On the Far North Coast there is currently no support group specifically for family members of crystal meth users, although the NCPHN's Substance Misuse Program is hoping to set one up before the end of the year. In the meantime, patients' families can access the existing alcohol and drug, family support groups.

With the latest group of students arriving in the Northern Rivers to undertake placements at local GP practices and hospitals, the program run by the University Centre for Rural Health/North Coast is proving its appeal to undergrads from metropolitan universities.

During stays ranging from 4 to 18 weeks, the 39 students will gain a good understanding of what it means to practice medicine in the community, and the importance of the relationship between patients and their family doctor.

The students are from Western Sydney University, University of Newcastle and University of Wollongong. They join the current group pf 16 ‘long-stay’ students from the University of Sydney, who spend a year in the latter phase of their studies.

The UCRH has educational campuses in Lismore, Murwillumbah and Grafton. It is committed to addressing rural health workforce shortages, and these placement programs play an important role in this.

Frozen rebates. They sound like they could be a new dessert - cold, quite tasteless but certainly not fattening. Some thought they were just a passing fad but it looks like there here to stay.

As a result many general practitioners will be disappointed by the return of the Coalition. Health financing was one of the key areas of difference between the two major parties in the recent election.

Bulk billing rates are at record highs. To the economists of the Liberal Party this means the rebates are at least adequate. The market has spoken and in these times of austere government spending it would be reckless to increase them.

Huntington's chorea is an autosomal dominant disease that affects patients in their middle to old age with a progressive dementia and writhing movements of their face and limbs. Since 1993, it has been possible to estimate the risk in children of affected patients. However, there is no cure and many individuals at risk have preferred not to know their status and carry on their lives in ignorance, if not bliss. Suicide rates in patients diagnosed as being positive can be up to 9%. Patients testing negative may experience “survival guilt”.

Testing for antenatal chromosomal abnormalities have also become increasingly available in recent years. Once again there are no trivial therapeutic options with termination of pregnancy an unacceptable choice for many people.

In the early 1980s there was no therapy for HIV and performing diagostic tests posed similar ethical challenges for doctor and patient alike.

In medicine we are taught that if the result will not change the therapy, the test should not be performed. However, as we see in end of life care, a better understanding of the disease process and a more accurate prognosis may allow patients to cope with their disease.

RDAA President, Dr Ewen McPhee

Responding to a report in the Australian (9 Aug) that the Federal Health Department seeks the removal of 41 health roles, including GPs, from the skilled occupations list for visas, the Rural Doctors Association of Australia (RDAA) says such calls should be part of Australia's future medical workforce considerations.

It also wants an ‘urgently required’ National Rural Generalist Framework to get more Australian-trained doctors to the rural and remote communities that need them.