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The many extracts on these pages are from copyright material. They are owned by the reference given or its owner. They are reproduced here for educational purposes and to stimulate public debate about the provision of health and aged care. I consider this to be "fair use" in the common interest. They should not be reproduced for commercial purposes. The material is selective and I have not included denials and explanations. I am not claiming that the allegations are true. The intention is to show the general thrust of corporate practices as well as the nature and extent of any allegations made. Any comments made are based on the belief that there is some substance at least to so many allegations.

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This corporate web site addresses the issues of corporate health care within a broad framework. A web page describing this broad context should be considered as an introduction to each page on the web site. If you have not yet read it then CLICK HERE to open it in another tab or web page.

Content of this page
 Dialysis provided for the benefit of shareholders is a recent development in Australia. It has been associated with a move from hospital to community setting. The same companies that have paid massive fraud settlements and whose care has been inferior to not for profit entities in the USA have been welcomed here. They have been given licenses by state authorities and contracted to care for public patients. Australian legislation requires that the providers of these services be "fit and proper" persons. Companies reaching criminal settlements could not possibly qualify. They should not be operating here. This information is and has been readily available on the most basic of internet searches. It is not possible for politicians and government officials to be ignorant of this unless it was a deliberate decision not to look. In spite of their international track record available indicators suggest that these companies have performed well here and have been good corporate citizens. There is no readilyavailable data on the quality of care provided in Australia.

Australian section

Australia Welcomes Dialysis Multinationals

  

CONTENTS


In Australia Dialysis services have generally been provided by kidney specialists in hospitals.   The operation of dialysis services by large corporate multinationals with a primary fiduciary duty to maximise profits for distant shareholders is a very recent development. Technical develiopments have made it possible to provide dialysis services more peripherally and in patients homes. This has provided opportunities for politicians to contract out their responsibilities and for commercial interests.


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Background

In reading this web page about the operations of multinationals in Australia I ask you to remember that of the three large global operators in this country two have been the largest in the USA where fraud and the misuse of recipients in order to generate profit has been both endemic and epidemic. These two have reached the largest fraud settlements in the sector.


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For-Profit Dialysis is inferior

Corporate for-profit dialysis services have been known since 2002 to have a significantly higher death rate than not-for-profit community focussed services.  A similar situation exists in hospitals.  These findings have as far as I am aware never been seriously challenged or disputed.  It is clear that this is a direct consequence of focusing on profits rather than care. Government regulators, political advisers and politicians cannot be unaware of this, unless they are deliberately so.

2002 More deaths in for-profit centres.
The pooled estimate, using a random-effects model, demonstrated that private for-profit dialysis centers were associated with an increased risk of death (relative risk, 1.08; 95% confidence interval, 1.04-1.13; P<.001). This relative risk suggests that there are annually 2500 (with a plausible range of 1200-4000) excessive premature deaths in US for-profit dialysis centers.
Comparison of Mortality Between Private For-Profit and Private Not-For-Profit Hemodialysis Centers : A Systematic Review and Meta-analysis Devereaux P. J. et al JAMA. 2002;288:2449-2457

 


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Company Track Records in the USA

The multinationals providing dialysis services in Australia are Fresenius, Diaverum (new name for Gambro Healthcare) and Baxter. All operate in the USA and have reached fraud settlements

The German company, Fresenius reached a massive US $486 million criminal and civil fraud settlement in 2000.  It was obliged to enter into an unusually long 8 year integrity agreement (usually it is 5 years)  In 2008 it is once again facing law suits alleging fraud.

The second, the Swedish multinational Gambro Healthcare (now renamed Diaverum) was a recurrent offender, re-offending while operating under a 5 year integrity agreement.  It paid a US $50 Million fraud settlement in 2000 and entered into a 5 year integrity agreement. Four years later, in 2004, it was in breech of its integrity agreement and reached a second US $350 million criminal and civil settlement with government.  It signed a second 5 year integrity agreement.

Connecticut Attorney General, Richard Blumenthal referring to Gambro's  conduct in defrauding the state's Medicare system for the poor said "Gambro's conduct was reprehensible. Their scams and schemes - including kickbacks, unnecessary tests and billing fraud - stole precious funds intended to care for some of society's neediest patients."  His opposite number in Missouri described it as stealing from the church poor box.

If Gambro were to be convicted a third time while under an integrity agreement it would almost certainly have its right to Medicare payments revoked and this would have ruined it. 

When further fraud investigations were commenced soon after the 2004 settlement it elected to sell its US dialysis operations to DaVita, but continued to operate its international dialysis clinics.

In both of these companies the fraud investigations were associated with a recent acquisition and both have claimed that the fraud related to the operation of these subsidiaries prior to their acquisition.  Reading the material and the response of authorities to the fraud it seems most unlikely that this is so.

Baxter is listed among the fraud offenders in the USA but its transgressions seem minor when compared with the other two.

All three companies supply dialysis equipment.  Both Baxter and Gambro have been reported as having serious problems with their equipment and this has resulted in deaths.

These matters are all covered in detail on the pages linked above.


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Implications in Australia

All Australian states have probity regulations requiring that owners/operators be "fit and proper people".  Under the regulations company's are treated as if they were individuals. In some jurisdictions (eg nursing homes) governments have tried to split hairs and circumvent the public interest by restricting the probity provisions to operators and excluding owners from any requirements.  This is deliberately deceptive. It allows politicians to pursue their ideological objectives at the expense of the population they claim to serve.  Owners control the purse strings and appoint operators. They take the profits from cost cutting. They dictate what they want to happen and ultimately have all the power. It is illogical to exclude them.

By any definition an organization with a criminal conviction in any jurisdiction cannot be considered as "fit and proper" and would not be eligible to operate a dialysis clinic in Australia.  Both Gambro and Fresenius have criminal records and therefore would not qualify for licenses to operate dialysis clinics.


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Could authorities have been ignorant?

The role of state health departments is to implement the regulations and protect the public.  To be fit and proper an organization is obliged to display integrity.  Failure to disclose matters relevant to securing the licence is a breech in integrity and impacts adversely on probity.

The extent of fraudulent and unethical practices in the USA is well known. All health departments and health ministers have in the past had to address objections to large US multinationals involved in unsavoury conduct. 

During the last few years these have included Tenet Healthcare, Columbia/HCA, Sun Healthcare and Citigroup among others.  All have been found wanting.  There were also serious concerns about Mayne Health.  Authorities are well aware that it is the largest and most "successful" operators in each sector that have been most implicated.  This was why they were successful. (see the US overview page)

Fraud settlements are documented as soon as they are made in press releases on the internet by the US government.  The web site Crime Reporter, a number of other organizations and several legal firms publish a record of fraud settlements on the internet.  A simple search for a US company rapidly reveals the situation and this can be explored further on US government web sites.

A failure to be aware of fraud settlements can only be consequence of a gross dereliction of duty by state authorities - or of a deliberate decision not to look and so not to know. The latter is most likely.

This is particularly worrying in Western Australia where the labor government and health minister Jim McGinty have strongly marketed Gambro to the public.  Could they really have done this in good faith?

When in opposition the WA labor party, including the present minister for health, were active in exposing Tenet Healthcare's dreadful track record. In 1995 they tabled the WA health department's previously hidden 1993 advice to the coalition government urging the then minister to pass laws to enable the department to rescind AME's (Tenet's Australian subsidiary) hospital licenses. This was because of Tenet's lack of probity. They simply cannot plausibly justify not looking at Gambro and Fresenius critically.

As revealed below the conduct of these companies in Australia has been exemplary to date.  You may be tempted to think that they have been warned that the support they are receiving depends on their good behavior.  They have been model corporate citizens in Australia. They have performed well in accreditation surveys.  Will it last?  Odd that no one in Australia seems to have known of their criminal past, nor was it reported in the Australian press!


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How I found out

I did not know that dialysis services were being provided by corporations in Australia until I saw a full page advertisement for the change of name of Gambro Healthcare to Diaverum.  This was in the 4th February 2008 edition of Australian Medicine, the official newsletter of the AMA. 

A name change like this is almost always a company seeking to escape a tarnished name.  This set alarm bells ringing as it should have for the editor of Australian Medicine.  A simple search brought up the fraud settlements immediately. I challenged the appropriateness of this tacit support.  The AMA indicated that they had been unaware.

Gambro facilities were registered in NSW and in WA.  I emailed both supplying documents and asking if they would disclose what had happened.  NSW phoned me and asked if they could disclose my interest and take the matter up with the company.   They had not known about the fraud settlements.  They have not responded to me since.

West Australian Health Department ignored the email and information as did the West Australian Newspaper. It was a very active critic of Tenet Healthcare between 1991 and 1996.

In following up the matter I found that Fresenius and Baxter were the two other companies supplying dialysis services.

At the end of this web page ask yourself if any of these departments are doing their job properly, and whether politicians are acting in your interests.  Are they trying to unload these services to the private sector and so avoid having to raise the capital to set up these services.


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The companies in Australia

Gambro Healthcare

Gambro has operated in Australia and New Zealand for over 25 years supplying dialysis equipment. It is recorded in 2001 as operating only one dialysis unit.  This is rapidly changing.

Mar 2001 Northern Territory
3.0 Representation in Australia and New Zealand
Gambro was incorporated in Australia in May, 1975 and has provided a service to the Renal community in Australia and New Zealand for the past twenty Žve years.  Sales and Service are available from Žve sites, manufacturing from two and dialysis facilities at one.

Most hospitals in Australia, practising dialysis, use products from Gambro as we are one of the few companies offering whole systems; including water treatment, dialysis hardware, disposables, technical service, education, home patient logistics and clinical services.
Quote from Gambro's submission in "Prevention and Treatment Options for Renal Disease in the Northern Territory" The Cooperative Research Centre for Aboriginal and Tropical Health and Department of Health and Community Services March 2001

 

The Annual Report 2005-2006 of The Australian Council on Healthcare Standards ACHS lists the following Gambro private dialysis units.

NSW granted Gambro's Lindfield Dialysis unit a license.  My contact with NSW about this is recorded above.

Jul 2007 NSW Licence
Gambro-Lindfield Dialysis Unit  DC2076 280 Pacific Highway LINDFIELD 2070 (02) 9415 8800 (02) 9415 8811 Ku-ring-gai Gambro Pty Ltd
Private Health Care Facilities in NSW Currently  Licensed by the Private Health Care Branch July 2, 2007

Sept 2007 Contracted to NSMA and MBF
Includes Gambro-Lindfield Dialysis Unit in NSW.
Lists Australian hospitals contracted to NRMA --MBF HealthInsurance  A Guide to hospitals. Sept 2007

 

The Victorian government lists the following Dialysis facilities.

Jul 2008 Licenses in Victoria
Day Procedure Centres - Contact Details

Private Hospitals in Victoria http://www.health.vic.gov.au/privatehospitals/day.htm Accessed July 2008

 


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Fresenius (operating as Nephrocare)

It is not clear when Fresenius entered Australia.  It expanded rapidly into Asia in 2000 and probably entered Australia at about this time or a bit earlier.  The earliest references I found were in 2001, soon after its huge fraud settlement in the USA.

The New South Wales government, responsible for our welfare and for keeping us properly informed, describes Fresenius business record but fails to mention the fraud investigations and  settlements in the USA.   These would be of much more interest to citizens than its corporate successes.

It is difficult to imagine how even the simplest check on the company could fail to detect this.  Are they serving the company supported by their political masters, or the citizens who pay their salaries and for whose welfare they are responsible?

Jul 2008 NSW public information
Fresenius Medical Care is the world's largest, integrated provider of products and services for individuals with chronic kidney failure, a condition that affects more than 1,100,000 individuals worldwide. Through its network of 1,430 dialysis clinics in North America, Europe, Latin America and Asia-Pacific, Fresenius Medical Care provides dialysis treatment to 108,600 patients around the globe. Fresenius Medical Care is also the world's largest provider of hemodialysis and peritoneal dialysis products, such as hemodialysis machines, dialyzerÕs and related disposable products.
Life Science Directory New South Wales Government State & Regional Development http://www.biotechnology.nsw.gov.au/Alphabetical.aspx?letter=f&companyid=354   accessed July 2008

 

There are several reports describing Fresenius dialysis services in the private sector in Australia.  Its subsidiary Nephrocare provides these services.  In 2005 it came to blows with insurers who refused to pay the full dialysis costs.  Once again it was patients who became the meat in the sandwich.

Sep 2005 Nephrocare
She (company spokesperson) says Nephrocare is the dialysis care services arm for Fresenius Medical Care, the world's largest, integrated provider of products and services for individuals with chronic kidney failure, a condition that affects more than 1.3 million worldwide.
Top spot available at Modbury dialysis unit The Advertiser September 10, 2005

Apr 2005 Chermside Brisbane
Fresenius Medical Centre state manager Brad Jory said a key reason for the selection of the building (in Chermside, Brisbane) was its good parking, central access for patients serviced by local hospitals and the low-scale nature of the building.

"Hospitals do a great job, but for some people they can be quite daunting to visit," he said, adding they had taken out a 10-year lease on the premises.
Chermside boost for kidney patients The Courier-Mail April 29, 2005

Aug 2005 Dispute with MBF
Changes by MBF now mean Ms Elborne, and the other patients at the Chermside unit, will be forced to pay a $120 gap for each visit.

Mrs Elborne said she was told when she started at the unit in January that MBF would cover the full cost of her treatments.
------------------------
NaphroCare Australia, the parent company to Fresenius Medical Care, which owns the Chermside unit, is negotiating with MBF to have the $120 payments reduced.
NaphroCare general manager Grant Rudman said that, before the Chermside Dialysis Unit's operation, its patients received treatment at Pine Rivers Private Hospital, which had a contract with MBF to cover the full costs.
Mr Rudman said since relocating from the hospital and establishing the Chermside unit, the company was forced to negotiate a new contract with MBF.
"We do not want to start billing the patients, but we cannot afford to cover the costs," Mr Rudman said.
He said the company would face bankruptcy if the patients or MBF could not make up the gap fee.
Dialysis at a cost Northside Chronicle August 17, 2005

Aug 2005 Dispute with MBF

The six seniors, with an average age of 78 and including war veterans, have been relocated to the new unit because of the coming closure of Fresenius' treatment clinic at nearby Strathpine. But upon making the transfer, the group learned MBF had not agreed to pay for the treatments.
Fresenius has told them that if the dispute is not resolved by September 1, they will have to pay for their treatment.
Ivan McDonald, 83, of Albany Creek, said he would have to pay almost $350 a week.
He said he was shocked by the predicament - - - -
-----------------------
John McDonald (no relation), 67, of West Chermside, said other people receiving dialysis at the clinic were being covered by their private health insurers.
Seniors suffering in MBF wrangle  Sunday Mail August 21, 2005

Sept 2005 Dispute with MBF

PATIENTS of the Chermside Dialysis Unit are still receiving free treatments despite the September 1 deadline for free care lapsing.
---------------------
Since the move, NephroCare Australia, which owns the Chermside unit, has been unable to negotiate a new contract with healthcare provider MBF, which is threatening to decrease its cover, leaving patients with gap payments of $120 a visit.
Renal care funds fight North West News September 14, 2005

 

In 2004 Fresenius broadened its Australian operation by forming a joint venture with an Australian pharmaceutical company Pharmatel. The new company had a different focus.

Sep 2004 Joint Venture with Pharmatel
"By joint-venturing with Pharmatel, Fresenius Kabi will inherit a strong, vital and robust presence in the Australian market," Pharmatel managing director George Shortis said.
Pharmatel and Fresenius Kabi in joint venture Australian Associated Press Financial News Wire September 3, 2004

Sep 2004 Joint Venture with Pharmatel

Pharmatel, which had revenues of more than $30 million in 2003, supplies hospital-administered infusion products for oncology patients and gastrointestinal products to specialists and hospitals throughout Australia.
Pharmatel in European joint venture AAP Bulletins September 3, 2004

Sep 2004 Joint Venture with Pharmatel

Fresenius Kabi holds a 25.1 % and Pharmatel a 74.9 % stake in the joint venture. Fresenius Kabi will increase its stake to 50.1 % until 2006. The new company, Pharmatel Fresenius Kabi Pty Ltd., was launched September 1, 2004 and sells products of Fresenius Kabi and of Pharmatel.
Fresenius Kabi is expanding its market presence in Australia 6 Sep 2004  http://www.fresenius.de/internet/fag/com/faginpub.nsf/Content/P-Info2004_09_06

Jul 2008 Joint Venture with Pharmatel

Pharmatel Fresenius Kabi specialises in these key areas:

    * Anaesthesia
    * Blood Volume Substitution
    * Critical Illness
    * Fluid Management
    * Gastroenterology
    * Nutritional Support
    * Oncology

supplying to pharmacies, public and private hospitals and health care professionals.
 Pharmatel Fresenius Kabi Pty Ltd http://www.pfk.com.au/ accessed July 2008

 


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Baxter

Baxter has been a global supplier of infusion fluids, dialysis machines and other equipment for many years and undoubtedly has operated in Australia for a long time.  It has not operated dialysis services until very recently.


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Government Policy

Since about 2000 governments eager to offload their responsibilities and avoid the costs of capital development have encouraged the same multinationals that have defrauded the US system.  State government's have granted them licenses to operate private clinics. They have enthusiastically contracted the care of public patients to them under PPP (Public Private Partnership) arrangements. This is driven and justified by prevailing political economic ideology.


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Northern Territory

In 2001 the Northern Territory was interested in contracting out dialysis services.  It sought expressions of interest. The Cooperative Research Centre for Aboriginal and Tropical Health and Department of Health and Community Services was supportive and evaluated the companies interested in the Tennant Creek Dialysis Unit. As far as I am aware the Northern Territory privatisations did not go ahead.

Mar 2001 Northern Territory
Three multinational companies expressed an interest.  These were  Gambro, Fresenius and Baxter.  BaxterÕs price was the lowest but there were doubts about its ability to deliver.  Fresenius quote was more qualified and included the training of staff.

The 5 year Baxter figure is impossible to meet even if 32 clients started from day 1. Baxter has a long history of service delivery in Peritoneal Dialysis but has only recently moved into the haemodialysis area. They are currently managing a facility in Perth under a similar offer and PPT.
-------------------------
Fresenius:- The company has indicated that they would be reluctant to be contracted to supply renal-trained staff to a remote area.
-----------------------
Fresenius has made a rapid expansion in Australia in the last 5 yrs. They have contracts in all states and their machines are extremely user friendly. It is estimated that salaries based on a 2:8 ratio will cost an extra $70 per treatment.
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They (Gambro) have a long history of providing haemodialysis services in Australia and were the first to enter into a PPT arrangement. They have recently provided the machinery for the Pt Hedland Dialysis Unit. The price is not as attractive as Baxter and the tender would need to be very specific to ensure the most is made from the contract.
--------------------------
The attraction of a PPT contract is the ability to reduce additional outlays to support the service such as  overheads. In addition the support provided to the clients and staff in terms of education, conference attendance and development of materials including translations is attractive as it eliminates the need for additional proposals for funding..
Prevention and Treatment Options for Renal Disease in the Northern
Territory The Cooperative Research Centre for Aboriginal and Tropical Health and Department of Health and Community Services March 2001

 


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The ACT

In 2006 the ACT entered into an arrangement with Fresenius to provide dialysis for public patients.

Feb 2006 Australian Capital Territory
The ACT Government's decision to open a Northside Dialysis Clinic at Calvary Hospital had made a huge difference, she said. Health Minister Simon Corbell said the new service would ease the travel burden on northside residents who currently made their way to Canberra Hospital for treatment.
Fresenius Medical Care would run the clinic for 27 patients initially, increasing to 37 by 2009-10. ''The Northside Dialysis Clinic is a new model of care delivery, with the private sector working together with the public sector to further strengthen services for the Canberra community,'' he said. ''This model has been developed through consultation between government, consumers, clinicians and private contractors,'' Mr Corbell said.
New clinic proves a tonic for patients Canberra Times  February 25, 2006


 


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West Australia

The Public private partnerships model has been most actively pursued in Western Australia.  Labour politicians have pursued it aggressively. They have moved the dialysis services provided in public hospitals into the community by contracting these to the private sector.  Gambro and Fresenius were the main beneficiaries.

In 2006 West Australia contracted Fresenius to provide home dialysis services. At the same time Fresenius replaced Baxter as the provider of dialysis products.  Baxter's tender to provide dialysis services was more costly.

May 2006 West Australian Parliament
Parliament of WA : Extracted from Answers to Questions on Notice 2/5/2006

(Q1) Is it correct that Fresenius Medical Care Australia Pty Ltd have been awarded the contract to supply dialysis products in Western
(A1) No. Fresenius Medical Care has been chosen as the preferred proponent to establish a Home Dialysis Program in partnership with the Department of Health and Area Health Services. Contract negotiations are ongoing. Australia?
----------------------
 (Q5) Is it correct that some years ago Fresenius Medical Care Australia Pty Ltd was contracted by the Health Department to supply peritoneal dialysis products and some patients developed infections and peritonitis?
 (A5) Peritonitis is a common complication of all peritoneal dialysis, irrespective of the type of peritoneal dialysis products used.
-------------------------
(Q4) Please detail advantages of using Fresenius Medical Care Australia Pty Ltd products over Baxter products?
 (A4) Fresenius is the world's largest dialysis company, while dialysis products are only one part of the products produced by Baxter. Fresenius actively participates in dialysis-related research and is currently supporting an Australian investigator driven research project involving peritoneal dialysis products.

With respect to haemodialysis products, Fresenius is the world leader in home haemodialysis equipment. Fresenius equipment is used in some of the largest home haemodialysis programs in the world, including in Canada and the UK. Fresenius currently provides the preferred home haemodialysis machine in WA and also provides many of the haemodialysis machines in in-centres and satellite dialysis units in this State and around Australia and the world.
---------------------
(Q7) What support system will be in place for peritoneal dialysis patients with the changeover to Fresenius Medical Care Australia Pty Ltd?
 (A7) It is proposed that Fresenius provide ongoing training and support for all peritoneal dialysis patients in this State. This includes the provision of all dialysis fluids and other consumables. Allied health and social/psychological support will also be provided. These services will also be supported by peritoneal dialysis staff and specialist clinical staff in the teaching hospitals.
------------------------
 (11) Will you confirm that Fresenius Medical Care Australia Pty Ltd can provide the optimum level of service and products to patients, and if not, why not?
 (11) Fresenius have a proven track record throughout the world in the provision of renal dialysis products and services. A Clinical Review Committee will be established by mid August 2006 to provide ongoing monitoring of the services and products supplied to patients.
This process will occur through the establishment of Key Performance Indicators that will be reviewed on a quarterly basis. There are also international standards that will be used to monitor services, including the CARI (Caring for Australians with Renal Impairment), ISPD (International Society of Peritoneal Dialysis), KDOQI (Kidney Dialysis Outcomes Quality Initiative) (USA) and the European Best Practice guidelines.
Parliamentary Question Parliament: 37 Question Type: Question On Notice Question Date: 28/03/2006 Answer Date: 02/05/2006
http://www.parliament.wa.gov.au/pq/qsearch.nsf/179ca7006fb68a1848256db4002455cd/48256a6400204f8e4825713a00187ab4?OpenDocument

 

Western Australia entered into PPP arrangements to provide dialysis clinics with Fresenius, Gambro and Baxter.

Jan 2007 PPP services at Metropolitan sites in WA
Provision of renal dialysis services at four metropolitan sites.
In all but the Melville unit, the private operator provides the accommodation, equipment and nursing staff (departmental nursing staff in Melville unit) with the Department providing medical support.  The details of the arrangements are as follows:

Delivering a Healthy WA :Delivering Health Care  through Innovation  and Reform : Public Private Partnerships (PPP) January 2007

Jul 2008 Midland by Baxter
The Midland Dialysis Centre has moved into new and bigger premises in the heart of Midland, and can treat close to 100 patients (up from 55).

The State Government opened the new centre last Thursday (July 17) and committed $21 million over five years to dialysis services in Midland.
------------------------
The Midland Dialysis Centre is a partnership between Baxter Healthcare and WA Health. The new unit is found at 11 The Avenue, Midland and is open seven days, including mornings and nights.
Centre a boon Midland Kalamunda Reporter July 22, 2008

 

The WA government went public strongly supporting the PPP model and promoting the services provided to the public.  Both the health minister and the Premier promoted Gambro in their marketing of the developments. It is interesting that the small local papers ran with the glowing government advertorials but the main newspaper the West Australian remained silent.

The new Gambro clinics were established in the south east suburbs and the northern suburbs of Perth. Others were sited at Cannington and Stirling.

Mar 2007 South Eastern Suburbs by Gambro
A new dialysis clinic in the south-eastern suburbs will mean 64 people with kidney problems can be treated closer to where they live.

Health Minister Jim McGinty said the $2.3million Gambro Cannington Renal Dialysis Unit would reduce travel time for patients and minimise the disruption to their lives caused by dialysis.

 "This modern new facility will make an enormous difference to the lives of local renal patients," Mr McGinty said.

"The unit takes people out of the hospital environment and back into the community."
---------------------------------
The Minister said the unit was a partnership between the Department of Health and private company Gambro Healthcare and would care for public and private patients.
New dialysis unit open for business  Media Statement Jim McGinty MLA Attorny General; Miniser for Health: Electoral Affairs Government of Western Australia14-Mar-2007


Mar 2007 South Eastern Suburbs by Gambro

The $2.3million Gambro Cannington Renal Dialysis Unit is a partnership between the Department of Health and private company, Gambro Healthcare. More...
New renal dialysis clinic Alan Carpenter MLA ; The Premier of Western Australia 16 March 2007

Mar 2007 Northernn Suburbs by Gambro

A new dialysis clinic in the northern suburbs will mean 120 people with kidney problems can be treated closer to where they live.

WA Health Minister Jim McGinty said the $2.2million Gambro Stirling Renal Dialysis Unit would reduce travel time for patients and minimise the disruption to their lives caused by dialysis.

"This modern new facility will make an enormous difference to the lives of local renal patients," Mr McGinty said.

"Satellite units such as this, take people out of the hospital environment and back into the community".
------------------------------
Gambro Healthcare is one of the world's leading providers of renal care services. The company operates in 15 countries and treats some 13,000 patients in more than 160 clinics.

"The Carpenter Government is using our strong economy to deliver better services for all Western Australians," Mr McGinty said.
Perth's Second New Dialysis Unit Opens http://www.searchingforhelp.com.au/pages/news/news.php?article=7110140&archive=1 About March 2007

Mar 2007 Cannington by Gambro

A NEW dialysis clinic in Cannington will mean chronic renal disease sufferer Carli Williamson can be treated closer to home.

Health Minister Jim McGinty opened the $2.3million Gambro Cannington Renal Dialysis Unit last week.
-------------------------
Before this centre opened I was travelling to Shenton Park three times a week for treatment, and each time it took about one and a half hours, she said.
--------------------------
Mr McGinty said the unit was a partnership between the Department of Health and private company Gambro Healthcare and would cater for public and private patients. The new clinic adds two new places to PerthÕs dialysis capacity and has the added benefit of reducing pressure on hospital dialysis units, he said.

A second dialysis unit, also with 20 dialysis chairs, will open in Stirling later in the year.

The Shenton Park dialysis unit will be phased out of use and will close in a year.
Life easier with unit Canning Times 20 March 2007

Mar 2007 Stirling by Gambro

State Health Minister Jim McGinty said the new $2.2m Gambro Stirling Renal Dialysis Unit would reduce travel time for 120 kidney patients and minimise the disruption to their lives caused by dialysis.
---------------------------
Most patients starting at the clinic this month will transfer from Sir Charles Gairdner Hospital, with others from Royal Perth and Shenton Park expected to use the service.

The Shenton Park dialysis unit will be phased out of use and will close within a year.
Clinic welcomed Eastern Suburbs Reporter 13 November 2007

2008 Cannington, Stirling by Gambro

THE growing number of people with kidney problems now have access to treatment closer to home thanks to two new metropolitan dialysis clinics located in Stirling and Cannington.

The conveniently located suburban clinics mean many patients no longer have to travel to hospital for dialysis.

Dr Harry Moody, who heads up Renal Medicine at Sir Charles Gairdner Hospital, said both the Gambro renal dialysis units have reduced travel time and minimised disruption to many patients caused by dialysis.
-------------------------
The new satellite unit is much closer to Mr Jarvis's home in Darch in the northern suburbs. Previously Mr Jarvis had to travel to Royal Perth Hospital for dialysis.

"Having the centre at Stirling has made it much easier for the people who take me for treatment. It has made quite a difference to my life."
Closer care for dialysis services Health News -- Advertising feature  2008

 


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Australian Concerns

When reporting international events, the Australian press was more concerned about patient safety issues than about fraud.  When Baxter's dialysis equipment was found to have caused deaths due to contamination the press took this up. US lawyers came looking for clients.  

When there were concerns about deaths from contaminated heparin (blood thinning drug) sold by Baxter this was reported. Baxter, a company with a better track record for fraud was targeted, while Gambro's equipment failures and its recurrent fraud settlements escaped mention.

Only the distant Townsville Bulletin followed the heparin issue up to show what actually happened, exonerating Baxter, and how the problem with contaminated heparin could be prevented in the future.

Oct 2001 Problems with filters causing deaths
THE US company at the centre of investigations into the deaths of dozens of kidney dialysis patients in Spain and Croatia yesterday began recalling thousands of pieces of its life-saving equipment after the deaths of two people in Texas. The US Food And Drug Administration (FDA) immediately launched an inquiry into the first unusual fatalities in America following treatment with blood-cleaning filters made by health-care company Baxter International.
----------------------
"This action is being taken due to reports of serious adverse events that have resulted in patients' deaths,'' Baxter director of quality systems Marge Brown said in a letter to doctors around the world.
Life-savers Recalled After US Deaths Sun Herald October 21, 2001

 

Medical authorities moved yesterday to quell concern among local kidney patients after a US company admitted chemicals used to test dialysis filters were probably responsible for at least 36 deaths.
Baxter Industries spokeswoman Patricia O'Hayer confirmed the filters were associated with the sudden death of dialysis patients in Spain, Croatia and the US over two months, and the company was now helping authorities investigate deaths in two more countries Colombia and Taiwan. She was unable to confirm reports that 41 dialysis patients had also died in India. Canberra Hospital's renal unit director Dr Michael Falk said that Baxter Industries' dialysis machines were used locally before Fresenius Medical Care won the tender about 12 months ago. Australian Kidney Foundation medical director Dr John Wright said he had contacted Baxter Industries yesterday and the company confirmed the contaminated filters had not been sent to Australia or New Zealand.
Canberra dialysis safe - authorities. Canberra Times November 7, 2001

Nov 2001 US lawyers come looking

LAWYERS in America are trying to determine how many Australians died or were injured after using a faulty kidney dialysis machine.
Kenneth Moll, of Chicago firm Moll & Associates, said he was investigating the deaths of two Australian dialysis patients - one from Sydney, the other from Brisbane - which might be linked.
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Baxter voluntarily recalled the machines in mid-October after reports of deaths associated with its product in kidney dialysis patients in Spain, Croatia, Italy, Germany, Taiwan, Colombia and the US.
Aussie deaths in kidney machine probe. Herald-Sun November 15, 2001

Mar 2008 Deaths from contaminated Heparin.
United States regulators say they have identified a contaminant in Baxter International's recalled blood-thinning drug heparin amid 15 more reports of deaths of patients taking the drug.
The contaminant, a large complex molecule chemically similar to heparin, was detected in samples from a Chinese and a US plant, both owned by Baxter's supplier, Wisconsin-based Scientific Protein Laboratories LLC (SPL).
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The FDA said 19 deaths have been reported in patients taking a version of heparin that appears related to the drug, though it is unknown if all of those patients were on Baxter's heparin or another company's product.
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Both FDA and Baxter officials said it was unclear whether the contaminant was added intentionally or if it occurred as part of a natural biological process.
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Most of the world's crude heparin comes from China, which has become a major supplier of raw ingredients to pharmaceutical companies. All the raw material for Baxter's product came from China as well.
Last week, the FDA said it found "objectionable conditions" at the Chinese plant that supplied the raw ingredient.
Contaminant in some Baxter heparin: US SBS World News Headline Stories March 6, 2008

Apr 2008 Issue resolved
AN international team of researchers have figured out how tainted batches of the blood thinner heparin slipped past safety screens to kill dozens of patients in the United States and Germany.
The scientists, led by Professor Ram Sasisekharan, identified the contaminant, and have shown how it triggered allergic reactions which left at least 81 dead in the US alone.
``There was an absolute imperative to solve this health crisis as quickly as possible,'' said Sasisekharan.
Based on the findings, the US Food and Drug Administration (FDA) identified the toxic substance earlier this week as a synthetic compound called oversulfated chondroitin sulfate (OSCS).
"The FDA has already moved to put screening methods in place to detect contaminated heparin,'' said Sasisekharan.
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US health authorities said Chinese companies had also supplied contaminated heparin to Australia, Canada, China, Denmark, France, Germany, Italy, Japan, the Netherlands and New Zealand.
``Traditional safety screens for heparin only test for contaminants such as protein, lipids or DNA,'' explained Sasisekharan.
But OSCS, like the drug itself, consists of long, complex chains of repeating sugar molecules, making it virtually impossible to spot.
Using new technology developed for analysing complex sugars, the researchers developed a way to screen for the toxin.
``Our findings suggest that a simple bioassay (chemical test) could help protect the global supply chain of heparin,'' Sasisekharan said.
Link to Chinese factories Answers to killer meds Townsville Bulletin April 25, 2008

 


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Performance

Both and Fresenius have had positive reports about their accreditation achievements.  Gambro seems to have had an association with the Council on Healthcare Standards  and its Lindfield facility has received a glowing report.  Fresenius pioneered and did well at a new form of accreditation.

2005 Gambro's accreditation
Gambro Healthcare /  Gambro pty ltd, Lindfield, NSW and Toowoomba, QLD  2005
National Report on Health Services Accreditation Performance 2003-2006 The Australian Council on Healthcare Standards
July 2007 Fresenius accreditation
Many organisations, such as NephroCare Queensland, which is the first organisation to achieve full accreditation under the new standards (EQuIP 4), have chosen EQuIP 4 for their accreditation survey or self assessment ahead of being required to by the ACHS.
"Fresenius Medical Care's service division, NephroCare is extremely proud to have been the first organisation in Australia to achieve full accreditation under the new standards. It gives great comfort to both our patients and shareholders that the standards to which we comply are at the forefront of the safe delivery of clinical care. Our staffs are confident and assured that the policies and procedures practised in our units are approved by the latest and most stringent EQuIP 4 standards. NephroCare is in the process of changing all our units (to EQuIP 4)," commented Grant Rudman, Director, NephroCare.
Health care organisations choose new standards Media Release: ACHS July 11, 2007

 

Baxter has obtained accreditation in a different sphere.

Sep 2003 Baxter
Internationally-recognised Worldstar has given Baxter Healthcare recognition for Quality ISO 9001, Environmental Management ISO 14001 and OH&S Management AS4801. Baxter's QA Compliance Manager Robert Caunce said the recognition provides the company's customers with an independent verification that the company's management systems and quality are of international standards.
3 WORLDSTAR ACCOLADES FOR BAXTER HEALTH Hospital & Healthcare (News Bites Summary)  September 1, 2003

 


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Being a good corporate citizen

Baxter

Baxter seems to have been a much deeper corporate citizen than its competitors.  It  was recognised for its social responsibility.

Mar 2003 Baxter
IF you want to win an award from the Office of Western Sydney for the most outstanding achievement in corporate social responsibility by a large business, take heed of the level of competition you'll face by this brief account of how Baxter Health Systems, Australian arm of an American business, went about winning a high commendation in the classification in this year's Western Sydney Industry Awards: Baxter sponsored last year's charity dinner that raised $50,000 for the Parramatta winter appeal, and will sponsor this year's dinner which will raise even more money - says determined Baxter managing director, Mr Brian Lee. Separately, the company presented $60,000 for a stainless steel commercial-quality kitchen for local charity.
Baxter employees raised and disbursed $50,000 for local hospitals, schools, sporting groups.
The company also maintains accommodation it owns for outpatients who must spend time near hospitals for health services including blood dialysis: six two-bedroom units near Westmead hospital, six more near Sydney's Royal North Shore hospital.
It runs a fleet of five or six cars driven by volunteers to take patients with immunosuppressing medical conditions to and from hospital for scheduled treatments: travel on public transport can cause them grave problems, and the volunteers are honour-bound to stand aside when they themselves have a cold or other ailment that might harm their passengers.
Moved by the fact that a local young woman lost both legs to meningococcal disease and experienced failure of both kidneys shortly before the arrival of Baxter's own anti-meningococcal vaccine, the company supports her continuing experience of dressage sport. It will buy her a new horse later this year.
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Baxter is a past winner of the Western Sydney corporate humanitarian award, but you understand that this year's program outlined above was enough only to get it to the highly commended level.
Company's sense of duty - Western Sydney Industry Awards 2003 - A Special Advertising Report. The Australian March 25, 2003


 


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Baxter and Dr Death

It says much for Baxter that it played a very positive role in the Dr Death saga stepping in to help the public hospital nephrologist keep his patients away from this surgeon.  They shouldered the additional costs involved.

Jun 2005 Offered to train Dr Patel
The Dr Death inquiry heard yesterday that Baxter Healthcare, which supplied the catheters, offered to train Dr Patel in their correct placement at about the time patient Eric Nagle died.
`Bizarre' scheme to evade Dr Death The Australian June 22, 2005

Jun 2005 Baxter covered costs of diverting patients

JAYANT Patel, the man dubbed Dr Death, fobbed off an offer of surgical training despite a raft of botched operations leading to serious infections in renal patients.
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Renal unit nurse Robyn Pollock yesterday told the Morris inquiry that Dr Patel was inserting catheters upside down and his patients had a 100 per cent infection rate.
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Ms Pollock said a representative from Baxter, a medical company that provides catheters and dialysis fluids, had visited the unit after she told him of her concerns at a conference.
He met with Dr Patel and offered him training and support, she said.
"Dr Patel said words to the effect of `you can fly me to Brisbane, wine me, dine me, put me up somewhere nice and then I won't listen to a word you say'," she said.
She said shortly after that the hospital began a program to have catheters inserted by specialists in a private hospital, paid for by Baxter, because Dr Patel was no longer trusted to perform the surgery at Bundaberg.
Dr Patel refused surgery training The Gold Coast Bulletin June 22, 2005


 


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Gambro and Fresenius

Its almost as if Gambro and Fresenius have been warned and told to behave well in Australia - but then authorities supposedly did not know of their track records. 

They have been more active  in areas where their philanthropy and support will give them contact with the doctors who prescribe their products and where they will get more public relations exposure.  They have funded scholarships, sponsored conferences, given disaster assistance and supported holiday camps for children with renal failure.  These are commendable activities.

2006 Gambro pays for scholarship
EXTRACT
Graham Burnley Memorial Scholarship Fund: Gambro have dedicated this scholarship to the memory of long-standing and influential colleague Graham Burnley.
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The annual scholarship recipient/s are announced at the annual RSA conference. Further information, including timelines and application process can be found under the "Funding" link via the RSA website, www.renalsociety.org, or from Gambro directly via Lorraine Burchell, Education Manager,- - -
 Australia and New Zealand Society of Nephrology Annual Scientific 2006 Meeting. http://www.icms.com.au/rsaanzsn2006/highlights.asp

Aug 2006 Sponsors at conferences
SPONSORS
Baxter Healthcare Pty Ltd (Corporate Sponsor)
Gambro Pty Ltd (Sustaining Member)
Fresenius Medical Care Australia Pty Ltd (Corporate Sponsor)
Australia and New Zealand Society of Nephrology and Renal Society of Australasia Annual Scientific Conference
Melbourne Exhibition and Convention Centre, Melbourne, Australia
Monday 14 - Saturday 19 August 2006 http://www.icms.com.au/anzsn2006/sponsor.asp

2007 Sponsors at conferences

Platinum Sponsor - Fresenius Medical Care
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Bronze & Keynote Speaker Sponsor - Gambro
Renal Society of Australasia National Conference 2007 15Š18 August 2007, Burswood Entertainment Complex, Perth, Australia http://www.rsa2007.com/sponsor.asp

Jun 2008 Earthquake assistance by Fresenius

Fresenius Medical Care is offering its assistance to the earthquake victims in the Chinese province of Sichuan. In addition to significant humanitarian aid, the Company has donated a total of $1.1 million in both cash and material goods to help ease the suffering of those affected by the natural disaster. Fresenius Medical Care is providing medical equipment, services and reconstruction assistance to hospitals and aid organizations in the region.
Media Release: Fresenius Medical Care AAP MediaNet Press Releases June 10, 2008

Jul 2008 Sponsoring Kids Kidney Camp

Kidney Kids Camp is a five-day camp run especially for 'Kidney Kids' -  young people aged between 7 and 17 years - who are affected by kidney disease and caters for approximately 50 to 60 Kidney Kids, with equal numbers of carers.
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The event was organised by Kidney Health Australia and kindly co-hosted by Monash Medical Centre (MMC) Melbourne, Paediatric Renal Unit.
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Camp provides these very special Kidney Kids with an extremely memorable highlight in their lives and more importantly, a chance to just have some good old fashioned FUN!
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Our proud sponsors and supporters of the National Kidney Kids Camp 2007:

Kidney Health Australia http://www.kidney.org.au/NewsEvents/KidneyKidsCamps/tabid/649/Default.aspx accessed July 2008

 


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A legal dispute

In 2004 Gambro and Fresenius were involved in a legal wrangle over a patent.  The court decided in favour of Gambro and this was confirmed on appeal.  An application for special leave to appeal again was refused.

May 2004 Gambro wins patent dispute
The Swedish medical technology and healthcare group Gambro said on Thursday (13 May) that the Australian federal court had ruled in favour of the company's subsidiaries Gambro Lundia AB and Gambro Pty Ltd in a patent case relating to Gambro's BiCart dry concentrate system.
The court ruled that the patent was infringed by distribution in Australia of the German medical technology company Fresenius Medical Care AG's biBag products and Fresenius dialysis monitor systems when they were distributed in conjunction with the biBag product.
Gambro wins patent dispute in Australia
Nordic Business Report,  May 13, 2004

Oct 2005 Fresenius appeal fails
On 21 October 2005, the full federal court of Australia handed down Fresenius Medical Care Australia Pty Limited v Gambro Pty Limited [2005] FCACF 220.
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This case concerns the appeal by Fresenius against this judgement. Fresenius' appeal failed.
Full Court Rules on Claim Construction BAZPAT28 October 2005 http://www.bazpat.com.au/Fresenius%20v%20Gambro.htm
Mar 2006 Leave to appeal refused
Fresenius Medical Care Australia Pty Ltd    
Gambro Pty Ltd & Anor (S597/2005)        
Federal Court of Australia (Full Court)
Special leave refused with costs
Result of Applications for Special Leave to Appeal 10 MARCH 2006 http://www.hcourt.gov.au/registry/slresults/10-03-06%20%20Sydney.htm

 

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This page created August 2008 by Michael Wynne