of these. However, a single picture is truly worth a million words.

NOTE: I started writing this page in 2000 and have updated it continually. In this page, there are over 1,200 external links to interesting and important pages. However, some of those pages have been terminated or moved, so there are dead links in this page. You can find the dead link on the Archive.Org website by copying the missing link address into the "Wayback Machine" address box at Archive.Org. If you will notify me of dead links by email, I will update this page to the archived page. BTW, there are about 270 versions of this page stored at Archive.Org and you can find the old pages here and the newer versions (2007 and more recent) here. DEPRESSION REALLY SUCKS! It needlessly sucks happiness and joy out of a person and may even suck the life out too if it can't be brought under control. I believe that the cure for depression is often extremely simple and quick using magnesium rather than drugs for many people - fortunately! Read my story and check out the facts in the links. Many links are directly to medical articles in the National Library of Medicine (PubMed) and other authoritative sources. You may find my story of a magnesium cure for depression to be important to you. Remember my point of view that depression, and particularly stress- and/or diet-induced depression, and many other "diseases" discussed below are often symptoms of magnesium deficiency (either directly or indirectly through excess stress) and not psychoses.


The National Institute of Health (NIH) reported in 2000 that a sign of magnesium deficiency is depression. NIH defined magnesium deficiency symptoms have three categories:

  • Early symptoms include (one or more) irritability, anxiety (including Obsessive Compulsion Disorder (OCD) and Tourette syndrome), anorexia, fatigue, insomnia, and muscle twitching. Other symptoms include apathy, confusion, poor memory, poor attention and the reduced ability to learn. (NOTE: If this essay appears difficult to understand, consider your magnesium status.)
  • Moderate deficiency symptoms can consist of the above and possibly rapid heartbeat, irregular heartbeat and other cardiovascular changes (some being lethal).
  • Severe deficiency symptoms can include the one or more of the above symptoms and one or more severe symptom including full body tingling, numbness, and a sustained contraction of the muscles, along with hallucinations and delirium (including depression) and finally dementia (Alzheimer's Disease).
If the NIH knows this, why don't doctors use magnesium to treat depression and other mental (and physical) disorders??? In 1989, C. Norman Shealy M.D., Ph.D. demonstrated that 99% of depressed patients have one or more neurochemical abnormalities; and that depression is a chemical disease as is diabetes, not a psychiatric disease. It seems to me that not using magnesium to treat depression is pure malpractice! We could rebuild and save lives! Magnesium ions are shown involved at the very heart of neural synaptic activity in this figure. Are you magnesium depleted or deficient? See this wonderful quick quizby Dr. Pricilla Slagle, M.D., a magnesium expert very interested in helping people with magnesium problems. Also, visit Dr. Herbert C.Mansmann, Jr., MD at THE MAGNESIUM RESEARCH LABORATORY (archived), another very interested magnesium expert.

Magnesium deficiency is a major risk factor for heart problems and diabetes and many other health issues, including sudden death. "The Magnesium Factor" by Mildred S. Seelig, MD, MPH and Andrea Rosanoff, PhD is an outstanding new book by the world's leading magnesium researcher and is highly recommended reading for learning how to prevent high blood pressure, heart disease, diabetes, and other chronic conditions. Many of today's "diseases" are actually "symptoms" of magnesium deficiency, and are not diseases. For another eye opener, see this amazing list and thorough documentation of hundreds of "diseases" that are often nothing more than magnesium deficiencies. What would happen to "medicine", pharmaceutical company income, and public health if these "diseases" were treated with magnesium before trying side-effect laden drugs? Wouldn't this approach to improving public health be more ethical? Unfortunately, for space reasons, this essay is restricted to mental health issues reasonably related to depression (and cardiology), but the health risks resulting from magnesium deficiency are very broad and need much exploration.


Depression Defined
Depression is an extremely common condition that affects more than 1 in 20 people in any one year in Western society. Depression used to be a rare condition, but as our consumption of magnesium has gone down over the last 100 years, or mental health has taken a serious hit as shown here. Depression is one of several hyperemotional states. A sudden loss of interest in life combined with a feeling of worthlessness may be associated with depression. Normally joy, sadness and grief are parts of everyday life. While a short period of depression in our response to daily problems is normal, a long period of depression and sadness is abnormal and is called "clinical depression". Depression can run in families, partly because families tend to eat the same foods and pass from one generation to the next similar eating patterns, and partly through genetics. Concerning genetics, I have found no evidence in the medical literature of a "depression" gene, but much evidence for a search for one. I suspect that the strong genetic component will be found to involve improper or inadequate magnesium metabolism.

Depression may be associated with a variety of symptoms, including but not limited to:

  • Persistent sadness and pessimism
  • Feelings of loneliness, guilt, worthlessness, helplessness, or hopelessness
  • Loss of interest or enjoyment in nearly every aspect of life
  • Diminished ability to think or lack of concentration
  • Insomnia or oversleeping
  • Poor appetite associated with either weight gain or loss
  • Fatigue, lack of energy
  • Physical hyperactivity or inactivity
  • Loss of interest in sex
  • Physical symptoms such as headache, backaches, stomach troubles, constipation and blurred vision
  • Anxiety, agitation, irritability
  • Thoughts of suicide or death (90% of suicides result from depression)
  • Slow speech; slow movements
  • Drug or alcohol abuse
  • A drop in school performance
Most depressive episodes are triggered by stressful personal event such as loss of a loved one or change of circumstances, and depression over a short period is a normal coping mechanism. Long-term stress-induced depression often, if not always, results when magnesium levels fall to dangerously low levels in the body by biochemical stress reactions discussed below. Magnesium deficiency related depression is a fixable biochemical problem and not necessarily a physiological problem.

Depression can also be due to many other factors such as underlying disease (particularly hepatitis C), brain chemical imbalances requiring antidepressant drugs of one type or another, hormonal imbalance (particularly hypothyroidism and low testosterone), low cholesterol, Wilson's Disease, food allergy (particularly gluten intolerance), heavy metal posioning, adverse reaction to medications and a list of other specific causes listed here, each of which requires professional care. Magnesium deficiency is not necessarily the only cause of depression, but it can be very useful in recovering from depression because the blood, body and especially the brain often become depleted of magnesium in depression, particularly stress-induced or diet-induced depression. Often, depression that does not respond to SSRI's (classical antidepressants - as in treatment-resistant depression) will respond best to magnesium treatment.

Symptoms listed for paying for magnesium serum level tests to detect hypomagnesemia (low blood levels of magnesium) by a major United States insurance carrier include depression. However, magnesium is an intracellular cation, and its only valid measurement is through red blood cell (not whole blood or serum) testing. This is because only one percent of all body magnesium is found in the serum, while the remainder is found inside cells. Consequently, serum testing, the routine clinical measure, makes as much sense as checking the carburetor bowl of a car to see if gasoline is needed. A huge list of diseases and health conditions meriting magnesium status testing is here However, brain magnesium is not well measured with anything except phosphorous nuclear magnetic resonance spectroscopy.

Not too certain what your problem is? If you are interested in knowing generally about mental health issues generally, look through the Mental health Net site. If you are interested in what life as a manic depressive (bi-polar) is like, click here. You can test your own level of mania on the Goldberg Depression Inventory here, and depression here.


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#11 User is offline   hukildaspida 

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Posted 29 June 2012 - 05:52 PM

New Zealand Herald — — A06 — 12 November 2008

Long-term handouts harmful for depression patients _ psychiatrist
Ministry says the number of patients on sickness benefits is decreasing
by Craig Borley


--------------------------------------------------------------------------------
New Zealand's tendency to keep depression patients on sickness benefits is harming the patients and the country, a psychiatrist believes.
Allowing such patients to live off a benefit for longer than two months made their depression worse and was a practice that should be stopped, Dr Anthony Djurkov said yesterday.

The consultant psychiatrist at Te Rawhiti community mental health centre in east Auckland said there was a trend around the world towards getting depression patients back to work as soon as possible.

The Ministry of Social Development was trying to apply the theory to New Zealand, but change was coming slowly, he said.

His research was presented at a recent Royal Australian and New Zealand College of Psychiatrists conference in Nelson.

He told the Herald that research showed New Zealand could improve management of depression patients on sickness benefits .

``If you keep somebody with depression on a benefit for longer than a month, you aren't doing a favour for that person.

Because at the end of the day they become scared and poorly motivated to work through their depression.''

A change was required in the way the medical profession viewed depression, and how society saw the disease, he said.

``And that's a very difficult thing to do, very difficult. But I don't think we should just leave it.''

```Return to work plans'' were needed, to be discussed with patients and doctors together and signed by both, he said.

``Even if [the patients] are terrified of returning to work, keeping them on a sickness benefit will just make them more terrified.''

Returning to work could be a gradual process, he said, involving training, voluntary work or a part-time job.

``I'm not saying, `Oh, you've been on a sickness benefit for two months so by Monday you must be in a full-time job.' That's the last thing they need, and I acknowledge that.''

But simply allowing them to sit at home promoted and maintained their depression, he said.

``They become more and more preoccupied with their non-importance, and their inability to work. And their terror increases and increases. And we promote that terror.

``We just maintain it by keeping them off work. And we promote their off-work identity by telling them, `You are sick, you should do nothing.'''

That was affecting the country's finances, he said, by demanding more spending than was needed on sickness benefits while decreasing the number of New Zealanders in the active workforce.

In the year to September, 6316 working age New Zealanders were on sickness benefits because of depression, from a total of 48,208 working age New Zealanders on such benefits.

The number had decreased from last year, when 7566 working age New Zealanders were on a sickness benefit because of depression.

The Ministry of Social Development's principal health adviser, Dr David Bratt, said that decrease showed a new appreciation by the ministry to see work as a ``health intervention'' _ something that was good for depression patients.

In the past year, the ministry had appointed health professionals to give advice to case managers on beneficiaries' conditions, and had begun an extensive programme of re-educating the health workforce and public on how best to help depression patients.

``The clinical evidence is absolutely clear, that people who do get into work do better and have less relapses. That is our approach, but it will take a little time for that to filter through.''

He said the rate of people becoming sickness beneficiaries was lower in New Zealand than in any other country in the OECD _ and that was a statistic the ministry intended to maintain.



--------------------------------------------------------------------------------

© New Zealand Herald, New Zealand Herald

DEPRESSED12


View Posthukildaspida, on 20 November 2008 - 10:03 AM, said:

Do a google on these Drs & discover what is really going on behind the scenes in these Depts in the last year.

MOH WEBSITE HAS SOME INTERESTING ARTICLES.

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#12 User is offline   hukildaspida 

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Posted 07 September 2012 - 11:46 PM

Interelated thread - New ACC Chair and Board Members appointed.

Note where, who with and when Dr David Bratt has previously held a position of power at http://www.acc.co.nz

http://accforum.org/...__1#entry136948


Wellington general practitioner David Bratt will be on the board of the new claims management subsidiary, chaired by Natural Gas Corporation chief executive and Business Roundtable member Richard Bentley. Matthias and Bratt will be replaced on the ACC board by Employers Federation chief executive Steve Marshall and Auckland investment banker Trevor Janes, a former Housing New Zealand board member.

Dr David Bratt Principal Health Advisor, Work and income

http://www.workandin...als-issue-1.pdf
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#13 User is offline   hukildaspida 

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Posted 08 September 2012 - 12:20 AM

Where does Dr David Bratt get his information and figures from to back up his statements?

http://www.nzdoctor....it-addicts.aspx

1 August 2012
< BACK TO ISSUE OVERVIEW
Harms lurk for benefit addicts

Lucy [email protected]

News David Bratt Mugshot

http://www.nzdoctor....att_mugshot.jpg

David Bratt

About 150 GP trainers gathered in Wellington for the fourth RNZCGP education convention last month. The theme was "Close Encounters: Teaching and learning in the practice environment". Lucy Ratcliffe reports

If the benefit was a drug, it would not get past Medsafe, according to Ministry of Social Development principal health advisor David Bratt.


Long-term unemployment has been shown to be as bad as smoking 10 packets of cigarettes daily, Dr Bratt says.

As a drug, it would be an addictive, debilitating substance, he told the RNZCGP education convention.

In the past quarter, almost 60,000 people received the sickness benefit, compared with 46,000 in 2008.

"I don't know if we have suddenly got all that sick," Dr Bratt says.

Whether a GP is signing a prescription or a medical certificate, similar considerations should apply.

Dr Bratt asks GPs to think about what is being treated. Is the treatment based on
evidence, is the treatment effective, what are the side effects, adverse reactions and interactions?

The evidence shows being out of work is not only as bad as chain smoking, but can also increase the risk of suicide, especially in young men.

Research into the impact of parental unemployment on children has found higher incidence of chronic illness, psychosomatic symptoms, psychological distress such as depression, substance abuse and delinquent behaviour, as well as increased risk of being out of work when they are adults, Dr Bratt says.

In New Zealand, one in five children grows up in a household where no one is in paid work.

In Northland, that figure is one in three, he says.

"When you write a certificate, there are consequences of that."

Working full time on minimum wage equates to a salary of about $28,000. The most beneficiaries can receive annually is $24,808 - and that is for a couple on an invalid's benefit.

The most a sickness beneficiary over 25 can receive is $11,908 annually.
"If someone is paid the minimum wage, they are better off than someone on the benefit," Dr Bratt says.

In 2010, Work and Income surveyed about 800 GPs and found 71 per cent thought signing a medical certificate was a mechanism to provide income for the patient.

Dr Bratt says 40 per cent of GPs believed no work was available. However, he says, even at the height of the recession, 35 per cent of people who walked into a Work and Income office either found work or started studying.

In 2012, that figure sits at 49 per cent, he says.

Seeking the real reasons why people do not want to work can be tricky; some will tell their GP: "I have a sore back, I can't work."

Given 80 per cent of the population have back problems, there is usually another reason, Dr Bratt says.

A UK study found of the main obstacles for going to work, medical problems made up just 3 per cent of the list.

The real obstacles are usually child care, language difficulties or the belief no one will employ them.
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#14 User is offline   hukildaspida 

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Posted 08 September 2012 - 12:45 AM

Click on and Check these LINKS for statistical data about Medical Appeal Boards

http://www.indymedia...ick-and-disable


Work and Incomes ATTACK on sick and disabled

Submitted by Radical (not verified) on 2 September 2012 - 4:02am
in

Community Issues
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Re: WELFARE REFORM:

We have heard Bennett and Key go on about "welfare reform", right? Well they have so far only given a bit of a foretaste of what is yet to come.
Some thorough research has revealed very disturbing facts and trends, and it pays to have a close look at it! This information is primarily about the challenges sick, disabled and invalids now face, and it should be looked at carefully and seriously, as they are amongst the most vulnerable "clients" of the supposedly "welfare agency" we now call "Work and Income":

I did some research into matters to do with designated doctors, some of whom also sit on Medical Appeal Boards, when as panel members (3) hearing "medical appeals" by applicants - or existing sickness or invalid's beneficiaries, and also some other Work and Income or MSD clients, I managed to find some more very interesting information. It is extremely hard to get figures re hearings, the costs associated with them, and re fees paid to attending medical and rehab professionals, but I managed to find some through searching the internet. Below are links to website pages with relevant documents containing interesting information.
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#15 User is offline   hukildaspida 

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Posted 11 September 2012 - 03:37 PM

Service staffed by experienced doctors: [3 Edition]
Evening Post [Wellington, New Zealand] 01 July 1996: 17.


If in the past five years you've needed after-hours medical care for something that required medical attention but not hospitalisation, chances are you've been to the After Hours Medical Centre in Adelaide Road. This week the centre - which was set up by Wellington GPs - marks its fifth birthday.

Wellington was one of the last cities in New Zealand to establish an after-hours service, using instead a system of duty doctors.

When the idea of a permanent after-hours surgery took root, it was decided to staff the clinic with its shareholders: Wellington general practitioners. Out of 94 GPs in Wellington, 87 are shareholders.

Most are rostered to do shifts at the centre, with only GPs over 60 years of age exempt.

One of the centre's main advantages as an after-hours service is that patients are being seen by experienced doctors who have their own practices, says chairman of the centre's board of directors, Dr David Bratt, a Newtown GP. Often, similar services in other cities are staffed by locums who may have only limited experience in general practice.

Dr Bratt sees the service as an extension of patients' relationship with their GPs. Patients are discouraged from using the centre in place of a regular doctor, he says. Having a GP is seen as part of "good life management skills", providing continuity of care. Notes of all consultations are faxed on to patients' regular GPs as soon as they have taken place. This procedure - notes are written in a standardised form to aid communication - means each doctor's work is regularly "reviewed" by his or her peers. The centre was one of the first in New Zealand to employ a quality assurance officer to co- ordinate this process.

Having a permanent surgery removes the reluctance people may feel about calling a doctor out, Dr Bratt says. He sees the centre catering for minor traumas and acute conditions.

Often the first thought for people who are injured is to go to the public hospital's accident and emergency service (A and E) when they could be seen and treated more quickly at the centre. This also makes sense in terms of public health expenditure, he says, because A and E visits - although free to the patient - consume a large portion of hospitals' budgets.

While consultation fees are slightly higher than average daytime practice charges, the centre is conscious that cost can be a barrier to seeking medical care and every attempt has been made to streamline the service to contain costs, given an emergency medical service is a labour intensive exercise, Dr Bratt says.

* The After Hours Medical Centre is open from 5pm to 8am, and on weekends and public holidays 24 hours.

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Illustration

CAPTION: From left, Gail Cusack (accounts clerk), Dr Ashton Fitchett (quality assurance officer), Jo Bailey (nurse co-ordinator), Dr David Bratt, Rose Dodd (director), Helen Ballantyne (manager), and Dawn Spackman (deputy manager).
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#16 User is offline   hukildaspida 

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Posted 11 September 2012 - 03:39 PM

Non-stop care: [3 Edition]
Evening Post [Wellington, New Zealand] 01 July 1998: 3.

Wellington's After Hours Medical Centre will be open 24 hours a day, seven days a week from today. The Newtown facility is also changing its name to Wellington Accident and Urgent Medical Centre. It was previously only open overnight and during the weekends but chairman David Bratt said the time was right to move to a 24-hour operation.


Mercer finds words from sick bed: [2 Edition]
Dominion [Wellington, New Zealand] 01 July 1998: 14.

ILL IN bed with a temperature of 40 degrees celsius, Capital Coast Health boss Leo Mercer still managed to help rename the old After Hours Medical Centre, which moved to a 24-hour, seven-day operation last night.

The new Wellington Accident and Urgent Medical Centre, though open 24 hours, would not be competing with its general practitioner shareholders, AMC chairman David Bratt said.

"Our extended hours will allow the centre to complement GP services with our additional resources. That is why this centre has the support of the majority of GPs of Wellington, and why Leo Mercer supported us in the change of our opening hours."

Dr Bratt said Dr Mercer was absent from the launch function because he was at home with a temperature of 40C, and "in urgent need of a GP".

Dr Mercer still managed to e-mail his best wishes, saying that Capital Coast Health welcomed the fact that AMC's longer hours increased the health options available to Wellingtonians.

He said he agreed to be associated with the launch for another reason: the AMC's emphasis on promoting the role of the family doctor.

"Furthermore primary care is most efficiently delivered by GPs, not by the hospital. When patients go to the right provider for the right ailment, they help improve the financial sustainability of the whole health sector -- and very often the right provider is their family doctor," he said.

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#17 User is offline   hukildaspida 

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Posted 11 September 2012 - 03:42 PM

Fears for outpatients at new regional hospital: [2 Edition]

FLEMING, GrantView Profile

. Dominion Post [Wellington, New Zealand] 03 Dec 2002: A; 8.


THE planned Wellington Regional Hospital could be a "disaster" if a greater focus on outpatient care means patients are thrust out into the community without proper support, say doctors.

The $303 million hospital will provide secondary services to the Wellington region and hi-tech tertiary-level services, such as neurosurgery, to the lower North Island.

But several key specialists are concerned at an overall drop in inpatient beds in the planned hospital -- about 511 beds spread between Newtown and Kenepuru, down from the present 540 -- and a shift in focus to more treatment of patients by general practitioners rather than in hospital.

Cancer Society Wellington chairman Peter Dady said bed reductions coupled with the changed focus could result in similar problems to those created by mental health system restructuring in the 1990s. Institutional beds were slashed before community workforce and facilities were built up enough to cope with the outflow, he said.

The region's population was growing, which meant an increased demand for inpatient beds. "It could be an absolute disaster . . . Already with the number of patients we are seeing we are bursting at the seams . . ."

Wellington Hospital chair of senior medical staff Joanne Dixon said the changes would mean GPs picking up more complex cases, when many were insufficiently trained for that level of work, or had no desire to do it.

Senior staff had expressed concern to management that there did not seem to be adequate services in the community to cope with the changes, she said.

"Consultation has not been wide enough, especially with GPs and those in the community. It's all been decided by a very small cartel."

Association of Salaried Medical Specialists spokesman Ian Powell
said more outpatient clinics and care at home might achieve some gains, but it was not known if it would reduce inpatient demand. "In terms of expectation of the model there is an excessive amount of wishful thinking."

But Capital and Coast District Health Board GP liaison David Bratt said many people were admitted to hospital for chronic health problems such as diabetes, respiratory illness and heart conditions. In many cases the hospital admission would have been unnecessary if they had sought GP assistance earlier.

He said that with more day surgery planned in the future, GPs and community nurses would also play a vital follow-up role.

Dr Bratt said decisions regarding what services GPs could provide were made in consultation with GP groups and hospital specialists.

He said he was confident adequate community support would be in place by 2008, the new hospital's planned completion date. Construction at the Newtown site is set to start next year.
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#18 User is offline   hukildaspida 

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Posted 11 September 2012 - 03:45 PM

Bullied for a benefit
Anonymous. The Southland Times [Invercargill, New Zealand] 29 May 2008: D.4.


IT'S the patient, not the doctor, we tend to regard as the vulnerable one.

When a GP closes his door to begin a consultation, a heavy cloak of privacy comes down. It is sometimes lifted in reproach of rogue misconduct by doctors like Morgan "Fingers" Fahey or Matthew Boyd, in cases of notorious betrayal of what should happen in that little sanctum.

Now, however, a Belgian locum has issued a reminder that doctors can themselves be subject to abuses. He warns particularly of bullying.

Tom Van Herck, who has worked in 16 surgeries around New Zealand during the past 30 months, tells of confrontational encounters with sickness beneficiaries he calls too lazy to work.

This is concerning enough in itself, but Dr Van Herck also complains that beneficiaries have told him they were sent by Work and Income to get medical clearance to stay on a sickness benefit.

Both Work and Income and the New Zealand Medical Association have acknowledged the existence of such a problem, though the scale of it remains, at very least, a tad unclear.

If nothing else, this is an acutely sensitive political topic because the National Party has repeatedly accused the Government of hiding unemployment by switching people to invalid or sickness benefits.

Work and Income maintains that it is "certainly not supposed to happen" that clients would show up at a doctor's surgery saying that the department had sent them simply for a GP to fill out a medical certificate. The department acknowledges that it is time for some more training in this area.

Clearly.

Displeasingly, the department's principal health adviser David Bratt says the issue "regularly" gets brought to attention and "usually in smaller provincial areas" .

The few examples given by Dr Van Herck from his own experience suggest something closer to truculence than standover tactics.

An asthmatic smoker on the sickness benefit for 19 years, who he said admitted she was too lazy to go to any of the quit programmes offered, and another whose documented reason for not working was that they "could not be bothered" seem, from the published report, to be more exasperating than intimidating.

In any case, to some extent, the public reaction may be a simple expectation that the medics simply need to man up and stand their ground.

But this is entangled in the wider issue of the corrosions of general practice. GPs face many pressures that would burden even the strongest and most robust personalities. They typically face the need to deliver distressing messages to people, some of whom may for one reason or another have their danders up. As a group they do not come across as people who would be easily browbeaten.

But it can happen. And it's not as if their jobs don't already have their downsides. As areas such as Southland have learned to their cost, doctors willing to serve in general practice can be hard to come by and harder still to retain. The Independent Practitioners Association Council recently warned that more than half this country's GPs are due to retire within the next decade, creating a huge replacement problem.

GPs told to dob in sick-note bullies
KAY; Martin. Dominion Post [Wellington, New Zealand] 29 May 2008: A.4.

DOCTORS should not approve sickness benefit claims for people who are fit to work and should report those who bully them, Associate Social Development Minister Darren Hughes says.

Under fire after The Dominion Post reported a locum doctor's claims that he felt pressured to sign medical forms for sickness beneficiaries, Mr Hughes said it was up to GPs to make the call on whether someone could work.

Locum GP Tom Van Herck said he had authorised continued sickness benefits for a woman who had asthma but who had turned down offers to quit her packet-a-day smoking habit because she was "too lazy" to go. Another sickness beneficiary's reason for not working was "could not be bothered".

Dr Van Herck said he signed both off but noted on their forms that they should have further assessment. He also said too many sickness beneficiaries could work and should be on the dole. Locums were especially prone to bullying by claimants.

In a letter,Work and Income principal health adviser David Bratt said claims of bullying by beneficiaries were regularly brought to the department's attention.

National Party social welfare spokeswoman Judith Collins
said the letter contradicted previous statements that there were no reports of doctor- bullying.

But Mr Hughes said anecdotal reports had been picked up in recent months as the department worked with doctors to help sickness beneficiaries into work.

He told Parliament that Work and Income staff were not qualified to determine a claimant's medical state, which was why the work was left to doctors.

"Able-bodied people shouldn't be signed off on the sickness benefit. That's what GPs are given the responsibility for."

Bullying of doctors was unacceptable and beneficiaries who tried to pressure decisions should be reported to Work and Income. GPs could also recommend a second opinion or specialist follow- up if they felt pressured.

A new handbook would be issued next month to help GPs decide who should be judged unfit to work
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#19 User is offline   hukildaspida 

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Posted 11 September 2012 - 03:49 PM

Medical staffer convicted of stealing cash: [2 Edition]
Dominion Post [Wellington, New Zealand] 09 Sep 2003: A.6.


A TRUSTED Newtown Medical Centre administrator has been ordered to pay reparation after being sentenced for stealing from it.

Two doctors from the centre told Wellington District Court of the devastation Gita Champaneri's offending had caused.

Dr David Bratt said the businesses ran on the trust of their employees and the whole incident had been surprisingly disabling.

Dr Bob Fearon said there had been emotional effects on the staff as well as financial consequences for the business. They asked for more than $18,000 in costs.

The centre had installed covert cameras and hired a security firm after money was stolen. Over two days in January Champaneri was seen taking $120 both from the cash register and straight from patients.

Judge Bridget Mackintosh said Champaneri had been employed since 1990 and was entrusted with the banking.

When spoken to by police, Champaneri denied the theft but Judge Mackintosh said she had been caught red-handed by the camera.

The centre also claimed for expenses in setting up the surveillance and dealing with Champaneri being dismissed.

Judge Mackintosh told Champaneri she had been in a position of trust and the centre and its workers were almost devastated by her offending.

She sentenced Champaneri to 80 hours' community work and ordered her to pay $4000 reparation.

Champaneri's lawyer James Johnson
said the conviction would impact on her ability to find a job and pay reparation.
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#20 User is offline   hukildaspida 

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Posted 11 September 2012 - 03:56 PM

'Elephant leg' blood clot pain excruciating: [A Edition]
FERGUSON, Lin. Sunday Star - Times [Wellington, New Zealand] 29 Oct 2000: A; 10.


Lin Ferguson

JAN Orr still shudders when she remembers the excruciating pain that flared in her leg within minutes of landing at London's Heathrow Airport from Hong Kong.

"I thought I was going to die. I had this elephant leg, all purple and orange." Orr, 49 at the time, had "economy class syndrome" - a deep vein thrombosis, or blood clot (DVT).

Last week it was revealed a young woman died after a 20-hour flight to England from Australia. The woman had developed a deep vein thrombosis.

Orr and husband Ken, of Christchurch, were flying to London in July 1995 to meet their son. She remembers feeling discomfort and pain in her lower back. Just before they landed, she could barely hobble to the toilet. "When the plane landed I couldn't walk, the pain was too intense. My leg felt as though it was on fire.

"If I hadn't had Ken with me I don't know what I would have done. I spent my holiday in a London hospital. I'm so lucky to be alive. If I fly now I wear compression stockings and I am still taking half an aspirin daily." She was off work for three months, had to wear compression stockings for a year and still gets occasional cramps in her legs.

Auckland vascular surgeon Wilbur Farmilo said there was a risk of thrombosis on flights of more than eight hours. "It can happen to any age group - it's a random thing."

Dehydrated overweight people and those who had had recent surgery were most at risk.

Farmilo warned against drinking alcohol and said it was safer to drink water or fruit juice. "Taking a sleeping pill is bad. It completely immobilises your body."

The condition was frequently caused by sitting still for a long time and was exacerbated by cramped conditions and the reduced air pressure of long-distance flying, he said. "If there is no exercise, blood pools in the legs and becomes very sluggish." He recommended passengers left their seats, walked and stretched for at least five minutes every hour. He also said wearing compression stockings and taking half an aspirin daily for three days before flying helped. "I always do."

Farmilo believes health warnings and instructions for long flights should be printed on tickets.

Wellington GP Dr David Bratt said one of his patients, a middle- aged man, had recently developed a thrombosis after returning to New Zealand from London. "There was nothing to suggest this man would develop a DVT. He was very healthy."

It was time airlines realised most people weren't dwarf-sized, he said. "I don't think we'd mind if the airlines took out a couple of rows of seats to give us more leg room and charged us a few bucks extra. It would be a damn sight safer."

Air New Zealand chief medical officer Dr David Powell said the risk of thrombosis associated with flying wasn't known. "Recent studies indicate it is just as much of a problem with other modes of transport, such as trains and buses."

And it appeared to be no more of a problem in economy class than other sections of the aircraft.
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