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NIB taken to court over hidden cuts to eye coverage

Wednesday, May 31, 2017


The Australian Competition and Consumer Commission (ACCC) has launched legal action against NIB after it alleged the health insurer had engaged in unconscionable conduct in relation to the removal of certain eye procedures from one of its schemes.

The competition regulator has alleged NIB also contravened Australian Consumer Law by engaging in misleading or deceptive conduct and making false or misleading representations. The allegations centre on NIB’s failure to notify members in advance of its decision to remove the procedures from its “MediGap Scheme”, despite previously making assurances to do so.

It has also been alleged that between June 2011 and October 2016, NIB informed its members that several policies that covered eye procedures would not incur any out-of-pocket expenses, when in fact members could have been liable for such costs. According to the ACCC, NIB made this representation by paying gap amounts on behalf of members for these eye procedures prior to August 2015.

ACCC chairman Mr Rod Sims said consumers had a right to be informed of changes to their insurance cover in advance.

“These changes can result in very large financial consequences at a time when consumers are at their most vulnerable,” he said.

“Private health insurers must ensure their disclosure practices are in line with the Australian Consumer Law. Insurers should not expect consumers to bear the responsibility of making independent enquiries to find out about important changes made unilaterally by insurers.”

Further allegations centre on NIB’s supposed identification of more than 400 members who had received two or more eye procedures in the previous financial year, in circumstances where NIB’s management considered that it “probably ought to proactively communicate” with these members about the MediGap Change. 

Additionally, after a doctor from Newcastle Eye Hospital sent a letter to his patients who were NIB members informing them of the MediGap Change and their right to move to another insurer, NIB contacted the hospital to request a commitment that its medical practitioners not communicate with NIB members or the media about the MediGap Change. 

In response, NIB rejected the allegations made by the ACCC, saying it believes it has acted both lawfully and ethically.
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Government funding for ophthalmic research made easier

Wednesday, May 31, 2017

The National Health and Medical Research Council (NHMRC) has overhauled its funding program in a move welcomed by research groups throughout Australia.

The new program is expected to reduce the burden of applying for funding across different schemes by providing consolidated, five-year grants for high-performing researchers at all stages of their careers. It is hoped this will provide more flexibility for collaboration and more time for reseachers to spend on their projects.

Another aim of the revamped program is to provide more opportunities for researchers early in their careers, and also for clinical researchers who split their time between research and caring for their patients.

Federal Health Minister Mr Greg Hunt said, “The new program will support research across the spectrum, from discovery through to translation and commercialisation of new therapies and devices, and the implementation of new policies and practices, tackling the challenges facing our health system.”

RANZCO welcomed the announcement and said it would allow researchers more time in the lab, rather than dealing with administrative tasks.

RANZCO president Associate Professor Mark Daniell said, “Today’s announcement by the NHMRC is a great step forward in advancing medical research in Australia and will make a huge difference to how research into eye disease is carried out. Grant applications take a lot of time to prepare and can often be discouraging, especially for those at the beginning of their research career. Improvements made to the NHMRC grant program will afford researchers at all stages of their career greater flexibility and creativity when it comes to delivering innovative eye research.”. 

“Ophthalmic research is fundamental to understanding eye conditions and developing appropriate treatments for patients, which can lead to better patient outcomes and help to prevent avoidable blindness,” he added. 
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Australia to avoid eyecare waiting list crisis

Wednesday, May 31, 2017

Despite a continued rise in demand for ophthalmology services, RANZCO has indicated Australia is unlikely to witness a similar backlog of cases like that recently experienced in New Zealand.

Thousands of patients requiring vital ophthalmic consultations were left stranded late last year, when the Kiwi patient waiting list was at its worst point. In October, one of the country’s 20 District Health Boards had a backlog of more than 7000 patients, and it was also revealed that 30 people were losing their sight while being forced to wait.

However, RANZCO president Associate Professor Mark Daniell said the likelihood of such a scenario playing out in Australia was slim: “An ageing population together with an increase in the prevalence of diabetes means that age-related disease and diabetic complications to the eye are increasing dramatically. It is true that this increase in demand has an impact on delivery of services, particularly in the public hospital system.”

“That said, Australia has a different health system model than New Zealand and so manages this increase in demand differently – in particular, through a private system supported by Medicare that has the capacity to take up the additional burden. For this reason, Australia is less likely to face the same crisis that has occurred in New Zealand.”

“RANZCO communicates regularly with federal and state governments in Australia to raise any eye health policy issues that need to be addressed and to share best practice and innovative approaches. We are also working with the National Medical Training Advisory Network on workforce issues to determine the optimal sustainable solution to the anticipated increase in demand from the ageing population.” Daniell added. 

Activities to clear the backlog have yielded some positive results, but chair of RANZCO’s New Zealand Branch, Dr Brian Kent-Smith, said a long-term approach was needed to avoid similar crises occurring in the future.

“While the historic backlogs are beginning to be cleared, there is a risk of the problem recurring as new patients are being added to waiting lists all the time. A one-off funding injection will help in the short term, but in the longer term a more strategic approach, which takes into account ongoing capacity, needs to be taken,” Kent-Smith said.

Daniell said a similar approach was needed for Australia.

“RANZCO believes that Australia needs a national strategic approach to eyecare to ensure that all patients, regardless of their geographical, cultural or economic situation, have access to the care they need when they need it. We continue to communicate and work with federal and state governments to advocate for policies that will help achieve this,” he explained.
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Optical chain fined $69,000 for misleading ad

Wednesday, May 31, 2017

A UK optical chain has been fined £40,000 (AU$69,000) for a ‘misleading’ advertisement concerning its range of blue light protecting lenses.

Boots Opticians published an advertisement in The Times in January 2015, which contained multiple overstating claims about blue light and the benefits of its BPPB lenses according the UK’s optical regulator, the General Optical Council (GOC).

The finding, handed down late last week, came after multiple complaints were lodged with the Advertising Standards Authority (ASA) about the content of the ad. 

Complaints related to claims that blue light from LED TVs, smartphones and energy saving light bulbs caused damage to retinal cells over time, and that BPPB lenses protected against blue light from these sources. The authority found that these claims were misleading and unsubstantiated. 

It was later revealed that despite the ASA’s ruling, some Boots practices were still making the misleading claims about the lenses through in-store leaflets. 

In handing down the fine, which is to be paid within 30 days, the GOC found that Boots’ fitness to practise as a business registrant was impaired and that it had gained a financial advantage through promoting the lenses.

“The committee imposed this level of fine to mark the seriousness of the misconduct and to send a signal to the business registrant, the profession and the public reinforcing the high standards of conduct and behaviour expected of all registrants,” a transcript of the GOC’s decision read.

The GOC took into account the fact that Boots had already incurred financial costs as a consequence of the advertisement and also suffered, and continued to suffer, reputational damage as a result of the transgression before imposing the fine.
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Major advances in macular degeneration research

Wednesday, May 31, 2017

(L-R) Damien Harkin, Ita Buttrose, Paul Mitchell, Gerald Liew and Robert Kaye at the Macular Degeneration Awareness Week Research Symposium


Some of Australia’s foremost ophthalmic experts gathered for the annual Macular Degeneration Awareness Week Research Symposium in Sydney last week.

More than 100 people attended the symposium, which focused on macular degeneration research, specifically recent breakthroughs and potential future discoveries. Macular Disease Foundation Australia (MDFA) patron Ms Ita Buttrose discussed her experiences with the condition, before keynote speaker, University of Sydney’s Professor Paul Mitchell, spoke about the major advances in macular degeneration research to date. 

Mitchell, one of the world's leading experts on the epidemiology and treatment of macular diseases, explained the importance of new knowledge concerning risk factors and improved diagnostic tests, before lauding the extraordinary transformation anti-VEGF injections had had on the treatment of wet-AMD. 

He also said the development of an effective treatment for dry AMD was a major global priority and that the increased knowledge regarding the genetics of macular degeneration was creating exciting opportunities for new therapies. 

Following Mitchell, fellow USyd researcher Assistant Professor Gerald Liew detailed the cutting-edge research he was conducting in the new field of metabolomics. His project, which is being partly funded by the MDFA, has the potential to develop a simple new blood test for macular degeneration and may also identify possible new targets for treatment.
 
Then, Professor Damien Harkin from the Queensland University of Technology described his work on a biological scaffold on which new retinal cells can be grown for subsequent transplantation into the eye, which will soon commence clinical trials.

Finally, a wide-ranging panel discussion followed, which included the importance of funding through the NHMRC and the MDFA’s Research Grants Program, the importance of collaboration between researchers, and how future research needs to focus on dry macular degeneration.  ...read more

Key findings of Optometry Australia survey revealed

Wednesday, May 24, 2017

Medicare remuneration and striking the right balance between workforce supply and demand are the key issues currently concerning Optometry Australia (OA) members, according to results taken from its biennial survey.

Of the 870 members who participated, 96% believed OA should focus on lobbying the government for changes to Medicare remuneration, while 87% said it was important to ensure there was not an oversupply or undersupply of optometrists.

Concerns over Medicare rebates were further highlighted by 25% of respondents indicating that they intended to decrease their number of bulk-billed consultations in the next five years.

The competing interests between sub-groups of optometrists and the challenge of representing the perspectives of all members was reportedly another concern, as was the relationship between OA and RANZCO.

A spokesperson from OA clarified that concerns regarding the relationship stemmed from the fact that many members wanted OA to communicate their disappointment with recent referral pathways developed by RANZCO.

“They [referral pathways] did not reflect the reality of the experience of many of our members who work collaboratively with ophthalmologists to help ensure that quality eyecare is readily accessible to patients. Optometry Australia made that point to RANZCO at the time, noting it was a missed opportunity to highlight how their fellows and our members work together for the best patient outcomes,” the spokesperson said.

“It’s important to our members that we have a relationship with RANZCO that is open and genuinely consultative with us as the voice for the profession, regardless of the environment in which optometrists practice.”

Members also believed it was important for OA to lobby for new Medicare items (94%), appropriate regulatory requirements (90%) and conditions for effective collaboration with other health professionals. 

Furthermore, 82% would like to see optometry’s scope of practice extended, while members also thought OA should be lobbying the government about potential changes to the Pharmaceutical Benefits Scheme, improving conditions for regional optometrists and ensuring disadvantaged groups had access to eyecare services.

According to the survey results, the vast majority of respondents – 89% – would recommend OA membership to colleagues, graduates and other optometrists. The main reasons given for being a member included professional indemnity insurance, representation to government, being a part of the professional body and access to CPD.
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Applications open for online eye banking course

Wednesday, May 24, 2017

Applications are now being accepted for the new ‘Graduate Certificate in Eye Banking’ course offered by The University of Melbourne (UoM). The course, which begins in September, is specifically designed to support eye bankers and associated disciplines.
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Presentation proposals requested for behavioural optometry congress

Wednesday, May 24, 2017

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World first trial of robotic eye surgery a success

Wednesday, May 24, 2017

In a medical first, UK doctors have employed a robot to perform a series of delicate operations to remove fine membrane growth on the retina, paving the way for similar precision-based surgeries in the future. 

Currently, surgeons perform this procedure without robots however, the procedure is so delicate even the pulsing of blood through the hands is enough to affect the accuracy of the cut and possibly cause small amounts of haemorrhaging and scarring. However, a trial of the groundbreaking surgical system, developed by Dutch medical robotics company Preceyes BV, found the use of robots could minimise this risk. 

The trial involved 12 membrane-removal surgical procedures in a UK hospital, with six performed in the traditional manner and the other half using the robotic process. Five of the patients in the traditional surgery group experienced micro-haemorrages and two had a retinal touch – which means there was an increased risk of retinal tear and detachment. Conversely, the robotic group resulted in only two micro-haemorrhages and one retinal touch.

The robot, controlled by a surgeon, functions like a mechanical hand and is equipped with seven independent motors capable of movement as precise as one micron. It can operate in and out of the eye through a single hole less than one millimetre in diameter. 

Study lead Dr Robert MacLaren, a professor of ophthalmology at the University of Oxford, designed the robot with ophthalmologist Dr Marc de Smet from Netherlands.

During the recent meeting of the Association for Research in Vision and Ophthalmology (ARVO), MacLaren said the technique was “a vision of eye surgery in the future”. He added the challenge was to devise a way to increase the accuracy and avoid causing damage to the retina during surgical procedures.

“The robotic technology is very exciting, and the ability to operate under the retina safely will represent a huge advance in developing genetic and stem cell treatments for retinal disease,” MacLaren said in an interview with LiveScience.

Meanwhile, his colleague de Smet said the researchers were at the early stages of what he described as a new, powerful technology.

“We have demonstrated safety in a delicate operation. The system can provide high precision [at] 10 microns in all three primary directions, which is about 10 times more precise than what a surgeon can do.”

This is especially important in procedures like the ones performed in the trial, where surgeons have to remove a membrane that is only 10 microns thick – about one-tenth the width of a human hair – without damaging the retina. Complicating the procedure is the fact that the eye of the anaesthetised patient jiggles with each heartbeat.

MacLaren said he hopes to next use the robotic system to place a fine needle under the retina and inject fluid through it, which could aid in retinal gene therapy.

IMAGE: Dr Robert MacLaren, University of Oxford professor of ophthalmology
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Over 50s urged to get eyes tested for macular degeneration

Wednesday, May 24, 2017

Only 6% of Australians aged between 50 and 64-years-of-age believe an examination for eye disease is their top health priority according to research released by the Macular Disease Foundation Australia (MDFA) this week.

The research, released in conjunction with Macular Degeneration Awareness Week (May 21–27), suggested family and work commitments, combined with time spent caring for ageing parents, were the major reasons people in this age group were not getting eye tests. This is despite the fact that one in seven Australians aged over 50 have some evidence of macular degeneration, and that people with a family history have a 50% chance of contracting the disease.
 
MDFA patron Ms Ita Buttrose said it was concerning eye health was such a low priority to ageing Australians.
 
“This at risk group of Australians clearly is not heeding preventative health messages. They are juggling family, possibly career and community activities, while trying not to let down those around them. However, they could be letting themselves down by not investing time in their own eye health,” she said.

“I make sure I look after my sight as I’ve seen firsthand with my late father how devastating living with vision loss can be, but I also know that early detection can save sight. My Uncle Gerald is proof of this. Thanks to treatment that has maintained his sight he was still driving at 92.”

Meanwhile, MDFA CEO Ms Julie Heraghty urged all Australians over 50 to have an eye test and macula check. 

“Vision is critical to maintain quality of life and independence, so it is vital that those over 50 have regular eye tests as prevention, early detection and timely treatment can save sight,” she said.

IMAGE: Julie Heraghty, MDFA CEO
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